Health and Care Bill

Debate between Jonathan Ashworth and Edward Argar

Report stage
Monday 22nd November 2021 Commons Chamber

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

rose—

[Edward Argar]

If the shadow Secretary of State will forgive me, the hon. Lady has attempted on a number of occasions to get in, so it is only fair that I give way to her.

--- Later in debate ---

[Edward Argar]

If I may make a little progress, I will then give way to my former boss, the former Secretary of State, and then, if I have time, to my hon. Friend.

To reiterate, as my right hon. Friend, the Prime Minister, said on 7 September, nobody—nobody—will be “worse off” than under the current system. Currently, around half of all older adults in care receive some state support for their care costs. This will rise to roughly two thirds under these reforms. This clause would also make a number of minor technical amendments to other sections of the Care Act 2014.

[Jonathan Ashworth]

Will the Minister give way?

[Edward Argar]

Before I give way to the right hon. Gentleman, I will give way to the former Secretary of State.

--- Later in debate ---

[Edward Argar]

Yes, of course, as we move through this reform process, it is absolutely right and vital that we work with our partners in the Local Government Association and local authorities of all political complexions. In respect of the impact assessment, I do believe that it is important that we have an impact assessment before this legislation completes its passage through both Houses.

[Jonathan Ashworth]

I am extremely grateful to the Minister. He is showing his typical courtesy in giving way. Many across the House are puzzled because we recall this document that the Government placed before the House when they asked the House to endorse the national insurance increase. Indeed, many Members did endorse that national insurance increase, even though they were breaking a manifesto commitment. This document actually says that it will introduce a care cap and

“deliver a core recommendation of the independent Dilnot Commission. It will be implemented using legislation already in place under the 2014 Care Act, which introduces the independent Dilnot Commission’s social care charging reform.”

It goes on to describe that as the “new cap”. Why have the Government moved away from the position of just a few months ago that they published ahead of a vote on increasing national insurance and moved to a policy now that disproportionately benefits those with greater assets, which surely cannot be fair?

[Edward Argar]

I am grateful to the shadow Secretary of State who, while I do not necessarily agree with what he says, as ever puts it courteously. We hold true to what we put in that “Build Back Better” document. It is necessary for this one particular element to see further primary legislation, hence the amendment today.

--- Later in debate ---

[Edward Argar]

I am afraid that I will not give way now.

[Jonathan Ashworth]

For Leicestershire!

[Edward Argar]

I did give way to the right hon. Gentleman, the shadow Secretary of State, and he is my other constituency neighbour in Leicestershire.

Let me turn to integrated care boards and integrated care partnerships. I remind the House of what my right hon. Friend the Secretary of State said on Second Reading. These bodies are critical for delivering the key aims of the legislation: reducing bureaucracy; supporting integration and collaboration; and improving accountability. At the heart of the legislation for these bodies is flexibility—giving systems the scope to shape structures according to their needs. This principle is widely supported across the NHS and local government, and we would not want to imperil that, which is why we will be resisting attempts this evening to constrain more tightly how ICBs and ICPs operate. However, we recognise that there are a number of points of clarification that would be helpful to include, and we have tabled a number of amendments to do just that.

Before we reach the meat of this section, there are a number of minor amendments to deal with. First, minor and technical Government amendment 29 will update a reference in the Health and Social Care (Community Health and Standards) Act 2003 to reflect the changes made to section 99 of the National Health Service Act 2006. Secondly, Government amendment 30 will designate integrated care boards as operators of essential services under the Network and Information Systems Regulations 2018. This will place requirements on ICBs to protect their network and information systems by managing risks to ensure service availability and prevent patient harm.

We expect ICBs to take decisions on IT investment, including on cyber-security, and owning systems—and the associated cyber-risk—that are critical to the provision of healthcare. This includes holding the shared care record. The loss or corruption of data from the shared care record could have clear implications for the delivery of care, and for wider public trust in the digitisation and data-sharing agenda. We must take this risk seriously, and assure ourselves that ICBs are doing so as well.

