Health and Care Bill (Third sitting)

Hywel Williams Excerpts

Committee stage
Thursday 9th September 2021 Public Bill Committees

[The Chair]

Could I just ask you to keep your answers to within the scope of the Bill, please? Also, I ask if we could perhaps have more succinct answers. I still have several people who want to ask questions and we do not have a lot of time to get them in. I intend to call the Front Bench spokespeople at about 10 minutes to 12. I now move to the hon. Member for Arfon (Hywel Williams), but if we could keep to the confines of the Bill, that would be good.

[Hywel Williams (Arfon) (PC)]

Q This question is specifically for Sara. You said in your response to the Bill that you agree with the Select Committee recommendation for an annual report on workforce shortages. The workforce move, specifically between England and Wales, very freely and the Governments of Wales, Scotland and Northern Ireland have their own appreciation of workforce shortages and how to respond. For example, after a long campaign, we now have a medical school being set up in Bangor in my constituency. Anyway, the point of my question is how do you see the Governments in those parts of the United Kingdom being able to feed into the process without ceding their power to decide for themselves? How do you see it going?

Sara Gorton: This is a matter of no small significance to organisations such as my own that have membership across the UK. That ability to understand and translate the statistics that we get from one environment in the UK to another, and understand how that feeds through and get a whole picture of it, is really difficult at the moment. That is not just for the basic nuts and bolts of who is in the workforce at the moment, doing what job—the training plans, the workforce planning, and other aspects of workforce are really difficult to compare.

The short answer is that we would like to be involved in the interpretation, assuming that we do get that amendment through and the workforce reporting is on a more frequent basis than five years. We would like to be involved in the conversation about what that looks like, and how it can answer some of the issues that you have raised about feeding into a UK-wide perspective as well.

[Hywel Williams]

Q You see that in Wales, acting through the Welsh Government, so would you be seeking direct access regarding Welsh issues to the Government here in Westminster?

Sara Gorton: That is not something we have considered in the passage of the legislation so far, but we are certainly willing to talk about it in future.

[Hywel Williams]

Q Lastly—if I may, Chair, very briefly—a great number of people from Wales receive treatment in England, mainly from north Wales. They go to Merseyside and Manchester, and sometimes to London as well, so I am sure you would be in favour of the health bodies in those areas taking due regard of not only the health needs of their own population, but those of the population that comes in from Wales.

Sara Gorton: There are all sorts of workforce aspects that are very relevant to the England and Wales environment. The joint systems we have for pay and pensions, and workforce planning as well, all need to be factored in, but lots of work on the detail of the workforce reporting is needed.

[Hywel Williams]

Thank you.

[Dr James Davies]

Q I am interested in Unison’s position on the social care aspects of the Bill, and in particular the CQC inspection that is proposed, and also the data collection powers, please.

Sara Gorton: That is not an area of the Bill that we focused on. Our main focus is on extending the provisions of the provider selection regime—the procurement. I can do some more work and send in something.

--- Later in debate ---

[The Chair]

Thank you very much. We have about 10 minutes, and three people have indicated that they want to ask questions, so if we could direct our questions to one person and keep questions and answers brief, that would be very helpful, because I would like to include everybody.

[Hywel Williams]

Q I have a question for Pat. You have indicated some concern about the new powers regarding professional regulators and the fact that there may be changes, including the dismissal of regulators and that sort of thing, through secondary legislation. Given that those bodies are UK-wide, do you think that the Senedd, the Welsh Government in Cardiff, and the other Governments should have some input into those sorts of decisions about professional regulators?

Pat Cullen: We have had some thoughts about this across the countries—and we can learn from all of the countries, really. Of course, you will know from my accent that I come from Northern Ireland, and our regulator is a four-country regulator. In relation to the standards that are referred to within the Bill, I think our royal college will play an important role in terms of working with our regulator to look at some of the devolved responsibilities and the role that we can play in setting standards for our profession, and assisting and supporting our regulator in the setting of those standards right across the country, and obviously the other countries as well.

More recently, we have just brought out our nursing workforce standards, which apply across the four countries, and we had significant engagement in those right across the four countries. If you look at those standards being aligned in the new Bill and reading across to the new Bill, working across with our regulator and having more powers devolved to a royal college will enhance the regulator’s response to standards and the applicability of those standards, and their implementation across the countries.

[The Chair]

Thank you very much, Mr Williams. I now turn to Edward Timpson.

