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Commons Chamber

Volume 670: debated on Tuesday 28 January 2020

House of Commons

Tuesday 28 January 2020

The House met at half-past Eleven o’clock

Prayers

[Mr Speaker in the Chair]

Business before Questions

Monken Hadley Common Bill

Bill read a Second time and committed.

Oral Answers to Questions

Health and Social Care

The Secretary of State was asked—

Access to GPs

With your permission, Mr Speaker, I will answer Questions 1, 4, 6, 11 and 20 together. [Interruption.] General practice is a popular subject.

We will create an extra 50 million appointments a year in primary care so that everyone can go to the GP when they need to.

There are many families with children in Gedling. What is being done to ensure that patients, particularly families with young children, can access GP appointments when they need them?

Obviously this is an incredibly important subject, and I know the frustration many families feel at not being able to access a GP appointment when they need it. We have a whole-scale programme of work to improve access. This includes recruiting 6,000 more GPs and 26,000 primary care staff other than GPs— increasingly patients at GP surgeries can be treated by nurses—and increasingly enabling people, especially those who find it difficult to travel, to use technology to get the treatment they need.

Hastings has a shortage of salaried GPs and GP services—locum GPs are available, at the right price. Will the Secretary of State please outline what steps he is taking to increase the number of salaried, rather than locum, GPs and GP services in Hastings and Rye?

My hon. Friend is right to ask. It is incredibly important that we get the right number of GPs, not least to reduce the amount spent on locums, who can be very expensive and often do not know the local population as well as salaried GPs. Her local clinical commissioning group is developing a new-to-practice fellowship in Hastings for GPs starting out in practice in order to encourage more doctors into practice and then to support them. It is also working with primary care networks so that more can become GP trainers and take on students. We are expanding the numbers going into GP training—there were record numbers last year—but I want the numbers to go up again and to make sure that Hastings gets the GPs it needs.

As part of the council area with the second-largest population increase in the country, the people of Biggleswade, Sandy, Arlesey and Stotfold are at their wits’ end over access to GP appointments. What special attention will the Secretary of State pay to those areas of large population growth to make sure that increases in housing are matched by increased access to GPs?

That is an incredibly important point. We have a manifesto commitment to ensure that where there is new housing there is also new primary care. Just as a new housing estate will often require a new primary school and new transport links, so we need to put in the GPs as well.

I thank the Secretary of State for visiting Tettenhall Wood surgery in my constituency during the general election campaign. Will he work with me to increase the numbers of patient appointments back up to where they were before?

Yes. My hon. Friend has already become an incredibly strong voice for Wolverhampton, and it was a pleasure to visit Tettenhall medical practice, which has joined with other GP practices to form a primary care network, which I hope will strengthen its resilience and enable it to provide extended access to appointments, which is what he is campaigning for. I am pleased, too, with the extra 16,000 appointments in Wolverhampton in the last quarter. As this shows, we are driving up the number of appointments, but we also appreciate, understand and feel the frustration people feel when they cannot get decent access to GP appointments.

Changes to pension contributions mean that some senior GPs, including in Newbury, are being hit with extra tax charges if they work overtime, which is leading to the paradoxical situation of GPs paying to work and so reducing their hours or taking early retirement. What steps is the Secretary of State’s Department taking to address this situation?

Tax is, of course, a matter for the Treasury, and the Chancellor would not be thrilled if I announced tax policy in the middle of health questions, tempting as that may be. However, we have been working with the Treasury, and also with the Academy of Medical Royal Colleges, the British Medical Association, employers in the NHS and others, to deliver on our manifesto commitment to sort this out.

You rather surprised me then, Mr Speaker!

The Secretary of State mentioned primary care networks. As he will know, two weeks ago GPs rejected the new service specifications in those networks. This has been described as a debacle, and as leading to more red tape and taking GPs away from patients. If the Secretary of State is going to fix these contracts, can he tell us how he is going to do it—or is he content to see more GPs walk out of primary care networks before they have even got off the ground?

Primary care networks have been an incredibly successful innovation, covering the whole country and allowing practices to work together. Of course, the negotiations with the BMA over the GP contract are always tough: they have been in every year in which they have taken place. The hon. Gentleman will understand why I want to get the best possible value for the money that the NHS spends, but I also want to see a successful conclusion to this negotiation, and we are working with the BMA to that end.

The Secretary of State describes primary care networks as a great success, but a local medical committee in Buckinghamshire and Berkshire has just warned that they will cost each practice £100,000 more. Having failed to deliver the 5,000 extra doctors that the Government previously promised, having failed to recruit more GPs in the poorest areas, having now bungled the negotiations over this contract, and having failed to fix the pension tax changes for which he was partly responsible, how on earth can the Secretary of State be trusted to deliver on the Prime Minister’s promise to cut GP waiting times to less than three weeks?

It is a bit of a disappointment to hear the hon. Gentleman talk down primary care. We are making record investments in primary care, we have record numbers of GPs in training, we are seeing an increase in the number of appointments in Wolverhampton and across the country, we are negotiating with GPs to strengthen general practice, in the last year we have introduced primary care networks that help to make primary care more sustainable, we are improving the technology that is available in primary care, and, for the first time in a generation, the proportion of the total NHS budget going into primary and community care is rising, whereas there were cuts under Labour. I think the hon. Gentleman should be standing up and saying thank you.

Hanwell health centre, which works hard to serve many of my constituents, has told me that it has been trying to appoint a salaried GP for three years, as well as a large number of nurses. There is generally a four-week wait for an appointment, although the centre has provided 75 more appointments to cope with demand. Under the Secretary of State’s plans, when will those waiting times come down?

This is precisely why we need to recruit more GPs, in the hon. Gentleman’s constituency and across the country, and also recruit more other clinicians to general practice. [Hon. Members: “How?”] I will tell you how, Mr Speaker. In the first instance, the record numbers of GPs in training will help, but that is not the entirety of the plan. I urge the hon. Gentleman to get on board and support general practice.

In 2015 the Secretary of State’s predecessor promised 5,000 more GPs by 2020. The Secretary of State repeated that promise when he took over the job, but my constituents are finding it increasingly difficult to get a GP appointment within three weeks. Will the Secretary of State now apologise to everyone who is waiting for failing to keep his promises?

The commitment that we have made is that we will have 6,000 more GPs and 26,000 other clinical staff in general practice. That is the commitment that we have made, and that is the commitment on which we will deliver.

In rural communities such as mine, GP surgeries often serve huge geographical areas with relatively small patient numbers. Coniston, for example, has a roll of about 900 patients, yet the next nearest surgery is two lakes away. Will the Secretary of State commit to establishing a strategic small surgeries fund to ensure that small surgeries in rural communities remain sustainable for the long term?

The hon. Gentleman makes an incredibly important point. General practice, where 90% of all NHS appointments take place, needs to reach every part of this country, including his beautiful constituency, which is, as he says, very sparse. Of course we need to ensure that the practices there are sustainable, and again this is an area in which technology can be of particular help. There is great enthusiasm for using technology so that the travelling times of patients and sometimes of GPs can be reduced.

Adult Social Care

The Government have enshrined in legislation through the Care Act 2014 a council’s statutory duty to meet eligible needs for adult social care. We have given councils access to up to £1.5 billion more dedicated funding for social care in 2020-21 to help them to meet this requirement.

Figures from Age UK show that 1.5 million people aged 65 and over have an unmet social care need, and Age UK estimates that this figure will rise to 2.1 million by 2030 if we carry on as we are. In my constituency, that equates to 3,012 older people with unmet needs and 2,517 older people providing unpaid care. Those are real people who are not getting the help they need. The Prime Minister said last summer that he had a plan to “fix” social care. Where is it?

As I have explained, the Care Act sets out the requirement that entitles individuals to a care needs assessment and sets a minimum national threshold at which care should be delivered. We have backed councils up by giving them access to £1.5 billion in additional funding in the next financial year. In the hon. Member’s constituency, that will equate to an additional £5.1 million from the new social care grant. This is something that the Government take very seriously.

According to the Institute for Fiscal Studies, more than 1.8 million older and disabled people are currently going without the support that they need to live independently. This crisis has come after the Conservative Government abolished the independent living fund and cut nearly £8 billion from adult social care budgets. In 2017, we were promised a Green Paper, but there has been nothing. Months ago, the Prime Minister stood on the steps of 10 Downing Street promising to “fix” social care, so when will the Government finally publish those plans?

