The Minister for Health (Stephen Hammond)
I beg to move,
That this House has considered the NHS Ten Year Plan.
Thank you, Madam Deputy Speaker. You will understand that I am pleased not to have to follow my predecessor’s responsibilities.
As last year’s 70th anniversary celebrations proved, the NHS is one of this country’s proudest achievements. That is clear from the number of people who want to contribute to the debate this evening, so I shall be as brief as I possibly can. The Government’s top funding priority is the NHS. By 2023-24, the NHS budget will increase by £33.9 billion in cash terms, which is the equivalent of £20.5 billion in real terms. This means that in five years’ time the total NHS budget will be £148.5 billion.
In January this year, the NHS published the long-term plan, which sets out the priorities for the next 10 years of the service. The additional funding has given the NHS the stability and certainty it needs to make that plan for the decade ahead. The plan represents a historic moment for patients across the country. It was developed by NHS leaders and clinicians, in consultation with patients and the public, and Members can be assured that it focuses on the biggest priorities for patients in the next decade.
John Redwood (Wokingham) (Con)
Will the plan ensure that areas such as mine, which has fast growth and lots of new housing, will receive adequate resources to put in new surgeries and additional capacity, which has not happened in the past?
Stephen Hammond
My right hon. Friend will note that the plan includes the transformation that we will bring to primary care, which will look not only at how primary care will be developed and delivered, but at ensuring that there is enough money to deliver the changes.
The plan sets out a scheme that will provide the best support for patients throughout their lives—from getting the best start in life to being supported into old age. The plan sets out the transformation needed at every level of the health system to ensure that it can continue to provide world-class care. Part of that, as I have just said to my right hon. Friend, is a fundamental shift towards primary care and prevention. The plan will keep people healthy and out of hospital by boosting services closer to home.
Stephen Hammond
I am sure that there will be a number of excellent questions and interventions, but it was a good question. The plan sets out that all local health systems will be expected to outline this year how they will reduce health inequalities by 2023-24, and the intention is that that process will consider exactly the health inequalities that the hon. Member for Sheffield, Heeley (Louise Haigh) mentions.
Additional money for the primary sector will ensure that funding for primary medical and community health services, such as GPs, nurses and physiotherapists, increases by £4.5 billion in real terms in the next five years. That will mean up to 20,000 extra health professionals working in GP practices, with more trained social prescribing link workers within primary care networks. By 2021, all patients will be offered a digital-first option when accessing primary care. The plan also considers the future of the health system, and the new proposals for integration are the deepest and most sophisticated ever proposed by the NHS.
Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)
The plan recognises that some proposals in the Health and Social Care Act 2012 were made in error when it comes to the transference of powers to public health bodies and local authorities. However, based on my reading of the plan, the omission from that list relates to addiction services. If we are serious about mental health and about improving care and reducing health inequalities in areas such as Sheffield, which was just mentioned, we need to get the commissioning of addiction services right and transfer that back to the NHS. Such services deal with some of the most vulnerable patients, but they are underfunded and failing to treat people, and the taxpayer is paying the price. Patients badly need those services, so will my hon. Friend take the matter up and give it a push?
Stephen Hammond
My hon. Friend makes a good point and urges me to take up the issue, which I will. He is obviously an expert in this field and will know that the Government have asked the NHS to come forward with proposals for legislative reform to support the long-term plan’s ambitions, and I will reflect on his comments in my thinking.
By 2021, every part of the country will be covered by integrated care systems, which will bring together local organisations, including local authorities, to redesign care and improve population health. They will become the driving force for co-ordination and integration across primary and secondary care. Any claim that such reforms might lead to privatisation are misleading. In fact, the Chair of the Health and Social Care Committee said that the proposals
“will not extend the scope of NHS privatisation and may effectively do the opposite”.
The NHS will invest more in preventing ill health and stopping health problems getting worse. That includes offering tobacco treatment services to all in-patients and pregnant women who smoke, establishing new alcohol care teams, and offering preventive treatments to more people with high blood pressure and other risk factors for heart disease.
Sir Paul Beresford (Mole Valley) (Con)
As my hon. Friend is probably aware, I have a part-time job in which I deal with a preventable disease: caries. In dentistry we spend £34 million to £38 million on this preventable disease. Will he consider looking seriously at how we could persuade local authorities to put fluoride in the water supply to prevent caries?
