Social Distancing: 2 Metre Rule

Edward Argar Excerpts

Monday 15th June 2020 Commons Chamber

[Greg Clark (Tunbridge Wells) (Con)]

(Urgent Question): To ask the Prime Minister if he will make a statement on publishing the review of the 2 metre social distancing rule.

[The Minister for Health (Edward Argar)]

I thank my right hon. Friend for his important urgent question. As part of our work to slow the spread of coronavirus, the Government have put in place social distancing guidance. The guidance specifies that everyone must keep 2 metres away from people outside their household or the support bubbles that have been in place since Saturday. I am grateful for the commitment and the perseverance of the British people in following these guidelines over the past few months; I know it has entailed huge sacrifice.

We keep all of our public health guidance under constant review to ensure it reflects the latest advice from the Scientific Advisory Group for Emergencies and the latest evidence that we have on the transmission of the virus. The Prime Minister has commissioned a comprehensive review of the 2 metre guidance. It will take advice from a range of experts, including the chief medical officer and the chief scientific adviser, as well as behavioural scientists and economists. It will also receive papers from SAGE, which is conducting a rolling review of the 2 metre guidance already. The review will examine how the current guidance is working, and will look at evidence around transmission in different environments, incidence rates and international comparisons.

Unless and until there is any change to the guidance, everyone must continue to keep 2 metres apart wherever possible, and must continue to follow our “stay alert” guidance, by washing their hands, for example, and self- isolating and getting tested if they have symptoms. I am aware there is a great deal of interest, understandably, in this matter from both sides of the House. However, I am sure that the House would agree that it would be premature to speculate about that review’s conclusions at this stage. We will, of course, keep the House updated on this work, and we will share any developments at the earliest possible opportunity.

[Greg Clark]

I am grateful to the Minister, for whom I have a very high regard, for his announcement of the review, but it was nearly three weeks ago when the Prime Minister told me at the Liaison Committee that he would commission just such a review and publish it in good time for the reopening of shops and other businesses today.

Let me be clear: I do not believe that we should act contrary to a rigorous scientific assessment; quite the reverse. What I asked the Prime Minister for was a scientific review. Among the questions it should consider are these. First, like the virus, science does not recognise national boundaries, so what is peculiar about the UK that has meant that we have had to have a 2 metre rule, when almost all other countries around the world, advised by reputable scientists, have had a smaller distance?

Secondly, what lessons have been learned from countries such as Germany, France, Singapore and Australia on their experience of shorter distance rules after a quarter of a year of operating them? Thirdly, many of those countries have a shorter distance rule, but require face coverings to be worn. Why is it right for them, but wrong for us?

Fourthly, there is a much lower rate of covid transmission outside compared with indoors. Why do we have the same rule regardless of setting? Will the review consider the total impact on lives and public health of the 2 metre rule, including the consequences of people being unable to work? Finally, and vitally, will it conclude in good time before 4 July, so that if more businesses are able to reopen then, including hospitality businesses, they can plan for what social distancing to enforce?

Millions of people—workers in pubs, cafés and restaurants and those in manufacturing industry, as well as children going to schools and young adults in colleges and universities—depend on this decision. We are fortunate in this country in having some of the very best scientists in the world, but so far our outcomes have not always been the very best in the world. Therefore, Ministers, officials and scientists should have the confidence, as good science itself does, rigorously to challenge current thinking and to apply lessons from the experience of others.

[Edward Argar]

I am grateful to my right hon. Friend. I can reassure him that his kind words about me are reciprocated; I of course have huge respect for him, not only for what he did in his previous roles in Government but for the work he is doing now as Chair of the Science and Technology Committee.

My right hon. Friend is absolutely right to highlight the importance of striking the right balance—and it is a balance—between protecting public health outcomes and public health, and understanding the impact that the restrictions are having every day on businesses. I am entirely seized of the difficulties of striking that balance.

My right hon. Friend asks whether the review will take into account the wider impact on society through the impact on business. I can reassure him that, given that economists are a key group in putting together this review, that is exactly one of the things that we will look at—scientific and medical evidence, but economic evidence too.

The work is already under way. My right hon. Friend highlighted the importance of timescales. Work has been ongoing for some time within SAGE, constantly to review and consider the impact and appropriateness of the 2 metre rule, but I hear exactly what he says about how important it is that businesses that are getting ready to reopen get guidance as early as possible to enable them to prepare.

My right hon. Friend the Prime Minister is clear that the review must report within a matter of weeks. I will of course reflect to him the feeling, which I suspect my right hon. Friend the Member for Tunbridge Wells (Greg Clark) will not be the only Member to convey, that it is important that this is done as quickly, efficiently and rigorously as possible to give businesses as much certainty as we can.

My right hon. Friend touched on the differences between the distances in different countries. The UK, Canada, Estonia and Spain, for example, have a 2 metre rule in place; the USA has 1.8 metres; Belgium, Australia, Germany and Italy have 1.5 metres; South Korea has 1.4 metres, and France and other countries have a 1 metre rule. The reality is that there is not a fixed science and there continues to be a scientific debate about what is the most effective distance.

One of the reasons that we have a 2 metre distance in place at present is that the scientific evidence from SAGE is that a reduction from 2 metres to 1 metre would carry somewhere between a twofold and a tenfold increased risk of transmission. That is why we have the present guidance, but we are very clear that the review will give us the basis to make considered decisions on the most appropriate way forward in striking the balance between public health and economic impact.

As ever, advisers advise—we have some of the best scientific advisers in the world, but we will of course look at the scientific advice from around the world—but ultimately Ministers decide, and Ministers will decide on the basis of the review and the evidence.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I congratulate the Chair of the Science and Technology Committee, the right hon. Member for Tunbridge Wells (Greg Clark), on securing the urgent question. We all want society to reopen, but we need to know the basis on which any changes will be made and by when they will be made.

I say that because, as we heard, a review was promised by the Prime Minister on 27 May, and he said at the time that we would get the results before 15 June and the reopening of non-essential retail. It is now 15 June and that review is nowhere to be seen, so what confidence can we have that this latest review will be published on time? The hospitality sector could reopen in England on 4 July, the date this review is due, but as we heard, even if it comes out on time, it will still be too late for businesses to put in place effective systems for reopening on that date. What about all those businesses that have already gone to great expense to reorganise on the basis of 2 metres? Will they receive financial support if the guidelines change?

As we heard, we know that if we change the rules on social distancing, we change the risk, so it is not only critical that the Government follow the science; they also need to be honest with the public about the level of risk that they consider acceptable. What evidence will be made available, particularly to those most at risk, in the event that we do see a change to this rule?

It is important that the review is not undertaken in isolation. The Government’s own scientific adviser and the World Health Organisation have said that measures should be eased only when there is a fully operational testing and tracing system in place. Will the review consider the robustness of that system, and can the Minister tell us when we will have a fully functioning system, with an app, in place?

Finally, since 11 May the Government advice has been to wear face-coverings where social distancing is not possible. That advice only became compulsory on public transport today. Can the Minister say why it took a month to make that advice compulsory? The Government were too slow on that, and have been too slow one PPE, on testing and on social care. We cannot afford to be too slow on this as well.

[Edward Argar]

I am grateful to the shadow Minister, as always, for his remarks and for, as ever, the constructive tone that he adopts on these occasions. I share his view that we do want to see the United Kingdom reopening for business, but we want to see it do so in a way that is safe for those going out and shopping—and I encourage people to go out and frequent their shops from today. I also want to ensure that when we are able to safely open hospitality again, we get it going and do so in a safe way based upon the evidence.

On timescales, as my right hon. Friend the Member for Tunbridge Wells (Greg Clark), the Chair of the Select Committee, and the shadow Minister have said, we recognise the importance of getting this information and this decision out there as swiftly as possible, because it is important to give businesses all the time we can to prepare for it. Equally, however, the shadow Minister would not expect me to set a particular deadline while the work is being done. I have said that that will be within a matter of weeks and that we recognise the urgency for business, but it is important that those conducting the review can do so properly and rigorously, so that it is useful for the decision we have to make. Once that review has reported and the Prime Minister has had the opportunity to consider it, I would, of course, expect the findings to be made public.

On the WHO’s comments, the hon. Gentleman is absolutely right to highlight that the 2 metre distance is only one part of the measures—only part of the complex package that is in place to reduce risk and to protect public health. As we have seen, different countries around the world have adopted different approaches, such as on whether to reduce the distance and have imposed different requirements on the wearing of face masks. Therefore, there is, in a sense, a menu of different options all of which can reduce risk, and the question is how to come up with the most appropriate balance between reducing risk while also opening up business. On the Committee we see economists and clinical and scientific expertise feeding into that balance-picture. As the Chancellor said at the weekend, it is not binary; we must consider this in the round, considering all relevant factors.

The hon. Gentleman mentioned test and trace. It is a hugely important part of the armoury of options to chase down this disease and allow our economy to reopen. As he will have seen last week, we made a very good start in the first week of the operation of the new test and trace system. We also saw a very, very high willingness on behalf of members of the public to self-isolate when asked to do so, and I pay tribute to everyone who has done that and thank them for doing so.

Finally, I say to the hon. Gentleman that I believe that throughout this pandemic we have been learning every day about how the disease behaves, about what is needed to tackle it and what steps are most effective, and I am confident that we have done the right thing at the right time throughout. However, like any responsible Government, of course there will be lessons to learn and it is important that we are willing to learn them.

[Sir Iain Duncan Smith (Chingford and Woodford Green) (Con)]

I congratulate my right hon. Friend the Member for Tunbridge Wells (Greg Clark) on securing this urgent question, because this is the most important and significant strategic decision the Government are going to have to make as they unlock the economy. The problem is that so much of this debate has been shaped around the idea of the economy as an economic tool, but it is not just economic. The reality is that, with our focus on covid, we are in danger of losing sight of what will happen, probably to the poorest in society, if people start to fall unemployed and suffer depression and increased illness. This will have a major effect on the ability of people to be able to manage their lives. So this is not just economic. It could be six weeks before we discover the outcome of a review, but I do not believe that a single fact is going to change in that six weeks. The reality is that the advisers are all divided; the Government must make a decision and get this one right.

[Edward Argar]

I am grateful to my right hon. Friend. I have huge respect for him and for his campaigning on this issue, particularly in the context of the extraordinary work he has done on social justice over many years. He highlights the importance of looking at the impact of covid-19, not just in the immediate context of health outcomes, but at its broader social and economic impact. He is absolutely right. He is also right to emphasise the need for urgency, and that is exactly how we will conduct this review.

On his final point, he is right: the science is mixed. There are different scientific opinions, and a balance must be struck between the best scientific advice and consideration of the impact on the economy. As a great former Prime Minister once said:

“Advisers advise, and Ministers decide.”

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

The risk of viral spread is influenced not just by the distance between people, but by the length of time they spend together. While research is measured in minutes, people could be sitting in a pub or restaurant for hours. Other factors include ventilation, the activity engaged in and whether face coverings are mandatory. The Government cannot wish away the fact that the risk of transmission increases as people get closer, and more than doubles from 2 metres to 1. Is it not safer to keep the distance at 2 metres but to work with all sectors to develop protective measures for when that is not possible? It could be a combination of personal protection, in the form of mandatory face coverings, and structural protection, such as using glass or perspex screens between tables in restaurants. We all recognise the impact on the hospitality sector, but surely a second wave would be devastating.

[Edward Argar]

Before I answer, may I put on the record on behalf of myself and my hon. Friends our very best wishes to the hon. Member for East Dunbartonshire (Amy Callaghan) for a swift and full recovery? I hope that the hon. Member for Central Ayrshire (Dr Whitford) will be able to convey our sentiments to her when they speak. The hon. Member for East Dunbartonshire is a member not just of the SNP family but of the family of this House, and we all wish her well.

The hon. Member for Central Ayrshire is well versed in these issues and is an eminent clinician in her own right. We have made it clear that the 2 metre rule taken in isolation is not the only factor. She is right to highlight the broader context: it is not just about distance, but about duration of contact, how close that contact was, and whether measures were in place to mitigate that, be it screens or other measures. She is absolutely right and, we must always remember that this is not a binary question—it is not just the 2 metre rule, or the distance rule, and nothing else. We must look at it in the round, as the Chancellor and, I believe, the First Minister of Scotland, rightly said. That is exactly what this review will be doing—looking at all those factors in the round, to come up with appropriate scientific and economic advice to the Prime Minister and Ministers so that they can make a balanced decision.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

The Minister is absolutely right that the evidence is changing daily and that we have a menu of options to deal with the transmission of covid. Increasingly, face coverings look effective. Would it not be worth relaxing some measures, such as the 2 metre rule, which make the pubs and restaurants in Thirsk and Malton and every other constituency financially unviable, and tightening up in other areas, such as requiring the compulsory wearing of face coverings in shops, and in pubs and restaurants when moving to and from a table?

[Edward Argar]

My hon. Friend makes a very good point and, as ever, a gentle but clear plug for his constituency encouraging people, when it is safe to do so, to come and enjoy those businesses and that hospitality. He is right to do so, because I—like every other Member of this House, I am sure—have spoken to restauranteurs and those in the hospitality industry and pubs, who are all very clear about the impact that this has on the operation of their business. We are incredibly sensitive to that, but it comes down to making an appropriate judgment on the scientific evidence, balancing economic impact and keeping the disease under control. He is right to allude to other measures within that package or menu of options, which will of course be taken into consideration in the review.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

A number of businesses in my constituency, just over the river in Vauxhall, were home to a thriving nightlife, with the culture of the South Bank. A number of them are small businesses in hospitality, tourism and the creative industries, with a number of people on freelance contracts and a number of people who have not been able to get any Government support over the last few months. They have all played their part in adhering to the lockdown rules, but their sector will be the last to open up. Social distancing rules will make a big difference to their ability to survive the next few months. Will the Minister take into account the particular nature of this sector? What assessment has been made of the additional impact of social distancing on these businesses?

[Edward Argar]

The hon. Lady is right, and I suspect that, like other Members, she has had many constituents coming to her to explain how this could make a real difference to the financial viability or otherwise of reopening their businesses. We are incredibly sensitive to that. The Chancellor said over the weekend that it could make a difference between a third of pubs being able to open up or three quarters, depending on where the distancing level is set. I am incredibly sensitive to this, but as I said, it is not a binary choice; a number of measures will be considered in the context of this review. As I am sure her constituents and mine would wish, it is important that we strike a balance between protecting public health, going on the basis of the best scientific and clinical evidence we have, which is what the review will look at, and getting the economy up and running again as soon as we safely can.

[Jerome Mayhew (Broadland) (Con)]

If our objective is to work towards social and economic normality while maintaining our hard-won control over the virus, as the incidence of infection in the general population reduces day by day, would it not be possible to reduce the social distance from 2 metres while maintaining downward pressure on the rate of infection? Is the acceptable rate of infection—below 1—a scientific or political decision?

[Edward Argar]

My hon. Friend makes a good point. Through the package of measures we have put in place to protect public health and press down on the transmission of this disease, we are seeking to do exactly that—as the incidence and infection levels go down, to start relaxing those restrictions where we can, step by step and in a cautious way, to allow businesses to operate. It is quite right and understandable that Members have different views on the pace at which we should be going on either one of those, but it is exactly those considerations that this review is looking to investigate.

[Munira Wilson (Twickenham) (LD)]

As the Minister has already acknowledged, as well as the social distancing rules, a rigorous system to test, trace and isolate every case is critical to keeping people safe. The WHO has said that the system has to be proven “robust and effective” before further easing lockdown measures. NHS leaders and leading scientists have said that test and trace is not fit for purpose, and local authorities, which have a critical role in tracing, say that their remit is still unclear and they do not have the critical data they need. When will he ensure that all local authorities have the information they need to support test and trace fully?

[Edward Argar]

I thank the hon. Lady, her party’s spokesperson on this issue. In the first week of its operation, having been stood up pretty much from scratch, this system has performed extremely well, with 67% of those testing positive successfully contacted and responding with the information needed, and 85% of their contacts agreeing to self-isolate. There is more to do—of course there is—but that is a very positive start to this programme, led by Baroness Dido Harding, in its first week of operation. In answer to the second point, it is right that we continue, as we have done throughout, to work hand in hand with local authorities, as well as other public health authorities.