Health and Care Bill (First sitting)

Hywel Williams Excerpts

Committee stage
Tuesday 7th September 2021 Public Bill Committees

[Chris Skidmore (Kingswood) (Con)]

Q I want to return to the issue of workforce planning, which obviously is integral to both of your organisations. You have discussed the strategic framework you have been working on, and hopefully that will evolve into a workforce strategy, which is addressed in clause 33 of the Bill. I have tabled an amendment to clause 33 which is to make the workforce report annual rather than once every five years. I think that the pandemic has demonstrated the futile nature of trying to produce a report once every five years, when we know that the nature of the workforce could change radically during that period. Would your organisations agree that it would be better for that report to be produced on an annual basis? Clause 33 states that NHS England and Health Education England

“must assist in the preparation…in this section,”

but only

“if requested to do so by the Secretary of State.”

You have talked about locally led decision making and planning. Do you both agree that we need better co-creation? My amendment covers the fact that a plan should be developed and agreed by stakeholders in particular. Would your organisations welcome this amendment, which would result in an annual workforce strategy and require it to be developed by all other healthcare organisations working in this sphere?

Dr Navina Evans: From HEE’s perspective, we will deliver on the duties that Parliament decides that we ought to deliver. We feel that we have the capacity and the capability. We can organise ourselves to deliver whatever is required of us by the Bill. The work that we do is lithe—it is iterative. We do iterative planning, in a meaningful way, at the national and system level, so we will be able to respond and fit in with whatever is required of us by the Bill and Parliament.

Danny Mortimer: Thank you for the question. Absolutely, there is an opportunity for the Bill to define a wider range of stakeholders. The systems at the centre of the Bill—integrated care boards and integrated care partnerships—are central to that, and their perspectives, as we have just talked about with Ms Smyth, in terms of the needs of their population and the services they need to put in place to respond to them, need to be at the centre of the process that Navina and others would lead on behalf of the Secretary of State. That is the first thing. Secondly, there is an opportunity through those systems to broaden our conversation to include social care as well as health. That is really important to us on this day of all days, in terms of the announcements later.

In terms of the regular appraisal, we absolutely believe that five years is absolutely insufficient for the task. We also believe that it cannot just be about process. It has to be about setting out clear requirements and clear specificity about those requirements over different time periods. There is something about the short-term need, and there is also something about five, 10 and 20 years. It needs to be regular. We have proposed two years because it is a huge amount of work and that feels to us to be a minimum in terms of how regular the perspective could be, but it may well lend itself to an annual update, as you have described.

We also see that organisations such as Health Education England and Skills for Care, which operates in the social care sector, absolutely have the capacity and capability to lead this work. Their way of working, similar to the Department’s way of working throughout the preparation of this Bill, is about engaging, convening and trying to bring stakeholders together to get a broad range of perspectives. That is our experience of the long-term process that Navina and her colleagues are leading on behalf of the Department at the moment. The Bill confirming that would confirm ways of working that we are starting to see develop with stakeholders in a really healthy and constructive way.

[Hywel Williams (Arfon) (PC)]

Q Good morning. This Bill is mainly about services in England, apart from the part about the health services safety investigations body and clause 112 on Welsh health bodies requesting help. However, there is significant traffic from Wales to England, and a certain amount in the other direction, to access health and care services. This might impact on services in the north-west of England and along the Welsh border. This is a very broad and quick question: in what ways do you see yourselves and other health bodies in England taking account of the priorities and needs of the Welsh Government and of the Welsh population to access health services in England?

Danny Mortimer: There are important links with Wales, and of course with Scotland as well, in many parts of the country. There are a couple of things to say. The first is that there are undoubtedly things that the English system can learn, and is learning, from our colleagues in Wales, Scotland and Northern Ireland who are taking similar approaches in terms of how they respond to the challenges we face in social care and health. In my own organisation, we represent organisations in Wales and Northern Ireland, and there is a really rich learning that we can do there.

Secondly, in practical terms, there are good lines of communication and liaison between healthcare organisations that operate along the borders that you have described. It will carry on being really important that those lines of communication, that liaison, the financial arrangements and the sharing of care between different teams on various sides of the borders continue, and we see nothing in the Bill that prevents that. If anything, we see opportunities through better co-ordination in England at a system level to be able to help patients who travel across from Wales into England, or patients who travel from Scotland into England. If anything, I think we can improve the planning and liaison through what is in this interesting Bill.

Dr Navina Evans: We already have very strong four-country relationships, particularly in the education and training space, where we make sure that we share standards, that we do planning around the curriculum and the reform of education, that we ensure quality and that we go for improvements in the way in which we support and train our future healthcare workers. In the regulation space, we work very closely with the General Medical Council, the Nursing and Midwifery Council and other bodies, to make sure that that happens. They obviously have four-country oversight, so we already work very closely with them. Also, all our professional bodies, such as the royal colleges, have to represent members from across the whole UK. In that space, there is a lot of good work that we can continue to build on, learn from and share as a result of this Bill.

