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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“The Minister knows very well that we cannot improve the NHS without social care working well. Earlier today I met with social care providers. They want to see reform, yet the Government have apparently abandoned cross-party talks on social care reform for an independent commission led by the very able Baroness Casey, who is still doing her Home Office work on grooming gangs and is yet to be full time on this commission, which has a deeply unambitious finishing time of 2028. When will Baroness Casey be full time on the commission? These providers were clear that they want a seat at the table when better care funds are distributed by the NHS—they want to have their voices heard in decision making on that funding. Will the Minister agree to that?”
“The Secretary of State needs to be more ambitious—words that I suspect will never be echoed by the Prime Minister or his team in No. 10. The capital budget remains broadly flat in real terms from this year onwards. The Minister has said she wishes to continue with the new hospitals programme and invest in technology to boost productivity, but it is unclear how that can be achieved with this settlement. These are not my warnings but those of respected independent think-tanks, including the Nuffield Trust and the King’s Fund. The Chancellor’s plan is clear—indeed, not one Treasury Minister has ruled it out: more tax rises are coming. Finally, and importantly, we have seen social care largely neglected again by this Government. There were just two sentences about it in a four-page statement. Social care deserves better.”
“Of course, we wish the Government well in achieving that and hope they succeed, but just yesterday The Times reported that internal departmental modelling showed they are not on track and could only come close to meeting the target with “implausible” and “over-optimistic” assumptions. The independent Institute for Fiscal Studies agreed. Can the Minister set out how the Government will meet that target? Again, where is the plan? We need a plan, not empty rhetoric. It is clear that the NHS needs reforms, not just more funding, so when will the 10-year plan finally be published? Will it be before the one-year anniversary of the Labour party being in government? Will it be like their elective reform plan: simply a reheat of the plan that Sajid Javid brought forward in 2022, with nothing new?”
“The chief executive of the NHS Confederation said yesterday that increases in NHS staff pay will “account for a large proportion” of the funding increase. The former NHS chief financial officer echoed that view at the Health and Social Care Committee in January, saying that pretty much all the last tranche of additional spending was absorbed by pay rises, national insurance and inflation. Can the Minister confirm how much the pay offers from the independent pay review bodies, alongside increased national insurance, will cost, how much of this funding will have to go to cover that and how much will actually make it to the frontline to improve patient services? The Minister touched on the aim of meeting the NHS 18-week target for hospital waiting times within this Parliament.”
“Despite 14 years in opposition and nearly one year in government, the Labour party has failed to come up with a plan for the NHS, with the exception of the abolition of NHS England, which will not happen for years and appears to be delayed and in chaos. Ministers respond to every written parliamentary question about it by saying they cannot set out the savings, how the people will change or how the structure will change at this stage—yet again, there is still no plan. We have been very clear that where the Government are wrong, we will oppose it, but where they get something right, we will work constructively with them. That includes reform, but there is still no reform for us even to consider supporting. Can the Minister tell us where the £29 billion she set out will be spent?”
“Yesterday, yet again, we saw the Chancellor do what the Labour party always does: default to high spending, more borrowing and higher taxes, leaving the public finances vulnerable. The Minister has spoken of additional funding for the NHS. To use the same comparison as the NHS England chief executive, the NHS budget will now be roughly the equivalent of the entire GDP of Portugal, yet we are still none the wiser as to how the Government actually intend to use most of the money—there is no real detail and no real plan. Just last September, the Prime Minister pledged that there would be no more money without reform. Despite the Minister’s words, that is exactly what the Government have done. There is still no plan for reform, and the Secretary of State is unwilling to set out the bold reforms that are needed.”
“I often wake with a jolt, suddenly remembering vividly something that took place then—something that we did or had to do, or a particular moment as a Minister. I suspect that that is true of many up and down this country in many different walks of life, particularly those who were on the frontline.”
