Graeme Downie (Dunfermline and Dollar) (Lab)
The Minister for Secondary Care (Karin Smyth)
The delivery of mental health services for children in Scotland is the responsibility of the Scottish Government. I hope that they will make the best use of the boost from the recent Budget to invest in mental health services. In England, we will support children and young people earlier by providing access to a specialist mental health professional in every school and rolling out Young Futures hubs in every community. We will also cut waiting times by recruiting 8,500 more workers across children and adult mental health services.
Graeme Downie
The long-term impact of the covid-19 pandemic on young people is often forgotten, with isolation leading to missed opportunities, lost life experiences and still unknown impacts on mental health. Child and adolescent mental health services referrals in Fife and across Scotland have skyrocketed, and despite a record Budget settlement from the UK Government, the SNP Scottish Government have told NHS Fife not even to bother asking for more funding to tackle this massive problem. I and colleagues will write to the Scottish Government about that. Will the Minister join me in urging the Scottish Government to reverse course and ensure that young people have the support that they deserve and need?
Karin Smyth
My hon. Friend makes an excellent point on behalf of young people. It is disappointing that the Scottish Government do not seem to be allocating the funding as they could. He raises a powerful case, and I know that he will work hard with the Government in Edinburgh to make the situation better for his constituents.
Damian Hinds (East Hampshire) (Con)
Is the mental health support in schools that the Minister just mentioned the same as or different from the plan for mental health support teams in schools that was already being rolled out by the previous Government?
Karin Smyth
Our plan is to have universal coverage in every school. That was not achieved by the previous Government, and we hope to ensure that it happens.
Charlie Dewhirst (Bridlington and The Wolds) (Con)
The Minister for Care (Stephen Kinnock)
This Government will never shy away from taking the choices necessary to fix the public finances and rebuild our public services. It is thanks to those choices that we are able to invest an additional £3.7 billion in 2025-26 in local authorities that provide social care. We are also delivering the biggest uplift to the carer’s allowance since the 1970s, an £86 million uplift to the disabled facilities grant, and a fair pay agreement for care workers.
Charlie Dewhirst
The increase in employer national insurance contributions comes at a time when we simply cannot afford to lose any more provision from care providers. Age UK estimates that 2 million people aged 65 and over already have unmet care and support needs. What assessment has the Minister made of the potential increase in unmet care needs as a result of the increase to employer national insurance contributions?
Stephen Kinnock
There is a pattern here. The Conservatives welcome the additional investment in health and care but oppose the choices that we have made to raise the revenue. They need to tell us which services they would cut or which taxes they would raise instead.
Helen Morgan (North Shropshire) (LD)
Coverage Care, a not-for-profit adult social care provider in North Shropshire that operates 11 care homes and employs around 1,000 local staff, has been in touch to say that it expects the impact of the increase in national insurance contributions to be £840,000 in the first full year of implementation. Given that there are huge numbers of vacancies across adult social care in North Shropshire, will the Secretary of State consider exempting social care providers from the national insurance increase? Otherwise we are putting money into social care with one hand and taking it away with the other.
Stephen Kinnock
I refer the hon. Lady to my previous answer on the very substantial funding that we are providing to local authorities, which of course are key to the adult social care system. However, funding must always be married with reform. We have brought forward a packed programme of reform—from data sharing and empowering care workers to take on basic healthcare to promoting better use of care technologies—and in the spirit of cross-party collaboration that we believe is absolutely vital and urgent in this area, I gently encourage her to see those reforms as the first step towards rebuilding our care service and making it fit for the future.
Calum Miller (Bicester and Woodstock) (LD)
The Secretary of State for Health and Social Care (Wes Streeting)
Today there are 1,399 fewer full-time equivalent GPs than in 2015, and NHS dentistry is at death’s door. This Government will fix the front door to the NHS. We have announced an additional £889 million in funding for general practice in 2025-26—the biggest boost in years—and we have already started hiring an extra 1,000 GPs on the frontline. Our 10-year health plan will shift the focus of healthcare out of hospital and into the community.
Nesil Caliskan
I thank the Secretary of State for his answer on the critical issue of access to GPs in primary healthcare. My constituency of Barking is woefully under-served by primary healthcare, and especially by GPs. On average, each GP looks after 2,000 patients; the national average is 1,600. In particular, the area of Barking Riverside has no GP services. Will the Secretary of State meet me to discuss this matter, so that the thousands of homes that are being built will also have a primary healthcare facility on site?
Mr Speaker
Order. I remind Members to look towards the Chair, because I cannot hear what is being said. I call the Secretary of State—I hope he heard the question.
Wes Streeting
Thank you, Mr Speaker. I would be delighted for my hon. Friend to meet me or the relevant Minister. The NHS has a statutory duty to ensure sufficient services in each local area, including general practice, and it is vital that we also take into account population growth and demographic changes. I strongly support the Deputy Prime Minister’s commitment to delivering 1.5 million new homes, and she and I know that that must be accompanied by local healthcare facilities. We are working together to achieve just that.
Alistair Strathern
I really welcome this Government’s focus on making sure everyone can see a GP when they need one. The crisis in GP provision nationally has been exacerbated by the failure under the last Government to ensure that primary care investment has kept pace with housing growth. With such a low share of integrated care board capital funding allocated to primary care by the last Government, how can we make sure we do much better in ensuring that GP capacity expands at the same time as local growth?