[Mr Speaker]

I call the gallant Member, Bob Stewart.

[Bob Stewart (Beckenham) (Con)]

Mr Speaker—at least I have got that right this week. Mr Speaker—not Mr Deputy Speaker. I have at last acknowledged it.

My question is very much like that from my hon. Friend the Member for Broadland (Jerome Mayhew). As the R figure approaches zero—in some places, it is getting there—why the heck do we need social distancing, face masks on public transport and social isolating? If we get near zero, surely we can get back to normal.

[Edward Argar]

I am always grateful for questions from my hon. and gallant Friend. The latest figures—as of last week—are that R is not near zero, but is between 0.7 and 0.9. That shows that the infection and transmission rate is going down, but it is still only just below 1, which is why we must keep up the pressure on this disease and keep transmission rates down. He is right, as my hon. Friend the Member for Broadland (Jerome Mayhew) alluded to, that as that figure and the transmission rate falls further, there will be more opportunities to relax, step by step and cautiously, the restrictions, but we are not there yet.

[Miss Sarah Dines (Derbyshire Dales) (Con)]

As my right hon. Friend knows, I represent Derbyshire Dales, where tourism, hospitality and pubs are essential, not only to the local economy, but to the mental health of constituents. Will he reassure me that these issues will be at the top of the list of factors considered when reviewing the 2 metre rule, not least to enable the opening up of pubs promptly but when it is safe to do so?

[Edward Argar]

My hon. Friend is right. She, too, champions her wonderful constituency of Derbyshire Dales, which I have had the privilege of visiting in the past. She is right that it is important that we can open up pubs and restaurants and other similar businesses as swiftly as we can, but it is important we do it when it is safe and when transmission rates and public health measures suggest it is appropriate.

[Alan Brown (Kilmarnock and Loudoun) (SNP)]

Scientific analysis is good, but many of the Secretary of State’s Back Benchers have long argued for a reduction of the 2 metre distance guidelines without basing that on science. Can he confirm, therefore, given that economists are on the review panel, that enough weight will still be put on the evidence from the scientists and that, if there is to be a relaxation, public health measures will go alongside it? On the economy, will he also look at the additional cost to business and consider the additional business support required to accommodate these measures?

[Edward Argar]

Quite rightly, right hon. and hon. Friends on the Conservative Benches, in their comments about relaxing the social distancing rules, were reflecting the fact that the science is mixed; there is no scientific consensus across the world. There are different distances around the world in different countries. That is why we have this review under way. I can reassure the hon. Gentleman that it will consider not only the clinical and scientific evidence, but the economic impact and evidence. It will look at that in the round, which is, as the Chancellor said, exactly the right thing to do. All that will be carefully considered, and decisions will then be made by Ministers on the basis of that review and the scientific evidence available.

[John Redwood (Wokingham) (Con)]

Given that the scientific advice is mixed and muddled and that the economic and business advice is overwhelming and clear, why do Ministers not today announce the halving of the distance and ask businesses to put in other measures, including protective clothing and screens where appropriate? If we want our hospitality industry to survive in any form, it needs to know today so that it can prepare its routes and tables and screens, and all the rest of it. Leaving it until 4 July will mean many more lost jobs.

[Edward Argar]

The reason is that the current scientific advice is that the 2 metre rule significantly reduces the risk of transmission and we have not yet beaten this disease. That is why the Prime Minister has put in place this review—to consider not only the scientific and clinical evidence, but—exactly as my right hon. Friend would expect—the economic evidence and impact. It is right that it be done on the basis of a review and of evidence, but I hear his very clear plea that the sooner the better for the sake of businesses. I accept that.

[Kate Osamor (Edmonton) (Lab/Co-op) [V]]

During the lockdown, small businesses in my constituency have planned considerable changes to their business models in preparation for reopening in a way that is safe for employees and customers. That not only takes time but is an extra financial burden for small businesses, in particular. Will the Minister please confirm what extra financial support is readily being made available for understandably worried small and medium-sized enterprises to help cover the extra financial costs associated with reopening?

[Edward Argar]

The hon. Lady is absolutely right to talk about the amazing work that many of our businesses, large and small, have done to get themselves ready to reopen. I would encourage people, following the rules, the guidelines and the social distancing guidance, to get out there and support their local shops now that they have been able to reopen. As she will know, in recent weeks the Chancellor has put in place a significant package of support for businesses and individuals, and that is still there. It will obviously, as he has set out, taper in the coming months as the economy is able to reopen more fully. We have supported businesses throughout and we will continue to do so.

[Imran Ahmad Khan (Wakefield) (Con)]

I fully support recent statements by the Prime Minister that as the number of new cases falls it is right to re-evaluate our social distancing measures. In May, the Government of South Korea reduced their social distancing requirements to simply two arm’s lengths. It is crucial that we ensure that our businesses have the best chance to recover and rejuvenate, and are provided with the measures that will best permit them to do so. The Secretary of State for Business, Energy and Industrial Strategy recently stated that if we do not reduce social distancing measurements, 3.5 million jobs will remain at risk. Does my hon. Friend agree that if it is safe to reduce social distancing measures, then that is the most reasonable and responsible thing to do?

[Edward Argar]

My hon. Friend is absolutely right that if and when it is safe to reduce social distancing measures, that is what we should do, but it is for the review to report and advise us, and the Prime Minister, on exactly that.

[Scott Mann (North Cornwall) (Con)]

The Minister will be aware that many of my constituents’ businesses are based around tourism, and that many of those may not reopen again in the winter should they find that distances are not reduced. First, may I ask him to join our Cornish campaign—Think Local, Shop Local? Secondly, will he employ all possible counter-measures to ensure that our tourism and hospitality sectors can be protected throughout covid-19?

[Edward Argar]

My hon. Friend is absolutely right to highlight this. I am very happy to join him in supporting Think Local, Shop Local in Cornwall. I do not know if I qualify for these brief few seconds as an honorary Cornishman, but if I do, that would be a privilege. He and my hon. Friend the Member for St Austell and Newquay (Steve Double) have highlighted to me how important this sector is to their constituencies and their local economy, so it is right that we work to reopen businesses as soon as we safely can.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his answers so far. My colleague Diane Dodds, the Northern Ireland Assembly Economy Minister, is attempting to address this issue and to strike the delicate balance between precautions and economic survival. She has been taking scientific advice on it from leading scientists. Will the Minister commit to sharing his Department’s scientific evidence with the devolved Assemblies to enable us all to have the most up-to-date information so as to make informed decisions and begin to move forward?

[Edward Argar]

We have a very close working relationship with the Government in Northern Ireland. We will continue to maintain that and to share information as appropriate, as we have done throughout this pandemic. I pay tribute to the work of the Government in Northern Ireland in tackling it.

[Mr Tobias Ellwood (Bournemouth East) (Con)]

The Lancet reports that there is a 2.6% chance of catching covid-19 at 1 metre and a 1.3% chance of catching it at 2 metres. The World Health Organisation recommends 1 metre. It is now time for the Government to decide. The Minister knows that this will be game-changing for reopening our schools and reopening our economy, but also for impeding the spread of this pandemic. He speaks about making the right decision at the right time. One metre is the right decision; now is the right time, not in two weeks.

[Edward Argar]

I am grateful to my hon. and gallant Friend for that question. The WHO says that the distance should be at least 1 metre, so it is not prescriptive in that respect. We should make sure that we note that. He makes a very powerful case for getting our economy, and particularly our small businesses and hospitality businesses, moving again. We are making good progress in tackling this disease, and we do not want to put that at risk. The review will give us the scientific evidence to make an important decision on the way forward.

[Carol Monaghan (Glasgow North West) (SNP) [V]]

Anybody who has seen the crowds waiting for shops to open today, the people at recent demonstrations, and, indeed, MPs queuing at Parliament will know that it is human nature to push the limits. A distance of 2 metres gives a margin for error. If it is reduced to 1 metre, surely people will push that limit as well and stand even closer. I ask the Government to keep the rule in place for as long as it is required, knowing what human nature will do.

[Edward Argar]

I am grateful to the hon. Lady, but the 2 metre social distancing rule has both a health and an economic impact. Therefore, we must look at this in the round, on the basis of both sets of evidence, which is exactly what this review will do.

[Jack Brereton (Stoke-on-Trent South) (Con)]

It is fantastic that more shops are now reopening in Stoke-on-Trent, and I hope that everyone supports our local retailers and market traders, but does my hon. Friend agree that it is vital to maintain social distancing and that we should reduce it from 2 metres only when the risks have been assessed and it is safe to do so?

[Edward Argar]

My hon. Friend is absolutely right, and that is exactly what the review will look at.

[Gordon Henderson (Sittingbourne and Sheppey) (Con)]

Caravans and chalets on holiday parks have to be at least 6 metres apart, so residents could easily observe current social distancing guidelines. When the Prime Minister undertakes his review, will my hon. Friend ask him to consider allowing holiday parks to open immediately? In doing so, he would help rescue the economy of coastal towns, which are already among the most deprived communities in the country.

[Edward Argar]

If I recall correctly, my hon. Friend has raised this issue previously. He is right to have done so and I am very happy to give him the assurances he seeks. I will pass his comments on to the Prime Minister.

[Kevin Brennan (Cardiff West) (Lab)]

Even if the Government were to reduce the limit as a result of this review, it would make very little difference to theatres and grassroots music venues. Neither a 1 nor 2 metre limit will make much difference to their capacity, because, just like us, they would still have to keep rows closed. Even with a 1 metre limit, half of the venue would be closed. Will the Minister ensure that the review takes that into account? Will he also pass on that information to the Chancellor and the Secretary of State for Digital, Culture, Media and Sport, to ensure that support remains in place for those sectors, even if the limit is reduced to 1 metre?

[Edward Argar]

The hon. Gentleman is quite right. A lot of the debate has focused on hospitality, pubs and restaurants, but he is absolutely right to talk about the impact on music venues, cultural venues and theatres, all of which play a huge part in our national life. I will, of course, highlight that issue for those conducting the review and the Prime Minister and the Secretary of State for Digital, Culture, Media and Sport.

[Mrs Heather Wheeler (South Derbyshire) (Con) [V]]

Can my hon. Friend confirm that the comprehensive review launched by the Prime Minister on the 2 metre rule will report back to Government as swiftly as possible? That will be very important to pubs and restaurants in South Derbyshire, which are chomping at the bit to reopen and welcome customers back.

[Edward Argar]

My hon. Friend emphasises what a number of right hon. and hon. Members have quite rightly said, not least my right hon. Friend the Member for Chingford and Woodford Green (Sir Iain Duncan Smith), about the need for the review to report with speed and urgency. I know that that message will have been heard very loud and clear.

[Richard Burgon (Leeds East) (Lab) [V]]

Throughout the coronavirus crisis the Government have failed the public. They failed to lock down quickly enough, failed on personal protective equipment, and failed on test, track and trace. Tens of thousands of people have needlessly lost their lives as a result of those failures. The Government’s chief scientific adviser has previously warned that

“the risk at 1 metre is about 10 to 30 times higher than the risk at 2 metres.”

Is not this push from Tory Cabinet members and Back Benchers to scrap the 2 metre rule a clear example of putting profit before public safety?

[Edward Argar]

Well, it is nice to see the hon. Gentleman, who shadowed the team I was in when I was a Justice Minister, but I have to say that it is unsurprising that his tone remains the same. We are doing the right thing at the right time. We are, of course, always seeking to learn lessons, and we are willing to take advice and listen to the scientific and economic advice and evidence. That is what we are doing with this review. Surely he would welcome our taking the appropriate advice and then considering our decisions on that basis.

[Bob Blackman (Harrow East) (Con) [V]]

The current scientific advice says that the risks of transmission are far less in the open air than in enclosed spaces. Clearly, the position now should be that the Government need to look at reducing the social distancing rules when people are in the open air, while potentially keeping the advice strong when people are in enclosed spaces. That is clearly important for the hospitality industry, where beer gardens and restaurants with external areas where people can sit outside could restart. Clearly at the moment, with a 2 metre rule in place, they will be unable to. Will my hon. Friend look at the scientific evidence to see if we could actually have two sorts of guidance, one for when people are in enclosed spaces and one for when people are in the open air?

[Edward Argar]

My hon. Friend is absolutely right to highlight that this is not simply a binary choice, as there are many other factors that play a part, as other Members have alluded to—be it the length of time that one is in close contact with someone, the distance, and also whether it is inside or outside. Those are exactly the sort of considerations that those conducting the review under Simon Case will be considering.

[Wendy Chamberlain (North East Fife) (LD)]

As we have found over the past few weeks, consistency of messaging is important, and 2 metres is currently consistent across the UK. All Governments in the UK have been questioned on this issue, so I ask the Minister to ensure that this and any future review involves consultation with the devolved Administrations. Can he confirm the mechanism that will be used for this, given that the Scottish Cabinet Secretary for Health and Sport expressed concern at last week’s Scottish Affairs Committee that the ministerial implementation groups have not met for at least two weeks?

[Edward Argar]

Throughout this pandemic, we have had a very close working relationship between Edinburgh, Cardiff, London and Belfast, sharing information and having regular discussions between Ministers— indeed, as I understand it, not just territorial Office Ministers but across Health and other Departments. That will continue.

[Dean Russell (Watford) (Con)]

Across my constituency of Watford, lots of people are today going to the intu centre and many of the shops and using the high street. I am hearing from many businesses that we need to allow them a certain level of flexibility as we come out of this review. Some shops where customers can wear face coverings should be allowed to have 1 metre distancing, and other areas should perhaps remain at 2 metres, but we should do it in a way that helps customers and helps shops and businesses get back to business.

[Edward Argar]

My hon. Friend is right to highlight the different pieces of the jigsaw that we have in use at the moment, be it distance, face covering or a whole range of other measures. I can reassure him that all those will be considered in the context of the review.

[Richard Thomson (Gordon) (SNP) [V]]

Given that the evidence shows that the risks from transmission increase between two to tenfold with reductions from 2 metres to 1 metre, would the Minister agree that comparisons internationally over distance can be misleading while infection rates in the UK remain higher? Can he assure the House that in considering the risks involved in any such reduction, commercial and political interests will not be placed ahead of the need to keep the public safe?

[Edward Argar]

While I note the hon. Gentleman’s point about international comparisons, actually I believe that learning lessons from other countries is something that can be valuable and is something that will be taken into consideration in this review. We should always be willing to look externally to see if there is anything we can learn. As I have made clear to him and to other Members previously, it is important that we consider the scientific evidence and ensure that whatever we do keeps pressing down on the virus and protects public health, but at the same time we must not lose sight of the fact that it is important we get our economy up and running again as swiftly and safely as we can.

[Gary Sambrook (Birmingham, Northfield) (Con)]

Businesses throughout Longbridge, Northfield, Weoley Castle and Kings Norton have done everything they can to follow the guidance, but they are desperate for the 2 metre rule to be reduced so that they can survive, and in many cases so that they can reopen. Will the Minister commit to publishing detailed guidance when the review is finished, so that organisations such as Northfield Business Improvement District can help to keep customers and staff safe and businesses can thrive?

[Edward Argar]

My hon. Friend is a great champion of businesses not only in his constituency but across his great city. I hear exactly what he says, and we have been clear that once the review has reported and the Prime Minister has had the opportunity to consider it, we expect the conclusions to be made public.

[Pete Wishart (Perth and North Perthshire) (SNP) [V]]

I thank the hon. Gentleman for his very kind remarks about my hon. Friend the Member for East Dunbartonshire (Amy Callaghan). We are all really rooting for her today.

It seems that one of the most obvious outcomes in politics is that the review will conclude that 2 meters will become 1 metre and the Government’s cavalier approach to easing the lockdown will continue. Thank goodness that we in Scotland have a “caution first” Scottish Government. Having listened to some Government Back Benchers today, one would almost believe that the health crisis is over and the issue is simply the reopening of the economy. Is the Minister prepared to stand up to them and tell them directly that there will be no reopening until the risks are overcome?

[Edward Argar]

I would not prejudge what the review will say—it would be wrong to do so—but I do not believe that the hon. Gentleman’s characterisation of the measured and sensible contributions from right hon. and hon. Members on the Government Benches is correct. We have been clear that it is important that we do what is right from a public health perspective and that we strike the appropriate balance between beating the disease and keeping people safe and, where we can do so safely, allowing businesses to start to work again.