NHS England Funding: Announcement to Media

Debate between Jonathan Ashworth and Edward Argar

Monday 25th October 2021 Commons Chamber

[Edward Argar]

I am grateful to my hon. Friend, indeed my friend, and I understand and entirely appreciate where he is coming from. He is an assiduous parliamentarian and quite rightly, as Mr Speaker alluded to, he takes the role of this House extremely seriously, as do I. I suspect that what he says, just as what Mr Speaker said, has been heard loud and clear both in the Department of Health and Social Care and across the Government, including in the Treasury.

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

Thank you for granting this urgent question, Mr Speaker. I remember a time when Chancellors went into purdah before a Budget. Perhaps that tradition needs to return.

Fortunately, I received the press release on Sunday. I should not have, but I was sent it, and obviously Members should have received it, too. Of course the NHS is in a desperate state and is under crushing, unsustainable pressure, partly because of a decade of under-investment in infrastructure, the cutting of thousands of beds and raids on the capital budget. It means that today, hospitals are facing a repair bill of £9 billion, and we have sewerage pipes bursting, ceilings collapsing and equipment breaking down. The number of safety incidents in hospitals as a result of these problems has increased by 15% in the last year alone. Not only is the equipment old and outdated but, on a head-for-head basis, we have some of the lowest numbers of computed tomography and magnetic resonance imaging scanners in Europe and the highest numbers of fax machines. Capital budgets have been raided throughout the last 10 years. Will the Minister confirm that, in what he is announcing, the total capital budget will be ring-fenced and not raided in the coming years?

The Minister has not mentioned mental health, but we have thousands of unsafe and undignified dormitory wards. Will there be extra capital investment to get rid of them? If so, by when? Will the diagnostics centres that he mentioned be provided and run by the NHS or run and supplied by private sector contractors? He said that we will clear the 1.3 million backlog in diagnostic tests by the end of the Parliament, but nobody wants to see ghost surgical hubs or new equipment standing idle. Who will staff the diagnostics centres? Who will staff the surgical theatres? Who will operate the new equipment?

The Minister mentioned diagnostics staff, but we are short of one in 10 of them. We are also short of 55% of consultant oncologists, short of radiologists and short of 2,500 specialist cancer nurses. Will he guarantee that the Health Education England budget will be not frozen or cut but properly funded to recruit the thousands of extra doctors, nurses and NHS staff needed to provide safe care and bring waiting times down?

[Edward Argar]

I am grateful to the right hon. Gentleman—my constituency neighbour—for his sensible and reasonable questions. I will endeavour to answer each of them in turn. On capital, he will know, not least because his local hospital—mine as well—is in that list to receive capital investment as part of the overall 40 new hospitals programme, that an initial £3.7 billion has been already allocated to the 40 hospitals that we are committed to delivering by 2030. That is investment not just in maintenance but in replacing old or outdated stock with new hospitals to minimise those longer-term maintenance bills. He is right that we must continue to support ongoing maintenance, as we have done. To take one example, we did exactly that by making an extra £110 million available to help support the maintenance of RAAC—reinforced autoclaved aerated concrete—plank hospitals around the country.

On mental health, the right hon. Gentleman is right to talk about capital investment. In the context of those new hospitals, mental health facilities and hospitals are included. They have not been left out; they have got their share.

The right hon. Gentleman also rightly talked about staff, which, as I said to the hon. Member for St Albans (Daisy Cooper), is a key point. We have seen significant increases in the number of doctors and nurses. He is right to highlight the need for continued increases in specialisms such as radiographers and radiologists. I highlighted the increases that we have seen, but we know just how valuable they are. I alluded to the £12 billion that the Secretary of State announced back in September, a significant part of which will go to support the workforce in the delivery of elective recovery.

On how community diagnostic centres and community diagnostic hubs will both be selected and operate, we are working closely with the NHS on exactly how to do that to ensure that the workforce are sufficient and that we do not impose burdens over and above those already imposed on them. I think that I have answered the right hon. Gentleman’s questions, but I am sure that his hon. Friends will come back if I have missed anything.

