(4 days, 8 hours ago)
Commons ChamberOn behalf of His Majesty’s Government, I congratulate the hon. Member for Strangford (Jim Shannon) on reaching his 70th birthday—I think you said 70th, Mr Speaker, but I am sure you meant 60th.
In response to my hon. Friend the Member for South Dorset (Lloyd Hatton), we promised in opposition to transform the NHS into a neighbourhood health service, and we have hit the ground running. As a first step, we have announced the biggest boost to GP funding in years—an extra £889 million—which will recruit 1,000 more GPs. We are delivering 700,000 extra urgent dental appointments, and we have given adult and children’s hospices a once-in-a-generation £100 million funding boost. At the same time, we are delivering our plan for change and have cut waiting lists for five months in a row. Change has begun, but the best is still to come.
I, too, pass on my best wishes to the hon. Member for Strangford (Jim Shannon).
In South Dorset we urgently need to restore clinics and shift services back into our community hospitals in Weymouth, Portland, Swanage and Wareham. Sadly, the previous Conservative Government hollowed out those community hospitals, meaning that services left our towns to go further and further up the road. Combined with poor transport links, this means that many local people in my patch find it difficult to access the care they need. With that in mind, what steps is the Secretary of State taking to restore clinics and services in our community hospitals, and will he support my campaign to restore the chemotherapy clinic at Wareham community hospital?
The big thrust of our 10-year plan will be to deliver on the three shifts: from hospital to community, from analogue to digital, and from sickness to prevention. We believe that by moving services closer to people’s homes—and, indeed, into their homes—we will be able to provide faster diagnosis and faster access to treatment, which will be better for patients and for taxpayers. Through the reforms we are making to the structure of NHS England and the governance of the NHS, we are also presiding over the biggest devolution in the history of the NHS, with more powers and decisions taken closer to the communities they serve. In that spirit, I urge my hon. Friend to make representations locally to his integrated care board, as I know he is doing. Ministers will also be open to receiving his representations.
Following the Government’s regrettable decision not to fund Watford general hospital’s refurbishment in this Parliament, providing community care facilities in a town such as Borehamwood in my constituency—a significant town without its own dedicated facilities—is more important than ever. Will the Secretary of State undertake to use his offices to urge the ICB and others to get their act together so that we can finally have those facilities in Borehamwood?
I am very sympathetic to the argument that the right hon. Gentleman makes about the importance of neighbourhood health services in Borehamwood, and indeed in towns and communities across the country. What I am not sympathetic to is a former Deputy Prime Minister complaining about the state of the NHS, which he played a key part in creating when he sat around the Cabinet table.
One in three hospital admissions occurs in a person’s last year of life, and 43% of people will die in an NHS hospital. Clearly, that is not acceptable when people are at their frailest. What is my right hon. Friend doing to invest in virtual wards so that we can keep those people at home, and in the district nurse workforce to ensure that district nurses have a proper career structure and that theirs can be a profession of choice once again?
My hon. Friend is absolutely right about the innovation and the impact of virtual wards. I have seen at first hand the impact they can have—not just in providing better value for taxpayers and freeing up hospital beds for those who genuinely need to be in hospital, but in providing what everyone wants, which is to receive high-quality care in the comfort of their own home wherever possible. That will be a big part of our 10-year plan, and of course, it will be underpinned by really good community nursing and community healthcare teams.
Stepping Hill hospital in Hazel Grove has a huge repairs backlog. Patients are having to park miles away to get to the hospital, corridors have been flooded and there have been frequent power cuts. Alongside Stockport council, the local hospital trust and the community, I am calling for an additional site in Stockport town centre, whether that is a diagnostic centre or otherwise. What assurance can the Health Secretary give my constituents that they will be able to get the health services they need closer to them, and what support can he provide?
I am well aware of the challenges at Stepping Hill hospital and the need for support and investment in services in Stockport, not least thanks to the representations of my hon. Friend the Member for Stockport (Navendu Mishra). We are looking carefully at this situation and are committed to working with leaders locally to try to improve the quality of and access to services to give local people what they deserve.
A new state-of-the-art surgical centre is set to open at the Victoria infirmary in Northwich in the next few weeks. The new facility will be a centre of excellence and a regional hub for outstanding cataract care, and it is an excellent example of how we can reduce pressure on our major hospitals, while making the best use of facilities in the heart of our communities. Will the Secretary of State join me in congratulating the Mid Cheshire hospitals trust on completing this project? Can I invite him to join me on a visit to the centre in the coming months?
I join my hon. Friend in congratulating the local trust on the work it is doing and the impact it is having, and I would be delighted to pay a visit as soon as my diary allows.
The new St George’s NHS hub in Hornchurch has freed up space in Queen’s hospital in Romford to remodel the accident and emergency there. Will the Secretary of State now fund that remodelling, so that our constituents can get better emergency care?
I am grateful to the hon. Member for raising the need for investment in the accident and emergency at Queen’s hospital in Romford. As she alluded to, that department serves my constituents, too, so this will be a rare occasion at the Dispatch Box where I urge and encourage her to lobby the Minister of State, my hon. Friend the Member for Bristol South (Karin Smyth), because in such decisions I must recuse myself. However, she will know where my sympathies lie.
Rebuilding our broken dentistry system is a priority for this Government. We are already rolling out 700,000 extra urgent dental appointments a year, as promised in our manifesto; we have launched a supervised toothbrushing scheme for three to five-year-olds; and we are committed to reforming the dental contract and making NHS dentistry fit for the future in the long term.
In Kettering, we know the scale of the challenge facing NHS dentistry after 14 years of Tory failure. My constituents regularly tell me how impossible it is to get an appointment. Some are driving tens of miles to see a dentist, and it is simply a scandal how many children are admitted to hospital with tooth decay. While it cannot be rebuilt overnight, in Kettering we welcome the extra 17,000 urgent appointments, which are a vital first step. Can the Minister confirm that it is this Government who will make NHS dentistry fit for the future?