[Hywel Williams]

Q I am very glad to hear what you have said. Professional staff are notoriously footloose, as far as Wales is concerned, so there is a certain issue about workforce planning. In my own area, I used to teach in social work education. We have a nursing school at Bangor University, which is a very valuable provision, but I am not sure how many are retained in the health service in Wales—or the other way around, of course.

There is one other point I would make, and this is more philosophical than practical. The Welsh Government’s approach to health is based on a wellbeing model. It is much more proactive than other models. I hope that, philosophically, that sort of approach is useful and interesting for you, and that you will be taking full notice of it.

Danny Mortimer: The second point, in particular, is really well made. That is absolutely the focus that we see integrated care systems taking. The engagement with population health that Navina described is about trying to gear a system much more to long-term investment in the quality of people’s lives.

We have become, in recent years—even before the pandemic—much more geared towards crisis response. That is not in the best interests of the long-term health of the population. It does not help us to address the inequities that we see in our population, and that we saw very starkly during the pandemic.

Navina may be aware of the issues around workforce mobility between the four countries. The co-ordination that Navina leads, and that we have with our professional regulators, is really important. We have a shared workforce, and we have shared approaches to education as well as things such as pay and contracts. That is really important to ensuring that the job market is stable, particularly if we experience supply issues in particular geographies or parts of the workforce.

Dr Navina Evans: I have nothing to add on the movement of the workforce between the four countries, but I take the point that this is something we need to be mindful of, and I will make sure that the issue is a priority in our conversations with our counterparts in the four countries.

On wellbeing services, that is absolutely the way in which the reform of education and the curriculum is moving. Health Education England is working with partners to develop that. Our integrated care systems, and our colleagues running services who are closest to the point of care, and who know their populations best, have been saying for some time that we need to focus on wellbeing, prevention, intervening earlier and keeping people well. That is a priority for our partners in NHS England and NHS Improvement as well. We already have programmes of work to take this forward.

[Hywel Williams]

Thank you.

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

Q Good morning. Thank you for coming. I am sure that you will be aware that everyone in the country, and the whole Committee, is very grateful for the work done by frontline health and social care staff, not only over the past 18 months, but over many years. The consequences of that work have been starkly drawn to everyone’s attention by the Health Committee report on staff burnout. What in the Bill will address the issues raised in the report?

Dr Navina Evans: I will give you three points that are really important. One is the absolute priority, focus and prominence given to looking after our workforce. Again, we will build on work that we have already been doing in the last few years. For example, in the interim pupil plan, there is a very strong focus on wellbeing, culture, leadership and retention. We have been working, together with Danny’s organisation and others, on thinking with staff about retention. One thing that is really important is looking after people. There are lots of good examples of work being done all around the country to improve wellbeing and therefore retention, and to minimise or prevent burnout. This is quite high on the agenda for our partners in NHS England and NHS Improvement. It is very high on the agenda for us in HEE, because we look after our students, trainees and learners, who are also part of the workforce, and they tell us what helps to keep them well and prevent burnout. We need to start doing that work, which is part of our business, very early on.

I am pleased to say that our partners in the universities, royal colleges and other professional bodies are really mindful of this. They all have work streams around wellbeing and preventing burnout. In the Bill, we can highlight the importance of this, and build on work that is already being done to look after our staff.

Covid-19: Government’s Publication of Contracts

Hywel Williams Excerpts

Tuesday 9th March 2021 Commons Chamber

[Edward Argar]

I pay tribute to my right hon. Friend for that question. I started out in Government as his Parliamentary Private Secretary when he was the apprenticeships Minister, and that is something that he has taken a huge and passionate interest in throughout his time in the House. I am sure that colleagues in the Cabinet Office responsible for Government procurement across the piece will be very happy to have a conversation with him about the point that he has just made as to how greater use of apprenticeships can be baked into procurement decisions.

[Hywel Williams (Arfon) (PC) [V]]

Initially, the Welsh Government anticipated a UK-wide approach to buying PPE; they then took responsibility for their own procurement, but they have still worked with this Government when the opportunity has arisen. Therefore, did the Secretary of State seek the agreement of the Welsh Labour Government before awarding any relevant contracts without competitive tendering or transparency, and did the Welsh Government themselves raise any concerns about the lack of competition on their own initiative?