Wes Streeting
My hon. Friend has been raising these issues with me since before he was elected to this place on behalf of the communities he represents. As I said to my hon. Friend the Member for Barking (Nesil Caliskan), we must make sure that additional housing—which is desperately needed—is accompanied by health and care services. The Deputy Prime Minister and I are working together to achieve just that, and thanks to the decisions taken by the Chancellor in the Budget, we are able to invest in the health and care services that this country needs and deserves.
Calum Miller
Woodstock surgery in my constituency is not fit for purpose. In September, heavy rain fell and caused the roof to collapse, causing the surgery to close. The nurse literally sees patients in a broom cupboard. The GPs want to increase their capacity to see more patients, but have been unable to access sufficient capital from the integrated care board. Will the Secretary of State meet me and the Woodstock GPs to discuss how the reforms announced yesterday will help them build a new surgery, so that they can see patients faster?
Wes Streeting
I am grateful to the hon. Member for that question. I am incredibly sorry about the awful conditions in which staff in that practice are having to see patients and in which the patients it serves are having to be seen—that is the epitome of the broken general practice system that we inherited. Thanks to the decisions taken by the Chancellor in the Budget, we are able to invest in the capital estate need in the NHS. That will take time, and we would be delighted to hear more about that individual case to see how the ICB and the NHS can assist.
Layla Moran (Oxford West and Abingdon) (LD)
Following the theme raised by my hon. Friend and neighbour, the hon. Member for Bicester and Woodstock (Calum Miller), may I make a plea for Summertown health centre? They are my doctors, by the way, so I declare an interest. They operate in an old Victorian building and are desperate to move to new premises. That health centre was at the top of the priority list, but the ICB says that there is no money, and the doctors say that there is no pot that they can bid into in order to get this seen to. Will the Secretary of State meet me as well? Clearly, £102 million spread across 50 projects in the country is not going to be sufficient. Can we get creative about how we can get new premises built for Summertown health centre?
Wes Streeting
Of course I will meet the hon. Lady. It would be daft of me to say no to the Chair of the Select Committee; otherwise, she will see me in less pleasant circumstances. In all seriousness, we are looking creatively at this issue. There are enormous capital pressures right across the NHS estate. We are regularly lobbied on new hospitals, for example, but we are also lobbied on general practice, the mental health estate and the rest. We will do as much as we can as fast as we can, thinking creatively about how we can get more capital investment in, and I would be happy to discuss that further with the hon. Lady.
Claire Hazelgrove (Filton and Bradley Stoke) (Lab)
When I am out regularly knocking on doors and listening to people across the constituency, one of the issues residents raise with me most frequently is the challenge in even being able to book a GP’s appointment. Could the Secretary of State please set out what his plans are for ending that 8 am phone scramble, including for those who do not use apps and websites as confidently?
Wes Streeting
I am grateful to my hon. Friend for that question. As the Prime Minister set out in our elective reform plan yesterday, we are determined to make sure that accessing NHS services, including general practice, dentistry and other primary care services, is as easy and convenient as accessing any other services at the touch of a button via our smartphones. We have committed to that in the elective reform plan, which will bring benefits right across the NHS as we modernise. Of course, she is right to mention those who may not be digitally connected or may not want to access services in that way. That is why I believe very strongly in patient choice—different courses for different horses. People like me booking via the app will free up telephone lines for those who prefer to access services that way.
Seamus Logan (Aberdeenshire North and Moray East) (SNP)
Is the Secretary of State aware that the increase to employer national insurance is actually reducing patient access to primary care? I met GP representatives in Aberdeenshire and Aberdeen recently, and they told me of two ways in which that is happening: first, they are having to let staff go; and secondly, some GPs are considering meeting these costs from their own pockets. Will he consider an exemption for GP practices from these charges?
Wes Streeting
That was a rare admission of failure in this House by the SNP. I am very sorry to hear that general practice in Scotland is in such a sorry state, because here in England we are investing £889 million in general practice, the biggest uplift in years. That is in addition to the funding I have found to employ 1,000 more GPs on the frontline before April, because we are prioritising general practice. As for the decisions the Chancellor took in the Budget, as I said before the election, all roads lead to Westminster. Thanks to the decision a Labour Chancellor has made here in Westminster, coming down that road from Westminster to Holyrood are the resources the SNP Government need to deliver the priorities of the Scottish people. If they cannot, Anas Sarwar and Jackie Baillie stand ready to deliver.
Dr Luke Evans (Hinckley and Bosworth) (Con)
To improve access, the Government have announced a planned expansion of advice and guidance, and GPs will be paid £20 per advice and guidance request they make for further expert advice from consultants. How do the Government expect this expansion to take place? Will they be mandating it given that the current position of the British Medical Association, under its collective action, is that GPs should
“Stop engaging with the e-Referral Advice & Guidance pathway”?
Wes Streeting
I think the shadow Minister will find that GPs welcome the £889 million uplift announced just before Christmas. That is the biggest boost to general practice in years. It is part of this Government’s agenda to fix the front door to the NHS and recognise the dire state that GPs were left under. Of course, with that investment comes reform. I think GPs would be delighted to manage more of their patients in the community if given the tools to do the job, and that is something this Government are committed to doing.
Dr Evans
Going back to advice and guidance, GPs use advice and guidance when they have come to the summit of their knowledge and need specialist input. For example, as a GP, I may see a rheumatology patient and ask for advice from a rheumatologist, who may advise specialist blood tests. The problem is that, as the inquiry clinician, I am legally responsible for those blood tests and have to pay for them out of the primary care budget. Do the Government propose that the £20 will cover subsequent follow-ups and the cost of suggested tests? Given the expansion of advice and guidance, will the Government be looking at a legal framework change in accountability for clinicians making requests?
