Health and Social Care (Kettering)

Edward Argar Excerpts

Wednesday 23rd October 2019 Westminster Hall

[The Minister for Health (Edward Argar)]

I congratulate my hon. Friend the Member for Kettering (Mr Hollobone) on securing this debate on health and social care in Kettering. It is testament to his strong commitment to the issue on behalf of his constituents that we hold this debate today, around six weeks after he secured a debate on his local hospital. I had the privilege, as he mentioned in his speech, of visiting his local hospital a couple of weeks ago. His constituents can be in no doubt of his tenacity and persistence in this place on their behalf—something all too familiar to numerous Ministers—and they are lucky to have him as a strong local voice fighting their corner here in Westminster.

The local context for health and social care in Northamptonshire, and in Kettering specifically, was well set out by my hon. Friend. The area has seen considerable population growth. On the basis of projections, the wider area is set to see further significant growth in population in the coming years, with circa 35,000 new homes over the next 10 years, as he set out. That will in turn see additional demand for health and social care services. The presence of my right hon. Friend the Member for Rutland and Melton (Sir Alan Duncan) emphasises the fact that not only Kettering and Northamptonshire residents are served by the hospital, but so are many of his constituents in Rutland as well.

If we overlay on this the broader national picture of an ageing population—a positive we should be proud of as we are all living for longer, but one that brings with it the need for additional support and care for people to live independent, fulfilling lives for longer—we see a clear need for new integrated models of care, addressing the increase in demand in numerical terms; the greater number of older people requiring support; and the young families that the new development and housing will bring with them. Working towards greater integration of health and social care services in Northamptonshire is a critical part of the journey towards local government reorganisation in the county.

On the establishment of the two unitary councils, I know my right hon. Friend the Secretary of State for Housing, Communities and Local Government is working hard to ensure that legislation can be considered by the House as soon as practicable. I know that my hon. Friend the Member for Kettering has, in that context, raised the proposition, as he did today, of trialling or piloting a new integrated health and social care system in Northamptonshire. That proposal was also highlighted to me compellingly by members of the hospital team and trust during my recent visit, and I understand it has been discussed with the Health Secretary and the Secretary of State for Housing, Communities and Local Government. Following that discussion, local council and NHS stakeholders have held further discussions on an outline proposal around system design principles and governance, as a precursor to any possible formal integration.

I look forward to seeing the outcome of those discussions as swiftly as possible. However, although effective, seamless integration is vital to patients and, as my hon. Friend set out, to the overall health ecosystem in his county, I must turn to the heart of his speech and to another key element of the health and social care landscape in Kettering—Kettering General Hospital and the challenges that it faces, particularly around urgent and emergency care provision.

Following the Secretary of State’s announcement of the health infrastructure plan—HIP—which set out a clear plan for strategic investment in our NHS, ensuring that it has the capital investment that it needs to progress and improve for many decades, atop the £33.9 billion annual funding increase for the NHS in the long-term plan, I had the privilege of visiting Kettering General Hospital with my hon. Friend. I received a very warm welcome and had the opportunity to speak with the amazing team of staff, led by the chief executive, Simon, as well as with patients. Equally importantly, I was able to see for myself conditions that I may read about in briefing papers, or be briefed about by my hon. Friend, and see for myself the real need.

As he has today, my hon. Friend and the hospital team set out to me compellingly the challenge facing an emergency department that opened in 1994 for around 40,000 patients a year and that, last year, had more than 90,000 and is forecast to have more than 100,000 this year. It is one thing to be briefed on something; it is another to see the problem for myself, despite the amazing work, which I also saw, by all staff—day in, day out—to ensure patient safety and care. I pay tribute to those staff for playing a central role in the trust’s removal from special measures for quality reasons in May this year.

Despite that amazing work every day to ensure that patients get the care they need, this is a real challenge that needs a long-term resolution. The trust has proposed an urgent care hub—an earlier bid to the sustainability and transformation programme having been unsuccessful —and my hon. Friend is a key part of the trust’s overall larger plans to address that need. I pay tribute to my hon. Friend, and my hon. Friends the Members for Wellingborough (Mr Bone) and for Corby (Tom Pursglove), for their commitment to campaigning for the hospital, and to all Northamptonshire MPs. I recognise my hon. Friend the Member for Northampton South (Andrew Lewer) in that context.

My hon. Friends have not given up. They have been clear that the proposal represents an effective long-term way to solve existing issues and to meet future need. They have pressed their case with eloquence and charm, but with determination. That is why I was delighted that the major scheme for Kettering General Hospital was selected, as part of the HIP2 announcement, to receive seed funding to develop its plan and investment case to deliver its proposals for a rebuild of the hospital. The trust and my hon. Friend the Member for Kettering fully welcomed that, but made a strong case that aspects of those plans were already well advanced and ready to proceed, and that all the preparatory work had been done on those aspects. When I visited, not only was that argument made compellingly to me, but the need to proceed swiftly with respect to urgent and emergency care provision was clear.

That is why I can go further: I am delighted to inform the House that, in the next capital review, Kettering General NHS Foundation Trust’s £46 million project for a new urgent care hub has been approved by Her Majesty’s Government. My officials and NHS England will be in touch with the trust to discuss further details, in order to ensure that funds are released and that work starts on the project as swiftly as possible. I am conscious of the urgency that my hon. Friend the Member for Kettering highlighted. I know that that news will be welcomed by all my hon. Friends in the Chamber and their constituents. It is a reflection not only of our commitment to delivering on the announcement that we made at the start of the month, but of the work of the trust and that of my hon. Friend and other hon. Friends in their campaign for the investment.

That investment is only one part of the health and social care landscape in Kettering and Northamptonshire, but it is a vital part, and further demonstrates our commitment to the NHS—to our NHS. The investment will, I believe, make a huge difference to the people of Kettering and beyond; having visited and heard my hon. Friend’s arguments, and those of the clinical staff, it is a pleasure to announce it in the House today. I conclude by paying tribute to my hon. Friend not only for securing the debate but for his central role in securing this investment for his constituents and his community.

Question put and agreed to.

Health Infrastructure Plan

Edward Argar Excerpts

Monday 30th September 2019 Commons Chamber

[The Minister for Health (Edward Argar)]

With your permission, Mr Speaker, I wish to make a statement on the health infrastructure plan announcement.

Our health is the nation’s biggest asset, and the NHS is the Government’s top domestic priority. We are backing our commitment to our NHS with record levels of funding. As part of this, today I am pleased to update the House on the biggest, boldest hospital-building programme in a generation. Through our new health infra- structure plan we are supporting more than 40 hospital- building projects across the country, with six getting the go-ahead immediately—HIP 1. That includes £2.7 billion of investment that gives those six hospitals the funding to press ahead with their plans now, alongside last Friday’s investment in technology to ensure that no CT scanner is more than 10 years old.

The six hospital trusts are Barts Health NHS Trust, Epsom and St Helier University Hospitals NHS Trust, West Hertfordshire Hospitals NHS Trust, Princess Alexandra Hospital NHS Trust, University Hospitals of Leicester NHS Trust and Leeds Teaching Hospitals NHS Trust. Under HIP 2, a further 21 schemes have been given the go-ahead with £100 million seed funding to go to the next stage of developing their plans, subject to business case development. This £2.8 billion capital investment follows on from August’s £850 million for new upgrades, which included, for example, a £72.3 million investment in the Greater Manchester Mental Health NHS Foundation Trust. All of this, of course, comes on top of the £33.9 billion cash increase in funding for the day-to-day running of our NHS.

This announcement represents another part of our long-term, strategic investment in the future of the NHS, properly funded and properly planned, to ensure our world-class healthcare staff have world-class facilities to deliver cutting-edge care and to meet the changing needs and rising demand that the NHS will face in the 2020s and beyond. Capital spend on NHS infrastructure is fundamental to high-quality patient care, from well-designed facilities that promote quicker recovery to staff being better able to care for patients using the equipment and technology that they need. It is also essential to the long-term sustainability of the NHS’s ability to meet healthcare need, unlocking efficiencies and helping to manage demand. The investment we are making in our buildings, our technology and our equipment is vitally important in itself, but it is most important because it gives our fantastic NHS staff the tools they need to do the job.

Our staff are at the heart of the NHS, which is why we have invested in the NHS’s workforce. Our interim NHS people plan has set out immediate actions that we will take to reduce vacancies and secure the staff we need for the future—including addressing pensions tax concerns, increasing university clinical placements by over 5,000 more and bolstering the workforce. But it is only right that we invest in the buildings they work in, and in which they provide first-class care for patients. For too long, Governments of all parties have taken a piecemeal and unco-ordinated approach to NHS buildings and infrastructure.

The health infrastructure plan will change that. In the future, every new hospital built or upgraded must deliver our priorities for the NHS, and happen on time and in a planned way, not the current stop-start that we see.

But NHS infrastructure is more than just large hospitals. Pivotal to the delivery of more personalised, preventive healthcare in the NHS long-term plan is more community and primary care away from hospitals. That requires investment in the right buildings and facilities across the board, where staff can utilise technology such as genomics and artificial intelligence to deliver better care and empower people better to manage their own health.

This is only the beginning. The full shape of the investment programme, including wider NHS infrastructure, digital infrastructure, and wider capital investments that support the economy and health system will be confirmed when the Department receives a multi-year capital settlement at the next capital review.

This is a long-term, strategic investment in the future of our NHS, properly funded and properly planned, to ensure that our world-class healthcare staff have world-class facilities to deliver care and meet changing needs and rising demand, so that the NHS can face the 2020s and beyond with confidence.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I welcome the Minister to his place and thank him for advance sight of his statement. I know him to be a decent man—we have worked together on many joint Leicester and Leicestershire campaigns—and I consider him a friend, but I am afraid that we have to hold him and his Government robustly to account. What was announced yesterday was not in fact 40 guaranteed new hospitals but six hospital reconfigurations. It was also not the biggest hospital rebuilding programme in history, because that happened under the last Labour Government.

Of course, I welcome investment in Leicester Royal Infirmary—it is a big investment and to have won it shows what an effective Member of Parliament I am—but will the Minister be clear that that also means a downgrade of Leicester General Hospital, with services closing, including maternity services, and a loss of beds? Will he also tell us what happened with the Epsom and St Helier reconfiguration? Will he confirm that that means moving from two acute services to one in a part of London where accident and emergency pressures are increasing? Will he tell us today whether, across these reconfigurations, the end result will be more beds or fewer?

We know that the NHS is facing a repair bill of £6 billion after years of capital cuts under this Conservative Government, but the Government have so far refused to publish the capital allowances for between next year and 2025. Will the Minister guarantee that the £2.7 billion allocated will be additional to the capital baseline, and will he undertake to publish the NHS departmental expenditure limits on capital spending so that we can be reassured, rather than our assuming that this is all smoke and mirrors?

The Minister has also invited 21 other trusts to make use of a £100 million fund to prepare plans for future upgrades, yet he has just admitted that that will be subject to “business case review”. Is not the truth that the Minister and the Secretary of State cannot give any cast-iron guarantee that each and every one of these hospitals will be upgraded between 2025 and 2030, because not a penny piece of extra investment has been allocated to the programme for 2025 to 2030?

Finally, how were the 21 trusts chosen? In our mental health hospitals, 1,000 patients are forced to stay in quite dire old-style dormitory wards—the Minister might have seen the ones at the Leicestershire Partnership NHS Trust, for example—yet not a single mental health trust is on the list of 21 produced yesterday. Does that not show yet again that this Government neglect mental health services and some of the most vulnerable patients in the land?

What is on this list, Mr Speaker? I will tell you. We have: Hastings and Eastbourne—marginal constituencies; Winchester—a marginal constituency; Plymouth—a marginal constituency; Reading—a marginal constituency; Truro—a marginal constituency; Torbay—a marginal constituency; Barrow—a marginal constituency; and Uxbridge—a marginal constituency. What a spooky coincidence it is that all these marginal constituencies are on the list. This is not a serious plan. It is a wing and a prayer ahead of a general election. The Prime Minister over-spins, under-delivers and is not straight with people—the truth is that you cannot trust the Tories with the NHS.

