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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“Friend the Member for Loughborough alluded to the fact that to support those who do not qualify for an exemption, the cost of prescriptions can be capped by purchasing a prescription pre-payment certificate, and that can be paid for by instalments. A holder of a 12-month certificate can get all the prescriptions they need for just over £2 a week. When we started the debate, I wondered whether we would use the full hour and a half. It is testament to the hon. Member for Strangford, and the contributions of all hon. Members, that we have, and I should stop here to give him a few minutes to come back. To conclude, it is right for him to bring this debate to the House. I am grateful, as other hon.”
“Member for Strangford at least three or four minutes for his winding-up speech. One point that has come up among hon. Members this morning has been about prescription charges: a challenging area. Currently, we have no plans to review or extend the NHS prescription charge medical exemption list to include asthma. I heard the points made by hon. Members, but a number of conditions are analogous to asthma, in terms not of their effects, but of their chronic or lifelong impact. Equally, a balance has to be struck with proportionate charges and the contribution that makes to the NHS drugs budget to facilitate the provision of new treatment. Approximately 89% of prescriptions are dispensed free of charge already, and arrangements are in place to help those most in need. My hon.”
“Diagnostics for respiratory conditions are part of the proposed core services to be provided by CDCs. I hope that gives reassurance. A review of diagnostics in the NHS long-term plan highlighted that patients with respiratory symptoms would benefit from that facility due to the number of diagnostic tests involved. At the spending review, we announced an extra £5.9 billion of capital support for elective recovery, diagnostics and technology over the next three years, with £2.3 billion of that to increase the volume of diagnostic activity and to roll out CDCs. The planned increase will allow the NHS to carry out 4.5 million additional scans by 2024-25, enhancing capacity, enabling earlier diagnosis and benefiting asthma patients. I am conscious that I need to leave the hon.”
“In writing that guidance, particular attention was paid to streamlining the process of moving patients on to biologic therapies, to compensate for any barriers that may have occurred because of changes to the NHS in response to covid-19. The hon. Member for Strangford raised the subject of unified guidelines. NICE’s updated guidance is produced jointly with the British Thoracic Society and SIGN, so it will update all three key areas. They are working with other UK expert bodies to develop a joint guidance for the diagnosis, monitoring and management of chronic asthma, which will update and replace existing guidance. Community diagnostic centres or CDCs—another theme raised by several hon. Members—which diagnose a number of conditions, are to be launched in place of asthma diagnostic hubs.”
“That is one of the easier things to do, given that this policy area belongs to the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), so I can commit to her writing to the hon. Lady. I am happy to do that, though I suspect that response will come back to the point about clinical judgment and decision making. I will also commit my hon. Friend to writing to the hon. Member for Strangford on the detailed and specific point he made about the annual review. The use of remote consultations and biologic medication that can be taken at home mean we have been able to support most people with severe asthma during the pandemic. At the start of the pandemic, NICE published “COVID-19 rapid guideline: severe asthma”, which provided guidance on starting or continuing biological treatment.”
“People should get the jabs they need for flu and covid-19 when the time comes, and should follow the rules that we have put in place. If they do that, we can protect not only the NHS but the progress that we have all made. I commend the statement to the House.”
“This investment will have a huge impact, and this is the beginning not the end of our investment, as we are continuing to identify and assess submitted bids for investment in the remainder of this financial year. It is part of £5.4 billion that we have announced to support the NHS response to the pandemic in the second half of the year and it builds on the work done ahead of last winter, where we invested £450 million to upgrade A&E facilities in over 120 separate trusts, to boost capacity. This is a Government who back the NHS. Ahead of what will be a testing winter, we are putting everything behind our health and care services, so everyone can access the services they need when they need them. I conclude by urging everyone to play their part this winter by taking simple steps that can help our NHS.”
“Today, we have published the regional breakdown for this funding, which was allocated on a fair basis, according to weighted population, to make sure there was an equitable spread across the country. This includes £112 million for the north-east and Yorkshire, £131 million for the midlands and £97 million for the north-west. At least £330 million will be invested in the NHS estate and a further £250 million will be spent on digital initiatives that aid elective recovery. Over £600 million from this fund has already been committed to approved bids, such as for new wards at University Hospitals Birmingham, a new South Mersey elective hub and a new, modular unit in Castle Hill Hospital in Hull.”