Wes Streeting
First, as the shadow Minister has said, advice and guidance happens in general practice, and we want to see more of it. We have to give GPs the tools to do the job, and that is what we are doing. My hon. Friend the Minister for Care will be talking to the BMA shortly in the context of contract negotiations in the usual way. What the shadow Minister neglects to mention is that these reforms and improvements to general practice are made possible thanks to the £889 million we are putting in, which is investment that he and his party oppose.
Helen Morgan (North Shropshire) (LD)
Dentistry is a key part of primary care, yet an estimated 5 million people in England have been left without an NHS dentist. That is why today a petition is being handed in at Downing Street signed by more than a quarter of a million people. We have moved on from the election, but we do not yet have a timetable for when the negotiations for a new NHS dental contract will begin and when another 700,000 extra urgent appointments will be rolled out. Can the Secretary of State confirm the timetable for those improvements? What specifically are the Government’s plans for the new patient premium, and will he offer assurances to dentists that any changes to the current model will be outlined in detail to them as soon as possible?
Wes Streeting
We are looking at two things, the first of which is making sure we deliver what we said in our manifesto, including the 700,000 urgent appointments. We are determined to deliver those as fast as we can and my hon. Friend the Minister for Care is having discussions with the British Dental Association to that effect. He is also looking closely, as am I, at the money that is already going into NHS dentistry—how that money could be better spent and how it is that year after year, despite people’s teeth rotting to the extent that they are having to pull them out themselves or children having to attend A&E to have their teeth pulled out, we saw consistent underspends in the dentistry budget under our predecessors. We are determined to give dentists the tools to do the job so that patients can see a dentist when they need one.
Dan Carden (Liverpool Walton) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
I thank my hon. Friend for his question and for his campaigning on this important issue—and indeed for speaking so honestly about his own experiences during his time in this House. An additional £267 million has been invested this year to improve the quality and capacity of drug and alcohol treatment and recovery. We are committed to correcting the years of disinvestment in treatment and recovery services and ensuring that people can access the support they need.
Dan Carden
The Minister has done it for me, but I alert colleagues to my interests in this area.
Last month, the Advertising Standards Authority ruled against seven companies posing as treatment providers or impartial advice services or for failing to make clear their role in earning commission when they were in fact brokers—and I can tell the Minister that many more such companies escaped that ruling. They are able to mislead families while taking cuts of up to 40% of fees being paid directly to treatment providers. Frankly, they have been able to run the sector like a racket. Can we make sure that this ruling by the Advertising Standards Authority is the start of something new, where we can seek to regulate practices properly, and will the Minister meet me and interested parties?
Andrew Gwynne
Attempting to exploit people with addictions is reprehensible. Free drug and alcohol treatment is available in every part of the country and I urge anyone who is struggling right now to visit the NHS addiction website. The Care Quality Commission has said that it could take legal action against companies misusing its logo, and Google has said it would remove search listings from these companies. I am more than happy to meet my hon. Friend to see what more we can do to stop this outrageous activity.
Jess Brown-Fuller (Chichester) (LD)
Social prescribing is one of the primary care services provided for drug and alcohol addiction, and it also supports the Government’s aim of moving from cure to prevention, which is why I was shocked to hear that a primary care network in my constituency is reviewing its social prescribing offering across the Chichester district and proposing to remove it entirely. Does the Minister agree that social prescribing is a key pillar of our primary care services, and does the money used need to be ringfenced to protect that service across the country?
Andrew Gwynne
Social prescribing is one of the tools, and it is an important one in addressing public health concerns in each of our constituencies. This Government are committed to ensuring that we get those shifts from sickness to prevention. We will be ensuring that local areas have public health funding in reasonable time. We are about to announce, in due course, this year’s allocations. We need to make sure that local systems maximise the use of their money, and that certainly includes social prescribing.
Rachael Maskell (York Central) (Lab/Co-op)
In 2022, there were more than 10,000 deaths from alcohol use. We know that more than 600,000 people have an alcohol dependency. We need to focus not just on treatment services and their funding, but on prevention. The last Government failed to bring forward a timely alcohol strategy. Will the Minister update the House on what he is doing to ensure that we are tackling this massive situation in our communities?
Andrew Gwynne
My hon. Friend raises an important point. As part of the Government’s health mission, we are producing a five-point plan for prevention, and alcohol harms is one of those areas. I hope to be able to update her and the House in due course on the actions we will be taking to drive down the prevalence of alcohol harms and other addictions, because they are costing lives and causing misery in communities. That is why this Government are determined to tackle these public health problems.
Jim Shannon (Strangford) (DUP)
I thank the Minister for his answers. While there are community addiction services for those over the age of 18, worryingly, across this great United Kingdom, those under the age of 18 are succumbing to alcohol addiction, too. There does not seem to be any provision for them. May I ask the Minister genuinely and helpfully what provision there will be for those under the age of 18, because addiction problems are rising among the younger generation?
Andrew Gwynne
The hon. Gentleman raises an important point. This Government are committed to having the healthiest generation of children ever. That means we will have a concerted effort on a whole range of health issues that determine the health and wellbeing of young people, which will hopefully ensure that they become healthy adults as a consequence. Alcohol harms are certainly one of the considerations we will be looking at.
Elaine Stewart (Ayr, Carrick and Cumnock) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
This Government are delivering on our commitment to cut NHS waiting lists and end the Tory backlog. We have taken immediate action with an additional £1.8 billion to support elective activity this year. That funding will support the delivery of our first step of 40,000 extra elective appointments a week. With investment must come reform, and the elective reform plan, published yesterday and announced by the Prime Minister, sets out how we will cut NHS waits to the 18-week standard, increase productivity, reform the system and improve patients’ choice and control over their healthcare.