Stephen Hammond
My hon. Friend will know that the plan has much on prevention in primary care and public health. I offer to meet him, and I will listen carefully. He tempts me down a line that I would rather not go down tonight.
The long-term plan marks a huge step towards parity of esteem between mental and physical health. In the next five years, the budget for mental health services will increase by at least £2.3 billion in real terms. This additional funding will be used to fund a major expansion of mental health services for both children and adults. In addition to piloting four-week waits for children and young people, we will test waiting times for adult and older adult community mental health teams, and clear standards will then be set. Specific waiting times for emergency mental health services will take effect for the first time from 2020 and will be set to align with the equivalent targets for emergency physical health services.
Layla Moran (Oxford West and Abingdon) (LD)
The mental health budget is 10.2% of the current NHS budget. If the overall budget increases, will there be an equivalent rise in the mental health budget? The mental health budget has risen because the overall budget has increased, but the proportion allocated to mental health has not risen. If we are serious about tackling mental health in this country, why is the proportion allocated to mental health not higher?
Stephen Hammond
The hon. Lady will know that, as I said a moment ago, the long-term plan, for the first time, sets a parity between mental health and physical health. The mental health budget will increase by £2.3 billion by 2023-24.
Of course, everything we have been talking about here needs to be supported by new innovations and new technology. Patients can expect a radical reshaping of how the NHS delivers its healthcare using technology, so that services and users can benefit from the opportunities of advances in digital technologies. That includes making care safer, enabling earlier diagnosis and giving more independence to those managing different health conditions.
Additionally, it is vital that we build a more innovative NHS, which will help patients to be among the first in the world to benefit from life-changing new technologies. Last year, the Secretary of State announced his ambition to sequence 5 million genomes in the next five years, making the NHS the first national healthcare system to offer whole genome sequencing as part of routine care.
Most importantly, none of that will be possible without dedicated staff who are properly trained and supported throughout their career. The long-term plan sets out a strategic framework to ensure that, over the next 10 years, the NHS will have the staff it needs to ensure that the detailed plan can be implemented. Baroness Harding is leading an inclusive programme of work to set out a detailed workforce implementation plan, which will be published in the spring, but the plan is not about numbers.
Vicky Ford (Chelmsford) (Con)
On the future workforce, I thank the Government for investing in our new medical schools. We are enormously proud of the new medical school in Chelmsford, which is training 100 doctors a year—I understand it is 12 times oversubscribed for next year. I am also pleased to hear that nursing numbers are up, but what will the Government do to target support at areas such as mental health nursing and adult nursing, where we have seen numbers drop?
Stephen Hammond
My hon. Friend is right that we need targeted support, which is why we have looked not only at increasing the recruitment of nurses but at the retention packages that might be offered, particularly for certain specialties—she mentioned mental health nurses. We have looked at the possibility of issuing golden hellos, and we have looked at targeted support for childcare and travel.
Mr Philip Dunne (Ludlow) (Con)
My hon. Friend has been generous in giving way. I welcome the workforce implementation plan, and I welcome the fact that Baroness Harding, the chair of NHS Improvement, will be taking this work forward. Will my hon. Friend ensure that Baroness Harding looks at the retention of senior, experienced general practitioners under the general practice forward view? That issue has been raised in a number of areas. We are losing too many of them too early in their career, and the situation is similar with experienced consultants in our hospitals. A contributing factor is the annual allowance for pension contributions, where tax payments take away the extra gross income staff receive as they progress through their later years. Will my hon. Friend pick that up with the Treasury?
Stephen Hammond
I have listened carefully to my right hon. Friend’s intervention, and he will be pleased to know that discussions with the Treasury are ongoing about certain potential incentives to senior serving staff.
The plan is not just about numbers; it focuses on getting the right people with the right skills in the right place, ensuring that our dedicated staff are supported, valued and empowered to do their best. It has clear commitments to tackle bullying, discrimination and violence, and a programme of work to sustain the physical and mental health of staff who work under pressure every day and every night.
Grahame Morris (Easington) (Lab)
All good policies should be evidence-based, so let me ask the Minister about the national cancer advisory group, which prepares an annual report detailing the progress of the cancer strategy each year. That report was expected in October/November but it has been delayed. When will it be published? It may well inform the work of the 10-year plan.
Stephen Hammond
The publication date has not yet been finalised. I understand that it will be soon, but I will write to the hon. Gentleman to confirm the date of publication.
