The Minister for Secondary Care (Karin Smyth)
With permission, I would like to make a statement on the outcome of the spending review for the Department of Health and Social Care.
This Government were elected on a manifesto to fix our broken NHS and make it fit for the future. Our job is twofold: first, to get the NHS back on its feet and treating patients on time again; and secondly, to reform the service for the long-term so that it is fit for the future. That is why, in her autumn Budget, my right hon. Friend the Chancellor took the necessary decisions to give health and social care a record uplift in day-to-day spending at the conclusion of the first phase of the spending review. The Department for Health and Social Care received a cash injection of £26 billion covering day-to-day spending and capital investment in 2025-26, compared with the 2023-24 out-turn.
All Opposition parties have rejected that investment and those changes to repair the damage done to our NHS and move it forward. They have rejected two above-inflation pay increases for our NHS staff, the recruitment of 1,700 more GPs and the agreement of a GP contract for the first time since the pandemic, the biggest investment for hospices in a generation, the biggest expansion of carer’s allowance since the 1970s, a boost for older and disabled people through the disabled facilities grant, and the biggest real-terms increase to the public health grant in nearly a decade.
We have also given pharmacies the biggest funding uplift in years, ensured that women across the country can access the morning after pill free of charge, frozen prescription charges for the first time in three years, enabled an extra 3.5 million appointments for operations, consultations, diagnostic tests and treatments—reaching and surpassing our manifesto pledge seven months early. I can update the House on waiting lists, which, as of this morning, have fallen by over 30,000 compared with last month, amid a reduction of 232,000 since this Government took office.
I could go on, but I have only 10 minutes, Madam Deputy Speaker, and I would not like to try your patience, so I will make this point briefly. To govern is to choose, and anyone who opposed the decisions that the Chancellor took in her Budget must tell us what they would have subtracted from that list. We cannot spend money if we do not raise it.
As the Minister of State for Secondary Care, I regularly hear appalling anecdotes from colleagues across the House whose local hospitals, GP surgeries and community services are crumbling, with rusty equipment, leaky pipes and buckets catching rainwater. Phase 1 of the spending review has allowed us to arrest 14 years of shocking neglect and undercapitalisation in the NHS, with a record capital investment of £13.6 billion in 2025-26. [Interruption.] The Conservatives do not like it, but I will go on. That money has gone towards repairing our crumbling hospitals, supporting over 1,000 GP surgeries to modernise their buildings, and installing state-of-the-art scanners across the NHS estate, including the latest linear accelerator machines. However, as my right hon. Friend the Secretary of State has made clear, investment must come with reform. This year we have unveiled our plan for change, our elective reform plan, our urgent and emergency care plan and a crackdown on agency spend in order to reinvest £1 billion into the frontline.
Yesterday, my right hon. Friend the Chancellor set out the conclusion of phase 2 of the spending review, setting budgets that will enable us to make firm plans to deliver on the people’s priorities in the coming years, while going further and faster on reform. Our settlement increases day-to-day spending on health, bringing the budget for my Department and our NHS up to £232 billion by 2028-2029. That means £29 billion more day-to-day funding for the NHS in England, in real terms, than in 2023-24. We have also secured the largest-ever health capital budget, with a £2.3 billion real-terms increase in capital spending by 2029-30, compared with 2023-24, representing a more than 20% real-terms increase by the end of the spending review period.
Let me hammer this point home: investment must be matched by reform. This will be a critical year for the NHS as we achieve better value for taxpayers, who must see their money being spent well and delivering results. We would rather take those difficult decisions now, to save our NHS so that it is there for future generations. NHS England is a top-down organisation—the biggest quango in the world—with a less efficient system than the previous Government inherited in 2010 and twice the headcount at the centre. That is why my right hon. and learned Friend the Prime Minister announced in March that we will bring together NHS England and the Department of Health and Social Care to form a new joint centre. That will put an end to duplication and enable substantial efficiency savings, while bringing the management of our NHS back under democratic control. We will also unlock £17 billion of savings over the spending review period through 2% annual productivity growth in the NHS—money that will be either reinvested in the frontline or used to support radical transformation to make the health system more agile and efficient.
Our elective reform plan set out how we will ensure that by the end of this Parliament 92% of patients will not have to wait more than 18 weeks for elective care. This settlement will drive us further towards that goal, with over £6 billion of additional capital investment over five years across new diagnostic, elective and emergency and urgent care capacity, which could deliver more than 4 million additional tests and procedures.
We will build on the record capital investment from phase 1 to repair the NHS estate. That means continuing the delivery of 25 new hospitals; investing £30 billion in maintenance and repairs, with £5 billion of it to address the most critical building repairs; and reducing by half the number of hospitals containing RAAC—reinforced autoclaved aerated concrete—over this Parliament.