My hon. Friend is absolutely right. After 14 years of Tory neglect and incompetence, far too many people are still struggling to find an NHS appointment. This Government are tackling the challenges for patients trying to access NHS dental care by delivering 700,000 more urgent dental appointments a year and by recruiting new dentists to areas that need them. My hon. Friend’s local integrated care board has been asked to deliver nearly 17,000 of the additional urgent appointments. I am in no doubt that she will continue to campaign tirelessly on behalf of her constituents.
My constituent, Kevin Buckley, had his NHS dentist shut with no notice. NHS dentists in Knowsley are not taking on any new patients and he is stuck. This is not just a local issue, but a national crisis. What action will the Minister take to address the shortage of NHS dentists?
I am sorry to hear of the difficulties faced by Mr Buckley. Sadly, that is a challenge we face nationally after 14 years of abject failure from those now on the Opposition Benches. There are no quick fixes or easy answers, but we are committed to reforming the contract and helping those who need it most. My hon. Friend’s local ICB has been asked to deliver more than 46,000 additional urgent care appointments from April onwards, getting care to those constituents who need it most. The north-west has also been allocated 21 posts in the golden hello scheme to recruit dentists into underserved areas.
More than one in three five-year-olds in Stoke-on-Trent has tooth decay. That is the worst rate in the west midlands and is 10% above the national average. Children in deprived areas, like much of my constituency of Stoke-on-Trent North and Kidsgrove, are twice as likely to suffer, and that is not acceptable. Can the Minister please outline what steps the Government will take to reduce regional inequalities in NHS dental access for children?
It is shameful that tooth decay is the biggest reason for hospital admissions of children aged between five and nine, and the inequalities surrounding that are stark. On 7 March, we confirmed a £11.4 million investment in supervised toothbrushing for three to-five-year-olds. The scheme is targeted at children in the most deprived areas—those in index of multiple deprivation groups 1 and 2—and will reach up to 600,000 children. Our innovative partnership with Colgate-Palmolive will result in the donation of more than 23 million toothbrushes and toothpastes, providing outstanding value for taxpayers’ money.
Aldershot and Farnborough are dental deserts. My constituent Nick had an infected wisdom tooth and was in agony. He had been registered with a practice in Farnborough, but it kicked him off its patient list. He obtained an emergency appointment through 111, but two weeks later the infection was back. He was left with little choice but to go private, which cost him £700—10 times what the treatment would have cost on the NHS. Can the Minister explain how Labour’s plan for change will help to prevent such cases from being repeated as we end the 14 years of dentistry failure that we saw under the Conservatives?
My hon. Friend has demonstrated again that she is a tireless campaigner for the people of Aldershot, and I am sorry to hear of the challenges faced by her constituents. This Government will deliver 700,000 more urgent dental appointments a year, and will recruit new dentists to the areas that need them most. My hon. Friend’s local ICB has been asked to deliver nearly 7,000 of those additional urgent care appointments in the year from April. In the long term, we will reform the dental contract with the sector, with a shift to focusing on prevention and improving the retention of NHS dentists.
The Secretary of State and Ministers’ commitment to 700,000 more emergency dental appointments is already taking effect in my NHS area, with an extra 27,000 slots, and the feedback is excellent. However, constituents have told me that some dentists seem to be removing non-emergency patients from their lists. Can the Minister please reassure them that their NHS dentists will be there when they need them?
As my hon. Friend says, we are delivering 700,000 additional urgent appointments. Patients are not limited to a registered practice in England, and practices are required to keep their status up to date on the NHS website. Anyone struggling to find a dentist should go to nhs.uk or call 111. It is also clear that while NHS England is not mandating an approach to the purchasing of these additional appointments, ICBs could consider either buying more appointments through new or recommissioned contracts or modifying existing contracts, and/or using flexible commissioning.
The Minister is aware of my concern about the inability of some 200 fully qualified Ukrainian dentists to practise because of the restrictions placed on them by the General Dental Council. I know that the Minister has written to the GDC about this, but has he received a reply?
I thank the right hon. Gentleman for the constructive meeting and discussion that we had on this matter. As he will know, we are exploring the use of provisional registration for overseas dentists, and we are urging the GDC to arrange more examinations for dentists. I have a meeting set up in short order with the head of the GDC, and I will keep the right hon. Gentleman posted on that conversation.
My constituents are being forced to travel out of county to Coventry or Evesham to obtain basic NHS dental care. Does the Minister agree that it is a disgrace that access to an NHS dentist has become a postcode lottery? What urgent steps are the Government taking to end this dental desert and restore NHS services to rural communities such as mine?
I absolutely agree. The state of NHS dentistry in our country is shameful. The golden hello scheme enables 240 dentists to receive a £20,000 joining bonus payment to work in dental deserts, and we are negotiating with the British Dental Association the long-term reform of the contract. The issue is not the number of dentists in the country, but the paucity of dentists who are doing NHS work.
The north-west has some of the worst levels of children’s oral health in England, with Cheshire and Merseyside falling below the national average. In rural villages in my constituency like Bunbury, where bus services have been cut, and Kelsall, where a dentist is keen to open an NHS practice but faces barriers due to city centre prioritisation, residents are struggling to access NHS dental care. Given the challenges of rural access, what steps is the Minister taking to ensure that NHS dental provision is available in those rural communities?
I find it quite striking when Conservative Members stand up and describe the abysmal state of NHS dentistry. It makes me think, “Well, who created this mess in the first place?” But that is as an aside. The fact is that we have the golden hello scheme for dentists to come and work in so-called dental deserts. We recognise that the fundamental problem is around incentives for dentists to do NHS work. That is why we are doing a long-term contract negotiation to ensure we have an NHS dentistry contract that is fit for purpose and where every penny allocated to NHS dentistry is spent on NHS dentistry.