Oral Answers to Questions

Debate between Jonathan Ashworth and Edward Argar

Tuesday 13th July 2021 Commons Chamber

[Edward Argar]

I pay tribute to my hon. Friend and the all-party group for their work. He raises an important point: the challenges posed by infection control and the impact of the pandemic on the operation of hospitals. That has had an impact in this space, but I entirely recognise the value and importance of hydrotherapy as a treatment for particular conditions and I will be delighted to meet him.

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

Of course the number of general and acute beds open across the estate impacts on a trust’s ability to get on top of the elective backlog, which now stands at 5.3 million—a record high—with 336,000 waiting over a year and 7,000 waiting over two years for treatment. On appointment, the Secretary of State promised trusts that they would get everything they need to get through the backlog. So how much will trusts get and when will they get it?

[Edward Argar]

It is an important question. The Secretary of State has made it clear that tackling the elective backlog is one of his key priorities in his new role. The right hon. Gentleman will be aware that the Government have already committed £1 billion to helping to tackle the elective backlog. That, of course, comes on top of the record funding of £33.9 billion to ’23-24 for our NHS, but that commitment remains. We will do whatever is necessary to ensure that our NHS can tackle the elective backlog and get those waiting lists down.

[Jonathan Ashworth]

I am grateful to the Minister for his answer, but if it is a priority of the new Secretary of State why on Friday were trusts told that the threshold for accessing that elective recovery funding was increasing, effectively making it harder for a trust to access funding at just the time when hospital admissions for covid are increasing and we have trusts, such as in Leeds and Birmingham, cancelling cancer surgery? Surely we should be giving trusts more resources now, not restricting access to the elective recovery fund.

[Edward Argar]

In terms of the elective recovery fund, we have worked with the NHS to determine the right thresholds and the right premiums for payment for elective activity over and above what we would be expecting in the circumstances. The NHS is doing an amazing job in difficult circumstances, as the right hon. Gentleman will appreciate, with the impact that infection prevention control restrictions have had on the ability of trusts to see the number of people that they normally would. Trusts are taking huge strides to restore services and the ERF is there to help to ensure that they are funded for that activity level so that they can get provision up and above where it needs to be in order to get the waiting lists down.

Covid-19 Restrictions: South Yorkshire

Debate between Jonathan Ashworth and Edward Argar

Wednesday 21st October 2020 Commons Chamber

[The Minister for Health (Edward Argar)]

With permission, I would like to make a statement on coronavirus, further to the statement made by my right hon. Friend the Secretary of State for Health and Social Care last night.

This virus remains a serious threat, and over a million people have tested positive for coronavirus in Europe over the past week. Here in the UK, we recorded 21,331 positive cases yesterday—one of the highest recorded daily figures. Average daily hospital admissions in the UK have doubled in the past 14 days, and yesterday we recorded the highest number of daily deaths, 241, since early June.

We must keep working hard, together, to keep this virus under control. We have been vigilant in monitoring the data and putting in place targeted local measures so that we can bear down hard on the virus wherever we see it emerging. We have seen how local action can help flatten the curve, for example in Leicester and Bolton. This targeted local approach, supported by our local covid alert level system, means we can have different rules in places like Cornwall, where transmission is low, from those in places where transmission is high and rising.

I would like to update the House specifically on the discussions we have been having with local leaders in South Yorkshire. The situation in South Yorkshire remains serious. There have been more cases in South Yorkshire so far in October—over 12,000—than in July, August and September combined. The number of patients with covid-19 in intensive care beds has reached over half the number seen at the height of the pandemic earlier this year, and the latest data suggests that the numbers of patients on mechanical ventilation will soon be comparable to the first peak in March. We need to act now to prevent the epidemic in South Yorkshire from continuing to grow.

I am pleased to inform the House that, following discussions this week, the Government have reached an agreement with South Yorkshire on a package of measures to drive down transmission. That means that South Yorkshire—so the city of Sheffield, Barnsley, Rotherham and Doncaster—will be moving to the local covid alert level “very high”, taking effect at one minute past midnight on Saturday morning. That includes the baseline measures to the very high alert level which were agreed by the House earlier this month.

As well as this, and as agreed with local leaders, unfortunately, casinos, betting shops, adult gaming centres and soft play centres will also have to close, and while gyms will remain open classes will not be allowed. On that point, the Liverpool city region and my hon. Friend the Member for Southport (Damien Moore) have also requested to bring their region into line with those measures. So gyms will be open and soft play centres will close in the Liverpool city region.