“I congratulate the hon. Member for West Ham and Beckton (James Asser) on his speech and on securing this important debate. The vast majority of contributions today have been measured, thoughtful and non-political, and I think they have done this House proud. It is right that we remember, reflect and learn. It is the least we owe those who lost loved ones during the pandemic. As someone who during the pandemic was doing the job of the Minister, I recall it incredibly well, as will so many in this House and outside it. The hon. Gentleman said—I know what he meant—that with the passage of five years, sometimes what happened then can feel a bit like a dream. It is something that still catches me in mine at night.”
“We owe it to those who lost loved ones and those who suffered in so many different ways: those with long covid, those with mental ill health, kids who were unable to attend school, domestic abuse sufferers and those who still suffer today. It is right that we remember, reflect and debate, as we do now, in order to learn. As a former Health Minister, I have memories that continue to surface. We will all of us live with our memories of that time till the end of our days. The least we can do is to ensure that this House and this country always remember and reflect carefully on what we can do better next time.”
“I pay tribute to the emergency services, to councillors and to the people of this country, particularly those who worked in health and social care and those who lost someone. It was a traumatic time for the whole country. There are lessons that must be learned about planning for future pandemics and supporting those with long covid. The hon. Member for Honiton and Sidmouth (Richard Foord) was right—like so many, I have constituents who lost loved ones and family members who were affected by the vaccine, as has been recognised by a coroner. They have been dignified and courteous, but they call for the Government to review the vaccine damage payment scheme. I hope that the Minister will take that suggestion in the spirit in which it is intended. We owe it to this country to make sure that we are better prepared for any future pandemic.”
“That is important, because people up and down this country still live with the impacts of the pandemic through long covid and mental health challenges. We see that huge impact still today on individuals and the NHS. We must remember how the country came together in the face of unprecedented events, about which we learned more every day. We had to adapt our approach to that changing knowledge. I am grateful to all Members from all parts of this Chamber for what they did. A few Members in the Chamber were in the House at the time, and they will remember the work of Jon Ashworth, which I recognise in particular. He was in this place at that time, and I remember his cross-party approach to so much that was done.”
“Sir Simon Wessely published the report of his review in 2018, and I take this opportunity to put on the record again our thanks for his important work.”
“In the same year, 2023-24, black people were 3.5 times more likely than white people to be detained under the Act, and seven times more likely to be placed on a community treatment order. The reasons for that are likely to be complex, and I will return to them later. That is why in 2017, just 10 years after the previous update, the then Prime Minister, Theresa May—now Baroness May—commissioned an independent review of how the Mental Health Act was used and how it could be improved. The review considered not only the trends in detentions, but wider concerns about whether some processes were out of step with what should exist in a modern mental health system, including the balance of safeguards, patient choice and patients’ agency in their own care, and the effectiveness of community treatment orders.”
“Those powers should only ever be used when absolutely necessary, and it is therefore right that they are reviewed and updated to ensure that they remain relevant, proportionate and appropriate. The most recent update to the Mental Health Act, in 2007 under the last Labour Government, introduced community treatment orders and independent mental health advocates and changed the detention criteria. Since then, as the Secretary of State alluded to, trends have emerged that have raised concerns. The overall number of detentions under the Act has been rising steadily. There were around 52,500 recorded detentions in England in 2023-24, including 963 of children aged 17 and under. That is a 2.5% increase on the previous year and around 14% higher than in 2016-17.”
“Let me take this opportunity to pay tribute to my right hon. Friend the Member for Godalming and Ash (Sir Jeremy Hunt), who has just left the Chamber, for the work that he did on mental health as Secretary of State. I think it is fair to say that, away from the to and fro of party politics, the current Secretary of State shares my right hon. Friend’s passion and determination to address these issues. As he said, we have done much, but I believe we can and must continue to strive to do better. Keeping legislation up to date is particularly important for a measure such as the Mental Health Act, which gives the state the power to deprive people of their liberties in order to protect the safety of the individual and those around them and to carry out treatment.”