There is an urgent need for dental training in Norfolk, so can the Minister confirm that the Government will enable the Office for Students to allocate new dental training places in the east of England to start in 2026?
I thank the hon. Gentleman for that question. I have met hon. Members from the area and made it clear that in principle we support any creation of new teaching capacity for dentistry. What I have also set out is that, before we can give an instruction to the Office for Students to go ahead with that work, we have to have the settlement of the comprehensive spending review, so we know what our financial envelope is. We will not have that until June, but certainly we will be looking at that as and when we know whether the funding will be available.
There’s only one Jim Shannon, by the way, you know? [Laughter.] Mr Speaker, thank you very much for your birthday wishes. I am terribly embarrassed. I thank right hon. and hon. Members for their kind wishes. As I often say, I don’t count the years, I make the years count. That is the important thing.
Can I ask the Minister a very important question? What discussions has he had with the Education Secretary on providing more financial support to young students who want to study dentistry, to ease the burden of high costs associated with studying dentistry which many young people may find off-putting?
I thank the hon. Gentleman for that question and I congratulate him again on his 60th birthday. [Laughter.] He raises an important point on teaching and training in dentistry. There is not enough capacity in the system. We absolutely want to ensure that we are building that capacity. As I said, a lot of that will depend on the comprehensive spending review settlement in June. I would be more than happy to discuss the issue with him in greater detail once we have a better sense of where we are on the funding.
The Government are committed to improving women’s health outcomes. We have already taken urgent action to tackle the gynaecology list through the elective reform plan, and we recently announced an £11 million trial using AI tools to detect breast cancer cases earlier. The 10-year health plan will set out how we will tackle the factors that lead to poor health outcomes and the improvements we expect to see.
What assessment has the Minister made of the adequacy of research into and the provision of fibroid treatment for women, taking into consideration that fibroids are three times more likely to appear in black women than in white women?
The Government welcome the work my hon. Friend has undertaken and the work of the Caribbean and African Health Network in highlighting health inequalities for black women. She highlights shocking and unacceptable statistics. The National Institute for Health and Care Research has funded a significant amount of research into women’s health issues, including a £1.5 million trial comparing treatment options for fibroids. I am happy to make sure she is updated on that work and on the details of that work.
Early diagnosis and treatment of breast cancer can make a huge difference to the women involved, and, of course, to the prognosis and the cost to the state of health provision. I welcome the reference in the cancer plan to early diagnosis, but what specifically will the Government do to encourage greater awareness of the full range of breast cancer symptoms, and to encourage women to get early diagnosis and treatment for better outcomes?
I thank the right hon. Gentleman for that question and for the work he has supported on behalf of his wife to raise awareness. Screening access and uptake are shockingly low across the country right now, and looking at that is a key part of what we need to do to ensure that women come forward for the screening test. The AI work will support the faster response time so that we can get women treated more quickly, and will absolutely form part of what we need to do in the coming years.
I want to put on the record my thanks to the Health Secretary for coming to Nottingham last week and meeting some of the families who have been harmed by extremely serious failings in maternity services at Nottingham University Hospitals NHS trust, and for his sincere commitment to them. It was clear just how moved he was by their stories. One of their asks is that the Government implement the 22 recommendations from the Shrewsbury and Telford Ockenden review, so I ask the Minister today to commit to doing that.
I know that my hon. Friend and other Members representing that area have supported the trust and particularly the families who have been affected. As she highlights, my right hon. Friend the Health Secretary visited last week and was deeply moved by those stories, and has committed to visiting again. The Government are working through those recommendations and will update the House shortly.
Following on from the question asked by the hon. Member for Nottingham East (Nadia Whittome), I held a debate in Westminster Hall a few weeks ago on maternity services and spoke to families across the country who have experienced failures in the system that ultimately left them without their babies to take home. It was a devastating experience for all involved. The immediate and essential actions in the Ockenden review were supported by the previous Government, and the Secretary of State for Health has been vocal in his support for their implementation. However, those families want to know how quickly they will see real change in maternity services up and down the country so that families can confidently go to deliver their babies.
The hon. Lady is right to highlight the impact of the failures in maternity services on women and their families across the country. As she highlights, my right hon. Friend the Health Secretary takes this matter personally and is looking at it. We will continue to work closely with Donna Ockenden on those recommendations and will continue to update the House regularly. This is an important issue for Members across the House representing their constituents, whether in this Chamber or Westminster Hall, and we are very keen to ensure that we support staff, build that confidence for women and their families and give them a good experience of maternity services.
I am grateful to Professor Sullivan for her report. Sex and gender identity are not always the same, and it is important for patients that we record both accurately. I know the House will share my concern at some of the findings from Professor Sullivan’s report, such as trans patients not being invited for cancer screening because of how their gender is recorded. I can assure the House that I am already acting on reports. Last week, I instructed the health service to immediately suspend applications for NHS number changes for under-18s to safeguard children. Taking such action does not prevent the NHS from recording, recognising and respecting trans people’s gender identity.
I thank the Secretary of State for his response, which will give much-needed reassurance to patients across the UK. Any public body that fails to accurately record sex and instead conflates it with gender puts people at serious risk of harm. Unfortunately, this type of organisational capture has been widespread across Scotland, with devastating consequences. Can the Secretary of State assure me that he will raise this issue with his counterparts in the Scottish Government to ensure that NHS Scotland does not put my constituents at risk?
