Edward Argar
MP for Melton and Syston · Conservative · United Kingdom
“I will not keep the Committee long. I am very pleased to see the hon. and gallant Gentleman, the Minister, still in post, as this is a policy area that he has cared deeply about throughout his life. I share the broad support for the instrument expressed by the shadow Minister, my hon.”
“I appreciate it may be set out in the 2006 or 2025 primary parent legislation to these draft regulations, but if he can, I would be grateful for a little clarification. Finally, paragraph 10.1 of the explanatory memorandum refers to the legislation being continuously monitored.”
“I live in my patch and I know that there will be genuine local fury at the contempt this Government have shown for my constituents in approving a Leicester city land grab, which has cross-party opposition locally.”
“Lady was right to highlight in her remarks the importance of timely discharge from hospital as a key element of whether we can achieve that flow into hospital beds and have hospital bed capacity to allow an A&E department or emergency department to function.”
“That should not be a challenge; I suspect that that data is already extant in some part of the system. She is proposing a very moderate measure, which would pull all that together in one place, and allow it to be focused on and looked at in the round, rather than in disparate little penny packets of data.”
“Gentleman’s point, however, that with many of these things—both clinicians and coroners grapple with this—it is often complex to determine the actual most significant contributory factor. My hon.”
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“I am grateful to the hon. Lady; to be fair, we may not always agree, but she always makes thoughtful points and knows this subject well. However, many right hon. and hon. Members across the House have regularly said that Exercise Cygnus gave everyone everything they needed to know in how to manage this pandemic, which is completely not the case. That was a flu pandemic exercise with a number of preconditions, one of which was that, at a certain point, it was assumed that antivirals would become available within—I think, off the top of my head—nine weeks of the pandemic beginning. That was not the case, because we were dealing with a completely new virus, so although there are valuable lessons to be learned, we need to be very careful about drawing direct parallels. The hon.”
“I agree entirely with my hon. Friend. As I said in response to the SNP Front-Bench spokesman, the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar), I hope the whole House could agree on paying tribute to all those civil servants and others who moved heaven and earth to ensure that we got the PPE that we needed for the frontline. That is the most important factor. We did what we needed to get the PPE to protect people and to protect lives.”
“In any circumstance where a contractual obligation has not been met or where goods that have been supplied do not meet that—I am not suggesting that is the case in this situation—we will look into it. The hon. Gentleman mentions company accounts, but that is a matter for the company and its filing of accounts; it is not a matter for Her Majesty’s Government.”
“My hon. Friend puts his finger on the issue absolutely. I mentioned in response to the hon. Member for Worsley and Eccles South (Barbara Keeley), who is no longer in her place, that a small proportion of this £8.7 billion went on PPE that did not meet the standard, and we continue to pursue those contracts and investigate them. However, my hon. Friend is right to say that the vast majority of this money purchased PPE that was delivered and is usable, and the difference in money reflects the fact that we bought at the height of a global pandemic, doing whatever was needed to get the supplies we needed. Of course, in the two to two and a half years since, that market has stabilised, with significantly more manufacturing also in this country.”
“The hon. Lady will know that I have not said that this is not real money; I have said that what has been published here in the accounts is what is required for an accounting purpose. The PPE was purchased, and that was done at the height of a global pandemic and at extremely inflated prices, because every country was desperately seeking to acquire the PPE that was needed. That situation has stabilised over the past two years and PPE can now be purchased for a much, much cheaper rate. Again, I make no apology for our purchasing this PPE to protect these very nurses, who did an amazing job in her local hospital, from the effects of covid.”
“That was a dexterous way of weaving together PPE and vaccines, but my hon. Friend is right to pay tribute to the amazing work done by the vaccine taskforce and by officials and others across Government in meeting the needs of our population during the pandemic. Of course I join him in welcoming the Novavax vaccine and the opportunities it presents for wonderful Teesside.”
“I pay tribute to the hon. Gentleman for, as ever, dextrously mentioning his Bill. I think he has done that to me once before when I have been at the Dispatch Box discussing similar issues. I am sure that Ministers, and indeed the Leader of the House, will read it very carefully.”