“In the more than 40 years that have followed the 1983 Act, healthcare, treatments and, crucially, our understanding of mental health illnesses have come on in enormous strides. It is not only important but right that our laws are updated to reflect the modern world and the knowledge that we have today. We are debating measures that impact those with the most severe mental health issues and their families, but as was highlighted in interventions on the Secretary of State, we should not forget the broader context, the challenges posed by mental health issues more broadly, or the importance of continued investment in this space. We should also recognise the many organisations that do amazing work both to educate society about mental ill health and to support people with mental health illnesses.”
“At the outset, let me join the Secretary of State in paying tribute to the families of Calocane’s victims in Nottingham for what they have done subsequently—their campaigning, their dedication and their work, including on this legislation—and for the incredible dignity with which they have conducted themselves in unthinkable circumstances. As the Secretary of State mentioned, the Mental Health Act 1983—I will not miss the opportunity to allude to his youthfulness—governs the compulsory detention and medical treatment of people with severe mental illness for the safety and protection of themselves and those around them. He also set out that sadly, all too often, those with learning disabilities or autism have been conflated with that group. We must take this opportunity to address that, and the Bill rightly seeks to do so.”
“I thank the Secretary of State for bringing the Bill before Parliament. The last update to the Mental Health Act, in 2007, took eight years following the Richardson review, and this Bill has been a similarly long time in the making, so I welcome the speed with which he has moved on it since taking office. Although we may tussle on occasion, as I have said since the election, we on the Conservative Benches will not oppose for the sake of opposition. We will be constructive, working to improve legislation and supporting the Government where we believe they are doing the right thing, and I recognise the Secretary of State’s constructive approach to the Bill.”
“The removal of police and prison cells—sensibly—as places of safety will require sufficient alternative capacity for people to be treated when they are detained. What approach do the Government intend to take in addressing this? Increasing the frequency with which patients can apply to the mental health tribunal to have their detention reviewed and widening automatic referrals will potentially increase demand and pressure on the system. We know that the legal system is already under pressure, and the impact assessment acknowledges that there will be impacts and costs, so is the Minister confident that the system has the capacity to handle the additional demands? If not, what steps are being taken with the Ministry of Justice to address that?”
“We were pleased that peers passed an amendment to better protect children who require a nominated person, removing the discretion where a court order regarding parental responsibility is in place. However, we believe there is more we can do to support and protect children, particularly regarding age-appropriate settings for treatment. I hope that when the Minister for Care winds up, or in Committee, he will explore in greater detail the steps the Government are taking to reduce the number of children being treated on adult mental health wards and to ensure that lessons are learned at both national and local service provider level. Thirdly, we are conscious that a number of elements of the Bill will require additional resources to be put in place.”
“In its current form, the Bill places a duty on NHS England and integrated care boards to make patients aware of their option to have such a document, but this could be as simple as having a poster on a noticeboard, for instance. It does not necessarily require a conversation. Introducing it as a legal right for patients who are being treated or for someone who is at risk of detention would mean that they have to be specifically told about the option, allowing them to make a deliberate decision. I suspect that in Committee we may gently press the Minister to go further in strengthening the patient’s right to have their voice heard. I have been on a number of Bill Committees, and gently hinting to the Minister areas where we might press further may make his and his officials’ lives a little easier when amendments are tabled in Committee.”
“That said, of course we will not stand back without scrutinising and seeking constructively to improve the Bill as it passes through the House. Part of our role as the Opposition is to engage constructively in the scrutiny of legislation—to ask questions, to probe further, to seek to prevent unintended consequences, and to identify potential problems and ensure that they are aired in Committee—in order to improve it for everyone’s benefit, and that is what we shall do. I know that my hon. Friend the Member for Hinckley and Bosworth (Dr Evans) will approach the Public Bill Committee in that vein. We very much welcome efforts to improve patients’ voice and involvement in their own care, including through greater use of advance choice documents.”
“We continue to believe that this is the right thing to do, so I put on the record our in-principle support for the Government on the Bill. I pay tribute to my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) for his work in this space as a shadow Minister. Not only does he have professional expertise, but he has brought it to the House’s deliberations on this legislation. I suspect that we may hear from him a little later. There are many areas of the Bill that we welcome, including the strengthening of the patient’s right to express a treatment preference, the expansion of access to independent mental health advocates, and the removal of police and prison cells as places of safety so that patients can be treated in an appropriate setting.”