Elaine Stewart
Almost one in six Scots is stuck on an NHS waiting list. People are borrowing money and remortgaging their homes to go private, because they cannot bear the pain. With an SNP Government who have abandoned the principles of an NHS free at the point of entry, does my right hon. Friend agree that Scotland’s health service needs a new direction?
Wes Streeting
I strongly agree with my hon. Friend. As I said during the general election campaign—it was quoted regularly by the SNP—all roads lead to Westminster. Down that road from Westminster is a record increase in funding for the Scottish Government through the Barnett formula. I know the Scottish Government published their own NHS recovery plan just before Christmas, and I look forward to reading it, although I know some have expressed concerns about the lack of detail in the plans to drive down waiting times. The Scottish people can therefore compare and contrast with the ambition of our elective reform plan, which was announced by the Prime Minister yesterday, and then decide at the next Scottish elections who they trust to govern: the SNP with its rotten record, or a Labour Government who will get on and deliver.
David Davis (Goole and Pocklington) (Con)
The Secretary of State knows that I wrote to him before Christmas about the planned ward closures and degradation of services at Goole and district general hospital. Doing so will take beds, facilities and employees away from the national health service, which will do nothing but undermine his real attempts to reduce waiting lists and all the plans he announced yesterday. Will he look at the trust-level decision systems that lead to such catastrophic decisions that will undermine every aspect of NHS strategy and all that he is trying to do?
Wes Streeting
I thank the right hon. Gentleman for writing to me before Christmas. I recognise the pressures that have been placed on NHS commissioners in recent years and the pressure that that has put on service configurations. I tend to support the devolution of decision making, with decisions about service reconfigurations taken closer to the communities they serve. I recognise also that commissioners do not always get it right, which is why engagement with Members of Parliament and other democratically elected representatives is important. Ministerial oversight is important, too. We will look seriously at the issues he raises and talk to NHS leaders, and I know he will be doing the same. This Government are determined to give NHS leaders the tools to do the job, so that we can get the right care in the right place at the right time, with a better experience for patients and better value for taxpayers.
Ms Polly Billington (East Thanet) (Lab)
I am sure my right hon. Friend will share my delight at the fact that in our growing community of Thanet, the NHS is looking to open the Thanet integrated hub in one of the most deprived parts of Kent. However, Tory-run Kent county council has put in spurious objections to the development. Does he share my concern that such unnecessary objections block access to healthcare and make it harder for the Government and the NHS to cut waiting lists?
Wes Streeting
I am grateful to my hon. Friend for the work she is doing to improve health and care services for her constituents. The Government are giving health and care providers the tools to do the job. Of course, change will take time, and it is therefore crucial that we all pull together locally and nationally. For the avoidance of doubt, the Government are on the side of the builders, not the blockers.
Josh Babarinde (Eastbourne) (LD)
The NHS Confederation has said that for the Government to be able to drive down waiting lists,
“the pause to the delivery of the new hospitals programme must be as short as possible and NHS leaders need clarity about timelines.”
With that in mind, will the Secretary of State tell leaders at Eastbourne district general hospital, as well as our community in Eastbourne, precisely when the new hospital programme review will be completed so that we can get cracking with our upgrades?
Wes Streeting
I thank the hon. Member for that question. I agree with him about the need for clarity as well as consistency. We undertook the review into the new hospital programme because the previous Government’s timetable was a work of fiction and the money was not there. I hope to report to him and to the House shortly on that, with the undertaking that the timetable we publish and the funding provided by the Chancellor in the Budget and at the spending review will mean that we will provide not just clarity but consistency, which is important for NHS leaders, important for patients and important for the construction industry partners we need to work with.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
Thank you, Mr Deputy Speaker. [Interruption.] I am sorry—that is the last time I will get called. Thank you, Mr Speaker.
Yesterday, in relation to the elective backlog, the Secretary of State said:
“Where we can treat working people faster, we will, and we make no apology for doing so.”—[Official Report, 6 January 2025; Vol. 759, c. 597.]
Labour politicians have struggled to define what they mean by working people, but his words have caused anxiety. Will he reassure those with disabilities that prevent them from working and retired elderly people who have worked all their lives that they will not be pushed to the back of the queue and that treatment will continue to be provided in the NHS on the basis of clinical need?
Wes Streeting
Of course, clinical need is paramount and must always drive decision making about who to treat when and the order in which people are treated. That is why I find the question posed so deeply disingenuous. [Interruption.] We inherited NHS waiting lists at record levels and waiting times that are frankly shameful. The shadow Minister should be apologising for her party’s record, and she should also apologise for the two-tier healthcare system that sees those who can afford it paying to go private and those who cannot afford it—working-class people—being left behind. That is the two-tier system that the Government are determined to end.
Dr Johnson
The Secretary of State needs to be careful with the words he uses, as you said, Mr Speaker, because his words did cause anxiety among people. It was not a disingenuous question; it was a genuine question to make sure that people are reassured.
It will not have escaped the Secretary of State’s notice that it is cold outside. Removal of the winter fuel allowance has reduced elderly people’s ability to follow the advice that he gave last week, which was to turn the heating on. What assessment has he made of the number of additional admissions caused by his removal of the winter fuel allowance? What effect is that having on the Government’s ability to deliver their reduction in elective backlogs?
