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Health and Care Bill
23 November 2021
Lead MP
Edward Argar
Debate Type
Bill Debate
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Other Contributors: 77
At a Glance
Edward Argar raised concerns about health and care bill in the House of Commons. Other MPs contributed to the debate.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Lead Contributor
Opened the debate
Mr Argar is proposing the commencement of Clause 138, which likely sets out when or under what conditions certain provisions within a bill are to come into effect. He emphasises the importance of ensuring that legal and regulatory frameworks are properly established before new laws take effect, thereby safeguarding public interest and legal clarity.
Edward Argar
Con
Melton and Syston
Mr Argar argues for the need to establish a clear timeframe for the commencement of Clause 138, ensuring that all necessary preparatory work is completed before any new legal measures are implemented. He highlights the importance of maintaining public trust in governance and regulatory compliance.
Eleanor Laing
Con
Dewsbury
The new clauses proposed aim to protect vulnerable individuals from harmful practices such as virginity testing, ensure that only appropriately trained and registered professionals can practice under the title 'nurse', introduce a licensing regime for non-surgical cosmetic procedures, mandate annual reporting on future workforce requirements, and enhance safeguards against the inappropriate disclosure of sensitive information during safety investigations.
Chris Grayling
Con
Epsom and Ewell
Highlights concerns about the acute shortage of locums and difficulty recruiting new GPs, advocating for better planning and training in primary care to address future workforce shortages.
Richard Fuller
Con
North Bedfordshire
Questions the role of technology and productivity improvements in reducing labour costs while maintaining service quality, urging the government to explore new pathways that require less qualified staff for equal or better outcomes.
Emma Hardy
Lab
Kingston upon Hull West and Haltemprice
Raises concerns about the Carr-Hill formula, suggesting it incentivises GPs to move away from poorer areas like Hull, urging for a fairer funding mechanism.
Rachael Maskell
Lab Co-op
York Central
Asks the Minister to establish an interim road map and regular reports to address current workforce crises, proposing measures for filling vacancies over a 15-year period.
Andrew Murrison
Con
South West Wiltshire
Proposes the need for a clear career progression structure within healthcare and social care to incentivise retention and advancement, suggesting that barriers between professions should be addressed.
Central Ayrshire
Raises concerns about the inclusion of coroners in HSSIB investigations, arguing it may weaken safe space and is opposed to extending exemptions or exceptions.
Jeremy Hunt
Con
Godalming
Intervened to express that it feels better this time, suggesting support for amendment 10.
Alex Sobel
Lab Co-op
Leeds Central
Emphasised the need for new clause 29 and amendment 10 as a minimum requirement to address the workforce crisis, noting that there is no more goodwill among staff after the COVID crisis.
Rachael Maskell
Lab Co-op
York Central
Stressed the need for expedited delivery of staffing plans to address the current crisis, particularly in light of the march with midwives that highlighted the profession's acute situation.
Emma Hardy
Lab
Kingston upon Hull West
Emphasised the importance of new clause 28 for anticipating and preparing for increased demand in mental health services, advocating for regular reviews to ensure proper staffing.
Richard Fuller
Con
North Bedfordshire
Suggested a focus on improving labour productivity rather than solely increasing funding or staff numbers. Questioned the effectiveness of new clause 29 and amendment 10 in addressing workforce needs without considering efficiency improvements.
Munira Wilson
Lib Dem
Twickenham
Argued for long-term planning to recruit the right skills, highlighting inefficiencies such as spending £6.2 billion on bank and agency staff in 2019-20.
North East Fife
Stressed the importance of considering all team members, not just frontline or administrative staff, for efficiency and effective service delivery.
Jim Shannon
DUP
Strangford
Supports amendment 10, highlighting the need for nursing bursaries and training to relieve workforce pressure in Northern Ireland with over 2,700 vacant nursing posts. Emphasises the importance of providing a decent working environment.
Munira Wilson
Lib Dem
Twickenham
Congratulates Jeremy Hunt on building support for amendment 10, noting the mental health workforce shortage and over 16,600 full-time equivalent vacancies. Advocates for ministerial accountability through regular reports.
Central Ayrshire
Emphasises safety issues with locum staff in acute specialties, highlighting challenges such as lack of familiarity and communication problems when moving between hospitals.
Andrew Murrison
Con
South West Wiltshire
Agrees on acute safety concerns but notes differences in chronic long-term care issues in general practice, stressing retention challenges for senior doctors due to contract issues.