Through the long-term plan, we will ensure that the NHS continues to strive to be a world leader. It will continue to push the boundaries between health and social care, and between prevention and cure. It will be at the cutting edge of technology and innovation, while providing high-quality service for all patients. More importantly, it will always be there in our hour of need, free at the point of use and based on clinical need, not on the ability to pay. I commend the long-term plan to the House.
The Minister for Care (Caroline Dinenage)
I thank hon. Members from across the House for their contributions to this debate. It is clear there is agreement on the importance and value we place on our national health service. That is why the long-term plan is such a historic moment for the public, for patients and, of course, for the staff who work tirelessly to make our NHS one of the most enduring British success stories.
I will try to respond to as many of the speakers as possible, but I agree we need a much longer debate to fully do justice to this important subject. It has been quite a collegiate debate, with Back Benchers from across the House having welcomed many of the promises in the long-term plan, although not so much the shadow Front-Bench team, whose attitude I will quickly sum up: they do not like it unless they thought of it first, and we are not putting in enough money, although considerably more than they promised in their 2017 manifesto until they did a back-of-the-fag-packet recalculation. Why can they not celebrate our NHS? Why can they not celebrate the fact that the Government are making the single biggest cash investment in our NHS in its history? Some will question, of course, whether the funding is enough for the health service to implement this vital transformation, but I remind them that this is a fully costed plan developed by NHS leaders and clinicians within the budget agreed by the NHS and with the Government.
We must also remember that the future of the NHS is not just about the additional £33.9 billion cash injection by 2023-24; it is about spending every single penny of taxpayers’ money wisely—in five years’ time the NHS budget will be £148.5 billion—which is important because our NHS is under more pressure than ever before. As my hon. Friend the Member for Mid Worcestershire (Nigel Huddleston) said, demand on A&E from type 1 attendances was 6.8% higher this January than last January—that is 2,700 more people through the doors every single day.
Of course, publishing one document will not translate all the long-term plan’s objectives into reality, which is why the NHS will develop a clear implementation framework by the spring to set out how the commitments should be delivered by local systems and ensure transparency for patients and the public. It is also why the Secretary of State has commissioned Baroness Harding, working closely with Sir David Behan, to lead a number of programmes to develop a detailed workforce implementation plan. The first stage of that will be revealed in the spring, and the rest will come forward in the autumn.
A key focus of the long-term plan is the importance of improving the patient experience, safety and flow through hospitals. The plan will support the reform of urgent and emergency care services to ensure that patients get the care they need quickly, relieve pressure on A&E departments and manage winter demands. Improving out-of-hospital care will ensure that people are treated in the most appropriate setting to avoid unnecessary visits to hospital and support quicker discharge.
Hon. Members spoke about the importance of local provision, community hospitals and local GP services. It is important that these services be decided and led by local NHS organisations that understand the local community healthcare needs, but of course we expect the NHS to work collaboratively to ensure that both urgent and routine care needs are met in a way that ensures the best possible use of NHS resources. Investment in primary and community services will increase by at least £4.5 billion, and spend on these services will grow faster than the rising NHS budget. Funding will be provided for an extra 20,000 other staff working in GP practices.
The long-term plan sets out how we will improve prevention, detection, treatment and recovery in respect of major diseases, including cancer, heart attacks and strokes—hon. Members have mentioned those today. Patients can expect the introduction of new screening programmes, faster access to diagnostic tests and new treatments and the use of technology, such as genomic testing. NHS England is already testing innovative ways of diagnosing cancer earlier, with sites piloting multidisciplinary diagnostic centres for patients with vague or non-specific symptoms, such as those common in blood cancers. The Government have pledged to roll out rapid diagnosis centres nationally to offer all patients a range of tests on the same day with rapid access to results.
Mental health has also been raised. The long-term plan renews the commitment to grow investment in mental health services faster than the NHS budget overall, with at least £2.3 billion in real terms.
The Government’s commitment to the health service is clear and undeniable. Our historic funding settlement has enabled the NHS to create a plan for the future of the system which will benefit patients now and generations to come. We will continue to support this system as it begins to put our plan into practice.
I thank the Members who have spoken this evening, and I will write to those to whose points I was not able to respond.
Question put and agreed to.
Resolved,
That this House has considered the NHS Ten Year Plan.