[Scott Benton (Blackpool South) (Con)]

The Chancellor’s world-leading packages of support have provided a lifeline to millions of people and businesses during these difficult times, but that can go only so far. Blackpool South now has the highest unemployment rate in the entire nation, and our local economy’s dependence on the tourism and leisure sectors has left us particularly vulnerable. Local businesses now need a successful summer season if they are to have any chance of survival at all, so will my hon. Friend commit to supporting those sectors and opening up the economy by relaxing the 2 metre rule when it is safe to do so?

[Edward Argar]

My hon. Friend is a doughty champion for his constituents in Blackpool, and my right hon. and hon. Friends the Ministers in the Treasury and Department for Business, Energy and Industrial Strategy will have heard what he said. He was absolutely right in his final sentence: we are keen to get his local economy and the economy around the country going as soon as we can, but when it is safe to do so.

[Ruth Cadbury (Brentford and Isleworth) (Lab)]

The pub and beer trade in my constituency employs almost 2,000 people. Companies such as Fuller, Smith & Turner, which is based there, say that the difference between 2 metres and 1 metre is the difference between only 50% of pubs opening and most pubs being able to open. When the Minister does his review, will he take into account what is now happening at some pubs, which is that they are doing takeaways, causing long queues, and as the warm afternoons go on social distancing is forgotten and people are urinating everywhere—on footpaths and in public places? That is also a health hazard, but it would be mitigated if more pubs were able to open, so I hope he will consider that.

[Edward Argar]

The hon. Lady makes a sensible point, as she always does. The review is being conducted under the auspices of the No. 10 permanent secretary, but with scientists, economists and others feeding into it. I am sure they will have heard what she said, but I will nevertheless ensure that it is passed on.

[Mr William Wragg (Hazel Grove) (Con)]

I am sorry to be a bit of a killjoy, but while we lose ourselves in thoughts of pubs and restaurants reopening, could we perhaps attend to the minor matter of our national education system and the ability to have children return to school? The current 2 metre rule makes that impossible. On Friday I visited my old primary school, Norbury Hall in Hazel Grove, to see some of the measures being taken there. It will be absolutely impossible to return all children to school by September unless the rule is sorted out.

[Edward Argar]

If I recall correctly, my hon. Friend was a distinguished teacher before his service in the House and served on the Education Committee before he ascended to his current chairmanship of the Public Administration and Constitutional Affairs Committee. He is absolutely right to highlight the fact that there are impacts on schools as well as on businesses; that is one of the things that will of course be taken into consideration.

[Kate Osborne (Jarrow) (Lab)]

As the Government ease the lockdown, we still do not have a sufficient test and trace system set up, the R level is increasing above 1 in some regions, and we still have more than 1,000 new confirmed cases every day. Should the Government be changing crucial social distancing measures, knowing that information? What immediate action is being taken in areas where the R rate has gone above 1 to help get it down? Would lowering this distance be putting profit before people and the economy before health?

[Edward Argar]

I would caution the hon. Lady, on the basis of the SAGE advice, that in no region is the R rate above 1. Out of 10 models done recently one suggested that in two regions it might have gone up, but we consider this in the round, not by cherry-picking one study and ignoring the other nine; so it is not above 1. On her points about test and trace, we have set up the system from scratch and I believe we have done extremely well in the progress we saw reported in the statistics on the first week of the operation of that scheme. On her final point, we have made it clear throughout that this is about following the scientific advice and opening up the economy when it is safe to do so.

[Michael Fabricant (Lichfield) (Con) [V]]

May I say how surprised and delighted I am to hear so many colleagues, on both sides of the House, who seem to have as their hobby being epidemiologists, and it is great to hear what they have to say? I say to the Minister that I am very reassured by the tone he is taking in the answers to these questions. He will be aware that in the United States, Sweden, Belgium, Germany and now China there has been a resurgence of covid-19 and that if we were to take any moves too soon nobody would thank us, including businesses, if we had to go back into lockdown.

[Edward Argar]

My hon. Friend is right to say that this is about conducting this review so that we have the best scientific and economic evidence, and so that we can make the right decision at the right time, when it is safe to do so.

[Ben Lake (Ceredigion) (PC)]

Whether the 2 metre rule is maintained or shortened, as the hon. Member for Cardiff West (Kevin Brennan) mentioned, many businesses will find it will still not be viable to reopen. Given that, will the Government consider extending financial support to businesses that have to remain closed because social distancing measures would make reopening not financially viable?

[Edward Argar]

As the hon. Gentleman will have heard the Chancellor say on many occasions, we continue to keep all measures to support individuals and businesses under constant review, and I know that the Chancellor will have heard the point he makes.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I concur with what has been said by many right hon. and hon. Members who have warned about the implications for the hospitality industry, in particular, unless we change these rules sooner rather than later and about the impact on coastal towns. I come back to what was said by my hon. Friend the Member for Hazel Grove (Mr Wragg), because has there not been greater flexibility on social distancing for pupils in schools but not for the many adults? That is part of the problem as to why so few children are able to come back. Can we look at this urgently? Otherwise in September we will still have many, many children deprived of an education.

[Edward Argar]

My hon. Friend, a distinguished former children’s Minister, makes a very good point and that is exactly the sort of thing I will pass on to ensure that the review team considers it in the work it does.

[Jeff Smith (Manchester, Withington) (Lab)]

The Minister rightly says that this review has to balance economic and health factors, but the weight of importance of the health factors will obviously be more for those who are vulnerable or shielding. Will the Government be publishing particular advice for people in those vulnerable categories? Will he publish some of the health advice so that they can have confidence in the Government’s overall decision?

[Edward Argar]

The hon. Gentleman is right to highlight that this disease appears at the moment to hit different groups of people with different characteristics differentially, with some being hit much harder than others. One reason why we are undertaking this review is to make sure we look at all that evidence in the round. I do not want to pre-judge it, but, as he will know, we have always published a range of guidance and advice at each stage, often tailored to different groups, and we will continue to do that, where it is appropriate.

[Peter Grant (Glenrothes) (SNP) [V]]

The Minister will be aware that what looks like a very marginal change in the R number, which demonstrates the infectiousness of the disease, can have serious consequences for public health. With the current 1,000 or so new cases a day, if the R number were held at 0.9 over 60 days, those 1,000 people would infect 7,000 other people. If we allowed it to creep up to just 1.1, they would infect 25,000 other people, which means that three and a half times as many people would get the disease and three and a half times as many people would, sadly, die. So will the Minister commit, when the review is published, to publishing not only the Government’s assessment of how the R number will be affected by any proposed changes but also the Government’s projections of how many more people will catch the disease as a result and how many more people will die if the Government reduce the 2 metre requirement?

[Edward Argar]

The review will consider economic and, particularly, clinical and scientific evidence. As I have said before, once the review has reported and the Prime Minister has had an opportunity to consider it, I would of course expect the conclusions of that review to be made public.

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

Our economy is heading for a deep recession, and the Government were slow to lock down, slow on PPE and slow on testing, tracking and tracing. As a result, we have the second highest death rate in the world. Easing the 2 metre rule will cost more lives. Not easing it will lead to millions unemployed. Either way, the Government’s negligence means that people are going to continue to suffer. The scientific and economic impacts of relaxing the rule are already available. Why are the Government running scared of making a decision?

[Edward Argar]

Throughout, the Government have taken advice from the best scientists and clinicians we have available, and we have looked around the world as well. That is exactly what this review will do. When the review reports, advisers will have given advice and Ministers will decide on the basis of that advice.

[Caroline Ansell (Eastbourne) (Con)]

One in five jobs in Eastbourne rely on hospitality. UKHospitality estimates that at 2 metres, businesses will operate at an unsustainably crippling 30% revenue, but at 1 metre, they would operate at between 60% and 70% and approach breaking even. We must of course pursue a safe recovery, as the Minister has outlined, but with the summer season now upon us and with opportunities to trade being time-sensitive, can he assure me that this guidance is being considered with the utmost urgency?

[Edward Argar]

I am happy to give my hon. Friend the assurance she seeks. We are very much aware that time matters, and this review is being conducted as swiftly and as rigorously as it can be.

[Clive Efford (Eltham) (Lab)]

Before it is safe to reduce the 2 metre rule, do we not require a world-beating track and trace system to be in place? And does a world-beating track and trace system not require a fully functioning app?

[Edward Argar]

As I have set out, I believe we have made an extremely strong and successful start with our track and trace system. Baroness Harding, who is heading up that piece of work, has made it clear that the app is important but that it is, as she characterised it, the cherry on the cake. It is not essential to the effective system that we have already got up and running.

[Ruth Edwards (Rushcliffe) (Con)]

Some hospitality venues in Rushcliffe have told me that even if they were allowed to open, doing so with a 2 metre rule in place would make their business economically unviable. Can the Minister reassure the owners of those businesses in my constituency that the Government are listening to their concerns and that that reality will be factored into Government policy across the board?

[Edward Argar]

My hon. Friend’s constituency is very near mine, so I suspect that both our constituencies have a similar perspective on that. I am happy to give her the reassurance she seeks.

[David Linden (Glasgow East) (SNP)]

If the review is based on genuine scientifically robust debate, I will have no problem with it, but does the Minister accept that if the Government are going to move from 2 metres to 1 metre, they cannot do so on the night before 14 July and expect consumers to have the confidence to go back into bars and other places? It is fine and well to have the review, but there has to be good public messaging as well.

[Edward Argar]

The hon. Gentleman makes a typically sensible point. It is important that the review is able to be conducted with proper scientific and economic rigour to ensure that we have the evidence base we need. I am not going to prejudge what the decision will be or what the review will say, but he is also right to highlight the importance of businesses having as much time as possible to prepare for whatever decision may be made.

[James Cartlidge (South Suffolk) (Con)]

On the health arguments, should we not remember that our hospitals have lost capacity in order to operate at 2 metres, and will the Minister assure me that the review will look at how many more beds we could get into hospitals to deal with the elective surgery backlog once they are safe in terms of covid?

[Edward Argar]

My hon. Friend makes an important point about getting our NHS back up and running again not just for emergencies, but for elective procedures and other procedures, which is what we have been doing. The infection control context within a hospital is slightly different—indeed, considerably different—from that in businesses and other contexts, but he is right to highlight the impact that the necessary restrictions are having in a range of contexts on the ability to treat people or to serve people and businesses.

[Mr Speaker]

In order to allow the safe exit of hon. Members participating in this item of business and the safe arrival of those participating in the next, I am now suspending the House for three minutes.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 5th May 2020 Commons Chamber

[Richard Drax (South Dorset) (Con)]

If he will allocate urgent additional funding to community hospitals as a result of the covid-19 outbreak.

[The Minister for Health (Edward Argar) [V]]

Public safety remains the Government’s top priority, and we have been clear that the NHS will get whatever funding it needs to respond to the coronavirus pandemic. As such, as a country, we have established a £14.5 billion coronavirus emergency response fund, with £6.6 billion going directly to the NHS. I know that my hon. and gallant Friend is a strong champion of community hospitals in his county. They are vital to our response to coronavirus and currently are managing well. I am not aware of any specific requests from his county; however, if additional urgent funding is required, we will of course consider that.

[Richard Drax [V]]

I am most grateful to the Minister for his answer. May I thank him and his team for the wonderful job they are doing? The main reason I asked the question is that beds at Portland Community Hospital had to move to Weymouth because of a shortage of trained staff. Can my hon. Friend assure my constituents that we will fill the thousands of nurse vacancies, thereby allowing community hospitals such as Portland to fulfil their proper function?

[Edward Argar]

Let me start by putting on the record my thanks to our amazing NHS and social care workforce at this time. As my hon. and gallant Friend is aware, the Government are committed to growing and supporting the NHS workforce to ensure that it continues to provide world-class health and care. We have set out our pledge that we will deliver 50,000 more nurses in our NHS by 2025 through multiple workstreams, including retention and recruitment. Many of those nurses will operate in community hospitals, enabling them to continue providing that world-class care and support.

[Mr Ben Bradshaw (Exeter) (Lab)]

For what reasons the Government did not join EU procurement schemes to help tackle covid-19.

[The Minister for Health (Edward Argar) [V]]

The UK has confirmed that we will participate in the current joint EU procurement scheme on therapeutics for covid-19 that is soon to launch. Owing to an initial communication problem, the UK did not receive an invitation in time to join the previous four EU joint procurements. However, participating in those four initial joint procurement schemes would not have allowed us to do anything that we have not already been able to do for ourselves. We will consider participating in all other future schemes on a case-by-case basis and on the basis of public health requirements and needs.

[Mr Bradshaw [V]]

Whatever mistakes were made or opportunities missed in the past, on the day that the UK has overtaken Italy as the country with the worst death toll in Europe, what reassurance can the Minister give the public that decisions taken now and in the future will be driven entirely by the public interest and not distorted by anti-European dogma?

[Edward Argar]

I gently say to the right hon. Gentleman that there is no suggestion of any decision having been influenced in the way that he suggests. Indeed, the permanent under-secretary at the Foreign Office made it clear in his clarification to the Foreign Affairs Committee that this was not a political decision. I reiterate that we are open to participating in future schemes on the basis of public health requirements and on a case-by-case basis.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

Operation Cygnus in October 2016 showed that the UK would struggle in a pandemic due to a lack of both ventilators and personal protective equipment for staff. Why did the Secretary of State not act on it?

[Edward Argar]

The Government did act in looking at all previous modelling and all previous exercises. That is why the UK was well prepared. Let me take the example of ventilators, which she mentioned. The UK has massively increased the number of ventilators available to our NHS, meaning that at no point thus far in this pandemic has there been a shortage of ventilators. I reiterate, returning to the original question, that participating in those four initial joint procurement schemes with the EU would not have allowed us to do anything we have not already been able to do for ourselves.

[Sir Edward Davey (Kingston and Surbiton) (LD)]

What recent assessment he has made of the adequacy of personal protective equipment for the social care workforce.

Public Health

Edward Argar Excerpts

Monday 4th May 2020 Commons Chamber

[The Minister for Health (Edward Argar)]

I beg to move,

That the Health Protection (Coronavirus, Restrictions) (England) Regulations 2020 (S.I., 2020, No. 350), dated 26 March 2020, a copy of which was laid before this House on 26 March, be approved.

[Madam Deputy Speaker (Dame Eleanor Laing)]

With this we shall take the following motion:

That the Health Protection (Coronavirus, Restrictions) (England) (Amendment) Regulations 2020 (S.I., 2020, No. 447), dated 21 April 2020, a copy of which was laid before this House on 22 April, be approved.

The Minister is asked to speak for no more than 12 minutes.

[Edward Argar]

These sets of regulations were made by the Secretary of State on 26 March and 21 April respectively. Following the return of the House after the Easter recess, they are rightly being brought before the House today for the scrutiny and debate that they require. They are exceptional measures, brought forward to reflect exceptional challenges and times, but although it is right that these regulations—necessary to meet the public health needs of the coronavirus pandemic—are brought forward, it is also right that we ensure that this House is able to play its proper role, and that due process and the rule of law are maintained. With that in mind, I thank the shadow Minister and the Opposition parties for facilitating this debate taking place today.

The country has been, and still is, engaged in a national effort to beat coronavirus covid-19. Delivering a strategy designed to ensure that our NHS is protected, with capacity at all times exceeding the demand for intensive care beds for coronavirus patients, flattening the peak, and driving down the rate of transmission of disease and the number of infections, alongside the work to significantly expand NHS capacity, have all helped to protect our NHS and to save lives. Sadly, although this has been working, there have been many who have died from this disease—each and every one of them a tragedy, and each and every one a real person. Our thoughts are with all their friends and families at this time. I also put on record all of our continued thanks and appreciation to NHS and care workers, and to key workers around the country, for the phenomenal work that they are doing caring for people and keeping the United Kingdom going.

The regulations we debate today have played a crucial role in the success we are seeing in reducing infection transmission levels. They impose significant demands upon individuals and society as a whole, with impacts on business, the economy and daily life, and I do understand the sacrifices people are making at this time, their frustrations, and, indeed, their anxieties. But these regulations are necessary, because the single most important step we can all take to beating this disease is to stay at home in order to reduce the spread and to protect ourselves and others.

