Sam Carling (North West Cambridgeshire) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
Mr Speaker, I associate myself with your remarks about the war in Ukraine. I know the whole House stands with Ukraine as it defends its freedom and democracy. This is precisely why the Prime Minister’s leadership at the G20, and in other international fora, is vital in standing up not just for our national interests but for our values across the world.
Over the past decade, the Conservatives’ mismanagement has left the NHS with 1,400 fewer full-time equivalent GPs than in 2015, hundreds of practice closures, the loss of over 1,000 community pharmacies, and NHS dentistry a distant memory, which is why this Government took immediate action to employ 1,000 more GPs. Through the additional roles reimbursement scheme, through the Chancellor’s Budget measures and through our 10-year plan, we will shift the focus of healthcare out of hospitals and into the community.
Josh Simons
In my Makerfield constituency, Wigan council and my local NHS trust are working closely together to pioneer a health system focused on prevention and delivered through neighbourhood health centres, but they need help. What is the Secretary of State doing to improve access to primary care, especially data-driven preventive care, through neighbourhood health centres?
Wes Streeting
I agree with my hon. Friend on the importance of prevention at a local level. We are trialling neighbourhood health centres across the country to bring together a range of services, ensuring that healthcare is closer to home and that patients receive the care they deserve. This is part of our broader ambition to move towards a neighbourhood health service, with care delivered close to home. I would be delighted to meet my hon. Friend to hear more about what is going well in his community and what further action we need to take.
Chris Vince
Does the Secretary of State agree that access to primary care is hugely important to supporting accident and emergency departments at hospitals like the Princess Alexandra in Harlow? Does he also agree that access to primary care is about not just GPs but dentists? Finally, what are the Government’s plans to support dental surgeries such as the aptly named Harlow dental surgery, which I visited last week?
Wes Streeting
My hon. Friend is right that many of the pressures on our hospitals, such as the Princess Alexandra in Harlow, are a result of pressures in other parts of the health and social care system. It is outrageous that the biggest reason for five to nine-year-olds presenting to hospital is tooth decay, which is why we need to get NHS dentistry back on its feet, along with the rest of the NHS.
My hon. Friend the Minister for Care and I have regularly met the British Dental Association since the general election to consider how the dental contract can be reformed to retain dentists and rebuild NHS dental services.
Sam Carling
In my local area of Cambridgeshire and Peterborough, GPs are reporting feeling increasingly burnt out, with working conditions becoming more extreme. The number of patients per fully qualified GP in my area has increased by nearly 400 since December 2016, a higher increase than the national average. Can the Secretary of State tell me what his Department is doing to make the situation more sustainable while improving access to primary care?
Wes Streeting
General practice is a valued part of the NHS, and GPs are a vital part of our NHS family. In fact, they are delivering more appointments than ever before, and we recognise the significant pressures they face. At the same time, we know that patients are struggling to see their GP, which is why we have invested an additional £82 million into the ARRS to recruit 1,000 more newly qualified GPs this year. This will take pressure off general practice, and we will be announcing further budget allocations in the not-too-distant future to set out what further support we will provide for general practice.
Layla Moran (Oxford West and Abingdon) (LD)
Last week, I visited Summertown health centre. Staff there implored me to say to the Government that the issue is not just more money—we welcome the £100 million that has been allocated for capital investment in primary care—but the snarled-up process at integrated care board level and getting investment to the right places quickly. What will the Secretary of State’s Government do to ensure ICBs deliver that money to where it is needed, and fast?
Wes Streeting
The Chair of the Health and Social Care Committee is right that investment is vital, but so is reform. We tasked ICBs with leading the development of the new neighbourhood health service. We are removing their responsibility for performance management of trusts in order to free up their focus, so that primary and community services have the attention that is desperately needed. In the coming weeks, we will be talking to the British Medical Association and the Royal College of General Practitioners about how we ensure the investment announced by the Chancellor leads to improved patient care and a reformed neighbourhood health service.
Lewis Cocking (Broxbourne) (Con)
Goff’s Oak, in my constituency of Broxbourne, has seen a lot of development. What steps is the Secretary of State taking to ensure that GP surgeries are delivered before hundreds of new homes are built?
Wes Streeting
Of course we need to deliver both new homes and GP surgeries, but the previous Conservative Government delivered neither. We have a housing crisis and an NHS crisis in this country; I would have thought Conservative Members might have shown some humility and responsibility for those facts before challenging a Government who have been in office for only four months.
Andrew George (St Ives) (LD)
In Cornwall, only 25% of delayed discharges from hospital are because of lack of social care packages, with the remainder involving the significant degree of support needed from primary and community NHS services. The Royal College of Nursing has pointed out that there has been a 45% reduction in district nurses in the last decade, so what can the Government do to replace those essential roles at a primary care level?
Wes Streeting
The hon. Gentleman is right. Last weekend, I was up in Middlesbrough with local Members, where we saw a great example of hospital at home delivered by the community nursing team and the community health trust. We have to do a lot more in that space to ensure we provide care closer to peoples’ homes—indeed, often in the home—keeping them out of hospital and close to home, which is better for them and better value for the taxpayer.
Wes Streeting
I can reassure health and care providers that we will be setting out allocations long before April next year. I recognise that people need to plan ahead of the new financial year. When deciding allocations, we take into account the range of pressures on different parts of the system. People have heard what I have said already about the need to shift out of hospital into primary and community services. The shadow Minister talks about choices; Conservative Members seem to welcome the £26 billion investment, but oppose the means of raising it. I am afraid they cannot do both. If they support the investment, they need to support the way in which we raise the money; if they do not support the way in which we raise the money, they need to spell out how they would raise it or be honest about the fact that if they were still in government, they would continue to preside over a mismanaged decline.