I will absolutely undertake to share the approach we are taking with my counterparts across the United Kingdom. The approach I have always taken is one that understands the importance of biological sex, that recognises, understands and supports that someone’s gender identity may not always match their biological sex, and that seeks to navigate a way through what has been an extremely toxic and sometimes harmful debate in a way that protects the sex-based rights of women and protects trans people and their identity. I know that my colleagues across Government are taking an equally sensitive approach, and I think it would be in everyone’s interests if we saw a similar approach across the whole of the United Kingdom. It is important not just in the provision of services, but in accurate data and research, that we make that distinction, which does not in any way undermine respect for people’s gender identity.
The inquest into the tragic death of a young woman who lived in Eastleigh has highlighted the importance of continuity of specialist care for vulnerable people who move home. My constituent, Alex, is still waiting for an appointment for ongoing specialist care three years after moving to Eastleigh. Will the Minister meet me to discuss the provision of mental healthcare in my constituency?
This question is about sex and gender. Do not worry; I am sure that the Secretary of State has the message.
I now call the shadow Minister.
Given the findings of the Sullivan review on patient and health safety, which came about as a result of inaccurate and poor data collection, can the right hon. Gentleman confirm what meetings he has had with Secretary of State for Science, Innovation and Technology to discuss the reliability of the data on sex that is intended to be used by the digital verification platform in the Data (Use and Access) Bill?
I am grateful to the shadow Minister for her question. I speak to the Science Secretary on too frequent a basis—on a daily basis. He and I are both looking very carefully at the findings of the Sullivan review and working through its implications for both the health and care services, for which I am responsible, and for the Government digital and data services, for which he is responsible.
The UK Health Security Agency, for which the Secretary of State is responsible, publishes health statistics. This includes data on sexually transmitted infections, which is published by sexual orientation and sex. However, a footnote states that women are defined in the dataset as “women and trans women”, which does somewhat undermine the value of the data. What will the Secretary of State do to ensure that data is not just collected properly, but published and presented in a way that is most clinically useful?
The shadow Minister raises a good example of how conflation of sex and gender identity is not helpful both in terms of data analysis and of recognising health inequalities. It is also not helpful in making sure that we understand variances between people based on their different backgrounds and characteristics and that we provide targeted, personalised and effective healthcare that deals with healthcare inequalities. That is why we are carefully studying the recommendations made by Professor Sullivan, with a view to making sure that we are meeting the needs of everyone, including the trans community, who I understand, not least because of the way that the debate has been conducted in recent years, are anxious about the implications of the report. However, I genuinely think that the report will lead to better, more inclusive and fairer outcomes for everyone, including the trans community.
I know the hon. Member is acutely aware of the impact that cancer can have on families. We are committed to catching cancer earlier and treating it faster. We have achieved our manifesto pledge of 2 million extra appointments seven months early and we have invested in more surgical hubs, longer opening times, which have benefited 23 community diagnostic centres in the south-west, and new radiotherapy machines. The national cancer plan will also seek to improve every aspect of cancer care to improve patient outcomes and experiences across the country, including in the west of England.
I thank the Minister for her answer. The Big Space Cancer Appeal being run by the Cheltenham and Gloucester Hospitals Charity is going on in my constituency. It is having to raise £17.5 million for a new cancer centre at Cheltenham general hospital, which is a regional cancer centre, because the previous Government did not fund it. I am proud of the fund-raising work that is being done by the hospitals charity, including by my caseworker, Mateusz, who is running two half marathons for the cause. Will the Minister meet me and Dr Sam Guglani and Dr Charles Candish to discuss how the Government might provide more support for this crucial piece of infrastructure?
I commend the hon. Member’s campaign activity for improved cancer facilities. I commend, too, Mateusz’s two half-marathons. I wonder when the hon. Member will be doing his half-marathon, but I can guarantee that I will not be joining him. The fact that this sort of activity is taking place is fantastic. Local provision for healthcare is managed by the local health system. I would be delighted to meet him and local representatives as soon as diaries allow.
Cancer care is important for people right across the UK, particularly early diagnosis. How do the Government plan to raise cancer awareness among young people during Teenage and Young Adult Cancer Awareness Month and ensure that they are fully aware of the signs and symptoms?
This is a really important issue. We have reinstated the children and young people cancer taskforce, which I visited a couple of weeks ago. We have tasked it with ensuring that children and young people are a part of its work. The Department will be marking Teenage and Young Adult Cancer Awareness Month appropriately. We encourage all children and young people to get the checks that they need and be aware of cancer symptoms.
I know that this subject is very close to my hon. Friend’s heart, after many years of NHS service. Ensuring great careers for NHS staff, including nurses, has been a key theme of our engagement with staff to shape the 10-year plan. I will shortly set out further measures to improve progression for nurses and their colleagues in other key NHS professions.
I thank the Minister for her answer. Nurses across the profession are increasingly taking on complex roles and responsibilities, yet many do not have access to higher pay bands that reflect these changes, and there is too much variation around the country. As well as looking at this, will the Minister ask the Department of Health and Social Care to implement a consistent model for supported, structured progression from band 5 to band 6 for early career nurses based on the completion of key competencies and the acquisition of necessary experience?
My hon. Friend is right that NHS staff, including nurses, should be paid appropriately for the work they are asked to do and will be asked to do in future. We are working with the NHS Staff Council to ensure that the national job evaluation scheme is implemented fairly and consistently across nursing and all professions.
My constituent Ben has spent two decades working as a nurse. He tells me that his paramedic and midwife colleagues received automatic pay band increases post qualification while he and his nursing peers did not. Ben and his hard-working nursing colleagues have missed out on tens of thousands of pounds compared to colleagues in other disciplines. Does the Minister agree that something must be done urgently to make up for this inequity?
I am absolutely clear that we need to make sure that the job evaluation scheme looks at staff across the piece and that people are rewarded appropriately for the work they are asked to do. We will do that as part of our discussions with the NHS Staff Council, and we will be working consistently with staff as part of the 10-year plan to ensure that people are rewarded. We depend on these staff, and we want to encourage them to be part of the NHS workforce. That is the approach we intend to take.