That is why, in these regulations, the Government introduce three main social distancing measures: requiring people to stay at home as far as possible, with only very limited exceptions; closing certain businesses and venues; and stopping gatherings of more than two people in public. These regulations are similar to those introduced by other countries. We have worked closely with the devolved Administrations, to whom I should also pay tribute, in developing and reviewing these measures.

The main statutory instrument, No. 350, requires enforcement of the closure of some businesses and restrictions on others from 12 pm on 26 March 2020. As set out in the notes, the regulations require the closure of drinking establishments, including bars, pubs and nightclubs, and food and drink venues with consumption on-site, excluding hospitals, schools, care homes, homeless services and prison canteens, as well as other exemptions. Regulation 4(4) requires the closure of entertainment venues including cinemas, theatres, concert halls, bingo halls, museums, galleries, spas, hairdressing and massage parlours, casinos, funfairs, libraries, community centres, and non-food outdoor markets. Regulation 5(1) requires businesses offering goods for sale or for hire, or providing library services, to cease to do so except in response to orders received online, by telephone or by mail order. Types of businesses specified in part 3 of schedule 2 are exempt from these restrictions. Regulation 5(2) excludes hot and cold food collection and delivery from the closure restrictions. Regulations 5(3) and 5(4) require hotels and similar establishments to remain open for permanent residence only to persons in a hotel because they are moving home, attending a funeral, or unable to return home.

The second set of regulations, No. 447, makes a small number of consequential amendments to improve the operational implementation of the main regulations.

These regulations are made under section 45C of the Public Health (Control of Disease) Act 1984, with Her Majesty’s Government clear that the powers under that Act are sufficient to introduce them.

Given the impact that these regulations have on individuals and businesses, notwithstanding the huge support package announced by my right hon. Friend the Chancellor of the Exchequer, I know that a number of issues relating to these regulations have been raised in recent days by members of the public and, indeed, by hon. Members, and I will touch on those now. However, I will endeavour to respond more fully to specific points raised by Members when I wind up the debate.

First, there is the question of enforcement. The Joint Committee on Human Rights and others have expressed concerns about variations in enforcement and in the approach adopted to it by different police forces. As hon. Members will be aware, guidance was issued to police forces, and this has continued to be updated and clarified. It is important that the police operate within the law, which is the law as it is set out in these regulations, and that guidance is treated as just that—clarifying guidance.

The British people have been amazing in their collective response to the restrictions, and compliance has been very high. However, a very small minority have not always complied. The police have been doing their very challenging job at this time with dedication and, by and large, pragmatism. The approach of “engage, explain, encourage, and only then enforce where it is absolutely necessary” is the right one. The small number of examples, while important, of what can seem like over-enthusiastic enforcement should not detract from the fantastic work being done by the police across the country.

The final aspect of the regulations that I draw attention to is the requirement that they be reviewed every 21 days, to ensure that they remain necessary and appropriate. The first review took place on 16 April, with the First Secretary of State confirming that they would remain in place. The next review is due on 7 May. I am aware of the desire of Members and across the country for more detail on the UK’s progress and future steps, which I understand. The review on 7 May will consider the necessity of the regulations against the public health aim, including the five considerations set out by my right hon. Friend the First Secretary of State: first, that the NHS can provide critical care across the UK; secondly, that there is a sustained and consistent fall in the daily death rate; thirdly, that infection rates decrease to an acceptable level; fourthly, that supplies of personal protective equipment and testing meet future demand; and fifthly, that evidence is clear that any changes will not risk a second peak of the virus.

The Prime Minister has set out that further announcements on this will be made soon. As he said on Thursday last week, the Government will set out a comprehensive plan this week, which will explain how we will get our economy moving while continuing to suppress the disease. It will set out how we will seek to get life back to normal for as many people as we can, as quickly, equitably and fairly as we can, while continuing to protect the NHS. And it will, of course, as throughout, continue to be guided by the best scientific and medical advice. I hope the House will understand that I do not intend to pre-empt what the Prime Minister might say later this week on the basis of that advice.

It is right that we made these regulations as and when we did to help tackle the coronavirus/covid-19 pandemic. Her Majesty’s Government consider these regulations to be proportionate and appropriate in the face of this pandemic, but it is absolutely right that this House properly scrutinises and debates them and their impact upon our country, and I look forward to hearing Members’ contributions. I commend these regulations to the House.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Before I call the spokesman for the Opposition, I should draw to the attention of Members in the Chamber and who are going to participate by electronic means that there will be a time limit of five minutes on Back-Bench contributions. I have to adhere strictly to that timetable in order to make these proceedings work in this unusual way, so please do not look for leniency. I also ask Members who are participating from home to have some way of checking whether they have spoken for five minutes. I now call Justin Madders, who I ask to speak for no more than eight minutes.

--- Later in debate ---

[Edward Argar]

Today we have had in this Chamber a very important debate on regulations that, while absolutely necessary to help beat covid-19, are having a profound effect on people’s lives and businesses. Despite that necessity, it is equally necessary that we uphold the hard-won rights we have in this country: the rule of law and the right and duty of this House to scrutinise and question the Government—something that Members have done with determination and, indeed, enthusiasm today.

In the course of the debate Members have raised a number of important points, to which I will endeavour to respond as fully as I can in the time allowed to me. First, the hon. Member for Ellesmere Port and Neston (Justin Madders) raised a number of key points. He talked about the need for clarity around an exit strategy and how it develops and the importance of taking the British people into our confidence, because in this country we govern and police by consent, and therefore it is important that it is a shared endeavour, where we take the British people with us.

As I mentioned in my opening remarks, the Prime Minister said last Thursday that the Government will set out a comprehensive plan this week, which will explain how we will get our economy moving while continuing to suppress the disease, seeking to get life back to normal for as many people as we can as quickly and, importantly—this goes to a point made by my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady)—as fairly across our society as we can, while continuing to protect the NHS.

The hon. Member for Ellesmere Port and Neston was right: that needs to involve a conversation and a dialogue. As he alluded to, that dialogue on where things may go in the future has already begun, which is a positive step forward. I am grateful for his typically reasonable and measured tone, and I want to put on record once again my gratitude to him and to the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth), my constituency neighbour. He, too, has adopted a constructive and reasonable tone throughout this, and I am grateful to them and Members across the House for the tone they have adopted.

I turn to other points that have been raised. If I miss anything, the shadow Minister is welcome to come back to me privately, and I am happy to write to him to fill in any gaps in my answers. My hon. Friend the Member for Altrincham and Sale West mentioned the importance of scrutiny, as did many Members, and that is absolutely right. It is important that we remember that these regulations are born out of necessity, but they are exceptional and should only be kept as long as the exceptional circumstances necessitate. He, too, mentioned the importance of a route map and giving the UK a route out of the current restrictions as quickly as we can when we can do so safely; he is right. Sadly, the necessity of the time means that we are not there yet, but it is important that that dialogue with the British people continues and is open, including in this House.

I am grateful to the hon. Member for Westmorland and Lonsdale and my hon. Friend the Member for North Devon (Selaine Saxby) for the tone of their remarks and their support for the necessity of what we are doing. They highlighted the impact—the hon. Gentleman in respect of the south lakes area and my hon. Friend in respect of rural north Devon—of these necessary regulations on the hospitality and tourism industries that play such a huge part in their local communities and economy. That is why it is absolutely right that my right hon. Friend the Chancellor of the Exchequer is looking carefully at the matter and has put together a package designed to do everything that he can to support industry and businesses in this country. Nevertheless, I hear what they say, and I know that my right hon. Friend the Chancellor will have heard it as well.

My hon. Friend the Member for Broxbourne (Sir Charles Walker) was the Chair of the first Select Committee that I served on after I became a Member of this House in 2015, and back then he emphasised to me that the key Committee to get on was the Procedure Committee, because by learning how this place works a person will not go too badly wrong. I do not know whether it has yet been long enough for me to have proven or disproven that, but he is right, and he is a doughty champion of the rights of this House and the importance of scrutiny and due process. He is also right to emphasise that just as we must ensure that we protect the NHS and protect people’s health, we must also recognise the need to support and protect our economy, because it is indeed a vibrant economy that pays for the NHS that we all rely on. My hon. Friend highlighted the need for openness, and his contribution was typically decent and insightful.

The hon. Member for Carmarthen East and Dinefwr (Jonathan Edwards) was right to emphasise the importance of the four nations working together and taking a co-ordinated approach. I again re-emphasise my gratitude and the Government’s gratitude to the devolved Administrations for the spirit of genuine partnership in which we have all been working in recent weeks. The hon. Gentleman talked about whether the fixed-penalty notice amount was an adequate deterrent; it is arguable that the far more effective penalty is, rather than the penalty imposed, the sense of common national endeavour in this country and everyone wishing to do the right thing because it is the right thing to do.

My hon. Friend the Member for Wycombe (Mr Baker) is not only an hon. Friend but a friend, and a good and decent man. He has long been a champion, inside and outside the House, of due process, the rule of law and the need, despite the safeguards in this country, always to be vigilant and protect the hard-won freedoms that we enjoy. Such voices as his are absolutely vital to the health of a vibrant democracy such as ours. He was right to emphasise the difference between guidance and law. As I said in my opening remarks, what is in the regulations is the law; guidance may be helpful but it is not the law. My hon. Friend drew on the highway code to make a point about the difference between “must” and “should” in the way we communicate these things. That is a good and valid point that my hon. Friend the Member for Witney (Robert Courts), who is not able to be present today, has made to me in the past.

My hon. Friend the Member for Wycombe also asked whether the regulations might or might not be ultra vires. I will say only a few more words on the issue, because I am conscious that, if the press reports are to be believed, there is a possibility that some may be considering legal cases on this issue and I would not wish to stray into that territory, save to reiterate what I said in my opening remarks: the Government believe that section 45C of the Public Health (Control of Disease) Act 1984 does give sufficient authority to Ministers and to the Government to implement the regulations.

The hon. Member for Oxford West and Abingdon (Layla Moran) was right to highlight the challenge posed in some businesses—she highlighted the experience of call-centre staff—and the need for businesses to do everything in their power, if people are working in a job that they cannot do from home, to ensure that their workers are supported and protected and that appropriate social-distancing measures are in place to protect workers who are fulfilling important roles to help everyone else in our society.

My hon. Friend the Member for Yeovil (Mr Fysh) and my right hon. Friend the Member for Wokingham (John Redwood) both highlighted the importance of reassuring the British public and this House about the need for openness and for scrutiny. They highlighted the fact that we must always treat liberty as a precious thing, protect it, and ensure that we do not see it whittled away: I reassure my hon. Friend the Member for Yeovil that there is no intention to do any such thing.

My right hon. Friend the Member for Wokingham also touched on the need to be open about the science. He spoke with a degree of erudition and knowledge that I will not seek to emulate, but he is right to say that we must interrogate the science carefully when making the decisions on where to go in future with these regulations.

Turning to the hon. Member for Strangford (Jim Shannon), we are, as ever, very grateful for his support and for his contribution to this debate. He is always a strong voice for his constituents. Among a number of points that he made, he was quite right to highlight the importance of doing what we can to ensure that people’s mental health is supported and protected at what is a very difficult time for many, many people. He also alluded to human rights implications. I reassure him that the Government are clear that these measures are fully compliant with the Human Rights Act 1998.

My right hon. Friend the Member for Ludlow (Philip Dunne) and a number of other colleagues, including my hon. Friend the Member for Witney, my right hon. Friend the Member for Forest of Dean (Mr Harper) and my hon. Friend the Member for Newcastle-under-Lyme (Aaron Bell), made the point, as have other hon. Members, that these regulations, while necessary, should be in force only for as long as they are absolutely necessary, highlighting not only the health impact but the broader impacts on society and on the economy. I reassure them that we are absolutely clear about that. These measures are a necessity at the moment, but the Government have always been clear that they will be retained only for so long as they are a necessity to tackle this disease.

My right hon. Friend the Member for Ludlow was right about the importance of testing, and also right to highlight the work of the Secretary of State in this respect. The Secretary of State has always been very clear in saying that it is a team effort that has got us to reaching the target, last week, of 100,000 tests per day. I would say, however, that in a team, leadership is important. He has shown that leadership in this very important matter, and I pay tribute to him for that.

My hon. Friend the Member for Arundel and South Downs (Andrew Griffith) was absolutely right to highlight the importance of consent. Consent comes from us following due process and adhering to the rule of law through this Chamber—through this House. We will always bear that very much in mind. The shadow Minister and others made the point very clearly that they would expect this House to be very much involved, as swiftly as possible, in any further decisions or changes. I know that will have been heard by my right hon. Friend the Prime Minister in Downing Street.

I conclude with my thanks—and indeed, I suspect, all of our thanks—to NHS and care staff and key workers around this country, all of whom are doing so much for all of us. These are exceptional measures that we should only maintain for as long as necessary, but at the moment, regrettably, they do remain necessary. Therefore, I also thank the British people for their incredible spirit and support for these measures. The fight against covid-19 is a tough one that has brought forth a national effort in this country. I am convinced that we will beat it, for when this great country comes together, it is unbeatable. I commend these regulations to the House.

Question put and agreed to.

Resolved,

That the Health Protection (Coronavirus, Restrictions) (England) Regulations 2020 (S.I., 2020, No. 350), dated 26 March 2020, a copy of which was laid before this House on 26 March, be approved.

Public Health

Resolved,

That the Health Protection (Coronavirus, Restrictions) (England) (Amendment) Regulations 2020 (S.I., 2020, No. 447), dated 21 April 2020, a copy of which was laid before this House on 22 April, be approved.—(Edward Argar.)

[Madam Deputy Speaker (Dame Eleanor Laing)]

We have concluded this session a few minutes earlier than expected—not through bad arithmetical calculation, I would like the House to know, but because a few people who had indicated that they wished to speak and had been on the list to speak decided at the last minute not to. I therefore suspend the House for rather more than 30 minutes, until 7.30 pm.

Supermarkets’ Role in Tackling Childhood Obesity

Edward Argar Excerpts

Wednesday 18th March 2020 Westminster Hall

[The Minister for Health (Edward Argar)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I congratulate the hon. Member for Birmingham, Selly Oak (Steve McCabe) on securing this important debate, and on his work with the all-party parliamentary group on a fit and healthy childhood. I remember responding to him in one my first outings as a then Under-Secretary of State and finding myself, with a slight degree of nervousness for my ministerial career, agreeing with virtually everything he said. However, I am still here, and it has not done me any harm. I fear that I may be in agreement with a number of his points again today, but hopefully at no risk to my ministerial career.

Before turning to the detail of the hon. Gentleman’s points, I thank our supermarkets, particularly at this important time. They are very much in the frontline of our battle with covid-19, and I know that they, and particularly all their staff, in whatever capacity, are doing all they can to keep shelves stocked, deliveries going out and the nation fed. It is a complex job at any time, so I thank them. In parallel, I encourage customers and shoppers to be responsible, to purchase only what they need and to think of others. Working together, I am confident that the supermarkets will ensure that their supply chains remain robust and that shelves will continue to be full.

In its 15th report, “Healthy Families: The present and future role of the supermarket”, alongside the previous reports to which the hon. Gentleman referred, the APPG has provided a valuable contribution to the ongoing debate on improving children’s health and reducing childhood obesity—I have a copy here, and I very much enjoyed it as my bedtime reading last night. He is right; with more than one in five children entering primary school overweight or obese, rising to more than one in three by the time they leave, it is right that we take bold action to improve the nation’s diet. There can be no doubting the key role, as he has said, that supermarkets and other retailers play in helping consumers make healthier choices. I know that many supermarkets and businesses get this. They know that their customers want a healthier offer and that it makes business sense.

Although I am not familiar with the group that produced the report, I saw a recent report by ShareAction that highlighted the importance of investors’ decisions in the sector and factors such as those highlighted by the hon. Gentleman. With environmental, social and governance considerations playing an ever more important role in investment decisions by big investors more broadly, it is right that supermarkets recognise that this agenda is good not only for their customers, but for their business.