We just do not recognise the figures that the hon. Lady is parroting. Public spending on adult social care in 2018-19 reached £17.9 billion in cash terms, which is the highest level on record. Since 2016-17, our sustained investment has enabled spending to increase by 7% over this period. But do not take it from me—the Local Government Association said last year:

“This is the biggest year-on-year real terms increase in spending power for local government in a decade and will allow councils to meet the rising cost and demand pressures they face in 2020/21.”

While the Scottish Government spend 43% more per head on social care, this Government’s NHS Funding Bill does nothing to address the £6 billion funding gap in England. Does the Minister accept that she cannot fix the NHS without fixing social care?

I completely agree with the hon. Gentleman that adult social care and the NHS are indelibly linked. The one must support the other, and the one drives costs with the other. The over-65 population is projected to rise over 50% by 2035, so putting social care on a sustainable footing where everyone is treated with dignity and respect is one of the biggest challenges we face in society. That is why it is one of the Prime Minister’s biggest priorities.

Scotland introduced free personal care for the elderly in 2002, and this has now been extended to those under 65 who need it. Will the Minister follow the Scottish Government’s lead and introduce free personal care so that people can live with dignity in their own homes?

The Prime Minister has set out his plans. He wants to seek political consensus and bring forward a plan for adult social care this year, and we are looking at a whole range of solutions, including free personal care. The issue we see in Scotland is that the initiative must be backed up with a huge amount of money. The money that the Scottish Government used to give to individuals covered around 50% of their care home costs and now only covers around 25%. That is why we must ensure that we address this issue with a long-term view.

It is time to tackle unmet need, which is clear from my hon. Friends’ questions. Ministers say that they want to seek a consensus on the future of social care, but we already have a proposal with wide-ranging support, including from former Conservative Chancellors in the Lords, major national charities, and the official Opposition: free personal care funded from taxation. Will the Minister accept that the way to move things forward is for the Government to join the existing consensus on introducing free personal care?

The Prime Minister said that the Government will deliver on our promises. We will bring forward a plan for social care this year—

This year. However, there are complex questions to address. A Joint Committee of the Housing, Communities and Local Government Committee and the Health and Social Care Committee came up with an entirely different solution—a social insurance model—which shows why we want to build a consensus. Even the Liberal Democrats have said that they want to build cross-party consensus, but we know the hon. Lady’s view on cross-party consensus: her way or the high way.

Given that we will not end the annual cycle of winter crises until we fix the problems in adult social care, does the Minister agree that, however important the commitment that people will not have to sell their home, the absolute priority in any discussions with the Treasury must be to get more money to local authorities so that they can discharge their responsibilities to older and more vulnerable people?

My right hon. Friend did some incredible work in this area when he was Secretary of State for Health and Social Care. In fact, he presided over the Department being renamed to draw reference to the importance of social care. He is absolutely right that we must ensure that councils have the money they need for the short term, but we must also work towards a consensus so that everybody will have safety and security and that nobody will be forced to sell their home to pay for their care.

I declare my interest as a member of Kettering Borough Council. Taking advantage of imminent local government reorganisation in Northamptonshire, will the Minister continue to encourage local councils and the two local hospitals to bring forward innovative proposals under one budget for an integrated health and social care pilot in Northamptonshire?

My hon. Friend has already been a really good champion of collaborative health and social care work. He has made some excellent suggestions, and we have seen how things such as the better care fund, through which health and care pool their resources, can have a positive effect for local communities. I encourage his local area to look closely at how that sort of work can be maximised and moved forward.

As the Minister will know, the particular problem in rural areas is that need is not just unmet, but unseen. What steps has the Minister taken, or what does she have in mind, to fix the situation and find that need so that it can be met?

My hon. Friend is right to draw attention to rural sparsity and the challenges facing rural communities. We are committed to undertake a review of relative needs and resources, and it will be a thorough evidence-based review of the costs facing all authorities, including how factors such as rurality, sparsity and other geographical features affect the cost of delivering services across the country and how to account for them in a robust manner.

For the record, I declare my interest as the spouse of an NHS doctor. The Pinn Medical Centre in my constituency is due to close its walk-in service so that the Harrow CCG can save money, but the likely diversion of patients to local A&E services will end up costing the NHS more. Will the Minister join me in encouraging the CCG to consider the wider context of NHS budgets and to support the service while local NHS providers consider how to increase access to GP appointments in line with our manifesto commitments?

My hon. Friend is right to highlight the importance of access to primary and community services within Pinner. My right hon. Friend the Secretary of State will be happy to meet him to discuss the matter further, but we will support anything he is doing to assist his local services.

PrEP Commissioning

3. What discussions he has had with the Secretary of State for Housing, Communities and Local Government on providing assistance to local authorities preparing for the routine commissioning of PrEP. (900429)

I have spoken to the relevant Ministers in the Ministry of Housing, Communities and Local Government, and my officials are working closely with other key stakeholders to ensure that we deliver routine commissioning of PrEP—pre-exposure prophylaxis—to help end new HIV transmissions. This is a key interest not only of many hon. Members but of many broader stakeholders, and I know the issue is particularly dear to the hon. Member’s heart.

I am grateful for the Minister’s response and for the Secretary of State’s announcement that he wants routine commissioning of PrEP by April, but what he and the Department have not done is spell out how they will achieve it. The PrEP trial will end this year, and we need a guarantee that every single person who needs and wants PrEP will get it from April.

I assure the hon. Gentleman that NHS England and NHS Improvement have already agreed to fund all the ongoing costs of the drugs for PrEP going forward. We will provide information on how the other elements of the programme will be funded and how commissioners will be supported. He is right that the trial ends in July, but routine commissioning will be rolled out from April—we will make sure they dovetail. It is hugely important that PrEP is available for each and every person who wishes to access it.

In October last year, the Government confirmed that the local authority public health grant will increase by 1% in real terms in 2020-21. However, this funding has not yet been allocated to local authorities. How will the Government financially support local authorities to establish the routine commissioning of PrEP by April?

As I said, NHS England and NHS Improvement have already agreed, within the ring-fenced funding for public health, to fund the ongoing costs of drugs for PrEP going forward. There will be an additional allocation of funds to cover the PrEP roll-out completely[Official Report, 3 February 2020, Vol. 671, c. 1MC.].

NHS: Take-up of New Technology

5. What steps he is taking to ensure the take-up of new technology by the NHS to support effective delivery of its services. (900431)

24. What steps he is taking to ensure the take-up of new technology by the NHS to support effective delivery of its services. (900451)

Using the best technology is good for patients, clinicians and the NHS. Work is under way to drive through the use of new technology, including electronic referrals and electronic prescribing, and to end the painfully slow logins in some trusts.

My right hon. Friend will know that the Future Fit programme, if passed, would have brought not only £312 million but a lot of innovative, pioneering technology into the county of Shropshire. Unfortunately, as he knows, the programme has been blocked thus far by the Labour-controlled, medically illiterate Telford and Wrekin Council. Does he agree that investing in technology would help patients and clinicians and would save money in the long term?

Yes, I do. It is striking how much clinicians working on the frontline are desperate for improvements in the technology they use. Our announcement over Christmas that we will have a single login, which is seemingly so simple, brought enormous enthusiasm from clinicians who spend hours of their week doing things that most of us can do with the click of a button on the systems we use.

My hon. Friend has been an assiduous campaigner for health investment in Shrewsbury, both physical capital investment and investment in modern technology.

I welcome the phasing out of outdated technologies, such as fax machines, in the NHS. As the switch-off date approaches, what steps is NHS England taking to ensure that patient records can be transferred electronically between primary and secondary healthcare providers?

My hon. Friend is spot on. We are driving interoperability so that the right people can see the right records at the right time. We will mandate that technology used in the NHS must allow for such interoperability, and we will set standards.

My hon. Friend started the “axe the fax” campaign, in which I was happy to play my part. Faxes are terrible for efficiency and for data security—even straightforward email is so much better—and we will drive up data security by axing the fax across the NHS.

What specific investment is being directed to supporting the 11 new radiotherapy IT networks that are required to provide a world-class radiotherapy service and improve cancer outcomes and survivability?

Radiotherapy is a good example of part of the NHS that can benefit hugely from improved technology now and from the cutting-edge artificial intelligence-type technologies that are coming down the track. I am happy to look at any specific proposals the hon. Gentleman has. We have a broad programme to support the technology needed in radiotherapy.