This spending review provides for an increase of over £4 billion for adult social care in 2028-29 compared with 2025-26, including an increase in the NHS contribution via the better care fund. Local authorities with responsibility for adult social care will also benefit from wider reforms to better align funding with need, multi-year settlements and simplification of the funding landscape that enables them to plan more effectively. Last but not least, we have taken steps to simplify targets and better monitor delivery, and we will continue to work with local systems to improve financial and operational performance, to get the most from every penny.
A key part of our 10-year plan is driving progress on the three shifts: from analogue to digital, hospital to community and treatment to prevention. On digital, we will invest up to £10 billion in technology and transformation, to start making the NHS app a digital front door and deliver a single patient record. We will work in partnership with the Wellcome Trust to launch the world’s first health data research service, backed by £600 million, to accelerate the discovery of lifesaving drugs.
On primary and community care, we will invest in training thousands more GPs, helping to bring back the family doctor through millions of extra appointments a year; in 700,000 additional dentist appointments annually; in at least 8,500 extra mental health staff by the end of this Parliament; and in mental health support teams for every school within five years. Finally, on prevention, our world-leading immunisation programmes will be supported by £2 billion, and we will invest £80 million in tobacco cessation programmes and our Tobacco and Vapes Bill.
I want to end by thanking the Chancellor for her unwavering commitment to getting our NHS back on its feet. Fixing broken Britain will not be easy, but nothing that is worth doing ever is. Today I have set out how every penny from the public purse will be matched by reform, to make our NHS fit for the future. We remember we were elected on a manifesto to end sticking-plaster politics and do the hard yards of fixing our country, and we will never betray that promise to the British people. The public have a right to know how public money will be spent, and this is something we take extremely seriously. They can put their trust in this Government, because we have fixed the NHS before, and with the help of this Chancellor, we will fix it again. I commend this statement to the House.
Madam Deputy Speaker (Caroline Nokes)
I call the shadow Secretary of State.
Edward Argar (Melton and Syston) (Con)
Yesterday, yet again, we saw the Chancellor do what the Labour party always does: default to high spending, more borrowing and higher taxes, leaving the public finances vulnerable. The Minister has spoken of additional funding for the NHS. To use the same comparison as the NHS England chief executive, the NHS budget will now be roughly the equivalent of the entire GDP of Portugal, yet we are still none the wiser as to how the Government actually intend to use most of the money—there is no real detail and no real plan. Just last September, the Prime Minister pledged that there would be no more money without reform. Despite the Minister’s words, that is exactly what the Government have done. There is still no plan for reform, and the Secretary of State is unwilling to set out the bold reforms that are needed.
Despite 14 years in opposition and nearly one year in government, the Labour party has failed to come up with a plan for the NHS, with the exception of the abolition of NHS England, which will not happen for years and appears to be delayed and in chaos. Ministers respond to every written parliamentary question about it by saying they cannot set out the savings, how the people will change or how the structure will change at this stage—yet again, there is still no plan. We have been very clear that where the Government are wrong, we will oppose it, but where they get something right, we will work constructively with them. That includes reform, but there is still no reform for us even to consider supporting.
Can the Minister tell us where the £29 billion she set out will be spent? The chief executive of the NHS Confederation said yesterday that increases in NHS staff pay will
“account for a large proportion”
of the funding increase. The former NHS chief financial officer echoed that view at the Health and Social Care Committee in January, saying that pretty much all the last tranche of additional spending was absorbed by pay rises, national insurance and inflation. Can the Minister confirm how much the pay offers from the independent pay review bodies, alongside increased national insurance, will cost, how much of this funding will have to go to cover that and how much will actually make it to the frontline to improve patient services?
The Minister touched on the aim of meeting the NHS 18-week target for hospital waiting times within this Parliament. Of course, we wish the Government well in achieving that and hope they succeed, but just yesterday The Times reported that internal departmental modelling showed they are not on track and could only come close to meeting the target with “implausible” and “over-optimistic” assumptions. The independent Institute for Fiscal Studies agreed. Can the Minister set out how the Government will meet that target? Again, where is the plan? We need a plan, not empty rhetoric.
It is clear that the NHS needs reforms, not just more funding, so when will the 10-year plan finally be published? Will it be before the one-year anniversary of the Labour party being in government? Will it be like their elective reform plan: simply a reheat of the plan that Sajid Javid brought forward in 2022, with nothing new? The Secretary of State needs to be more ambitious—words that I suspect will never be echoed by the Prime Minister or his team in No. 10.
The capital budget remains broadly flat in real terms from this year onwards. The Minister has said she wishes to continue with the new hospitals programme and invest in technology to boost productivity, but it is unclear how that can be achieved with this settlement. These are not my warnings but those of respected independent think-tanks, including the Nuffield Trust and the King’s Fund. The Chancellor’s plan is clear—indeed, not one Treasury Minister has ruled it out: more tax rises are coming.