As the hon. Gentleman alluded to in various examples, many supermarkets have already taken the lead in the UK and feature the voluntary front-of-pack nutrition labelling on their pre-packaged foods, helping consumers make informed and healthier choices about the food they buy. The UK-wide voluntary front-of-pack traffic light labelling scheme introduced in the summer of 2013 is proving successful, but he makes a good point. It is important to ensure that UK labelling remains effective for UK consumers. We will always be willing to consider a range of measures to build on the success of the current traffic light system to ensure that it keeps up to date and continues to be successful. It is right that people are informed when choosing what they eat and what they buy.

As the hon. Gentleman mentioned, we have seen great work by supermarkets in a range of areas. I will add a few to the list. I hasten to add that if I miss any out, it is not because of any conscious decision; I have merely picked a few examples to illustrate the work that supermarkets do. For example, Aldi and Lidl—a point he touched on—were the first retailers to introduce healthier checkouts in 2015 when they removed all confectionery and sweets from checkouts and replaced them with healthier options, including dried fruit, nuts and water. I have seen that in Waitrose and other supermarket checkouts. It goes to the point made by the hon. Member for Strangford (Jim Shannon) about the importance of what is in the physical environment as we queue up at the checkout and the influence that can have at the last minute, with young children saying, “Mummy, Daddy, can I have that?” It is therefore important that supermarkets do their bit at least to gently steer people in the direction of healthier options.

Sainsbury’s has removed all multi-buy promotions on food and replaced them with lower regular prices on everyday items. Tesco has reformulated its entire soft drinks portfolio—the first supermarket to do so—to be below the level for the soft drinks industry levy, and has given away 100 million pieces of fruit to children in their free fruit for kids campaign. All supermarkets and many larger retailers have restricted the sale of energy drinks to children. In January, Aldi and Lidl announced that they will remove familiar figures from their own-label cereal boxes. All of that is important and positive and should be welcomed. However, as the report acknowledges, there are areas where supermarkets can go further, including doing more to promote and market a healthier food and drink offer more broadly.

As the hon. Gentleman pointed out, promotional marketing by price and store location can impact on the food purchases that we all make. Some can increase the amount of food and drink that people buy by around 20%, which can lead to overconsumption of less healthy products and can cost consumers more money in the long run. Obviously, parents want a healthier balance of offers and deals, but they are not helped by the fact that most deals and offers are currently for unhealthier products.

I am conscious that none of us wants to be hectored and lectured about what to eat. I feel strongly that people should have the right to choose freely for themselves and their families as they know best, but they need to do that on the basis of making an informed decision. People need information to make the choices about their and their children’s lives. It is not fair when all the promotions in store are mostly for unhealthy food, so the balance of the promotions needs to shift towards healthier options to make it easier to make healthier choices when shopping.

To respond to the point made by the hon. Member for Strangford (Jim Shannon), we hear the frustration of parents about what could be called pester power, particularly when queuing at checkouts. It can be hard to say no, so it is important that supermarkets do what they can to help parents in that situation. Again, rebalancing promotions in prominent locations such as tills and shop entrances towards healthier options can help reduce excess calorie consumption and contribute to reductions in childhood obesity in the long term. Many supermarkets are doing so, and I commend them for that, but there is more to do. I encourage supermarkets to continue down that path.

All of that is why in the second chapter of our childhood obesity plan we committed to consult on our intention to restrict promotions on products high in fat, sugar or salt by location and price in businesses that sell food and drink. The consultation closed last year and we will set out our response as soon as we can. I know that both hon. Members who spoke in the debate and the APPG will want to study the response carefully. They may well revert with their reflections on the adequacy of the Government response and whether it goes as far as they would wish. Indeed, I encourage that; it is part of what the House and debate are for.

We want a fairer deal for everyone wherever they live or shop, and whatever their background or financial situation. We want the healthy option to be an easier option for everyone so that we can help all our children grow up healthier. Indeed, as we look towards the future and the demands on our NHS and social care, we are always conscious of what changing demographic demands might do in the future and what children and young people may be letting themselves in for by virtue of their diet or lack of exercise, which in future may require longer-term care and have an impact not only on them but on the NHS and social care’s ability to meet those needs. It is right that, as well as ensuring that the social care and health system can meet those needs, we do everything we can to prevent long-term conditions coming about in the first place.

[Steve McCabe]

I have no desire to bludgeon supermarkets, and I understand the Government’s desire to work with them but, given the Minister’s point about long-term health conditions, I was struck that Public Health England’s report showed how some supermarket’s own food products—I will not name the supermarkets—showed increases in sugar content. An increase was found over the period of the report in sweet confectionary, chocolate spreads and morning goods. While the Government are trying to persuade supermarkets, should they also consider fiscal measures as an incentive to meet sugar reductions?

[Edward Argar]

The hon. Gentleman gently tries to tempt me into an area that is perhaps more properly the remit of my right hon. Friend the Chancellor of the Exchequer. I do take the point behind what he says: we need to use multiple means to encourage supermarkets—perhaps that is the best way to phrase it. Again, I encourage him and the all-party parliamentary group to wait for the consultation response and beyond that to engage fully. I am sure that he will. We may well find ourselves here in a few months’ time—or when the report is published—for another debate in the light of the Government’s response.

I think the hon. Gentleman will agree that we will need supermarkets to continue their good work, alongside the out-of-home sector, health professionals, schools, local authorities, families and individuals, who all play an important role. We must also be willing to encourage supermarkets, building on their good work to date, to be ambitious and go that step further. We all have a role to play in what we eat, keeping ourselves healthy and doing the right thing by our long-term health. It is important that supermarkets play their role, and it is important that all of us do as well.

Question put and agreed to.

Income tax (charge)

Edward Argar Excerpts

Monday 16th March 2020 Commons Chamber

[The Minister for Health (Edward Argar)]

Thank you, Mr Deputy Speaker.

My right hon. Friend the Secretary of State is currently at a Cobra meeting, determining the next stage of the Government response to the coronavirus. He therefore apologises for the fact that he is unable to open this debate. With your permission, Mr Deputy Speaker, he will be making a statement to the House a little later this afternoon. That will provide right hon. and hon. Members with the opportunity to question him on the latest position, so I urge colleagues to pause any specific questions related to coronavirus until that statement, when they will have the latest information.

May I also say that it is a pleasure to be back after last week’s precautionary self-isolation, following contact with a confirmed case and on Public Health England advice? It has subsequently advised me that, as I am symptom-free, I can return. Let me put on the record my thanks to PHE for the work it is doing for everyone at the moment, and to hon. Members and constituents for their kind words last week.

Coronavirus is the most serious public health challenge that our country has faced in a generation. Our goal is to protect life and to protect our NHS. Last week’s Budget showed that we will rise to that challenge. Under the plans laid out by my right hon. Friend the Chancellor, workers will have a strong safety net to fall back on if they fall sick, businesses will get financial help to stay in business, and the NHS will get whatever resources it needs. All in all, the Chancellor announced last week a total of £30 billion of investment in the financial health of the nation.

[Kevin Brennan (Cardiff West) (Lab)]

Many of those measures are extremely welcome, but is it not becoming clear that the economic impact of coronavirus is perhaps even greater than was anticipated, even last week? Perhaps now is the time to consider a temporary universal basic income for people who work as freelancers or who are self-employed, for the duration of the crisis.

[Edward Argar]

I am grateful to the hon. Gentleman for his comments. I believe that the package announced last week is the right package, at this time, to meet the challenges posed by this situation. Without necessarily referring to the hon. Gentleman’s particular proposal, I note that the Chancellor continues to keep all interventions under review as the situation develops. At the moment, what was proposed last week remains the right approach.

[Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)]

I underline my support for the comments of my hon. Friend the Member for Cardiff West (Kevin Brennan). The Minister asked us to wait to question the Secretary of State later, but I have a specific question about personal protective equipment. I am hearing a lot of concerns—shared throughout the country—about care homes, and particularly those involved in domiciliary care, as well as about some of the differentials between what is going on in private care homes and in public sector care homes. How is the Minister going to make sure that, working with the devolved Administrations, people throughout the whole UK get the PPE that they need, particularly in the care sector?

[Edward Argar]

I reassure the hon. Gentleman that, first, we are working across the four nations, because the situation needs an entire-United Kingdom response, and secondly, we are working extremely hard to ensure that all those who are on the frontline looking after people and keeping them safe get the protective equipment that they need. I suspect the Secretary of State will say a little more about that later this afternoon.

[John Redwood (Wokingham) (Con)]

Will the Government look again at the issue of the hospitality, travel and leisure industries? Some of those businesses are losing not just 10% or 20%, as they might in a normal recession, but the bulk of their revenue. Do they not need some revenue-sharing with the Government? Could we have a scheme like the German one to keep workers in work for a bit when they have a major loss of demand? I have declared my interests in the Register of Members’ Financial Interests—they are not in this particular sector.

[Edward Argar]

My right hon. Friend is right to highlight the challenges for particular sectors that are posed by what is currently happening, and he is right to mention the hotel and hospitality trade. Alongside the measures set out by the Chancellor last week, my right hon. Friend the Secretary of State for Digital, Culture, Media and Sport continues to have discussions, not only within his Department and across Government but with the sector, about what can be done to ensure that it gets the appropriate support that it needs as a sector.

[Bob Seely (Isle of Wight) (Con)]

Just to follow up on that point, I have several cases of businesses coming to me and saying that their business-interruption cover is not being recognised by their insurance companies because coronavirus was not a notifiable disease at the time. If the insurance industry takes that attitude nationwide, many businesses—not only in tourism and hospitality—are going to go to the wall, and my constituents on the Isle of Wight will be especially badly hit.

[Edward Argar]

My hon. Friend makes an important point. The Treasury, my hon. Friend the Economic Secretary to the Treasury and others are in conversations with the industry more broadly—I believe that more conversations are set to occur tomorrow—to ensure that businesses get the support that they need and are treated in a fair way.

Our investment in the financial health of the nation includes £40 million for literal vaccines, research and testing, because we base our decisions on the bedrock of the science. This national response is made possible because of our careful stewardship of the British economy over the past 10 years—because record numbers of businesses are making, selling and hiring; because millions more people are in work, earning and paying taxes; and because we have backed the NHS with a record long-term funding settlement.

This is a national effort and we will get through this together, as the Prime Minister has said. In Government, we will do the right thing at the right time, working through each stage of our coronavirus action plan guided by the science and the advice of our medical and scientific experts. We will stop at nothing to defeat the disease, but we will succeed only if everyone does their bit: washing their hands regularly; self-isolating for seven days if they have symptoms, such as a new, continuous, persistent cough or a high temperature; and looking out for their neighbours. In that spirit, may I thank the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth), my constituency neighbour, and the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), for the constructive approach that they have taken since the start of the outbreak? They are doing their bit. They are good and decent people and public servants, and their approach is a prime example of how we can work together during this crisis.

[Emma Hardy (Kingston upon Hull West and Hessle) (Lab)]

One question I am getting from constituents who already have medical conditions is to do with their worry over any interruption to their supply of medicine and their treatment. What reassurances can the Government give to people with epilepsy, for example, that they are still going to get the medication that they need?

[Edward Argar]

The NHS has robust procedures in place to ensure the continuity of medical supplies. In respect of supplies bought over the counter, I urge people not to stockpile, to behave responsibly and to buy what they need. In respect of prescription medicines, I can reassure the hon. Lady that we have very strong and robust processes in place to ensure that those medicines continue to be available.

[Louise Haigh (Sheffield, Heeley) (Lab)]

I wonder whether we could consider the language that we are using around the at-risk groups of people. Very few people will self-define as vulnerable or elderly, and, in fact, people with underlying health conditions might not even realise that they are particularly at risk of infection. Can we think about the language that we are using and specifically issue guidance to those groups of people?

[Edward Argar]

As ever, the hon. Lady makes a sensitive and sensible point. She is right that clarity in definitions and the language that is used is important. I do not want to pre-empt what my right hon. Friend may say in the House in a little while, but I think that she will see in the coming hours and days a greater degree of clarity for people and more information and guidance on that matter.

[Jim McMahon (Oldham West and Royton) (Lab/Co-op)]

rose—

[Edward Argar]

I will take one more intervention before I move on.

[Jim McMahon]

I thank the Minister for giving way. Clearly, we are very early into this, and we do not quite know what the business continuity impact will be or the financial impact on business. Do the Government have a framework by which they will operate and have discussions? For instance, when Virgin Atlantic comes forward and says that it needs financial support, what will be the framework of that support and what might the Government want in return for that investment?

[Edward Argar]

The hon. Gentleman makes a good point, which, almost to a degree, goes back to the point made by the hon. Member for Sheffield, Heeley (Louise Haigh) about giving people greater clarity and understanding of how things will work and in what way. Because the matters are fast evolving, as he says, they continue to be under review, but we will ensure that we work with industry—including both the example that he gives and others—to give the support that people need and that is most appropriate. Again, I hesitate to say this, but I caution slightly, as I did at the beginning, and say that if he waits until the Secretary of State’s statement, which I think is at half-past five, he may well get more details on that.

Coronavirus is the biggest challenge facing the NHS today. With clean hands and calm heads, we can help tackle it together, but, equally, we will not allow it to divert us from the long-term improvements that patients and staff rightly want to see. As the founders of the NHS knew better than anyone, we can fight the war while also planning for the peace.

Let me now turn to the measures in the Budget that will secure those long-term improvements. Last week, my right hon. Friend the Chancellor committed £6 billion of extra spending to support the NHS over the lifetime of this Parliament. That comes on top of our record long-term NHS funding settlement—£33.9 billion more over five years—which we have now enshrined in law. Most of the extra £6 billion will go towards delivering our flagship manifesto commitments. They include starting work on 40 new hospitals, 50,000 more nurses, and 50 million more appointments in primary care—more buildings, more people and more services. Let me take each in turn.

[Peter Grant (Glenrothes) (SNP)]

I thank the Minister for giving way. I can say quite honestly that it is an impressive list of capital spending commitments that he is giving us today. He will be aware that the Office for Budget Responsibility has based its longer term debt forecasts on the assumption that 20% of those capital promises will never actually happen. Does he accept that view from the Office for Budget Responsibility?

[Edward Argar]

The Office for Budget Responsibility is independent of the Government and sets out its opinions as it sees fit. We are committed to the hospital building programme. If the hon. Gentleman waits a moment, I will come to the detail of that capital spending.

The Budget increases my Department’s capital budget by £1 billion in 2020-21. That will allow trusts to continue investing in vital refurbishment and maintenance. Of course, we are funding the start of work on 40 new hospitals and the 20 hospital upgrades that are already under way. The work to plan and design those 40 new hospitals has already begun.

[Mike Amesbury (Weaver Vale) (Lab)]

Halton General Hospital campus—which, as the Minister knows, is part of Warrington and Halton Teaching Hospitals NHS Foundation Trust—has been turned down twice for capital funding for much needed refurbishment work. I plead once again for the Minister to ensure that it is prioritised; I am still waiting for a meeting with him.

[Edward Argar]

I hear what the hon. Gentleman says. As ever, he is a vocal champion for his constituents and his hospital. I say very gently that recent events have slightly impacted on my ability to schedule as many meetings as I might wish, but I remain committed to meeting him and talking to him about that particular project.

We want the new hospitals to be fully equipped with the very best modern technology, with touch screens, not clipboards, and systems that talk to each other. We also want them to be fully integrated with other local NHS organisations. But this is just the start, and we will follow this work up with multi-year capital funding through the spending review to be announced later this year.

[Geraint Davies (Swansea West) (Lab/Co-op)]

Is the Minister looking to divide up hospitals—new ones and, indeed, the existing ones—into coronavirus and non-coronavirus, with people wearing protective suits in coronavirus sections? China has been building a number of hospitals within weeks specifically to deal with this problem, so will the Minister refocus the programme he is outlining and bring it forward to address the coronavirus crisis?

[Edward Argar]

I suspect that Chinese building regulations and similar are possibly a little different from the processes in this country when it comes to speed, but the hon. Gentleman makes a good point. These hospitals, though, will be built for the future of our country—for the next 10, 20 and 30 years. He alludes to an important point and one that I was touching on in my speech, which is that we should ensure that our new buildings are adaptable and can be adapted to the changing needs of medical emergencies and the long-term demographic trends in this country. On that front, yes, we are building hospitals that are fit for the future, whatever that future may throw at us. But the issue he is raising is perhaps a little more short term than the length of time it will take us to build some of these hospitals.