“The previous Government published a draft Mental Health Bill based on the recommendations in the report, giving others the opportunity to have their say. The draft Bill was subject to pre-legislative scrutiny by a Joint Committee of Parliament, allowing Members of both Houses to thoroughly review it and make recommendations before the final version was introduced. Given the importance of this area of policy, which can have such a profound impact on people’s lives, I believe it is right that we took the time to get this right. The work to update the Mental Health Act started under the previous Government and we had a commitment in our election manifesto to update the law in this area, and that has been carried on by the new Government.”
“The hon. Gentleman is right to highlight both the costs and the investment that is needed, but the cost does not detract from the importance of and need for the measures set out in the legislation. He points out that as a proportion of overall health spending, mental health spending has fallen slightly in the latest figures. I hope that the Minister in his wind-up will address how the Government will ensure that this legislation, which enjoys broad support across the House, has the resources behind it to deliver the outcomes we all wish to see in practice?”
“We welcome this important opportunity to look again at how we treat and protect people with the most severe mental illnesses, and to ensure that our laws remain relevant and proportionate in the modern world, empowering people and treating them humanely. Updating the Mental Health Act is the right thing to do, and we will work constructively with the Government to improve the safety, treatment, agency and, crucially, dignity of mental health patients who are detained, and of the wider public.”
“What steps are being taken to ensure that there are sufficient services, with sufficient capacity, to properly support people with autism and learning disabilities? Can he confirm that under this legislation, there will always be a central role for professional clinical judgments on these matters? This debate in part follows on from concerns being raised about racial disparities in the application of the Mental Health Act. Can the Secretary of State or the Minister provide more evidence to help the House better understand this issue? What research has been undertaken, or is being planned, to enable us to understand what is behind the statistics?”
“It would be helpful if, during the Bill’s passage, he or the Minister could tell either the Bill Committee or this Chamber what the changes that he envisages making through this legislation will mean for the workforce. We recognise the significance of the provisions limiting the detention of patients with a learning disability or autism. Under the Bill, they can be detained for treatment only if they have a co-occurring mental health condition that requires hospital treatment and meet the criteria in the Mental Health Act 1983. Autism alone would no longer justify continued detention under the 1983 Act; in theory, this will ensure that those with autism receive the appropriate support in the right setting, as we would all wish.”
“While it is the right principle to direct more mental health patients away from in-patient hospital settings and to community treatment settings where clinically appropriate—this is key, and goes to the Secretary of State’s point—we must ensure that the NHS has the capacity to provide community treatments when the Bill is on the statute book. The Government accepted that the reforms will take a number of years to implement, given the need to recruit and train more clinical and judicial staff, but what is the plan and how much will it cost? Will it be phased in over a number of years? The NHS workforce plan will nearly double the number of mental health nurses by 2031-32, but the Secretary of State has said that he intends to update the plan.”
“The Secretary of State was kinder than he normally is, and I am grateful to him for acknowledging the reduction in the proportion of mental health spending—it is slight, but it is none the less a reduction. I hear what he says more broadly, but I hope that he and the Minister will reiterate their commitment to ensuring that the legislation succeeds, which we all wish for, and that the pressures it may place on parts of the system will be addressed and not simply be absorbed within the system. I suspect that the Minister will come to that in his concluding remarks.”
“I fear that many will have found the Minister’s answer to my hon. Friend the Member for Windsor (Jack Rankin) disappointing. He highlighted that the previous Government committed to the headline recommendation of the cross-party birth trauma inquiry led by the hon. Member for Canterbury (Rosie Duffield) and the former Member for Stafford, Theo Clarke, who has recently written about her experiences in a book, and in the Daily Mail called for a national maternity improvement strategy. No equivalent commitment has been made by this Government. Let us try again: will the Minister commit without any equivocation to implementing the inquiry’s recommendation to produce a national maternity improvement strategy?”
