House of Commons
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Mr Speaker
First of all, may I wish everybody a happy new year? Let’s hope for a peaceful one.
Oral Answers to Questions
(1 year, 7 months ago)
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Harpreet Uppal (Huddersfield) (Lab)
The Secretary of State for Defence (John Healey)
This is day 1,049 of Russia’s brutal, illegal, full-scale invasion of Ukraine, and 2025 will be the critical year in the conflict. My job as Defence Secretary is to put Ukrainians in the strongest possible position on the battlefield and at any negotiating table, so throughout 2025, we will develop UK training, strengthen defence industrial co-operation, increase pressure with allies on Russia, and step up and speed up military aid to Ukraine.
Harpreet Uppal
I welcome the recent announcement of £225 million in new military assistance to Ukraine. Alongside that, we must continue to step up our efforts to pressure Russia. Following the reported damage to a major undersea cable in the Baltic over Christmas, which Finnish authorities suggest may be linked to a shadow fleet vessel, what further actions is the UK taking alongside European allies to undermine the Russian shadow fleet?
John Healey
My hon. Friend is right in general terms: Russian aggression is not simply confined to Ukraine, and we all saw what happened on Christmas day. We are deeply concerned about the damage and sabotage to undersea cables. I can confirm to the House that for the first time the joint expeditionary force—the JEF—has activated an advanced UK-led reaction system to track potential threats to undersea infrastructure and to monitor the movements of the Russian shadow fleet. That will be run out of the standing joint force headquarters at Northwood.
Dr Andrew Murrison (South West Wiltshire) (Con)
The Secretary of State said that his aim is to ensure that Ukraine is in the “strongest possible position”, but for what? Does he intend to support Ukraine in commanding her internationally recognised borders or to ensure that the de facto border, which excludes Donbas and Crimea, becomes a more permanent feature?
John Healey
Quite simply, our job as the UK is to support Ukraine in its fight and, if and when it decides to talk, to support it in any negotiations. It is the Ukrainians who are fighting; it is the Ukrainians who decide when to start talking; and it is for the Ukrainians to decide on what terms they may start talking.
Mr Richard Holden (Basildon and Billericay) (Con)
The Secretary of State for Defence (John Healey)
The AUKUS partnership will create new contract opportunities for hundreds of small and medium-sized firms. It will create 7,000 new jobs both in UK shipyards and across the UK supply chain.
Mr Holden
As the Secretary of State knows, under the defence equipment plan about half of MOD expenditure is on equipment, with around 40% of that going overseas. What impact does the Secretary of State think that the Government’s abolition of business property relief and the massive increase in national insurance will have on UK SMEs’ ability to compete in the defence sector with our AUKUS allies following the previous Government’s signing of that agreement?
John Healey
It is certainly the case, as the right hon. Gentleman rightly recognises, that in government the Conservatives were too often largely blind to where British firms were based and to where the contracts that they were ready to award went. This Government have come into power committed not just to strengthening UK security but to boosting the UK economy. That means designing, making and buying more in Britain.
Patrick Spencer (Central Suffolk and North Ipswich) (Con)
The Secretary of State for Defence (John Healey)
The Government are delivering for defence by increasing defence spending. There is already £3 billion extra for next year, and a commitment to setting a path to spend 2.5% of GDP on defence in the spring.
Patrick Spencer
It is all very well spending 2.5% of GDP on defence, but we have to spend it on the right kit. Over the weekend I noted a story about our NATO allies being frustrated with Britain for not investing in appropriate missile defence systems. As the Secretary of State meets his 2.5% commitment, will he commit to investing in surface-to-air missiles, precision and hypersonic missile systems, DragonFire laser systems and counter-drone blocking technology to ensure that the British Army is the most advanced and able in the western world?
John Healey
The UK has for many years been one of the highest spenders on defence in NATO. We continue to hold that proud record. Increasing spending this year will mean that Britain continues to be one of the highest spenders in NATO. I remind the hon. Gentleman that the last time this country spent 2.5% on defence was in 2010 under the previous Labour Government—a level of defence spending that was not matched once during the 14 years in which his party was in government.
Mr Tanmanjeet Singh Dhesi (Slough) (Lab)
On defence spending, I am glad that UK-based defence firms will be prioritised for Government investment under the defence industrial strategy, which should boost British jobs in constituencies such as Slough and help to strengthen national security, but major defence programmes are currently in disarray, with only two out of 49 on time and on budget. What actions are the Government taking to fix the waste and mismanagement in the system?
John Healey
My hon. Friend is right. Everyone agrees that more needs to be spent on defence to meet the increasing threats. He asks why only two out of 49 of the major defence projects are on time and on budget. That question may best be directed at the shadow Defence Secretary, the hon. Member for South Suffolk (James Cartlidge), who was responsible for exactly that up until the election six months ago. There is of course a question about how much we spend, but there is also a challenge in how well we spend it. The shadow Armed Forces Minister, the right hon. Member for Rayleigh and Wickford (Mr Francois), was one of the strongest critics of the previous Government and of what he described as the “broken” procurement system. We are getting a grip of MOD budgets, driving deep reform in defence and ensuring that we reduce the waste and delay in procurement contracts.
James Cartlidge (South Suffolk) (Con)
I congratulate the Minister for Veterans and People, the hon. and gallant Member for Birmingham Selly Oak (Al Carns), on receiving a distinguished service order—we are all proud of him.
The Government have tied the announcement of their timetable for 2.5% to the publication of the strategic defence review, so we need it to be published as soon as possible. Will the Secretary of State clarify why he has pushed back the SDR’s publication in Parliament from the spring to the summer?
John Healey
I have not done that. The work of the reviewers leading the strategic defence review is thorough and flat out. The review has been widely contributed to and is the first of its kind in this country, allowing fresh thinking in defence planning. On the 2.5% commitment, as we said in the plan for change, we will set out a path to spending 2.5% of GDP on defence in the spring. The Government are delivering on defence and defence reform; we will deliver on defence funding, too.
James Cartlidge
The Secretary of State says that publication has not been pushed back, but I remind the House that at the previous Defence questions on 18 November last year, the Secretary of State was asked specifically about SDR timing and said:
“The reviewers will report in the spring.”—[Official Report, 18 November 2024; Vol. 757, c. 4.]
However, in a written answer to me on 17 December—just before the House rose—a Defence Minister said:
“The Reviewers will make their final report to the Prime Minister, Chancellor of the Exchequer and Defence Secretary in the first half of 2025. The Secretary of State for Defence will subsequently report the Strategic Defence Review to Parliament.”
If the first part is in the first six months of the year, even I can see that the second part, which is subsequent to that, will happen in the second half of the year. That is not the spring, is it?
John Healey
We are dancing on the head of a pin here—the spring is in the first half of the year. I think the hon. Gentleman should take my words to this House and to him, which have been consistent that the strategic defence review will report in the spring. It will report directly to the Prime Minister, to the Chancellor and to me, and I will update the House directly. We will also set out our clear path to spending 2.5% of GDP on defence in the spring.
Jacob Collier (Burton and Uttoxeter) (Lab)
Danny Beales (Uxbridge and South Ruislip) (Lab)
Tonia Antoniazzi (Gower) (Lab)
Charlie Dewhirst (Bridlington and The Wolds) (Con)
Anna Dixon (Shipley) (Lab)
Euan Stainbank (Falkirk) (Lab)
Kirsteen Sullivan (Bathgate and Linlithgow) (Lab/Co-op)
The Minister for Veterans and People (Al Carns)
Thank you, Mr Speaker.
This Government have already taken swift action to demonstrate our commitment to renew this nation’s contract with those who have served. We have awarded £3.7 million in veterans’ housing grants, veterans will be exempt from the local connection test for social housing in England, and veteran cards are now accepted ID for elections. We have launched a £75 million LGBT financial redress scheme; Op Fortitude, Op Courage and Op Restore are all progressing at pace; and we are currently reviewing how we can make veterans’ support more institutionally resilient. This demonstrates that we have a bias for action, and this Government are delivering for defence.
Jacob Collier
Last year, I had the pleasure of meeting Tim Latter, a Royal Navy veteran and owner of Grindhouse gym in Tatenhill. After facing his own mental health challenges, Tim set up that gym and launched Project I Got Your Six, which is an inspiring fitness coaching programme designed for the military, but also a way for people to talk openly about their mental health. What steps are this Government taking to support veterans with their mental health after their service? Perhaps the Minister would like to meet Tim with me, to see the amazing work he does.
Al Carns
I thank my hon. Friend for a really relevant question. It is essential that we cater for both the physical and psychological impacts of service on those who have served. Op Courage has already had 35,000 referrals. I congratulate Tim Latter on the work he has done, and I would be glad to visit his gym—and perhaps do a little phys with him—to see how it helps veterans’ mental progression in due course.
Danny Beales
I welcome the Government’s commitment to a new armed forces covenant. Will the provisions apply to local councils, so that we see Conservative Hillingdon council end its unfair parking charges on military personnel and their families in service accommodation—an issue that was raised with me recently when the Secretary of State visited to announce the welcome investment in military housing—and we can finally say that Hillingdon puts our heroes first?
Al Carns
I thank my hon. Friend for what, again, is a very important question. I ask him to write to me on the specific issue of Hillingdon council and parking. The important underlying fact is that we have to put the covenant into law—we have made that commitment, and it will happen within the next two years. We will deliver it, and hopefully we will eradicate the postcode lottery in support to veterans across the country.
Tonia Antoniazzi
I welcome this Government’s quick action to deliver on our promise to veterans of making veteran ID cards an accepted form of voter ID, which rightly ensures access to elections for those who have served to protect our freedoms. Will the Minister work with colleagues across government to ensure that veterans are made aware of that very important change?
Al Carns
It took us four months from starting the process to getting the veteran ID card recognised as voter ID, which is superb. We will move this matter forward, and I would love to discuss it in more detail. I highlight that it is not only a physical ID card: we now also have a digital card, which is increasing veterans’ ability to register with all the different services available.
Charlie Dewhirst
Will the Minister join me in congratulating East Riding of Yorkshire council on achieving the armed forces covenant employer recognition scheme gold award, and pay tribute to both the council leader Anne Handley and our armed forces champion Councillor Liam Dealtry for their roles in achieving that? Could he also tell the House what he is doing to encourage more organisations to achieve this highest standard in veterans’ support?
Al Carns
I thank the hon. Member for raising that point, and congratulate the people he has mentioned on signing up to the covenant duty, which is superb. They join about 12,400 others who have given their signatures, which is a fantastic example of British society standing up to support veterans. In due course, I would like to visit and meet them when we get a chance.
Anna Dixon
In Shipley constituency, there are over 3,000 veterans. I have enjoyed meeting local veterans recently, and I invite my hon. Friend to join me in thanking them for their service. However, with the number of homeless veteran households in England reaching 2,270 in the year 2023-24, will the Minister assure me that veterans in Shipley constituency will receive the housing support they need?
Al Carns
I join my hon. Friend in paying tribute to the veterans of Shipley. It is essential, especially over the Christmas period and the next three or four months, that anyone who needs a roof over their head has one. That is why Op Fortitude is really moving at pace: we have had just under 3,000 referrals, and over 800 veterans have been put into housing. I would say that if anyone has any veterans in their constituency, please get them to go on to gov.uk and look at the services available. There are plenty of services out there to get those individuals into housing as fast as possible.
Euan Stainbank
It is welcome in Falkirk that this Government are determined to renew this nation’s contract with those who have served and their families. Can the Minister assure veterans in Falkirk that this Government’s work to strengthen the reach and practical application of the armed forces covenant will be a major focus for his Department in 2025?
Al Carns
Absolutely. As a fellow Scot, I take that very seriously, and I will be visiting there at the end of this week. I have already met the Scottish Veterans Minister, and I want to champion best practice and mutual understanding between England, Scotland, Wales and Northern Ireland to ensure that we can all learn off each other and deliver the most and best services for veterans in due course.
Kirsteen Sullivan
As a former councillor, I know that many veterans can find themselves at a disadvantage when trying to access services, including social housing. Veterans face housing challenges not only in Bathgate and Linlithgow, but across the country. With many Scottish councils and indeed the Scottish Government having declared a housing emergency, will the Minister advise the House what engagement he has had with the Scottish Government to ensure that the housing needs of veterans are prioritised?