Wes Streeting
What the shadow Minister neglects to mention is that the Chancellor has protected the winter fuel allowance for the poorest pensioners, and she has also put in place the warm home discount to assist people with their energy bills throughout the winter. If the shadow Minister does not support the decisions that the Chancellor took at the Budget and ahead of the Budget to raise vital investment for our health and care services, that is fair enough, but then she needs to tell people which NHS services she would cut or which other taxes she would increase.
Josh Fenton-Glynn (Calder Valley) (Lab)
The Minister for Secondary Care (Karin Smyth)
In response to the report by Dr Penny Dash, we have made it clear that the CQC is not fit for purpose and requires significant reform. We have increased our oversight of the CQC to ensure implementation of the recommendations in Dr Dash’s review, and we will continue to monitor the CQC’s progress through this period of improvement. We are also supporting the swift and efficient recruitment of CQC leadership roles, including the new chief executive Julian Hartley, who started in December.
Josh Fenton-Glynn
It is inarguable that the CQC needs improvement. Many who run care services in local authorities have little confidence in its performance. Does my hon. Friend agree that we could go some way to improving how it is viewed by looking at the use of single-word assessments, which create undue stress for social services leads? They were raised by the Dash review as insufficient to support local authorities to improve, promoting box-ticking over real improvement and giving little information to members of the public on the quality of social services provision.
Karin Smyth
My hon. Friend is right that confidence is the key word in the huge agenda that the CQC has to deliver. Dr Dash and Professor Mike Richards highlighted serious failings that need to be re-addressed. As one of our predecessors said, priorities are our language. Currently, a review of one or two-word ratings is not a priority, but it will be kept under review.
Mr Gregory Campbell (East Londonderry) (DUP)
Is the Minister indicating today that there will be a new start in the Care Quality Commission, and that things will change for both staff and the recipients of care?
Karin Smyth
The hon. Gentleman makes an excellent point, particularly with regard to staff, who need support to continue their important work. A new start with new leadership is what they need, as well as implementation of the recommendations.
Tom Gordon (Harrogate and Knaresborough) (LD)
Gideon Amos (Taunton and Wellington) (LD)
The Minister for Care (Stephen Kinnock)
As Lord Darzi’s independent investigation found, around 1 million people are waiting to access mental health services in England. This Government will fix our broken mental health services by recruiting 8,500 more mental health workers, providing access to specialist mental health professionals in every school and rolling out young futures hubs in every community.
Tom Gordon
In my constituency of Harrogate and Knaresborough we have heard harrowing stories from people who have tried to reach out and get access to mental health services before they reach crisis point. Often, people end up facing months-long if not years-long waiting lists. When all too often they reach a crisis point, they end up having to access services as far away as Newcastle or Manchester. What are the Government doing to make sure that we can root local community mental health facilities in communities such as Harrogate and Knaresborough?
Stephen Kinnock
In addition to the measures that I just set out, in the Budget the Chancellor made funding available to expand talking therapies to 380,000 extra patients. We have a £26 million capital investment scheme for mental health crisis centres and, as always with this Government, investment goes with reform. We are finally reforming the Mental Health Act—that was first talked about when Theresa May was in 10 Downing Street. This Government are rolling up their sleeves and getting on with the job.
Gideon Amos
Taunton and Wellington is a trailblazer in taking mental health from hospital to community and from sickness to prevention. The trust is the first in the country to merge mental health with the hospital trust. Will the Minister meet the trust and me to understand how successful that programme is, and to discuss the much needed maternity and paediatric unit at Musgrove Park hospital?
Stephen Kinnock
It sounds like there is some interesting, dynamic and innovative work going on in the areas that the hon. Gentleman mentioned. I would be happy to meet him to discuss it further.
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
I have just been visited by my former medical student, a young doctor in Yorkshire working in an intensive therapy unit, who told me that 40 of the 50 patients who were admitted with covid died. Many healthcare workers are suffering from flashbacks and post-traumatic stress disorder. What measures will the Government take to look after the mental health of the healthcare workers who so bravely helped us during the covid pandemic?
Stephen Kinnock
My hon. Friend raises an important point, which provides an opportunity for us all to reflect on the incredible work of those working in our health service; they are, in many ways, heroes, and we should absolutely acknowledge that fact. We need to explore the point he has raised—we could meet to discuss it further, or I would be happy to write to him.
Anna Dixon (Shipley) (Lab)
In England, more than 200,000 people were waiting for an autism assessment in September 2024. In my constituency, some adults have waited more than two years for an autism assessment, and one child has been waiting eight years—and is still waiting—to receive support from child and adolescent mental health services. These delays have a profound impact on people’s lives. Will the Minister commit to the mental health investment standard and ensure that as the Government reduce waiting times, they do so for both physical and mental health services for young people and adults?
Stephen Kinnock
We remain absolutely committed to the mental health investment standard. We have prioritised the expansion of NHS talking therapies and individual placement and support schemes, and provided £26 million of capital funding to open new mental health centres. However, we are not complacent on this issue. My hon. Friend spoke about autism assessments, which is a red light that is flashing on my dashboard. I would be happy to discuss that further with her.
Sir Desmond Swayne (New Forest West) (Con)
The Minister for Care (Stephen Kinnock)
Counsellors and psychotherapists form an integral part of the NHS mental health workforce, delivering support to people with mental ill health across a range of settings in services for both children and young people and adults. We will publish a refreshed NHS long-term workforce plan to ensure that the NHS has the right people in the right places with the right skills to deliver the care that patients need.
Sir Desmond Swayne
Is there a plan to maintain service provision where psychotherapists and counsellors operating in the charity sector have been hit by eye-watering cost increases as a consequence of the national insurance increase?