I am disappointed that the Secretary of State could not come to the opening last Friday of the Advanced Wellbeing Research Centre in my constituency, which is looking at linking research into the prevention and treatment of chronic diseases with physical activity, using new technologies including robots. I am pleased that he has contributed £14 million to this project. He has missed that opportunity, but may I invite him to come to the centre and to discuss how he can help to set up a centre for child health technology, again using innovative and technological solutions, towards which we will expect his contribution to be helpful?

The hon. Gentleman is a man after my own heart. I am sorry that I missed the ribbon cutting, as I love a good ribbon cutting, especially where the project sounds so brilliant and innovative, bringing different parts of the NHS together and helping clinicians in order to help patients. I am glad that he is as enthusiastic as I am about our £14 million investment.

Health and Social Care (Buckinghamshire)

8. If his Department will fund the digital transformation of health and social care services in Buckinghamshire; and if he will make a statement. (900434)

We are driving forward the technology agenda across the NHS, as we have just been discussing. Buckinghamshire Healthcare NHS Trust is one of the many trusts being considered for digital aspirant funding, which is the next generation of funding to bring hospital trusts into the 21st century.

I am grateful for that, but will the Secretary of State support moving to devolved, multi-year and unified budgets, to enable the delivery of digital technology and, in particular, best value, against specific outcomes?

Yes, my hon. Friend is spot on. We recognise the need for a multi-year capital settlement in the NHS to support exactly that sort of planning and to modernise, and the Treasury has confirmed that we will publish that settlement at the next capital review.

University Hospital of Hartlepool

9. What discussions he has had with the Hartlepool and Stockton-on-Tees clinical commissioning group on the future of services at the University Hospital of Hartlepool. (900435)

My right hon. Friend the Secretary of State has had no discussions with the CCG on the future of services at the University Hospital of Hartlepool.

Hartlepool’s hospital is vital to our community, but its future very much depends on consultancy-led services. What reassurances can the Minister give me that consultancy-led services will be returned to that hospital?

I am conscious that both the energetic Mayor Ben Houchen and the hon. Member have campaigned on working to reinstate accident and emergency and maternity services at Hartlepool’s hospital. Although there are currently no plans that I am aware of to change the model of services, and reconfiguration matters are for the CCG, I am happy to meet him and the Mayor to discuss the hospital if that is useful.

Thank you, Mr Speaker. As another north-east MP concerned about local healthcare, I asked the Prime Minister two weeks ago about retention of the stroke service at Bishop Auckland Hospital. Has the Minister made any progress on that point?

My hon. Friend is already a doughty champion and spokesperson in this House for her constituents on health matters—indeed, she was just that in yesterday’s Second Reading debate on the NHS Funding Bill. I am pleased to inform her that my right hon. Friend the Secretary of State has already met the chief executive of the NHS and the regional NHS director responsible and discussed this matter with them.

Life Expectancy

Although life expectancy at birth remains the highest it has been, we want everyone to have the same opportunity to have a long, healthy life, whoever they are, wherever they live and whatever their background. We are committed to giving everyone five extra years of healthy life by 2035, and to addressing the needs of areas with the poorest health.

Life expectancy advances depend on good local service provision. Does the Minister agree with me and the people of Jarrow that, following the devastating closure of St Clare’s Hospice, we should take all possible steps to ensure that palliative care provision is put in place urgently in Jarrow constituency? Will she meet me to discuss this important issue?

I am unaware of the closure of that hospice, but my door is open to the hon. Lady. If she would like to see me at the back of the Speaker’s Chair after questions, we can arrange a suitable time to discuss the issue.

Today, a baby girl born in Liverpool can expect to live 13 fewer years in good health than a baby girl born in Richmond. A new study from University College London shows that being wealthy adds nine years to healthy life expectancy. Does the Minister agree that such health inequalities are an injustice in society that must urgently be addressed?

The best way to improve life expectancy is to prevent health problems from arising in the first place. Prevention is one of the top five priorities for the health service, and we are taking action to help people live longer and healthier lives. The Government have a proven track record of reducing the harms caused by obesity, tobacco and other substances. That is where we need to focus our efforts to ensure that life expectancy rises in all areas throughout the country.

The most shocking trend in life expectancy is that people with learning disabilities die so early—on average 25 years younger than the general population. We must see action to learn the lessons from each of those early deaths. The contract for the University of Bristol’s running of the learning disability mortality review ends in May, and there is now a growing backlog of cases, so will the Minister tell the House what the future of this important review is, and what staff resources are needed to continue the vital work of reviewing and reporting on early deaths?

We will introduce mandatory training for all health and social care practitioners. I hope that that will address the particular problem that the hon. Lady has brought up. It comes back to the substantial life expectancy issue, which is that regardless of the group, prevention is key.

In her initial response, the Minister rightly emphasised the importance of rising healthy life expectancy, as well as life expectancy more generally. Will she therefore join me in welcoming the forthcoming report from the all-party group on longevity—[Interruption.] If the Minister is listening, will she welcome the report, which will give the Government practical advice specifically on how to use prevention to raise the levels of healthy life expectancy?

I could not agree more with my right hon. Friend. We want everyone to have the same opportunity to have a long and healthy life, whoever they are, wherever they are and whatever their background. We will certainly look at that report.

I welcome the fact that one theme underpinning the NHS long-term plan is prevention, to help enable people to live better lives for longer. Does my hon. Friend agree that supporting people to make healthier choices, combined with improved screening and diagnostic services, will help to increase life expectancy?

I very much agree, and that is where the Government are directing their efforts. My hon. Friend mentioned screening; we have put extra resources into screening and scanners, including in Peterborough. We are absolutely attacking on screening programmes and on obesity and tobacco—all those issues that we know affect life expectancy and cause harms. The Government have made those issues their top priority.

Health Inequalities

We are determined to address the long-standing inequalities that exist in many areas, be they in access, outcomes or people’s experience of their local health service. Our world-leading childhood obesity plan, NHS health checks, the tobacco control plan and the diabetes prevention programme all see us leading the way, but there is undoubtedly more targeted work to do on this complex issue, particularly in areas of high need.

The recent mental health prevention Green Paper recognised the link between deprivation and poor mental health outcomes. Along with the proper funding of frontline and early intervention services, mental health inequality needs urgent action, so when will the Minister get to work to sort out this mess? People in east Hull desperately need access to services that are currently not available.

I agree with the hon. Member. I and my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), who has responsibility for the mental health element of the portfolio, are working hand in glove on this. Often, it is the dual toxicity of addiction—be it substance or alcohol abuse—and mental ill health that drives health inequalities. We are targeting the matter and working together on access to make sure that we drive down these health inequalities.

Many people with severe conditions such as agoraphobia face inequalities in accessing life-saving services such as cervical smear tests. What is my hon. Friend doing to ensure that these services can be administered outside a clinical setting, thus reducing health inequalities for those who, for whatever reason, are housebound?

No woman should be denied access to vital screening. I believe that my hon. Friend is referring to a particular matter in her constituency where it has been very difficult for somebody to access screening. I am happy to meet her to see how we can work through this. We are actually working on a home kit for cervical screening, which should help in time, but nobody should be denied access. We are committed to improving access for all women, and I will be happy to meet her to see what we can do.

Primodos

Ministers have not received any recent representations. However, as we know, Baroness Cumberlege is leading the independent medicines and medical devices safety review, which includes an examination of what happened in the case of Primodos. Her review has had lengthy engagements with people who have been affected.

As the Minister is aware, the hormone pregnancy drug test Primodos was taken by around 1.5 million women in the ‘60s and ‘70s, leading to birth defects, miscarriage and stillbirth, and, 50 years on, those affected still wait for justice. The review into this scandal, announced in 2018, was very welcome, but can the Minister confirm that, if it is merited, she is open to establishing a comprehensive public inquiry following the publication of the review to ensure justice for those affected?

Baroness Cumberlege’s review is examining what happened in the case of Primodos and will determine what further action is required. Ministers will consider any recommendations very carefully. We do not have a date for the publication of the review, but it will be very soon. Perhaps we can continue the conversation then.

Accident and Emergency Waiting Times

19. What recent assessment he has made of performance against waiting time targets for A&E services throughout England. (900445)

Winter is the most challenging time of year for our NHS, when cold weather and an increase in flu cases place additional pressures on the service. As ever, the NHS staff have done an amazing job this winter, and the NHS has seen a significant increase in demand, with 1 million more patients attending A&E in 2019. The December figures, when compared with those in 2018, show a 6.5% increase on attendance at A&E.