Al Carns
My hon. Friend highlights a pretty important point. The Government as a whole are pushing forward to deliver houses at a faster rate over the next five years than, I hope, ever before. Veterans will be included in that, and when I come to Scotland at the end of the week these are exactly the issues I will be talking to the Scottish Veterans Minister about.
Sir Ashley Fox (Bridgwater) (Con)
Operation Prosper was launched in April 2024 to support veterans into work after they leave the armed forces. Does the Minister expect to continue the funding for Operation Prosper after the conclusion of the spending review?
Al Carns
As we move forward, we will be involved in the SDR and looking at supporting veterans into transition and employment in due course. A large proportion of veterans who leave services go into employment. We want to continue that and increase the percentage over time.
Sarah Dyke (Glastonbury and Somerton) (LD)
Service Dogs UK is a charity dedicated to supporting armed forces and emergency services veterans with post-traumatic stress disorder. Since opening its south-west hub in Somerton in 2020, it has matched rescue dogs with veterans across Somerset and the wider south-west, giving veterans an opportunity to manage their PTSD and move on with their lives. Will the Minister join me in congratulating the charity, and will the Government support such charities to expand their crucial work?
Al Carns
The charity has my full congratulations on the work it is doing. Having pets such as a dog provides psychological comfort and friends, especially for people healing from some of the psychological impacts of service or indeed combat, and I fully support it. If the hon. Member would like to discuss at a later date how we could push that forward, she should please reach out to me.
Jim Allister (North Antrim) (TUV)
Just before Christmas, we had the welcome announcement of a new veterans commissioner in Northern Ireland, Mr David Johnstone. Although I am sure the Minister will join me in wishing him well in his new post, it is a part-time post, it has only two seconded staff and it is not on a statutory basis like elsewhere. Will the Government put that post on a statutory basis so that the many veterans in Northern Ireland can have the service they deserve?
Al Carns
I thank the hon. and learned Member for his important question. First, we must get the armed forces covenant into law, which should cover a large proportion of the veteran support mechanism. I congratulate David Johnstone on taking up his post; I phoned him just before the Christmas recess. I am excited and looking forward to working with him and ensuring that the unique attributes of veterans in Northern Ireland are accounted for and represented in the correct manner.
Jess Brown-Fuller (Chichester) (LD)
Maggie Haynes is the founder of Tuppenny Barn, a horticultural therapy charity in my constituency, and she is a veteran herself. She established a female veterans course after observing that the challenges faced by women leaving the armed forces combined with poor communication from the MOD was leaving them unaware of the services available to them. What is the Minister doing to improve support for female veterans?
Al Carns
We are working on our armed forces strategy, part of which will be a specific section for female veterans. We understand the nuances and difficulties of female veterans leaving service and trying to find employment or linking employment with family life and so forth, so we are pushing that forward really hard. Again, I would be very pleased to discuss that with the hon. Member in due course.
Jim Shannon (Strangford) (DUP)
I thank the veterans Minister for his answer. In previous questions in this Chamber I have suggested to the Minister that he might wish to visit Beyond the Battlefield, a charity in my constituency that gives the only care for soldiers whenever they have fallen on bad times. Will the Minister make time available to come and see what we do with that charity in Portavogie and Strangford as an example for everyone else?
Al Carns
Later this week I am going to Scotland, and we will do Wales and then Northern Ireland in due course, and when I visit I would be honoured to come to see the good work the charity is doing.
Will Stone (Swindon North) (Lab)
The Minister for the Armed Forces (Luke Pollard)
This Labour Government are delivering for defence and the landmark Armed Forces Commissioner Bill is the first step in renewing the nation’s contract with those who serve. The commissioner will be appointed following the passage of the primary legislation establishing the role. The Bill passed Committee stage in the Commons in December and I look forward to Report stage in due course.
Will Stone
I thank the Minister for his response. As an ex-rifleman, I have seen at first hand the negative impact of shoddy care and equipment on service personnel’s mental and physical health. What will installing an armed forces commissioner do to make their standard of living better?
Luke Pollard
I thank my hon. Friend for his service. It is absolutely vital that the voices of armed forces personnel and their families are listened to more. That is why we are establishing in the commissioner an independent champion for armed forces and their families. The commissioner will have an independent role, be able to scrutinise the actions of the armed forces and report to Parliament rather than to Ministers, and will not be beholden to the whims of either any Government of the day or the chain of command. That independence will allow the commissioner to scrutinise general service welfare matters, shining a spotlight on the issues that really matter to those who serve in uniform and their families.
Graham Stuart (Beverley and Holderness) (Con)
The Government have said that part of their inspiration for the Armed Forces Commissioner was such a role in Germany, yet Germany has a parliamentary armed forces commissioner. Why is there that difference and why, in line with what the Minister said in an earlier answer, can we trust the independence of this new appointment?
Luke Pollard
The right hon. Gentleman is right that the German armed forces commissioner is part of the inspiration for the role. Dr Eva Högl is a superb example of how we can scrutinise and champion the armed forces and provide solutions and a voice to those who serve. She sits effectively as a Member of Parliament in the German Parliament, which we did not feel was appropriate for the UK Armed Forces Commissioner, but the independence and the way she has pioneered much of that work in recent years is a real inspiration to us. We hope that such a workable example from a key NATO ally—people can raise issues with her and shine a spotlight on those issues to improve service welfare matters and as a result improve morale and the operational effectiveness of the armed forces—will give strength to the independence of the role.
Mr Mark Francois (Rayleigh and Wickford) (Con)
During debates on the Bill in Committee I raised the worrying issue that under the Treasury’s proposed inheritance tax changes, service personnel who are unmarried but in a long-term relationship could have their partner’s service benefit taxed should they die while in service. The Forces Pension Society has rightly highlighted that that would be totally contrary to the spirit of the armed forces covenant. Has the Minister yet raised this with the Treasury, as we strongly suggested last month he should, and if so what progress has been made?
Luke Pollard
As the right hon. Gentleman will recall from the Bill Committee, which in parliamentary sitting days was only a few days ago, we are raising issues around a number of things, including the one he raises. It is subject to a consultation, as he knows, so a decision has not been made. It is a responsibility for the Treasury, rather than the Ministry of Defence, but I undertook to write to him, and I will do so.
Sadik Al-Hassan (North Somerset) (Lab)
Mr Paul Foster (South Ribble) (Lab)
Lewis Atkinson (Sunderland Central) (Lab)
The Minister for Veterans and People (Al Carns)
I thank my hon. Friends for raising an exceptionally important matter. The deal to sell off most of our service family accommodation in 1996, then rent it back and upgrade it, is probably one of the worst deals I can think of. The recent Annington homes deal, supported by those on both sides of the House, was delivered at speed by this Government, and it saves this country and the taxpayer £600,000 a day, or £230 million a year. It puts us back in the driving seat of owning all our family accommodation. It allows us to renovate or rebuild as required over the next five to 10 years and long into the future. In the medium to long term, we have a once-in-a-generation, lifetime opportunity to rebuild all our accommodation.
Sadik Al-Hassan
May I wish a happy new year to you, Mr Speaker, to Members and to constituents in North Somerset?
Morale in our military hit record lows under the last Government, and I am proud that this Government have already delivered the largest pay rise for the forces in more than 20 years. Does the Minister agree that this housing deal is the next practical step in the action that this Government are delivering to improve service lives for dedicated personnel?
Al Carns
My hon. Friend makes an important point. I have lived in some of the accommodation and I have seen how bad it is, and this deal will allow us to change that. Over time we will have a chance, saving £230 million a year, to give the people who serve this country the deal they deserve when it comes to housing.
Mr Foster
During my service in the late ’80s, through the ’90s and into the early 2000s, I had the pleasure of having to live in military accommodation. Its poor condition was discussed almost weekly. Roll forward 20 years, and we are still having the same discussion. Can Ministers please assure me that they will now seriously get a grip of that and, through the strategic defence review, give some clear programme delivery dates for when we will deliver for our forces?
Al Carns
Absolutely. As part of the SDR, we will set out our new defence housing strategy. We will look at how we take Annington, build on it and improve the housing available for those who serve in our armed forces.
Lewis Atkinson
As a member of a forces family, I welcome the Government’s landmark decision to renationalise service housing. For too long, military families have been living in substandard accommodation. How will the Minister ensure that this investment leads to tangible improvements? In what timescales can our servicemen and servicewomen expect to see those improvements start?
Al Carns
We are buying back, we are breaking it down and we will build back up. That will be part of a comprehensive plan across the country and across 36,000 homes over time. It will look to deliver housing that is fit for those who serve and the family members who are often left behind when those individuals deploy. I have absolute confidence that we will deliver that, in conjunction with independent bodies as well as those in defence.
Sir Geoffrey Clifton-Brown (North Cotswolds) (Con)
The Minister has already referred to his successful £6 billion deal to repurchase the MOD housing estate from Annington. It will give members of our armed forces the opportunity to have their homes refurbished, which they have longed for, for a very long time. Has he managed to persuade the Treasury that he will need to provide further funds to pump-prime these improvements? If so, how will he strengthen the hitherto very poor management of our military housing estate?
Al Carns
As part of our new defence housing strategy, we will look at how we will manage that estate as a whole and whether we will do it completely differently. As part of the SDR, we will look at how we will pump-prime some of that to get building back across the whole defence estate, bearing in mind that there are 36,000 houses and some of them have been in situ for about 50 years and will need to be knocked down and rebuilt.
Richard Foord (Honiton and Sidmouth) (LD)
Under the previous arrangement between the Ministry of Defence and Annington, £100 million was released for accommodation upgrades in the first seven years of that arrangement. What due diligence was carried out ahead of the sale? What additional investment will be made in the married quarters that the Government have brought back into the MOD’s ownership?
Al Carns
This is one of the best deals that defence has done in a long time. It has bought back 36,000 homes, saving the taxpayer £600,000 a day or £230 million over a year. We are in discussions with the Treasury now about where that money goes and how it will be used in the future, but I assure the hon. Member that the rebuild plan will be within the defence housing strategy as part of the SDR.
Ben Obese-Jecty (Huntingdon) (Con)
Since October 2023, more than 5,000 Afghans eligible for support via the Afghan relocations and assistance policy have been moved into Ministry of Defence service families accommodation—both transitional and then settled service families accommodation—under Operation Lazurite. How many SFA houses in the defence estate are currently being used to house Afghan families? What is the plan for their onward movement once their three-year eligibility for settled service families accommodation has elapsed?
Al Carns
I thank the hon. Member for that really important question. We have a duty of care to those from Afghanistan who are now living in the UK and we are absolutely committed to delivering on that. I will write to him in due course on the specifics of his question.
Helen Maguire (Epsom and Ewell) (LD)
In 2023, there were over 5,000 reports of damp and mould in service accommodation. Members of the armed forces are willing to put their lives on the line to support the freedoms that we take for granted, so it is inconceivable that they and their families are forced to live in homes filled with damp and mould. Now that the MOD has agreed to buy back thousands of these family homes, will the Government commit to ensuring that all service family accommodation meets the minimum standards for social housing as set out in the decent homes standard?
Al Carns
We already do that. The reality is that a large proportion of these houses were built 50 to 60 years ago, so the thick insulation and double-skinned walls that we would see as commonplace just do not exist. The Annington deal is therefore such a good one, as it allows us to refurbish or rebuild as required.
Wera Hobhouse (Bath) (LD)
The Minister for the Armed Forces (Luke Pollard)
The Labour Government are delivering for defence by stepping up and speeding up support for Ukraine. In December, we announced an additional package of artillery, air defence and drones. The Defence Secretary holds regular discussions with his US counterpart on how best to support Ukraine, most recently on 16 November.
Wera Hobhouse
I thank the Minister for his reply. Last year, Bath and North East Somerset council entered into a formal agreement with the city of Oleksandriia, providing medical support as well as strengthening cultural and community ties. In talks with the incoming US Government, will the Minister ensure that they are aware of the enduring and deep solidarity that the British people feel towards the people of Ukraine in their effort to defeat a brutal aggressor?
