John Redwood (Wok) (Con):
I am glad the hon. Gentleman agrees that we needed better parliamentary scrutiny and more options for the handling of the pandemic but, given that that is the case, how on earth does it make sense to give away powers to an international quango, which will then instruct future Ministers to do these things, with Parliament being told that it has no right to talk about it or to vote on it?

Justin Madders:
If that was how it was going to proceed, I would agree with the right hon. Gentleman, but I do not believe that is the case. Any Government Member concerned about parliamentary sovereignty and scrutiny would not have voted for the Retained EU Law (Revocation and Reform) Bill, which has put thousands of laws into the hands of Ministers without any parliamentary accountability.

John Redwood (Wokingham) (Con):
To colleagues who like this treaty, is the easy answer not that we will, of course, remain members of the WHO, read its advice and accept that advice where we wish? Why should we have to accept advice when the WHO may get it wrong, and we can do nothing about it because it decides, not us?

Danny Kruger (Devizes) (Con):
That is absolutely right. We have the opportunity to say no, and it is an opportunity we need to take. Once we have said yes, we are then under the obligation to introduce, potentially, terrible infringements on liberty. I will make some more progress and then let Members intervene.

John Redwood (Wokingham) (Con):
What actions are senior NHS managers taking to resolve non-pay issues for which they could offer better work experiences to doctors? What use can they make of flexibilities over pay increments, promotions and gradings so that good staff can be better rewarded?

Steve Barclay, Secretary of State for Health and Social Cate:
As ever, my right hon. Friend raises an extremely important point. As part of the negotiation with the AfC staff council, a number of non-pay issues were discussed. Job evaluation is one such issue. Likewise, for junior doctors, areas such as e-rostering are extremely important. I share his desire for investment in technology, and to look at the time spent by clinicians that could be spent by others in the skills mix or through better use of artificial intelligence technology and a better estates programme. That is why it is important that we continue to have that funding, as well as reaching the offer that we have with the AfC staff council.

Yesterday I joined in the Parliamentary discussion of an Urgent Question on pay talks and strikes in the NHS. There was was nothing new and nothing the two sides have regarded as particularly urgent in what was talked about. The Labour front bench was controlled in its demands, just wanting a resumption of talks but not backing the junior doctors’ demands for 35% and understanding that several of the Unions favour accepting the current offers made to NHS staff by the government. A few on the Labour left intervened to demand higher taxes to pay for bigger pay rises but were out of tune with their front bench and the government.

I asked about the role and work of the senior managers in the Trusts and NHS England. The Secretary of State confirmed that the junior doctors have raised a number of issues about rosters, work practices, technology and staff support for their roles. I asked what the managers were doing to improve the rosters, work packages and support for the doctors. I pointed out again that senior managers have considerable powers to change the ask of doctors, to reward good ones with promotions, salary increments and  revised gradings of jobs. Should more of these flexibilities be used to improve the mood of the workforce and to achieve more with the people the  NHS does employ?

I find it very strange that Ministers take all the burden of the pay negotiations with the staff. Senior managers rarely come onto the tv or radio to talk about the NHS though they claim considerable independence in running the service. When they do if asked about the strikes they always say it is a dispute between Ministers and Unions. Surely they must have strong  views on what is affordable, what is needed to recruit and retain, and what should happen going forward to make it easier for them to run a good service?

The establishment of NHS England was designed to distance Ministers from day to day management of the service and to leave most of the decisions in the hands of professional managers and w the clinicians they employ. So why when the service is  being damaged by strikes and when employee relations are so strained is there this silence from highly paid senior managers? Why will they only talk about trying to offset the worst impact of the strikes and not have ideas on how to end them? Why are we still waiting for the manpower plan, which should be a basic evergreen necessity in a service that relies so heavily on what employees do for patients?

There is growing suspicion of government by international treaties. Democratic countries find increasing restrictions on what their elected representatives can do as they tie themselves in a colonial type relationship to global and regional quangos. The ultimate most powerful one is the EU

Prime Ministers and Presidents  are expected to devote considerable precious time and energy to travelling around the world to talk to each other at conferences. This is increasingly bizarre, full of hypocrisy as most of them tell the rest of us to give up jet travel to save the planet. These  all too regular events come with a price, normally requiring the leaders to pledge more public spending to some global cause. They also can result in signing up to expensive and freedom sapping future commitments, as with the net zero plans at successive COPs.

These conferences also have an opportunity cost. Leaders strutting at conferences cannot at the same time pursue domestic aims and solve home problems. Money and above all precious Leader time and energy is diverted. Leaders are also more exposed to the press and international pressure groups which can result in illjudged or unwanted commitments. These gatherings are thought to promote more trade friendship and understanding but can instead create or worsen disagreements through presence which might otherwise lie dormant.

The recent wish to host President Biden in Northern Ireland was a good example of  a badly judged visit which highlighted the differences. It had come with the high price of the Windsor Agreement.