[Edward Argar]

I will at least start by expressing gratitude to the hon. Gentleman for his kind words at the beginning of his remarks. As he says, we work closely together in our city and county, although I suspect that that spirit of co-operation might not extend across these Dispatch Boxes. None the less, it is a pleasure to stand opposite him. Although I would not agree with his characterisation of where the money has gone, is he, on the basis of that characterisation, suggesting that his own seat is a marginal constituency?

I find it extraordinary that the shadow Secretary of State takes opposition to a new level by opposing investment in our NHS, trying to cavil and challenge it. He will forgive me if I do not take his specific questions in the same order as he asked them, but I will run through as many of them as I can recall or as I noted down.

On mental health, I have to say that I find it very difficult to take lessons from the hon. Gentleman when this Government have invested huge additional sums in mental health care. As I mentioned in my opening remarks, we have allocated capital for Greater Manchester Mental Health NHS Foundation Trust—the announcement was made earlier this summer—and for Mersey Care NHS Foundation Trust, so I think the hon. Gentleman is perhaps being a little unfair in suggesting there is no investment in mental health from this Government.

This is an ambitious programme, but unlike the last Labour Government, we will not leave hospitals saddled with masses of private finance initiative debt. That programme was massively expanded under the Labour Government he served as a special adviser. Perhaps he should welcome this Government’s approach, which is to give hospitals the funding they need to deliver without saddling them with debt.

We have made it clear that the hospitals named in HIP 1 have the funding to go ahead, including the hospitals that serve his constituency and mine. I am a little surprised to hear the hon. Gentleman challenge the notion that anyone bidding for huge sums of public money should have to go through a business case. Surely when we are spending public money, it is reasonable of us to make sure it delivers value for money and better outcomes for patients. I know the Labour party does not pay much attention to value for money, but my party and this Government do. We are focused on patient outcomes and delivering investment in our NHS. We can say proudly that, with this raft of announcements, the extra £33 billion and the announcements made already, we truly are the party of the NHS.

[Sarah Newton (Truro and Falmouth) (Con)]

I very much welcome the allocation of £450 million to Royal Cornwall Hospitals NHS Trust. We are keen to work with the Department. Local NHS leaders are eager to work on producing a good business plan that meets the needs of patients and staff in Cornwall. When will the seed funding enabling them to develop those plans be available? If all goes as well, as I am sure it will, we will be able to start building those new facilities in 2025.

[Edward Argar]

I know that my hon. Friend’s local hospital trust and her constituents have no greater champion in this place than her. She is right to highlight the allocation to Royal Cornwall Hospitals NHS Trust. The seed funding was announced yesterday and is there now, so we hope that the trust will get to work using that money to develop plans to improve services at local hospitals.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I am grateful to the Minister for advance sight of his statement.

UK Government decisions on pension costs and funding already result in a shortfall of £48.4 million for the NHS in Scotland, which comes on top of the UK Government making wider budget reductions in health funding for Scotland of £42 million compared with their previously claimed level of consequentials. Scotland now faces a shortfall of £90 million for its health services as a result of UK Government decisions. Now that the UK Government have apparently opened the spending taps, will they pay back the moneys due to Scotland, or will we continue to be short-changed? When will the full Barnett consequentials of this new investment be published?

In total, the Tories’ decade of austerity has cumulatively cut the Scottish block grant by more than £12 billion in real terms. With the economy already faltering, the Chancellor’s predecessor warned that a destructive no-deal Brexit could inflict a £90 billion hit on the Exchequer and suggested that no new money would be available. How then can the Minister guarantee that this money will come to the NHS?

[Edward Argar]

I will not stray into the politics of the NHS in Scotland. The hon. Gentleman asks specifically about Barnett consequentials. I can confirm that they will apply, and if it would be helpful I will write to him with details.

[Sir Paul Beresford (Mole Valley) (Con)]

As my hon. Friend might guess, I am delighted by the announcement about Epsom and St Helier University Hospitals NHS Trust, which will find favour with hon. Members on both sides of the House. We have been talking about it for a long time, and this is the first genuine movement.

I have a tiny, slightly off-the-wall additional request. As my hon. Friend is aware, I have a declared interest in dentistry, which means that every time the word “health” comes up, I get prodded in the back by my colleagues. In most western nations, 60%, 70% or 80% of the public water supply is fluoridated. It is a proven caries prevention. Would he include in his plans the infrastructure to greatly expand the fluoridation of our water supply? It would bring benefits in terms of prevention and, in due course, cost.

[Edward Argar]

As he said, my hon. Friend showed some dexterity in asking that question, but I am happy to reassure him. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), is looking at this matter, and I am sure that she will be happy to discuss it with him further.

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

I would always welcome more money for our NHS, but as always the devil is in the detail. The “Shaping a healthier future” programme proposed the closure of four A&Es in north-west London, at a cost of £76 million, but just six months ago the Health Secretary stood at that Dispatch Box to declare the scheme scrapped. The author of that scheme, Daniel Elkeles, is now the chief executive at St Helier, where he is plotting to use these latest funds to reduce two A&Es to one—away from those most in need—which would place intolerable pressure on nearby St George’s. Does the Minister not see a pattern here?

[Edward Argar]

I always think it a little unfair in this House to name or attack individuals where they do not have the ability to answer back. The Government have made it clear that the announcement today and yesterday is about putting more money into our NHS, which will improve services for the hon. Lady’s constituents and for those across the capital and indeed the country.

[Andrew Percy (Brigg and Goole) (Con)]

Northern Lincolnshire and Goole NHS Foundation Trust faces some particular challenges in delivering across two district hospitals and the community hospital to a relatively small population but one that has a big and complicated geography. Goole Hospital, for example, is still operating on a coal-fired boiler. I will write to the Minister following this, of course, but can he look at the particular requests we have with regard to the backlog of works at the trust?

[Edward Argar]

My hon. Friend is quite right to highlight that in certain parts of the country, including his constituency, geography can present a challenge for the delivery of services. I look forward to his letter and will be very happy to respond and to look into the matter with him.

[Ms Karen Buck (Westminster North) (Lab)]

With a £1.3 billion maintenance backlog, Imperial College Healthcare NHS Trust, which includes St Mary’s, which serves my constituency, faces the largest challenges in the country and has been waiting for years for the approval to go ahead with the St Mary’s development. In recent years, we have seen the Grafton ward closed because of significant structural concerns, with the loss of 32 beds; a ceiling collapse in Thistlewayte ward; the Paterson centre flooded; and floods, electrical issues and drainage issues commonplace across the whole estate. Can the Minister guarantee me that today’s announcement will mean no repeat of these sorts of problems in St Mary’s in the coming months, and how does he feel it will be better served by the £200 million deficit the trust has and the £120 million deficit in our local clinical commissioning groups?

[Edward Argar]

As the hon. Lady will recall, many years ago, when I had more hair and it was not so grey, I sat on Westminster City Council, and St Mary’s was an issue back then that we discussed on various occasions. She is right to highlight it, but I would have expected her to very much welcome the inclusion of Imperial and St Mary’s in the announcement of seed funding to develop their proposals and get the investment they need.

[Steve Brine (Winchester) (Ind)]

We are rather pleased in Winchester at today’s announcement and with our place within it. My constituents do not care about the political knockabout in this House. They love their hospital and are really pleased that it is going to be invested in. Will the Minister confirm how the seed funding process will work in the immediate term—we are in wave 2, but we are keen to get cracking so that we are ready—and will he also confirm that this is a huge vote of confidence in the Royal Hampshire County Hospital in Winchester, not just from the Government, but from the NHS as well?

[Edward Argar]

I know that, since my hon. Friend was first elected to this House, he has made health and the NHS his No. 1 priority. He served with distinction as a Minister in the Department and continues to champion his constituents’ interests in this respect. On the seed funding, we have made the announcement and are keen to get the money to those trusts as swiftly as possible so they can work with us to develop their plans. I agree entirely that its inclusion in this list is a vote of confidence from us and the NHS in the work his local hospital is doing.

[Grahame Morris (Easington) (Lab)]

I thank the Minister for his statement. He said that the Government would focus on outcomes, and he mentioned £200 million for new CT scanners for diagnosis, but The Times recently published the details of answers to freedom of information requests indicating that half of NHS trusts are treating cancer patients with out-of-date radiotherapy machines. The UK will remain at the bottom of the cancer survival league until we dramatically improve our radiotherapy services, so what steps is he taking to implement the “Manifesto For Radiotherapy”, invest in modern radiotherapy equipment and train personnel in IT networks, to provide modern radiotherapy services to cancer patients in every region of the UK, not just those in London and the south-east?

--- Later in debate ---

[Edward Argar]

I am grateful to the hon. Gentleman for that question and for the tone in which he asks it; it is an extremely important point and he makes it well. The investment in CT scanners and X-ray machines is an important start. It means that none of them will be over 10 years old, which is hugely important. He is absolutely right to talk about treatment, the workforce and the many parts of the system that provide effective cancer care. Although it is a specialist hospital, I recently visited the Royal Marsden Hospital in London to see the amazing research and work being done there. He is absolutely right that we must continue to promote that specialism and expertise right across the country to ensure that everyone gets the diagnosis, treatment and cancer care that they deserve. I would be happy to meet him subsequently to discuss the manifesto he highlighted.

[Derek Thomas (St Ives) (Con)]

I welcome this fantastic announcement. Our fantastic NHS staff are expected to deliver modern NHS services in buildings that were designed for a completely different era. Therefore, when considering the proposals that will come forward from Cornwall, will he pay particular attention to those that involve modern technology, so that people do not have to travel to the centre to receive diagnosis and treatment?

[Edward Argar]

My hon. Friend makes a good point. Local NHS trusts will be developing their plans and proposals on how they wish to see services modernised, but he is absolutely right and I am sure that they will have heard him, just as I have.

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

In 2003, the Labour Government opened Hull’s women and children’s hospital, which is where I had the “pleasure” of giving birth to my two children. However, the main Hull Royal Infirmary site is a 50-year-old tower block that is in need of serious investment, so it is a shame that the Government have not even attempted to match the previous Labour Government’s NHS investment in Hull. Can the Minister at least explain how he will fund the existing maintenance backlog?

[Edward Argar]

The hon. Lady makes a good point. This Government will invest in our NHS without leaving it saddled with private finance initiative debt for many decades to come. However, she is absolutely right to highlight the need to manage a backlog of works, because many of the buildings are old and not entirely fit for purpose. This announcement represents a huge step forward in that, alongside the work that has already been set in train through the Naylor review of the management of NHS capital and property maintenance. I believe that we are making significant strides forward in that. If she wished to write to me about the specific issues with her hospital trust, I would be happy to respond to her on those as well.

[Robert Halfon (Harlow) (Con)]

I, alongside my wonderful right hon. Friend the Member for Epping Forest (Dame Eleanor Laing) and my hon. Friend the Member for Hertford and Stortford (Mr Prisk), have been campaigning hard for a new hospital in Harlow, and we are delighted by the Minister’s announcement that we will now be getting it. Will he send us the full details about the process? We are delighted that we are in the first wave of six. I ask him not only to visit the hospital, but to pay special tribute to the incredible domestic and support staff, the nurses, doctors and consultants, and the management team, led by the chief executive Lance McCarthy, because for years they have done an incredible job, against the odds, in a building that was not fit for purpose. Will he pay tribute to those wonderful NHS staff?

[Edward Argar]

I am grateful to my right hon. Friend, who is right to highlight the work for his local hospital by our hon. Friend the Member for Hertford and Stortford (Mr Prisk) and by the right hon. Member for Epping Forest (Dame Eleanor Laing) who, given the nature of her office, may not speak but works incredibly hard for her constituents on this. My right hon. Friend the Member for Harlow (Robert Halfon) has a strong track record of campaigning successfully on a range of issues, so I suppose he will be pleased that yet again he has secured a victory for his constituents and his area. I join him in paying tribute to Lance McCarthy and the entire team at the hospital and the trust.