“To fix this, the NHS needs to be able to offer more appointments, operations and treatments, and we need to adopt new, innovative ways of working so patients keep getting the best possible care. We are determined to maximise the capacity of the NHS to keep elective services going over the winter months so that people can keep getting routine treatments such as hip surgery and diagnostic tests. Today, I am pleased to update the House on the £700 million fund that we announced in September for elective recovery. This transformative funding, which is being split across all regions in England, will support 785 schemes across 187 hospital trusts. It will help reduce waiting times for patients by providing more operating theatres and beds, and greater capacity for our NHS.”
“Yesterday, we announced how we will be buying a total of 114 million additional Pfizer and Moderna doses for 2022 and 2023, which will future-proof our Great British vaccination effort and make sure we can protect even more people in the years ahead. Another defence is antivirals, and it was fantastic news that yesterday another covid-19 treatment was approved by the Medicines and Healthcare products Regulatory Agency, after it was found to be safe and effective at reducing the risk of hospitalisation and death in people with mild to moderate covid-19 infection. Just as we tackle the virus, we are also tackling what the virus has brought with it. The pandemic has put unprecedented pressure on the NHS and led to a backlog for elective care.”
“For example, the NHS has given ambulance trusts an extra £55 million to boost staff numbers this winter; there is nearly half a billion to fund an enhanced discharge programme; and we have measures to reduce pressure on accident and emergency departments, reduce waiting times and improve patient flow. This document comes ahead of a critical winter for our NHS. We face the challenge of fighting covid-19, and the new omicron variant, along with the other challenges, such as flu, that winter can bring. We are doing everything we can to strengthen our vital defences. One of our main defences is, of course, our vaccination programmes, and we are expanding our booster programme, which hit the milestone of 19 million doses yesterday, along with delivering the largest flu vaccination programme in UK history.”
“Madam Deputy Speaker, with permission, I would like to make a statement on the work we are doing to keep our country safe this winter. Today, we have published our health and social care approach to winter. This shows the preparations we are making so that health and social care services remain resilient, joined up and available to patients over the coming months, and it sets out what actions the public can take. As this plan shows, we are also doing everything in our power to give our NHS what it needs and keep it standing strong this winter, including through our plans to recruit more staff, give greater support to the NHS workforce and bolster capacity across urgent and emergency care.”
“We all know that one of the biggest challenges we face with capital in our NHS is the millstone of PFI debt around the necks of NHS trusts—private finance initiative programmes put in place under the last Labour Government. We are still paying for that. I welcome the hon. Gentleman to his post, and I suspect that on many occasions in the future we will have further such exchanges across the Dispatch Boxes. I am sorry that on his first outing in his new role he is facing me rather than the Secretary of State, but it is a pleasure to be opposite him.”
“In 13 years we had two Green Papers, one royal commission and the 2008 spending review, all of which were designed to fix the social care problem. Result: nothing. This Government said they would come forward with a plan, and have come forward with a clear and coherent plan. I pay tribute to the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), and indeed to her predecessor, my hon. Friend the Member for Faversham and Mid Kent (Helen Whately), for the work that they have done in grappling with this very challenging issue. The hon. Gentleman mentioned hospital buildings. Again, he was right: we are building 40 new hospitals. I would, however, say to him and to other Opposition Members that they should be very careful when talking about this subject.”
“Buildings and technology are important, but they are, essentially, the tools that the workforce use to provide that vital patient care. We have a clear plan not only for winter, but for the recovery of waiting list times and for driving down those waiting lists. Ours is the party that has given the NHS record funding. Even before the pandemic, we put the £33.9 billion increase into law: we said we would do it, and we did do it. We are backing our NHS to give it the tools that it needs. One issue on which I agreed with the hon. Gentleman is prevention. He is right: we need to look not only at the symptoms and the consequences in treating people, but at prevention of long-term and serious illness. He was also right in what he said about fixing social care, but I would urge a bit of caution.”