We know that some of the measures I have announced today are challenging and will have a real impact on people and businesses in South Yorkshire, so we will be putting in place substantial support. That includes the job support scheme, which ensures those affected by business closures are still paid. Once topped up with universal credit, those on low incomes will receive at least 80% of their normal income. The agreement also includes additional funding of £11.2 million for the local area for local enforcement and contract tracing activity. As well as that, we are putting in place extra funding so that local authorities in South Yorkshire can continue to support businesses through this period.

From the Dispatch Box, I would like to thank all the local leaders in South Yorkshire for the collegiate and constructive way in which they have approached the negotiations. I would like to thank all hon. Members representing constituencies in the region as well. We have worked across party lines to reach an agreement that will protect public health and the NHS in South Yorkshire, while also supporting those who need it most. I know those local measures will be hard and entail further sacrifice, but through bearing down hard on the virus, wherever and whenever we see it emerge, we can help to slow the spread of this virus and protect our loved ones and our local communities. The agreement will help us to protect lives and livelihoods in South Yorkshire and I commend the statement to the House.

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

I thank the Minister of State for advance sight of his statement. Today, we have another great swathe of the north put into lockdown. Sheffield went into tier 2 restrictions last Wednesday, so did Ministers make the wrong judgment a week ago or has new evidence come to light that was not apparent last Wednesday? How many other areas in tier 2 today are facing the same fate as Sheffield, such as those areas in tier 2 that neighbour South Yorkshire, such as North East Derbyshire or Nottinghamshire?

The Secretary of State could not answer yesterday the question of how long Greater Manchester will be in lockdown, or what the criteria will be for leaving lockdown, so can the Minister of State today tell us how long South Yorkshire will be in lockdown? Does the nationwide R number need to fall below 1, as the Prime Minister suggested last week, or just the regional R number? Or, if an area such as Doncaster gets the R below 1, will it be able to leave lockdown?

The Prime Minister at the Dispatch Box earlier talked about hospital admissions, so could the Minister tell us what level hospital admissions need to come down to for an area to exit lockdown?

As I said yesterday, my dad worked in casinos in Salford and my mum worked in bars. I know people will want to do the right thing and will understand that further measures are necessary to contain the spread of the virus, but families should not face financial ruin. The Minister wants congratulations for the package he has allocated to South Yorkshire, but why is contact tracing funding subject to the negotiations and deals? The virus is out of control because of the failures of the £12 billion test and trace system. If local areas had been given the resources months ago to put in place effective contact tracing, we would not be in this situation now. Those failures on contact tracing are having a direct impact on people’s lives.

This afternoon, families across South Yorkshire who work in hospitality—whether in Doncaster, Sheffield, Penistone, Rother Valley or Don Valley—will be asking why, if it was fair to pay 80% of wages in March, they should now be expected to get by on just two thirds of their wages in the run-up to Christmas. This matters to families everywhere, because we know that further restrictions will be needed. Indeed, according to sources briefing Times Radio, plans are being developed for a three-week lockdown more widely next month. Perhaps the Minister could confirm that his officials are now working on plans for a three-week national lockdown next month.

The Communities Secretary said this morning that there was now a national formula for areas under local lockdown, but Ministers say they want a targeted local approach because circumstances vary. Yet when an area such as Greater Manchester, which has had restrictions since July, says, “Our circumstances are different,” the Prime Minister says, “Tough. Hard luck. You can’t be treated any differently,” and vindictively refuses Greater Manchester just £5 million extra to get a deal over the line. This is playing politics with people’s jobs and people’s livelihoods. We cannot defeat this virus on the cheap, nor should it be broken on the backs of the lowest paid. Public health restrictions must go hand in hand with economic support, because as night follows day, falls in employment lead to rises in chronic illness. The Chancellor must pay out to help out, and deliver a fair deal to support jobs and livelihoods under lockdown.

[Edward Argar]

I am grateful to the hon. Gentleman, my constituency neighbour up in Leicestershire. He was, as usual, typically reasonable and measured, until almost the last moment, when I am afraid the only person playing politics was him.