I do not know whether the Minister is aware, but we have a winter every year. We have had one for the past 71 years, and yet these are the worst A&E waiting times in history, and they are the culmination of the policies that his party has followed for the past nine years: the cuts in social care, the number of GPs driven out of practices, and this Government’s failure on prevention. All of that has led us to the worst A&E waiting times in history, and the Minister’s answer does not start to look at the failure that he has delivered.

Well, as I pointed out to the hon. Gentleman—he may not have heard this—demand in A&E has significantly increased this winter. He asks about GPs. I am sure he fully supports our clear commitment to 50 million more GP appointments and 6,000 more GPs. I am sure he also welcomes, in his own constituency, the £19 million investment by this Government in 2017 in a new urgent treatment centre, which will serve his constituents and is due to start work this summer.[Official Report, 29 January 2020, Vol. 670, c. 6MC.]

Between winter 2018 and winter 2019, the proportion of A&E attendances in Bradford that were seen within the four-hour target fell by seven percentage points, putting patients at risk and overstretching already pressured staff. In Health questions in October last year, I warned the Minister of these very real dangers, but he refused to meet me even to discuss the matter. Will he now answer the question as to why further funding was not made available to stop staff and patients at Bradford Royal Infirmary being put at risk?

I remind the hon. Gentleman that Bradford treated more people in A&E this winter than in any previous one, and although he may have omitted to do so, I want to pay tribute to and thank the staff at Bradford for that work. The Conservative party is the party that is investing in our NHS, our A&Es and our staff, and the hon. Gentleman should welcome that.

I think it is time that we shook this Government out of their complacency. On their watch, the four-hour A&E waiting target has never been met, and performance is getting worse each month. It is no wonder they are putting so much effort into getting rid of it. We agree with the president of the Royal College of Emergency Medicine, who said:

“Rather than focus on ways around the target, we need to get back to the business of delivering on it.”

Does the Minister agree?

First, 1.7 million more people are being seen within the four-hour target now than before 2010. I hope that the shadow Minister will acknowledge that that reflects the significant increase in demand due to the number of people going through the system. He talks about the review of standards. That is a clinically-led review, and I am sure he would want to let those clinicians lead it. We will see what it reports and will consider its recommendations when they come back to us. In the meantime, we are getting on with investing in our NHS, and improving services.

Topical Questions

As well as working to protect the public from infectious disease outbreaks, we are working to improve technology and recruit the workforce that the NHS needs. Figures just out show that we have record numbers of nurses working in our NHS—up by over 7,800 on the same time last year.

May I acknowledge the good work done by the Minister for Care, my hon. Friend the Member for Gosport (Caroline Dinenage), resulting in a regional breakdown of the transforming care programme? It shows where progress is not being made, and that the target of 35% of in-patient beds being closed down will not be met by this March. How will the Secretary of State shut down these hell-holes, and will he hold to account commissioners who are still sending people with learning disabilities to them?

I am really pleased that my right hon. Friend has driven forward, and is holding us—and, in turn, the NHS—to account for delivery of this vital agenda; it is incredibly important to get this right. The number of people with learning disabilities and/or autism who are in in-patient settings is falling, but not as fast as I would like. We have a clear commitment in the long-term plan to bring it down by half. As she says, there is a target to bring it down by the end of March. The Minister for Care has done a huge amount of work to drive this forward, and we will do everything we can to ensure that all these people, who are some of the most vulnerable in the country, get the best support they can in the right setting. I welcome my right hon. Friend’s scrutiny.

T3. The West Suffolk Hospital has been in the news for all the wrong reasons. I guess all Members try to keep their fingers on the pulse of their local hospitals, but does not the fact that West Suffolk constituents are represented by both the Secretary of State and the Under-Secretary of State for Health and Social Care, the hon. Member for Bury St Edmunds (Jo Churchill), show that something has gone fundamentally wrong in the scrutiny and oversight of our NHS? What has gone wrong, and what is the Minister going to do about it? (900454)

I would not draw that conclusion about my right hon. and hon. Friends. What I would say, though, is that I want all staff to feel that they can speak up and have the confidence that anything they raise will be taken seriously. That is why I requested on 17 January that NHS England and NHS Improvement commission a rapid and independent review into how the West Suffolk NHS Foundation Trust has handled this issue. I will be happy to update Members, including the hon. Gentleman, when that review reports.

T2. Last week, due to ongoing workforce challenges, Northern Lincolnshire and Goole NHS Foundation Trust temporarily transferred all oncology services to Grimsby’s hospital. This is not acceptable to local patients. Will the Secretary of State join me on a visit to Scunthorpe General Hospital so that we can discuss this and other issues with local NHS staff? (900453)

I appreciate the concerns raised by my hon. Friend about that matter. I understand that the changes, which have been made for patient safety reasons, are temporary, with a review to follow led by the Humber, Coast and Vale cancer alliance. As we monitor the results of the review closely—I will continue to take a close interest in this matter—either I or my right hon. Friend will be happy to take up her invitation for a visit.

T8. In my constituency, year-on-year reductions in funding of both adult and young people’s mental healthcare mean that some of our most vulnerable citizens are falling through the net. Can the Government guarantee that adequate funding will be made available to tackle the mental health crisis now? (900459)

There have been year-on-year increases in funding for mental health services, but there is also an increase in demand. The long-term plan has the largest increase reserved for mental health services, because we want to see mental health and physical health treated on a par.

T4. Labour’s private finance initiative contract means that Royal Stoke University Hospital is paying double the interest on its debt than if it had been funded directly from the Treasury—money that should be going to improve patient care. Will my hon. Friend agree to look at how these costs can be mitigated? (900455)

I am grateful to my hon. Friend, who, along with my other hon. Friends who represent Stoke, has raised this issue in the past; they are right to highlight it. My hon. Friend is absolutely right that Labour’s PFI deal has left the trust burdened with debt. My Department’s PFI centre of best practice supports trusts in ensuring best value, and I will happily ask it to work with him. Yesterday I also committed to meet him and my other hon. Friends to discuss this matter.

Throughout the election there were empty promises from the Conservatives, and one of those promises was to tackle the social care system—but there is still no Green Paper. There are dementia patients who are trapped in hospital due to an inadequate social care system, and yet this Government still do nothing. How many more families have to suffer before this Government act?

In Maghull, Formby and Crosby in my constituency, the health facilities are simply not fit for purpose. Significant house building will only make matters worse and make it that much harder for the Secretary of State to deliver on the promises he set out earlier in today’s Question Time. Will he meet me to discuss how to get the funding so that we have the state-of-the-art, high-quality facilities that my constituents and medical staff need?

I spent much of the latter part of last year travelling around the hon. Gentleman’s part of the world and meeting then candidates. I am very happy to meet him to see how we can use the record levels of capital investment in our NHS—the record levels of funding that he should support—to support his constituents as well as everybody else’s.

T5. Tameside Hospital A&E has seen a huge increase in patient numbers, often leading to overcrowding, with patients being assessed and treated in unsuitable areas. The Government have rightly responded by committing to building a new urgent care centre for Tameside. Will the Secretary of State update the House on when construction is due to begin? (900456)

We want to begin construction urgently. My hon. Friend has been assiduous in promoting and supporting this project, which he has raised with me a number of times. I look forward to meeting him in the next week or so to go through the details of when we can see it open.

T6. My right hon. Friend will know that the A&E services at Burnley General Hospital were closed in 2007 by the then Labour Administration. Given our record investment in the NHS, and the pressures on the A&E, will he agree to meet me to talk through the future of the hospital and the services we can provide locally? (900457)

My hon. Friend, like his colleagues, has already proved himself to be a doughty champion for his constituency. The urgent care centre at Burnley General Hospital will continue to play an important role in meeting urgent care needs locally, but he is right to highlight the broader importance of Burnley as part of the health ecosystem in his area. I would be delighted to meet him.

There are real concerns in east London about the big delays in the breast cancer screening programme, meaning that many women are not getting their first screening until close to their 53rd birthday. Will the Minister meet me and other concerned east London MPs to ensure that we tackle that, to the benefit of our constituents?

I would be delighted to meet the hon. Lady and other east London MPs. Mike Richards has done a review of screening, and we need to level up and ensure that everybody can access screening.

T7. In December, more than 2,200 patients waited in excess of 12 hours in A&E departments in north Wales. What is the Secretary of State’s response to the Welsh Government, who have managed the health board in special measures for nearly five years? [R] (900458)

I worry about the delivery of health services to people in Wales. Although this issue is devolved, I am the UK Health Minister, and my hon. Friend is right to raise that issue for his constituents. The number of people waiting more than one year in Wales is over 4,000. In England, despite the much larger population, it is only just over 1,000. The Welsh NHS, frankly, is an advert for why people should not want the Labour party running the NHS.