Let me turn to people—the 1.4 million-strong team who make up the most dedicated workforce in the world. What is the one thing most NHS staff would change if they could change one thing? What is the best present we could give our nation’s nurses? [Interruption.] I will not be led astray by the Opposition. The answer is more nurses—more nurses to share the burden of rising demand, and more nurses bringing their compassion and determination to their work in the NHS. Over the next five years, we will deliver 50,000 more nurses for our NHS. We will do so by retaining and returning existing NHS staff, and by recruiting more nurses from abroad, but crucially by attracting more young people into the profession in the first place. The Budget delivers that by providing new non-repayable maintenance grants for nursing students of at least £5,000 a year for every undergraduate and postgraduate nursing student on a pre-registration course at an English university, with more for students with childcare costs or in disciplines such as mental health where the need is greatest. More than 35,000 students are expected to benefit.

In the coming months, the British people will have even more reason than usual to give thanks to our nation’s nurses, and we will work to repay them by making the NHS the country’s best employer—more supportive, more inclusive and more concerned with the wellbeing of staff as well as patients, an NHS that cares for its carers. We will set out how in our landmark NHS people plan.

We will also tackle the taper problem in doctors’ pensions, which has caused too many senior doctors to turn down work that the NHS needs them to do. Thanks to action in the Budget and the work of the Economic Secretary to the Treasury, from April the taxable pay threshold will rise from £110,000 to £200,000. That will take up to 96% of GPs and up to 98% of NHS consultants out of the scope of the taper based on their NHS income. I am particularly grateful to my hon. Friend for his work on delivering that.

Turning to staff in primary care, the Budget funds 6,000 more doctors and 6,000 more primary care professionals in general practice, on top of the 20,000 primary care professionals already announced. Why? It is because we want every NHS professional working at the very top of their skills register; because there are brilliant physios, pharmacists and healthcare assistants who can offer great treatment and advice for people seeking primary care; and because we can improve patient access to the NHS while freeing up GPs for those who need them most.

[Ruth Cadbury (Brentford and Isleworth) (Lab)]

While we welcome the numbers of professionals in the range of clinical areas that the Minister has outlined, can he tell me the numbers in each of those clinical specialisms and say when they will be ready to start work? When will they be fully trained and where will they come from?

[Edward Argar]

I set out in my remarks just now exactly where they would come from—from a variety of different sources. We have already seen, from the latest numbers for nurse recruitment, for example, many thousands more recruited in the last year. We are succeeding in delivering on our pledge, and we set out very clearly in our manifesto the timescales within which we would deliver.

That brings me to my third point—NHS services. I have said that I want the NHS to pursue two long-term policy goals to which my right hon. Friend the Secretary of State is committed. They are five extra years of healthy life and increased public confidence in the service. The coronavirus outbreak demonstrates that we have to target both. It is an explicit goal of our policy not just to tackle the disease, but to maintain public confidence. We take the same approach more broadly in healthcare. We want people to live healthier for longer, and we want people to be confident that the NHS will always be there for them, that it will treat them with dignity and respect, and that it will feel like a service, not an impersonal system. We want people to know, for instance, that they can always see a primary care professional whenever they need to. The Budget funds our manifesto commitment to create an extra 50 million appointments a year in general practice.

[Alex Cunningham (Stockton North) (Lab)]

I am grateful to the Minister for meeting me last week and very glad that I did not have to follow him into isolation. We had a good discussion last week and talked very much about those health inequalities and the necessity for more people to have more healthy years. I was grateful to him for being kind towards North Tees and Hartlepool and talking about a new hospital for Stockton. If there is a bit of capital to get that under way, I hope he will come up with it soon.

[Edward Argar]

The hon. Gentleman and, indeed, my hon. Friend the Member for Stockton South (Matt Vickers) are both strong advocates for Stockton and for the hospital there. I very much enjoyed our discussion. I am glad that the self-isolation rules are such that the hon. Gentleman did not have to follow me into it, but I am very happy, as I said when we met, to pick up on that discussion further in the future.

We also want people to know that the NHS will treat them fairly in their hour of need. That is why we care about hospital parking. Thanks to this Budget, from next month we will start the roll-out of free hospital parking more broadly across our hospital estate for disabled people, frequent out-patient attenders, parents with sick children staying overnight and staff working night shifts, delivering on our manifesto commitment.

[Emma Hardy]

rose—

[Edward Argar]

The hon. Lady tempts me a second time. How can I say no?

[Emma Hardy]

I thank the Minister; it is a very quick one. Can that list of those eligible for free parking also include any students on a placement at the hospital—for example, nursing students or occupational therapists?

[Edward Argar]

The hon. Lady will know that the four categories I have just referred to are the four categories we explicitly referred to in the manifesto on which we were elected. As she knows, if she wants to write to me, I am always happy to receive and respond to letters from her on that issue.

The last measure I want to point to may have escaped notice last week, but it is an incredibly important part of putting the “service” into national health service. Too many people with autism or a learning disability are being treated as in-patients in mental health hospitals instead of being helped to live in their communities. In our manifesto, we committed to making it easier for them to be discharged from hospital. This Budget makes good on that commitment. It creates a new learning disability and autism community discharge grant that will be available to local authorities in England. That is new money and all local areas will receive a share of that funding.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I am grateful to the Minister for giving way. On that point concerning people with autism and learning disabilities in assessment and treatment units, can he advise on the arrangements that are being made during the coronavirus pandemic to ensure that those people currently in in-patient provision will not suffer additional isolation and further breaches of their human rights as a consequence of restrictions that might be put in place?

[Edward Argar]

The hon. Lady makes an important point, which is that throughout this challenge that we face as a country, we must ensure that everyone is treated with dignity and receives the care and support that they deserve. I was about to say that I know my right hon. Friend the Secretary of State will have heard what she said, but given he is in Cobra, he might not. I will ensure that he does. I will mention the matter to him, and in the context of the future tranches of guidance that will be coming forward in future days, the hon. Lady may want to raise the issue with him specifically later.

Modern buildings, more staff, an NHS that continues to truly serve its patients and a national response to coronavirus—that is what the Budget delivers. We can tackle this emergency while putting in place the long-term improvements that NHS clinicians are asking us for. We can fight the war against coronavirus as a united country, but we can also build the peace. We will stop at nothing to protect life and to protect and invest in our NHS. I commend the Budget to the House.

[Mr Deputy Speaker (Mr Nigel Evans)]

I point out that the statement on coronavirus will now be coming at 6 pm.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 10th March 2020 Commons Chamber

[Elliot Colburn (Carshalton and Wallington) (Con)]

22. What steps he is taking to build new hospitals.

[The Minister for Health (Edward Argar)]

We have announced £2.7 billion of funding for six new hospital schemes under HIP1—the first tranche of the health infrastructure plan; and £100 million of seed funding for a further 21 schemes covering 34 hospitals under HIP2, ready to go to the next stage. That is 40 new hospitals in total.

[Robert Halfon]

I am hugely grateful to my right hon. Friend the Secretary of State for granting Harlow the capital funding for a brand new hospital. Does the Minister agree that our new hospital will transform the patient experience for Harlow residents and the working environment for our brilliant NHS staff, and deliver state-of-the art healthcare for our town and surrounding villages?

[Edward Argar]

I agree entirely. I am looking forward to visiting it with my right hon. Friend the Member for Harlow (Robert Halfon) soon.

[Elliot Colburn]

It is thanks to this Government that we have £500 million of investment in the Epsom and St Helier University Hospitals NHS Trust, not only to improve existing hospitals but to build a third new one as well. Does the Minister agree that this is excellent news for local patients and will he encourage my constituents and those in surrounding areas to get involved in the consultation on where the new hospital is to go?

[Edward Argar]

My hon. Friend is absolutely right. It is indeed excellent news. As he will be aware, the public consultation process is under way. It would be wrong for me to prejudge that, but I encourage everyone to participate.

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

Does the Minister agree that it is important to spend taxpayers’ money well, and that to spend it on a site that is going to cost 20% more than St Helier—away from the people with the greatest health needs—is not the best way to spend public money?

[Edward Argar]

I gently say that I am not going to prejudge the outcome of the consultation, in which I am sure that the hon. Lady would encourage others to participate. Regardless of the outcome, I am sure that she would want to welcome the £500 million investment from the Government that will benefit her community and others.

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

During the election campaign, the Prime Minister promised 40 new hospitals, but the Government have only pledged funding for six: £2.7 billion. After more than five years of raiding capital budgets, when will the Government provide the £6.5 billion that is required to fix the maintenance backlog alone?

[Edward Argar]

As I have made clear, we have set out the funding for the six new hospitals in the first tranche; we have invested seed funding in the development of the schemes for the further 34; and further capital announcements will be made in due course.

[Andrew Bowie (West Aberdeenshire and Kincardine) (Con)]

6. What steps he is taking with the Home Secretary to fast-track immigration applications from doctors and nurses who want to work in the NHS.

--- Later in debate ---

[Duncan Baker (North Norfolk) (Con)]

17. What steps his Department is taking to improve health facilities at Cromer Hospital.

[The Minister for Health (Edward Argar)]

My hon. Friend is a strong advocate for Cromer hospital. It is relatively new, but the area’s 2015 cancer strategy projected a 200% increase in the need for cancer care over the next 10 years. So last year we saw the start of the £4.15 million proposal for a new cancer centre at Cromer, in partnership with Macmillan. However, I know he and his trust a more ambitious than that.

[Duncan Baker]

I thank the Minister for that answer. North Norfolk is one of the oldest constituencies by demographics. It is very rural and a very long way from the Norfolk and Norwich hospital. What I am looking for is an enhanced urgent treatment centre with mental health facilities. That would really help my constituency and, not only that, it would take pressure off the Norfolk and Norwich hospital. Will the Minister support my campaign for more improvements there please?

[Edward Argar]

My hon. Friend is right to highlight that his constituency has the highest average age in this country. As an assiduous reader of the Eastern Daily Press I recently saw the story outlining the trust’s plans for a UTC. I look forward to seeing those proposals develop further. The key to delivering them, or their making progress, will be partnership. I look forward to the hospital trust, my hon. Friend and the CCG working in partnership to deliver an outcome.

[Cat Smith (Lancaster and Fleetwood) (Lab)]

19. What recent assessment he has made of trends in life expectancy.

--- Later in debate ---

[Sam Tarry (Ilford South) (Lab)]

20. What steps he is taking to reduce the number of patients who wait longer than four hours for treatment in A&E.

[The Minister for Health (Edward Argar)]

Despite the NHS seeing a substantial rise in demand, with 1 million more attendances at A&E in 2019 than in 2018, our amazing NHS staff continue to work hard to ensure that everyone gets the care they need, including seeing 1.7 million more people within the four-hour standard than in 2010.

[Sam Tarry]

This morning, as I scanned the NHS England winter situation report covering Barking, Havering and Redbridge University Hospitals NHS Trust in my constituency, I saw that it had massively underperformed in terms of ambulance handover delays. Across this winter, it averaged 38% of handovers taking at least 30 minutes. The national average was just 14%. How do the Government explain the fact that, despite trusts seeing 16,000 fewer arrivals this winter, there were 22,000 more handover delays?

[Edward Argar]

The hon. Gentleman will know that the London ambulance service serves the whole of London. His trust does see increased demand and increased challenges associated with winter, but I would also point out the positive. His trust received £1.2 million of winter capital in 2018 to aid preparations for winter. He will also know that the 20 hospital upgrades programme includes the St George’s site, serving the trust more broadly with a health and wellbeing centre, which will ease pressures.

[Amy Callaghan (East Dunbartonshire) (SNP)]

T1. If he will make a statement on his departmental responsibilities.

--- Later in debate ---

[Gareth Davies (Grantham and Stamford) (Con)]

T2. Over three and a half years ago, Grantham Hospital was closed overnight owing to temporary measures. This has gone on for far too long. Enough is enough. Can the Secretary of State help me and offer any guidance or update on what we can do to get those doors back open 24 hours a day?

[The Minister for Health (Edward Argar)]

It is vital that the people of Grantham are able to access 24-hour care for both accident and emergency and urgent treatment needs. I urge my hon. Friend to continue to work with his local health services and commissioners to develop plans to ensure the needs of his constituents are met. I know he has already been a strong advocate on this matter in this House for his constituents since his election, but I am of course very happy to visit him in Grantham if that would be helpful to him.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Personal protective equipment can be as important in social care settings as it is in hospital or GP settings, but care staff report having to buy their own gloves and one care provider had their order of protective equipment requisitioned by the NHS. The Secretary of State says that he is all over this issue, so what plans does he have to ensure that care staff have access to protective equipment to protect them and the people they care for?

--- Later in debate ---

[Stephen Hammond (Wimbledon) (Con)]

Last Friday I held an open meeting so that my residents could better understand the proposals for Epsom and St Helier University Hospitals Trust. While I understand that the Minister cannot comment on the consultation, does he not agree that my residents would do better to consider the evidence that shows these proposals will improve access and quality and have no adverse impact on health inequalities?

[Edward Argar]

My hon. Friend is right. I do not intend to prejudge the consultation, but I agree that his constituents should look very carefully at the evidence of what it will do to save lives and improve healthcare and respond accordingly.

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

T6. In response to an urgent questions from the shadow Health Secretary yesterday, the Secretary of State confirmed that emergency legislation being introduced to tackle coronavirus would include changes to statutory sick pay. Can he confirm to the House that the emergency legislation will include specific proposals to remove the lower earnings limit of £118 per week in order to provide access to statutory sick pay for 1.8 million low-paid workers?

--- Later in debate ---

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

At a time when the NHS is under pressure as never before because of coronavirus, does the Secretary of State agree that to close Mildmay Mission Hospital in my constituency would be an act of unbelievable folly? It is a specialist unit for people with HIV/AIDS, and to force those patients into the mainstream would endanger lives. Can he commit today to providing the much needed additional funding of £5 million a year to save this very important hospital, which is doing very important work?

[Edward Argar]

I welcome, as I am sure we all do, the huge advances in HIV/AIDS care and treatment in recent years. The hon. Member and her trust came to see me recently to discuss this case. Following that meeting, I understand that NHS England, the clinical commissioning group and others met the trust to discuss the issue and the way forward. That is the right forum in which to find the right way forward—a way forward driven by the clinical evidence of the right approach.

[Adam Afriyie (Windsor) (Con)]

In Windsor we have an ageing but distinguished population, and we recognise that adult social care is one of the biggest challenges facing the country and local authorities. I thank the Secretary of State for his dedication to resolving these issues, with the better care fund allocation and his call for input from MPs, among others. In those discussions, will he have an open mind to the concept of a precept for adult social care for local authorities?

--- Later in debate ---

[Mr Philip Hollobone (Kettering) (Con)]

I thank my hon. Friend the hospitals Minister for his personal attention to Kettering General Hospital, and for the plans for a new £46 million urgent care hub. Can he assure me that progress on the delivery of that facility is on track?

[Edward Argar]

I am happy to give my hon. Friend that assurance. The fact that the money is being invested is largely due to his campaigning efforts and those of his colleagues. I look forward to the opportunity to visit him again soon, and to see progress on the ground when I meet the team.

Mount Vernon Cancer Centre

Edward Argar Excerpts

Wednesday 4th March 2020 Westminster Hall

[The Minister for Health (Edward Argar)]

I thank the hon. Member for Harrow West (Gareth Thomas) for securing this debate on the future of Mount Vernon cancer centre. I know that the provision and location of radiotherapy services is of great interest to many hon. Members, and I was delighted to meet my hon. Friend the Member for Stevenage (Stephen McPartland) and my right hon. and learned Friend the Member for North East Hertfordshire (Sir Oliver Heald) earlier this month to discuss aspects of this matter as it relates to their constituencies and their campaigns for a satellite radiotherapy centre, working with Mount Vernon to help serve their constituents.

The hon. Gentleman rightly paid tribute to the work of the staff at Mount Vernon—not just the work that they are and will be doing to help deal with coronavirus, but the work that they do day in, day out, for his constituents and many others. I join him in paying tribute to their work and dedication. He has made a typically courteous but powerful case for investment in that hospital and in the services that serve his constituents. If I may, I will say a little bit about cancer care more broadly before I turn to the specifics of what he has said regarding Mount Vernon.