Dr Evans
One GP described the situation as “Schrödinger’s primary care”: GPs are seen as private contractors, so not exempt from the NI increases, but they are exempt from the small business relief because they are deemed to be “public”. Did the Department of Health team knowingly go along with the Treasury team’s plan to tax primary care without mitigation, leading to cuts? Or did it not understand or spot the complexity of what is going on, so mitigations have to be put in place now? Which is it?
Wes Streeting
I was terribly impolite; I should have welcomed the shadow Minister to his place in response to his first question.
Conservative Members seem to welcome the £26 billion investment and are happy to tell us how it should be spent, but they oppose the means of raising it. They cannot do all those things. They need to be honest with the country: either they support the investment in the NHS or they say they would cut it. Which is it?
Tessa Munt (Wells and Mendip Hills) (LD)
The Minister for Secondary Care (Karin Smyth)
The Darzi review made it absolutely clear that the NHS has been starved of capital. It is 15 years behind the private sector in its use of technology and we have fewer scanners per person than in comparable countries. That is why at the Budget the Chancellor announced an investment of £1.5 billion for capital funding, which will include investment for new artificial intelligence-enabled scanners, which will help tackle that backlog.
Tessa Munt
Residents in Somerset, and in North Somerset, my part of the world, recognise the £70 million that has been granted for new radiotherapy machines, as announced in the Budget, which will fund up to 30 machines. However, 70 machines will pass their sell-by date—their 10-year recommended life—by the end of this year. Will the Secretary of State and the Minister agree to meet Radiotherapy UK, which wants to highlight the huge cost benefits of having a more consistent, rolling programme of machine maintenance and replacement in the NHS 10-year plan?
Karin Smyth
The hon. Lady highlights the important matter of the lifetime of some of the machines, which we are finally addressing after the last 14 years of not addressing issues that include providing support to ensure that the machines work properly. Officials regularly meet Radiotherapy UK and the Department values its input. If there are specific incidents that the hon. Lady wishes to highlight, I am happy to respond to her.
Deirdre Costigan (Ealing Southall) (Lab)
Does the Minister agree that the NHS cannot continue to rely on outdated and obsolete equipment? It is ridiculous that GPs still use pagers and hospitals communicate with each other using fax machines. After 14 years of decline under the previous Government, will she commit to bringing our NHS into the 21st century?
Karin Smyth
My hon. Friend lays bare an important issue. We all know, and critically, staff know, that we are asking them to do the most incredible job with outdated technology. It is bad for staff and it is bad for patients. That is why moving from an analogue to a digital system is crucial. I was fortunate to visit colleagues at NHS England offices up in Leeds last week to see some of the fantastic work they are doing on the app. We will ensure that the NHS comes into the 21st century.
Abtisam Mohamed (Sheffield Central) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
Lord Darzi found that mental health waiting lists have surged, with more than 100,000 children waiting a year for their first appointment. That is why we will recruit 8,500 more mental health workers, provide access to mental health support in every school and roll out young futures hubs in every community. I am delighted to tell my hon. Friend that a Bill to modernise the Mental Health Act 1983 was introduced in the other place on 6 November. That was a promise that we made before the election—a promise that we kept.
Abtisam Mohamed
I welcome the Minister’s comments. My brother has very complex mental health needs. We as a family know at first hand the difficulties not only of accessing the services and of the long waiting times, but the challenge of support staff who are not constantly on a churn and the lack of community-funded support services. Our experience is no different to that of many other families. Will the Minister meet me to discuss how we will make mental health services more accessible in communities, invest more in preventive services and fund more community-based provision?
Andrew Gwynne
I will be pleased to meet my hon. Friend. This Government think it is unacceptable that too many people are not receiving the care that they deserve, and we know that waits for mental health services are far too long. We are determined to change that with the measures I set out in my opening. The Government have also introduced NHS 111 for mental health so that people who are in crisis or are concerned about a family member or loved one can now call 111 and speak to a trained mental health professional.
Josh Babarinde (Eastbourne) (LD)
Facilities such as leisure centres and swimming pools—like the Sovereign Centre in Eastbourne where I learned to swim—are critical in supporting people’s mental health locally. Will the Minister support me in putting pressure on the Ministry of Housing, Communities and Local Government to expand the criteria of the towns fund to allow us to be able to spend it to invest in our leisure centres and sports and fitness facilities for local people?
Andrew Gwynne
I am grateful to the hon. Member for his question. We are a mission-led Government and, of course, tackling health inequalities is a job not just for the Department of Health and Social Care, but for all Government Departments. I will be very happy to raise the role that Ministers can play in improving mental health and wellbeing in my bilaterals with the Ministry of Housing, Communities and Local Government.
Jerome Mayhew (Broadland and Fakenham) (Con)
The Minister for Care (Stephen Kinnock)
Fourteen years of Conservative neglect and incompetence have left huge swathes of the east of England as dental deserts. As part of our 10-year plan, we will be working with NHS England to assess the need for more dental trainees in areas such as the east of England where we know that many people are struggling to find an NHS dentist. I am aware of the University of East Anglia’s plans to open a dental school and I recently met MPs from the east of England, including the hon. Gentleman, to discuss that process. I encourage the UEA to continue with its bid for a new dental school.