[Edward Argar]

My understanding is that the procurement process for PPE, as the hon. Gentleman rightly highlights, was a UK procurement process. As he will have seen, we invoked regulation 32, recognising the speed needed to meet the demand for PPE in the frontline, and throughout this process we worked at pace to ensure that the focus was on the procurement of the PPE required. Throughout this process—throughout this pandemic—we have worked closely with the Welsh Government.

Covid-19 Update

Hywel Williams Excerpts

Tuesday 2nd March 2021 Commons Chamber

[Matt Hancock]

I do not have those specific figures to hand, but the MHRA—the regulator—regularly publishes what are called adverse events when somebody still has a problem with coronavirus having had the vaccine or has a response to the vaccine, and I will ensure that the appropriate body, whether it is MHRA or Public Health England, publishes both the number and the percentage.

[Hywel Williams (Arfon) (PC) [V]]

The covid testing package reservation form for international travellers from red list countries into England requires proof of purchase of two covid-19 tests before they can travel on to England and Scotland. However, there is no reference to Wales on the form. Will the Secretary of State assure me that that is an oversight that will be remedied immediately and that international travellers from England continuing on to Wales are indeed required to comply with the testing and quarantine rules?

[Matt Hancock]

Yes, all international passengers are required to comply with the rules. It is the first time I have heard of that particular issue. I will write to the hon. Gentleman to set out either why the system is done in that way or that it has been rectified, if that is what is needed.

Covid Contracts: Judicial Review

Hywel Williams Excerpts

Wednesday 24th February 2021 Commons Chamber

[Edward Argar]

I have made it clear that I and Ministers always respect the courts and the judgments delivered in them. I also have great respect for, and recognise the importance of, transparency. I would say to the hon. Lady, however, that I also respect the need to rapidly deliver the PPE that was needed last year at the height of the pandemic, which is what our constituents would expect us to do. As we cast our minds back, I think that is what they would have wanted us to focus on at that time. On her final point, yes I am quite happy to restate the Government’s commitment to the importance of transparency.

[Hywel Williams (Arfon) (PC) [V]]

Using the VIP lane, a PPE contract for £313 million was awarded to PestFix, a company that had never before supplied medical PPE. To put this fantastical sum into perspective, a free school meal every day for a year for every child in Wales in a family getting universal credit would cost £101 million —less than a third of the sum gifted to PestFix. Given the Minister’s unapologetic replies so far, does he even begin to understand why the perception of his Government’s default cronyism has angered so many people?

[Edward Argar]

I am grateful to the hon. Gentleman. I will not comment on specific cases because, as I mentioned at the beginning, some are still subject to actions before the courts and I do not want to cut across those legal processes. The broader point I would make is that I think people will understand that this Government and the unsung heroes of the pandemic—the civil servants and officials who have worked throughout it—pulled out all the stops to do what was necessary and essential to procure the PPE. If we look back 10 months or so, it was the most pressing issue in this country to ensure that our frontline workers got the protection they needed.

Covid-19 Update

Hywel Williams Excerpts

Tuesday 9th February 2021 Commons Chamber

[Matt Hancock]

Yes, of course I will.

[Hywel Williams (Arfon) (PC) [V]]

Yesterday, the number of deaths from covid in Wales passed the grim total of 5,000. Our public health leaders say that the Welsh Government’s £500 self-isolation payment is not enough and is indeed an economic driver for people to go to work. Sick pay, on the other hand, is the responsibility of this Government, so will the Secretary of State now commit the Government to increasing the paltry level of sick pay, as suggested, from £96 per week, to enable working people to self-isolate safely?

[Matt Hancock]

We have put in place the extra £500 for those on low incomes to ensure that everybody can get the financial support that they may need while self-isolating.

Covid-19 Update

Hywel Williams Excerpts

Tuesday 2nd February 2021 Commons Chamber

[Matt Hancock]

I can confirm what the Prime Minister has set out: schools will be the first in the queue for reopening. We will consider the data in the middle of this month, my right hon. Friend the Prime Minister will set out a statement after that, and we will give two weeks’ notice. Schools will not open before 8 March, and of course we will look at the data, as I set out in a previous answer.

[Hywel Williams (Arfon) (PC) [V]]

The Health Minister in Wales has now admitted, at last, that many lives could have been saved had the Welsh Labour Government locked down sooner last year. Does the Secretary of State believe that an earlier general lockdown in England would have saved many lives? If so, how does that belief inform the quarantine and lockdown decisions that his Government now face?

[Matt Hancock]

We have taken action very rapidly when we have seen rises in cases. The most recent example here in England was, of course, right at the start of this year, when we saw the sharp spike in cases and took very rapid action to close schools after some of them had been open for just one day. We do not take such measures lightly and we understand the impact that they have, but they were absolutely necessary.