“He is extremely diligent in all the roles he performs, so I welcome him to a challenging but fantastic role. I will be relatively brief in my answers, because I am conscious that Fridays are for private Members’ Bills and private Members’ speeches. We brought the statement to the House because we believe it is important, given that it is going to the media, that we give the House an opportunity to question it. The shadow Secretary of State was right to pay tribute to the workforce—the social care workforce and the health workforce, as well as all the other key workers who have helped get us to where we are in this pandemic. The workforce are the golden thread that runs through our NHS and through social care.”
“I join the shadow Secretary of State in paying tribute to his predecessor, the right hon. Member for Leicester South (Jonathan Ashworth), who is my near neighbour in Leicestershire. Although we may have occasionally crossed swords across the Dispatch Box, he is a deeply honourable and decent man. I also take the opportunity to pay tribute to the hon. Member for Leicester West (Liz Kendall), who is planning to take maternity leave in due course. She is a doughty champion for social care and the sector. I know that she will be much missed in her time away from the Dispatch Box. I genuinely congratulate the hon. Member for Ilford North (Wes Streeting) on his post, although after that response, I do so with a degree of trepidation about what we might have in store for us in the months ahead from him challenging us—quite rightly.”
“Of course I join my hon. Friend in paying tribute not just to Harwich port but to his local healthcare system, about which he and I have spoken on many occasions. It does an amazing job: its willingness to find innovative solutions to boost our booster rates is exactly what we need to see. I commend everything that his local trusts are doing.”
“As the hon. Lady knows, I do not have responsibility for social care. The Minister for Care and Mental Health is sitting next to me and will have heard what she said and will take it back to the Department to see whether a letter in response can be expedited. We are fixing the system for the long term, but my hon. Friend the Minister has announced £162 million that is already going into the bank accounts of organisations to help support the social care workforce. The hon. Member for Wirral South (Alison McGovern) is right that we need short-term support, but we also need a long-term solution. We are putting the money in to support this vital sector.”
“My hon. Friend is a doughty champion for Birmingham and his local trust. It is always a pleasure to announce more money going into his trust, and he is right to highlight the Labour party’s record on PFI.”
“The right hon. Gentleman is absolutely right that ambulance trusts across the country are under pressure, which is why they have already been given an additional £55 million, well in advance of this winter, to help them prepare for and manage the pressures they are experiencing. This money is on top of that, but they already have additional funding to help support them through what will be a very challenging winter.”
“I am grateful to my hon. Friend for highlighting both the investment and the need for us, as the custodians of the taxpayer’s pound, to make sure that the money is well spent by implementing innovation and reform so that it gets to the frontline and delivers patient care, which is exactly what we are doing.”
“I have never found the hon. Gentleman to be irritating in any way, and I have always enjoyed my interactions with him on a range of issues. On a serious point, I pay tribute to him for his campaigning work on this issue. It is a huge step forward, and I know the insight he will bring, working with the Minister for Care and Mental Health, will genuinely make this a strategy of which we can all be proud. I congratulate him on his achievement.”
“I am not right hon., but I am grateful to my hon. Friend for the promotion. Of course I pay tribute to the staff at Watford General Hospital and, indeed, to him for his volunteering on the frontline in that hospital trust during the pandemic. He is absolutely right. As I said to my hon. Friend the Member for Kensington (Felicity Buchan), it is vital that this money gets to the frontline and is used to improve patient care, which is exactly what we intend to do.”
“No one, absolutely no one, particularly in our emergency services, should be subject to abuse of any sort while doing their job.”
“I am grateful to the hon. Lady; I had the pleasure some months ago of visiting one of her local hospitals, where I had the opportunity to speak to staff. They do an amazing job. No one, irrespective of the role they perform, should be subject to intimidation or violence in doing their job, still less those who are working hard to save lives, to protect us and to get us through this pandemic. I join with her entirely in condemning both physical and verbal assaults on members of our emergency services. I highlight the important legislation that went through recently to increase the penalties, and pay tribute to those responsible for getting it on the statute book—the hon. Member for Rhondda (Chris Bryant) once again.”
“I am grateful to my hon. Friend, who rightly highlights the hugely important contribution of GPs to our health system. We continue to look at the best ways to support them, not only by recruiting more GPs and supporting existing ones, but by investing in general practice buildings to ensure they have the tools to do the job.”