A number of women in my constituency have recently been in touch who are going through the menopause and struggling to access hormone replacement therapy, which they really need. What assessment has the Secretary of State made of current supplies of HRT, and what is he doing to address the shortages?

That is obviously an incredibly important issue. The shortages come from problems with factories outside the UK. We have been working hard on it through the autumn. I am advised that the shortages are starting to be mitigated and that production is back up and running, but we keep a close eye on it, because I understand how important it is.

T9. Will my hon. Friend commit to working with me to secure the long-term future of hospice services in any reorganisation of the Mount Vernon Hospital site in my constituency? (900460)

We are very committed to hospice services, which is why an additional £25 million went into hospices last year. I am certainly happy to meet my hon. Friend to discuss the hospices in his area.

Cuts to local government budgets have led to cuts to public health budgets, which have led to cuts to preventive services, which have led to greater demand in A&E and social care. It is bad for individuals, and it is terrible for the health and social care system, yet this weekend, we saw media reports that there are more cuts coming to local government, especially in the poorest communities. Can the Secretary of State assure us that he will tell colleagues in the Treasury and the Ministry of Housing, Communities and Local Government that those cuts cannot take place?

I do not need to, because we are clear that there is an increase in the spending power of local authorities and in the public health grant.

T10. Last week was Cervical Cancer Prevention Week. Will my hon. Friend join me in commending the work of my constituent Maria Dullaghan and the charity Jo’s Cervical Cancer Trust, which campaigns to raise awareness? Will she underline the Government’s support for Sir Mike Richards’s review of the adult screening programme? (900461)

I am delighted to join my right hon. Friend in congratulating Jo’s Cervical Cancer Trust on the work it does. I had the pleasure of meeting its team only last week, who do fantastic work to raise awareness of vital cervical screening. He is right about Mike Richards’s review. We must ensure that we screen all the available population in order to see cervical cancer eliminated for good, which would be brilliant. I am delighted to support this year’s “Smear for smear” campaign. There is nothing shameful about human papillomavirus, and we must bust the myths, because being tested can save someone’s life.

Following the desperately upsetting news headlines last week about preventable baby deaths at East Kent, including that of Harry Richford, aged just seven days old, whose death was described by the coroner as “wholly avoidable”, will the Secretary of State join me and Harry’s family in calling for a full, transparent public inquiry?

I thank the hon. Lady for raising this issue, and also my hon. Friend the Member for Dover (Mrs Elphicke), who made an excellent speech last night about this very issue at East Kent. I would like to reassure the hon. Lady that the Care Quality Commission conducted a further investigation of the whole trust last week and will take enforcement action if necessary. On Monday, I asked it to provide a summary report within 14 days. The Healthcare Safety Investigation Branch has examined 26 individual maternity cases at the trust, and it has already reported on 15. It was also asked on Monday to complete its work within 14 days and to send in a summary report to give us further information.

The Secretary of State will know that my local Labour party has been running an outrageous campaign saying that the Parsons Green walk-in centre is set to close. The clinical commissioning group has confirmed that that is not the case, and the facility is both busy and popular. Will he join me in condemning this latest scare tactic from my local Labour party about local NHS facilities that are both popular and well used?

That is absolutely right. Last year, my right hon. Friend campaigned for and secured the long-term future of the Parsons Green walk-in centre. That announcement was made, and then the scaremongering carried on, supported by the local Labour party and the hon. Member for Hammersmith (Andy Slaughter), who is a disgrace in the way he campaigns because it worries vulnerable people who think that things are going to close. I pay tribute to my right hon. Friend and send a message to people far and wide in Parsons Green that their walk-in centre is staying open.

Order. I am sure the Secretary of State would acknowledge that I am trying to get the last few questions in, and I think we can speed up rather than trying to make any last final points.

May I ask the Secretary of State what screening plans are in place for those arriving in the UK from China, and has a contingency fund been established to tackle the potential effects of the coronavirus?

Of course, it is incredibly important that we have appropriate measures in place for those who return from China—not only those returning from outside Wuhan, but those returning from Wuhan should they do so. Those are being put in place, and of course we are making budgets available to ensure that all support necessary is given.

Order. Unfortunately, that is the end of questions. I hope that we will get in a few more next time.

The House will wish to be aware that there will be a statement today after the conclusion of proceedings on the Direct Payments to Farmers (Legislative Continuity) Bill. I cannot confirm a time exactly, but it should be before 3.30 pm, and the start of proceedings on the Third Reading of the Bill will serve to give some notice of the likely start time. I hope that is helpful to Members.

Direct Payments to Farmers (Legislative Continuity) Bill

Considered in Committee

[Dame Eleanor Laing in the Chair]

Clause 1

Incorporation of EU legislation governing the CAP direct payment schemes

Question proposed, That the clause stand part of the Bill.

With this it will be convenient to discuss the following:

Clauses 2 to 9 stand part.

That schedule 1 be the First schedule to the Bill.

Amendment 8, in schedule 2, page 12, line 11, leave out “3(1)(a) or”.

This amendment together with Amendment 9 would make regulations under Clause 3(1)(a) subject to affirmative resolution procedure rather than the made affirmative resolution procedure.

Amendment 9, page 12, line 13, leave out “3(1)(b), 3(b) or (4)” and insert

“3(1)(a), (1)(b), (3)(b), (4) or 6(1)”.

This amendment is linked to Amendments 8 and 10.

Amendment 10, page 12, line 16, leave out paragraph 3.

This amendment together with Amendment 9 would make regulations under Clause 6(1) subject to affirmative resolution procedure rather than negative resolution procedure.

That schedule 2 be the Second schedule to the Bill.

Clause 1 provides the legal basis for the Government and devolved Administrations to make payments to farmers under the direct payment scheme for 2020. The clause is needed because article 37 of the withdrawal agreement means that the EU legislation governing the 2020 common agricultural policy schemes will no longer apply in the UK on exit day. This was fully intended; it is part of extracting the United Kingdom from the European Union’s next multi-annual budget cycle, which starts in 2021, and it allows us to take back control of agriculture policy and domestic agricultural funding.

The Bill is needed because of a quirk in the way that the EU common agricultural policy is funded. Pillar one payments—the so-called basic payment scheme payments —are funded from the following year’s budget, unlike pillar two payments for things such as countryside stewardship, which are funded from the budget year in which they apply.

It includes the basic payment scheme. Only direct payments are in the Bill’s scope, and that includes the annual area payments that most farmers would receive.

As we are not contributing to the next multi-annual financial framework, we have decided that we should fund this year ourselves to provide farmers with continuity. The withdrawal agreement therefore disapplied the direct payment scheme to the UK. The European Union (Withdrawal Agreement) Act 2020 applies that agreement, and disapplies the direct payment scheme, so to pay farmers for this year, we have to provide this regulation.

Chelmsford is largely an urban constituency, but when I visited one of my local farms just before Christmas, it was devastating to see that, because of the wet weather, people there had not been able to plant any of their winter wheat. They are doing some fantastic work with new crops such as millet, so that we do not need to import that. Will the Bill help to give farmers across Essex and the east of England the certainty they need at this challenging time?

The Bill will absolutely give them that certainty. The Bill is essential if we are to give farmers their direct payments—those area-based payments—in December. If this direct payment regulation did not come into UK law, we would be unable to do that.

Will the Minister confirm that as we move on to the new policy, there will be an emphasis on growing more food at home for import substitution, so that these general moneys can lead on to moneys that help us to build a bigger domestic food industry?

My right hon. Friend will be aware that we have presented a separate Agriculture Bill, which has had its First Reading. It sets out all the powers we would need to reform agriculture policy. The direct payment regulations before us bring the CAP into UK law and on to the UK statute book, and in the Agriculture Bill, there are powers to modify these regulations, so that we can remove the rough edges and simplify them. There are also powers in the Agriculture Bill to strike a very different course for our agriculture—a course based on payment for public goods, but also on providing farmers with grants to invest in new technology, so that they can improve their profitability or add value to their produce. That Bill also recognises that our food security is vital, and commits the Government to reviewing it every five years. That, however, is obviously a matter that we will debate in the coming weeks and months; I want to return to this direct payments Bill.