To address the hon. Gentleman’s points, we are taking these steps now, at the right time, as the infection rate has continued to go up. In respect of other tier 2 areas or neighbouring tier 2 areas, it is only this announcement that we are planning to make at this point. It is the only move that has been announced and that is currently being considered.

The hon. Gentleman asked about criteria, essentially— a number of his questions were, “How long for?” and, “How will it be judged?”, which are fair questions. Areas will remain in tier 3 or tier 2 for as long as necessary to protect the health of the local people and the NHS in that region. He asked about the sort of things that will be relevant to when an area enters and comes out. These include infection rates per 100,000, the impact on the NHS in terms of hospital capacity and how full hospitals are, and hospitalisation rates, as well as relying on local knowledge and listening to local public health officials, as he would expect us to.

The hon. Gentleman touched on contact tracing and how that is working. What we have in this country is a blended system, which brings together the scale of a national approach with the local knowledge provided by local public health teams. He has seen in his own city of Leicester how effective that can be and how both parts are absolutely vital.

The hon. Gentleman finished by talking, I think reasonably, about the need for economic support for those affected by this. As I set out in the statement, the job support scheme, coupled with universal credit for those eligible, will ensure that people receive at least 80% of their wages. On his broader point about the big picture of economic support, I would remind him that this Government and the Chancellor have provided an unprecedented package of economic support over recent months to businesses and individuals. The Government are very clear in our commitment to protect the health of this nation and the economic health of this nation.

NHS Funding Bill

Debate between Jonathan Ashworth and Edward Argar

2nd reading & 2nd reading: House of Commons
Monday 27th January 2020 Commons Chamber

[Edward Argar]

I have already stated that at the Dispatch Box and my hon. Friend makes the point even more forcefully.

Let me turn to the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth). Like the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), he is a good man and genuinely believes passionately in our NHS, and he campaigned passionately for his party. I have to say, though, that I was a little surprised by his comments suggesting that the Bill caps spending. Had he read the Bill, he would have found that, only four lines in, it states clearly:

“an amount that is at least the amount specified”.

That is a floor, not a cap.

More broadly, I suggest to the Opposition that they may want to be a little cautious when talking about the financial situation that we inherited. Labour’s legacy, as so wonderfully encapsulated in a letter by the former Chief Secretary to the Treasury, the right hon. Member for Birmingham, Hodge Hill (Liam Byrne), is that “there is no money”. It is this Government who have invested in supporting and rebuilding our nation’s finances to give us the strong economy that allows us to invest in our NHS.

[Jonathan Ashworth]

I am grateful to the Minister for his comments about me. He is a fellow Leicestershire MP and I know that he is passionate about the NHS as well.

If the Bill is not a capped-expenditure Bill, why are the numbers in it in cash terms and not the real-terms percentage increases that the previous Secretary of State, the right hon. Member for South West Surrey (Jeremy Hunt), set out to the House in June 2018?

[Edward Argar]

Because the cash set out in the Bill is the money that the NHS is going to be getting as a floor.

The shadow Minister rightly raised the issue of mental health. My right hon. Friend the Secretary of State was rightly clear that spending on mental health provision will increase the fastest under the proposals in the Bill, with spending on children’s mental health increasing the fastest of all. I am sure the Opposition will welcome that.

My right hon. Friend the Member for South West Surrey (Jeremy Hunt) rightly highlighted the quantum of spending and how that compares to other countries around Europe and, indeed, in the OECD. I pay tribute to him, because a lot of what we are talking about today is based on the foundations that he built when he did such a fantastic job as Secretary of State.

The hon. Member for Central Ayrshire (Dr Whitford) and my hon. Friend the Member for West Aberdeenshire and Kincardine (Andrew Bowie) rightly alluded to the Bill’s impact on Barnett consequentials and spending in Scotland. As the hon. Lady will know, the Barnett consequentials will apply. My hon. Friend highlighted the fact that not only the NHS in England but the NHS in Scotland faces challenges that we must all step up to meet.

My hon. Friend the Member for Newton Abbot (Anne Marie Morris) highlighted the need for us to focus not just on inputs but on outcomes and what we achieve with the money that we invest. That is exactly what the Secretary of State is determined to do.