“I have not yet had the privilege of visiting the hon. Gentleman’s hospitals in this role; maybe at some point in the coming months, perhaps when they are not quite so busy, I will do so with him—if he will have me. We have committed to the investment, but it is important that that investment programme is run as a programme, with all the hospitals being looked at in terms of the phasing and profile of the investment to ensure it delivers the results we want. On that specific point, knowing the interest he has taken in it, I am happy to meet him to talk specifically about his local hospital project and the improvements to be made.”
“I think it does exactly that, and demonstrates this party’s and this Government’s commitment to the NHS. What my hon. Friend has also demonstrated, as always, is his unwavering commitment to his constituents in Darlington and to championing their cause in this House.”
“I can reassure the hon. Gentleman that it is not him who is looking a little old or worn around the edges. I understand the point he makes, and he and I have met about this particular issue, which goes back to what counts against capital allocations in terms of accounting. He tempts me to change Treasury rules; I fear that could be career-limiting, as I am not a Treasury Minister, but I will continue to talk to him and work with him to see whether we can find a way to allow the project to proceed.”
“The hon. Gentleman showed admirable brevity in making his point very clearly, as ever— [ Interruption. ] I suspect he faces a bit of competition from his hon. Friend the Member for Wythenshawe and Sale East (Mike Kane) for the funding. In my recollection—forgive me if I am off on this—I think that Halton and Warrington have submitted a bid for funding as part of the next eight. There is considerable interest in this. We are evaluating all those at the moment and, in the coming months, we will work that down to a shortlist. It would be wrong for me to prejudge that process, but it is not wrong, of course, for the hon. Member for Weaver Vale (Mike Amesbury) to continue championing his local hospital and its cause.”
“My right hon. Friend is right to highlight primary care, essentially, as the front door for many people into the NHS system. GPs and general practice have done a fantastic job. They have worked very hard, but it has been very challenging. The Secretary of State announced additional money to support GP practices in returning to face-to-face appointments and in seeing more people—we have seen significant investment in that. The percentage of face-to-face appointments continues to go up, which I know matters to a large number of all our constituents.”
“I remember that Adjournment debate very clearly. My hon. Friend made an incredibly moving and powerful speech, highlighting Jessica’s situation, what happened to her and her circumstances. My hon. Friend made the point about the importance of early diagnosis and a holistic approach to a patient’s symptoms, and then diagnosis and treatment. The investment that we are putting into diagnostic hubs will help to do exactly that and bring those diagnostics to the heart of our communities, allowing more people to be seen more quickly.”
“I will certainly join my hon. Friend in paying tribute to all the volunteers and all those who have come forward for their jabs. For a brief moment, I thought that that was where he was going to end, but he is a proud champion of Doncaster, just as you are, Madam Deputy Speaker, and it would have been very strange were he not to conclude by lobbying once again for the new hospital that he wants. I pay tribute to him for that.”
“It would be easy to commit the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), to a visit because she is not here. Equally, I am conscious that East Leake is just up the road from my constituency, so it may be that my hon. Friend gets me instead. I will certainly look into that visit.”
“My hon. Friend, along with many right hon. and hon. Members, is doing his bit to push the cause of his local hospital investment bid. As I said to the hon. Member for Weaver Vale (Mike Amesbury), I commend that, but it would be wrong for me to be drawn while the process is still under way.”
“The latest statistic I have on the number of cases in this country is, I believe, 42. That work is still being done. We have seen various news reports today on things that might be encouraging, but I encourage everyone to wait and see while that analysis is done. It will take two to three weeks for the scientists to do their amazing work in understanding whether this new variant is more infectious and more virulent as well as how it responds to therapeutics and vaccines, and I am afraid that we will have to be patient while they do that work. Hopefully, they will come back with positive news, but it is too early to say.”
“My hon. Friend is absolutely right to highlight that. My hon. Friend the Minister for Care and Mental Health has done a huge amount of work on both investment and working with local systems to improve hospital discharge for those who do not need to be in hospital any more, to give them that step-down support, be that domiciliary care or in other settings. In the current context, we must do that safely, but she is working extremely hard to deliver that and doing a fantastic job.”