Greg Clark
Con
Islington North
Supports amendment 10 and adds that future considerations should include training medical scientists in medical schools, recognising the importance of expanding research capabilities alongside NHS workforce needs.
Rachael Maskell
Lab Co-op
York Central
Highlights the impact on public health and prevention strategies, noting that rapid changes in the workforce can have unintended consequences. Supports the need for long-term strategic planning.
Central Ayrshire
The speaker supports workforce planning that takes a long-term view and involves consultation with devolved nations. She highlights the importance of retaining EU staff, addressing early retirements due to pension tax changes, and improving staff wellbeing post-pandemic.
Laura Trott
Con
Sevenoaks
The speaker supports new clause 1, which aims to regulate the use of botulinum toxin by those over 18. She highlights the lack of regulation and safety concerns in current practices, citing Save Face’s report on 2,000 complaints from patients.
Andrew Mitchell
Con
Sutton Coldfield
Supports amendment 10 tabled by Jeremy Hunt. Argues that burnout in the NHS is a serious issue, and accurate workforce projections are crucial for addressing shortages of healthcare professionals. Emphasises the importance of long-term planning to prevent exploiting doctors from developing countries.
Dawn Butler
Lab
Brent East
Supports new clause 12 to protect the title 'nurse' for patient safety. It is endorsed by nursing organisations, charities, and professional bodies. She thanks supporters including former Secretary of State Jeremy Hunt and highlights the importance of addressing nurses’ issues beyond just protecting titles.
Taiwo Owatemi
Lab
Coventry North West
[INTERVENTION] Supports nurses and emphasises the need for investment in NHS resources, staff retention strategies, and addressing winter waiting times. Highlights Nursing Support Workers’ Day.
Caroline Nokes
Con
Romsey and Southampton North
Supports new clause 1 on regulating aesthetic non-surgical cosmetic procedures to ensure public safety, echoing concerns about unlicensed practitioners causing harm. Cites horror stories from constituents and experts who advocate for licensing or regulation.
Tonia Antoniazzi
Lab
Gower
Antoniazzi highlights that staffing is the biggest challenge facing the NHS. She argues that without adequate staff, new hospitals will be useless and supports Macmillan research showing a need for an extra 3,371 cancer nurse specialists by 2030 at a cost of £174 million. Antoniazzi also emphasises the impact on patient care with 25% of people diagnosed with cancer in the past two years lacking specialist nursing support.
Graham supports amendment 10, highlighting a long-standing staffing issue. He recounts a conversation from early in his tenure showing a persistent shortfall between recruitment needs and actual numbers trained locally. Graham discusses various initiatives to address this gap but stresses that without systematic planning for different regions' needs, the problem will persist.
Kevan Jones
Lab
Durham North
I am concerned about the lack of regulation in the cosmetic surgery industry, which is putting patients at risk and costing the NHS money. The Keogh review from 2013 recommended increased regulation but these have not been implemented despite assurances from Health Ministers. There are no national standards for those performing non-surgical treatments, leading to unqualified individuals offering dangerous procedures without proper oversight or insurance.
Clive Lewis
Lab
Norwich South
Intervened, suggesting that Paul Bristow’s proposal is moving towards a model where the NHS provides core healthcare while more lucrative parts are siphoned off to the private sector—a model seen in the US.
Central Ayrshire
Intervened, pointed out that surgeons do not just operate but also run clinics and perform diagnostics, suggesting that Paul Bristow's argument about operating frequency is misleading.
Ben Spencer
Con
Runnymede and Weybridge
Agreed with the idea of primary care professionals focusing on core medical roles rather than social advocacy tasks, suggesting that other multi-disciplinary team members should take over these duties.
Sarah Olney
Lib Dem
Richmond Park
Supports amendment 10, highlighting the severe staffing shortages in healthcare that are affecting patient access to services. She emphasises that workforce planning and improving terms and conditions for staff, especially in social care, are crucial. Cites specific examples of constituents’ issues with accessing mental health support and elective procedures.
Nigel Evans
Con
Chorley
Acknowledges the debate's importance but focuses on managing time for Minister’s response. No detailed arguments provided in this brief speech.
Matt Warman
Con
Boston and Lincolnshire
Supports amendment 10 with reservations, urging the Government to consider technology integration, staff retention, transparency in planning, and addressing social care issues. Emphasises the importance of retaining staff despite increased recruitment efforts.