Improving cancer treatment remains a priority for this Government, and survival rates are at a high. Since 2010, rates of survival from cancer have increased year on year, but we know there is more to do nationally. That is why the NHS long-term plan states how the Government will achieve their ambition of seeing three quarters of all cancers—

[Sir Oliver Heald (North East Hertfordshire) (Con)]

Will the Minister give way?

[Edward Argar]

I will.

[Sir Oliver Heald]

I am grateful to the Minister for giving way, and apologise to the sponsor of the debate, the hon. Member for Harrow West (Gareth Thomas). Does the Minister agree that both of the preferred options put forward for Mount Vernon include a satellite radiotherapy centre in our area of Hertfordshire? I hope that will form part of the Minister’s thinking, as it seemed to during our recent discussion.

[Edward Argar]

I am grateful to my right hon. and learned Friend for his intervention. He is right about the importance of satellite radiotherapy centres for his constituents and for large parts of Hertfordshire. He and others have made a powerful case and I have considerable sympathy for it. I find it compelling and I am looking at ways in which we might be able to deliver on that for his constituents and those of other colleagues in the area.

As I was saying, the long-term plan sets out how the Government will achieve their ambition for three quarters of all cancers to be detected at an early stage, and for 55,000 more people to survive cancer for five years in England each year from 2028. That plan includes providing new investment in state-of-the-art technology to transform the process of diagnosis and boost research and innovation. NHS England has committed more than £1.3 billion in funding over the next five years to deliver the long-term plan’s commitments on cancer.

I suspect that the hon. Member for Harrow West will say, “That is great, but what does it mean for Mount Vernon, my constituents and my constituency?” He has set out the background of what has gone on at Mount Vernon cancer centre, and of the review. He will know that the strategic review of that centre’s long-term future was launched by NHS England and NHS Improvement in May 2019. The review began with an independent clinical advisory group visiting the site and speaking with staff and patients. Its report advised that the current service model was not clinically sustainable, as the hon. Gentleman has said, and recommended that leadership of services from a specialist tertiary cancer provider would be key to future service development and sustainability, staff recruitment and retention, and enabling patient access to clinical trials. I am happy to provide him with more details in writing, if that is helpful. Indeed, if I am unable to answer all of his detailed questions in the course of today’s debate, I will write to him with detailed answers as soon as possible.

The hon. Gentleman asked specifically how the review would work, who was leading it, and who would be involved in it. It is being led by a programme board chaired by the NHS regional director of specialised commissioning and health and justice for the east of England. That board includes representatives from Healthwatch Hillingdon, Healthwatch Hertfordshire, London and the East of England Cancer Alliance, as well as local sustainability and transformation partnerships, clinical commissioning groups and a number of acute hospitals. They all sit on that board and are active participants. If it is helpful to the hon. Gentleman, rather than simply giving him the job titles, I can seek to furnish him with some names—those of the senior leadership, at least.

The hon. Gentleman said that the independent clinical advisory group made recommendations for short-term actions, including addressing urgent backlog maintenance of existing clinical facilities and the strengthening of acute oncology services. The current provider, East and North Hertfordshire NHS Trust, supported those recommendations. In January of this year, following evaluation of proposals from interested trusts, University College London Hospitals NHS Foundation Trust was selected as the preferred provider, subject to a period of due diligence. Depending on the outcome of that due diligence, the contract for running the site should transfer in April next year, with UCLH providing additional leadership support for that site over the next 14 months.

The hon. Gentleman mentioned backlog maintenance, which I have touched on. He is right to have done so, because, as he knows, backlog maintenance has increased in recent years. Although the trust received £33 million of central capital in 2019 to tackle critical infrastructure issues across the estate, monitored by NHSE&I, I know that it continues to be of concern. Although I do not wish to prejudge the future capital settlement and the capital spending review, the hon. Gentleman has powerfully made the point that the capital needs of his hospital and his trust should be considered in any future allocations of capital funding.

The hon. Gentleman raised the issue of access to brachytherapy services, which will be wrapped up in the review that is currently under way. Regarding the future location of services, I can assure him and hon. Members that options for the short-term and long-term future of the centre are being actively considered by the clinical advisory group and NHSE&I, with the local area and the hon. Gentleman’s hospital at the forefront of their thinking. When I write to him, I suspect he might wish me to be a little firmer in my reassurances. As far as I am able, subject to that review, I will endeavour to do so.

The hon. Gentleman also talked about staffing issues at the hospital. Existing clinical leads at Mount Vernon have increased their leadership duties at the hospital alongside their clinical responsibilities. Recruitment of a full-time clinical director will take place in conjunction with the new provider, once it is appointed. The hon. Gentleman mentioned the business case for appointing additional staff to the acute oncology service that has been developed and submitted to NHS England. My understanding is that the business case has been approved and recruitment has begun. I will take up with NHS England his request that he have sight of it and—ideally from his perspective, I think—that it be made publicly available. I do not know what the answer will be, but I will certainly ask that question, because it does not seem an unreasonable request.

Regarding whether the three linear accelerators due for replacement this year are going to be replaced, my latest understanding is that although East and North Hertfordshire NHS Trust has not yet agreed its full capital programme for the 2020-21 financial year, it has identified a requirement for capital funding, which the board will consider in that context. As soon as I hear the outcome of those decisions, I will write to the hon. Gentleman, who, as ever, makes his case politely but forcefully. More broadly, as he will be aware, NHS England has invested £130 million in the modernisation of radiotherapy across England, ensuring that older linear accelerators—that is, radiotherapy machines—used by hospitals are upgraded. We have made significant progress. I think the hon. Gentleman’s request acknowledges that, but he is essentially saying, “Yes, I have been given a promise, but please make sure that the delivery follows.” The decision on the trust’s investment priorities rightly sits with the board, and we will wait for that decision, but I will make sure that what the hon. Gentleman has said is communicated to the board. I suspect he will make sure of that as well, but I will ensure that the board is aware of his views.

The hon. Gentleman suggested quarterly updates to track progress against a basket of key indicators or asks in the context of the action plan. I hesitate to give a clear commitment until I have had the opportunity to talk to the trust and NHS England, but what I will say—I hope gives him an indication of my thinking—is that it sounds like an eminently practical and reasonable request to ensure that he, other interested parties and his constituents are kept informed about and engaged with a process that will, of course, be of concern to them but also of interest as well. It sounds reasonable—I am not aware of a factor that makes it unreasonable—and I will certainly press that point, because I think it is a sensible way forward.

In response to my right hon. and learned Friend the Member for North East Hertfordshire, I have touched on satellite radiotherapy centres. Alongside working with the Mount Vernon Cancer Centre, we are proactively looking at providing satellite radiotherapy centres for his constituents in the northern part of Hertfordshire and around Stevenage. It is too early to say exactly how we might do that, but I am determined to work proactively with colleagues to see if we can achieve it.

We are committed to the digitisation of paper records, which the hon. Member for Harrow West mentioned, to enable effective patient care and enhanced patient safety. The digital transformation plan, which will include the digitisation of patient care records, is under way for Mount Vernon’s main acute services and is expected to conclude in May 2020. I understand that the commitment to do that—to support and fund it—remains unchanged. If anything has changed, I will make sure that he is updated as appropriate.

There are a number of hon. Members present. I suspect they are not here to hear my or the hon. Gentleman’s eloquence, but possibly that of other hon. Members and, indeed, my right hon. Friend the Financial Secretary to the Treasury, who will take part in the debate that will start in a few minutes. Given the interest, however, I will see if it is appropriate to put in the Library a copy of my letter to the hon. Gentleman so that it is on the record.

If the hon. Gentleman thinks it would be useful, I am happy to meet him and to visit Mount Vernon with him to meet the staff, to hear the executive team’s thinking on what is going on, and to see it for myself. He raised a number of detailed and precise questions and important points. In the short time I have had, I have sought to reassure him and address a number of them, but I look forward to the opportunity to give him a more detailed answer in writing following the debate, and to visit him.

I reassure hon. Members that cancer, and improving cancer treatment and care, remains a key priority for the Government and the Department. We, along with NHSE&I and other arm’s length bodies, are working hard to ensure that the hon. Gentleman’s constituents and those of all hon. Members are provided with the best care.

Although cancer care and cancer services are the responsibility of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), given that a large amount of what the hon. Gentleman has talked about relates to performance and to capital and funding, which are in my portfolio, I will endeavour to maintain a personal direct interest in the issue, in partnership with my hon. Friend, to make sure that we both give it the attention it deserves and that he and his constituents have a right to expect.

Question put and agreed to.

NHS Funding Bill

Edward Argar Excerpts

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[Alex Cunningham]

I am very grateful, Madam Deputy Speaker.

Amendment 2 concerns spending on mental health services and the Secretary of State’s plans to achieve parity of esteem. Mental illness is often not viewed as a risk to human life, but it is exactly that. In 2018, according to the Samaritans, 6,507 deaths in the United Kingdom were registered as suicides—an increase of 10.9% on the previous year. That means that nearly 7,000 people did not believe that there was help, or another way out of what they were going through.

It can be hard for adults to talk about the feelings that come from being mentally unwell. The words are in their vocabulary, and it may be simple enough to string them together into a sentence, but it is incredibly difficult to say them out loud. I can only imagine how hard it must be for children to express how they are feeling when something is not right. Perhaps they do say the words that are in their heads, but they are not taken seriously. It is a scandal that there are suicidal children as young as 12 who are having to wait more than two weeks for a mental health bed. By not viewing mental illness as life-threatening, we are letting generations down.

There is much debate about what causes mental illness and what is the best form of treatment, but it can take several visits to a GP for people to be taken seriously about not being OK—although many GPs, of course, respond immediately. When parents are fighting for their unwell children to be taken seriously and receive the urgent care and treatment they need, it is horrifying for that to be delayed.

At this stage I should pay tribute to my former colleague Paul Williams, who was the Member of Parliament for Stockton South. He is a GP, and as a member of the Health Committee he spoke extensively about health matters, but locally he took on the child and adolescent mental health services. He knew, as I did because we shared the same area, that it was taking well over two years for young people to be seen by CAMHS. As a direct result of his work, that ended, up to a point, because some children who were due to be seen quickly were actually seen when they should have been. However, those long waits still exist in our area. As we heard earlier from the right hon. Member for South West Surrey (Jeremy Hunt), the former Health Secretary, sometimes children are just not taken seriously.

It is right for the Secretary of State to answer to the House on exactly what the Department is doing, because this is a matter of life and death. Not only the House but the country needs assurance and answers. The state of mental health services will only get worse unless we take action to deliver what is required. The additional money is more than welcome, but I see the amendment as the first, necessary step to provide the funds that are so desperately needed. Equally important is the ability to monitor what those funds are being spent on, and how.

There are many other services on which people depend heavily, including some that we may take for granted, such as smoking cessation services. There is widespread concern about existing funding for services to help people stop smoking. Nearly a third of local authorities no longer provide specialist “stop smoking” services. Stopping smoking is not just a matter of nicotine patches or vaping; people need behavioural support as well, particularly pregnant women, children, and people who are already unwell. One ward in my constituency has some of the highest incidences of smoking in families—whole families smoking—but we also have some of the highest incidences of smoking during pregnancy, and that is not good for the unborn child.

We cannot afford to lose the progress that we have made. We have made tremendous progress over the years, but we need local services that are effective and properly funded. The Government also need to return to funding the multi-media approach to smoking cessation services. I was particularly pleased to learn last week that research has shown that the ban on smoking in cars when a child is present has produced a 75% drop in children being exposed to cigarette smoke in a car. I led on that issue during my first few years as an MP, through private Members’ Bills and a ten-minute rule Bill. The Bills were unsuccessful, but I was delighted when the Government adopted my clause a few years later. We still need to be ambitious and bold about helping people to quit smoking, but services need the resources. I hope the Minister will commit to ensuring that such services are provided, whether for mental health or for smoking cessation, and that they are fully funded so that we can continue to make real progress in that area.

Finally, I shall turn to the matter of capital. The Minister has already heard me talk about the needs in my own constituency. In one ward—the same one I referred to earlier: the Town Centre ward in Stockton—men live 14 years less than those in the Prime Minister’s constituency. His constituency is getting a new hospital, but there are no plans yet for us. However, I have good news for the Minister, because the plan for our hospital is still sitting there. I met the chief executive of North Tees and Hartlepool NHS Foundation Trust just two weeks ago, and she told me that they were ready to dust off the plans again and see how we could provide a hospital. At the time we asked for £100 million from the Government as a guarantor in order to make the project work. The numbers do work, and the health inequalities need to be addressed.

We need to be able to attract the best doctors and clinicians that we can to address the problems in our society. The heart problems are higher on average than anywhere else in the country. We have smoking problems, as I have mentioned, with their related lung and respiratory problems. We also have the legacy of our heavy industry on Teesside, where men who have now retired are in extremely ill health but sometimes cannot get the support they need because we do not have the experts locally to provide it.

In my final sentences, I appeal to the Minister to meet me and the trust members so that we can sit down and talk about this project.

[The Minister for Health (Edward Argar)]

indicated assent.

[Alex Cunningham]

I am glad that he is nodding his head. Ten years ago, the Tory-Lib Dem Government cancelled the project, despite the fact that it was a priority for the country and for the national health service, so I hope that we can now have a meeting and actually start to motor on this. I am pleased to see the Minister smiling, and I hope that he can leave me smiling as well.

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[The Chairman of Ways and Means (Dame Eleanor Laing)]

The hon. Gentleman is absolutely right in regard to the procedure. If we finish this part of the procedure before 5.29 pm, there will be a very short time for the next part of the procedure. If this part of the consideration of the Bill goes to 5.29 pm, there will indeed be no time for the Report and consideration stage. That is correct, as is normal in any Bill, but I am grateful to him for pointing it out so clearly.

[Edward Argar]

In the 15 or so minutes remaining to me, I will endeavour to address all the points that have been raised. First, I thank Members on both sides of the House for their contributions and for the amendments that have been tabled. I particularly thank the shadow Minister for his typically reasonable tone in making his case forcefully. This Committee debate has been a wide-ranging and important one.

I will turn in detail to the amendments shortly, but, in the interests of time, I will swiftly address the requests for meetings or visits. The hon. Member for Stockton North (Alex Cunningham) was right when he said that he saw me nodding. I will be very happy to meet him, my hon. Friend the Member for Stockton South (Matt Vickers) and the chief executive of his hospital trust to discuss the issues that he raised. I will also be very happy to meet the hon. Member for Harrow West (Gareth Thomas) separately to discuss the issues that he raised.

[Pete Wishart]

rose—

[Edward Argar]

I will give way very briefly, because the hon. Gentleman is eating into his own time.

[Pete Wishart]

The Minister is in a very accommodating mood. Does he accept that this Bill has funding implications and consequences for health spending in Scotland?

[Edward Argar]

As has been very clear throughout the progression of this Bill so far, there are Barnett consequentials, which will be dealt with in the usual and appropriate manner.

I will turn to the detail of the amendments in a moment, but before I do, let me say that my hon. Friend the Member for Telford (Lucy Allan) addressed the debate in Westminster Hall just before the general election. In that, I said that if her constituents wanted a strong voice in this place, they should vote for her. I am very pleased that they did exactly that. Her speech shows exactly why.

This legislation is a simple Bill of two clauses. The substantive clause—clause 1—puts a double-lock duty on the Secretary of State and Her Majesty’s Treasury to ensure that NHS England will receive, as a minimum, £33.9 billion extra a year by 2024, enshrining in law the NHS England revenue budget rise in line with the Government’s manifesto commitment. The Bill has deliberately been drawn narrowly to focus on that core commitment.

--- Later in debate ---

[Theo Clarke (Stafford) (Con)]

This Bill is about funding, but buildings and services are key to delivering on our national health service priorities, so may I highlight the importance of the A&E at the County Hospital in Stafford and ensuring that we are supporting NHS services in my constituency?

[Edward Argar]

My hon. Friend is a sound and vocal champion for her constituents in Stafford. I am sure that she will continue to champion their cause, and I am happy to meet her to discuss the specific issue she raised.