My hon. Friend the Member for Chelmsford (Vicky Ford) mentioned the need for certainty in her arable sector. We have a strong arable sector in North Dorset. Does the Minister agree that the certainty that this Bill provides to our farmers is of particular importance to those involved in the dairy and beef sectors, both of which are incredibly strong in North Dorset?

I very much agree with my hon. Friend. The Bill will give certainty and clarity about this year to all farmers who currently make a BPS claim and have done for some years. That will include, of course, dairy farmers and beef farmers. Beef farmers in particular have been through a rather difficult year, in which beef prices have been suppressed, and the knowledge and clarity that there will absolutely be continuity this year, and that payments will be made, will be very welcome to them.

The Minister’s own Department’s figures recognise that 85% of livestock farm income comes through basic payments. Of course, this 12-month stay of execution will be welcomed by many of my farmers, but from next January, he is planning to phase out BPS, and the danger is that there will be no certainty about its replacement before 2028. Does he not worry that we will lose many livestock farmers during that seven-year transition, and does he agree that he should therefore delay the phasing out of BPS?

It is important to recognise that a significant proportion of sheep farmers in particular do not receive the basic payment scheme area payment, because they are on contract farm agreements and the landlord receives that money. Nevertheless, the hon. Gentleman makes an important point. I think the principle of investing in public goods has support across the House, but we need to strike this new course sensitively and ensure that agriculture remains profitable. We want a vibrant and profitable agriculture industry, which is why the Agriculture Bill also makes provision for payments to improve productivity, and sets a quite long transition period of seven years, so that we can gradually phase out the old legacy scheme. He will be reassured to hear that the Bill before us makes no changes at all for the coming year. Farmers in his constituency can rest assured that once this Bill is passed, the direct payment scheme will operate this year in exactly the same way as it has in previous years.

Does the Minister agree that there is a balance to be struck between incentivising productivity and rewarding farmers for their role in looking after our countryside—the hedges, copses and spinneys that make England, and indeed Scotland, Northern Ireland and Wales, so unique in their character, and so different from some intensive agricultural operations in European and beyond? If we are to remain competitive and our land is to remain productive and profitable, we need to find a system that balances those priorities, protecting what we love about our countryside, while recognising the wonderful contribution our farmers make to our agricultural economy.

My hon. Friend makes a very important point. It is all about striking the right balance. The premise behind the direction of agriculture policy is this: rather than trying to put on a sticking-plaster, and masking poor profitability in agriculture, we ought to have a coherent policy that rewards farmers properly for their work to improve the environment, create new habitats and so on, and that makes them able to become more profitable by investing in new equipment, adding value to their product and improving transparency in the supply chain. That is our approach—tackling the causes of poor profitability, not masking them with an arbitrary area-based subsidy.

My hon. Friend is being characteristically generous in giving way. I hope he will agree with me, and probably most people in this House, that as important as this Bill is—so, too, is the Agriculture Bill, to which he referred—it will be for nothing if we do not have some form of equivalence clause on food imports to ensure standards of animal welfare and public health. All of the Minister’s good intentions, both for this Bill and the Agriculture Bill, will come to nothing if we suddenly find ourselves swamped by cheaper imports that make all the countryside issues to which my hon. Friend the Member for Milton Keynes North (Ben Everitt) referred absolutely irrelevant.

My hon. Friend makes an important point. Obviously, that is not a matter for this Bill, but our party’s manifesto makes a clear commitment to our maintaining standards as we approach new trade deals, and to our ensuring that we do not water down our standards or undermine our producers.

The Minister says that there will be complete continuity of the basic farm payment over the coming year. Does that include continuity of the three crop rule and all the regulation that goes with the present system? Farmers will need to know that. They have got used to the system, and so has the Rural Payments Agency, so we need to know whether the system will be exactly the same, or whether there will be some changes.

My hon. Friend makes an important point, and I will come on to that when I describe some of the regulations that will be brought across by the Bill. The system will be exactly the same, including the so-called three crop, or crop diversification, rule, the requirement for environmental focus areas, all the scheme deadlines for getting forms in, and the penalty matrix. I am not a huge fan of many of those things, and have been critical of them in the past, but we have taken a decision that charting a different course is a matter for the Agriculture Bill. This is a short Bill that is about providing farmers with immediate continuity and legal certainty that they will get their payment in exactly the way they used to—for this year only; then we will set out a different approach and a different course.

Can the Minister remind the House how, in the implementation period, we will avoid having to pay twice—both sending money to Brussels and paying direct?

As my right hon. Friend will be aware, under the financial settlement in the withdrawal agreement, we did not make a contribution to the next multi-annual financial framework, so the UK will not contribute to the EU budget from 2021 onwards, and will therefore not contribute to the budget that would fund this current year of BPS. We will fund it domestically, and that is why the direct payments regulation must be brought on to a UK regulatory footing.

There is an argument that for many years the UK has actually contributed much more to the common agricultural policy than we have received from it. Can the Minister assure me that as we will not make those payments, we should save some money for the Exchequer?

My hon. Friend will remember the debate that took place in 2016. The UK has typically received back roughly half of what it put into the EU budget, and our contribution to the common agricultural policy on average has been double what we have received from it, historically.

Further to the intervention from my right hon. Friend the Member for Wokingham (John Redwood), and so that I understand this point, am I right that in this transition year we effectively pay as if we were members, but we are also funding domestically this farming payment under the Bill? Is it netted off, or are we in effect paying more for this year overall? Does that make sense?

It is complicated—as ever—with the common agricultural policy, but I tried to explain this point in my opening remarks. It is a quirk of the way that the EU budget works that the EU borrows the money for the pillar one payment—the BPS and area payments—from next year. Because the payments are made typically from December onwards, the money comes out of the 2021 budget. The pillar two payments come out of the 2020 budget—the year in which the money is spent. Put simply, we have not contributed to the 2020 capped budget because it is borrowed from 2021. I know that is complicated, but in essence we are not paying twice.

Am I right in saying that the Welsh Government take 15% of the direct payment away from farmers and transfer it into pillar two, and that that is the most that any Government across the European Union can take?

Yes, my hon. Friend is right. Under the common agricultural policy, there is provision for something called modulation, under which member states are able to transfer a chunk of money from pillar one to pillar two. Wales transfers 15%, or modulates by 15%, from pillar one to the pillar two budget. England modulates at the rate of 12.5%, and Scotland and Northern Ireland modulate considerably less, but still a little bit. There is a provision for that, and the Bill brings that regulation into UK statute.

Without clause 1, neither the Government nor the devolved Administrations would be able to continue to operate the 2020 direct payment schemes, and that would severely affect the agricultural industry, threatening the financial viability of agricultural producers who have planned on the basis of continuity of payments for this year. The direct payments basic legislation, and the implementing and delegated legislation, will become domestic law on exit day, as opposed to at the end of the implementation.

Climate change is a threat that we must all take action to tackle, and my constituents and farmers care deeply about it. Does my hon. Friend agree that the Agriculture Bill and these changes will provide us with a great opportunity to encourage greener practices in the world of agriculture?

Yes—my hon. Friend makes a very important point. As we chart a new course on agriculture policy, one key objective set out in the Agriculture Bill, which was recently published, was on climate change. It is absolutely the case that we should support farmers to farm more sustainably and reduce their greenhouse gas emissions, and that will be a matter for future policy. This Bill does not envisage radical change compared with what has gone before. Some provisions—the so-called “greening provisions” that are brought across by the Bill—will potentially have a modest impact on our carbon emissions and climate change, but addressing that issue properly will be a matter for future policy.

Clause 1(3) sets out the regulations that are covered. That includes the direct payments regulation, apart from article 13. Article 13 of the direct payments regulation is still there in retained EU law, because the withdrawal agreement Bill brought that element of the regulation across, so we do not need to do that a second time. We need that state aid provision because the withdrawal agreement committed us to an equivalent approach to the EU for this year. There is also the Commission delegated regulation (EU) No. 639/2014, which supplements the direct payments regulation, and Commission implementing regulation (EU) No. 641/2014, which lays down rules for the application of the direct payments regulations.

In Beaconsfield, we are still very keen to receive these payments, and the Minister is right to bring forward the Bill. Many of my farmers would like to produce more, but that is currently restricted under the CAP. Does the Bill deal with that? For example, I have a chicken farmer who would like to increase the number of chickens and eggs that they produce, but there are restrictions because of the common agricultural policy payments. Is there anything in the Bill that will allow them to increase productivity as we move out of the EU?