Every day, our NHS staff go above and beyond everyone’s expectations in whatever buildings, to make sure that they deliver first-class care for all our constituents and, indeed, for us all. I will happily write to my right hon. Friend setting out the process in more detail. I believe that my predecessor in this role was due to visit on the day on which he was reshuffled, so I very much look forward to taking up that invitation if it is extended and coming to see my right hon. Friend.

[Stephen Pound (Ealing North) (Lab)]

It is said in the House that the vote follows the voice. On NHS infrastructure, it seems that the cash follows the camera. On that basis, may I ask the hon. Gentleman to pop round to Ealing Hospital, where he will be welcome? In his statement, he referred to staffing as well as infrastructure, so is he prepared to be asked about the current situation on nursing bursaries? Would he care to share his thoughts with the House?

[Edward Argar]

I am grateful to the hon. Gentleman for his question, asked in his inimitable style.

[Stephen Pound]

It wasn’t that bad, was it?

[Edward Argar]

It was one of his better ones. I will happily take up the hon. Gentleman’s invitation to visit his local hospital, which, as I recall, he told me was opened by Lord Patrick Jenkin. I am always happy to visit hospitals with colleagues, and when I do so I am always happy to talk to any staff members who want to talk to me about anything that is of concern to them. The hon. Gentleman is absolutely right to highlight the importance of adequate supplies of nurses for our NHS, both in the recruitment and training of new nurses. We also need to focus to returnees, whatever the reason they left the profession, and tempt them back. He is absolutely right, and I look forward to seeing him in his hospital.

[Peter Heaton-Jones (North Devon) (Con)]

I thank the Minister and the Health Secretary for the announcement that North Devon is one of the areas that will benefit from investment. I thank the Minister and his predecessors for listening to all the lobbying and campaigning, which proves the truth, Mr Speaker, of your oft-repeated mantra that persistence pays. Will he accept an invitation to come and visit North Devon with me, to work with the trust to get these plans going, particularly in a place such as North Devon, to ensure that we can deliver these services sustainably, including to areas that are more rural and isolated?

[Edward Argar]

My hon. Friend is right that persistence does pay off, and it certainly has done so in his case on behalf of his constituents. He is right to highlight the importance of the sustainability of services, which is what we are seeking to do with the investment, and also ensuring that services are designed to reflect the geography and needs of the local population, to ensure that they have access to the healthcare that they need when they need it. He kindly invited me to visit. I suspect that it is a little easier to visit Ealing than Devon, but I shall endeavour to do so.

[Stephen Pound]

I asked first.

[Mike Kane (Wythenshawe and Sale East) (Lab)]

As a Mancunian MP, I am absolutely sickened to see Members on the Government Benches today. If you will forgive the personal pronoun, you should be in Manchester spending your hard-earned wages on our economy. [Interruption.] I was just trying to take the toxicity out of the place.

The NHS is a devolved matter in Greater Manchester, but NHS financial technicalities are holding back the redevelopment of the wonderful Wythenshawe Hospital in my constituency. Will the Minister meet me to discuss those technicalities?

[Edward Argar]

If it is any reassurance to the hon. Gentleman, I can say that I was enjoying Manchester yesterday and this morning, and then came down here to enjoy being at the Dispatch Box. Let me also say that if he wanted to see fewer of us here and rather more in Manchester, perhaps he should have voted in favour of a small recess to allow us to go and support the economy of his city. As for his question about the hospital trust, of course I should be very happy to meet him.

[Victoria Prentis (Banbury) (Con)]

We had some bad news in Banbury last week about our obstetric unit, but partly as a consequence, two positive steps have been taken. I have met the Secretary of State twice in the past week, and I have managed to get the clinical commissioning group and the head of the trust on the same page, and we were able to apply for some seed funding. Can the Minister assure me that he will look on that application favourably and that we will make Horton General Hospital fit for the future?

[Edward Argar]

I know the Horton well from my time as the parliamentary candidate for Oxford East, which I fought in 2010 and which, sadly, fought back. I also know of the work that my hon. Friend has done since before her time in the House in campaigning in the hospital’s interests. I will certainly look carefully at any application that is made, and I will judge it swiftly and fairly, as will the Secretary of State.

[Wes Streeting (Ilford North) (Lab)]

I warmly welcome the investment in Whipps Cross University Hospital, which is one of the six projects that have actually been committed to, as opposed to the 40-odd that have been promised. However, as the Prime Minister found during his recent visit to the hospital, when he met my constituent Omar Salem, all is not well in respect of the consistency of the care provided there—not because of a lack of dedication on the part of the staff, but because the hospital and, indeed, the wider Barts Health NHS Trust do not receive the funding that they need to cater for such a large population across the whole of east London. I welcome the investment in the fabric of the hospital, but what will the Minister do to ensure that my constituents receive a consistently excellent quality of care when they visit the hospital?

[Edward Argar]

I am grateful to the hon. Gentleman both for his question and for the reasonable tone in which he pitched it. [Interruption.] Indeed, he is always reasonable. As he knows, the capital investment will allow for investment in a new hospital, providing a range of services across emergency, maternity and specific out-patient and other diagnostic services. As for consistency of care and the experience of patients, the hon. Gentleman is absolutely right to pay tribute to the fantastic work done day in, day out by the NHS workforce, and that is why we have seen that workforce grow under this Government. Equally, however, when I visit hospitals, as I have done since I was appointed, I observe that the infrastructure and the buildings in which they operate can play a huge part in delivering not only consistency of care, but speed of care and speed of access. That capital investment in the hon. Gentleman’s local hospital will play a huge part in giving its excellent staff the tools with which to do their job and the environment in which to do it, and he will see that delivering better and more consistent care to patients.

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

During the summer, we welcomed the £30.6 million investment in a new urgent care centre at Stepping Hill Hospital. Does the Minister agree, however, that support will be needed for infrastructure, particularly for adequate car parking? That is a big issue for local residents, who regularly experience problems parking.

[Edward Argar]

My hon. Friend is absolutely right. Capital improvements in hospitals are hugely important, but it is also important for them to be set within the broader context of car parking and other facilities to ensure that those hospitals can run smoothly.

[Sir Vince Cable (Twickenham) (LD)]

Now that the Government are no longer using the private finance initiative, what are the terms and conditions for Treasury funding of capital investment in hospitals? Is this all grant, or is it a new kind of loan?

[Edward Argar]

The right hon. Gentleman will know from his time in government that the approvals process conducted by the Treasury and, indeed, the NHS is not always the simplest. We are looking into what we can do to ensure that it is better streamlined, while also delivering value for money for taxpayers and the assurance that is required. However, it is important that this money—while not tied to the same conditions as the ruinous PFI deals entered into by the previous Labour Government—does deliver value, and we know that it is delivering on outcomes for patients.

[Mr Mark Prisk (Hertford and Stortford) (Con)]

I thank the Minister for the decision, principally in listening to the outstanding campaign led by my right hon. Friend the Member for Harlow (Robert Halfon), which will benefit east Herts, Harlow and, indeed, the Epping Forest area. May I also say that the Minister need not be defensive, because we have not forgotten that when Labour was in government, it chose not to build a new hospital in our area but to scrap those proposals? We need take no lessons from the Opposition.

[Edward Argar]

I am pleased that two of the trio who have fought so hard for my hon. Friend’s local hospitals and services have had the opportunity to contribute. He is absolutely right to say that while the Labour party talks the talk, when we look at its track record in government, we see that all too often it absolutely failed to deliver by scrapping services or saddling trusts with debt.

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

The finances at King’s College Hospital were destabilised in 2011, when the Lib Dem-Tory coalition forced King’s to take on two additional hospitals following the failure of another hospital trust. King’s is now struggling with the greatest financial challenge of any hospital trust in the UK. It is desperately in need of capital investment to enable it to meet local needs. Will the Minister explain to this House and, more importantly, to the hard-working staff at King’s—whose life-saving and life-enhancing work every single day is so important in our area and across London, where their work was critical in responding to the Grenfell Tower tragedy and to the Westminster bridge and London bridge terror attacks—why there is not a single penny for King’s College Hospital in today’s announcement?

[Edward Argar]

While I recognise and pay tribute to the hon. Lady for her championing, as one would expect, of her constituents and local hospital, I am sure she will none the less welcome this Government’s massive investment in our NHS. I hear what she says about her own local hospital, and she is right to highlight the work done by the staff, who do amazing work day in, day out, particularly in the aftermath of some incredibly challenging disasters. I would be very happy to meet and talk to her in more detail about the finances of her hospital and trust since 2011, if she feels that would be useful.

[Stephen Hammond (Wimbledon) (Ind)]

I welcome my hon. Friend to his role and wish him every success. I also welcome this Government’s continuing investment in the NHS, particularly that in the Epsom and St Helier University Hospitals NHS Trust. Does he agree that it will provide high-quality A&E services for my residents, maintain key services at the St Helier site and confound those naysayers who said that this Government were going to shut that hospital?

--- Later in debate ---

[Edward Argar]

My hon. Friend was a distinguished predecessor of mine in this post. He is very much missed by the Department and, I am sure, by all those working in the NHS who came into contact with him. He rightly highlights the positive news in this announcement, including for his hospital trust. This money will allow it to invest and for the hospitals to continue providing first-class services to his constituents.

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

The £100 million seed funding needs to be put in context, which for Oldham is a £95 million capital requirement just for basic maintenance and upgrading, so it is not really a significant investment at all. More importantly, I am here to call and collect. Two years ago, the Government promised £80 million for Greater Manchester as part of the Healthier Together proposals, but they still have not written the cheque. So, fewer announcements, more cash, please.

[Edward Argar]

The hon. Gentleman makes his point forcefully but courteously. I will take away what he said and I will write to him.

[Mrs Maria Miller (Basingstoke) (Con)]

May I welcome my hon. Friend’s announcement that the Government are backing Basingstoke’s plan for a new hospital to serve not just north Hampshire but across mid-Hampshire? It has the support of our local council and local residents. However, the 1970s buildings in which my incredible doctors and nurses and chief executive Alex Whitfield work are already creaking at the seams and are very expensive to maintain. What can my hon. Friend do to support the hospital’s bid and to ensure that a new hospital is in place as swiftly as possible, so that the money is not patching up the old but building the new?

[Edward Argar]

My right hon. Friend makes an important point. This money will be hugely important to doing exactly what she says: investing in our NHS buildings for the long term, so reducing the reliance on expensive capital repairs.

With this plan, we are also looking to deliver a step change in how we deal with capital in the NHS, which is also hugely important. Instead of stop-start investment, we are looking for a rolling programme of investment to make sure we get those facilities up to standard in order to reduce the day-to-day spend on repairs. I will happily talk to my right hon. Friend about what we can do to ensure that we go through due process as swiftly as possible so that her hospital trust can get on with it.

[Karin Smyth (Bristol South) (Lab)]

I worked on many business cases for capital projects during my long NHS career. These projects are important to local people, but local people across the country were misled over the weekend. This is a proposal to give permission to think about building a hospital; they are not new hospitals. The Government’s own response to the Naylor report said that sustainability and transformation partnerships are the chosen means of planning and delivering capital projects, so how were STPs consulted about which projects to progress?

[Edward Argar]

The hon. Lady, as she says, comes to this with a wealth of experience. The bids were put forward by individual trusts working with their STPs, and in the context of the STPs that have been developed. There is a synthesis and a read across to ensure that, in this announcement, we have picked the trusts that put together the most compelling bids in order to deliver value for money and improvements where they are needed.

[Jeremy Wright (Kenilworth and Southam) (Con)]

I welcome my hon. Friend to his new post and, of course, I welcome the investment he has announced, but he will recognise that, however new the hospital, being an in-patient can be a profoundly distressing experience for someone with dementia. Good design can help tremendously, so will he do all he can to ensure that the best possible design standards are used when building these hospitals, with the interests of people with dementia in mind?