Luke Pollard
I thank the hon. Member—my fellow south-west MP—for her advocacy of that as well as the people of Bath who have opened their homes to so many Ukrainian families, as have families right across the country. It is vital that we continue to support not only Ukraine to stay in the fight to protect its sovereignty and freedom but those Ukrainians in the United Kingdom and in Ukraine to ensure that they can go about normal life as much as possible. The Government support that work and will continue supporting Ukraine for as long as it takes.
Dan Carden (Liverpool Walton) (Lab)
The Secretary of State and the Minister have put Britain’s military production capability at the heart of the Government’s support for Ukraine. I wonder what opportunities the Minister spies for transatlantic co-operation in that regard. May I make a special plea that the whole defence team discuss plans for developing our industrial capacity with regional mayors so that jobs and factories can be set up and developed around the country, including in regions like my own?
Luke Pollard
It is vital that we continue to support Ukraine and build our industrial capacity in the United Kingdom and across the NATO alliance to ensure that Ukraine can fight not only tonight but tomorrow. Part of that is about increasing the industrial supply of not just UK manufacturers but indigenous manufacturers within Ukraine itself. Building that greater industrial capacity is something that the Government take seriously. That is why the Secretary of State and the Minister for Defence Procurement and Industry have published the outline of the defence industrial strategy. We will continue to work with partners at both national and international level—and additionally at a regional and local level—to ensure that we have the industrial capacity and skills required to restock our own supply and continue to support Ukraine.
Alan Strickland (Newton Aycliffe and Spennymoor) (Lab)
The Minister for Defence Procurement and Industry (Maria Eagle)
We are delivering for defence, boosting spending by £3 billion in real terms this coming financial year. I hope that more of our procurement spend can go to SMEs. The defence industrial strategy will set the conditions to unlock the full potential of SMEs, to seize future opportunities and ensure the growth and resilience of our defence manufacturing base, providing more good jobs in every nation and region.
Alan Strickland
The North East Technology Park in Sedgefield is home to many innovative defence businesses, producing satellite technology and biological and radiation detection equipment that is used by our allies across the world. Those businesses proudly contract directly with the Defence Advanced Research Projects Agency, NASA, the American Defense Department and other allied Governments, but too often they struggle with MOD procurement rules, which exclude SMEs. Will the Minister meet me and NETPark businesses to discuss how to remove the red tape that hits small businesses in my constituency and across the country that are designing and producing innovative defence supplies?
Maria Eagle
First, I would be happy to meet my hon. Friend and his North East Technology Park businesses as soon as possible. The Government recognise that SMEs face particular challenges, which I want to address. Through the defence industrial strategy we will reduce barriers to entry and foster a more diverse community of suppliers, including non-traditional SMEs and those that are developing future technologies. We will also send a clear market signal about our preference to grow onshore production capability.
Mark Pritchard (The Wrekin) (Con)
As part of the defence industrial strategy, does the Minister of State recognise the link between successful defence vehicle manufacturing, such as Rheinmetall BAE Systems Land manufacturing the Challenger 3 tank in my constituency, and the onshoring of barrel technology and defence engineering? Does she recognise the link between that skills cluster and the importance of companies such as RBSL having a future in manufacturing not just vehicles but barrels? I look forward to her visit to my constituency in the coming days.
Maria Eagle
I do not disagree at all. I look forward to visiting the right hon. Gentleman’s constituency and to seeing the potential of firms. He is completely correct that clusters of excellence and skill are the way forward. I look forward to visiting his constituency shortly.
Mr Calvin Bailey (Leyton and Wanstead) (Lab)
The defence sector supports one in 60 of our jobs in this country—more than 400,000 well-paid jobs that are central to this Government’s growth mission and to our nation’s security. However, the majority of those jobs are outside London and the south-east. Therefore, growth and—crucially—engagement with defence and security are inhibited for young people in constituencies such as mine. Will the Minister confirm that the key ambition of our defence industrial strategy will be to broaden access to the defence sector in every region, including constituencies such as mine?
Maria Eagle
I am happy to accept that point, and I agree. Plenty of jobs and skills will be needed around the country in every nation and region, so that we improve matters everywhere.
Mr Andrew Snowden (Fylde) (Con)
Christmas came early for the UK defence industry when Spain placed an order for 25 Eurofighters on 20 December, and Italy followed suit on the 24th. But there is still nothing from the UK Government on the 25 Typhoon jets that are needed for the RAF. Will the Minister spread some festive cheer into the new year, and give us an update on where the Government are with placing that order for 25 Typhoon fighter jets—a delayed Christmas present for the UK defence industry and the RAF?
Maria Eagle
I recognise the hon. Gentleman’s point. It is certainly true that exports are important, in addition to production for our own use. We are working very hard on the export campaigns. I cannot say any more than that at present, but I can assure him that we are working very hard. The rest of our spend on such matters is part of the SDR. Once that is completed, there will be conclusions. It might not be a Christmas present—I do not know when his birthday is—but a present some time later.
Mr Mark Francois (Rayleigh and Wickford) (Con)
On defence industrial strategy, the new amphibious multi-role support ships are several years away—a point the Armed Forces Minister obviously appreciated when, in opposition last January, he wrote to his local paper to say that scrapping HMS Albion and Bulwark would be bad for our national security, for the Royal Navy and for Devonport. When the Defence Committee looked at this issue a few years ago, it firmly concluded that the decision would be “militarily illiterate”, yet today the Ministry of Defence is all for it. Even if the Minister for Defence Procurement and Industry does not agree with the Defence Committee, does she at least agree with the Armed Forces Minister that these vital ships should be retained?
Maria Eagle
Neither of the ships has been at sea for years—one since 2022 and the other since 2017—and neither was due to go back out to sea before their out-of-service date. The question of who might be said to have scrapped them is moot; the ships have not been scrapped, but we took the tough decision in November to retire ageing capabilities, so that we can save the money for dealing with the threats that we will face in future.
Manuela Perteghella (Stratford-on-Avon) (LD)
The Minister for Veterans and People (Al Carns)
The Prime Minister has made it clear that ensuring that veterans and their families can access support—including for housing—is a priority; he mentioned that in his speech at party conference. He has also announced that veterans will be exempt from the local connection test for social housing in England, and committed an additional £3.5 million to continuing the reducing veteran homelessness programme, including Op Fortitude.
Manuela Perteghella
The transition from military to civilian life is a critical moment for many veterans, but too often, those with complex mental health issues fall through the cracks, especially when it comes to accessing housing. The armed forces covenant is an excellent positive step forward, but its voluntary nature means that not all veterans will benefit equally. Will the Minister commit to reviewing the transition process, and particularly mental health services provision, to ensure that all veterans receive more comprehensive and tailored support?
Al Carns
The career transition pathway that has just been set up is a great example of how we are helping those leaving the services to transition into civilian life. Op Courage, in particular, has had more than 35,000 referrals; it is for anybody with mental health issues caused by their service. I recommend going on to gov.uk and looking at the services available, as they are pretty ample.
Amanda Martin (Portsmouth North) (Lab)
The defence sector provides well paid jobs across my city and constituency, and across the country. With 10,000 adults in the constituency on the minimum wage, will the Minister help me to work with the Department for Education to ensure that kids in my city get opportunities to work in this brilliant sector?
Al Carns
I thank my hon. Friend for a very important question. I would like to talk further about this. We have been working with the Department for Education—
Mr Speaker
Is the Minister happy to answer the question? I do not quite see how it links to the subject, but if he is happy—
Rebecca Smith (South West Devon) (Con)
The Secretary of State for Defence (John Healey)
On this first day after the recess, I thank all armed forces personnel who worked over Christmas, including the nearly 10,000 personnel deployed overseas, and the crew of HMS Somerset, who were recalled on Christmas day to shadow Russian vessels around our shores. I also congratulate the many exceptional servicemen and women and veterans recognised in the new year’s honours list for their outstanding contributions, including the Minister for Veterans and People. My new year’s message to everyone working across defence is that this Government will continue delivering for defence throughout 2025, making the UK secure at home and strong abroad, stepping up support for Ukraine, boosting the UK defence industry, strengthening ties with allies and improving service life for armed forces personnel and their families.
Rebecca Smith
We have long-standing, cross-party support in Plymouth and Devon for ensuring the future of the Royal Marines, including 42 Commando in my constituency. Given the amphibious assault capability gap that we have as a result of scrapping—or, should I say, retiring—Devonport ships HMS Albion and HMS Bulwark, what commitment can the Secretary of State give that the green light will be given to building six multi-role support ships, and can he give a firm indication of when he hopes they will be in service?
John Healey
HMS Bulwark and HMS Albion were not genuine capabilities. The Minister for Defence Procurement and Industry made that clear. Neither ship was set to put to sea again before their out-of-service date. This decision allows us to focus resources on where they need to be: on the capabilities that we need to support our Marines and deal with our adversaries.
Harpreet Uppal (Huddersfield) (Lab)
The Minister for Veterans and People (Al Carns)
We owe a debt to our nuclear test veterans, who delivered their service in a courageous and honourable way. I have already committed to looking into the records issue in detail, and to continuous engagement with all the charities and nuclear test veteran groups.
James Cartlidge (South Suffolk) (Con)
At every turn, Ministers have refused point blank to tell us how much their Chagos deal will cost British taxpayers. Now we know why: the Mauritians want £800 million a year. Whatever the figure is, will the Secretary of State tell us what percentage of the cost of leasing back a base that we currently own will come from the Ministry of Defence budget?
John Healey
I regret the Conservative carping over the Diego Garcia deal. The negotiations were started by Conservative Ministers, who conducted 11 rounds of negotiations. The agreement safeguards the effective operation of the joint UK-US base for at least 99 years. It is supported by US agencies and is welcomed by India, the African Union and the UN Security Council—almost everyone, it seems, except the Conservatives.
James Cartlidge
My apologies. I am, like you are Mr Speaker, very passionate on this subject. We see this as a terrible deal. That is why we would have never signed it. The incoming US President opposes the deal, the Mauritians are seeking to renegotiate it, and by any measure it is terrible value for money for the over-taxed British public. Does the Secretary of State really think that it is in our national interest to spend hundreds of millions of pounds leasing back a military base that we currently own, instead of spending every penny of that money on our armed forces in the UK?
John Healey
The agreement means that the base will be undisputed and legally secure for the first time in 50 years. The US Defence Secretary described it as an “historic agreement” and said:
“it will safeguard the strategic security interests of our two nations and our partners in the Indo-Pacific region”.
Paul Davies (Colne Valley) (Lab)
Al Carns
I absolutely agree. This is a once-in-a-lifetime opportunity to change housing for our service families. It will save taxpayers £600,000 a day, and £230 million over the year. It gives us an opportunity to build back over the medium to longer term, and to deliver the deal that those families deserve.
Helen Maguire (Epsom and Ewell) (LD)
We face serious national defence vulnerabilities, with no land-based anti-ballistic-missile systems to protect critical infrastructure, military bases or population centres. Recent suspected sabotage of undersea cables in the Baltics highlights the hybrid threats for which we must also prepare. What steps is the Ministry of Defence taking to address the UK’s deficiencies in anti-ballistic-missile defences, and how are we preparing for potential hybrid attacks on our critical infrastructure?
The Minister for the Armed Forces (Luke Pollard)
It is important that the strategic defence review is able to report its recommendations. It is certainly true that we inherited armed forces with capability gaps, falling morale and a recruitment and personnel crisis, which is why the SDR is so important in setting out a clear direction for the future. This Government back defence and will continue to do so, ensuring that those capability gaps are filled.
Kirsteen Sullivan (Bathgate and Linlithgow) (Lab/Co-op)
Al Carns
The essential role played by women throughout both major wars in delivering an industrial powerhouse to support our armed forces is not lost on the Government. I am happy to take this matter offline and discuss it in due course.
Richard Tice (Boston and Skegness) (Reform)
John Healey
The hon. Gentleman has put his finger on a long-standing, deep-running weakness, namely a procurement policy under the last Government that did not recognise the UK steel industry as a strategic industry and was content for the amount of UK steel sourced for some new ships to be in the single figures. [Interruption.] Under previous procurement Ministers, the proportion was 4%. We will change that: the SDR will set out a plan to not just boost UK security, but strengthen the UK economy.