Jerome Mayhew
The Minister well knows that there is a lack of dentists in the east of England, because there is no undergraduate training facility. The nearest place is either Birmingham or London. He has kindly mentioned the University of East Anglia, which is ready to go with a new building under construction. It has wide cross-party support, as he also knows from the meeting that he held recently, so when will he make the announcement?
Stephen Kinnock
I thank the hon. Gentleman for that follow-up question, but he will recall that, when we met, I and my officials made it clear to him that the UEA has not yet submitted its bid for a dental school. In that meeting, we said: “Please go back to the UEA and encourage them to submit that bid. When they do, we will look at it very carefully.”
Mohammad Yasin (Bedford) (Lab)
Many of my constituents in Bedford are struggling to get an NHS dentist. I am also hearing from those who have tried to book an appointment only to discover that they have been removed from the NHS list without any warning. The Government have committed to improve the dental contract. In doing so, will they ensure that dentists can no longer drop people from their books—leaving them without any access to care—without prior notice?
Stephen Kinnock
My hon. Friend is right: we will reform the dental contract to rebuild dentistry in the long term and to increase access to NHS dental care, with a shift to focusing on prevention and the retention of NHS dentists. We continue to meet representatives from the British Dental Association and other representatives of the sector to discuss how we can best deliver our shared ambition to improve access for NHS dental patients.
Wendy Chamberlain (North East Fife) (LD)
The Secretary of State for Health and Social Care (Wes Streeting)
The leadership shown by the Chancellor has enabled her and the Government to fix the foundations of the public finances and fill the £22 billion black hole left by the previous Government. The decisions that she took meant that she was able to provide this Department with an extra £26 billion and a real-terms increase in core local government spending power by about 3.2%. That was the right decision for the right reasons in the national interest, and I am taking into consideration pressures on all parts of health and social care before making final allocations for the year ahead.
Wendy Chamberlain
In North East Fife, we have a particular issue with access to dental surgeries, especially with the recent closure of a surgery in Leven. Difficulties stem from recruitment from abroad as a result of visa changes and also simply from practices going private and coming out of the system. Obviously, the NHS is devolved in Scotland, but does the Secretary of State agree that putting staffing under further strain from increasing national insurance contributions will only make things worse for dentists? What in his conversations is he doing to ensure that dentists get the support that they need?
Wes Streeting
It is because the Chancellor took the decisions that she did in the Budget that my Department has received £26 billion to reform and improve health and social care. As I said before the general election, all parts of the United Kingdom suffered under the previous Conservative Government, which is why I am sure that Members from across Scotland will welcome the extra £1.5 billion this year and £3.4 billion next year—the biggest funding increase since devolution. I am sure that the SNP Government will welcome the increase, and they certainly have no excuses now for not acting.
Rachael Maskell (York Central) (Lab/Co-op)
Fourteen years of neglect have left hospices in a perilous condition. They are dealing with the rise in national insurance contributions, pay and other cost pressures, so I welcome the fact that the Secretary of State is putting in place measures to ensure that the funding recovers. Will he assure me that integrated care boards not only will pass on that recovery from the increased costs to hospices, but will help them catch up from the Tory years of neglect of the whole sector?
Wes Streeting
I am grateful to my hon. Friend for her question. I am looking carefully at the pressures on hospices. In fact, only last Friday I visited Saint Francis hospice, which serves my constituents and people right across east London and west and south Essex. I saw at first hand the brilliant work it is doing on end of life care, but also the pressures it is under, and I am taking those pressures into account before deciding allocations for the year ahead.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
I have tried repeatedly through written parliamentary questions to get an answer to this without success, so I will try asking it face to face: will the Secretary of State tell the House how much his Chancellor’s changes to national insurance contributions will cost the NHS?
Wes Streeting
The hon. Member talks about the employer national insurance contributions as if they were a burden on the NHS. It is thanks to the decisions taken by the Chancellor that we can invest £26 billion in health and social care. The Conservatives welcome the investment but oppose the means of raising it. Do they support the investment or not? They cannot duck the question; they have to answer.
Dr Johnson
The right hon. Member speaks of ducking questions, but it is worrying that three weeks after the Budget he still does not know, or will not tell the House, how much it will cost the NHS. Of course, changes to national insurance contributions affect not just the NHS directly, but suppliers, contractors, charities and other NHS care providers. I know you are a great supporter of your local air ambulance service, Mr Speaker, as I am of the Lincs & Notts air ambulance, which now needs to raise £70,000 extra just to fund this Government’s ill-advised changes to NICs. That £70,000 is a lot of cakes to sell, cars to wash and fun runs to complete, and that is just one example of pressures placed on lifesaving services right across the country. Will the Minister confirm that he will meet the Chancellor, explain the disastrous effects of the policy and insist that she reverses it?
Wes Streeting
Again, we have not yet announced how we are allocating the budget for the year ahead, but I remind the Conservatives that it is thanks to the choices the Chancellor made in her Budget that she is able to invest £26 billion in health and social care. Would they cut the £26 billion this Labour Government are investing in the NHS? If not, how would they pay for it? Welcome to opposition.
Wes Streeting
I am grateful to the Liberal Democrat spokesperson for her question. I pay tribute to the children’s hospice in her constituency and, indeed, to Haven House children’s hospice, which serves my constituency.