Finally, and importantly, we have seen social care largely neglected again by this Government. There were just two sentences about it in a four-page statement. Social care deserves better. The Minister knows very well that we cannot improve the NHS without social care working well. Earlier today I met with social care providers. They want to see reform, yet the Government have apparently abandoned cross-party talks on social care reform for an independent commission led by the very able Baroness Casey, who is still doing her Home Office work on grooming gangs and is yet to be full time on this commission, which has a deeply unambitious finishing time of 2028. When will Baroness Casey be full time on the commission? These providers were clear that they want a seat at the table when better care funds are distributed by the NHS—they want to have their voices heard in decision making on that funding. Will the Minister agree to that?
Finally, the Chief Secretary to the Treasury said he has modelled his assumptions on continued trends in local government finance and local government precepts —in other words, a 5% uplift in the precept. However, a large number of counties are now controlled by Reform—whose Members are, as ever, notably absent from the Chamber when we talk about health and social care—who have pledged no tax rises whatsoever in their councils. If they do that, what is the Minister’s plan to make sure social care is funded? As ever, the Government have gone for the headline announcement, but sadly without a plan, without delivery and with no real reform to benefit patients.
Karin Smyth
I am entirely unclear, after that run-through of a number of different issues, whether the Conservatives welcome the extra investment in the NHS or oppose it. We know they oppose the means of funding it, but after that, I have no idea. At some point, they have to make up their mind whether they support that extra investment or not. As I said in my statement, if they do not, what out of the list of the improvements that we have already made would they not do?
As Lord Darzi made clear, under the Conservatives’ watch for 14 years the NHS was broken. Staff were left with out-of-date equipment and unable to do the job they needed to do. We agreed with Lord Darzi’s diagnosis, but Conservative Members have still not said whether they agree with it, or apologised for the state they left the system in. I do not know whether the right hon. Member for Melton and Syston (Edward Argar) has not been able to read the elective reform plan or the urgent emergency care plan that we published recently. It is up to him to read those plans properly and try to understand what is happening.
The right hon. Gentleman has started to do my job for me again, because he cites various think-tanks and people who have said that this cannot be done. Well, I can tell him that we were told, for example, that waiting lists would not drop in April because of seasonality, but we have shown—by keeping a relentless focus on the system, working closely with leaders on the frontline and being clear with officials in the Department—that it can be done. That is what we heard this morning.
We are taking a relentless approach to spending, line by line, throughout the NHS and the Department of Health and Social Care. We have rolled up our sleeves and we will not accept putting more and more taxpayers’ money into a leaky system, which is what happened under the right hon. Gentleman’s Government. If he had read the patient satisfaction survey, he would know that taxpayers across the country, in all our constituencies, love the NHS. They understand that the Tory party broke it and that it will take long time to fix. They also know that they are paying more taxes for it and getting a worse service, and they expect us to do much better. That is what we have already shown we are doing, and what we will continue to do.
I have outlined the capital that is going into the new hospital programme, which we are committed to, and we have already seen increases in diagnostic capability and surgical hubs throughout our constituencies. We will continue to do more of that. I agree with the right hon. Gentleman that it is critical to ensure that social care is supported alongside the NHS. That is why £4 billion is going into social care through our colleagues in the Ministry of Housing, Communities and Local Government, and as he knows, Louise Casey will publish her interim report next year.
We are clear that fiscal responsibility does not stop at the Treasury or down in Victoria Street with the Department of Health and Social Care. It is important that everybody in the NHS is aware that we are determined to fix the NHS and put it back on a sustained footing. There is record investment; that is our commitment to people, and I know from the people I worked with in the health service over many years that they are determined to make it better. Morale sank to an all-time low under the Conservative party, but we are raising that morale, and we will continue to work with the system to make sure that it is fit for the future.
Alex McIntyre (Gloucester) (Lab)
I welcome my hon. Friend’s statement about the record funding going into our NHS. We are already seeing the benefit in my constituency, with millions of pounds going into investment in our hospital; that is so desperately needed to get waiting lists down. People were left behind by the Conservative party, and I note that there is still no apology to any of my residents who were left in pain and agony for years and years under their watch—not one word of an apology.
One of the big challenges facing my constituents is accessing an NHS dentist—my hon. Friend knows about that from the time she came to visit me during my campaign. I am campaigning to get new dentists for my constituents in Gloucester, so will she help me to get a meeting with the relevant Minister to ensure that some of this record funding comes to Gloucester to get an NHS dentist for all my constituents?
Karin Smyth
As my hon. Friend said, this is a health area that I know well, and he has been the most amazing campaigner for Gloucester and the health service there since he became the Member of Parliament. He is absolutely right: dentistry is a key worry. It is one of the key areas that the Conservative party neglected for 14 years. That is why it was a manifesto commitment, and why I was able to outline today that meeting the target of 700,000 is front and centre, and part of the plan as we go forward. I know that the Minister for Care, who is responsible for dentistry, is keen to meet many hon. Members, and I will make sure he has heard that request.