Tristan Osborne (Chatham and Aylesford) (Lab)
The Minister for Defence Procurement and Industry (Maria Eagle)
Yes, she will make a commitment to visit the site. I agree with my hon. Friend: our defence industrial strategy will enhance the incentives for long-term investment in the UK defence sector. It will encourage investment by private firms, alongside public money, align the imperatives of national security, and ensure that we have the necessary skills.
Pippa Heylings (South Cambridgeshire) (LD)
Luke Pollard
It is certainly true that this Government inherited a recruitment and retention crisis from the Conservatives. Morale was falling. That is why we are renewing the nation’s contract with those who serve. There will be more announcements about that in due course.
Mr Alex Barros-Curtis (Cardiff West) (Lab)
Luke Pollard
As the Prime Minister has made clear, Britain is back on the world stage, and we are deepening our defence relationships with our European allies. That means continuing to implement the Trinity House agreement between the UK and Germany. There is also the new UK-Estonia road map, and there is more to come: we will refresh the Lancaster House agreement with our friends in France as well.
Olly Glover (Didcot and Wantage) (LD)
Luke Pollard
We have laid out clearly that this Government will stand with Ukraine for as long as it takes. That means committing £3 billion a year, as we have done, to make sure that the Ukrainians have the equipment and ammunition they need to stay in the fight, as well as deepening our defence relationships with them. We are taking that across the NATO alliance to all NATO members, and we will continue to stand with Ukraine for as long as it takes.
Sam Carling (North West Cambridgeshire) (Lab)
Al Carns
I completely agree with my hon. Friend. The defence housing strategy will be a medium to long-term strategy and will be published, in line with the SDR, in the spring.
David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)
I refer the House to my entry in the Register of Members’ Financial Interests. Given the Secretary of State for Defence’s previous remarks, can he set out for the House exactly what discussions there have been between Ministers and the incoming Trump Administration on the future of the Diego Garcia base?
John Healey
As the right hon. Gentleman knows very well, the system in the US is very different from ours. The Administration who are in place at present are in place until inauguration day on 20 January. That will be the point at which we in the UK Government will start to pick up direct discussions with the incoming Administration. The US is our closest security ally, and we will work with them to ensure that that continues.
Andrew Lewin (Welwyn Hatfield) (Lab)
Since Putin’s unprovoked invasion of Ukraine, our European Union allies have contributed €47.3 billion in funding to the Ukrainian military. One of those integral allies is Poland, which has just assumed the presidency of the EU Council, having started on 1 January. Will the Minister set out in a little more detail how we are working in lockstep with crucial allies like Poland at this dangerous time for the continent?
Luke Pollard
My hon. Friend is absolutely right to suggest that it is vital to deepen our relations with our European friends. Poland is a key European ally for us, not only in defence exports but in operational deployments. I have visited Poland twice recently, including to see the amazing work of the British Army in Operation Stifftail, which used our Sky Sabre system to help to defend Polish airspace. There will be further such joint deployments of our armed forces in due course.
Sir Julian Lewis (New Forest East) (Con)
It sounds like the Government are not very keen to talk about Diego Garcia with President Trump, but when people as diverse as President Trump and Lord Neil Kinnock agree that NATO countries should be spending between 3% and 4% on defence, would it not be sensible to take them seriously?
John Healey
On Diego Garcia, Members will have the chance to scrutinise the detail of any treaty once it comes before the House. Just as the previous Government did, we made sure throughout the negotiations that the US Administration were fully informed, fully briefed and fully content with the steps that we were taking.
Louise Jones (North East Derbyshire) (Lab)
The procurement of Ajax wasted hundreds of millions of pounds—money desperately needed in my North East Derbyshire constituency. Can the Minister update me on the progress made in learning the lessons of that failure and implementing the findings of the Sheldon report?
Maria Eagle
Yes. My hon. Friend will know that the report was produced under the previous Government. Its findings were set out under the previous Government, and I think they announced that all the necessary steps to implement all 24 recommendations—15 were accepted and nine were accepted in principle—had been completed. We need to continue to learn the lessons and make sure that such problems do not arise in other programmes.
Dave Doogan (Angus and Perthshire Glens) (SNP)
The cost of the 10-year equipment plan for the Defence Nuclear Organisation stood at £44 billion in 2019. In 2022, it went up by 27% to £60 billion, and in 2024 it inflated by 62% to £99.5 billion. Can the Secretary of State reassure us that the MOD has not lost the run of itself on this worst-of-all defence procurement debacles? What personal commitment can he give the House that he has the foggiest idea what to do about it?
John Healey
I can absolutely give the hon. Gentleman that assurance. I can also tell him that this is a national enterprise of the utmost importance that maintains the underpinning security for this nation, as it has done over decades, and that the management of our nuclear enterprise and the budget controls are in place and stronger than they have been for years.
Douglas McAllister (West Dunbartonshire) (Lab)
The naval base at Faslane and companies such as BAE Systems support thousands of jobs in my constituency. Does the Minister agree that we need to grow an integrated, innovative and resilient defence sector that will address problems such as skills shortages and the need for strategic long-term partnerships?
Lincoln Jopp (Spelthorne) (Con)
When the Secretary of State appeared at the Defence Committee recently, he was sitting alongside his permanent secretary when the permanent secretary announced that it was his aspiration to reduce the number of MOD civil servants by 10% within this Parliament. Does the Secretary of State recognise and welcome that aspiration?
John Healey
Yes, and I trust that the hon. Gentleman does too.
Tom Hayes (Bournemouth East) (Lab)
The Veterans Minister and I recently visited Bournemouth War Memorial Homes, a specialist social housing provider for veterans in my constituency. Will the Minister outline what the Government are doing to support housing providers to buy or build homes for heroes across our country?
Al Carns
I thank my hon. Friend for the visit to Bournemouth to see that exemplar of how to house veterans. The Prime Minister has just announced £3.7 million of funding towards veterans’ housing and there will be more to come in due course.
Julia Lopez (Hornchurch and Upminster) (Con)
There were reports over the weekend of NATO worries that the UK is not contributing enough to the European defensive shield. That leaves us vulnerable to a missile attack. I hear what the Minister has said about the strategic defence review, but what assurance can he provide that he will look at our defence spending commitments with sufficient speed to provide good enough defence for our country?
Luke Pollard
The hon. Lady is right to raise the capability gaps that this Government inherited from the Government she served in. The strategic defence review is looking at those capability gaps and at what is needed to protect ourselves and our allies in the future. When that is set out later in the spring, she will be able to see how we plan to address those gaps, ensuring that we support British industry while also addressing the security challenges that we and our allies face.
Oliver Ryan (Burnley) (Lab/Co-op)
As a great supporter of the British-American alliance, I am disappointed to have to ask this question, but, given some of the recent tweets from people associated with the incoming US Administration, what assessment has the Secretary of State made of the UK’s exposure of our defence capabilities, given that there may be some changes in the White House?
John Healey
The US is the closest ally of this country, and this country is the closest security ally of the US. That has been for case the decades—it has withstood the ups and downs of the political cycle on both sides of the Atlantic—and we as a Government will work closely with the incoming US Administration.
Robin Swann (South Antrim) (UUP)
Defence spend with Northern Ireland small and medium-sized enterprises last year accounted for only £3 million. What will the Secretary of State and the Minister do to proactively increase that spend with Northern Ireland SMEs?
Maria Eagle
The hon. Gentleman makes an important point. I hope that our defence industrial strategy, in enabling SMEs to access contracts and work for the MOD more easily, will increase that number substantially.
Jayne Kirkham (Truro and Falmouth) (Lab/Co-op)
Will the Minister agree to meet me to discuss the figures for the incidence of blood cancers and sarcomas in veterans and current service personnel who have crewed particular military helicopters?
Al Carns
Given the concerns around exposure to exhaust fumes and the importance that we place on safety, the MOD is this month initiating the testing of the exhaust emissions of in-service helicopters to ensure that we are meeting our duty of care for personnel. Nevertheless, I would also like to meet my hon. Friend to discuss the issue further.
Nick Timothy (West Suffolk) (Con)
Following the Christmas day attack on Finnish sea cables, what assessment has the Defence Secretary made of the threat to British interconnectors? Which individual Minister is ultimately responsible for their security?
John Healey
The Finnish investigation into what caused the damage to the Estlink 2 cable is continuing, but many analysts conclude that it is likely that the Eagle S was the cause. That reinforces the case for Operation Nordic Warden, which I confirmed to the House in response to an earlier question. It is being run from the Northwood standing joint forces headquarters and will cover a number of areas of interest, including areas where we have British undersea cables.
Graeme Downie (Dunfermline and Dollar) (Lab)
I recently visited HMS Swiftsure at Rosyth in my constituency, a former Royal Navy submarine now being safely and securely dismantled and recycled by Babcock, as a pilot project of the submarine dismantling programme. Will the Minister provide an update on the programme, which could secure hundreds of jobs in Dunfermline and Dollar by dealing with similar submarines at Rosyth over the coming decades?
Maria Eagle
My hon. Friend will be aware that despite the fact we have had nuclear submarines since 1980, we have never dismantled one, so there is a lot of work to be done. What is happening with Swiftsure is very encouraging and will hopefully provide many jobs in dismantling nuclear submarines. I hope my hon. Friend will be happy with that reply.
Health and Adult Social Care Reform
(1 year, 7 months ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Mr Speaker
We now come to the first statement. I am sure there must be something left to say.
The Secretary of State for Health and Social Care (Wes Streeting)
A happy new year to you, Mr Speaker, and to everyone across the House. With your permission, I will give an update on health and adult social care reform.
I start by paying tribute to the NHS and social care staff who worked throughout the Christmas break, including by staffing our hospitals, ambulance services, care homes and call centres on Christmas day and throughout the new year. From visiting hospitals and residential care homes in the south-west of England, Essex, London, South Yorkshire and the north-west over the past two weeks, I know the extent of the pressures they are dealing with. They are going above and beyond to keep the NHS standing, to provide people with the social care they need and to give patients and care users the best care they possibly can against the most challenging backdrop.
We have seen more than three times as many patients hospitalised with flu this winter compared with last year, in a service with no slack left to give. Since coming into office, the Government have been doing everything we can to prepare the NHS for winter, including by ending the resident doctors’ strikes. This is the first winter in three years when staff are on the frontline, not the picket line. The Chancellor made an additional £1.8 billion available in-year to fill the black hole left by the previous Government, and we introduced the new respiratory syncytial virus vaccine to protect more than 1.2 million people against the virus.
But I am not going to pretend for a second that the experience of patients this winter is acceptable. The Government have been honest about the state of the NHS since the election, and we will continue to be. The NHS is broken but not beaten. It will take time to fix, but it can be done. That is why the Chancellor made an additional £1.8 billion available in-year to fill the black hole left by the previous Government and to enable us to deliver on our first steps to cut NHS waiting times. That is why we are undertaking fundamental reform, and it is why we are acting on social care.
These are the honest facts. The social care system in this country is failing, leaving hundreds of thousands of disabled and elderly people without the care they need. The failure of social care is piling enormous pressures on the NHS. In November, more than 12,400 hospital patients a day were well enough to leave but had to stay overnight because they were not able to be discharged. We have an ageing society: by 2050, there will be 4 million more people aged 65 and over in England. If we do nothing, social care costs are expected to double over two decades.
Of course, there is plenty of blame to go around. In 2009, when Andy Burnham established cross-party talks on social care, the Conservatives pulled out and leaked details of the talks to attack Labour. In 2017, it was Labour who torpedoed Theresa May’s proposals. And in 2022, the right hon. Member for Richmond and Northallerton (Rishi Sunak) as Chancellor delayed Boris Johnson’s cap on care costs, and then defunded them as Prime Minister. There has not been a shortage of good ideas in the past 15 years, but a lack of good politics. It is time all of us across the House do things differently.
I have written to my opposite numbers and the leaders of all UK-wide parties represented in the House to invite them to help break out of the cycle of political failure. I hope all of us across the House will put aside our ideological and partisan differences, and work together on this, to finally find a way through to a long-term plan that can build the broad consensus we need.
We do not need to agree on everything, but in April we will launch an independent commission on building a national care service. I am delighted that it will be headed by one of our country’s leading social reformers, and Whitehall’s greatest doer, Baroness Louise Casey. Baroness Casey has served Labour, Conservative and Liberal Democrat Governments. She is a trusted, independent figure, who will take views from all parties and, crucially, the public as she seeks to build a cross-party and national consensus on the future of social care. She will get things done. Her first report will be published next year, making a series of recommendations that can be implemented straight away throughout this Parliament, and her final report will come later in this Parliament.