I turn to amendment 3, in respect of capital-to-revenue transfers. Clause 1(2) ensures that the funding specified in the Bill can only be used for NHSE revenue spending, meaning that day-to-day spending for the NHS is protected. As we have highlighted in the House previously, the Government have made a range of capital commitments to the NHS, including the commitment to 40 new hospitals. Nevertheless, going to the point in the amendment itself, we have been clear that the transfers from capital revenue should have only been seen as short-term measures that were rightly being phased out, and we are doing so. My right hon. Friend the Member for South West Surrey (Jeremy Hunt), the former Secretary of State, did, however, set out why a degree of flexibility is required, and we would not believe that a blanket ban set in legislation was the right approach.

[Gareth Thomas]

Will the Minister give way?

[Edward Argar]

I will not, if the hon. Gentleman will forgive me, as I only have 10 minutes or so left.

There are sometimes very good and logical reasons why adjustments between capital and revenue are needed. As the former Secretary of State highlighted, in some cases, for perfectly good reasons a capital pot may not be spent fully within a year and there is an opportunity to achieve patient good from transferring it. While I take his point and believe it is right that we should continue to move away from such transfers, I would not wish to see that rigidly set in legislation.

Amendments 2 and 1, and new clauses 1, 2, 3 and 9, relate to mental health services both for children and adults, and accountability to Parliament and reporting mechanisms. We have rightly seen considerable interest in mental health in this debate, so I will seek to address both those points together. I begin by paying tribute to Paul Farmer of Mind, Sir Simon Wessely, Professor Louis Appleby, the Mental Health Foundation, Rethink Mental Illness, YoungMinds, the Royal College of Psychiatrists, and a host of other individuals and organisations up and down the country, for their fantastic work in making mental health such a feature in our debates and in the public consciousness. It is absolutely right that they have done so.

I pay tribute to the Under-Secretary of State, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), and her predecessor, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), who brought to the role of mental health Minister passion, dedication and a determination to make a difference. I should also reference some former Members of this House: Norman Lamb, who did so much in this area; the former Prime Minister, David Cameron; and of course my right hon. Friends the Members for South West Surrey and for Maidenhead (Mrs May), who ensured that it was front and centre of this Government’s commitment.

I want to be totally clear that the Government are fully committed to transforming mental health services. That is why we enshrined in law our commitment to achieving parity of esteem for mental health in the Health and Social Care Act 2012. As my right hon. Friend the Member for South West Surrey said, that is driving real change on the ground. We have also committed to reforming the Mental Health Act 1983 to provide modernised legislation. I would also highlight that at £12.5 billion in 2018-19, spending on mental health services is at its highest ever level.

We have made huge strides in moving towards parity, but there is still so much more to do. We are ensuring, through the NHS long-term plan, that spending on mental health services will increase by an additional £2.3 billion by 2023-24. This historic level of investment in mental health is ensuring that we can drive forward one of the most ambitious reform programmes in Europe. It will ensure that hundreds of thousands of additional people get access to the services they need in the lifetime of the plan. I flag that up because we can and will always strive to do more, and it is right that we are always pressed by this House to do so. While proposals for a ring fence in mental health spending are understandable, the approach that this Government have already set out, with long-term commitments to funding, is already driving the results we wish to see.

I now turn to new clause 9, tabled by my hon. Friend the Member for Newton Abbot (Anne Marie Morris). If I may, I will also address new clause 2 in this context because there is a degree of overlap. I welcome my hon. Friend’s new clause. Although I hope that, as she indicated, she will not press it to a vote—and I heard what the hon. Member for Twickenham (Munira Wilson) said in respect of hers—the sentiment behind it is a good one, particularly the focus on outcomes and outputs rather than simply inputs and the amount of money going in, and on adopting a holistic approach. I know that my hon. Friend the Member for Newton Abbot recently met the Secretary of State to discuss the matter, and I am happy to meet both her and the hon. Member for Twickenham. While we do not believe it is the right approach to set additional reporting mechanisms in legislation over and above the different reports that NHS England and the Secretary of State already make to Parliament, which offer opportunities for debate, we are happy to consider whether, within the existing reporting mechanisms, there is a way to better convey to the House and the public more widely the progress we are making against those targets.

The NHS long-term plan represents the largest expansion of mental health services in a generation, renewing our commitment to increase investment faster than the overall NHS budget in each of the next five years. Not only will spending on mental health services increase faster than the overall NHS budget as a proportion, but spending on CAMHS will increase at an even faster rate. The hon. Member for Twickenham was right to highlight the importance of CAMHS. In our surgeries, we have all had constituents come to see us who are deeply worried and concerned about the mental health and welfare of their children, be that in relation to eating disorders, which I focused on when I came to this place, or a range of other factors. We are committed to delivering the NHS long-term plan to transform children and young people’s mental health services, with an additional 345,000 children and young people being able to access those services.

While we are deeply sympathetic to the spirit behind the amendments on mental health spending, we do not believe that putting a ring fence into the Bill is the appropriate way forward, given the work already being done, the money already being spent and the outcomes already being delivered. We believe that the reporting requirements are already extensive and varied. They already give the public and Parliament the opportunity to scrutinise the work of the Department and NHS England. We are happy to look at ways in which those reports might be more accessible and include different metrics, but we believe it would be wrong to legislate on them at this point.

As I said on Second Reading, this is a simple Bill. It has two clauses, of which one is substantive. It has a single, simple aim: to enshrine the funding settlement behind the NHS long-term plan in law. It delivers the funding that the NHS said it needed and wanted, and it delivers on this Government’s pledge to do so within three months of the election. In the light of that, while the amendments are clearly well intentioned and we appreciate the spirit behind them, they are unnecessary additions to the Bill, and I urge their proposers not to press them to a vote. I appreciate that Members have indicated their intention to press some amendments to a vote, I urge them, in the short period remaining before Committee ends, to reflect a little longer on whether they might reconsider and not move their amendments to a vote.

--- Later in debate ---

[Madam Deputy Speaker]

The hon. Gentleman’s analysis is not wrong. The knife has fallen. The House voted some days ago to provide three hours, or four hours in total, for consideration of this Bill, and it is indeed the case that because those four hours have passed, there is no time for debate on consideration and Report—that is absolutely correct. There is also no time for debate on Third Reading.

As to whether the Government did not provide sufficient time, or Members of this House took up all the time in the early part of the proceedings, that is not a matter for me to judge; I have merely facilitated it. Members might have decided not to speak for very long at the beginning. If so, the hon. Gentleman and his colleagues would have had the opportunity to discuss the matters that they had tabled. I thank him for his further points.

Does the Minister intend to move a consent motion in the Legislative Grand Committee?

[Edward Argar]

indicated assent.

The House forthwith resolved itself into the Legislative Grand Committee (England) (Standing Order No. 83M(3)).

[Dame Eleanor Laing in the Chair]

Health and Social Care

Edward Argar Excerpts

Wednesday 29th January 2020 Ministerial Corrections

[Mr Perkins]

I do not know whether the Minister is aware, but we have a winter every year. We have had one for the past 71 years, and yet these are the worst A&E waiting times in history, and they are the culmination of the policies that his party has followed for the past nine years: the cuts in social care, the number of GPs driven out of practices, and this Government’s failure on prevention. All of that has led us to the worst A&E waiting times in history, and the Minister’s answer does not start to look at the failure that he has delivered.

[Edward Argar]

Well, as I pointed out to the hon. Gentleman—he may not have heard this—demand in A&E has significantly increased this winter. He asks about GPs. I am sure he fully supports our clear commitment to 50 million more GP appointments and 6,000 more GPs. I am sure he also welcomes, in his own constituency, the £19 million investment by this Government in 2017 in a new urgent treatment centre, which will serve his constituents and is due to start work this summer.

[Official Report, 28 January 2020, Vol. 670, c. 664.]

Letter of correction from the Minister for Health, the hon. Member for Charnwood (Edward Argar):

An error has been identified in the response I gave to the hon. Member for Chesterfield (Mr Perkins).

The correct response should have been:

[Edward Argar]

Well, as I pointed out to the hon. Gentleman—he may not have heard this—demand in A&E has significantly increased this winter. He asks about GPs. I am sure he fully supports our clear commitment to 50 million more GP appointments and 6,000 more GPs. I am sure he also welcomes, in his own constituency, the £19 million investment by this Government in 2017 in a new urgent treatment centre, which will serve his constituents and is due to start building works this summer.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 28th January 2020 Commons Chamber

[Mike Hill (Hartlepool) (Lab)]

9. What discussions he has had with the Hartlepool and Stockton-on-Tees clinical commissioning group on the future of services at the University Hospital of Hartlepool.

[The Minister for Health (Edward Argar)]

My right hon. Friend the Secretary of State has had no discussions with the CCG on the future of services at the University Hospital of Hartlepool.

[Mike Hill]

Hartlepool’s hospital is vital to our community, but its future very much depends on consultancy-led services. What reassurances can the Minister give me that consultancy-led services will be returned to that hospital?

[Edward Argar]

I am conscious that both the energetic Mayor Ben Houchen and the hon. Member have campaigned on working to reinstate accident and emergency and maternity services at Hartlepool’s hospital. Although there are currently no plans that I am aware of to change the model of services, and reconfiguration matters are for the CCG, I am happy to meet him and the Mayor to discuss the hospital if that is useful.

[Dehenna Davison (Bishop Auckland) (Con)]

rose—

[Dehenna Davison]

Thank you, Mr Speaker. As another north-east MP concerned about local healthcare, I asked the Prime Minister two weeks ago about retention of the stroke service at Bishop Auckland Hospital. Has the Minister made any progress on that point?

[Edward Argar]

My hon. Friend is already a doughty champion and spokesperson in this House for her constituents on health matters—indeed, she was just that in yesterday’s Second Reading debate on the NHS Funding Bill. I am pleased to inform her that my right hon. Friend the Secretary of State has already met the chief executive of the NHS and the regional NHS director responsible and discussed this matter with them.

--- Later in debate ---

[The Minister for Health (Edward Argar)]

Winter is the most challenging time of year for our NHS, when cold weather and an increase in flu cases place additional pressures on the service. As ever, the NHS staff have done an amazing job this winter, and the NHS has seen a significant increase in demand, with 1 million more patients attending A&E in 2019. The December figures, when compared with those in 2018, show a 6.5% increase on attendance at A&E.

[Mr Perkins]

I do not know whether the Minister is aware, but we have a winter every year. We have had one for the past 71 years, and yet these are the worst A&E waiting times in history, and they are the culmination of the policies that his party has followed for the past nine years: the cuts in social care, the number of GPs driven out of practices, and this Government’s failure on prevention. All of that has led us to the worst A&E waiting times in history, and the Minister’s answer does not start to look at the failure that he has delivered.

[Edward Argar]

Well, as I pointed out to the hon. Gentleman—he may not have heard this—demand in A&E has significantly increased this winter. He asks about GPs. I am sure he fully supports our clear commitment to 50 million more GP appointments and 6,000 more GPs. I am sure he also welcomes, in his own constituency, the £19 million investment by this Government in 2017 in a new urgent treatment centre, which will serve his constituents and is due to start work this summer.[Official Report, 29 January 2020, Vol. 670, c. 6MC.]

[Imran Hussain]

Between winter 2018 and winter 2019, the proportion of A&E attendances in Bradford that were seen within the four-hour target fell by seven percentage points, putting patients at risk and overstretching already pressured staff. In Health questions in October last year, I warned the Minister of these very real dangers, but he refused to meet me even to discuss the matter. Will he now answer the question as to why further funding was not made available to stop staff and patients at Bradford Royal Infirmary being put at risk?

[Edward Argar]

I remind the hon. Gentleman that Bradford treated more people in A&E this winter than in any previous one, and although he may have omitted to do so, I want to pay tribute to and thank the staff at Bradford for that work. The Conservative party is the party that is investing in our NHS, our A&Es and our staff, and the hon. Gentleman should welcome that.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I think it is time that we shook this Government out of their complacency. On their watch, the four-hour A&E waiting target has never been met, and performance is getting worse each month. It is no wonder they are putting so much effort into getting rid of it. We agree with the president of the Royal College of Emergency Medicine, who said:

“Rather than focus on ways around the target, we need to get back to the business of delivering on it.”

Does the Minister agree?

[Edward Argar]

First, 1.7 million more people are being seen within the four-hour target now than before 2010. I hope that the shadow Minister will acknowledge that that reflects the significant increase in demand due to the number of people going through the system. He talks about the review of standards. That is a clinically-led review, and I am sure he would want to let those clinicians lead it. We will see what it reports and will consider its recommendations when they come back to us. In the meantime, we are getting on with investing in our NHS, and improving services.

[Penny Mordaunt (Portsmouth North) (Con)]

T1. If he will make a statement on his departmental responsibilities.

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[Daniel Zeichner (Cambridge) (Lab)]

T3. The West Suffolk Hospital has been in the news for all the wrong reasons. I guess all Members try to keep their fingers on the pulse of their local hospitals, but does not the fact that West Suffolk constituents are represented by both the Secretary of State and the Under-Secretary of State for Health and Social Care, the hon. Member for Bury St Edmunds (Jo Churchill), show that something has gone fundamentally wrong in the scrutiny and oversight of our NHS? What has gone wrong, and what is the Minister going to do about it?

[The Minister for Health (Edward Argar)]

I would not draw that conclusion about my right hon. and hon. Friends. What I would say, though, is that I want all staff to feel that they can speak up and have the confidence that anything they raise will be taken seriously. That is why I requested on 17 January that NHS England and NHS Improvement commission a rapid and independent review into how the West Suffolk NHS Foundation Trust has handled this issue. I will be happy to update Members, including the hon. Gentleman, when that review reports.

[Holly Mumby-Croft (Scunthorpe) (Con)]

T2. Last week, due to ongoing workforce challenges, Northern Lincolnshire and Goole NHS Foundation Trust temporarily transferred all oncology services to Grimsby’s hospital. This is not acceptable to local patients. Will the Secretary of State join me on a visit to Scunthorpe General Hospital so that we can discuss this and other issues with local NHS staff?

[Edward Argar]

I appreciate the concerns raised by my hon. Friend about that matter. I understand that the changes, which have been made for patient safety reasons, are temporary, with a review to follow led by the Humber, Coast and Vale cancer alliance. As we monitor the results of the review closely—I will continue to take a close interest in this matter—either I or my right hon. Friend will be happy to take up her invitation for a visit.

[Ian Byrne (Liverpool, West Derby) (Lab)]

T8. In my constituency, year-on-year reductions in funding of both adult and young people’s mental healthcare mean that some of our most vulnerable citizens are falling through the net. Can the Government guarantee that adequate funding will be made available to tackle the mental health crisis now?

[Jack Brereton (Stoke-on-Trent South) (Con)]

T4. Labour’s private finance initiative contract means that Royal Stoke University Hospital is paying double the interest on its debt than if it had been funded directly from the Treasury—money that should be going to improve patient care. Will my hon. Friend agree to look at how these costs can be mitigated?

[Edward Argar]

I am grateful to my hon. Friend, who, along with my other hon. Friends who represent Stoke, has raised this issue in the past; they are right to highlight it. My hon. Friend is absolutely right that Labour’s PFI deal has left the trust burdened with debt. My Department’s PFI centre of best practice supports trusts in ensuring best value, and I will happily ask it to work with him. Yesterday I also committed to meet him and my other hon. Friends to discuss this matter.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

Throughout the election there were empty promises from the Conservatives, and one of those promises was to tackle the social care system—but there is still no Green Paper. There are dementia patients who are trapped in hospital due to an inadequate social care system, and yet this Government still do nothing. How many more families have to suffer before this Government act?

--- Later in debate ---

[Antony Higginbotham (Burnley) (Con)]

T6. My right hon. Friend will know that the A&E services at Burnley General Hospital were closed in 2007 by the then Labour Administration. Given our record investment in the NHS, and the pressures on the A&E, will he agree to meet me to talk through the future of the hospital and the services we can provide locally?

[Edward Argar]

My hon. Friend, like his colleagues, has already proved himself to be a doughty champion for his constituency. The urgent care centre at Burnley General Hospital will continue to play an important role in meeting urgent care needs locally, but he is right to highlight the broader importance of Burnley as part of the health ecosystem in his area. I would be delighted to meet him.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

There are real concerns in east London about the big delays in the breast cancer screening programme, meaning that many women are not getting their first screening until close to their 53rd birthday. Will the Minister meet me and other concerned east London MPs to ensure that we tackle that, to the benefit of our constituents?