Madam Deputy Speaker (Caroline Nokes)
I call the Liberal Democrat spokesperson.
Dr Danny Chambers (Winchester) (LD)
To reiterate: after years of Conservative mismanagement, the NHS is in crisis, with patients left waiting hours for ambulances, women giving birth in unsafe maternity units, and children turning up at A&E with rotting teeth because an NHS dentist cannot be found. That is the Conservative legacy, and they must never be trusted with our health service ever again. So yes, we welcome this funding boost—we really do—and we agree that funding must come with reform, because unless this funding is targeted properly, it will not bring the change that patients urgently need.
When it comes to reform we need to talk about fixing social care, because putting more money into the NHS today will be like pouring money into a leaky bucket. Last year, the Secretary of State for Health and Social Care stated that £1.7 billion a year is wasted because patients who are medically fit for discharge cannot leave hospital, simply because no care is available to support them at home. The hospital in Winchester that supports both your constituency, Madam Deputy Speaker, and mine has up to 160 people waiting to be discharged at any given time, and they would be better cared for with social care packages.
We need urgent action and a higher minimum wage for care workers. We need proper respite and financial support for family carers, and a clear commitment to conclude the social care review, hold cross-party talks, and deliver the real reform that the Minister has been talking about. We also need to tackle the crisis in primary care, because that is where prevention happens and where pressure on hospitals is eased. Will the Minister confirm that the funding boost will deliver the extra 8,000 GPs that are needed to guarantee everyone an appointment within seven days, or within 24 hours for urgent cases? Can she also confirm that the funding will bring dentists back into the NHS, and bring an end to dental deserts? That will not happen without urgent reform of the NHS dental contract, which is outdated, unworkable and driving dentists out of the system.
Finally, we cannot ignore the shocking state of NHS buildings, including our hospital in Winchester. It is an outrage that overcrowded hospitals must close operating theatres due to unsafe ceilings and other health and safety issues. I urge the Minister to spend the money where it matters: on primary care, on social care, and on ensuring that our existing NHS buildings are fit for purpose.
Karin Smyth
I thank the hon. Gentleman for welcoming, on behalf of his party, the commitment that the Chancellor has made and the extra funding that she has identified, but I think his party still opposes the way in which we have raised the funding to do just that. It is good to have your cake and eat it, but we are clear that the funding does come with reform. As I said in my statement, we are committed to improving the front door—primary care—as well as social care and discharge. That is why the NHS contribution, as part of the settlement to the better care fund, increases. He will be aware that we previously revised the better care fund to make it better and more targeted on discharge, which is important.
The urgent and emergency care plan that we published a couple of weeks ago also confirms our recognition that flow through the hospital system is important for patients and staff; we must ensure that we do not face that continued crisis of corridor care over many years. We are committed to the fair pay agreement, and our colleagues in the Ministry of Housing, Communities and Local Government will make more statements in the coming weeks about how that will work.
Yasmin Qureshi (Bolton South and Walkden) (Lab)
I draw the attention of the House to my entry in the Register of Members’ Financial Interests, as chair of the all-party parliamentary group for dentistry and oral health. Access to NHS dentistry is in crisis, including in my constituency. New analysis by the British Dental Association shows that the share of NHS funding spent on dentistry has more than halved since 2010, from over 3% to just 1.5%. I know how committed the Government are to reforming the dental contract, but the Public Accounts Committee made it clear that reform will work only if it is backed by proper, sustainable funding. Will the Minister ensure that NHS dentistry gets a fair share of the £29 billion announced in the spending review, so that we can end forever the crisis that is affecting millions across the country?
Karin Smyth
I thank my hon. Friend for her question and for the work she does to support NHS dentistry as part of the all-party group. As I have said, this issue is of huge importance to our constituents, and the shocking state in which the Conservatives left dentistry is there for all to see—particularly the shocking state of children’s oral health. That is why we acted rapidly to introduce the toothbrushing campaign—which, if I remember rightly, was ridiculed by Conservative Members when we discussed it in opposition—and the arrangement with Colgate to ensure that we improve children’s oral health. We are absolutely committed to reform of the contract; the Minister for Care is working hard on that and he will continue to update the House regularly. It is our confirmed commitment, as I have reiterated today, to increase access to dental services.
Sir Edward Leigh (Gainsborough) (Con)
Our spending on the NHS is now as much as the entire GDP of Portugal. We used to be a country with an NHS attached to it, but we are almost becoming an NHS with a country attached to it. Of course we would welcome this spending if we got the same outcomes that people get in civilised countries, like the Netherlands or Australia, but every time I mention fundamental reform, I am dismissed as wanting to bring in privatisation, so it is hardly worth raising that issue. Australia has an extremely successful pharmaceutical benefits scheme; I know that the Secretary of State for Health and Social Care went out there, and I have talked to Australian doctors about it. Will the Minister at least look at the successful outcomes, including some of the highest life expectancies in the world, that are being delivered in countries like Australia and the Netherlands, to see how we can deliver better outcomes? There is no point spending more money if people’s only right is to join the back of a queue.