Wes Streeting
And indeed your very own local hospice, Mr Speaker—I am sure that will appear on the record. I am particularly thankful for the advocacy we have received from Hospice UK and charities such as Together for Short Lives and others that are making their voices heard about the pressures on the system. I say to all hospices across the country that I am taking those pressures into account before deciding allocations for the year ahead, because I want to ensure that everyone, whatever their age, receives access to the timely and good-quality end of life care, palliative care and, of course, support for people with life-limiting conditions that all of them deserve.
Antonia Bance (Tipton and Wednesbury) (Lab)
The Minister for Care (Stephen Kinnock)
I was proud that the Chancellor raised the salaries of hundreds of thousands of care workers in the Budget. Last month, the Government introduced legislation to deliver the first ever fair pay agreement for adult social care. While we were giving care workers a pay rise, the Leader of the Opposition was belittling their work as merely wiping bottoms. I gently say to the Conservative party that it is better to be wiping bottoms than talking out of them. This is an important issue, and I am dealing with ministerial colleagues on it.
Antonia Bance
According to last month’s Skills for Care report, most care workers are paid only a couple of pennies above the national minimum wage, while the sector cannot recruit and retain the people it needs. Will the Minister set out the timetable for establishing the fair pay agreement and adult social care negotiating body, and will he give the House an assurance that the care trade unions will be closely involved in its design?
Stephen Kinnock
We took quick action on the Employment Rights Bill, which includes the fair pay agreement, within 100 days of taking office. The consultation process on the negotiating body can begin only once the Bill has become an Act. We are engaging widely with stakeholders, and I assure my hon. Friend that unions will play a central role in that process, but let us remember that, through the national living wage, we are giving the lowest-paid full-time care workers a pay increase of £1,400 per year.
Seamus Logan (Aberdeenshire North and Moray East) (SNP)
One barrier to better staff salaries in the care sector is the additional employer national insurance contributions. Are the Minister and his colleagues considering an exemption for GP practices, charities and hospices from national insurance employer contributions?
Stephen Kinnock
As my right hon. Friend the Secretary of State for Health and Social Care pointed out, when we won the general election on 4 July, we inherited public finances in their worst state since the second world war. Through the Chancellor, we have taken responsible action to deal with those issues. My right hon. Friend the Secretary of State has also said that we are looking at the Budget in the round, and we will report on that in due course.
Andrew Pakes (Peterborough) (Lab)
Dan Aldridge (Weston-super-Mare) (Lab)
The Minister for Care (Stephen Kinnock)
After 14 years of Tory neglect and incompetence, NHS dentistry in England has been left in a parlous state. Tooth decay is the most common reason why children aged five to nine are admitted to hospital, and 28% of the country—13 million people—have an unmet need for dentistry. Rescuing NHS dentistry will not happen overnight. We will expand the provision of urgent dental appointments across the country, and we are working with the sector to reform the dental contract in order to increase access and incentivise more NHS care.
Andrew Pakes
Yesterday, I heard from a disabled constituent who has spent over a year trying to find an NHS dentist, but without success. The only solution was to come to London for emergency treatment—that became a shockingly common story under the previous Government. As a first step, our integrated care board is putting 12 extra dentists into Peterborough and the surrounding towns to increase access. Will the Minister update the House on progress and on how we will further improve access to NHS dentistry?
Stephen Kinnock
I am very pleased to hear about what my hon. Friend’s ICB is doing. Working with the dental sector, we will deliver measures to improve access, targeting areas that need it most. Those measures include 700,000 additional urgent appointments and reform of the dental contract. The golden hello scheme, which incentivises dentists to work in underserved areas, is under way across the country, and dentists are also being offered a new patient premium to treat new patients.
Richard Baker
Does the Minister agree that it is unacceptable that more than 40,000 people in Fife are not registered with an NHS dentist? Will he share any learning from this Government’s action to increase access to dentistry with his colleagues in the Scottish Government, and urge them to fulfil their responsibilities so that people in my constituency can get the dental treatment that they need?
Stephen Kinnock
Responsibility for dental services in Scotland is of course a matter for the Scottish Government, but Governments across the UK work together to spread best practice and deliver on our common goals. The Scottish National party Government have an extra £1.5 billion this year, and £3.4 billion next year, through the Barnett formula. I hope that they will prioritise health, including dentistry, and undo some of the damage that they themselves have done to dentistry in Scotland.
Dan Aldridge
Some 37% of five-year-olds in Weston-super-Mare have enamel or dental decay—a figure well above the national average. The Better Health North Somerset team does amazing work to promote good oral health, but regular dentist check-ups are the oral health silver bullet. Will the Minister explain and outline the work he is doing to ensure that children in Weston and Worle and across the country get the dentistry service that they so desperately need?
Stephen Kinnock
My hon. Friend is absolutely right to raise this vital issue. Prevention is of course always better than cure, so I am very proud of the fact that we are introducing supervised toothbrushing for three to five-year-olds in the most deprived communities and where there is the most unmet need. We are also working to sort out the NHS contracts so we can ensure that children get the care they need.
James Wild (North West Norfolk) (Con)
Having training locally at the University of East Anglia is important for my constituents, but in the short term, what steps is the Minister taking to speed up the process by which dentists get on the dental performers list, so that they can work in the NHS and not just privately? Is he also considering bringing in a provisional overseas registration scheme?
Stephen Kinnock
I thank the hon. Gentleman for that question. We are looking at provisional registration. As I also mentioned to his hon. Friend the Member for Broadland and Fakenham (Jerome Mayhew), we are very open to the idea of a dental training school at the University of East Anglia. We need to ensure that we push on the full spectrum of all these measures, because there is a crisis in NHS dentistry and we need to get on and fix it.