“My hon. Friend is right. The key words are “where necessary”, and that is a clinical judgment. I have highlighted the improvements that we are seeing in terms of the number of face-to-face appointments going up in primary care. Equally, we do not want to lose the benefits of telephone appointments or other appointments for those who wish to interact in that way. It is about trying to craft the system around the patient and taking those clinical judgments into account.”
“My hon. Friend highlights the hugely important point that over winter we face challenges not just in physical health but in mental health, particularly as we come through the pandemic. One reason that we are investing £500 million in mental health catch-up is that we know how vital it is that we do not just talk about parity of esteem but recognise it in the resources that we put in.”
“I join my hon. Friend in paying tribute to the team in the sterilisation unit in his local accident and emergency hospital. He is absolutely right: throughout the pandemic and the Government’s existence we have given the NHS the resources and the backing that it needs to get on with the job.”
“I am grateful to my hon. Friend. This money is being allocated to the regions, then to individual trusts. A large amount of that money has already been allocated to specific projects that have been announced today. The rest of the money, when allocated to local systems, will then be allocated by that local system—the people who know their area best.”
“I am happy to join my hon. Friend in paying tribute to the work of the staff in his local hospitals. He is absolutely right to highlight the fact that that money will make a huge and real difference to patient care in his local hospital trust and in his local area.”
“It looks as if I might be going on tour again; the same thing happened when I last did one of these statements. I am happy to go to “Bluecar”—or Redcar, to call it by its proper name—to see my hon. Friend in his constituency, and to make such a visit when it can be arranged.”
“Absolutely, I can give my hon. Friend that assurance. He rightly alludes to the fact that the inputs are important, but for those of us on the Government Benches, it is the results they bring—the outputs—and what we do with the money that matter. We will ensure that that money is well spent, harnesses innovation and delivers even better patient care and access to his constituents and many others.”
“She is right—I characterise this in these terms and I hope that she will not demur from this—that although the NHS workforce is the beating heart of our NHS, it is beholden on us to give them the tools that they need to be able to use their skills to treat and support the maximum number of possible patients in the most effective way. I think that is a fair reflection of the point that she made at the outset.”
“As ever, I congratulate my hon. Friend the Member for Newton Abbot (Anne Marie Morris) on securing this debate and I pay tribute to her work in this area. That work has been sustained for as long as I have been a Member of the House—I was first elected in 2015—but I suspect that this area was of interest to her long before then. I pay tribute to her for her continued engagement on this area, which is not always top of the news or top of the political agenda, but is hugely important none the less, so I pay tribute to her work in this space. I reassure my hon. Friend that the Government share this priority.”
“I believe that it is more appropriate and proportionate that that information is collected and published by a single national body using agreed methodology, rather than multiple organisations that may have different ways of measuring and presenting the data. My hon. Friend made a number of other points. Given the time constraints, I fear that I cannot address them all, but I will reflect carefully, as ever, on what she has said. Given that neither of them are present in the Chamber, it is a pleasure, as always, to agree on their behalf that my noble Friend the innovation Minister and my hon. Friend the Member for Mid Norfolk (George Freeman)—the life sciences Minister—will be delighted to meet her to discuss the matter in more detail. I am very grateful to her for bringing this evening’s debate to the House. Question put and agreed to.”
“I suspect that she will continue to push me on it, but at the moment I believe it is the right approach. My hon. Friend is right that the system needs monitoring. She called for an obligation on integrated care boards to report uptake of new medicines annually, which is effectively monitoring. I am pleased to say that the Government support the view that uptake of NICE-recommended medicines should be monitored. Since 2013, NHS Digital has published an innovation scorecard that reports, at a national and a local level, the uptake of selected medicines that NICE has recommended in the last five years.”
“In addition to the statutory funding requirement that applies to NICE-recommended treatments, NICE’S guideline “Developing and updating local formularies” recommends that, when NICE approves the use of a medicine through a technology appraisal, it should be automatically adopted into local formularies. The standard contract mandated by NHS England for use by commissioners stipulates that providers must ensure that formularies include all NICE-recommended treatments. That process should take place within three months, allowing services a realistic timeframe to prepare for the introduction of a new technology. I appreciate that my hon. Friend went a little further on tightening the timeframe and the compulsion element, but given the complexity of some new treatments, I think that three months probably remains an appropriate timescale.”