The 18-week standard for elective care has not been met for almost a decade. That is the legacy of the Conservative party. Our plan for change commits us to cutting waiting lists from 18 months to 18 weeks by the end of this Parliament through a combination of investment and reform. Since we took office, the waiting list has reduced by over 190,000. We achieved our manifesto pledge of 2 million extra appointments seven months early, and waiting lists have fallen five months in a row. A lot done, but a lot more to do. Change has begun, and the best is still to come.
I welcome that NHS waiting lists for physical health have fallen for the last five months in a row and that NHS waiting lists are down by almost 200,000 since Labour was elected, but with people who have mental health conditions eight times as likely to have to wait 18 months for treatment, what steps are the Government taking to ensure that we see the same progress in waiting times for both mental and physical health treatments? Can they deliver a parity of esteem that the Opposition failed to achieve in their 14 years in power?
I am grateful to my hon. Friend for his question and for his long-standing commitment to improving mental health services. Lord Darzi highlighted that those waiting over a year for mental healthcare outnumbered the entire population of Leicester. We are committed to tackling this. We will fix the broken system by recruiting an extra 8,500 mental health workers, introducing access to a specialist in every school and rolling out community Young Futures hubs in England. We will shortly be publishing before Parliament our mental health investment standard report, which will show that when it comes to mental health this Government are putting their money where their mouth is.
Waiting times for patients living in the village of Burton outside Christchurch could be drastically cut if the local integrated care board were to approve the creation of a new branch surgery. That application has been outstanding for more than four months. Will the Secretary of State put a bomb under Dorset ICB and get it to approve it straight away?
That sounds like an invitation to commit a criminal offence, and I think I will resist the temptation. I am sure that the ICB has heard the hon. Gentleman’s forceful representations, and we will make inquiries to get him an update.
Shrewsbury and Telford hospital trust has some of the longest waiting lists in the country for cancer and A&E, among other areas. It has been receiving national mandated support from NHS England’s recovery support programme. NHS England also provides support to hospital trusts that are struggling with excessive waiting lists through its Getting It Right First Time programme. Given the announcement to abolish NHS England, will the Secretary of State reassure my constituents that there will be continued support for hospital trusts such as Shrewsbury and Telford with unacceptable waiting times, and a clear pathway to improvements for patients who deserve better?
Yes is the short answer. Removing the duplication, waste and efficiency that came with having two head offices for the NHS will lead to better, more effective and streamlined decision making, but that will not in any way detract from the support that the hon. Member describes. In fact, we should see more support and, crucially, more investment going to the frontline as a result of the savings, efficiencies and improvements that we are making.
This Government recognise the vital role that community pharmacies play as an integral part of our health system and local community. We are working with Community Pharmacy England on the pharmacy contract, which will start to stabilise the sector and make it fit for the future, and we will announce the outcome very shortly. On hub and spoke dispensing, we intend to lay draft secondary legislation in the coming weeks to come into force later this year.
Community pharmacy funding is at a critical juncture, with many pharmacies in my constituency facing financial challenges. With running costs increasing and uncertainty around the date of the upcoming settlement, community pharmacies are concerned that there may be disruption to their business. What steps is the Department taking to ensure that input from community pharmacies is considered, and prior to any further legislative or regulatory changes relating to the hub and spoke model?
My hon. Friend is right that we inherited a community pharmacy system that had been neglected for far too long, such that over the past two years, on average six pharmacies have been closing every week. A wide range of community pharmacies and representative organisations fed into the public consultation on hub and spoke reform, and I am pleased to confirm that their responses were overwhelmingly positive in support of model 1 of hub and spoke, which we will be going with.
I recently visited Well pharmacy in Northallerton, which, like so many others, plays an important role in providing community health services. One valued service is the provision of free blood pressure checks to those over the age of 40. Will the Minister to join me in urging anyone with health worries or a family history of high blood pressure to take advantage of this fantastic free, pharmacy-led, preventive community health service?
The right hon. Gentleman is right that a big part of the Government’s shift from hospital to community is the pivotal role that community pharmacies will play in that process. We are committed to the Pharmacy First model of enabling community pharmacies to do more clinical work, such as the type that he just described. That is at the heart of our 10-year plan.
Now that the Secretary of State is abolishing NHS England, will he listen to the calls from the National Pharmacy Association and the Independent Pharmacies Association, and publish immediately the independent report commissioned by NHS England on pharmacies’ finances?
We will publish the economic analysis imminently. He mentioned the National Pharmacy Association, which gives me the opportunity to say that I think that the collective action that it is taking is premature, unnecessary and detrimental to community pharmacy patients. I urge the NPA to reconsider its position and wait for the outcome of our negotiations with the CPE, which will come very shortly. We will announce that very soon.
The National Pharmacy Association, which has been waiting for months to get the answer, is advising all its 6,000 pharmacy members to reduce services and hours, for the first time in 104 years. That has never happened before under a Labour Government, or under the Lib Dems or the Conservatives, but it is happening under this Government. Its chair said:
“The sense of anger among pharmacy owners has been intensified exponentially by the Budget”,
citing unfunded national insurance contributions and national living wage increases. The Minister acknowledges that there is potential action. What contingency plans does the Department have to ensure that we keep patients safe if pharmacies close their doors in industrial action next week?
On the NPA, it has taken us a while to clean up the utter mess that we inherited in community pharmacy. That involved agreeing financial envelopes and getting into negotiations with CPE. Those negotiations have been constructive, and I am delighted to confirm again that we will soon announce the outcome of those negotiations. What we see here is the shadow Minister apparently taking the side of people taking collective action in a premature way that is detrimental to patients. They would be better off waiting for the outcome. The Government are taking industrial relations into the 21st century, as opposed to the performative nonsense that we saw for 14 years.