Ben Obese-Jecty (Huntingdon) (Con)
Toothless in Huntingdon in my constituency has written to me highlighting that 36% of patients under Cambridgeshire and Peterborough integrated care system no longer have an NHS dentist. It wants dental practices to provide access to those needing emergency treatment and a priority pathway for referrals from hospital departments such as cardiology and oncology. To that extent, what steps are being taken in Huntingdonshire to improve dental access across rural Cambridgeshire? How are the Government helping the Cambridgeshire and Peterborough integrated care system to address those issues?
Stephen Kinnock
Obviously the golden hello scheme for rural areas is very important. We are pushing forward on that, and I am pleased to say that hundreds have expressed interest in it and appointments are starting on that basis. The hon. Gentleman is right about training places. As I have already mentioned, we are very open to establishments and institutions coming forward with proposals for that. We are living in a country where the biggest cause of hospital admission for five to nine-year-olds is having their rotten teeth removed. That is a truly Dickensian state of affairs, and it needs to be fixed as a priority.
Tom Gordon (Harrogate and Knaresborough) (LD)
Earlier this year, I was at an orthodontist’s practice that carries out work on behalf of the NHS. It said the issue is that when people are referred to it by their general dentist, it cannot go on to do the orthodontic work because their teeth are in too bad a state, so they are referred back to the dentist, but they cannot get in because of waiting lists and issues. When we look at reforming dental contracts, will we look at orthodontic ones too?
Stephen Kinnock
Absolutely. As my right hon. Friend the Secretary of State has said, we have already met with the British Dental Association, and no issues are off the table. We absolutely need to look at orthodontists in the round as part of the contract negotiations, and we will certainly report back on that in due course.
Tristan Osborne (Chatham and Aylesford) (Lab)
Kevin Bonavia (Stevenage) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
Before the election, we made it clear that investment and reform were needed in the NHS. The Chancellor announced the investment in the Budget, and since the general election we have confirmed the introduction of new league tables of NHS providers, with high-performing providers being given greater freedom over funding and flexibility. We are sending turnaround teams into struggling hospitals, giving the best performers greater freedoms over funding to modernise technology and equipment. We are creating a new college of executive and clinical leadership that will help to attract, keep and support the best NHS leaders. We are banning NHS trusts from using agencies to hire temporary entry-level workers in bands 2 and 3, such as healthcare assistants and domestic support workers. We are sending crack teams of top clinicians to areas with long waiting lists and high economic inactivity to improve the productivity of their clinics, and we are running a GP red tape challenge to slash bureaucracy. I could go on, because this is a Government who are walking the talk on NHS reform.
Wes Streeting
I would be delighted to meet my hon. Friend and other Members from across Medway to discuss the challenges that their part of the south-east faces, and to explain why our predecessors made promises they could not keep, with timetables that were completely fictitious and funding that runs out in March. I am really sorry for the way that communities were let down by the previous Government. This Government will not make the same mistakes.
Kevin Bonavia
I am grateful to my right hon. Friend for his earlier answer. Last week, I spoke to one of my constituents, Norman Phillips, who has been an unpaid carer for his wife Ros for the past 18 years. Like many unpaid carers across Stevenage, Norman has been put through absolute hell by the previous Tory Government’s complete inaction on social care for over 14 years. Does the Secretary of State agree that unpaid carers such as Norman play a vital role in providing care, and that unpaid carers need to be at the heart of any reforms to the social care system—reforms that are much needed?
Wes Streeting
I, too, pay tribute to Norman and to family carers like him, who play such a vital role supporting loved ones. Through the carer’s allowance uplift in the Budget, the Chancellor announced the largest increase to the weekly earnings limit since the introduction of carer’s allowance in 1976. As well as that investment, we will have a 10-year plan for social care, and I see the care workforce, care providers and family carers as all being important partners in building that plan.
Jeremy Hunt (Godalming and Ash) (Con)
I welcome the Secretary of State’s plans to reform the NHS, but may I caution against the idea that the answer is to fire more incompetent managers? The problem is not bad management: it is micromanagement from the centre that sees hospitals managed with more than 100 targets by NHS England, making ours one of the most micromanaged healthcare systems in the world. Will the Secretary of State’s plans allow managers more autonomy, helping them to innovate, save money and improve care for patients?
Wes Streeting
I am happy to confirm that it is my view that, when there are too many targets and everything is being measured, nothing ends up being measured. We need to give more freedom and autonomy to good leaders, including clinical leaders and managers in the NHS who are coming up with some of the best productivity gains in the system. That is why we have announced new support for, and investment in, the college of leadership for both clinical and executive leaders in the NHS. I would be delighted to meet the right hon. Gentleman to discuss those issues. He was a great Chair of the Health and Social Care Select Committee, but back in July, we saw a great example of how we can improve things by sacking bad managers.
Bob Blackman (Harrow East) (Con)
One of the lessons from the pandemic is the importance of NHS communications. Last week, I joined victims of the sodium valproate scandal to hand in a petition. They tried to download from the website the Medicines and Healthcare products Regulatory Agency’s yellow card adverse drug reactions literature, but were unable to do so. Will the Secretary of State look at this as a matter of urgency? People need to be warned about the risks of taking certain drugs.