[Edward Argar]

My right hon. and learned Friend makes an important point that is close to my heart, as a former co-chair of the all-party parliamentary group on dementia. I recently, or relatively recently, had the opportunity to visit Leicester Royal Infirmary, which has done exactly that and worked with the Alzheimer’s Society and others to create a dementia-friendly ward. He is right that that sort of thing should be hardwired into our designs as we upgrade hospitals.

[Rachael Maskell (York Central) (Lab/Co-op)]

Had the Minister conducted an appraisal of the full NHS estate, he would have realised that mental health hospitals are not on his list. In the light of the urgent need for a new child and adolescent mental health services unit in York, how did he miss CAMHS from his list? This will have a real impact on clinical services.

[Edward Argar]

The hon. Lady makes an important point about mental health and the services for those with mental health needs. This announcement is very much focused on acute hospitals, and investment was recently announced for mental health services in, for example, Mersey Care and Manchester. Indeed, my own county recently invested in a new unit.

The hon. Lady raises a specific point, and it would be wrong to suggest that this Government are not investing in mental health services. However, if she wishes to discuss the specifics of her constituency and of the needs in Yorkshire, I would be happy to meet her.

[Andrew Bridgen (North West Leicestershire) (Con)]

I wholeheartedly and unreservedly welcome the massive £450 million investment in the University Hospitals of Leicester NHS Trust. It is every penny that management and clinicians said they need to ensure that we have world-class healthcare facilities for the people of Leicester and Leicestershire. Will my hon. Friend join me in welcoming the fact that this Government abandoned the discredited Labour funding mechanism of PFI? PFI stood for “private finance initiative,” but it should have stood for “pay for indefinitely”.

[Edward Argar]

My hon. Friend and constituency neighbour makes a positive point, perhaps in contrast with some of the points made by Opposition Members, in welcoming the huge investment that we will see in the University Hospitals of Leicester NHS Trust. Although the hospitals are in the constituency of the shadow Secretary of State, the work to campaign for this money has been a team effort, across all parties and all constituencies, and I pay tribute to my hon. Friends the Members for South Leicestershire (Alberto Costa) and for Harborough (Neil O'Brien) in that context. My hon. Friend the Member for North West Leicestershire (Andrew Bridgen) is right to highlight PFI again. It was massively expanded under the previous Labour Government, who ran it so badly that it left trusts saddled with debt.

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

On Friday, I had a meeting with Mid Yorkshire Hospitals NHS Trust, whose chief executive said to me:

“The impact of low levels of funding over seven years has been longer and more impactful than when funding was squeezed by the Mrs Thatcher Government. More investment is required to increase staff training and in turn employ more qualified health staff.”

We know that hospitals in towns are often not funded to the same level as hospitals in cities, so could the Minister give me the number of hospitals in towns that are not in marginal seats which are having extra hospitals and funding? Will he meet me to discuss extra funding for Dewsbury’s hospital?

[Edward Argar]

The hon. Lady makes a powerful point. I am sure she would therefore welcome what we are doing, which is addressing capital funding needs with a long-term, rolling programme of capital investment to address both the immediate need and the shortfalls from the previous Labour Government’s landing trusts with PFI debt. On her local hospital, and the need to invest in cottage hospitals, community hospitals and town hospitals, I will of course meet her.

[Karen Bradley (Staffordshire Moorlands) (Con)]

I realised from the earlier exchanges how lucky I was, because my hon. Friend the Member for Wimbledon (Stephen Hammond) did visit my local hospital, Leek Moorlands Hospital, but please do not let that stop the incumbent from adding it to his address book, because he would be very welcome any time he feels like a visit to north Staffordshire. Can the Minister confirm that this investment is possible because of this Government’s careful stewardship of the economy and that these hospitals will not be saddled with debt, as the ones built on PFI were?

[Edward Argar]

My right hon. Friend is right. In my previous role, I enjoyed a visit to her constituency to visit a prison with her and I am more than happy, although I am sure my officials will wince at the diary management involved, to take her up on her offer of a visit as well. She is exactly right: we are able to make this investment because, unlike the previous Labour Government, who left that note saying, “Sorry, there is no money”, we have stewarded the national finances well and we now have the money to invest.

[Bill Esterson (Sefton Central) (Lab)]

There was nothing in the announcement about Southport and Formby District General Hospital, which desperately needs a new walk-in centre to relieve the pressure on the accident and emergency department, and nothing about the much-needed health centres in Maghull and Formby, also in my constituency. Given the cancellation and delay in previous projects, and the growing repairs backlog, why should anyone think that these projects will go ahead in the way the Minister has announced any more than previous projects that have not?

[Edward Argar]

The hon. Gentleman is understandably and rightly fighting the corner for his local trust and local hospitals, but I am sure he would none the less welcome the huge investment by this Government in our NHS that this announcement amounts to. On delivering on these commitments, we are clear: we want to see these hospitals built as swiftly as possible. Unlike the Labour party, when we say we will do it, we get on with doing it.

[Sir Mike Penning (Hemel Hempstead) (Con)]

As the Minister knows, in his short time in office I have been pinging his ear, as I did his predecessor’s, over the investment we need in west Hertfordshire. The Secretary of State kindly took a call from me at the weekend. Now £400 million is welcome, but not if we are going to chuck it into Watford Hospital, which is a Victorian hospital that took all the work from Hemel Hempstead Hospital when Labour closed our acute hospital. Hemel Hempstead is the largest town in Hertfordshire. We welcome the money, but we would like a new hospital where we could look after St Albans, Hitchin and Harpenden, Watford and Hemel Hempstead in the 21st century—we do not want to plough this into a Victorian hospital.

[Edward Argar]

My right hon. Friend rightly campaigns vociferously for his constituents in Hemel Hempstead, and I know he has spoken to the Secretary of State about this issue on several occasions. No formal decision has been made on the detail. He will know that his hospital trust has a view. I hope he will continue to engage with the trust and with us Ministers, and that he will put the points that he just put to the House to us in a meeting.

[Helen Goodman (Bishop Auckland) (Lab)]

Around 15 years ago, when there was a Labour Government, we had a new hospital in Bishop Auckland. My constituents want to know why it is not used properly. In particular, will the Minister look at the latest proposal to close the stroke rehabilitation ward—ward 3—and reverse it?

[Edward Argar]

The hon. Lady highlights an issue of great importance to her constituents and her local hospital. As she will be aware, decisions on changes to services are made by local NHS trusts and clinicians, to reflect their assessment of the best way to deliver care and meet clinical need in a particular locality. If she wishes to write to me about the details of her local hospital and the issue she just highlighted, I would be happy to respond as swiftly as possible.

[Simon Hoare (North Dorset) (Con)]

The delivery of healthcare in rural settings presents some complex challenges, so I was delighted to hear what my hon. Friend said in his statement about the importance of community hospitals. Dorset is in phase 2, for want of a better phrase; will the Minister flesh out, to the best of his knowledge, how that will come about, the timeframe and what my residents should expect?

--- Later in debate ---

[Edward Argar]

I notice that my hon. Friend did not invite me to visit Dorset, although I visit him fairly regularly anyway so may well take advantage of such an occasion. The seed funding in the HIP 2 for Dorset is for the trust to develop its proposals for 12 community hospitals. That is an improvement. He is absolutely right to highlight the importance of community hospitals in a large rural county with transport challenges, given its rurality, and often an older population in some villages. As I said to my right hon. Friend the Member for Harlow (Robert Halfon), if it is helpful, I will be happy to write to my hon. Friend to set out the process by which his local trust will work with the seed funding.

[Andy Slaughter (Hammersmith) (Lab)]

I spoke to Imperial College Healthcare NHS Trust earlier and asked what there might be from this announcement for our local hospitals; I was referred to the Conservative party press release, which is the only information that the trust has so far received. If I divide up the seed money between the three major hospitals that will get some money, I see that we could get as much as £9 million for planning for currently unfunded work that could happen in six to 10 years. That can be compared with £76 million wasted on consultants; £170 million, which is the current-year deficit for north-west London; and £1.3 billion, which is the Imperial maintenance backlog. We need that money now. When are we going to see it?

[Edward Argar]

The hon. Gentleman made several points. I am pleased that he has been enjoying improving reading of Conservative party press releases. On his serious point about the Imperial trust, the seed funding will be for the trust to develop its plans as a trust and to put forward its proposals. I am happy, as I am in respect of other colleagues, to write to the hon. Gentleman to set out the process, how the money will be spent and how swiftly it can be allocated. There is always a need for the development of a business case when large sums of public money are involved, and I am sure he would expect one for any major investment in his trust. The seed funding will enable the trust to get going quickly and put together its case.

[Mark Menzies (Fylde) (Con)]

I welcome the excellent announcement of the seed money for Royal Preston Hospital. This is indeed a great day for healthcare in Lancashire. Will the Minister assure us that he will work with right hon. and hon. Members to shape the health vision for this part of our county?

[Edward Argar]

Again, I am happy to welcome the positivity from my hon. Friend and the welcome for this money; the welcome for this massive additional investment into our NHS has been clear on the Conservative Benches. I am, of course, happy to give him the commitment that he wishes, which is to work with him and his colleagues to make sure that his constituents continue to get the healthcare that they need.

[Liz McInnes (Heywood and Middleton) (Lab)]

The King’s Fund has commented on the recent announcements:

“these piecemeal announcements are not the same as having a proper, multi-year capital funding plan.”

So could the Minister clarify by what criteria these schemes have been selected, and what are his spending plans for the long term to repair our crumbling NHS?

--- Later in debate ---

[Edward Argar]

The hon. Lady refers to piecemeal announcements. I have to say that the reason we are now coming up with an approach—a new approach—that delivers rolling capital investment to a strategic vision linked to investment elsewhere in the health service is that, singularly, the previous Government utterly failed to do that. On criteria and process, as I mentioned, the bids considered were put forward by individual NHS trusts and we have considered them against the usual bidding process value-for-money criteria. If it is helpful to her, as with other colleagues to whom I have committed to write, I will be happy to write to her about process rather than the specifics of individual hospitals. If there is a particular trust that she wishes to highlight to me, if she writes to me, I will include the response on that in the letter.

[Andrew Jones (Harrogate and Knaresborough) (Con)]

May I congratulate my hon. Friend on his statement, which is so encouraging because it demonstrates our long-term ambitious plans for the NHS? I was particularly pleased to see the investment in CT scanners as technology and medicine are moving so fast. Does he agree that the screening programmes in the NHS, supported by the capital budget that he is announcing today, are helping to save lives and that we must do all we can to encourage these programmes?

[Edward Argar]

My hon. Friend is absolutely right. We are investing to make sure that, when people need care, that care is there for them, but he is absolutely right to highlight that prevention is always better than cure. The investment that we are making in these CT scanners and X-ray machines and, indeed, the steps forward that we are seeing in the research and development of new technologies, all contribute to improving our ability to prevent illnesses.

[John Spellar (Warley) (Lab)]

May I express to the Minister my disappointment that, in the list of hospitals, there is not one in the whole of the west midlands? I say that in particular because when, in January 2018, Carillion went bust, a major casualty was the half-completed, but much-needed, Midland Metropolitan Hospital. After long representations to his negotiations, the new contract with Balfour Beatty has now been sent to both his Department and the Treasury. It just needs ministerial sign-off, so will he go back to his Department, get out the file and get this project moving?

[Edward Argar]

I am grateful to the right hon. Gentleman. He is absolutely right to highlight the challenges about Midland Metropolitan Hospital. I know, in the spirit of bipartisan sentiment, how hard he has been working on that issue on behalf of his constituents, and I also know how hard Toby Lewis has been working on this as well in running that hospital trust. I have looked into the matter recently. I am very happy to meet him to talk through with him where we are and what the next steps are because, like him, I am keen that we get things moving.