“My question to the Secretary of State is simple: when will that first high-level plan for the merger, with a full assessment of costs and savings, be published?”
“The Health Service Journal reports that officials have acknowledged that the first draft of a high-level plan for merging NHS England and DHSC has been delayed. When we ask any written question about the merger, the standard answer seems to be: “Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to determine the structure and requirements needed to support the creation of a new centre for health and care.” Even when we ask a question specifically about the size of the transformation team, the answer is virtually identical. The Government either wilfully decide not to answer, or simply do not know. As with so many things, the Government go for the headline-grabbing announcement and talk the talk on reform, without having done the actual work to deliver it.”
“As ever, even though there are strong feelings on both sides, the House has shown itself able to grapple with difficult issues with courtesy and thoughtfulness. Question put, That the Bill be now read the Third time.”
“I am conscious of time, so I will be brief. I recognise the sincerely and strongly held views on both sides of the debate, which has played out with courtesy in this Chamber and in Committee, where Members have shown respect for one another and for differing views. I want to put on record my gratitude to all right hon. and hon. Members who have spoken. I congratulate the Minister on being thrown in at the deep end and taking through a piece of legislation with courtesy, very swiftly after she was appointed. I thank the Clerks, the Whips and those who served on the Bill Committee. I do want to single out the phenomenal work done by the shadow Minister, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), and her staff, Angus Forbes-Cable and Joey Ricciardiello, who did so much on the Bill, especially in Committee.”
“May I take this opportunity to thank the Secretary of State for his kindness following the death of my father earlier this month? It was very much appreciated. I welcome the moves to streamline decision making and improve efficiency in the context of the Secretary of State’s NHS England announcement, if he genuinely drives decentralisation to integrated care boards. However, in a written answer on 21 March, the Minister for Secondary Care said: “We recognise there may be some short-term upfront costs as we undertake the integration of NHS England and the Department”. For clarity, can the Secretary of State confirm what the quantum of those reorganisation costs will be and the date by which they will have been recouped?”
“Can I also welcome, as I did in January, the Secretary of State’s commitment to seek to work cross party on the future of social care? He was right and I welcomed that at the time, but like him and many others, we are all keen to see progress. Can he update the House on when he anticipates the cross-party talks that were postponed in February will be rescheduled to take place?”
“Understandably, pensioners are asking what the Labour party has against them—or, for that matter, against farmers or businesses.”
“It is a great shame that his successors in a Labour Government today have taken a very different view on support for pensioners. The choice made by the Labour Government—almost their first choice in office last July—is as cruel as it is unnecessary, and it has real-life consequences for vulnerable people. Like many other Members, I suspect on both sides of the House, I have met my local branch of Age UK and other local charities. They all tell me about how hard their services—services vitally important to pensioners, such as GPs, hospices and pharmacies—will be hit by the Government’s jobs tax, the NICs hike. Alongside that impact on services pensioners rely on, this Government have slashed the winter fuel payment for so many.”
“As has previously been said: “Although the poorest do receive some help through cold weather payments, they go only to those on income support, who generally have to wait until after the cold weather for help to be available. The payments are no help at all to most pensioners, including…those on the margins of poverty”. The individual continues that they were “simply not prepared to allow another winter to go by when pensioners are fearful of turning up their heating, even on the coldest winter days, because they do not know whether they will have the help they need for their fuel bills.” —[ Official Report , 25 November 1997; Vol. 301, c. 779-80.] Those were the words of the former Labour Chancellor and Prime Minister, Gordon Brown, who brought in the winter fuel payment.”
“This afternoon, we have heard some fantastic speeches in which Members have set out heartbreaking real-life stories from their constituents about the situation older people have found themselves in this winter. Pensioners have been forced to choose between eating and heating as a result of the Government’s choice to remove the winter fuel allowance from around 10 million of them. That was compounded by shocking delays in processing pension credit claims. Along with those who have just missed the threshold to receive support, it has meant that many, many people who are desperately in need have missed out on hundreds of pounds that would have made a real difference to them this winter.”