Wes Streeting
As the hon. Gentleman knows, I am a great champion of patient power, and a key part of giving patients more power and control over their healthcare is better access to information. That is why, as well as improvements to the NHS app—which will provide far easier interaction with the NHS for patients—I am working with my right hon. Friend the Secretary of State for Science, Innovation and Technology to make sure all the information held by Government is more accessible for our citizens, particularly where that includes vital safety information and guidance, as the hon. Gentleman has mentioned.
Pamela Nash (Motherwell, Wishaw and Carluke) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
Thanks to the decisions that the Chancellor took in the Budget, we are able to provide an additional £26 billion to give the NHS the funding it needs. This will support the NHS in England, enabling it to deliver an extra 40,000 appointments a week to cut waiting lists. Of course, for my hon. Friend and her constituents, the Budget has given Scotland the biggest real-terms increase in funding through the Barnett formula since devolution began. I hope the Scottish Government will use that investment to deliver improved services for the Scottish people.
Pamela Nash
The Labour party is the party of the NHS, and the significant additional investment announced in the recent Budget has reaffirmed that. The Secretary of State has made it very clear in this question session that the benefits of that additional funding must be felt across the UK. Will he join me in urging the Scottish Government to ensure that that funding reaches the frontline and creates the badly needed additional appointments in GP, dental and hospital services that my constituents and people across Scotland badly need?
Wes Streeting
I am grateful to my hon. Friend for her question. It is thanks to the people of Scotland sending 37 Labour Members of Parliament here at the last election—not only have they shown that they value the NHS and are demanding change, but they voted for change—that we are now delivering that change through the Budget. I say to Scottish Government Ministers that, as they know, I said before the election that all roads lead to Westminster and that we all suffered under the Conservative Government, but this year that road is carrying an extra £1.5 billion to the Scottish Government and next year it will carry an extra £3.4 billion to the Scottish Government, so they have no excuse not to act.
Saqib Bhatti (Meriden and Solihull East) (Con)
Approximately 220,000 people currently reside in the Solihull borough, and if Government planning reforms go through, the number will increase significantly. My hon. Friend the Member for Solihull West and Shirley (Dr Shastri-Hurst) and I have written to the Health Secretary about the need for infrastructure and A&E services at Solihull hospital. Will he agree to meet us to see how we can make this Budget work for the people of Solihull?
Wes Streeting
I know, not least because of the mismanagement of the NHS during the last 14 years, that communities right across the country, including the hon. Gentleman’s constituents in Solihull, are struggling with poor services and crumbling estates. We would be happy to receive representations from him, but he has to level with his constituents. If he wants money to be spent in his community, he must support the investment and be honest about the fact that he supports the means of raising it. If he does not support the means of raising it, he should tell us where that investment would come from.
Mr Speaker
We have been very slow to get to topicals, so let us see if we can speed it up. Dan Tomlinson will set a good example.
Dan Tomlinson (Chipping Barnet) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
This weekend, we launched the first in-person consultation as part of change.nhs.uk, the biggest national conversation about the future of the NHS we have ever seen. We know that the Leader of the Opposition wants a conversation about whether the NHS is free at the point of use, and I can tell her, from that first conversation, that no one agreed with her.
Dan Tomlinson
Earlier this month, I visited Barnet hospital to see the way in which it is changing the emergency care department so that more patients can be seen more quickly, freeing up capacity in accident and emergency. What steps are the Government taking to ensure that trusts such as the Royal Free and others across the country get the support they need, through investment and reform, to improve patient care?
Wes Streeting
I am grateful to my hon. Friend for his question. The Royal Free hospital saved my life when I went through kidney cancer, so it holds a special place in my heart. Thanks to the Chancellor’s decision and the investment she put into the NHS at the Budget, and the reform my Department is delivering, we will deliver the change and improvement that his constituents and mine, and the rest of the country, deserve.
Wes Streeting
It is thanks to this Government and the action we have taken that, for the first time in three years, we go into winter without the spectre of national strikes looming over the NHS, and with NHS staff on the frontline not the picket line. It is thanks to the priority this Government have given to prevention that we have already delivered almost 15 million covid-19 and flu vaccinations, alongside the new RSV—respiratory syncytial virus—vaccination to help vulnerable groups for the first time. The shadow Secretary of State mentions the winter fuel allowance. This Government are protecting support for the poorest pensioners to protect them not just this winter, but every winter, and over the coming years the value of the pension will of course rise with the cost of living.
Edward Argar
I am grateful for that response but, just as my hon. Friends have highlighted in respect of the damaging impact of increases in employer national insurance contributions on GPs, hospices and care providers, I fear it was another example of the Government simply not answering the question and not having a plan yet. Either the Government have not done their homework and, as with the impact of NICs increases, they have not thought this through and do not know, or worse, they do not care—which is it?
Wes Streeting
This Government are prepared for winter and we are already standing up the operational response to winter pressures. On funding, the right hon. Gentleman was in government just before the general election. Is he saying that his Government did not provide enough funding for the NHS this winter? If not, why not? If he does accept that it is enough money, he will surely welcome the extra investment that the Chancellor is putting into the NHS from next year.
Dr Lauren Sullivan (Gravesham) (Lab)
The Minister for Secondary Care (Karin Smyth)
The Department has been working with suppliers of medicines used to treat ADHD to seek commitments from them to address the issues, expedite deliveries and boost supplies. We are working with NHS England to approve the modelling for industry and communications regarding ADHD medicine supply issues. We will continue to engage with industry to address the remaining issues as quickly as possible.