If my hon. Friend writes to me on the specific issues for the chicken producer that she mentions, I am happy to look at that. As a general rule, poultry producers tend not to qualify for the basic payments scheme, because it is area-based. Of course, it could be a mixed enterprise, where the producer has a poultry unit and some land on which they claim BPS. There are also some domestic environmental regulations and a licensing scheme that the Environment Agency runs that would affect certain establishments in the poultry sector.

The Bill brings across existing legislation exactly as it is and does not envisage any change. The only change might come from the absence of EU auditors, as this is no longer an EU budget. Therefore the absence of the risk aversion that is a feature of Whitehall—where we have perpetual legal jeopardy and the constant threat of infraction, of disallowance risks and of arbitrary fines slapped on by EU auditors—means that we may be able to have a margin of appreciation in how we interpret some of these regulations, so that we can, for instance, send farmers a warning letter, rather than stinging them with a fine as we are required to under EU law.

It is very welcome to us in Cheltenham that in future the Government plan to use state support to promote biodiversity on farms to a far greater extent than is permissible under the CAP. However, will the Minister indicate how we can expect our landscape to change as a result of these very welcome policy changes?

The Agriculture Bill, which is a matter for future discussion, envisages in clause 1 that we would support, for instance, measures to reduce climate change and carbon emissions and measures on carbon sequestration. We have a commitment to establish additional new woodland areas. In some areas, I suspect that there would be some land-use change. We also want to use our future policy to support a more sustainable approach to farming, for instance getting more farmers involved in catchment-sensitive farming schemes, integrated pest management, better soil husbandry and better stewardship of our hedgerows. All these issues will have an impact on our environment and its biodiversity.

The Minister talked about having a lighter touch, in terms of moving to a warning letter rather than having fines, and many farmers will breathe a huge sigh of relief at that. What scope does he see in the Bill to build on the trend of performance improvement, which we have started to see from the RPA but where there is still headroom for further improvements, therefore hopefully further de-stressing the art of agriculture in this country?

My hon. Friend makes an important point, which links to something I said earlier about the removal of the perpetual legal jeopardy that Whitehall has been subjected to while we have been an EU member. The issue, particularly in the CAP, is that there is a system of fines relating to what is called disallowance risk. The UK typically pays around £100 million a year in disallowance risk fines, often for very trivial errors such as a supposed lack of accuracy on maps, with a requirement that we map fields to four decimal points of accuracy, and issues about how things are recorded—even though they may be recorded, it may not be in the form that the EU auditors require. Some EU audits retro- spectively make things up, so we never know how an auditor will interpret the regulations in front of us. That means that officials who work very hard in DEFRA to make sense of these complex regulations will often take a view, have legal advice and interpret a regulation in a particular way. Subsequently, auditors will come along with a different view and that creates a disallowance risk. It is a very difficult situation to have a constant sense of legal jeopardy, which leads to risk aversion and people being very cautious and sometimes quite draconian in how they deal with farmers. That has been a constant problem with the existing scheme.

As a former Parliamentary Private Secretary to my hon. Friend, I am pretty forensic on these matters, as he will know—I am grateful to him for his indulgence. What plans do he and our right hon. Friend the Secretary of State have for communicating, monitoring and embedding the change of culture in the RPA? I do not say this to be rude to the RPA, but it will have been trained in a certain way of doing things and, rather like people who have been held prisoners for 40 years, will have no idea how to deal with its freedom once it is released. How will he ensure that the lighter touch that is now available as a result of the domestic legislation is communicated to all levels of the RPA so that as soon as possible, from day one, farmers will feel the benefit? A legislative change, if not implemented by the practitioners, is no change at all.

My hon. Friend makes an important point. All of us—officials in Whitehall, Members of this House, and indeed, generally as a country—have to get used to our freedom and to enjoying it, and develop the confidence to exercise judgment in all fields as we leave the European Union and become a genuinely self-governing country again, which is what we will do.

I have already had a meeting with the chief executive of the RPA. It has made considerable progress over the past 18 months in improving its performance, but I have tasked him with looking at any changes in process—anything that could be adapted, removed or changed—that would make the application of the scheme easier once we have removed the constant threat and legal jeopardy caused by EU auditors, so we are doing a piece of work on this.

I just want to say well done to the Minister. It is really uplifting that there is something positive and that we can save some money.

I thank my right hon. Friend for that comment. He and I have taken a similar view of pan-European legislation for some time, and obviously there will be many opportunities as we leave.

Many upland sheep farmers, particularly in my constituency, will welcome not only the extra year of payments and the confidence it will give them, but the less draconian approach that the Government seem intent on taking. With the Agriculture Bill coming, can the Minister further reassure farmers in my constituency that there will be a phased approach so that they have time to get used to the new measures?

Yes, my hon. Friend makes a very important point. Today’s Bill today simply brings across the existing schemes, including, as I have pointed out, all the so-called greening rules, all the cross-compliance rules, and so on. There is a small margin of appreciation that we can apply to interpret these sensibly and proportionately, which we have not been free to do to date. That said, we recognise the importance of a gradual transition to our new agriculture policy, which is why that policy envisages a seven-year transition, with a gradual phasing out of the BPS and with support to ensure that farmers have a prosperous and profitable future.

Now we are getting rid of the cosh of legal threat hanging over our hard-working farming community, including in Rother Valley, can we use this as an opportunity to help, educate and upskill our farming community on the importance of biodiversity and so increase the flora and fauna in our beautiful areas? The farming community in Rother Valley already knows this, but what other support can the Government provide to encourage these things?

There are several important schemes, such as the Government-funded Farm Advisory Service and the various wildlife campaigns that also support farmers to farm in a more environmentally sensitive way. The future agriculture policy envisages that we will provide advice and support to farmers—direct on-farm advice—about what might work on their particular holding, with their particular soil, landscape and topography. It is an exciting future, and having the right technical advice will be an important part of it, so my hon. Friend makes a good point.

The Minister will have seen the Scottish Affairs Committee report on agriculture in Scotland. It recommends that in considering the funding envelope across the UK he support less-favoured areas and that the funding follow the quality of the land. He was not particularly enthusiastic about that suggestion. I wonder if he has changed his mind. If not, on what central tenet does he see the distribution of funding across the UK being based?

Obviously we will work with the devolved Administrations on future funding. The Bill—in later clauses, so I will not dwell on it now—deals with recommendations for the allocation of funding this year, pertinent to the conclusions of the Bew review, which I will come on to. More generally, future policy envisages payment for public goods, but it also envisages a long transition towards that. We have given a commitment to keep the agriculture budget the same at least for this Parliament. [Interruption.] Within the UK, yes, there will be some discussions on allocation, but every component of the UK is likely to adopt a transition period during which they would want to keep, at least for a time, something akin to the current system as they move to a new one. That said, the funding settlement is for a future day and discussion, not for the Bill today, which covers this year only.

The Minister talked about public goods. As a veterinary surgeon, I am proud to say that in Penrith and The Border, in Cumbria and across the UK we have the highest standards of animal welfare and farming. Does he agree we need to articulate the fact that those standards will not be watered down and that these Bills are an opportunity for the UK to become a beacon for the rest of the world and that we will be able to raise animal welfare standards in our future trading partners?

Yes, my hon. Friend makes a very important point. As I have said, we have a manifesto commitment to protect animal welfare and food standards in future trade deals. Moreover, future policy envisages our being able to make payments to farmers—for instance, those who enter into a high welfare or high animal health scheme. We have an exciting opportunity to support high health and welfare schemes that could, for instance, reduce our reliance on antibiotics, which has been identified as a clear public good for future policy.

I will return to clause 1, as I realise there have been many interventions, which I have taken because clause 1 contains the meat of the Bill in that it brings across all the regulations.

Order. For the sake of clarity and because new Members are present who might be concerned about sticking to the rules, I should explain that in addressing clause 1 the Minister is perfectly in order and absolutely right to address all the other aspects of the Bill because we have grouped all the clauses and amendments together, and any Member may at this point refer to any aspect of the Bill they wish to raise.

Thank you, Dame Eleanor.

The Bill also covers the horizontal regulation, which governs the way paying agencies should operate; Commission delegated regulation 907/2014, which supplements the horizontal regulation with regard to paying agencies and other bodies, financial management, clearance of accounts, securities and use of the euro; Commission implementing regulation (EU) 908/2014, which lays down the rules for the application of the horizontal regulation with regard to paying agencies and other bodies, financial management, clearance of accounts, rules on checks, and securities and transparency; Commission implementing regulation 809/2014, which lays down rules for the application of the horizontal regulation with regard to the integrated administration and control system—the so-called IAC system—rural development measures and cross-compliance; and Commission delegated regulation 640/2014, which also supplements the horizontal regulation with regard to the IAC system and conditions for refusal or withdrawal of payments and administrative penalties applicable to direct payments, rural development support and cross-compliance.