In the meantime, we are stabilising the social care system today. We have legislated for the first ever fair pay agreement for social care, to tackle the workforce crisis—the 131,000 vacancies we see today. In the Budget, the Chancellor provided the biggest increase in carer’s allowance since the 1970s, worth £2,300 a year to family carers, and an extra £3.7 billion for local authorities.
On Friday, I visited the home of Keith and Elaine in Carlisle. I saw at first hand how extended doorways and the installation of accessible kitchen and bathroom facilities have changed their lives, thanks to the disabled facilities grant, allowing them to live with renewed dignity, independence and happiness. That is why I announced last week the immediate release of £86 million through the disabled facilities grant, to provide an extra 7,800 home adaptations before April, changing the lives of thousands more disabled people for the better, just as Keith and Elaine have experienced.
We are not hanging around on reform either. We are introducing new standards to help people who use care, their families and providers to choose the most effective new technology as it comes on the market. We are joining up care and medical records, so NHS and care staff have the full picture they need to provide the best possible care. And we are training care workers to perform more health interventions to help people stay well and at home. A lot done, a huge amount more to do and, if this House gets this right, the best is yet to come.
Turning to the elective reform plan the Prime Minister has launched today, the Government inherited NHS waiting lists at 7.6 million. The NHS standard, that patients should wait no longer than 18 weeks for treatment, has not been met for a decade. Millions of patients are forced to put their lives on hold while they wait. In his investigation, Lord Darzi listed the causes of this crisis: the undoing of new Labour’s reforms, the disastrous top-down reorganisation, and slashing GPs and community health services, all of which have led to a dramatic drop in hospital productivity. Lord Darzi has diagnosed the condition; now this Labour Government are prescribing the cure.
In November, the Prime Minister set out the Government’s plan for change—a plan to dig this country out of the hole it was left in and an act of resistance against the status quo of managed decline. It committed to cutting maximum waiting times from 18 months today to 18 weeks by the end of this Parliament. Today, we are setting out how we will hit that ambitious target, so that once again the NHS is there for us when we need it. This will demand faster improvement than even the last Labour Government achieved. That means doing things differently. It had to be a plan for investment and reform. Investment and reform is what Labour promised before the election. Investment and reform is what we are delivering. Our elective reform plan will cut waste and inefficiency, ramp up the number of appointments, scans and operations that the NHS performs, and give NHS patients greater choice, control and convenience.
Any patient using the NHS can see the waste and inefficiency in the service when they use it. Staff feel it holding them back every day. When the Government announced significant investment in the Budget, I said that it would come with reform, so that every pound was well spent, and here it is. Resources will be diverted from hospitals to GPs, to get hundreds of thousands more patients cared for faster in the community. Patients will have the choice of whether they want or need follow-up appointments, saving a million pointless appointments a year. GPs will be able to directly refer patients for tests and scans, cutting out the middle man and speeding up diagnoses for patients across a wide range of conditions. For years, restaurants have been texting customers reminders of their bookings, giving them the chance to cancel or rearrange, to cut down on no-shows. The NHS will learn from the hospitality sector, do the same for patients, and cut around a million missed appointments every year as a result.
In opposition, we said that investment in new and more productive ways of working would make a significant dent in waiting times. Today, we are announcing 17 new and expanded surgical hubs to run like Formula 1 pitstops and bust through the backlog. Community diagnostic centres will open at evenings and weekends so that patients do not have to take a time off work for their appointment, and can get diagnosed faster. We are rewarding trusts that cut waiting times fastest with extra capital investment as an incentive, and we are publishing a new agreement with the independent sector—the first of its kind for 25 years—to cut waiting times.
Over the past 14 years, a two-tier healthcare system emerged in this country. People who can afford it are increasingly going private to skip the queue, while those who cannot are left behind. Working people are going into debt, and others are running fundraisers to pay to get an operation. Those stories belong in pre-war Britain. They should shame the Conservative party. I am determined to end two-tier healthcare in this country, so that whether you are the richest or poorest person in Britain, you get timely, quality treatment, free at the point of use. This new agreement will see more NHS patients able to choose to be treated in a private hospital where there is capacity, paid for by the state. More capacity will be available for people in working-class areas of the country, and for women stuck on gynaecology waiting lists. Where we can treat working people faster, we will, and we make no apology for doing so.
Working-class patients in this country deserve the same choice, control and convenience as the wealthy expect—indeed, as we all expect from other apps and services that we use every day, but not the NHS. That is why we are also modernising the NHS app to put patients in the driving seat for their own care. If customers can choose when their Deliveroo meal will arrive, and be kept informed until it is dropped off, why should patients not be afforded the same service by the NHS? With this plan, they will be. Patients will be able to manage their appointments, book tests and scans, view results as soon as they are ready, and choose where they will be treated. We will cut down on letters that arrive in the post after an appointment, and give power back to the patient.
In the past six months, we have ended the resident doctors’ strike and invested billions more in our health service, with the biggest investment in hospices and end of life care for a generation. We are delivering investment and reform in general practice to fix the front door to the NHS and bring back the family doctor, and we have started to get NHS waiting lists falling. This plan for investment and reform will press down harder on the accelerator and will change our NHS and the experience of millions of patients. It will put the NHS on the road to recovery, and I commend this statement to the House.
Edward Argar (Melton and Syston) (Con)
I am grateful to the Secretary of State for his typical courtesy in early sight of his statement, as well for his call last week. Indeed, it was earlier sight than I am used to because I was able to read most of it in the media before coming here, which was not unhelpful.
I echo the Secretary of State’s comments in thanking and paying tribute to NHS and social care staff up and down the country, including those in my university hospitals of Leicester NHS trust, GPs and, indeed, all those in Chorley hospital, Mr Speaker, for all they have done over the festive period. They work full-on day in, day out every day of the year, but they particularly feel the pressure over the festive period when they are not able to spend it with their families, so it is important that we across the Chamber share our recognition of that.
The Secretary of State set out clearly the challenges facing the system. We all know that clinical care, the NHS and social care must work well and as a whole for our health and care system to function, so it is right that his statement addresses both those issues. He also highlighted the challenges we face as an ageing society. We are all living longer, which is a good thing, but that brings challenges of care and more complex needs. Of course, that comes on top of the ongoing challenges of the legacy of the pandemic, which are still with us in many ways.
In his comments, the Secretary of State referred to previous reforms. He opted not to reflect another point in Lord Darzi’s report: his positive remarks about our 2022 reforms, which the Secretary of State knows I took through this House and which laid the foundations on which he is now able to build. Given the serious and cross-party work we have done certainly on social care, I highlight that the challenge is real, and we must address both challenges swiftly.
Before turning to the long term, I turn to the immediate and ask the Secretary of State a few questions about winter and the challenges the NHS is facing. We heard from the Minister before Christmas about the work being done for extra co-ordination and new data, but what extra capacity in beds specifically for the winter period has the Secretary of State put in place to help ease pressure? What additional capacity has he put into A&E? We always recognised that winter is challenging, and we always put in extra resource, support and capacity, so I would be grateful for an update.
I would be grateful for an update from the Secretary of State on the pressure being felt in respect of the “quad-demic” of various challenges faced by the sector. Also, how many critical incidents have trusts declared since 1 December? I would be grateful if he could update us on the pressures being felt and the response to them in the light of the winter weather. In my Melton and Syston constituency in Leicestershire and in many constituencies across the country, we have seen extensive flooding, which has had an impact on our ambulance services in particular.
Turning to reform and elective recovery, I want to support the Secretary of State where he is doing the right thing, and it is important that he is keen to pursue a bold and innovative agenda. It is in all our interests that he is bold, but I call for him to be more ambitious. Those are not words often spoken about him, and I suspect certainly not in No. 10, but I call for him to be bolder and to go further. That is because, as with so much from the Prime Minister with multiple relaunches of previous announcements, what we see here is yet another relaunch of a previous announcement. The difference is the former Secretary of State Sir Sajid Javid’s announcement from 2022 has been reheated and re-served up today. We delivered 160 community diagnostic centres with 9 million additional appointments, and we delivered 18 surgical hubs. How will the Secretary of State’s plan go beyond that? We worked with the independent sector to allow it to be used to help tackle backlogs. We improved technology and the kit available, with £6 billion of investment. The NHS app created during the pandemic was designed and redesigned by my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay) and his team to allow for regular updates. Again, it is right that the Secretary of State is updating the app, but how is he radically changing what was already in place? I certainly already receive text updates—as, I suspect, do others—on treatments and appointments, so my challenge to the Secretary of State is this: what is he doing that is fundamentally different?
The key underpinning point in the former Secretary of State’s plan was on workforce, because none of this can be delivered without the staff to deliver and interpret tests. He set out his plan to grow the workforce, and we have record numbers of doctors and nurses, and increased medical school places. What is this Secretary of State’s plan to grow the workforce and deliver on his ambitions?
Turning to social care, the Secretary of State will know—because I have said it publicly—that I will work constructively with him and the commission. He is right to highlight the challenges that Governments of all complexions have faced, including a Royal Commission, two Green Papers and a comprehensive spending review that did not deliver under Tony Blair and Gordon Brown. Similarly, Theresa May’s reforms did not deliver. We proposed reforms that were due to come in this year, but the Chancellor scrapped them. I think it is important that we look to the future and at how we can work constructively on social care.
I say to the Secretary of State that we will enter into discussions with him and the commission in that spirit, but I challenge him on the pace of his ambitions. The sector is already under pressure, and that has been added to by the national insurance increases, which it does not yet know how it will pay. The real challenge for him is: why 2028? The sector is crying out for a faster pace—be bolder; be more ambitious—and we will work with him to deliver it. It takes a year-plus to deliver a diagnosis—we know the challenges. He has had 14 years in opposition; he should have a plan now.
We will call out the Secretary of State when he gets it wrong or simply re-announces what is already happening, but he is right in his approach to social care and finding a way forward, and we will work constructively for the good of patients and all our constituents. Many of them already feel let down by promises broken by the Labour party over just the past six months, so I ask him not to break this promise, and to work with us, across the House, to deliver the change that our constituents deserve and expect us to work on together to deliver.
Wes Streeting
It seems to be the Conservative line across the board now to say, “You’ve had 14 years in opposition, so why haven’t you sorted it all out in six months?” I say gently that the Conservatives had 14 years in government, and it will take longer than six months to clean up their mess. Honestly, their contributions to discussions in this House might have more credibility and a stronger landing zone if they at least acknowledged their part in the deep mess and malaise that they have created over the past 14 years.
None the less, on social care, I very sincerely and warmly welcome the Conservative party’s support for the independent commission. It is important, as a matter of principle, to try to establish in broad terms the level of consensus about what social care should look like and how it should be delivered to meet the needs of older and disabled people in the 21st century, with changing demography, changing challenges, changing pressures and a changing pace of technology, and about the balance of provision between the individual, the family and the state, and the balance of financial contributions for social care between the individual, the family and the state.
Of course, those issues will inevitably be contested across the party political divide from one election to the next, but just as we have had broad consensus on the national health service since 1948, just as we have had broad consensus on state education since Rab Butler’s reforms, and just as we have mostly had broad consensus for much of the past century on how public services should be delivered, so too should we try to establish the same consensus on social care. That is not to say that we should agree on everything, but we should agree on as much as possible, because whether it was Gordon Brown and Andy Burnham in 2010 or Theresa May in 2017, we can see the extent to which party political wrangling, rancour and sometimes opportunism has sunk well-meaning attempts to grasp the nettle of reform.
On the question of pace, I reassure people that in our first six months we have already legislated for fair pay agreements, delivered the biggest expansion of carer’s allowance since the 1970s, and immediately injected £86 million into the disabled facilities grant, with another £86 million to follow from April—£711 million in total over the next year—as well as the increased spending power for local government in the Budget and £880 million for social care specifically. With respect to the people who are saying, “Go faster”, I urge them to bear in mind that we have already done quite a lot in six months. We do not pretend that we have solved all the problems—we have not nearly solved all the problems—but that is not a bad start for a Government who are determined to show that we understand the pressures in social care today and are willing to deliver.