The hon. Member for Nottingham South (Lilian Greenwood), a fellow east midlands Member, highlighted the need for capital investment in her local hospitals in Nottingham. I am happy to meet her to discuss that further, if that would be helpful to her.

Let me turn to maiden speeches. My hon. Friend the Member for Darlington (Peter Gibson) made an excellent maiden speech. As Members have said, his predecessor Jenny Chapman was respected and well liked in the House. I suspect that, given his speech, he will achieve exactly the same distinction. He spoke forcefully and powerfully on behalf of his constituents. I am sure that they will find him a doughty local campaigner in their interest.

My hon. Friend the Member for Ashfield (Lee Anderson) paid tribute to his predecessor, Gloria De Piero, who was my shadow when I was a Justice Minister. He was right to pay tribute to her, because she was a fantastic colleague to have in this House. None the less, he achieved a fantastic result. As a fellow east midlands MP, I know his constituency well. It is a fantastic place and his constituents are very lucky to be represented by him. He is a local man standing up for his community. He also spoke movingly of his journey—if I may put it this way—from pit to Parliament, and the power of social mobility, of aspiration and of opportunity. He reminded me of a former colleague of ours and a good friend of mine, Sir Patrick McLoughlin, who made the same journey. He ended up in the Cabinet, so I will be watching my hon. Friend’s inevitable ascent carefully.

The hon. Member for Feltham and Heston (Seema Malhotra) touched on, among other things, Heston health centre. Again, as ever—as in my previous role—I am happy to meet her to discuss that. The hon. Member for Kirkcaldy and Cowdenbeath (Neale Hanvey), in an eloquent but forceful maiden speech, clearly put this House on notice that he will always speak up for his principles and his beliefs, and, while we may on occasion disagree on policy, I doubt we will disagree on his passion and determination to champion his constituents’ interests.

My hon. Friend the Member for Dover (Mrs Elphicke) also focused on achieving outcomes. She touched on the tragic death of Tallulah-Rai Edwards. I extend my condolences to the family, but may I also say that my hon. Friend the Parliamentary Under-Secretary of State for patient safety will be happy to meet her to discuss that in more detail.

It is always a pleasure to meet the hon. Member for Easington (Grahame Morris) and to hear from him. We have met previously, and he and the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), are due to meet again to discuss this matter in a few weeks’ time when we will pick it up further.

Let me turn now to my hon. Friend the Member for Birmingham, Northfield (Gary Sambrook). May I pass on my congratulations to his sister on the birth of Freddie and pay tribute to all staff, as he did, working in our amazing NHS for the work that they do. Many hon. Members paid tribute to them, including the hon. Member for Rhondda (Chris Bryant), and my hon. Friend the Member for Banbury (Victoria Prentis)—I have no doubt that I will be hearing from her about the Horton on many occasions in the future. My hon. Friends the Members for North Dorset (Simon Hoare) and for South Dorset (Richard Drax) made powerful pleas for investment in their community hospitals and in their local health infrastructure. I am a regular visitor to the constituency of my hon. Friend the Member for North Dorset, so I look forward to visiting both colleagues in due course.

As well as talking about Crawley Hospital, my hon. Friend the Member for Crawley (Henry Smith) highlighted the need for Gatwick airport to be included in the conversations on the coronavirus, and I know that my right hon. Friend the Secretary of State will have heard what he said, and is already factoring that in.

Before concluding, I will touch very briefly on two other contributions: my hon. Friends the Members for Stoke-on-Trent Central (Jo Gideon) and for Stoke-on-Trent North (Jonathan Gullis)—and indeed my hon. Friend the Member for Stoke-on-Trent South (Jack Brereton), who was not in his place. They have all highlighted the issue of the private finance initiative. I am happy to meet them to discuss it further.

Let me turn now to my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) and the hon. Member for Mitcham and Morden (Siobhain McDonagh). I have to say that my hon. Friend made a very strong case for the benefits that this investment will bring for all those who are served by his local trust. I encourage the hon. Lady to engage with this process and engage with the benefits that this investment will bring.