When someone is detained, family involvement is extremely valuable, and families should be supported to maintain contact with their loved ones. Our Mental Health Bill will strengthen requirements to involve families in people’s care. We will require clinicians to involve patients and their families where possible when developing new statutory care and treatment plans.
I have two ongoing constituency cases with adult men who have serious and long-term mental health issues. One of my constituents believes that her life is in danger because of her son’s threatening behaviour towards her—her own mental health has been seriously affected by the fear and stress. The other case involves a young man causing serious distress to his neighbours with his behaviour, which recently led to an incident where he reportedly threatened a police officer with a knife. Both men are living alone in unsupported accommodation, both are at risk of coercion and abuse because of their mental health problems, and both are causing serious distress to their families and neighbours. Will the Minister tell the House whether he is working with other Departments to ensure the availability of more provision to support people such as my constituents to live safely in the community and not cause harm or distress to those around them?
I know that the hon. Member has met my right hon. Friend the Secretary of State about at least one of those constituency cases. NHS England has asked mental health trusts to review the care of high-risk patients and has published national guidance on the standards of care that are expected. Ultimately, the Mental Health Act is there to protect people and provide the necessary powers to enable clinicians to manage and support such patients—and to do so, where possible, in the community.
Yesterday I met Essex partnership university NHS foundation trust and spoke to it about the need to support the families of those suffering with mental health issues in Harlow, and particularly those with caring responsibilities. Will the Minister consider how mental health services can better identify and support young carers?
My hon. Friend will be aware that we are bringing forward the Mental Health Bill, and an important part of that legislation will enable family members—when they are chosen as a nominated person—to have powers to request assessment under the Act, challenge decisions and request considerations of discharge in line with the nearest relative powers.
I commend my hon. Friend for her dedication to improving support for children in her role as the opportunity mission champion. Children with special educational needs and disabilities may access a range of NHS services, including health assessments and specialised support. All integrated care boards must have an executive lead for SEND to ensure that that work receives sufficient focus. We are working closely with the Department for Education on reforms to the SEND system.
As the Minister is aware, last year we faced the devastating closure of the Accrington Victoria hospital after 14 years of mismanagement by the Conservative party. I place on record my thanks to the frontline staff who have managed that transition and the operational challenges to relocate services, but sadly a fully purposed building for children with SEND had to be used to relocate clinical services. How does the Minister plan to ensure that those with SEND are at the heart of commissioning plans and service development?
The system we inherited has been failing to meet the needs of children with SEND for far too long—that became clear in what happened at the Accy Vic. Through the 10-year health plan, we will consider all those policies, including those that impact on children and young people. We are working closely with the Department for Education to support the delivery of the opportunity mission. I also hosted a roundtable recently with children and young people, including those with SEND, so that they can feed directly into the 10-year plan. They will be at the heart of our thinking and planning on these issues.
Mr Speaker, your heart would have been gladdened last week to see colleagues from across the House coming together to support my debate calling for the Down Syndrome Act 2022 to be implemented three years on. The Minister for Secondary Care said in response that Down syndrome-specific guidance would be produced, which is welcome. Will the Minister ensure that the consultation group is restricted to organisations that represent Down syndrome people only, and will she promise that, after three long years, that statutory guidance will finally be issued before the end of this calendar year?
Work to develop the Down Syndrome Act statutory guidance is being taken forward as a priority, with a view to publishing it for consultation by the summer. It does involve people with Down syndrome, as part of a wider group.
Since I reported to the House on the Government’s plans to abolish NHS England, hammering the final nail into the coffin of Lord Lansley’s disastrous 2012 reorganisation, the reforms have been welcomed almost universally across Parliament—with the exception of Lord Lansley. I am pleased to report that the new chief executive of NHS England, Sir Jim Mackey, has appointed the transformation team that will deliver better care for patients and better value for taxpayers’ money. We are working closely together as we finalise the 10-year plan for health, which will be published around the spending review in June.
My constituent June is 74 years old and has stage 4 cancer. She had to queue—not phone, but queue—at her GP surgery at 8 am, only not to be given an appointment. What is the Secretary of State doing to stop such dreadful situations?
I am very sorry to hear of June’s experience. It illustrates why our determination to end the 8 am scramble for appointments is so necessary, starting with a new requirement for practices to make online appointment requests available through core hours, as well as the big uplift we have invested into general practice. I hope that will start to see improvements so that people like June will not be left queuing outside in the cold.
May I take this opportunity to thank the Secretary of State for his kindness following the death of my father earlier this month? It was very much appreciated.
I welcome the moves to streamline decision making and improve efficiency in the context of the Secretary of State’s NHS England announcement, if he genuinely drives decentralisation to integrated care boards. However, in a written answer on 21 March, the Minister for Secondary Care said:
“We recognise there may be some short-term upfront costs as we undertake the integration of NHS England and the Department”.
For clarity, can the Secretary of State confirm what the quantum of those reorganisation costs will be and the date by which they will have been recouped?
I am sure that the whole House will want to send our condolences to the right hon. Gentleman following the loss of his father. It is good to see him back in action—if not always back in action.
Given the scale of the job reductions and savings that we are seeking to make, the total quantum will be determined once the final shape of the organisation is determined.
Can I also welcome, as I did in January, the Secretary of State’s commitment to seek to work cross party on the future of social care? He was right and I welcomed that at the time, but like him and many others, we are all keen to see progress. Can he update the House on when he anticipates the cross-party talks that were postponed in February will be rescheduled to take place?
Baroness Casey will be making contact with all party groups in order to set dates with parties across this House very shortly, and of course she will be kicking off her commission in April, which is now only days away.