[Mr Philip Hollobone (Kettering) (Con)]

Record numbers of patients are being treated at Kettering General Hospital with increasingly world-class treatments. The difficulty that we have at Kettering General Hospital is the A&E department, which, when it was constructed 25 years ago, was designed to cope with 45,000 visitors and is expected to go through 100,000 attendances this year. The solution is an urgent care hub. There is already a fully worked-up business plan in place. May I welcome the addition of Kettering General Hospital on the list of future projects and ask: when can the hospital expect the money and when can it expect to start to build the new urgent care hub?

[Edward Argar]

I am grateful to my hon. Friend for his question. He is right to highlight the importance of design, particularly in A&E and emergency departments, for the ability of staff to manage increasing demand and increasingly complex cases. As he highlights, Kettering General Hospital NHS Foundation Trust is included in HIP 2 for the seed funding to develop that business case and its proposal. I am happy to work with him and I hope that he will work with the trust to develop the business case in accordance with the criteria for bidding against future funds.

[Jenny Chapman (Darlington) (Lab)]

A couple of years ago, my constituents and I led a spirited and successful campaign to maintain A&E and maternity services at Darlington Memorial Hospital, but our attention now turns to the state of mental health services in Darlington. I know these problems are not unique to my constituency, but they are dire. There are young people and children in Darlington who have been waiting for 18 months for an autism diagnosis. The situation needs urgent attention. Will the Minister please meet me to discuss how we can improve the situation?

[Edward Argar]

As the hon. Lady will know, improving mental health services for those with mental health needs is at the heart of this Government’s agenda. The Government have already announced investments of over £400 million in improving the mental health estate since July 2017, but she highlights a specific point and has a specific request—that I meet her. Given the number of meetings and visit requests I have had today, there may be a slight wait, but I would be very happy to meet her.

[Huw Merriman (Bexhill and Battle) (Con)]

On Friday, I had the pleasure of visiting the Conquest Hospital in Hastings with my amazing neighbour, my right hon. Friend the Member for Hastings and Rye (Amber Rudd). The hospital was delighted with the £14 million that has just been allocated to its sister hospital in Eastbourne to help to develop wards there, and the trust would be absolutely delighted if it were able to deliver a new hospital. May I ask my right hon. Friend—he will soon be right hon. if he is not already—what more the Conservative MP team in East Sussex, one of whom, my hon. Friend the Member for Lewes (Maria Caulfield), is sitting right in front of me, can do to get a new hospital delivered to our constituents on the East Sussex coast?

[Edward Argar]

I pay tribute to my hon. Friend and to my right hon. Friend the Member for Hastings and Rye (Amber Rudd) for their campaigning work on behalf of their local hospital trust, East Sussex Healthcare NHS Trust, and their two local hospitals, the Conquest and Eastbourne. The investment that we envisage flowing from this seed funding will lead to current district general hospital services being provided from a significantly enhanced environment at both Eastbourne and the Conquest—something that my hon. Friend the Member for Bexhill and Battle (Huw Merriman) has campaigned for very actively. I encourage him to continue doing so and to continue working very closely with his local trust to ensure that it continues to develop those services.

[Nic Dakin (Scunthorpe) (Lab)]

I have with me a letter from the chief executive of North Lincolnshire and Goole NHS Foundation Trust, which identifies a capital gap in excess of £247.36 million as of July 2019. Will the Minister meet local MPs to discuss how the Government can work with the trust to address this capital need?

[Edward Argar]

At the risk of being a little brief at this point—yes.

[Scott Mann (North Cornwall) (Con)]

Many of my constituents have a two-hour round trip to access an acute general hospital, so they are jumping for joy at the opportunity of getting more money for the cottage hospitals or for a new general hospital in Cornwall, but what reassurances can the Minister give my constituents that this is more than just an aspiration for the people of Cornwall?

[Edward Argar]

My hon. Friend is absolutely right to highlight the need for access to facilities in his county, given its geography. I have been clear today, the Secretary of State has been clear and the Prime Minister has been clear in our commitment to the list of schemes that we have said will get the HIP 2 funding. I know that officials in my hon. Friend’s trust will be looking forward to working with him to develop their proposals.

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

I am pleased that my persistent and passionate campaigning for the University Hospitals of Morecambe Bay NHS Foundation Trust must have been heard by those on the Government Benches; I am sure it has nothing to do with the two marginal constituencies of Morecambe and Lunesdale, and Barrow and Furness, which fall into the trust’s footprint.

When constituents get in touch with me frustrated with NHS wait times, it is invariably about the wait for mental health services, and some of the most difficult conversations I have had to have as a constituency MP have been with parents who have lost children to suicide or eating disorders, so why is the Government’s announcement today so silent on mental health issues, particularly regarding CAMHS?

[Edward Argar]

I am grateful to the hon. Lady, who I know has campaigned on this. My hon. Friend the Member for Morecambe and Lunesdale (David Morris) has taken a real lead in fighting for improvements and investment in this area, so I pay tribute to him as well. The hon. Lady raises a point that other hon. Members have rightly raised about mental health services, particularly for children. She will know that before I was a Minister I campaigned in this House on eating disorder support services with the charity Beat. She is absolutely right to highlight the importance of early and appropriate intervention in those areas. That is why improving mental health is at the heart of our agenda and why, alongside these announcements, since July 2017 we have, for example, announced investments of over £400 million in improving mental health services. Yesterday’s and today’s announcements are another part of our overall strategic vision for investing in and improving our NHS, and they should be read in the round with all the other announcements.

[Michael Tomlinson (Mid Dorset and North Poole) (Con)]

I warmly welcome the Minister’s statement demonstrating, yet again, our commitment to the NHS. I particularly welcome the commitment to community care. In that regard, will he meet me to discuss Wareham Community Hospital and the proposal for a hub, perhaps in addition to going to Ealing, North Devon and Staffordshire? He is officially welcome in Dorset. Perhaps he could even stop off in North Dorset on his way back home.

[Edward Argar]

What is one more invitation to a meeting and a visit? I am of course very happy to accept my hon. Friend’s hospitality in his constituency and to meet him. He makes a very important point, which my hon. Friend the Member for North Dorset (Simon Hoare) alluded to, about the importance of community hospitals and community health facilities. That is exactly what is at the heart of the proposals that his county and his trust are developing, and that is exactly the right thing for them to be doing.

[Mr Clive Betts (Sheffield South East) (Lab)]

I am sure the Minister will agree that Sheffield Teaching Hospitals NHS Foundation Trust is an outstanding trust. It always comes in within budget and regularly has good or outstanding ratings for care, as I have experienced personally over the past two years. Disappointingly, Sheffield is not mentioned in this announcement. However, rather than my simply complaining, will he agree to meet me, the chair of the hospitals trust, Tony Pedder, and officials to discuss their very ambitious plans to renovate Weston Park Hospital in Sheffield, which already provides a top centre for cancer treatment and could be even better with the Minister’s help and the necessary funding?

[Edward Argar]

I am grateful to the hon. Gentleman for that note of deep positivity, which has not necessarily been universally heard from Opposition Members. Again, I would be happy to meet him.

[Chris Green (Bolton West) (Con)]

As we all recognise, the NHS is coming under increasing pressure to meet people’s health needs. Does my hon. Friend agree that the new Bolton College of Medical Sciences will play a key part in delivering the next generation of health professionals to meet those needs?

[Edward Argar]

My hon. Friend is absolutely right to highlight the huge contribution that that new medical school will make to delivering a highly trained, highly motivated local workforce. There is strong evidence that when people graduate from medical school their first post tends to be in the near vicinity of that school. I therefore think that he can look forward to, as I say, a highly motivated, highly trained workforce to continue delivering first-class healthcare to his constituents.

[Emma Little Pengelly (Belfast South) (DUP)]

I welcome today’s statement and the benefit it will bring to Northern Ireland by way of the Barnett consequentials. I also welcome the reference to NHS workforce investment. The Minister will no doubt be aware that Northern Ireland faces a very particular challenge with the recruitment and retention of consultants. Will he outline when and if the situation will be addressed that currently disincentivises consultants from doing any overtime while attempts are made to fill those vacancies, because that is having a knock-on impact on the waiting lists in Northern Ireland?

[Edward Argar]

I am grateful to the hon. Lady for her comments and for their tone. She is absolutely right to highlight the importance of the workforce. Investment in new, first-class buildings and in equipment is vital because they are the tools that the amazing workforce need to do their job. She highlights a specific point about pensions, particularly consultants’ pensions. As she will be aware, we have been looking at this, and the Secretary of State has recently launched a consultation more broadly on proposals to address the challenges on pensions taxation.

[Ian Austin (Dudley North) (Ind)]

Thanks to the brilliant chief executive, Sarah-Jane Marsh, and the fantastic team of doctors and nurses and all the support staff, the most seriously ill children from Dudley and elsewhere in the west midlands receive the most fantastic care at Birmingham Children’s Hospital. But that care is provided in buildings that are 155 years old and, as I understand it, there is no possibility of them being replaced for at least another 15 years. I know that the Minister has had a lot of requests for meetings and visits today, but I would like to ask him to make the short trip to Birmingham and come with me to meet Sarah-Jane Marsh and the staff, see what they are doing and see how much better it could be if he managed to find a way of enabling the hospital to have the new facilities it needs.

[Edward Argar]

I am grateful to the hon. Gentleman. He is right to highlight the world-leading work of that hospital, carried out by Sarah-Jane Marsh and her team. He is right: it is a team effort. Every single person in the NHS family is vital to delivering those amazing outcomes and he is right to highlight that. I am very happy, as ever, to visit the great city of Birmingham, and even more so to do it in tandem with him.

[Chris Elmore (Ogmore) (Lab)]

I want to push the Minister on the whole issue of the devolution settlement and the Barnett consequentials. Can he confirm when the Welsh Government will receive this additional capital funding, so that we can make decisions in Wales about where our hospitals need investment? He can be reassured that he does not need to visit any Welsh hospitals.

[Edward Argar]

I am grateful to the hon. Gentleman. He will be aware that I spoke last week with the Welsh Health Minister and may yet be visiting Cardiff to see him anyway. He is right to pick up on the need for the devolved Administrations to understand what the Barnett consequentials are, so that they can start planning. If I may, I will write to him about timescales and so on, but I want to reiterate the reassurance that the Barnett consequentials will be there.

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

The two Budgets in 2017 allocated some £3.9 billion for estates planning and also to tackle the huge maintenance backlog that has been allowed to mushroom under the Government. As of now, how much of that allocation from 2017 has been spent, and how much of it has been announced in today’s statement?

[Edward Argar]

I am happy to tell the hon. Gentleman that the announcements we are making today are for new money.

[Jim Shannon (Strangford) (DUP)]

I welcome this statement on the commitment to the selected six hospitals in this year and 34 others over a period. I had occasion on Friday past to visit the Royal Victoria Hospital in Belfast, which is well aware of the squeeze on staffing, resources and equipment, with theatres lying vacant because there are not the people to be there. The Government have to understand that hospitals in every area need investment, and the NHS needs to be sustained with block funding. Under the Barnett formula, how much will hospitals in Northern Ireland benefit from this money?

[Edward Argar]

I am grateful to the hon. Gentleman. As I said to the hon. Members for Ogmore (Chris Elmore) and for Linlithgow and East Falkirk (Martyn Day), I am happy to write detailing the process, and I am happy to include the hon. Gentleman and his hon. and right hon. Friends in that.

[Matt Western (Warwick and Leamington) (Lab)]

I welcome the Minister to his new position and congratulate him. We have a mental health crisis, as everyone is well aware. I want to highlight the predicament in Warwickshire, where the suicide rate is significantly higher—25% higher —than the national average. St Michael’s Hospital in Warwick has a fantastic reputation but, despite that, it is losing all its acute mental health beds to Coventry. We need greater capacity, not reduced capacity. The Caludon Centre site in Coventry does not have the capacity and is not fit for purpose. Will the Minister meet me and visit St Michael’s Hospital, which is an excellent facility that needs investment?