Helen Morgan (North Shropshire) (LD)
The Conservatives’ disastrous legacy on dentistry means that more than 4.4 million children have not seen a dentist in the past year. In Shropshire, dentists continue to hand back their contracts, including one in Wem in recent weeks. Will the Minister outline his plan to reverse that terrible decline and ensure that the issue is addressed in rural areas where there are dental deserts?
The Minister for Care (Stephen Kinnock)
There will be 700,000 extra urgent appointments, golden hellos, and a prevention and supervised toothbrushing scheme for three to five-year-olds.
Paulette Hamilton (Birmingham Erdington) (Lab)
Wes Streeting
We all know that general practice is under enormous pressure, and that will be a big part of this Government’s agenda. I reassure my hon. Friend that our view is that there should be patient choice, patient control and different courses for different horses. I value online and over-the-phone appointments, but they will not be right for everyone on every occasion. Patients should have a voice and a say.
Lincoln Jopp (Spelthorne) (Con)
Wes Streeting
I would say to GPs who are thinking about staffing for the next financial year that they should hold tight and wait for funding allocations shortly, so that they can make informed decisions about staffing and care for patients.
Damien Egan (Bristol North East) (Lab)
Stephen Kinnock
We have pledged to bring back the family doctor, and we have already invested an additional £82 million in the additional roles reimbursement scheme to recruit 1,000 more newly qualified GPs in 2024-25. We are also committed to fixing the front door of the NHS, for example through £100 million of capital funding that was announced in the Budget. We are fully aware of the pressures, and we will set out further details on funding allocations for next year in due course.
Charlie Maynard (Witney) (LD)
Wes Streeting
I might resist the invitation to give a specific date today, but the hon. Gentleman makes a valuable point about the ease of use of the NHS app, and I will write to him further on that point.
Mark Ferguson (Gateshead Central and Whickham) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
The UK rare diseases framework aims to improve the lives of people living with all rare diseases. I am more than prepared to meet my hon. Friend to look at the adequacy of support available to people with Usher syndrome.
Sarah Olney (Richmond Park) (LD)
Wes Streeting
We have not yet announced allocations for general practice for the year ahead, and we are taking into account all the pressures that general practice is under.
Dr Beccy Cooper (Worthing West) (Lab)
Andrew Gwynne
We will confirm the 2025-26 local authority public health grant allocations in due course. Local government plays a critical role in delivering the Government’s health mission and driving action on the prevention of ill health. We are committed to working in partnership with local government to tackle the wider determinants of ill health.
Martin Wrigley (Newton Abbot) (LD)
Wes Streeting
I am in no doubt about the state that general practice was left in by our Conservative predecessors. That is why, in making decisions about funding allocations for the year ahead, we are taking into account all the pressures that general practice is under, as we clean up the mess left by the Conservatives.
Alice Macdonald (Norwich North) (Lab/Co-op)
In summer 2023, I spoke to Rachel, who suffers from endometriosis. She was told that she might have to wait 18 months for urgent surgery. She is still waiting. In fact, she has had the menopause induced to help tackle her symptoms. Can the Minister tell me what the Government are doing to improve the diagnosis and treatment of women, including Rachel, who have had to wait far too long?
Karin Smyth
My hon. Friend makes an excellent point on behalf of Rachel and many other women suffering from this disease. We are looking urgently at gynaecological waiting lists. They are far too high, including for endometriosis. I welcome the new National Institute for Health and Care Excellence guidelines. We will be looking at women’s health hubs and how they work, and future guidelines will help women to get a diagnosis more quickly and help with situations like Rachel’s.
Wera Hobhouse (Bath) (LD)
Respiratory health conditions are one of the main drivers of NHS winter pressures, yet only 32% of asthma sufferers in Bath and across the country can access the most basic level of care. What will the Government do to improve access to basic levels of care for the 68% of asthma sufferers who are currently missing out?
Andrew Gwynne
NICE is reviewing its guidelines for the diagnosis, monitoring and management of chronic asthma, and an updated version is due to be published in late November 2024. I am happy to meet the hon. Lady to discuss it further.
Andy McDonald (Middlesbrough and Thornaby East) (Lab)
Women with spinal cord injuries face significant challenges in accessing core health services, including breast screening, cervical screening and gynaecological care. Research shows that women with disabilities, including spinal cord issues, are 30% less likely to attend routine breast screening appointments, in significant part due to the physical inaccessibility of the screening equipment. Will the Minister meet me and representatives of the all-party parliamentary group on spinal cord injury to discuss these unacceptable disparities and ensure that women receive the equitable and accessible care they deserve?
Karin Smyth
My hon. Friend highlights a shocking example of inaccessibility in these important services. I will make sure that the Department responds to him and that either me or a ministerial colleague meets him.
Stuart Anderson (South Shropshire) (Con)
Ludlow community hospital in my constituency provides a great service for the local community, but it is restricted by its location and its building. There is a business model that would be more cost-effective in the long term that involves moving the facility to the eco park. Will the Secretary of State meet me, healthcare stakeholders and the league of friends in Ludlow to take that forward?
Wes Streeting
The hon. Member is welcome to make representations to the Department for the capital investment that he is calling for, but he should welcome the means of providing it, which was the Chancellor’s decision in the Budget.