“I am grateful to my hon. Friend and join him in paying tribute to the work of his local healthcare system during the pandemic. He makes a couple of points. First, he is absolutely right to highlight that this was ramped up at pace. Initially, the NHS supplied PPE directly to about 250 hospital trusts and other trusts. In the early months of the pandemic, that was ramped up to supplying it to well over 50,000 different settings. That is a phenomenal ramping up of logistics and distribution capabilities. To his second point, he is absolutely right that, from about 1% of PPE being manufactured in the UK before the pandemic, we now have the capacity to manufacture about 70% of the PPE it is currently assessed we need in this country. That is a great British success story.”
“I take the hon. Gentleman’s point about speed and the context in which we were operating. I have to say all contracts were assessed through an eight-stage process undertaken by neutral civil servants. As the National Audit Office found, Ministers were not involved in the award of contracts.”
“I think I am the only Member who has been a Health Minister throughout this pandemic, and I recall them desperately calling in 2020 for whatever it took to get and buy more PPE to protect the frontline. I agreed with that stance, but now they are suggesting that the Government got it wrong by prioritising whatever it took to get the PPE that the frontline needed.”
“Lady touched on NHS funding and pressures. I appreciate that she was not a Member of this House at the time, but this Government have put in record funding for our NHS. One of the first Acts after the 2019 election enshrined in law a £33.9 billion increase by 2023-24, and we are also putting in place the health and care levy to both assist our NHS and provide that sustainable footing for social care in the future. I acknowledge entirely that she was not a Member of this House, so it would be wrong to draw any inference as to how she may have voted, but I want to put that record investment on the record. I also gently say that the Liberals’ stance on this issue shows, even by their standards, a degree of political contortion and a stretching of credibility.”
“I welcome the hon. Lady to her place. I do not think I have had the opportunity to respond to a question or a speech from her previously, so I congratulate her, slightly belatedly, on her election and welcome her to this place. I will just correct one thing. She mentioned £9.7 billion. The sum involved is actually £8.7 billion. To the hon. Lady’s point, first, it is not wasted. As I made clear, it purchased PPE. There is a small amount in these accounts which has been made clear. The shadow Secretary of State said that it was snuck out. If I recall, I tabled a written ministerial statement to draw attention to these issues to be open and transparent with the House, as I always endeavour to be. We did whatever was needed at the time, in the context of the highly inflated pricing in the midst of a global pandemic. More broadly, the hon.”
“I hope that, as we are able to bring forward more information, we will make it available to the House.”
“I am grateful to the hon. Lady for asking a sensible and serious question. We have already recovered, through prevention or termination of contracts, £157 million of potential fraud. We continue, with our anti-fraud unit, to look into a number of contracts where there is either a contractual dispute or a risk of fraud. There are contractual mechanisms for reconciling or trying to manage situations in which both parties have different interpretations of whether what was delivered is what was ordered. We are already looking into more than 100 contracts in that respect. As those investigations develop, I hope I will be able to update the House further, but it necessarily takes time to have conversations with contractors through those contract dispute mechanisms and to investigate.”
“The NHS and the Department get their annual budgets and spend them on what is necessary to meet the health and care needs of the nation. On the hon. Gentleman’s specific point, he might characterise the £33.9 billion increase by 2023-24, which we have enshrined in law, as part of the Brexit dividend.”
“Different settings require different standards of PPE, so some that was purchased may not be of the standard for the NHS but can be used elsewhere. We are exploring all options to make sure that the PPE we have, where it can be, is used.”
“I am grateful to the hon. Gentleman for his question. I have made it clear throughout that our priority was getting the PPE that we needed to give that protection and to save lives but, equally, every pound of taxpayers’ money is valuable. Where fraud or failure to deliver contracts is evidenced, we will go after that money, quite rightly, and seek to recoup it for the taxpayer. On the amount that is, for want of a better way of putting it, lost through goods not being fit for use, that is £673 million, but that is what we are investigating through those contract dispute resolution mechanisms and through anti-fraud work. The other amounts of money in here did purchase PPE, which was delivered and which we have.”