[Edward Argar]

The hon. Gentleman rightly highlights the importance of mental health care and services for those with mental health needs. I go back to the point that this Government have placed those needs and that care front and centre of our approach and have put investment in place to back up that commitment. In respect of his specific request for a visit and a meeting, it may take a little time, given the number of colleagues who have asked to see me, but of course I am happy to do so.

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

I saw the professionalism of NHS staff on one of my recent night shifts at Derriford Hospital. They told me that they need more staff, not necessarily more buildings, but may I ask the Minister about the £600 million commitment to Derriford Hospital? This is welcome but surprising, as we have not asked for a new hospital. May I ask how that figure was arrived at and, if the actual figure is more than £600 million, what will happen—will the Minister fund the difference? Does this mean that the projects we had asked for, such as the planned care centre and the health hub network, will now be approved quickly, so that we can get on and build those shovel-ready projects?

[Edward Argar]

I am grateful to the hon. Gentleman for attempting to pile a number of requests into his question. On where bids have come from for these moneys, they have come from those trusts and been worked up by those local trusts. On the specific requests he has and that he wants to raise with me about particular shovel-ready projects, I am very happy to look at those with him.

[Mike Amesbury (Weaver Vale) (Lab)]

May I welcome the new Minister to his place and give him the opportunity to make his mark? Halton Hospital has been turned down twice for much-needed capital investment. It is desperate for investment. Will he meet me and my neighbour, my hon. Friend the Member for Halton (Derek Twigg), and secure the future for Halton Hospital?

[Edward Argar]

As that is the final request for a meeting, it would be churlish of me to say no to the hon. Gentleman. I am very happy to meet him, as I am happy to meet any Member of this House to discuss this announcement and our commitment to funding the NHS because we are the party of the NHS.

Brexit: Reciprocal Healthcare Arrangements

Edward Argar Excerpts

Thursday 26th September 2019 Written Statements

[The Minister for Health (Edward Argar)]

Today I am notifying the House about an announcement that the Government have made about transitional healthcare arrangements across the EU if we are unable to secure a deal.

The UK is leaving the European Union (EU) on 31 October 2019, with or without a deal. The UK Government are working hard to secure a deal that covers healthcare arrangements, but it is important that people understand what will happen if the UK leaves without a deal and what support the Government have put in place for that scenario.

Our priority is to maintain reciprocal healthcare arrangements with member states (MS) when we leave the EU. That is why the UK Government have proposed consistently to all MS that existing reciprocal healthcare arrangements (under regulation 883) continue until 31 December 2020 in a no-deal scenario. These arrangements safeguard healthcare for the hundreds of thousands of UK-insured persons who live in Europe or require medical treatment while holidaying in Europe. They also ensure that EU citizens can receive healthcare in UK, whether they are here on holiday, or to live and work.

Regulation 883

Current EU reciprocal healthcare arrangements (Reg (EC) No 883/2004) support large numbers of UK nationals living in, working in, or visiting the EEA or Switzerland to access healthcare. The arrangements require equal treatment between EU/EFTA citizens when accessing healthcare in other MS. Any EU citizen (or economically active third country national) resident in the UK who moves to the EEA or Switzerland can access state-provided healthcare by paying the same taxes as nationals of that country or people who are eligible for state healthcare.

In addition, the UK reimburses other MS for the state-funded element of healthcare for certain groups known as “UK-insured” who do not need to pay local taxes:

(a) S1—the UK covers the healthcare costs of S1 holders, which include state pensioners, people with disability benefits, certain workers and their dependents living in the EU.

(b) European health insurance card (EHIC)—the UK funds “needs-arising” healthcare when UK residents visit the EU temporarily (for tourism, study or work).

(c) S2—the UK Government fund UK-insured individuals who travel to receive pre-authorised planned treatment in the EU (e.g. maternity).

The UK administers reciprocal healthcare, including paying for overseas medical costs, on behalf of England, Scotland, Wales, Northern Ireland and Gibraltar.

Arrangements with member states

Arrangements are already in place with a number of MS, and the UK Government are still seeking further reciprocal agreements ahead of leaving the EU on 31 October. The Government are currently undertaking technical discussions with countries such as Belgium who have already passed domestic legislation that will support reciprocal healthcare with the UK after Brexit.

The UK Government stand ready to reciprocate all arrangements with MS, and have the necessary legislation in place, under the Healthcare (European Economic Area and Switzerland Arrangements) Act 2019 and the European Union (Withdrawal) Act 2018.

Ireland

Under the common travel area (CTA). British citizens living in Ireland will be able to access healthcare in Ireland on the same basis as Irish citizens which means that they may need to make a financial contribution. The UK Government are in detailed discussions with the Irish Government to reach an arrangement which would enable current reciprocal healthcare arrangements to continue. British and Irish citizens who live in Ireland will also continue to have access to free-of-charge healthcare while visiting the UK. This is regardless of the circumstances in which the UK leaves the EU.

Spain

Healthcare access in Spain will remain the same after exit day, whatever the Brexit scenario. This is because the UK and Spain have each taken steps to ensure that people living in each country can continue to access healthcare as they do now until at least 31 December 2020, using their S1 forms. UK EHIC holders in Spain, and those who have planned treatment in Spain using an S2 form will also be able to continue to access healthcare in the same way when they are in Spain until at least 31 December 2020. The UK Government are now seeking to work closely with Spain to agree how this will work in practice. The Spanish Government’s guidance on access to Spanish healthcare and Brexit can be found here:

www.lamoncloa.gob.es/lang/en/brexit/Paginas/index.aspx.

Switzerland

The UK has reached an agreement with the Swiss Confederation to ensure that the rights of UK nationals living in Switzerland and Swiss nationals living in the UK are preserved in a no-deal scenario after the UK leaves the EU on 31 October. This means that UK-insured individuals who reside in Switzerland at the time of Brexit will still be able to access healthcare using their S1 form, as they do now.

Moreover, UK nationals travelling to Switzerland, before the UK leaves the EU will continue to be covered by their UK issued EHIC for the duration of their stay. This includes visits which started before Brexit and end after the UK’s withdrawal from the EU. If a visit starts after the UK leaves the EU, EHIC may no longer be valid.

Norway, Iceland and Liechtenstein

The UK has reached an agreement with the EEA-EFTA states (Iceland, the Principality of Liechtenstein, and the kingdom of Norway) to ensure the rights of UK nationals living in these countries, and that nationals of Iceland, Liechtenstein and Norway living in the UK, by 1 November are preserved after the UK leaves the EU on 31 October 2019. This means that UK-insured individuals in these countries at the time of the UK’s exit will be able to access healthcare using their S1 form, as they do now, after 31 October.

Moreover, UK nationals travelling to Iceland, Liechtenstein or Norway before the UK leaves the EU will continue to be able to rely on their UK issued EHIC for the duration of their stay. This includes visits which started before Brexit but end after the UK has left the EU. If a visit starts after the UK has left the EU, EHIC may no longer be valid.

Other EU countries

Updated information has been published on gov.uk and nhs.uk on the situation for each MS, including what arrangements have been put in place. These pages will be kept updated as further assurances from MS are received.

Those living in the EU whose healthcare is funded by the UK should not delay in reviewing their circumstances in order to secure their future healthcare needs. It is important that people review their own needs now and consider options carefully by checking the guide for the country they live in. People can also sign up to email alerts to check these country guides regularly as the situation may change as the UK gets closer to leaving the EU.

Preparing for leaving the EU

The UK’s offer to EU citizens resident in the UK is clear. We offer complete assurance to EU citizens who are living in the UK on or before 31 October 2019, that they will be able to access free healthcare on the NHS after we leave the EU on 31 October. Should EU countries not agree to our offer to continue the existing reciprocal healthcare arrangements until December 2020, visitors from those EU countries will be charged for NHS care.

Beyond the bilateral arrangements, it is difficult to predict what exact arrangements will be in place for UK nationals in other MS as we continue to hold our technical discussions with them. This is because of the varying nature of each country’s healthcare system. In view of this uncertainty, UK-insured individuals living in the EU should be ready for possible permanent changes to how they access healthcare.

Everyone living in the EU is strongly encouraged to think about their own healthcare needs and circumstances and consider the steps they need to take to be assured of continuing healthcare coverage. The Government have produced detailed advice for each country which can be accessed here: www.gov.uk/uk-nationals-livinq-eu

Specifically, individuals should consider: whether they need to register as a resident under local rules; the documentation they need to have in place; taking steps to understand how the local healthcare system operates and how their healthcare cover may change; and, if appropriate, purchasing private insurance.

Contingency arrangements

While we continue to promote our offer to all MS to continue existing reciprocal healthcare arrangements until at least 31 December 2020, the Government recognise that as we leave the EU, arrangements may not be straightforward and people may experience some challenges. As such, while countries and individuals put arrangements in place, we have taken a number of steps to support and protect UK-insured individuals living in the EU.

Not all UK-insured individuals will need to access these UK arrangements, as we may negotiate some further arrangements and many countries have put in place comprehensive arrangements already for UK-insured individuals and others may follow suit. However, coverage does vary, and the UK Government want to ensure that all UK-insured individuals are in a good position to assess their options and prepare for what comes next.

Specifically:

(1) We have provided information online and are sending a letter to S1 holders living in EU and EFTA MS, encouraging individuals to consider their circumstances and options and to take the necessary steps to ensure they have appropriate coverage in place. The steps necessary will vary depending on individual’s circumstances and by country.

(2) For UK-insured individuals who may find themselves in a particularly vulnerable situation because they fall ill before the UK leaves and require treatment that spans exit day, we have made specific transitional provisions. If an individual requires healthcare treatment before the UK leaves the EU and the treatment will continue until after Brexit, the UK Government will pay for this course of treatment for up to one year (or the authorised period in relation to an S2) or the period of treatment if shorter. This will apply for those receiving healthcare as an S1, S2 or as an EHIC holder.

(3) The UK Government will fund the healthcare of existing UK-insured individuals living or working in the EU, on the same basis as now, for a further six months from the point of Brexit. This provision is aimed at providing individuals time to make alternative arrangements for their future healthcare cover, including registering for healthcare in their country of residence.

The UK-funded protection may be required if the EU or MS refuse to enter into arrangements with the UK or refuse to offer comprehensive protections to UK-insured through domestic legislation.

In addition, some MS do not fund healthcare for those who are going through the healthcare registration process. To give as much protection as possible to UK-insured individuals, after the six months is over, the UK Government will continue to fund healthcare for the length of the registration period if that MS does not fund healthcare for that period (up to one year) and the individual has taken steps to register in-line with local timeframes and no later than six months from exit day. This will ensure there is appropriate coverage should there be delays or overly lengthy registration processes. If a UK-insured individual leaves their country of residence to travel to another country, they will have to take out full travel insurance as their EHIC will not be valid.

(4) The UK will also continue to cover those travelling to the EU, whose visits commenced prior to Brexit day until they return to the UK, up to a period of six months.

(5) Students may find themselves in a particularly challenging position if they are already studying abroad. All students are encouraged to take out comprehensive travel insurance and to investigate local healthcare schemes that they may be eligible for. However, given the circumstances, the UK Government have agreed to continue existing cover of healthcare costs for students for the duration of their course, should they be already studying in a MS at the point that the UK leaves the EU and on the basis of evidence from their Institution. More information on support for students can be found here: www.gov.uk/guidance/studying-in-the-european-union-after-brexit.

(6) In exceptional circumstances, the UK Government have put in place provisions to provide bespoke support to people who find themselves in a challenging position due to a change in their healthcare cover after Brexit. This scheme will run from 1 November 2019 for at least a year with strict criteria and will only support those with very limited financial means.