“Let me just complete the point. I know that the hon. Gentleman has only come into the debate relatively late, but I will take an intervention from him afterwards. The message is, under this Government, do not run a hospice, a pharmacy or a care home. Do not be a farmer. Do not run a business and, heaven forbid, do not get old.”
“I will make a number of points to the hon. Gentleman. I was going to come on to his first point, but I will happily do so now. He seems to be alluding to the mythical so-called black hole that is so often bandied around. The OBR pointedly declined to validate that or back it up in its assessment, and it cannot be deemed a rationale for doing this.”
“I want to make a little progress. We have seen a real black hole emerging following the Chancellor of the Exchequer’s disastrous Budget. It is also not the case that the Government can claim they have saved the pensions triple lock, which was introduced by a Conservative and Liberal Democrat Government back in 2010. The previous Government had already committed themselves to it, in that election’s manifesto and others. Pensioners could rightly bank on the uplift from the triple lock coming through. What they have seen now, however, is a real cut in what they were receiving, and what they had a right to expect, with the slashing of the winter fuel payment.”
“The hon. Gentleman will be aware that, as I mentioned earlier, I have read the report, and he will know, having also read it—he is gently waving it at me from the other side of the Chamber—that the OBR pointedly declined to back up the claim about the so-called £22 billion black hole. As we have heard, the former Prime Minister Gordon Brown, as Chancellor of the Exchequer, initiated the winter fuel allowance, announcing it in 1997 and introducing it in 1998; but it is worth remembering that, even in the challenging circumstances of the time, George Osborne did not cut the allowance, despite the appalling financial and economic inheritance in 2010. Why not? Because it was a cost-effective benefit, and because it genuinely made a difference.”
“Let me just make a further point. I am about to deal with some of the hon. Gentleman’s own points, as he will find if he pauses for a minute, but he may want to intervene at that moment. George Osborne did not cut the winter fuel allowance because it gave pensioners the confidence to turn the heating up those extra few degrees, knowing that the money was coming. I will now give way to the hon. Gentleman.”
“I was about to be quite nice to the hon. Gentleman, because I have to say that, during a debate that has, perhaps, produced a lot of heat and not always a huge amount of light, he addressed the issues before us in a measured way. I did not agree with everything he said, but he was reasonable and made some valid points. Let me gently say to him, however, that our record speaks for itself. We did not get rid of the winter fuel allowance. The fact is that Labour Members are in government, and have a large majority, and, as they are discovering, to govern is to choose. They must be accountable for the choice—the choice—that they have made.”
“I will make a little bit of progress, and then I will give way to my right hon. Friend. UK pensioners are not fools, so I am sorry that Labour Members want almost to insult their intelligence by repeating the debunked claim about the so-called black hole, or the debunked claim that the triple lock was in some way under threat and has been saved by the current Government. Let me also gently remind them that pensioners are unlikely to forget. They feel let down by Labour; they feel that the trust that they placed in Labour Members when they voted for them has been betrayed, and within a month of Labour’s taking office. So I ask again, why did this Government make the political choice to introduce these cruel, unnecessary cuts? I now give way to my right hon. Friend.”
“Will that message once again be one of ignoring their concerns, with the Government showing they are deaf to them and do not care, or will they take the opportunity to do the right thing this evening, and back our motion to send the message to their older constituents that they do care and are standing up for them against this cruel and unnecessary cut? This choice, and it is a choice, will tell pensioners in their constituencies exactly where they stand. The Conservatives and other Members on this side of the House are standing up for our pensioners on winter fuel payments. The Conservatives are backing the generation that gave so much to our country. Will Members on the Government Benches have the courage to do the same?”
“To conclude, because I am conscious of the time and wish to enable the Minister to respond, this money was genuinely needed by vulnerable people—vulnerable pensioners—this winter. In my Melton and Syston constituency, I get heartrending messages about choices between eating and heating, and we should not forget, as my hon. Friend the Member for Bromsgrove (Bradley Thomas) mentioned, the impact on rural communities reliant on heating oil and having to pay for that in one bulk payment. Labour Members have an opportunity this evening to send a message to pensioners.”