“At the moment, if I may put it this way, the ball is in the trust’s court, for it to send its proposal and business case over. However, my commitment is that as soon as the trust does so, I will task officials with considering them as swiftly as possible.”
“As I understand it, given the scale of the enabling works, they would not need to go through the full internal approvals process, but the trust needs to submit a business case for that element. The second element, which I know my hon. Friend and the trust are keen to see being advanced as swiftly as possible, is the new boiler room and power plant. Essentially, that would have to go through the full approvals process, but I understand that the board of the trust is due to meet in April to agree and finalise its proposal and business case on that work. As soon as it submits that, I can commit to my hon. Friend that—assuming that it is up to scratch, which I am sure it will be—it will go before the first joint investment committee of the Department following its submission, so that it can be considered as swiftly as possible.”
“It means that the hub will now be part of the first stage of the building of the new hospital, enabling the more efficient use of resources to deliver better results. In respect of the business case for that plan—I know that my hon. Friend is keen that there is progress on that as swiftly as possible—my officials have been in touch with the trust recently, most recently yesterday and before that on 26 or 27 January, asking the trust to put forward its proposals for those enabling works. We need those to progress the business case. My officials continue to nudge the trust gently, saying, “Please submit your proposals for that and the business case for it”. My commitment is that my officials will consider those proposals as swiftly as they can, once they have received them.”
“That is largely because the trust changed its plans. That money was ringfenced for an urgent treatment centre. We had discussions about that with the trust and accepted its proposal to merge the two pots of money. That then necessitated their coming forward with proposals about how they would spend that money as part of the enabling works for a broader scheme. If changes are made, it is right that those changes are justified, in the context of the appropriate stewardship of public money. The hub and the new hospital that are to be built both share a set of common enabling works, which have been factored into the new hospital development plans. As a result, the trust is incorporating the urgent care hub delivery into that broader plan.”
“I know that officials are in discussion with the chief executive of the hospital trust regarding the trust’s plans for enabling works on the Kettering General Hospital site and have set out what will be required for these proposals to be assessed as quickly as possible, once business cases are received from the trust, which is in line with what my hon. Friend would expect of appropriate processes for spending public money. I will provide a little background. The Department wrote to the chief executive on 16 June last year to confirm that, at his request, the urgent care hub and new hospital programme schemes could be brought together as a single pot of money, to maximise the benefits that local people could derive. Essentially, my hon. Friend asked why things have not progressed since 2019.”
“It is part of the broader programme to build 40 new hospitals by 2030. On 13 January, Natalie Forrest, who is the senior responsible owner for the new hospital programme, and officials attended a virtual meeting with the chief executive and staff from Kettering General to discuss progress and provide an update on the scheme in the context of the programme. As my hon. Friend knows, Kettering General Hospital NHS Foundation Trust has received £4.4 million of funding to develop its plans for the rebuilding of Kettering General Hospital. They were successful in securing funding back in 2019, at that stage for a new urgent care hub, which would transform the provision of urgent and critical care in the area.”
“I also take his suggestion of visiting Northampton at the same time. Without setting a specific date, my aim is to try to visit him during the February recess—I will discuss this with him. It is not a long haul for me from my constituency in Leicestershire to his in Kettering or Northampton, so that is what I will hope to do, subject to that working for the trust. Ministers are often surplus to operational requirements in a busy trust at busy times, but I suspect that Simon will welcome me to explain what progress he has made. That is my commitment to my hon. Friend. As my hon. Friend set out, Kettering General Hospital is part of the broader foundation trust, and continues to work closely with the central programme team in taking forward the rebuild of Kettering General as a new hospital for his community.”
“I hope that I might move matters a little bit further forward in this debate for my hon. Friend the Member for Kettering. It was a pleasure to meet him, my hon. Friends the Members for Wellingborough and for Corby and Simon Weldon on 17 January to discuss Kettering General Hospital and receive an update on its plans. I join my hon. Friend the Member for Kettering in paying tribute to Simon and all of the team at Kettering General Hospital and at Northampton General Hospital for the work they have done, not only in the past two years, but day in, day out every year, to support the local community and provide first-class care. My hon. Friend the Member for Kettering made, as ever, a generous offer to visit Kettering General Hospital with him. It was a pleasure to do so in 2019, when he gave me a very warm welcome in Kettering.”