Karin Smyth
I was expecting the right hon. Gentleman to talk about the funding model, and I am disappointed that he did not; it is something that he has talked about for many years. I do not know the details of the Australian model, but will ensure that he gets a proper answer. I am always happy, as is my right hon. Friend the Secretary the State, to look at models from across the world. We want to learn from the best, and we want to deliver the best in the NHS.
The Conservatives seem to have an obsession with input into the health service. It is true that the last Government put more money in, but it went into a leaky bucket and they got nothing out. This Government have taken a different approach. We are not just taking money from the Treasury, handing it out and then coming back for more. We are being very clear with providers and the system more generally. My right hon. Friend the Secretary of State is talking at the NHS Confederation conference this afternoon; we are working with them to ensure that we look not just at the inputs, but at what goes on in the system. We want to ensure value for taxpayers’ money in all our constituencies. There are outstanding examples of both financial and operational good practice across the country. We want to take the best to the rest, and make the best of every taxpayer pound.
Rachael Maskell (York Central) (Lab/Co-op)
The Minister has demonstrated the difference that a Labour Government make to our NHS, and to the people of our country. As she mentioned, reform is needed. May I draw her attention to the report by the independent Commission on Palliative and End of Life Care? Around 100,000 people cannot access hospice care, and too few people are able to access specialist palliative care. The report demonstrates a new system of end of life and palliative care that will transform people’s end of life experience. To go alongside the reform agenda, will she ensure that we invest in that precious time in people’s lives, and deliver a comprehensive palliative care service?
Karin Smyth
My hon. Friend is right to highlight end of life care. We know it has been neglected. I worked on it during my time in the health service, over 15 years ago, and I feel very passionately about it. It is important that we support people. We must have a system that allows people to have those conversations, and that ensures there are options for people throughout the pathway of their life. The Minister for Care is working hard to ensure that happens as part of our overall development of the health service over the next 10 years.
James Wild (North West Norfolk) (Con)
Will the Minister confirm that the funding envelope that she set out in a letter to the Queen Elizabeth hospital in King’s Lynn in April stands unchanged after this spending review?
Terry Jermy (South West Norfolk) (Lab)
I warmly welcome the news that waiting lists are continuing to fall, not by chance, but because of the choices made by this Government. As the Minister will know, both the hospitals that serve my constituency have reinforced autoclaved aerated concrete, and both have received funding, but as I visit GP surgeries and dentists, it is clear that there is a link between crumbling buildings and the availability of appointments. Will the Minister reassure me that primary care in particular will continue to be supported by upgrades to buildings?
Karin Smyth
I thank my hon. Friend for the great work that he is doing to support progress on work at the RAAC hospitals in his constituency. He makes the excellent point that such issues exist not only in hospitals. As our settlement makes clear, we understand the strain in primary care, as well as in mental health services and community services, which often do not get discussed. When we publish the 10-year plan later in the summer, he will see that the move towards community and neighbourhood health services will be front and centre of what we want to achieve over the next 10 years.
Caroline Voaden (South Devon) (LD)
Like my hon. Friend the Member for Winchester (Dr Chambers), I welcome the increased investment, and the attention that the new Government are giving to the NHS. I would like to turn our attention to dentistry. My constituency of South Devon is a dental desert. I welcome the announcement of 700,000 extra dental appointments, but we have lost three dental surgeries since the election last year, and more are on the brink. The Government have been in office for a year now, and have talked about reforming the dental contract with the NHS. If that contract is not reformed, we will lose so many dentists that we will never be able to catch up. How long will it take the Government to announce a newly reformed contract with NHS dentistry, so that we can start increasing the number of appointments, and saving the dentist surgeries that we have left?
Karin Smyth
The hon. Lady is right to highlight the shocking state that dentistry was left in by the last Government. They could have reformed that contract at any time over the past 14 years. We were ready to do that in 2010, but things worked out differently; we left office, and the Liberal Democrats and the Conservatives between them did not reform the contract. The Minister for Care is working at pace to ensure that happens, and we will update the House as soon as possible.
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
I very much welcome yesterday’s statement, the funding, and the fact that the funding will go on for several years. Does the Minister agree that we depend on the people in our NHS? Will she join me in congratulating Dr Cameron and all the teams at the West Suffolk hospital, who, by adopting a whole-hospital approach, have abolished corridor care and improved the hospital’s throughput, using a model that could be widely adopted?