As my hon. Friend says, we have brought NHS waiting lists down five months in a row, including during the peak winter pressures. We have delivered the 2 million more appointments we promised seven months early, and we published our elective reform plan at the beginning of the new year with the Prime Minister, which sets out the combination of measures, the investment and the reform that will ensure that we deliver the shorter waiting times and the faster access to treatment that my hon. Friend’s constituents and people right across the country deserve. I look forward to keeping him updated.
We are not going to get everyone in unless we pick up the pace. The Liberal Democrat spokesperson will set a good example.
In last night’s “Panorama” programme, the Secretary of State was reported to have said that he did not need to wait for a review to put more money into social care, which we agree with. If that is the case, will he explain why the Casey commission will take three years, and will he instead commit to getting it done this year in order to fix the social care crisis straightaway?
Phase 1 of the Casey commission reports next year and the final Casey report is due by 2028, but the Chancellor has already announced an increase in funding for social care in the Budget, through means that the hon. Lady’s party regrettably seems to oppose.
I commend my hon. Friend’s constituent for her work with the Brain Tumour Charity, and I wish Lily well with her treatment. The Government have launched the brain tumour research consortium, which will support efforts to speed up the diagnosis of tumours and aid the recovery of patients, and the national cancer plan will ensure that we include brain tumour patients. We know that everyone’s cancer is as unique as they are, and this will be reflected in the plan.
The Chancellor took almost immediate action to deliver the uplift in pay for NHS staff that they deserve. We are working closely with the Royal College of Nursing, Unison and others ensure that we tackle the challenges of low pay in the nursing profession that the hon. Member describes.
I am very sorry to hear about my hon. Friend’s constituents’ experience. Accessing vital medicines while travelling between nations should be seamless, and I will ask NHS England to work with NHS Scotland to better understand what needs to change to make things easier for patients across the UK.
Despite the significant uplift announced by the Chancellor at the Budget, system financial returns during the planning round suggested an overspend for the coming year of between £5 billion to £6 billion. When I said I would not tolerate overspending in the NHS, I meant it. When I said I would go after unnecessary administrative costs, duplication and bureaucracy, I meant it. That is what this Government are doing to protect frontline services.
In Saxmundham in my constituency, Dr Havard has led a campaign for 20 years to transform the healthcare centre into a one-stop community healthcare hub. His practice has already expanded services, transforming health locally. Does the Minister agree that the Saxmundham healthcare hub is an excellent example and model for what this Government are trying to do to transform community healthcare?
My hon. Friend is absolutely right that shifting care from hospitals to the community is at the heart of our 10-year plan. I would be happy to meet the doctors leading this pilot to find out more about the excellent work that she describes.
For eight years, I have seen how a young constituent has been able to completely control his previously life-threatening seizures with medicinal cannabis, but at huge cost to his family—a cost that is prohibitive for other people. Will the Secretary of State meet me to discuss how we can make access to such treatments more affordable, accessible and safe, so that we can help more people?
We recently had a helpful debate in Westminster Hall on this topic. We are doing more research on this issue to ensure that the evidence base is there. I am happy to discuss the matter further with the hon. Member.
In the ongoing discussion on assisted dying, one point on which we all agree in this House is the urgent need to improve palliative care. I therefore welcome the Government’s recent £100 million commitment to supporting hospices, including those that help my constituents. Can the Minister confirm whether long-term funding for hospices will be a priority in the upcoming 10-year health service plan?
My hon. Friend is right that the hospice sector has been provided with the largest capital spend in a generation—£100 million. We are also providing £26 million of revenue funding to children and young people’s hospices. I can confirm that hospices will play a key role in our shift from hospitals to the community, as he set out in his question.
Tragically, Ed was just 24 years old when he decided to take his own life, and that is why the family have joined us today in the Gallery. What urgent action are the Government taking to improve mental healthcare and suicide prevention for young people like Ed?
The hon. Member raises an important issue. We are investing in 8,500 more mental health specialists, as well as specialists in every school, and in Young Futures hubs across the country, to ensure that we do whatever we can to prevent these tragedies.
An early day motion from 2007 noted that women were typically waiting eight years to be diagnosed with endometriosis. Shockingly, nearly 20 years later, that wait has increased to nine years. The Government are right to tackle the appalling waiting lists for surgery, but the one in 10 women who suffer with endometriosis often struggle with years of pain before surgery is even suggested. What plans does the Department have to deal with these delays, and how we can ensure that those working in primary care recognise this debilitating condition earlier?
Those statistics are shocking. Campaigns here and elsewhere have helped to raise awareness of endometriosis. The update to National Institute for Health and Care Excellence guidelines will help, as will more appointments, and our commitment to the 18-week target. Training for GPs is now part of the core curriculum, and we expect that to yield good results. NHS England and the Office for National Statistics have look-across to the statistics on diagnostic metric standards. I am happy to update my hon. Friend outside the Chamber, and I know other Members are also interested in how we are delivering on these commitments.
My constituents in South West Hertfordshire remain concerned about the significant delay to the redevelopment of Watford general. With the Chancellor already bringing a second emergency Budget before the House tomorrow, and with care homes, hospices and charities facing unsustainable pressure from this Government’s national insurance increases, what reassurances can the Minister give my constituents that the Labour party truly care about healthcare, rather than scoring political points?
The irony! There is one big difference between what this Government are doing and what the Conservative party did for 14 years, which is that this Government will actually deliver a new Watford general hospital where the Conservative party failed.
Do Ministers agree that a logical conclusion of the Darzi report is that the national care service that we are committed to creating must be free at the point of use? As Lord Darzi found, as long as the social care system remains means-tested and the NHS is a universally free service, unmet care needs will continue to put unsustainable pressure on our health services.
That is a vital issue. The Casey commission will look at how best to create a fair and affordable adult social care system, and at which structural reforms will be needed where health and social care meet, because reform must always be married with investment.