“It is a pleasure to serve under your chairmanship, Mr Twigg. I congratulate my hon. Friend the Member for Kettering (Mr Hollobone) on securing this debate. By my tally, this is the fourth debate I have responded to that he has secured on the future of Kettering General Hospital and its redevelopment. That fact reflects his commitment to this issue on behalf of his constituents, and his typically courteous but tenacious approach to the matter. I will put on record, as they are unable to be here, the work done by my hon. Friends the Members for Wellingborough (Mr Bone) and for Corby (Tom Pursglove) in this respect. I welcome the intervention from my hon. Friend the Member for Northampton South (Andrew Lewer). The topic is not a new one for this House to discuss, but it is an extremely important one.”
“Friend’s clear steer that he believes it is capable of going further and faster, but we need to look at it in the context of all the other schemes and the availability and profile of moneys being made available. I just sound that slight note of caution, so I will not commit to a date, much though he tempts me to do so.”
“Therefore, there will be individual conversations with trusts about where they align with the programme, or where they may need to adapt to meet that national approach. My hon. Friend touched on the trust’s desire to go faster and begin the main project construction in 2023. In the spirit of openness, my only caveat to that is that, in the nature of funding through multiple spending review periods, it is not the case that a pot of money is earmarked for each programme and is just waiting to be drawn down; there is a profiling of moneys made available by the Treasury. I appreciate the trust’s eagerness to go faster, and I appreciate my hon.”
“This collaborative approach is intended to help each trust to get the most from its available funding, while avoiding repetition of work and design, and ensuring that adherence to the principles, which my hon. Friend alluded to, of repeatable design, modern methods of construction and net carbon zero, is embedded from the outset, to maximise the potential benefits of the programmatic approach, as well, of course, as providing better value for money for the taxpayer. All the projects that are part of that 40-hospital programme need to ensure that their approach is consistent with the programme, which has been developed over the past year and has reached a greater level of maturity.”
“I am happy to look at that. The point I am making to my hon. Friend is that for the moneys that he and the trust wish to draw down from the £46 million, we do not have the business cases from the trust that would enable that work. I suspect that they will be winging their way to the Department pretty swiftly following this debate and as soon as they arrive we will look at them. Regarding the broader business case for the overall scheme, I will turn to that, if I may, in just a moment. All the new hospitals that will be delivered as part of the programme, including Kettering, are required to work with the central team and, with the support of regional and local trust leadership, to design and deliver their hospitals in keeping with a consistent and standardised national approach.”
“Friend continues to be an incredibly powerful advocate for the interests of his constituents and those in the wider area of Northamptonshire who are served by the hospital. I look forward to continuing to work with him very closely in the future, as well as with the trust’s chief executive and team, other hon. Friends from Northamptonshire and my team in the Department, to help progress these very exciting and important plans, which will make a huge difference to his constituents’ lives in the years ahead. Question put and agreed to.”
“I will not prejudge the advice that I will be given by officials as to which schemes are most mature, but he makes his case clearly and forcefully on the Floor of the Chamber. I am grateful to my hon. Friend not only for the opportunity to discuss and debate Kettering General Hospital, but for the opportunity to visit Kettering. On my last visit, I received a very warm welcome from him and the team at the hospital. In what I have said today, I hope I have ensured that I get an equally warm welcome when I come and see him this month. Like him, I am keen to see all these schemes progress, and I am keen to see the benefits that the schemes will realise. In the context of Kettering General Hospital, my hon.”
“I am grateful to my hon. Friend, because I was about to turn to his final ask, which was whether the Department would look favourably on Kettering’s scheme if there was slippage from other schemes in the course of the spending review period. Although I cannot prejudge in this place that Kettering will be top of the list, he makes a strong case. It is absolutely right that we look at schemes and have a list of schemes that we believe could fill the gap if moneys are not going to be spent in year. It is important that that contingency is built in, and my hon. Friend makes a strong case for Kettering to be one of the hospitals that is considered for acceleration if it is ready and the moneys become available.”