Stephen Kinnock
As I have said in answers to previous questions, and as my right hon. Friend the Secretary of State has said, there is something of a pattern emerging here: Opposition Members say that they welcome the investment the Government have made, but oppose the revenue-raising measures and refuse to set out whether they would increase taxes or cut services. I still have not heard an answer on that from those Members.
Martin Rhodes (Glasgow North) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
This Government recognise the crisis in social care that we inherited, which is why over the past six months we have taken steps through the Budget to increase investment in social care, deliver the biggest expansion of the carer’s allowance since the 1970s and invest in the disabled facilities grant. Of course, as my hon. Friend alludes to, we cannot deliver great social care without the workers who deliver it. That is why I am proud that within our first 100 days, the care worker-turned-Deputy Prime Minister included fair pay agreements in her landmark Employment Rights Bill, so we can give our care staff not just the pay they deserve, but the professional status, recognising the hard work they do as care professionals. That is a crucial step on our path to building a national care service.
Martin Rhodes
Does the Secretary of State agree that the SNP’s National Care Service (Scotland) Bill was a missed opportunity to improve pay and conditions for social care workers, particularly when compared with Labour’s Employment Rights Bill, which creates the fair pay agreement for social care workers?
Wes Streeting
I agree with my hon. Friend. I am proud that this Government have taken quick action within our first 100 days. Thanks to the Employment Rights Bill, which is UK-wide legislation, this Labour Government in Westminster are giving the Scottish Government the tools they need to do the job of establishing fair pay for care staff. If they do not do it, Anas Sarwar and Jackie Baillie will.
Martin Vickers (Brigg and Immingham) (Con)
In north-east Lincolnshire, a social enterprise employs 800 staff providing health and social care. I have been approached by many staff who are unhappy that they have not benefited from the increases that NHS staff have gained. They have the support of the Royal College of Nursing and are looking for the Government to provide Care Plus Group, which employs them, with the resources to ensure that they are recompensed to the same level. What is the Secretary of State able to pass on to them?
Wes Streeting
I am grateful to the hon. Member for that question. With our fair pay agreements, we will be bringing together government, public and private sector employers and staff trade unions to negotiate the future for fair pay agreements that will benefit care workers across the system and give them the professional status and career progression they deserve. The Chancellor, through the Budget, also took steps to ensure that we could invest in our social care services. I am deeply saddened that the Conservative party has not supported that investment.
Emily Thornberry (Islington South and Finsbury) (Lab)
The Minister for Secondary Care (Karin Smyth)
I thank my new Dame Friend for her question. The Department does not collect data on the number of people who have specifically received enhanced maternity leave entitlements. Access to an enhanced maternity leave benefit forms part of the total reward package for Agenda for Change staff, which we believe is critical for retaining our much-valued and needed NHS workforce.
Emily Thornberry
Thank you very much, Mr Speaker. Doctors throughout the NHS, no matter who employs them, have blanket maternity agreements, but nurses do not. When I visited the River Place health centre, I found that nurses employed by Whittington Health were working alongside nurses employed by the GP practice who got completely different maternity leave and pay. As we turn out our hospitals into the community and do much more work in that way, such anomalies will get worse. It is not fair and I wonder what my hon. Friend is going to do about it.
Karin Smyth
My right hon. Friend highlights a problem throughout the system, not just in her area. Self-employed contractors to NHS GP surgeries are not bound by national terms and conditions; they can develop their terms and conditions as they see fit. They have the flexibility to set terms and conditions to aid recruitment and retention. We anticipate that good employers will set wage rates and terms and conditions that reflect the skills and experience of their staff. That is better for staff and for patients, and I know that she will continue to highlight that with her local employer. It is certainly something that we need to keep an eye on as we develop services further.
Pippa Heylings (South Cambridgeshire) (LD)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
We believe that every child deserves the best start in life. Due to the challenging fiscal context, we are initially prioritising family hubs and Start for Life funding to areas of high deprivation. We will consider the case for extension to South Cambridgeshire in future financial years.
Pippa Heylings
We know how important the best start in life is for opportunities for all. Only half upper-tier local authorities currently receive prioritised Start for Life and family hub funding—78 do not. In South Cambridgeshire, officers are doing huge work to provide support and signposting without dedicated funding, which means that babies, young parents and young families do not receive the full benefits. Will the Minister commit, in the next spending review, to extending these services across the whole of England?
Andrew Gwynne
Local authorities were pre-selected using the income deprivation affecting children index average rank scores, with a rural and urban weighting applied. Tackling child inequalities in health and outcomes is crucial. As resources allow, it is the ambition of the Government to ensure that Start for Life services reach every child.
Gregory Stafford (Farnham and Bordon) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
Let me start by commending the hon. Gentleman for his fundraising efforts to fight cancer in Surrey and his support for the Brain Tumour Charity. We are committed to ensuring that people with brain tumours have access to more effective treatments and excellent care through, for instance, our national cancer plan, and we will give more details shortly.
Gregory Stafford
I thank the Minister for his answer, and for his googling of my background! Early detection is essential in ensuring that brain tumours do not fall further behind other cancers in priority. Will the Minister update us on the Government’s progress to ensure that screening is prioritised?
Andrew Gwynne
We absolutely want to ensure early detection of these cancers, and I recently met representatives of the Brain Tumour Charity to discuss how we can roll that out. The Government are investing an awful lot of money in tackling cancers, but there is a great deal more that we can do on brain cancer.