Does my hon. Friend agree that these proposals show how the Government are leading the fight on climate change while also protecting our precious farming community? Not only will this Bill safeguard our payments for the next year, but the whole thrust of the Agriculture Bill is to allow our farmers to farm in a sustainable, environmentally friendly way that rewards them for protecting and helping our environment, which has to be applauded.

Yes, my hon. Friend makes a very important point, and that is why we have set a very different course with our future agriculture policy, though it is based on payment for public goods. It is important that we support our farmers and properly reward them for the work they do for the environment.

Farming in South Suffolk is fairly horizontal—fairly flat—so I welcome these regulations. On a key technical question, under all those regulations the top level of payment awarded at EU level is in euros, whereas, of course, the allocation for the payment in UK law is in pounds sterling. Is there therefore any currency risk through the year to the payments that will ultimately be received by our farmers?

There is no currency risk for British farmers in this year, because the total size of the budget has already been set by the Treasury, and it has been set at the same level as last year. Under the regulations, we have to go through the formal process of setting the exact payment rate, but, because the budget has been guaranteed and it has been guaranteed that the payment system will be the same, farmers have a high degree of confidence that—barring any minuscule changes—their payment will be the same as it was last year.

My hon. Friend has put his finger on an important problem with the common agricultural policy. It introduced an entirely unnecessary exchange rate risk for our farmers, in that money was sent to the European Union in pounds and was then denominated in sterling at a fixed point in time, typically in September each year. That meant that if the pound had had a good year and had rallied against the euro, farmers found that their payment would be lower, whereas sometimes when the pound fell, as it did after the 2016 referendum, they had an early Brexit dividend and received a higher payment than they might otherwise have expected. That unnecessary exchange rate risk has now gone, and the budget is set for this year.

I do not want to bore people too much with these regulations. I have listed them all in detail, and there is a reason for that. In the European Union, particularly in the context of the CAP, there are three types of regulations. There are the basic regulations, which the Council of Ministers has quite a bit of involvement in shaping, and on which, through working groups, the member states have a vote. There are delegated Acts or regulations, in which there is far less involvement for the member states. They collectively have a kind of veto power, but have less of an amending role. Then there are the implementing Acts or regulations, which the Commission pretty much just makes up without any particular involvement of the member states.

That said, I am conscious that Members will never have debated any of these regulations. Ministers will have been aware of debates and discussions taking place in working groups as the basic regulation was formed, and they will have received submissions letting them know that something alarming had been handed down in an implementing Act and we could not do anything about it. Obviously, as we make regulations in future, the scrutiny of the House will be brought to bear, and Members will be able to engage in and scrutinise every bit of the detail of future agricultural policy.

The regulations that I read out earlier may have seemed like a list of rather meaningless numbers, but I can tell Members who are interested in what they mean collectively, in terms of what the farmer is required to do, that basic payment scheme rules are published annually by the Rural Payments Agency. Let me give Members a flavour of those.

The publication “Basic Payment Scheme: rules for 2019” sets out the key dates during that scheme year to which farmers must have regard. It includes, for instance—and all this is born out of the regulations that are being brought across today—the setting of 1 January as the official start of the year. The period between 1 January to 30 June is regarded as the

“EFA period for EFA fallow land” .

That is the period during which land must be fallow if farmers want to claim it. On 13 March, the “window opens”, and farmers can start sending in their applications. Between 1 May and 30 June, the so-called three crop rule kicks in, along with the

“EFA period for nitrogen-fixing crops”.

During that period, farmers must demonstrate that in that window and that window only, they have three crops on their farms. Another rule states that one of those crops can be fallow land, but the qualifying period for that type of fallow land is different from the one for the type that is covered by the EFA period.

There is a deadline of 15 May for farmers to submit their BPS application forms. They are then given a couple of weeks’ grace during which they can make changes, and they have until 31 May to do that. There is then a “late application” deadline, which means that farmers are effectively given 21 days to submit late applications, but will lose, typically, 1% of their payment for each late application day.

Will my hon. Friend tell us a little more about the legal provisions enabling amendments and corrections to be made after we have left the EU, and how it can be ensured that the Bill is operable and can continue to be implemented?

My hon. Friend has made an important point. Let me say two things. First, clause 3, which I was going to come on to—I understood that you wanted me to address all the clauses simultaneously, Madam Deputy Speaker—deals with that issue in respect of the claim year 2020, in that it gives us powers akin to those that were in the European Union (Withdrawal) Act 2018 to make particular modifications and changes, simply to make this body of law operable. For instance, it enables us to replace the words “European Commission” with the words “UK Minister”, or, indeed, “devolved Administration Minister”, and it gives us the power to introduce subsequent statutory instruments to make the legislation operable.

Secondly and more broadly, for the purpose of future policy, the Agriculture Bill includes a power to modify policy. This Bill does not modify policy, but it gives us the power to make operable changes akin to those in the European Union (Withdrawal) Act.

I think it important to learn the lessons of our involvement in the common agricultural policy over the years, and to consider some of the things that have gone wrong with it. In the context of implementing future changes in regulation, we should recognise that, for example, the set-aside rule—which those of us who were in farming in those days know and love—would sometimes represent the difference between profit and loss for a farm. To put it bluntly, the difference between the farm being viable and not viable was what the EU paid farmers not to grow anything. How can we incorporate that balance between productivity in our land and a viable economic agricultural and rural sector in our future legislation? I am heartened to hear that we are keeping that option in this Bill.

I agree that we must learn the lessons of the common agricultural policy. Having dealt with it for some seven years in total, I know that it is something of a bureaucratic quagmire. It is very difficult to navigate, and we tend to find that the more rules we invent, the more rules we need in order to make sense of the ones that we already have. That is why we end up with all sorts of complexity, as set out in the 127-page document containing guidance and rules for farmers.

The real lesson to be learnt is that whatever we do in future should be less rules-based and more based on delivering outcomes, and should also be tailored to the needs of an individual farm. When farms have poor profitability, we should try to tackle the causes of that poor profitability by helping farmers to invest and improve fairness in the supply chain, rather than by means of an arbitrary area-based payment. That is the direction of travel that we have set out.

Does my hon. Friend agree that those like me who have smallholdings are often overwhelmed by the body of rules, and end up not claiming money that they should rightly claim? Has that been a problem historically, and are there any records that show how many people are covered by this?

Every month I have to deal with appeals lodged by farmers following decisions made against them involving, for instance, penalties or disqualifications for their particular claim year, perhaps because they were late in submitting their claim. There is often a tragedy behind those stories, and the scope for a Minister to address that within the boundaries of EU law is often quite limited, but we will have the chance to address it in the future.

I do not think that anyone will disagree with the Minister about the need to get rid of overt bureaucracy, but on Friday I attended a farmers’ breakfast with representatives of the Farmers Union of Wales, and I know that my local farmers fear that they will lose access to their biggest export markets. Over 90% of Welsh lamb and beef goes into the European single market. What assurances can the Minister give that access to that market will remain unfettered following the completion of the negotiations?

The hon. Gentleman makes an important point—a number of others have raised it—about the importance of trade. That can be about protecting our standards in respect of the trade deals that we do, but it can also be about access to the European market, which is particularly important for some sectors, notably the sheep sector. That is why the political declaration that was agreed as part of the withdrawal agreement—effectively a heads of terms—sets out the ambition to move to zero-zero tariffs on all goods. That is the approach that we will be taking, as outlined in the political declaration, but it is not dealt with by this particular Bill.

I know I am pushing the boundaries slightly, but was the Minister at all concerned by the comment by the Chancellor of the Exchequer about a week ago that there would be no alignment with European standards? If that is the case, there will be no access to EU markets, will there?

The political declaration was very clear, and it is implicit in the withdrawal agreement that we have now put in place that there will be no alignment with EU law. We are seeking agreement on the recognition of equivalence and understandings based on equivalence. It is understood that, yes, there could be some border checks and some additional paperwork, because we will not be aligning with EU law and those rights. I was not alarmed by what the Chancellor said, and I was not surprised by it, as it has been in our manifesto and it is also in the political declaration. I fully support that approach.