The overall contingency package will be most relevant in MS whose domestic legislation does not protect UK-insured individuals during the registration period, exposing them to gaps in healthcare coverage and potentially high costs. We are seeking to agree with MS that they will accept our payments for healthcare cover if the UK leaves the EU without a deal. Where a MS does accept these payments, this would mean UK-insured individuals could continue accessing healthcare as now, beyond deciding whether to register with the local scheme or return to the UK within six months of Brexit. If a MS does not agree to this, then the UK Government will step in to pay healthcare costs directly. To access this support after the UK leaves the EU, UK-insured individuals will need to contact the NHS business services authority (NHS-BSA) to provide them with the healthcare provider’s details, so that the BSA can arrange for the healthcare provider to invoice the UK Government directly.

Individuals should not delay taking action to put appropriate permanent arrangements in place for when the UK leaves the EU on account of this additional support, particularly as for some EU countries the timeframe for UK-insured individuals to register with their domestic health system is far shorter than six months.

Planned treatment

The UK Government will fund planned treatment within MS (S2 scheme) if authorisation for that treatment has been applied for before Brexit and later granted or authorised before Brexit, even if that treatment is scheduled to start after Brexit. The UK Government will pay for these treatments if the provider agrees to honour their commitment.

Returning to the UK

After the UK leaves the EU some people may decide to return the UK. UK nationals living in the EU whose healthcare is currently funded by the UK will be able to access free NHS care when temporarily visiting England, Scotland and Wales. UK nationals living in the EU will be eligible for NHS care if they move permanently back to the UK (including Northern Ireland) and meet the ordinarily resident test. Accident and emergency services and services that are deemed urgent or immediately necessary will always be provided free at the point of delivery first in the UK, with entitlement to NHS care determined afterwards. More information can be found here: www.gov.uk/guidance/using-the-nhs-when-you-return-to-live-in-the-uk.

[HCWS1832]

Gosport Independent Panel

Edward Argar Excerpts

Wednesday 21st November 2018 Commons Chamber

[Matt Hancock]

The point about coroners is a matter for the Ministry of Justice, but I am pleased to see that the Under-Secretary of State for Justice, my hon. Friend the Member for Charnwood (Edward Argar) is present. He would delighted to meet the hon. Lady to take up that point—

[The Parliamentary Under-Secretary of State for Justice (Edward Argar)]

indicated assent.

[Matt Hancock]

Yes: good.

I will, of course, be happy to meet the families, but the advice of Bishop James Jones is that that will be appropriate after this stage of the police investigation. I wrote to the families to explain the position before making my statement. It is important that we go through the process properly during the police investigation to ensure that justice can be done, but I shall be more than happy to meet the families at the appropriate moment.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 20th March 2018 Commons Chamber

[Jackie Doyle-Price]

First, I commend the hon. Lady for the work she does on tackling knife crime and I know it is an issue close to her heart. The work with Redthread is being co-ordinated with the Home Office, and I would not want to allocate its expenditure, any more than it should be allocating mine.

[Edward Argar (Charnwood) (Con)]

12. What steps the Government are taking to support Dementia Awareness Week.

[The Minister for Care (Caroline Dinenage)]

Dementia Awareness Week runs from 21 to 27 May, and the Department of Health and Social Care is expecting to participate fully in a range of activities that week, working with partner organisations and the voluntary sector.

[Edward Argar]

Alongside the work of Governments of both parties to improve dementia research, care and awareness—Dementia Awareness Week is a key part of that—the role of voluntary organisations and dedicated volunteers around the country is vital. Will the Minister join me in paying tribute to the fantastic work of specialist dementia care Admiral Nurses and in backing Leicestershire Dementia UK volunteers in their campaign, which is well on track, to raise the £50,000 needed for an Admiral Nurse for our county?

[Caroline Dinenage]

First, I pay tribute to my hon. Friend for the sterling work he does as co-chair of the all-party group on dementia. He is absolutely right to say that Admiral Nurses do fantastic work in many parts of the country, helping people with dementia to maintain their independence, and improve their quality of life and that of their families. I very much support all the fundraising activities going on in his local area.

Eating Disorders Awareness Week

Edward Argar Excerpts

Tuesday 27th February 2018 Commons Chamber

[Edward Argar (Charnwood) (Con)]

Anorexia nervosa, a well-known eating disorder, has the highest mortality rate of any mental health condition. When eating disorders are not fatal, they can still lead to significant and long-lasting health issues. An estimated 1.25 million people in this country suffer from an eating disorder. Of course, it affects not just them but their families, yet eating disorders are all too rarely discussed in public.

We discuss with comparative ease physical illnesses that may devastate people’s lives, but when it comes to mental illnesses this is too often not the case. That is also true of eating disorders. Despite the ever-increasing pressures of daily life leading to increased instances of poor mental health, we still do not speak about these issues enough. These illnesses can thrive on secrecy. The longer they go unchallenged and unacknowledged, the harder it is to beat them. It is only by talking about them, bringing them out of the shadows that we can reduce the power they hold over those who suffer. To really improve the lives of those with eating disorders and prevent those at risk from falling victim to these illnesses, we must bring eating disorders, as with all mental health issues, to the forefront of the collective deliberations and consciousness of our society. That is why, in this Eating Disorders Awareness Week, I am very pleased to have secured this important debate so that we in this House, the centre of our national debate, can talk about it and play our part, however small, in raising awareness and making it that bit easier for others to talk about it. I am very pleased that this Minister is responding to the debate, because I know she is a lady of compassion, dedication and determination to improve people’s lives. May I also say, Mr Speaker, that with all the pressures on your time, I am pleased that you are in the Chair for the start of this debate, because I know the close interest you have taken in these issues as well?

[Alex Chalk (Cheltenham) (Con)]

Will my hon. Friend join me in commending the outstanding compassion and professionalism of the community team and other professionals at the Brownhill Centre in Cheltenham, who provide such a vital lifeline for those suffering with eating disorders?

[Edward Argar]

I will. My hon. Friend is absolutely right to raise this issue. Indeed, my hon. Friend the Member for South Ribble (Seema Kennedy) highlighted earlier today the work of the SEED—Support and Education for Eating Disorders—organisation in Penwortham in her constituency. They are both absolutely right to highlight the work of such organisations.

As hon. Members may know, since my election to this House I have on a number of occasions raised health and mental health-related issues on behalf of my constituents and more widely. In this case, last year I accepted an invitation from Beat, the national eating disorder charity, to the launch of its important report, “Delaying for years, denied for months”, which focuses on how long it takes from someone developing an eating disorder to their receiving treatment for it. It is a piece of research I will draw on extensively today.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on securing the debate. Over the years, a number of my constituents have had these problems. Through the good work of the NHS and the Beat organisation, to which he has just referred, they have been able to pull through to the other end. In Northern Ireland, we have some 20,000 people who suffer from eating disorders at any one time. Given that fact, does he feel that the Government could enter into discussions with the regional assemblies across the whole of the United Kingdom of Great Britain and Northern Ireland to agree a strategy that can accommodate where we are in the UK?

[Edward Argar]

The hon. Gentleman makes a very important point. This is one of those issues on which I would hope we can see the widest engagement across the UK, across all involved in government and the provision of services, to come up with a coherent and common approach to beating eating disorders.

[John Howell (Henley) (Con)]

My hon. Friend is making a very good point. I wonder whether he has a feeling for how much extra training GPs will require to be able to spot the signs of these disorders.

[Edward Argar]

My hon. Friend makes a very important point and if he will perhaps be patient for a few more minutes, I will turn to, among other things, exactly that point.

At the launch that I referred to, I met and heard from some impressive and inspiring people, who had grappled with eating disorders and who wanted to share their experience and raise awareness. I subsequently met Beat to discuss its work and what more needs to be done. The people I met at Beat’s launch event did something important and brave in speaking out, but they had already done something brave in seeking help for their illness in the first place.

[Margaret Greenwood (Wirral West) (Lab)]

One of my constituents is an ambassador for Beat, and I met her recently. Does the hon. Gentleman agree that one of the organisation’s strengths is that it draws on people who have been through the experience, so they can speak knowingly and convincingly to people they recognise as being in the same situation that they were in not that long ago?

[Edward Argar]

The hon. Lady is absolutely right. It is always true in any situation that someone who has been there can speak with much more power and in a much more compelling way than someone who has not, however empathetic they are. The reality is that the recognition of an eating disorder for what it is—an illness—and getting the help and treatment for it is, all too often, still too slow. With an eating disorder, as with illnesses generally, the earlier an intervention and treatment take place, the easier it is to treat and the better the outcome for the patient.

[Sandy Martin (Ipswich) (Lab)]

Does the hon. Gentleman agree that mental health services require the ability to provide advice and counselling, especially to younger people, and that in many cases that is lacking?

[Edward Argar]

The hon. Gentleman makes a very important point. Mental health services, whether they are statutory mental health services or supported services from the voluntary sector, have to be able to address the needs of the individual as an individual. I will come shortly to funding and the provision of those services.

Beat’s report last year found that the average cycle of relapse and recovery could be six years, and that it took an average of three and a half years, or 176 weeks, between someone getting an eating disorder and their getting the treatment that they need. That average of 176 weeks goes across people who are under 19 and adults. For those under 19, the average is 130 weeks, and for those over 19, the average is 256 weeks.

Those statistics are worth unpicking a little. It is important to be clear that 91 of the 176 weeks come before an individual or those around them recognise that they have an eating disorder, and a further 58 weeks come after that point, before they seek professional help. Increasing awareness of the symptoms of eating disorders is vital. As a recent YouGov survey found, 79% of the people who were surveyed could not list a single psychological symptom of eating disorders, and 34% were unable to name any correct sign or symptom. Alongside that, however, it takes real bravery for someone to admit to themselves that they need help. It is incredibly hard for someone to talk about an eating disorder.

[Kirstene Hair (Angus) (Con)]

I congratulate my hon. Friend on bringing this important debate to the Floor of the House. He says that it takes a lot of encouragement for people to say that they need help, and I commend the Government for their four-week target of 95% of patients to be seen within four weeks of referral. Will he join me in urging the Scottish Government to reduce the number of weeks from 18 weeks to four?

[Edward Argar]

I certainly join my hon. Friend in urging that. I daresay that were the Speaker to express a political opinion, he might, too, but of course, he cannot.

It will always take courage to talk about an eating disorder, but by talking about them in this House and in our communities, we can help to make it easier and to reduce the 149 weeks that I talked about. I hope that in the Minister’s response, she will set out what is being done to raise awareness and to help the national conversation to take place, working alongside charities such as Beat.

The remaining 27 weeks of the total come from an average of 11 weeks between someone first visiting a GP and receiving a referral, often with three visits to a GP taking place before that happens; eight weeks between referral and formal assessment; and eight weeks from assessment to receiving treatment. We can and should be able to further reduce this 27-week period.

Let me be clear: this is not, and should not be, a partisan or party political issue. Governments of different political colours have all made significant progress, but of course there remains more we can all do. When someone has made the important leap to talking about their illness and seeking help, it is at this time that they are most receptive to engaging with that help when offered. When they make that leap of faith, we must meet them with action.

[Matt Warman (Boston and Skegness) (Con)]

I want to unpack what my hon. Friend has just said and pay tribute to the work done by all Governments on this important issue. Ultimately, however, pressure on resources sometimes means that people who seek help are effectively told to come back when they weigh less. That is at the heart of the challenge we have to address.

[Edward Argar]

My hon. Friend makes an important point. One of the key themes drawn out from this and related research is that it should not just be one symptom or factor that determines when someone needs help; there is a basket of factors and considerations that demonstrates when that need is there and when treatment is needed. He is absolutely right, therefore, to highlight that point.

As we know, GPs do an amazing job, but, as my hon. Friend the Member for Henley (John Howell) said, we need to ensure that doctors’ medical training gives them the tools they need in this area, as in others, to recognise all the symptoms of an eating disorder; and to ensure that that training is kept up to date and that medical professionals are familiar with and follow National Institute for Health and Care Excellence guidelines on eating disorders, including its guidance that single measures—this touches on the point my hon. Friend the Member for Boston and Skegness (Matt Warman) has just made—such as body mass index and duration of illness alone should not be used to determine whether to offer treatment or what treatment to offer.