Calum Miller (Bicester and Woodstock) (LD)
The Secretary of State for Health and Social Care (Wes Streeting)
We have been busy announcing investment in hospices, an uplift in funding for general practice, action through disabled facilities grants and a new independent commission on adult social care, and yesterday the Prime Minister announced the elective care reform plan. As I have said, however, the NHS is experiencing a period of significant winter challenge. The number of beds occupied by people with flu has been much higher than the number last year, and is continuing to rise. An average of just over 4,200 beds were occupied by flu patients at the end of December, surpassing the peak of about 2,500 reported last year. We monitor the situation closely, working hand in hand with NHS England and care leaders, and I continue to chair weekly meetings with senior leaders in social care, NHS England and the UK Health Security Agency.
Calum Miller
I am sure the Secretary of State will share my shock and anger about the number of young people in my constituency who are waiting more than four years for a first assessment by child and adult mental health services. Can he confirm that yesterday’s commitment by the Prime Minister that patients would not wait more than 18 weeks for a first appointment will apply to CAMHS in Oxfordshire?
Wes Streeting
We are determined to improve children and young people’s experience of both mental and physical health services, and we are determined to do more to ensure that mental health and paediatric waits are put under the spotlight and given the same attention as the overall elective backlog. I am sure we will have more to say about that when we publish the 10-year plan.
Adam Jogee (Newcastle-under-Lyme) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
In September the Secretary of State and I met the families of people who had suffered harm following the covid-19 vaccination, including my hon. Friend’s constituent Sheila Ward, and they raised the need for reform of the vaccination damage scheme. We listened closely to their descriptions of what they had been through and agreed to look at a number of options, noting that cross-cutting Government decisions might be necessary. We are also working with the NHS Business Services Authority to improve claimants’ experiences of the scheme, and to ensure that claims are processed quickly.
Mr Speaker
Order. May I remind Members not to walk past when the Minister is replying to a question? Please have regard for each other; this sets a bad example.
I call the shadow Secretary of State.
Edward Argar (Melton and Syston) (Con)
The Prime Minister’s announcement yesterday of his elective recovery plan mirrored that of Sir Saijd Javid in 2022, but one aspect was different. Our plan explicitly recognised the importance of the workforce being in place to deliver the 9 million extra tests and interpret the results, and it set out proposals to increase that workforce further. What plans has the Secretary of State to boost the workforce in community diagnostic centres specifically, over and above the plans that he inherited from us, to ensure that his elective recovery plan is deliverable?
Wes Streeting
The shadow Secretary of State is right to say that we need staff in place to do the job. The additional funding announced by the Chancellor in the Budget is central to the delivery of this plan—I note that he opposes that funding, which is deeply regrettable—but we need to improve productivity as well. That is why the plan sets out steps to free up patient appointments that are unnecessary or of low clinical value, but, crucially, staff time in productivity gains is also important, so as well as making the most of the additional investment, we are making the most of delivering value for taxpayers’ money—
Mr Speaker
Order. Please help me a little bit. You have had a good run today—don’t spoil it.
Edward Argar
On hospices, while the Secretary of State’s pre-Christmas hospice funding announcement was, of course, welcome, the vast bulk of it was in fact non-recurring capital funding, which cannot be used to help them cover the hiked employer national insurance tax on hospices’ most precious asset: their staff. What steps is he taking to ensure that they receive recurring revenue funding, to enable them to cover the additional costs?
Wes Streeting
The £100 million capital investment we set out before Christmas is the biggest boost to hospice funding in a generation, and it comes on top of the £26 million that we announced for the children and young people’s hospice grant. The right hon. Gentleman cannot welcome the investment and keep opposing the means of raising it. Would he cut services or raise other taxes? He has got to answer.
Tristan Osborne (Chatham and Aylesford) (Lab)
The Minister for Care (Stephen Kinnock)
We are making a priority of resuming consultations with the sector to stabilise community pharmacy. Pharmacy First has built on existing services to increase the clinical scope. The conditions treated under Pharmacy First vary across the UK, and the NHS will keep this under review.
Claire Young (Thornbury and Yate) (LD)
Stephen Kinnock
I am sure the hon. Lady will welcome the fact that we have found an £86 million uplift for the disabled facilities grant, but on the specific question she raises, I would be happy to meet her and discuss that further.
Jo Platt (Leigh and Atherton) (Lab/Co-op)
Andrew Gwynne
My hon. Friend raises a really important point. NHS England is due to complete a stocktake of long covid services throughout England at the end of this month. That will provide an accurate in-depth overview of not only long covid services but ME/CFS—myalgic encephalomyelitis/chronic fatigue syndrome—services. The stocktake will provide a comprehensive and accurate national picture, identify key challenges and make strategic recommendations for future service improvement, development and assurance.
Rosie Duffield (Canterbury) (Ind)
Wes Streeting
Yes, I or the Minister of State for Health would be delighted to meet the hon. Member. She is right to describe the scale of challenge in urgent and emergency care. Of course, there are other challenges in east Kent, particularly in maternity services, which I am acutely aware of too, and I would be delighted to work with her to help solve some of those challenges in her community.
Natasha Irons (Croydon East) (Lab)
Stephen Kinnock
My hon. Friend is absolutely right: the NHS dental contract simply is not working. We are working with the sector to reform the contract, with a shift to focusing on prevention and the retention of NHS dentists. We will deliver on our pledge to provide 700,000 more urgent dental appointments at the earliest possible opportunity, targeting areas that need them most.
Tim Farron (Westmorland and Lonsdale) (LD)
One in five social care jobs in Cumbria are currently unfilled, and the consequences are unbearable for those who are vulnerable; indeed, they are causing pressure on the rest of the NHS. Will the Secretary of State look carefully at the specific needs of rural communities such as ours, where it is so much harder to recruit and retain social care workers?