Neil Coyle (Bermondsey and Old Southwark) (Lab)
I welcome Ministers’ leadership in attacking the record waiting times inherited from the Tories. Will they in turn recognise Guy’s and St Thomas’ efforts to reduce delays, especially in the ear, nose and throat and paediatric spinal surgery teams? Will the Secretary of State outline measures to protect our NHS from cyber-attacks, which was another issue neglected by the last Government but is affecting patients in Southwark?
Wes Streeting
I am grateful to my hon. Friend for the question and pay tribute to the work being done by Guy’s and St Thomas’. He is right to raise cyber-security. That is why the capital investment announced by the Chancellor is welcome and necessary, and joint working across Government, including with security colleagues and my right hon. Friend the Secretary of State for Science, Innovation and Technology, is vital to keep patients’ data and information safe and to keep critical systems running.
Mr Lee Dillon (Newbury) (LD)
When the Secretary of State reviews GP funding, will he also consider the burden that sits on GP practices when they have to hold the lease for their surgeries and what role integrated care boards could have in holding that risk, which is stopping the recruitment of GPs to join practices as partners?
Stephen Kinnock
NHS England currently accepts ICBs holding leases only as a last resort or by exception due to the significant capital required. While we know that is not the most effective use of ICB resources, it is an important safeguard. We are committed to fixing the front door of the NHS by supporting GPs and ICBs through, for example, the £100 million of capital funding announced at the Budget for GP estate upgrades.
Jacob Collier (Burton and Uttoxeter) (Lab)
My constituent Ollie Horobin’s life has been completely transformed after contracting covid, leaving him wheelchair-bound with a feeding tube and battling debilitating symptoms every single day. His story is a stark reminder of the devastating impact that long covid can have. Will the Minister commit to meeting Ollie and me to hear about his experience at first hand, and prioritise further research into the causes, treatments and long-term impacts of extreme long covid?
Andrew Gwynne
As somebody who still suffers from long covid, I know how debilitating and complex it can be, and I am committed to improving support for people affected by it. There are now more than 100 long covid services across England, and £57 million is being invested in long covid research. I recently co-chaired a roundtable on strategies to stimulate further research into treatments. I am more than happy to meet my hon. Friend and Ollie for further discussion.
David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)
Opt-out testing for HIV at A&E has been a great success since it was announced last year, particularly in identifying those who were not aware they had the disease and among difficult-to-reach communities. Can the Health Secretary confirm whether the programme will continue?
Wes Streeting
Opt-out HIV testing has been a great success so far. Of course, we will make further announcements on its future in due course. I would like to say, as a former member of the HIV commission that made the representations to the previous Government, that he has me at a real advantage—or disadvantage, depending on the side of the spending fence. I very much welcomed the approach taken by the previous Government, which this Government plan to continue.
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
Will the Secretary of State explain what plans he has—if any—to limit the scope of practice of anaesthetic associates and physician associates, about whom there has been such publicity lately?
Wes Streeting
Indeed there has. Medical associate roles can and do play a valuable role in freeing up other clinicians’ time to do the things that only they can do, but there are legitimate concerns within the professions about scope of practice, doctor substitution and transparency for patients. We need to grip that and address it. We will have a further announcement to make about that shortly.
Mr Richard Holden (Basildon and Billericay) (Con)
South Green surgery in my constituency has been given notice by its landlord that it has to move by the end of March next year. Will the Secretary of State meet me to see what we can do to ensure that other facilities can be provided if available, or to do the best for those local patients?
Wes Streeting
That would be a matter for the right hon. Gentleman’s ICB. I know that he is new to the area, so I am happy to make some introductions.
Karl Turner (Kingston upon Hull East) (Lab)
My constituent Craig Eskrett was diagnosed with motor neurone disease 12 months ago. He says that the services are there in the local NHS trust, but there is a distinct lack of co-ordination. Will the Minister meet me to discuss what improvements can be made to co-ordinate those services for sufferers of MND?
Andrew Gwynne
My hon. Friend raises a real issue about how we join up the whole of the patient journey. Once diagnosed, patients need appropriate treatment and wraparound care. I am more than happy to meet him and his constituent.
Richard Foord (Honiton and Sidmouth) (LD)
At the weekend in Devon, I met a psychiatric nurse who previously worked in London and has been recruited to the south-west. She does not have a start date, and is still subject to routine checks after waiting months. Can the Secretary of State expedite these routine checks, given waiting lists for mental health?
Wes Streeting
Absolutely. That is a good example of why investment needs to be matched with reform to speed things up, improve productivity and get staff to the frontline, where they want to be.
Harpreet Uppal (Huddersfield) (Lab)
Last week, the chief executive of Forget Me Not children’s hospice visited Parliament with local dad Steve, whose son is supported by the hospice. The hospice provides vital services to families such as Steve’s, but its services are at risk in the longer term without sustainable funding, including the NHS England children’s hospice grant. Can the Health Secretary take urgent steps to improve funding for hospices?
Wes Streeting
I am grateful for the steps that my hon. Friend is taking to make representations on behalf of her local children’s hospice, both on the Floor of the House and outside the Chamber. I recognise the pressure she describes. We are determined to help hospices to overcome them.
Jim Shannon (Strangford) (DUP)
Can the Secretary of State confirm what assessment has been made of the number of women waiting for endometriosis surgery across the United Kingdom? What has been done to reduce waiting lists?
Wes Streeting
As my hon. Friend the Minister for Secondary Care said, the wait for women with common conditions such as endometriosis is far too long. That is why we are taking steps to cut waiting times and stop the merry-go-round of repeat visits to the same clinician to get the same answer, until someone finally listens to what a woman has to say.