Karin Smyth
I am very happy to thank Dr Cameron and the whole team. As ever, with his vast experience of the health service, my hon. Friend makes an excellent point. We are reliant on clinical and managerial staff to make the system better. I know, and he knows, how low morale has been; Lord Darzi made that point very clear, and we cannot over-estimate how difficult that is for staff. That is why we have reached two record inflation-beating pay settlements for staff, and importantly, we have supported the independent process, because we want to work with staff to make things better at all levels. My hon. Friend gives an excellent example of how, by working with excellent clinical leadership and excellent managers, we can bring the best of the NHS to the rest of the NHS.
Andrew Rosindell (Romford) (Con)
The Minister will know that I too want to abolish corridor care at the Queen’s hospital in Romford. I thank her deeply for meeting me on Monday, with the chief executive of the NHS trust for Barking, Havering and Redbridge, Matthew Trainer, who is appealing for a new A&E facility at the Queen’s hospital. The situation has led to patients being cared for on trolleys in corridors. I find that unacceptable, and it is costing my local trust, which services 800,000 people in the area, an extra £100,000 a month because of additional staffing needs. Will the Minister ensure that what was said at our meeting is carried forward, and that we get a better facility for boroughs in the east London and Essex area, which the Queen’s hospital serves?
Karin Smyth
The hon. Gentleman is absolutely right that this is unacceptable. I was pleased to meet him and his local NHS leaders this week. They made, as hon. Members always do, an excellent case. Clearly, the situation was left badly under his Government. I hope that he will welcome the extra measures in this settlement. I know that my right hon. Friend the Leader of the House told him earlier that she looks forward to him joining us in the Division Lobby to support the extra funding. I hope that hon. Members know that, whatever party they come from, when I meet them, particularly in surgeries, I will follow up on the questions that are asked. They are often matters for the local integrated care board, but we will continue to work with all local systems to deliver the best care possible for all our constituents.
Sonia Kumar (Dudley) (Lab)
As an NHS physiotherapist, I welcome the statement. The Government will soon launch their 10-year plan for our NHS, in which a focus will be a move from sickness to prevention. Will the Minister set out how the spending review will support Dudley integrated care board and other ICBs in bringing healthcare on to our high streets, so that patient care is at the heart of our communities?
Karin Smyth
I thank my hon. Friend for the excellent role she plays as a clinician. Her expertise is really welcome; we want to hear from a wide variety of experts in this House—that is very valuable. She understands from her professional background, as well as from her constituency, how important it is to look at the entire pathway of care for patients, and to ensure that they have the best possible care as close to home as possible. We think that is better not just for patients, but for clinical outcomes, and it is more efficient and better use of taxpayers’ money. The move from hospitals to communities is front and centre of our 10-year plan, as is delivering neighbourhood health services.
Sir Julian Lewis (New Forest East) (Con)
The Minister will be well aware of Sir Andrew Dilnot’s ambitious plan to put a cap of £86,000 on the cost of the social care that any family would ever have to pay. It was never going to be easy to implement that. Previous Governments postponed the plan, and the Chancellor effectively scrapped it completely. May I appeal to the Minister to work across party lines, and to focus on the crippling debt that hits hard-working families when they come to the end of their working lives and need the support of the state?
Karin Smyth
I agree that this issue absolutely needs to be resolved. There was agreement previously, under the coalition, and it is so disappointing that it was so unceremoniously dumped when I came to this place in 2015; that was one of the first things that the subsequent Tory Government did. It was a great disappointment to many people across the country, particularly those who were responsible for supporting an older person or a disabled person. We have ensured that we will address this issue, and have appointed Louise Casey to lead the interim report. I know that she will continue to work with everybody, and that all hon. Members will take an active interest in that work.
Liz Twist (Blaydon and Consett) (Lab)
I welcome the additional £29 billion of day-to-day funding and additional capital announced yesterday. Our investments are already paying interest, in the reduction of waiting lists. May I remind hon. Members of the announcements made earlier this year? I was particularly pleased that the Shotley Bridge hospital replacement in Consett was announced in wave 1, and I thank the Minister for her personal interest in ensuring that wave 1 happens. The 10-year plan will soon be announced. How will the comprehensive spending review announcements help us to shift from a sickness model to a prevention model?
Karin Smyth
I thank my hon. Friend for welcoming the Government’s investment in the health service. She has been such a strong campaigner for Shotley Bridge, and it has been a pleasure to work with her; I know she has continued to advocate strongly on behalf of her local population. The hospital is needed, but as she knows, in her community—and all our communities—patients should not always be expected to travel to hospital for care that can be delivered closer to home. We see massive improvements in virtual care and technology, which is why we have announced a £10 billion increase for technology over the spending review period. We are improving the NHS app and ensuring that people are enabled to do more digitally, but I recognise that does not suit everybody, so we will ensure that parallel processes are available for everybody. Our constituents deserve and need care closer to home, and want more of it.