The Dilnot proposals were very good technical responses to a question that Andrew Dilnot was set by David Cameron, but we should reflect on why it was that every single Prime Minister since Lord Cameron, including Lord Cameron himself, did not implement those reforms. There has always been something else in health and social care that has been more pressing and urgent. I am sure that Baroness Casey will consider the Dilnot proposals alongside all the other challenges and potential solutions to the wider issues in social care, but we are determined to respond at pace. That is why the first phase of the Casey commission will report next year, setting out an action plan throughout this Parliament. I hope that we can achieve broad consensus on those actions too.
Turning to the winter situation, the right hon. Gentleman has asked what capacity there is. According to the latest figures, there are 1,300 more acute beds this year than last year. Of course, those figures flex up and down depending on pressures, but the pressures are enormous. The number of beds occupied by flu patients is much higher than this time last year—somewhere between three and four times higher. The number of adult beds closed due to norovirus has reduced in the latest figures, but it is still above last year, when 485 beds were closed—the latest figure is 666. On ambulance responses, we have seen many more call-outs this year. There has been a 3.8% increase in emergency admissions compared with the same period last year, with the highest November on record for A&E attendances. Ambulance response times are nowhere near where we would want them to be because of the enormity of the pressure, which is why I have been out on the frontline, including over the Christmas period. We are not just looking at what we can do to mitigate challenges this year; we are already beginning to plan for next year, because I want to see year-on-year continuous improvement in urgent and emergency care.
I now turn to the challenges on the reform plans we have proposed and set out today. Starting with the workforce, one of the reasons we have emphasised the importance of not just investment but reform is the need to free up the staff capacity that we already have in the NHS to best effect. That means dealing with the number of non-attendances by sending reminders to patients and giving them ease and convenience in rebooking. It is why we are getting rid of unnecessary, low-clinical-value out-patient appointments, with the consent of patients in every case. It is why we are asking general practitioners to do more to manage cases in the community with more advice and guidance, and funding them to do so, working with colleagues in secondary care to ease pressure on hospitals.
Today’s reform plan answers the challenge we have heard from people across the NHS: how do we tackle the elective backlog without doing so at the expense of general practice, urgent and emergency care, community care or social care? The truth is that this is a systemic challenge, and we will only be able to deal with the challenge in the elective backlog by also acting on urgent and emergency care, general practice, community care, and delayed discharges in social care. We are taking a system-wide approach to meeting this essential target.
A number of things are different from under the previous Government. For example, on the deal with those in the independent sector, giving them the stability and certainty of working with this Government gives them the confidence to open and invest in new capital estate and new kit, particularly in parts of the country that are relatively underserved by the independent sector. We have insisted they do that with their own staff and resources, and that they put their money where their mouth is in relation to training new staff to deal with some of those pressures. That is how we will ensure that we will not be taking Peter from the NHS hospital to treat Paul up the road at the independent hospital.
Finally—I am happy to take more questions on the detail of the plan—the shadow Secretary of State asked what is different from 2022? In fact, I think he asked me to commend my predecessor Sir Sajid Javid for his work in 2022. In the bipartisan spirit of the new year, let me commend the work that he and Sir Sajid Javid did in trying to undo Lord Lansley’s disastrous top-down reorganisation, and that was a very good thing to do. There will be a very big difference between this Government and our Conservative predecessors: real delivery, shorter waiting times and an NHS fit for the future.
Deirdre Costigan (Ealing Southall) (Lab)
Does the Secretary of State agree that his plan to transform adult social care services has already started with Labour’s Employment Rights Bill ensuring that social care workers will get fair national pay and conditions, and increased access to training and progression? Does he further agree that we will never have a quality social care service in this country if we do not value the people delivering it properly, as this Labour Government intend to do?
Wes Streeting
My hon. Friend is absolutely rightly. The Employment Rights Bill, introduced in our first 100 days, contains provisions for a new fair pay agreement for care workers, and who better to be leading the charge on that than the care worker turned Deputy Prime Minister, my right hon. Friend the Member for Ashton-under-Lyne (Angela Rayner).
Helen Morgan (North Shropshire) (LD)
I add my thanks to those of the Secretary of State and the shadow Secretary of State to all those who worked in our health and care services over Christmas and the new year.
Our health and social care system is in crisis, so the Liberal Democrats are broadly supportive of the measures that the Government have announced today. However, we do have some concerns, not least that action on social care may arrive too late and that the focus on elective care may come at the expense of emergency care. The Liberal Democrats have long called for cross-party talks on social care, so we are glad that the Government have listened and we look forward to working constructively with the Secretary of State and other UK-wide parties as the review develops. However, carers, care providers and councils are on the brink of bankruptcy and they need solutions right now, not in three years’ time. There have been many such reviews, and what is needed now is action on the recommendations they have made.
It is absolutely crucial that waiting times for elective care are cut radically, so the action announced today to speed up scans and treatment is very positive. A waiting list of more than 6 million people is one of the worst legacies left by the Conservatives, but those legacies include overcrowded A&Es and unacceptable ambulance delays, which can mean the difference between life and death, as people in North Shropshire know only too well. Emergency care is under immense pressure at the moment—one visit to Shrewsbury hospital demonstrates that—and we need bold action if we are to ensure that this is the last ever winter crisis.
As the MP for a rural area, I hear every week from constituents suffering because of the crisis, so they will be following today’s developments closely. Many of my constituents are elderly—far more than average—and they are the people most likely to need the NHS and the most likely to be digitally excluded. According to Age UK, around 29% of people aged 75 and over do not use the internet, and around a third do not have a smartphone. They deserve as much choice and control as everybody else, so can the Secretary of State outline how those without access to the NHS app will be able to benefit from the same options and information as those who do have access?
Will the Secretary of State consider fast-tracking the social care review so that the sector can get the urgent attention it needs? Will he commit to rescuing our emergency services by supporting Liberal Democrat calls to make the NHS winter-proof with a new winter taskforce that builds resilience in hospital wards, A&E departments and patient discharging? Finally, will he define what a working-class area is, because the health and care crisis is acute in rural Britain and we cannot afford to be left behind?
Wes Streeting
I thank the Liberal Democrats for their support for the commission and for the way in which their party has put the issue of social care much higher up the political agenda, particularly during the general election campaign. That has been very helpful to me in the last six months and to the Government, and we look forward to working with the Liberal Democrats to build as broad a consensus as we can on the solutions to the social care crisis.
As I have mentioned, we have hit the ground running in a number of respects, including the biggest expansion of carer’s allowance since the 1970s. On investment in health and social care, I just point out that the £26 billion the Chancellor allocated to the Department of Health and Social Care alone at the Budget dwarfed what the Liberal Democrats promised in their manifesto. I know that not all the funding decisions the Chancellor and the Government have made in the last six months for the desperately needed investment in our public services have been popular, but I respectfully say to people who disagree with the decisions the Chancellor has made that they need to spell out which services they would cut or which other taxes they would increase, because those are the choices. We have made our choices; we stand by them. What people cannot do is welcome the investment but not say how they would fund it if they oppose what we have done. The Prime Minister, the Chancellor and the entire Government have been willing to make unpopular choices in the last six months because we believe they are the right choices to get Britain out of the hole it was left in by our predecessors. People will not thank us for resorting to the short-termist, sticking-plaster, government-by-gimmick politics that plagued this House during the last Parliament.
I turn to some of the other issues that the hon. Lady mentioned. We will make further proposals on urgent and emergency care reform. I want to take the best of the NHS to the rest of the NHS, whether it is “hear and treat” over-the-phone triage—a more appropriate community response that is often faster than ambulance response times—or getting ambulances and ambulance handover speeded up at all our hospitals with the “release to respond” approach. We have seen that working successfully in some parts of the country, but it needs to be consistently rolled out.
The hon. Lady talked about patient choice for those who are digitally disconnected or do not want to organise their lives around their smartphones. That is why I believe very strongly in choice—different courses for different horses. Those of us who do not book appointments over the phone free up the line so that those who prefer doing their business and booking appointments by phone can get through.
The hon. Lady asked us to fast-track the social care work. The first phase of Louise Casey’s commission will report next year, but we are of course willing to talk to parties across the House about how we move forward.
The hon. Lady urges us to set up an urgent and emergency care taskforce. Let me reassure her that the Minister of State for Health my hon. Friend the Member for Bristol South (Karin Smyth) and I have every week—and often more frequently—convened health and care leaders virtually and in the Department to keep a grip on what is going on, to provide as much central support as possible, and to respond to crises as they emerge. If only that was just about setting up a taskforce. We already have one; what we need is sustained improvement from one year to the next and that is what we are determined to deliver.
Several hon. Members rose—
Mr Speaker
May I suggest that we help each other by asking short questions—with short, punchy answers, I am sure? Ben Coleman will set a good example.
Ben Coleman (Chelsea and Fulham) (Lab)
Mr Speaker, I take that personally, in a positive way.
This is a very encouraging statement. It is great to start the new year with some good news and to be so clear that we are keeping our promises as a Government. It is also very good that we are taking the necessary time to create this cross-party consensus on social care while keeping the show so firmly on the road. Carers will be supported to carry out more health tasks, as they do already in my constituency with wound dressing and medicine management. The problem is they do not have any possibility of career progression. [Interruption.] I am sorry, Mr Speaker, I forgot your initial encouragement; I will bring this to a close.
Does the Secretary of State agree that as carers are encouraged to do more health tasks, they need proper opportunities for career progression even within the NHS, in collaboration with local authorities?
Wes Streeting
Brevity was not my hon. Friend’s new year’s resolution, but at your encouraging, Mr Speaker, it is mine. We will provide more training to care professionals to deliver a wider range of tasks in the home, making better use of their skills and the career progression that my hon. Friend describes. Crucially, that career progression must be in status and in pay. That is what we will work with the staff to deliver.
Sir Edward Leigh (Gainsborough) (Con)
I welcome the consensual parts of the Secretary of State’s statement, but I wonder whether we have been entirely honest with the public about the sheer unaffordability of the cap proposed by Dilnot. I do not absolve my own Government from this: maybe we should start telling the truth to the public. Does the Secretary of State think we need a new social compact on bringing in social insurance so that people can plan for their entire life? They would know that they will have to pay more in taxes during their life for their old age, but at least they would have certain rights.
Wes Streeting
The right hon. Gentleman is right to say that we need a debate as a country about the balance of financial contribution between the individual, the family and the state. I well understand why David Cameron was so concerned about catastrophic care costs and people having to sell their homes to pay for their care and the problem he was trying to solve. With every Government since, the issue has been seen as less urgent than others, but that does not mean it does not matter or that we should not consider it as part of the Casey commission. We need to consider all these issues in the round and, as much as we can, build a consensus not just in this House, but throughout the country about the balance of financial contribution and what is fair, equitable and sustainable.
Jen Craft (Thurrock) (Lab)
Just before Christmas, one of my constituents visited my surgery and gave me pause to reflect on the massive, often lifelong impact on loved ones who have someone in the social care system, and the devastating impact on their ability to work and to live healthy, fulfilling lives. Does the Secretary of State agree that the commission will lay the foundation for real change so that people in the social care system and their families can live the healthy, fulfilling lives they deserve?
Wes Streeting
I strongly agree with my hon. Friend, who has done much already in the past six months to champion social care. Whether people are in residential care home settings or we are doing everything we can to ensure that they can stay in their own homes, everyone deserves to live comfortably, well supported, with independence and with dignity. That is why the steps we are taking, particularly through the disabled facilities grant, will be immediately impactful on thousands of people across the country in just the next three months. We have so much more to do, and that is why I am genuinely excited by the work of the commission.
Layla Moran (Oxford West and Abingdon) (LD)
Given that the Health and Social Care Committee’s first inquiry is “Adult social care reform: the cost of inaction”, we welcome any action. As the name of the inquiry suggests, we are concerned about the length of time taken, because every year without reform costs money, not only to the NHS, but to the wider economy and in people’s lives. We have Andrew Dilnot in front of us on Wednesday, and it is 14 years since his report, which has been put into legislation twice. I ask the Secretary of State to be specific: what will stop the next iteration of the Committee having Louise Casey in front of it in 15 years’ time? What will be different this time, so that we get that cross-party consensus and it sticks?