Richard Holden
Con
Basildon and Billericay
Supports amendment 10 on virginity testing, noting its UK-wide application. Expresses hope for the inclusion of hymenoplasty ban in future amendments.
Derek Thomas
Con
St Ives
Mr Thomas spoke about his personal experience with an ambulance delay in Cornwall, highlighting systemic issues causing delays in patient care. He emphasised the urgent need for better workforce planning to support NHS and social care workers through improved training, pay, and status, aiming to ease pressure on hospitals.
Edward Argar
Con
Melton and Syston
Mr Argar acknowledged the persistence of campaigners like Richard Holden but did not specifically support Amendment 10. Instead, he focused on other amendments such as New Clause 1 regarding licensing regimes for aesthetic non-surgical cosmetic procedures and addressed concerns raised by Margaret Greenwood about regulated professions.
Richard Holden
Con
Basildon and Billericay
[INTERVENTION] Richard Holden thanked the Minister for his engagement throughout the process, showing support for the changes being discussed, even though he did not speak directly about Amendment 10.
Dawn Butler
Lab
Brent East
[INTERVENTION] Dawn Butler suggested that the Government could pass a new clause today and amend it later in Committee to address issues raised by Alison Leary’s petition.
Nigel Evans
Con
Stoke-on-Trent North
Mr Evans requested short contributions from all participants, as only an hour remained for the debate.
Nigel Evans
Con
Chorley
Expressed gratitude for the Minister's brevity and acknowledged the number of Members trying to catch his eye.
Tan Dhesi
Lab
Slough
Agreed with Justin Madders' concerns about waiting times, noting difficulties constituents face in booking appointments, and highlighted that the term 'waiting time' is not mentioned once in the Bill.
Theresa May
Con
Maidenhead
Supported amendments 93 to 98 which aim to ensure parity of esteem between physical and mental health treatment. She emphasised the importance of addressing the backlog in mental health services exacerbated by the pandemic.
Central Scotland
Proposed amendment 82 to ensure legislative consent if the Bill is used in devolved aspects of healthcare, emphasising the importance of consultation and consent due to fears about health services being changed in future.
Matthew Hancock
Con
West Suffolk
Supports new clauses 60 and 61, arguing for UK-wide application of health data interoperability to ensure seamless healthcare access across the country. Highlights examples such as international travel scenarios where patient records should be accessible. Emphasises that this is a necessity for improving research and treatment accessibility.
Geraint Davies
Lab
Swansea West
Expresses concerns about data privacy, suggesting that there might be risks associated with sharing personal health information across the UK. Argues that the benefits of such a system may not outweigh the potential threats to individual privacy and security.
Central Ayrshire
Supports the concept of data interoperability but notes that it is currently possible for patients to receive care elsewhere with appropriate funding arrangements in place. Emphasises the importance of existing ad hoc access to specialist services.
Barbara Keeley
Lab
Worsley and Eccles South
Supports amendment 73, which aims to introduce safeguards for unpaid carers during the discharge-to-assess process. Argues that without proper assessment of carer capability, this process can lead to significant financial and health burdens on carers. Cites statistics highlighting the stress levels among carers due to lack of support.
Daisy Cooper
Lib Dem
St Albans
Supports new clause 63, which aims to give NHS a duty to identify carers. Seeks clarification on the minister's response to this proposal in his winding-up speech.
John Baron
Con
Basildon and Billericay
Supports new clause 19, which focuses on improving cancer survival rates by prioritising outcome measures over process targets. Argues that focusing on outcomes can drive better patient-focused solutions and improve overall health service efficiency.
Jeremy Corbyn
Ind
Islington North
Supports the idea of emphasising cancer survival rates as an outcome measure. Highlights the importance of reducing delays in GP appointments, which can affect early diagnosis and treatment outcomes.
Mossley and Saddleworth
Proposes amendments to ensure NHS staff's terms and conditions are not undermined by private healthcare companies. Also, seeks removal of clause 80 due to risks posed by hospital discharge proposals.
Fiona Bruce
Con
Telford
Supports new clauses reducing the upper gestational limit for abortion and clarifying that abortion on the ground of sex or disability is illegal. Argues for updating the current 24-week limit due to advances in medical science.
Edward Leigh
Con
Gainsborough
Intervened to point out the inconsistency between saving a 22-week gestation baby medically and legally allowing abortion at 24 weeks. Suggests reviewing outdated technology and practices.