The Government have made huge strides in focusing on reducing delays through investment and funding and waiting-time targets, but these targets are not always fully applicable to everyone. As my hon. Friend the Member for Angus (Kirstene Hair) set out, the Government have a target of 95% of non-urgent cases involving under-19s being seen for treatment within four weeks. I understand from the latest figures that that target is now being met in 79% of cases. That is good progress, but there is still more to do. It is vital, however, that these waiting-time standards for accessing treatment also apply to over-19s. I would welcome the Minister’s reflections on that, and, of course, I reiterate what my hon. Friend the Member for Angus said and hope that the Scottish Government will follow the very positive lead set in this respect.

More broadly, I would also highlight the waits experienced for child and adolescent mental health services and adult mental health services more generally. In some parts of the country—I have highlighted this in my county of Leicestershire—delays in treatment can have a profound effect on individuals and the families who care for them. I hope that the Minister will touch more broadly on that bigger picture.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

I attended an NSPCC event yesterday where we were made aware that young people, despite accounting for 20% of mental health need, receive only 9% of the mental health budget. Does the hon. Gentleman agree that more needs to be spent on meeting young people’s mental health needs?

[Edward Argar]

I will come very shortly to overall spending, but part of that is not just the overall size of the pot, but how that money is spent and works its way through the system to reach the frontline. In 2016-17, we spent a record £11.6 billion on mental health services, and that amount will continue to rise year on year until 2020-21, by which point 21,000 new mental health posts will be in place. This is all very welcome, and I commend the Health Secretary and his colleagues in the Department for it. Funding is vital. However, although £30 million per annum will be available over the next five years to fund eating disorder services, the way in which such funds are spent by clinical commissioning groups sometimes lacks transparency. At times it is hard to follow the funding from its source to ensure that it reaches the frontline. Implementation is key, and I hope the Minister will tell us how the Government are working to ensure that every penny reaches the frontline eating disorder services for which it is needed.

Community-based mental health services are often the most effective local services to help people, but they and in-patient mental health services are commissioned separately, by the CCG and by NHS England respectively. That can lead to a sense of a lack of joined-up care, and it can mean that people have to receive treatment many miles from their homes and families. That can place a huge strain on families, and, indeed, on family finances. Beat’s report suggests that in some instances the cost can be up to £32,000 as a result of lost earnings, travel and a range of other expenses. I believe that funds for eating disorder treatment should be held locally by the same budget holder in the same pot to create incentives for the development of improved treatment and reduced costly in-patient care, with CCGs working to extend their focus on early intervention to include the earlier stages of the illness.

[Rachael Maskell (York Central) (Lab/Co-op)]

Will the hon. Gentleman give way?

[Edward Argar]

Very briefly.

[Rachael Maskell]

I am grateful to the hon. Gentleman, who is making an excellent speech. Would what he is suggesting include support in schools?

[Edward Argar]

That is indeed very important. A key issue is the need to ensure that, as far as possible, there can be school referrals or, indeed, self-referrals as well as referrals made via a professional medical route. Some people may choose those ways of reaching out for the help that they need.

I hope that the Minister can update us on the progress of NHS England’s “Testing New Care Models in tertiary mental health services” pilot, which I understand is currently under way, and can tell us whether any initial findings are emerging in respect of the opportunity to put in-patient and community funding into a common pot.

I cannot end my speech without highlighting the impact that eating disorders have on the families and loved ones of those with the illness. Many of them care for people patiently and lovingly, and delays in securing the help that is needed can have devastating consequences for them. While in some cases it may not be appropriate, for good reasons, in many others, engaging those who are caring for someone receiving treatment—the “whole family” approach that I understand is used in Leicester, which will serve some of my constituents—can be hugely positive. I would welcome any reflections on that from the Minister.

Finally, I pay tribute to the work of Beat, which has campaigned tirelessly to highlight this issue, and to the work of those who operate its advice helpline. I commend its report to the Minister, and to all colleagues. However, I pay the greatest tribute to all those who suffer from an eating disorder and have had the bravery to talk about it, to seek the help that they need, and to face down an illness that depends on secrecy, isolates sufferers, and affects every aspect of their lives and those of their families. We must ensure that we match the courage of those who face it, determined to beat it, with an equal determination to give them the support, treatment and investment that they deserve. We must continue to drive down the delays and waiting times, raise awareness, and strip this disease of some of the power that it has over people by talking about it. We must stand shoulder to shoulder with all who face it, with the clear message that, together, we will beat eating disorders.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 6th February 2018 Commons Chamber

[Michelle Donelan (Chippenham) (Con)]

5. What steps he is taking to improve mental health provision for children and young people.

[Edward Argar (Charnwood) (Con)]

8. What steps he is taking to improve mental health provision for children and young people.

[Kirstene Hair (Angus) (Con)]

13. What steps he is taking to improve mental health provision for children and young people.

--- Later in debate ---

[Mr Hunt]

I thank my hon. Friend for raising that issue, and I understand that in that particular case clinicians are meeting this week to resolve those issues. She is right: we need to expand the number of beds available for children and young people. They are at a record level—1,440, and that went up by another 81 last year—but more needs to be done, which is why we published our children and young people’s mental health Green Paper.

[Edward Argar]

I have been approached by a number of my constituents in Leicestershire who are concerned about the wait between a referral to child and adolescent mental health services and the allocation of a named caseworker and formal treatment. Will my right hon. Friend enlarge on how the steps that he is taking, which he has set out, will help to reduce such waits in Leicestershire and across the country?

[Mr Hunt]

I am happy to do that. The simple truth is that it is a tragedy for every child who has to wait too long to access mental health care, because half of all mental health conditions become established before the age of 14. If we do not nip them in the bud, they can get a lot worse. What are we doing? We are setting up a whole new service inside schools to spot such problems earlier and we are going to introduce a waiting time target for CAMHS appointments.

Mental Health Units (Use of Force) Bill

Edward Argar Excerpts

2nd reading: House of Commons
Friday 3rd November 2017 Commons Chamber

[Edward Argar (Charnwood) (Con)]

Like other hon. Members, I pay tribute to the work of the hon. Member for Croydon North (Mr Reed) in bringing forward this Bill. As someone who was lucky enough to get drawn in the private Members’ Bill ballot last year, I know that luck plays a part but, more importantly, so does passion. He has shown that in talking very movingly today about his constituent and what has motivated him to take forward this important Bill. I think his constituents will rightly be very proud of the work he is doing on it.

I very much welcome and support the Bill. I know from my casework and more generally that it will be welcomed in my constituency and more broadly across the country. The tone in which this debate has been conducted reflects very well on our proceedings in the House today, as does the fact that on such an important issue, hon. Members who wish to speak are having the opportunity to do so. Our constituents would expect no less. They would expect all of us who wish to speak to have the opportunity to put our views on the record about this important issue.

As the shadow Minister made clear, this Bill is about transparency and accountability. It is also about changing attitudes, and about risk. Most importantly, it is focused on making the processes involved in our treatment of those who are detained in mental health units more people-centric. As my hon. Friend the Member for Richmond (Yorks) (Rishi Sunak) said, the circumstances that can lead to someone being detained in a mental health unit could happen to anyone. Mental ill health can happen to anyone, and it is important that we remember that. We are talking about people at their most vulnerable in these situations. As my hon. Friend the Member for Hertsmere (Oliver Dowden) pointed out, we are very good as a society at understanding physical ill health because we can see it, but less good at understanding mental ill health because it is more intangible and much harder to see. The hon. Member for Croydon North said that this is about compassion, not cruelty. At times, given the nature of the circumstances, restraint may be needed at a moment of crisis, but it must be applied in the right way and it must be minimal. We must always focus on dealing with such incidents in the right way and doing what we can to assist people in their recovery.

It is important that we highlight—as hon. Members have done, most recently my hon. Friend the Member for Wells (James Heappey)—the debt of gratitude that we owe to all those working in the emergency services, including in the mental health setting, for the incredibly difficult job they do with an amazing degree of professionalism, compassion and care. In that context, I very much welcome clause 5, with its emphasis on the provision of training. This is about protecting and supporting not just those who are detained in mental health units, but those who may have to intervene in applying restraint. The hon. Member for Stroud (Dr Drew) referred to the need for those workers not only to be trained at the induction stage but to have the training refreshed throughout their careers. That is an important point.

This Bill is about reducing the use of restraint where possible, but, as I said, it is also about risk. Too often in our society, be it in the private sector or in the public sector, there is an understandable desire to eliminate risk. The reality is that that simply cannot be done. Instead, we must seek to understand and mitigate risk, and ensure that that understanding drives the right behaviours. The data that the Bill will provide, the transparency it brings, and the understanding of how restraint operates in these settings will all feed into a better understanding of risk that will hopefully improve the way in which we treat those detained in mental health units. Of course, as the hon. Member for Croydon North made clear, this is about justice. In the tragic cases—I hope they are few in number, but they do occur—in which someone dies, it is important that the evidence exists to facilitate justice for that person and to ensure that we learn the lessons of the incident.

Finally—conscious of the importance of giving all who wish to speak the opportunity to do so, because that is what our constituents would expect—I turn to the point about changing attitudes. Attitudes to mental health in this country are changing, but there is still a long way to go. Every time we talk about mental health in this Chamber, we help to change attitudes and reduce any stigma attached to mental ill health. It is right that we continue to do so. We are on a journey, on which this welcome Bill is a hugely important step. A similar step will be the review that is under way of the Mental Health Act. The legislation may be of its time, but it is certainly not fit for our time. In that context, in addition to what we are discussing today, we must seek to create a mental healthcare system of which we can be proud, and which is fit for the 21st century. It is a pleasure to support the Bill.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 4th July 2017 Commons Chamber

[Mr Hunt]

I completely agree with the hon. Lady that that is a very important issue. It is particularly important because people with mental health conditions need regular visits from their friends and family to help them to get over a crisis. Indeed, their chances of getting discharged and being able to go home are much higher when they are nearer home. She will be aware that we have a commitment to eliminate all out-of-area placements for children by 2020, and we are making big efforts with adults as well.

[Edward Argar (Charnwood) (Con)]

T4. Leicester and Leicestershire MPs, irrespective of party and led by the hon. Member for Leicester West (Liz Kendall), are united with local people, patients and medical professionals in opposition to NHS England’s badly thought out and, frankly, wrong proposals to close Glenfield hospital’s children’s heart unit. Can my right hon. Friend reassure me that he continues to appreciate the strength of feeling on this issue and that he will ensure that the eventual decision reflects the responses received to the consultation?

[The Minister of State, Department of Health (Mr Philip Dunne)]

My hon. Friend and other Leicestershire MPs have made their views very clear to me. I hosted a number of them, from both sides of the House, to discuss this issue. He is aware that the public consultation on congenital heart disease services continues until 17 July. Obviously, we will take all the comments made into account when we come to the conclusions from that report.

NHS Funding

Edward Argar Excerpts

Monday 31st October 2016 Commons Chamber

[Mr Hunt]

I am happy to visit the hon. Gentleman’s local hospital, as I have been concerned about it for some time. I know that things have been particularly challenging there in the wake of what happened in neighbouring Mid Staffs, which has created its own pressures on the hospital. I also know that its staff work extremely hard in very challenging circumstances, so, yes, I will visit that hospital.

[Edward Argar (Charnwood) (Con)]

Does my right hon. Friend agree that achieving improvements in public health comes down not simply to the amount of money spent by the Government on it, but to a range of factors, including how it is spent, regulation, education and individuals’ choices?

[Mr Hunt]

I absolutely agree with that. This House should be very proud of the fact that, according to the UN, when it comes to public health this is the fifth healthiest country on the planet—after Iceland, Andorra, Singapore and Sweden, if my memory serves me correctly. That is a record we want to continue.