Ellie Chowns (North Herefordshire) (Green)
More money for the NHS is of course welcome, although if we in the Green party had our way, it would be raised by taxing extreme wealth fairly, rather than by taxing work. The small amounts of money for social care announced in the spending review are nowhere close to the funding needed to tackle the social care crisis, and the burden is put on local authorities. In the Minister’s Department, there is a reduction in the revenue budget for social care and public health. When will her Government stop going slow on social care? When will they hold the long-promised and much-delayed cross-party talks? When will they recognise, as Lord Darzi has said, that we cannot fix the NHS without fixing social care? A truly joined-up approach to health and social care is long overdue.
Karin Smyth
The economics of the Green party are even more fantastical than the economics of the Conservatives and Reform; we all dread to think what things might be like under that party. We see that in the local council in my city of Bristol, and it is an absolute disaster. If the council could just get on with building council houses and social homes, it would help more people to live a better life, and would aid prevention. We are getting on with tackling social care. That was announced in the spending review, and that is what the Casey review will do.
Peter Swallow (Bracknell) (Lab)
I warmly welcome the largest-ever capital investment in our NHS in the spending review yesterday, building on the Chancellor’s announcement in last year’s Budget of the money to rebuild RAAC-infested hospitals such as Frimley Park hospital, which will benefit my constituents. That was committed to by the previous Conservative Government, but, shockingly, it was never paid for. With the Government standing four-square behind rebuilding Frimley Park hospital, does the Minister agree it is time for Frimley Health NHS trust to get on and announce the site for the new hospital?
Karin Smyth
I thank my hon. Friend for his support for the Chancellor’s statement and our commitment to the NHS. I know he has been working so hard on this issue on behalf of RAAC hospitals and Frimley Park hospital since he became a Member of Parliament last year, and we are four-square behind that work getting on. It is at the beginning of a very long queue in the new hospital programme. It is one of the things we inherited—we wish it was a better inheritance, but we are working with what we have. We have put the new hospital programme on a firm financial footing, and Frimley Park is at the beginning of that queue. We are very keen that people get on with it very quickly, because there are very many other people waiting behind them.
Graham Stuart (Beverley and Holderness) (Con)
The hon. Member for North Herefordshire (Ellie Chowns) is absolutely right about social care. We have a system in which healthcare is dependent on social care—Lord Darzi says so, and I think even Ministers have said so—yet all funding is going into the NHS, not into social care. We are fundamentally pouring the money into a bucket with a hole in the bottom. The Minister pretends the exact opposite of the truth. Will she share a more honest assessment with the House? What went on? Labour had 14 years to think about it, and here we are with the funding going into the NHS. As the Father of the House, my right hon. Friend the Member for Gainsborough (Sir Edward Leigh), said, the Minister is following on from the last Conservative Government and pouring more and more money into an unreformed NHS with a social care system underneath it that is broken, and she is not doing anything about it.
Karin Smyth
I have already given a history lesson about some of those 14 years. When the Conservatives and the Liberal Democrats were in the coalition together, we had a commitment, a promise and a cross-party agreement; the Conservatives then got into government by themselves and broke it, so we are where we are. We want to invest in social care, which is why we have announced the £4 billion. We are seeing a very interesting alliance going on between our Green and Conservative colleagues; they agree on something, as we saw in the Lobby last week.
Warinder Juss (Wolverhampton West) (Lab)
I thank the Minister for her statement and the excellent work that this Government are doing in bringing additional investment in the NHS and bringing waiting lists down. We have had to make really difficult decisions to clear up the mess left by the previous Government, and I am sure we all agree that we need to protect our charitable adult social care providers. Will the Minister facilitate a meeting with myself and Woodlands Quaker Home in my constituency, which provides non-profit residential social care for older people so that they are able to carry on in the best way possible?
Karin Smyth
My hon. Friend makes an excellent point about bringing down waiting lists for his constituents, and we are so pleased to see that that is continuing, as we were able to announce this morning. He also makes an excellent point about social care providers, which do an amazing job for many of us who have close family members supported by them, and it is important that they are supported and work. I am not sure whether an answer to his question about a meeting needs to be from my Department or from my colleagues in the Ministry of Housing, Communities and Local Government, but I will ensure that he has an answer.
Tom Gordon (Harrogate and Knaresborough) (LD)
I welcome the funding announced to repair hospitals with RAAC, which will hopefully include Harrogate district hospital in my constituency. It has already received some money to remove RAAC in one building, which has since been demolished, but it still has a £15 million business case waiting with the Department of Health and Social Care for the next round of RAAC repairs. Will the Minister set out a timetable for repairs to hospitals such as Harrogate’s and for when we should expect to know if we will receive some of that funding?