Marie Rimmer
Lab
St Helens South and Whiston
Proposes new clauses to prohibit UK citizens from receiving transplants abroad without clear consent of the donor, aiming to stop forced organ harvesting in China. Also seeks stringent consent requirements for imported cadavers.
Robin Millar
Con
Worcestershire South
Mr. Millar supports new clauses 60 and 61, arguing for good data collection to improve services and accountability. He cites issues in Wales where lack of data results in long patient waiting times.
Emma Hardy
Lab
Kingston upon Hull West and Haltemprice
Ms. Hardy proposes new clause 32, which aims to improve access to mediation services, clinical ethics committees, second medical opinions, legal aid for families in conflict with NHS over treatments, and a legal test to ensure parents' rights.
Maria Miller
Con
Basingstoke
Ms. Miller proposes new clause 50 to decriminalise abortion in England and Wales, treating women equally with those in Northern Ireland. She emphasises the vulnerability of victims of abuse and rape under current laws.
Peter Dowd
Lab
Bootle
Mr. Dowd supports new clause 13 to formalise self-care in NHS by publishing a national care strategy, reducing strain on GPs and A&E services.
David Simmonds
Con
Ruislip, Northwood and Pinner
Mr. Simmonds briefly supports amendments 103 to 105 regarding effective consultation with local authorities on statutory obligations.
Carla Lockhart
DUP
Upper Bann
Seeks clarification that sex-selective abortions are illegal and argues for a consistent upper gestational limit on abortion due to disability. Emphasises the moral implications of these practices.
Jim Shannon
DUP
Strangford
[INTERVENTION] Supports Carla Lockhart's new clauses, citing significant public opposition and expressing concerns about sex-selective abortions and abortion due to disability.
Supports new clause 19 tabled by his colleague but does not directly address the clauses debated. Raises issues around local hospital construction and public opinion.
Edward Argar
Con
Melton and Syston
Agrees to accept new clause 19 and discusses meeting with the shadow minister. Acknowledges the sentiment behind other amendments but cannot commit further due to time constraints.
Bolton West
Expressed concerns about the discharge-to-assess proposals and questioned the Department's ability to provide clinical outcomes data. Also mentioned that 4 million people have been discharged under this policy but did not know how many had readmitted within 30 days.
Jim Shannon
DUP
Strangford
Commented on the Secretary of State's remarks about delivering for all four regions, noting that 60% of people in Northern Ireland oppose abortion on demand and felt Westminster does not represent those views.
John Redwood
Con
Wokingham
Asked the Secretary of State to confirm that value for money and cost control will be prioritised in the reorganisation process.
Charles Walker
Con
Harwich and North Essex
Thanked the Secretary of State for considering concerns about parity of esteem between mental health and physical health, even if amendments were unsuccessful at this stage.
Daniel Poulter
Con
Carences
Expressed disappointment that while the Bill pulls people together in integrated commissioning boards, it does not commit to putting money into the same place for true integration.
Andrew Murrison
Con
South West Wiltshire
Supported the opportunity to end the practice of frail elderly people being expected to live out their days in acute hospital wards, favouring more homely settings.
Jon Ashworth
Lab/Co-op
Delyn
Thanked various Members for their work on the Bill but expressed that Labour does not support it due to its timing and provisions which they believe are damaging. Noted concerns about the care cap amendment, private sector roles in integrated care boards, and continued potential for privatisation.
Matthew Hancock
Con
West Suffolk
Welcomed the passage of the Bill, emphasising its role in embedding pandemic lessons by removing bureaucracy. Argued that accountability to Ministers is crucial given the £150 billion NHS budget and was surprised Labour does not support this.
Peter Aldous
Con
Waveney
Access to NHS dentistry is a long-standing issue, exacerbated by covid. Rural and coastal areas face dental deserts affecting vulnerable populations. Funding must increase, new contracts must be implemented next April, recruitment of dental professionals needs improvement, water fluoridation should be highlighted, and accountability on integrated care boards must improve.
Bob Seely
Con
Isle of Wight
Highlighted fairness for small hospitals in isolated communities. Stressed additional costs due to isolation and requested support from Ministers on a better funding model for unavoidable small hospitals.
Jim Shannon
DUP
Strangford
Emphasised dedication to life issues, expressed concern over abortion guidelines and their impact on Northern Ireland. Opposed clauses that could remove safeguards for women seeking abortions up to 28 weeks.
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