“Given his assiduity in attending debates in this House, that could be said for a vast array of subjects, on which he has given well-informed and eloquent contributions, not only representing his constituents, but putting issues of national concern on the agenda.”
“I remember Bob Russell from the time before I was a Member, when I worked for previous Members in this place. I admire his belief in the power of EDMs, although I have to say that I do not share it and, like the hon. Lady, I occasionally have to explain to constituents and others who understand-ably think that an EDM moves the agenda forward, that it rarely does, but that it may, on occasion, put down a marker. As ever, I am grateful to the hon. Member for Strangford (Jim Shannon) for his comments. He mentioned that he has been in just about every debate on this subject, along with the hon. Member for Bristol East.”
“Members have said, it is always incredibly powerful and moving in this place when an hon. Member is willing to share their own experiences, not just with this House and colleagues but essentially with the public. It was powerful, it was personal and it was poignant, and I thank him for that. I also thank the hon. Member for Bristol East (Kerry McCarthy) for her contribution, in which she set out—again, very movingly—very personal stories, to make this real. It is very easy in this place for us to slip into talking about policies and grand strategies and to not always relate that to people and individual lives and experiences. I am very grateful to the hon. Lady. I do not always agree with her on everything in a political context, but I certainly agree with her on EDMs. I share the experience.”
“It is a pleasure as always to serve under your chairmanship, Mr Sharma. I congratulate my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) on securing this important debate and thank all hon. Members who have taken part. Although this issue falls within Lord Kamall’s ministerial portfolio rather than mine, it is privilege to answer in this place and to engage in this debate. Nobody here today, and nobody viewing our proceedings or reading them when they are written up in Hansard , can fail to have been moved by the experiences and stories that we have heard. Hon. Members on both sides of the House told moving stories about their constituents—in the case of my hon. Friend the Member for Ashfield (Lee Anderson), who spoke of his very personal experience, it was his wife, Sinead. As hon.”
“I will also ensure that I will not only speak to my noble Friend, the Minister with portfolio responsibility for this issue, but draw to his attention the transcript of today’s debate.”
“Members. When the exemption list was first put in place in 1968, 42% of items on prescription were free; now 89% are free. There has been considerable change in that space, but to go to the heart of what right hon. and hon. Members have asked for today, were my right hon. Friend the Member for South Holland and The Deepings in his place, I would disappoint him by saying that, as he will appreciate, I cannot make policy standing at the Dispatch Box. It is important that everything is considered carefully. Although this is not my policy, I will continue to reflect on the points that have been made by right hon. and hon. Members today and by campaigners on this issue.”
“As the hon. Member for Enfield North alluded to, I know that the answers that Ministers have given, stating that the Government have no immediate plans to review the list, will have caused disappointment to right hon. and hon. Members and to those with this condition. We do think it would not be right in this context to look at one condition in isolation, separate from other conditions, because others would rightly argue that their condition was potentially equally deserving of an exemption if it fitted the same criteria. My hon. Friend the Member for Blackpool North and Cleveleys has rightly advanced the case of cystic fibrosis, and I entirely understand why, but I know that he will also recognise that other conditions might qualify for consideration in the same way, or for the same case to be made for them by right hon. and hon.”
“Member for Enfield North (Feryal Clark), alluded to, there has been a review since 1968—only one—which resulted in the addition of cancer in 2009. When the exemption list was drawn up, decisions on which conditions to include were based on medical knowledge at the time—for instance, children with cystic fibrosis were not expected to live to see adulthood—and it is entirely understandable that, given advances in treatment and increases in life expectancy, those who are now living with cystic fibrosis for a lot longer should wish to pursue exemption from prescription charges to help them maintain their quality of life with the drugs that are essential to their quality of life. The issue of prescription charges was reviewed more broadly in the round in the 2010 Gilmore report, which did not recommend further changes at that stage.”