General practitioners in my constituency have consistently restructured over 10 years of constant systemic and economic pressures. How will the Minister convince the Treasury to exempt GPs from the increase to national insurance contributions, and show my GPs that he has their back?
It was thanks to the decisions taken by the Chancellor in the Budget that we were able to award £889 million for general practice. That is why the Minister for Care was able to get the GP contract agreed for the first time since the pandemic. Opposition Members cannot continue to welcome the investment and oppose the means. They have to spell out where they would cut services or raise taxes instead.
Last year, my constituent Danielle was diagnosed with POTS—postural orthostatic tachycardia syndrome. She found herself unable to get out of bed and unable to speak for long periods. She could not receive care in Scotland. Specialist treatment does not seem to exist for POTS. What more can we do for people like Danielle, and what conversations has the Minister had with counterparts about establishing specialist treatment in Scotland?
In England, it is the responsibility of local integrated care boards to work with clinicians, service users and patient groups to develop services and care pathways that are convenient and meet the needs of patients with POTS. NICE has published a clinical knowledge summary on the clinical management of blackouts and syncope, which provides advice for UK clinicians on best practice and the assessment and diagnosis of POTS.
I have twice invited Ministers to visit Bridlington district hospital with me to see its much-underutilised potential. In the light of the ongoing challenges faced by coastal and rural health services and the newly announced changes to integrated care boards, may I hope that it will be third time lucky, and extend that invitation once again?
We are delighted to receive the hon. Gentleman’s representations. We will look carefully at the case he makes and will consider visits as diaries allow.
Much to my alarm, the North Central London ICB has recommended the closure of the maternity unit at the Royal Free hospital in my constituency. The Secretary of State knows the Royal Free well. Will he meet me to see how I can save my local maternity unit, which looked after me so well when I had gestational diabetes?
These local services are so important for local women, as my hon. Friend has experienced. It is really important that reconfigurations are discussed with local Members of Parliament, representing their constituents. This is obviously a matter for the local ICB, but I am happy to discuss it further with her.
Following my long-running campaign, I am grateful to the Government for finally updating the outdated Treasury rules that were preventing local health boards from spending more money on keeping city centre GP locations. Will the Government now issue guidance to local health boards and NHS trusts to accelerate the pooling of resources, so that we can get more services out of hospitals and on to our high streets, especially as our high streets need extra footfall right now?
I am grateful to the hon. Member for all the work she has been doing on this issue. She is right: we need more integration of services, and we need to look at where we can share facilities to achieve better care for patients and better value for taxpayers.
The former chair of my local trust, Bradford teaching hospitals NHS foundation trust, Dr Max Mclean, has today secured whistleblowing protection for himself in a landmark victory. Last week marked a year since a non-exec director at the trust was suspended, and a third non-exec director has put in an ET1 form to the employment tribunal. There appears to be a clear culture of targeting and witch-hunting whistleblowers at Bradford teaching hospitals trust. I appreciate the Secretary of State’s team supporting me, but given these recent developments, will he meet me?
I am grateful to my hon. Friend for raising these serious issues. There are issues of concern here, and she clearly describes a concerning situation for the local community. We need to look carefully at what is happening, and the Minister of State for Health, my hon. Friend the Member for Bristol South (Karin Smyth), would be delighted to meet her.
Smile Dental Centre is in one of the least affluent parts of my community in Basildon. It is looking to expand and provide more NHS dental services, but it has come up against a few issues. Will the Minister, or one of his officials, meet me and Smile Dental Centre to see what we can unblock to deliver more dental health services for local people?
We are always looking for opportunities to unblock more capacity, and I would be happy to meet the right hon. Gentleman.
Coastal constituencies such as mine in Bournemouth East suffer significant health inequalities. What are the Government doing to address them, and will the Minister meet me and coastal Labour MPs to address the issue?
My hon. Friend is right: coastal communities face unique challenges when it comes to health inequalities. I will shortly attend the all-party group for coastal communities, where I will meet him and colleagues to discuss these issues.
As the Secretary of State will know, in 2018, this House allocated £40 million of funding in memory of Dame Tessa Jowell, who was killed by a brain tumour. Seven years on, less than half of that money has been spent. The money is doing no good sitting in a bank, so will the Secretary of State please commit to spending that money within a decade of Dame Tessa’s death?
I am grateful to the hon. Gentleman for his question, as it gives me the chance to pay tribute to the late great Baroness Jowell, as well as to the work taking place in her name through the Tessa Jowell Brain Cancer Mission. There have been frustrating delays in getting funding out the door for the purpose for which it is intended. Ministers are looking carefully at this issue, and we want to make more progress more quickly, to ensure that families do not receive the same death sentence that our late friend did.
On a point of order, Mr Speaker. Since 14 January, I have tabled 15 named day written parliamentary questions to the Department of Health and Social Care. Fourteen have received a holding response, meaning that just one was answered on time. To give a simple example, I asked how many times the Minister had met Community Pharmacy England. Four days later, I received a standard holding answer, which stated that
“it will not be possible to answer this question within the usual time period.”
It then took five days for an answer to come, which stated:
“Ministers meet regularly with external stakeholders on a variety of topics, including, but not limited to, pharmacy.”
May I ask your advice, Mr Speaker? What mechanisms are in place to ensure that named day questions are answered on time? If they continue not to be answered on time, how can I escalate the matter further?
First, I am disappointed that questions are not being answered, but I am not responsible for ministerial answers. I hope that those on the Treasury Bench, including the Secretary of State, have taken on board the importance of replying. Named day questions are called that because they are meant to be answered on the day that is named. I am very disappointed. The Department may be overworked; if that is the case, perhaps we ought to bring in staff from other Departments to ensure that questions are answered on time. I know that the Secretary of State will have immediately made a note to ensure that those questions are answered.