Wes Streeting
I was in Cumbria recently, and I was struck by the fact that the care home I visited in Carlisle is delivering great intermediate care for the NHS at half the price of a hospital bed—a really good example of how social care often delivers better value and better care. However, the hon. Gentleman is right about the recruitment challenges. We are determined to work with local training providers and the local university to make sure that we recruit social care workers, grow our own in Cumbria and keep them in Cumbria.
Mohammad Yasin (Bedford) (Lab)
The Minister for Secondary Care (Karin Smyth)
My hon. Friend is right to highlight the particular problems in his constituency. Decisions on the configuration of call centres are a matter for local trusts in consultation with staff and representatives, and I encourage him to continue to engage with the trust in the interests of his constituents.
Greg Smith (Mid Buckinghamshire) (Con)
Will the additional money announced for hospices before Christmas cover the full cost of the increase in employer’s national insurance contributions or not?
Wes Streeting
The Conservatives cannot, on the one hand, welcome the investment and, on the other hand, condemn the means of raising it. Would they cut NHS and care services, or would they raise other taxes? They have to answer.
Cat Smith (Lancaster and Wyre) (Lab)
Wes Streeting
I would be delighted to meet my hon. Friend. She was literally the first person to lobby me immediately after the general election, about her hospital, having already lobbied me before. I am delighted that, thanks to her efforts, we have been able to deliver for her community; indeed, thanks to your efforts, Mr Speaker, we have done so for yours too. I would be delighted to meet her.
Mike Martin (Tunbridge Wells) (LD)
Becky’s son Will was a normal, happy teenager until he suffered multiple covid infections. His mother tried to find out what was wrong with him, but she found that there were no paediatric long covid care services in Kent. Will the Minister update the House on whether Kent, with a population of 2 million, will ever get a paediatric long covid service?
Andrew Gwynne
I am very sorry to hear about the hon. Gentleman’s constituent. I know at first hand how complex and debilitating long covid can be. As I mentioned in an earlier answer, there is a stocktake taking place, which should show where there are deficiencies, but let me be clear: I want to ensure that there are good services for people suffering with long covid in every part of England.
Mr Richard Quigley (Isle of Wight West) (Lab)
Stephen Kinnock
My hon. Friend is absolutely right to describe the Isle of Wight as a dental desert. That is perhaps one of the reasons why the good people of that island elected a Labour Member for the first time in history. Our ambition is to make sure that everyone who needs a dentist can get one. Sadly, 28% of adults in England—13 million people—have an unmet need for NHS dentistry. I would be glad to meet my hon. Friend to learn more about how the experience of the Isle of Wight can improve services nationally.
Rishi Sunak (Richmond and Northallerton) (Con)
Prostate cancer is the most common cancer in men, yet it has no national screening programme. We worked on this issue in government, and I thank the Secretary of State for taking an interest in this area. Will he join me in commending Prostate Cancer Research’s excellent new report and urge his team to consider the findings, not least on increasing screening of at-risk groups so that we can not just save the NHS money but, more importantly, save thousands of lives?
Wes Streeting
I welcome the former Prime Minister’s question, and he is right to commend the research. We are actively looking at it. Given that he is here and that we are currently taking through the Tobacco and Vapes Bill, I thank him for his leadership on that issue.
Deirdre Costigan (Ealing Southall) (Lab)
The last Government treated mental health as a Cinderella service, with my constituents waiting days in A&E to be admitted to hospital mental health wards. The Solace Centre in Ealing Southall provides help and support in the community for those with mental health problems, at a fraction of the cost of a hospital stay. How does the Minister intend to move more mental health services from hospital to the community, and to create more great services like the Solace Centre?
Stephen Kinnock
I thank my hon. Friend for her excellent question. She is right that it is vital to move services from hospital to community. The Chancellor made funding available for 380,000 more talking therapies for patients and put in place a £26 million capital investment scheme for mental health crisis centres. A lot of work has been done, but there is a lot more still to do.
Vikki Slade (Mid Dorset and North Poole) (LD)
Will the Secretary of State confirm what is being done to ensure that patients with rare and complex conditions, such as functional neurologic disorder and achalasia, can access consistent and co-ordinated care, including referrals to the multidisciplinary teams they need for the different symptoms they experience?
Wes Streeting
The hon. Member is right to raise cases where there are multiple comorbidities or complex conditions requiring a range of care services. That is why we need to design services around the patient, not expect patients to contort themselves around the services. Our approach to neighbourhood health services should make a real difference in that regard, but we have to go further and faster on health and care integration, and we absolutely will.
Kevin McKenna (Sittingbourne and Sheppey) (Lab)
I strongly welcome yesterday’s announcement about using initiatives such as community diagnostic centres to move services closer to the public. In the Isle of Sheppey, we are particularly exposed as a coastal community, but thankfully a new CDC will really help. Unfortunately, my experience in the NHS over the past few years shows that while the previous Government talked the talk about shifting care to the community, they failed to deliver. Will the Secretary of State set out what steps will be taken, so I can show my constituents that this shift will actually happen?
Wes Streeting
I am delighted to have my hon. Friend and his experience in the House, standing up for his community and giving us his advice and wisdom as we develop our 10-year plan. We are already walking the talk on the shift to community, not least through the big uplift in funding for general practice announced before Christmas. Many people assume our elective reform plan is just about hospital waiting lists, but a big part of it is about delivering the left shift by asking and funding general practice to do more to manage patients in the community.