“Thanks to advancements in treatments, better care and the work of organisations such as the Cystic Fibrosis Trust, people with cystic fibrosis are now living for longer, with a better quality of life, with half of those with the condition living past the age of 40. Children born with cystic fibrosis today are likely to live longer than that. That is a positive story and a reflection on our medical and scientific advances. I turn to the crux of the debate. When the medical exemption list was drawn up in 1968 in agreement with the British Medical Association, it was limited to readily identifiable, permanent medical conditions that automatically called for continuous, lifelong and, in most cases, replacement therapy without which the patient would become seriously ill or even die. As the shadow Minister, the hon.”
“As we have heard, cystic fibrosis is a life-limiting condition affecting many thousands of people in the UK. It is not only a life-limiting disease but, as we heard from my hon. Friend the Member for Ashfield, a disease that can impact on the quality of life and the life experiences of those affected and their families. While there is no cure for cystic fibrosis, there are treatments available on the NHS to help reduce the effect of symptoms and make it easier to live with. It is not that long ago that conditions such as cystic fibrosis saw life expectancy so low that many were advised not to expect to live beyond their teens.”
“Before I do so, I want to recognise the fantastic work undertaken by the Cystic Fibrosis Trust, which does a fantastic job on behalf of people living with cystic fibrosis and their families, and in bringing the condition and the needs of people with it to the attention of this House, and more widely. I also acknowledge the work of the Prescription Charges Coalition, of which the Cystic Fibrosis Trust is a member. It has worked tirelessly to raise awareness of the help available to patients with the cost of their prescriptions and campaigns on an issue that its members feel strongly about. In our democracy, whether or not we agree on the policy position, it is right that we recognise those who get out there, campaign and seek to drive change and policy. It is important to recognise those who are active in our democracy in that way.”
“I am grateful to the hon. Gentleman for his spirited defence of early-day motions, of which he makes powerful use, as he does with every opportunity he has to speak in this place. My right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes) is no longer able to be here, but he made a valuable contribution, and I am grateful to you, Mr Sharma, for allowing him to speak—even if, as a former Minister, he should have known better the consequences of seeking to tempt me to make policy at the Dispatch Box without cross-Government agreement, which might have led to an early termination of my ministerial career. He made a powerful point, as all right and hon. Members have done, and I will turn to some of those points in a moment.”
“Friend the Member for Blackpool North and Cleveleys said, with current exemptions providing valuable help for those on the lowest incomes.”
“Lady rightly presses her case, but I know that she will appreciate my position, and it is important that I am honest with the House in that respect. I touched on the help with prescription costs previously, and the number of items. While I know that this is not at the heart of the point made by my hon. Friend the Member for Blackpool North and Cleveleys, it is still important that I put on record the point that I alluded to: when medical exemptions were introduced, only 42% of all NHS prescription items were dispensed free of charge. That figure is now around 89%, and around 60% of the English population do not pay prescription charges at all. Many people with medical conditions not on the exempt list already get free prescriptions on other grounds, as my hon.”
“I am grateful to the hon. Lady. She may or may not always agree with me, but I will always endeavour to be straight with the House, even when the message may not always be the one that Members want to hear. I cannot stand here now and say that there will be a review of that list; it is important for me to be honest with her. What I can say—which she may feel is insufficient, and I entirely respect her if she does—is that I will reflect on the points made today and the issues raised. I will discuss this issue with my noble Friend and ensure that the points that have been made in this debate are conveyed to him, but it would be wrong of me to commit to something that I am not in a position to commit to. The hon.”
“Many people do not see what happens in Westminster Hall, where, in a measured and sensible way, people can discuss, debate and sometimes disagree on issues that really matter and impact on the lives of individuals or particular groups of people. This debate is one of those that clears a very high bar for the quality of the contributions, for the importance of the subject and for its ability to cause us to leave this Chamber continuing to reflect on what we have heard.”
“Friend the Member for Ashfield has had that effect today. I will reflect carefully on what he said, within the context that I cannot make policy at the Dispatch Box. In response to the point made by the hon. Member for Strangford, I will pick up that issue and convey the sentiments of Members speaking today to my noble Friend Lord Kamall, and ensure that he has a copy of the transcript of the debate. I conclude by thanking all hon. Members for their contributions. Often, people judge what goes on in this place by the half an hour or 40 minutes that they see at 12 noon on a Wednesday on both sides of the Chamber and what happens there.”