Wes Streeting
That is a great question. First, I will put on my shin pads and crash helmet if Andrew Dilnot is in front of the hon. Lady’s Select Committee this week. I can well understand his frustration. He is a decent man who did an excellent piece of work. It must be frustrating to see one Government after the next not implementing something that was welcomed. The issue for us as an incoming Government is that the money was not there, and even if it had been, the system had not been set up to deliver for the October 2025 deadline. We chose to act on other immediate pressures in other areas, because we saw those needs as more pressing. That does not mean for a moment that I think Andrew Dilnot’s work is no longer valuable—I think it might well be. However, we have to consider the issues in the round and come up with a clear and sustainable plan that we can stick to.
On why the Casey commission will be different and will work, it is important to have as much political consensus around the House as possible. The national consensus and getting the public on board will be important. Anyone who has ever met Louise Casey will know she is a difficult woman to say no to. I have no doubt that if Louise Casey says something needs to be done, this Government and future Governments—whoever is in government—will make sure that it happens.
Dr Rosena Allin-Khan (Tooting) (Lab)
Happy new year, Mr Speaker. Yesterday and over the Christmas recess I was working shifts in my local A&E at St George’s in Tooting. Up and down the country, doctors like me were seeing older and disabled patients who could not be discharged from hospital due to a lack of good, affordable social care in the community, so I welcome the steps that have been outlined. What steps will the Secretary of State outline to ameliorate the imminent pressures sooner?
Wes Streeting
I thank my hon. Friend for the work that she does on the NHS frontline, particularly when Parliament is in recess but often alongside her everyday work as a Member of this House. It is truly above and beyond the call of duty. She sees at first hand the pressures and failures that the NHS is experiencing.
My hon. Friend is right about delayed discharge. In fact, when I was at Burnrigg Court, a residential care home in Carlisle, last week, I saw wonderful ensuite room facilities with people in intermediate NHS care—there are NHS-funded beds in those care homes—and those people were in better settings at half the costs of the hospital beds they left behind. Delivering better care in the right place at the right time is often not only great for patients but better value for taxpayers. That is why I will be reforming the better care fund to ensure that we make good use of NHS and social care budgets together to get people out of hospital as quickly as possible, freeing up vital bed capacity for others.
Paul Holmes (Hamble Valley) (Con)
I congratulate the Secretary of State on taking community diagnostic hubs and expanding their hours, which is something that the last Conservative Government established. Will he outline what impact that will have on his workforce plan and expand on that? Have the unions accepted the extra hours—they are not excessive by any stretch—that he has proposed? Will he have a serious conversation with me, please, about Fareham community hospital, which has space for a community diagnostic centre that would be welcomed by my constituents in Hamble Valley?
Wes Streeting
Persistence pays off: I would be happy to receive representations from the hon. Member about his local hospital and the potential to provide more community diagnostics. On the workforce, when we were consulting on this in opposition, we found a real willingness on the part of NHS staff to put in the extra hours, so long as they are fairly remunerated, which they will be. I am grateful for the investment that the Chancellor has provided to enable us to do that.
NHS staff want to see progress to beat the backlog. They are as frustrated as anyone else—and demoralised, actually, at work—seeing people waiting for so long, so I have no doubt about their willingness to assist. I am looking forward to working with NHS staff across the country so that we can all feel that together we are delivering an improving NHS.
Several hon. Members rose—
Mr Speaker
We are going to finish at about 10 to 5, so the speedier we go, the more that will help.
Rachael Maskell (York Central) (Lab/Co-op)
I thank NHS staff for working under severe duress over this winter. One way of ensuring better patient flows is to have better rehabilitation, so will my right hon. Friend say what he is doing to improve rehabilitation access not only in acute sectors but out in the community?
Wes Streeting
Further to the previous question, we will be refreshing and updating the NHS workforce plan alongside the long-term plan that we will publish in May, and my hon. Friend is right that rehab is key not just to good recovery but to prevention of future demand on the NHS. I saw a great example of that rehabilitation delivered in social care settings only last week. Whether in the NHS or in social care, we definitely need to do more on rehabilitation, because rehabilitation is often secondary prevention.
Ellie Chowns (North Herefordshire) (Green)
I agree with the Secretary of State that community-based services are crucial. My local NHS trust contacted me in the week before Christmas about Hereford community diagnostic centre, which is currently in the process of being built. It was told to be ambitious with this project, but in December it was told that only a sixth of the funding that it needs is available. Does today’s announcement mean that the Government will fully fund Hereford community diagnostic centre?
Wes Streeting
We will certainly write to the hon. Member with further information about Hereford CDC. On capital investment, I say to her and to other right hon. and hon. Members that we were very pleased with what the Chancellor was able to deliver in the Budget. We recognise that the stop-start we saw on a number of capital programmes under our predecessors was frustrating and we are determined not to repeat that. That is why we are setting out clear and consistent proposals for capital investment in the NHS.
Dame Siobhain McDonagh (Mitcham and Morden) (Lab)
Last summer we celebrated the 25th anniversary of the elective orthopaedic centre in south-west London. The driving force behind that was Professor Richard Field, who came to my surgery every week after the 1997 election. With the help of the Prime Minister Tony Blair and the late Health Secretary Frank Dobson, he made it real. It has the lowest blood use rate for hip and knee replacements, the shortest stays and lowest levels of infection. Will my right hon. Friend congratulate Professor Richard Field and agree that his elective hubs are the way to cut waiting lists?
Wes Streeting
I warmly congratulate Professor Richard Field on his clinical leadership, which has made a difference to countless lives, not only in my hon. Friend’s part of London but because of the national example that he set, which many others followed. That confirms my strong conviction that the best innovations will come from great clinicians. It is our determination to make sure that senior leadership in the NHS and in government back great clinical leadership and innovation, and take the best of the NHS to the rest of the NHS.
Graham Stuart (Beverley and Holderness) (Con)
The Secretary of State said that 12,000 patients had to stay in hospital beds because of a lack of social care, yet we have it kicked down the road once again. What will Louise Casey tell us that we do not already know about the tough political trade-offs that have led successive Governments to fail to create a truly coherent health and social care system, and what will he do to make sure that we meet needs today, as he exemplified in November?
Wes Streeting
Once again, the arsonist is complaining that the fire brigade is not doing a quick enough job. We are a bit sick of it on the Government Benches, but we are at least rolling up our sleeves, getting on with the job and making improvements, and we will continue to do that. I heard the same complaints about Darzi: “What can Darzi tell us that we did not already know?” Quite a lot, actually. The Conservatives should hang their heads in shame for it.
Nadia Whittome (Nottingham East) (Lab)
I thank the Secretary of State for his clear commitment to action. There are 131,000 vacancies in the social care sector, and low wages are the prime culprit. Last year, Unison found that three quarters of care staff who do home visits continue not to be paid for journey times between appointments. Will my right hon. Friend commit to ensuring both a £15-an-hour minimum wage in the social care sector, and paid travel time as a contractual requirement?
Wes Streeting
I thank my hon. Friend for that question. I am a proud member of Unison, and I am proud of its work to stand up for its workforce in the social care sector. She and Unison are absolutely right to argue that fair pay is essential to recruitment and retention. That is why I am delighted that the Deputy Prime Minister included fair pay agreements in the Employment Rights Bill in the first 100 days. I am looking forward to working with Unison, GMB and others to negotiate the first ever fair pay agreements for care professionals in this country.
Alison Bennett (Mid Sussex) (LD)
I would appreciate it if the Secretary of State could unpack a phrase in his statement. He said:
“Where we can treat working people faster, we will”.
That phrase is ripe for misinterpretation. Please could he explain what that means? Does it mean stay-at-home mums waiting for an appointment, and family carers, 26% of whom are on waiting lists?
Wes Streeting
It does. I was talking about the fact that working class people are often left behind in a two-tier system where those who can afford it pay to go private, and those who cannot are left behind. It is the determination of this Government to bring back to life the essential Bevanite principle of an NHS that is there for everyone when they need it: healthcare available to all on the basis of need, not on ability to pay.
Josh Fenton-Glynn (Calder Valley) (Lab)
I welcome the commission, which hopefully will lead to some certainty on the future of social care. However, a 2023 National Audit Office report found that 17% of local authority directors of social services were concerned about their ability to meet statutory obligations last year, and a further 18% are concerned about their ability this year. I have concerns about what will be done to fix the immediate crisis in social care. Will my right hon. Friend outline what he will do to guarantee the sustainability of our care system now, while we await the further structural reforms that we dearly need?
Wes Streeting
I am grateful to my hon. Friend for his question. That is why in the Budget the Chancellor delivered a big uplift in the spending power of local authorities, with £880 million ringfenced specifically for social care. We are also delivering through measures such as the disabled facilities grant to deal immediately with the pressures—[Interruption.] It is no good the right hon. Member for Beverley and Holderness (Graham Stuart) complaining. He voted against the investment, so he cannot very well complain about it.
Dr Andrew Murrison (South West Wiltshire) (Con)
The previous Labour Government did a hatchet job on community hospitals, including in Wiltshire, with a consequent uptick in the amount of delayed discharges in the acute sector, notably at Bath, Salisbury and the Great Western in Swindon. Will the Casey commission look at that and find ways of unpicking the damage that was done?
Wes Streeting
The previous Labour Government delivered the shortest waiting times and the highest patient satisfaction in history.
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
There are very worrying reports of cash-strapped universities reducing the numbers of clinical academics; indeed, some are being made redundant at a time when there is increased demand for doctors. Does the Secretary of State agree that this is an extremely concerning development?
Wes Streeting
Clinical academics have an important role to play in the national health service and in innovation in medicine. My right hon. Friend the Secretary of State for Education is focused on university finances, and I think universities should ensure that they prioritise efficiently and effectively, making best use of the resources available to them. I would gently say that universities have not struggled as much as other parts of the public sector over the past 14 years.
Llinos Medi (Ynys Môn) (PC)
During 14 years of austerity, the NHS has been starved of the resources it badly needs. Four months ago, the Secretary of State for Wales made a big announcement about cross-border NHS partnership to tackle waiting lists; however, the First Minister of Wales later poured cold water over the idea, and today’s plan for England does not mention Wales. Was this so-called partnership ever real, or was it just another empty promise?
Wes Streeting
By definition, an elective recovery plan for England does not include Wales. However, I can assure the hon. Lady that we have a great working relationship with Jeremy Miles, the Health Minister in the Welsh Government, and with the First Minister herself. Not only are we providing support to the Welsh Government on elective reform to help them to cut waiting lists and waiting times, but we are receiving advice from the Welsh Government on areas where health and social care services are doing better than in England. Together, we will create a rising tide that lifts all ships across the UK.
Jo White (Bassetlaw) (Lab)
Bassetlaw has an increasingly older population, with 22% now over the age of 65. As the needs of my constituents change, I welcome the additional £198,000 in funding for local disabled facilities grants. Does the Secretary of State agree that it is vital to shift care out of our hospitals and into our community?
Wes Streeting
I am so grateful to my hon. Friend for her question and for championing that issue since she arrived in the House six months ago. The disabled facilities grant is not just about new handrails, new ramps, new accessible kitchens and bathrooms and home adaptations; it is about freedom, independence, dignity and happiness. It is really good investment in preventing demand on other health and care services by giving people back their own independence and happiness.
Dame Harriett Baldwin (West Worcestershire) (Con)
My constituents will welcome the opportunity to get more services delivered through their GP surgeries, of which there are many excellent examples in West Worcestershire, and through community hospitals. However, I hear from those very same GP surgeries their concerns over the national insurance rises, and how that is leading them to think about reducing services. When will the Secretary of State be able to square that circle?
Wes Streeting
Before Christmas—I appreciate that it was just before, but I wanted to get out the certainty to general practitioners before we all went off for Christmas—we announced the biggest uplift in funding for general practice in a considerable number of years, and we will now negotiate the contract in the usual way. That should give general practitioners the stability and certainty to know that this Government are determined to fix the front door to the NHS.
The other thing I would say to the Opposition is that they cannot continue to welcome the investment while opposing the means of raising it, unless they spell out which services they would cut or which other taxes they would increase. They do not have an answer; they do not have a leg to stand on.
Matt Rodda (Reading Central) (Lab)
I warmly welcome the Secretary of State’s statement, and his emphasis on investment and reform. Will he say a little more about the important role of training for staff and investment in new technologies such as AI to speed up diagnostics?
Wes Streeting
Of the many great possibilities and opportunities facing this country are our strengths in life sciences and medical technology. If we can combine the strength of our scientific and technological base with the ingenuity and care of our NHS staff and our ability to deliver at scale with the model that was designed in 1948, which is well served to take us well into the 21st century, the sky is the limit for what we can achieve. We will have to support staff through that revolution. I appreciate that for many staff working in the NHS today they would be grateful if the machine simply turned on when they turned up for work.
Sarah Dyke (Glastonbury and Somerton) (LD)
I am concerned about the lengthy timescale set out in the social care review, with the second phase not due to report until 2028. The care system is broken and it particularly affects rural areas such as Glastonbury and Somerton. For example, a resident in Castle Cary, a 105-year-old D-day veteran, is facing moving care homes due to high care costs. This will have a negative impact on his health, wellbeing and quality of life. What actions will the Secretary of State take in the near term to reform the social care sector and provide older people with the dignity they deserve?
Wes Streeting
I am very grateful for that question for two reasons. First, it gives me the chance once again to say that the first part of the Casey commission will be reporting next year, so we can set out a whole range of further actions that will be needed throughout this Parliament. We have taken a great number of actions already in the first six months and I dare say there will be more to follow in the next 12 months. I must say it is very encouraging that one thing we are hearing from across the House on the Casey commission overall is to go faster. I think that shows genuine cross-party appetite on this issue and that is a really good place to start.
Ms Stella Creasy (Walthamstow) (Lab/Co-op)
I welcome the Secretary of State’s commitment to tackling the backlog of appointments—all our constituents would benefit from that—and his honest recognition that there is a risk, because there are not two separate workforces. Unless we have sensible safeguards, we could end up paying the same NHS doctors more to do operations in the private sector. The Secretary of State for Education set a cap on the profits that can be made in the children’s care sector. Is the Secretary of State considering a similar cap to protect the NHS and ensure value for money in his work with the independent sector in the NHS?
Wes Streeting
I am grateful for that question. I am not sure that the level of exploitation in either independent healthcare or adult social care mirrors what we have seen, disgracefully, in children’s social care, but we keep a sharp eye on that. I remind my hon. Friend of the commitments we made in opposition around tackling the excesses and the worst kind of behaviour of some private equity-owned care homes that are leeching money out of the system. We will not tolerate that. We will act to regulate further. I hope that provides Members across the House with the assurance that we are taking both a principled and a pragmatic approach to the constructive and positive relationship we want to build with the independent sector, as we rebuild our national health service and build a national care service we can be proud of.
John Glen (Salisbury) (Con)
I would love to see a consensus evolve on social care. I welcome the Secretary of State’s appointment of Louise Casey and the talk about the balance between the individual family and the state. However, in every fiscal event that I was part of in the Treasury, more money was put into the NHS, so I respectfully ask the Secretary of State this: what does he say about wide variance in performance across the NHS? Secondly, what does he say about consumption patterns? I understand his emphasis on the Deliveroo concept, but we have to come to terms with the fact that most GPs would say that they have excessive demand from people who do not really need to see their GP. That is a delicate and difficult subject to grasp, but one that we really must grasp, collectively, in this place.
Wes Streeting
I am grateful for that thoughtful question. Let me say two things to the right hon. Gentleman. The first relates to the wider fiscal pressures on the Chancellor. I find it difficult enough to manage the different choices and trade-offs to be made between different parts of health and social care and the competing challenges that I hear from Members in all parts of the House, so I am always thankful that I am not the Chancellor of the Exchequer, who has to balance demands from the NHS alongside the demands of education, a rising welfare bill, rising child poverty and the threats to our nation. These are enormous challenges, which is why I am determined to ensure that every penny that goes into the health service is well spent.
My second responsibility, in addition to ensuring that patients are treated at the right time, in the right place and in the right way, is ensuring that we have a sustainable healthcare system in which there is reduced demand. That means doing more on the prevention side, so that we can keep people out of hospital and not needing to knock on the door of their GP surgery, so that they do not achieve the frequent flier status in the NHS that so many people do achieve—the one frequent flier status to which they do not aspire. We can deal with this only through both health service reform and public health reform, and I want very much to build cross-party consensus on the latter.
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. That was a very lengthy answer.
Nesil Caliskan (Barking) (Lab)
Just before Christmas, I met care workers in my constituency, who told me about the day-to-day work that they do supporting the most vulnerable people in our community. Does the Secretary of State agree that just as access to GPs helps to relieve pressure on hospitals and A&E departments, an adequate number of adult social care workers will help to relieve the pressure on our GP services, which also have to deal with huge demand?
Wes Streeting
I wholeheartedly agree with my hon. Friend, who has done much to bang the drum on this issue during the six months in which she has been a Member of this House. That is why we are taking a systematic approach to health and social care reform.
Seamus Logan (Aberdeenshire North and Moray East) (SNP)
I thank the Secretary of State for advance sight of his statement, and for writing to the leader of my party. I am sure that the Scottish Government will co-operate and engage fully with Baroness Casey as she does her work. The Secretary of State spoke of failure. One such failure—the elephant in the room, in fact—is the labour shortages that the NHS and social care are experiencing as a result of Brexit. I ask him not to pass the buck, but to tell me what steps he will take, after consultation with Cabinet colleagues, to address those shortages by making it easier for migrant workers to come to this country and fill the vacancies.
Wes Streeting
We had a referendum and two subsequent general elections on the issue of Brexit, and I can tell the hon. Gentleman that none of those three democratic events went the way that I wanted. As we said to people at the time, the country chose a path that would have consequences and implications. However, we have a constructive working relationship with our friends and allies in the European Union, and while we cannot change the past, we can build a new partnership and a brighter future for our country.
Derek Twigg (Widnes and Halewood) (Lab)
As my right hon. Friend will know, a large number of elderly people are admitted to hospital, through A&E, with respiratory conditions. What plans does he have to strengthen the community respiratory teams, who do a great deal of good work but could do more work, if they had the resources, to prevent admission, and certainly readmission?
Wes Streeting
My hon. Friend is right, and that is why the vaccination campaign has been so important this winter. He is also right about the importance of community-based teams. One of the Darzi conclusions was that since 2019, we have significantly increased staffing in our hospitals, but because we had the wrong people in the wrong place, we ended up with falling productivity in hospitals. We need a shift out of hospital into the community, which is what our 10-year plan will deliver.
Jeremy Corbyn (Islington North) (Ind)
Most residential social care in England is delivered by the private sector. Is the Secretary of State able to give local authorities the resources necessary to allow them to reopen residential care facilities, or to open the new facilities that are so desperately needed? Will he assure me that in the review that Baroness Casey is undertaking, the primary objective will be the delivery of a public sector national care service, not a privatised service?
Wes Streeting
Thanks to the decisions taken by the Chancellor in the Budget, we are boosting the spending power of local authorities significantly, and £880 million has been ringfenced specifically for social care. I appreciate that a single Budget cannot undo 14 years of Conservative failure, but this is an important start, and of course we want year-on-year improvement in the delivery of social care. Baroness Casey will consider all these issues, and also how we can improve ease of access and care quality across the public and private sectors.
Mr Calvin Bailey (Leyton and Wanstead) (Lab)
I strongly welcome the Government’s action to help my constituents in Leyton and Wanstead get the care that they need faster. Our local hospital, Whipps Cross, continues to struggle, despite the hard work of its staff and leaders, NHS workers and carers, who continued to provide services to our community over Christmas. In November, 36% of patients at Whipps waited more than four hours for emergency care. In recent weeks, 16% have waited longer than 12 hours. Does my right hon. Friend agree that this welcome package of long-term reforms will address both elective care and emergency care for our constituents by moving the effort from hospital to the community?
Wes Streeting
My hon. Friend is absolutely right about that. If we improve the service at Whipps Cross hospital for his constituents, it will have the added benefit of improving the service at Whipps Cross Hospital for my constituents, too.
Rebecca Smith (South West Devon) (Con)
What is missing from today’s announcement is any sort of update on the new hospitals programme review, which is vital in my constituency of South West Devon, because Derriford hospital needs its urgent and emergency care centre to bring down ambulance waiting times before it can even start to tackle its general waiting list issues. When will Derriford hospital hear whether it has been successful in the new hospitals programme review?
Wes Streeting
I was grateful to staff at Derriford hospital for showing me at first hand the emergency department pressures when I visited just before Christmas. I have also visited Derriford at the height of summer, when it experiences high pressures. There are year-round difficulties at Derriford, and I thank the staff and leadership of the hospital for what they are doing in difficult circumstances. We will come forward shortly with the timetable for the new hospitals programme. I expect that it will be published sooner than the Conservatives apologise for their appalling record.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
I welcome my right hon. Friend’s statement, but can he expand a bit more on the new agreement with the private sector? For example, he mentioned that the surgical hubs will be delivered solely by the private sector, but what arrangements will there be for emergency care, when the occasion arises?
Wes Streeting
Some of the new capacity announced in today’s elective reform plan will come through the independent sector, and some of that new capacity will be in the NHS. It is our ambition to rebuild the NHS so that it is available for everyone where and when they need it, and we will work with the independent sector. We are publishing full details of our independent sector agreement, so that people can see the deal that we have reached, and the sensible and effective partnership, including safeguards and protections, that we have come to. I look forward to working with the sector to make sure that everyone, whatever their income and background, can get faster access to care.
Sir Gavin Williamson (Stone, Great Wyrley and Penkridge) (Con)
When the Casey review reports, if its recommendations are implemented, it will have a significant impact on local government. As the Secretary of State will be aware, large parts of the country are going through local government reorganisation, and the outcomes of the Casey review will determine the right reorganisation for those areas. In the best interests of joined-up government, to use an old Blairite phrase, is there any way to bring forward the review, so that the best choices for local government reorganisation can be made?
Wes Streeting
I can definitely reassure the right hon. Gentleman that the Deputy Prime Minister and I are working very closely on this issue, which is close to her heart; she has a huge amount of experience in this area. We will follow her progress as she embarks on her local government reforms. Baroness Casey will take those reforms into account when she considers what the long-term future for social care will look like. Once again, I note the exhortation to go faster.
Clive Efford (Eltham and Chislehurst) (Lab)
When I raise concerns about GP appointments, GPs tell me that they have difficulty recruiting to posts in their practices. Too few newly qualified doctors choose general practice as their profession. What can we do to get those doctors in place, so that we can make diagnostics in the community work?
Wes Streeting
That is an excellent question. Having put in place funding to ensure that there are 1,000 more GPs on the frontline before April, and having announced just before Christmas a significant uplift for general practice, I hope that in the first six months of this Government, we have sent the strong message to people who aspire to long careers in medicine that general practice has a huge role to play in the NHS in the 21st century. It is an exciting place to be, but I recognise that we have to fix the front door to the NHS to make it more attractive. The situation is even worse than my hon. Friend has described, because when the Conservatives left government, there were qualified GPs unable to find jobs, at a time when patients were unable to find GPs. We got to work on that issue within weeks of taking office, and we will do more over the next 12 months.
Jim Shannon (Strangford) (DUP)
It is good to hear the latest announcements on overhauling the increasingly costly care for older and disabled people, and I very much welcome what the Secretary of State has said. I understand that this will happen through a three-year review, and that we will be clearer on the plan to introduce this in 2028. Health is devolved to Northern Ireland, but thousands of care packages in Northern Ireland are not fulfilled. What can he do to assist Northern Ireland in achieving its goals? Goals that are set here for England and the United Kingdom need to be in place in Northern Ireland as well.
Wes Streeting
The ministerial team and I have enjoyed working with counterparts in the devolved Governments over the last six months, and we will continue to do that. Thanks to the decisions that the Chancellor took in the Budget, we see significant investment in health and care services here in England, and the Barnett consequentials will create a rising tide that will lift all ships across England, Wales and Scotland. I might even say that all roads lead to Westminster. I say this to Scottish National party colleagues: down the road to Westminster lie the resources for the SNP Government, so they do not have an excuse not to act.
Several hon. Members rose—