Karin Smyth
We are committed to ensuring that those RAAC hospitals are sorted and fit for purpose, and I was able to visit Airedale myself recently. We are asking people on the ground to do a really difficult job, keeping hospitals going and serving patients while remedying the problem of RAAC. I do not have in front of me the exact timescale for the hon. Gentleman’s hospital, but I encourage it to work very closely with the team at the Department of Health, which I think is working really well. As long as a clear timetable has been put forward, I will ensure that the hon. Gentleman gets a response to his question.
Amanda Hack (North West Leicestershire) (Lab)
I thank the Minister for her statement. The NHS is the No. 1 issue for my constituents, and I know that they will welcome the investment in the spending review. My constituency is a rural area, and one thing people often raise with me is ambulance waiting times, which I am pleased to report have improved in every category over the past year. Can the Minister explain how the spending review will ensure continued improvements in ambulance waiting times, supporting my constituents to get emergency care when they need it?
Karin Smyth
My hon. Friend is right to raise the issue of ambulances. We ensured that they were a key part of our urgent and emergency care plan, which was issued the week before last, I think—I cannot remember the exact date. We recognise how crucial that issue is, and how much more can be done by ambulances by the roadside. I was privileged to go out with the South Western ambulance service recently; it is so impressive to spend time on the frontline with people who are dealing with whatever comes at them. We know that they can do more, including remotely. We are very keen to ensure that ambulances do not spend time outside hospitals; that is why we have introduced a 45-minute turnaround time through the release to rescue scheme, which has worked very successfully in many parts of the country. We are keen to see that scheme rolled out across the country, so that we do not have ambulances queuing outside of hospitals with people, but put them back on the road where they need to be.
Greg Smith (Mid Buckinghamshire) (Con)
We have been here before with Governments of all different political persuasions. Ministers come to the Dispatch Box and trumpet what seem like very attractive amounts of money for the NHS, but the reality on the ground is that that money just about covers pay rises and inflationary pressures. On care, Buckinghamshire council and no doubt all councils are worried that the money being offered up may only just cover things such as the fair pay agreement. Can the Minister confirm from the Dispatch Box that with increasing amounts of councils’ budgets rightly being spent on care, they will get funded for things such as the fair pay agreement separately from core social care spend?
Karin Smyth
The hon. Gentleman says that we have been here before, and we really have. I was on a primary care trust board under the last Labour Government, so I saw at first hand what good government, working with local systems, can deliver: the best patient satisfaction in the NHS’s history, the lowest waiting lists, and the best access to GP and primary care. We have been here before, and that is what we will do again. From the hon. Gentleman’s questions, I do not understand whether he wants more spending or less. That is what the Conservative party is still not saying; its Members stand up and ask for more, like Liberal Democrat Members, but they will not identify the means of raising that money—in fact, they oppose them.
To respond to the specific question that the hon. Gentleman asked, over the coming weeks, my colleagues from the Ministry of Housing, Communities and Local Government will obviously be outlining in more detail how the spending review will fall out.
Alice Macdonald (Norwich North) (Lab/Co-op)
I welcome this brilliant investment in our NHS, which will also be welcomed by my constituents. I know that this Labour Government will ensure that everyone in every part of the country benefits, including women. Last year, I highlighted that women in Norfolk face the longest waits in the country for gynaecological care, with hundreds waiting more than a year for treatment for conditions such as endometriosis. Can the Minister assure me that as we advance these plans for the NHS, we will ensure that we tackle those waiting lists? Far too many women are paying the price for years of inaction under the Conservatives.
Karin Smyth
My hon. Friend has been such a strong and powerful campaigner for women’s health since becoming an MP last year, and she is absolutely right to do that. I am pleased that we have been able to make some progress on conditions such as endometriosis. Many campaigns have been fought by many women in this House—including you, Madam Deputy Speaker, if I may say so—to highlight the importance of this issue. We see women’s health as front and centre. We want to learn from the women’s health hubs in their different guises and ensure that they are an integral part of neighbourhood health services.
Clive Jones (Wokingham) (LD)
I was really saddened that there was no mention of cancer in the Minister’s statement, so I will give her the opportunity to correct that omission. Will this new money for our NHS ensure that all cancer waiting time targets are met by the end of this Parliament, and can the Minister confirm that those targets will be included in the 10-year health plan? Finally, have Ministers had a chance to read my 11-page letter and accompanying submission on what should be in the national cancer plan?
Karin Smyth
I have a slight “get out of jail free” card, because I think that letter might be with one of my colleagues, not with me. Obviously, though, I look forward to the summary.
The hon. Gentleman makes a really important point about cancer. I would have to check, but I do not think I mentioned lots of disease-specific areas, including key manifesto commitments such as dentistry. Obviously, cancer is a huge part of waiting lists overall. We will get those waiting lists down—we are determined to meet that target—and we will issue a cancer plan later in the year.
Dr Scott Arthur (Edinburgh South West) (Lab)
I thank the Minister for supporting the launch of Sarcoma UK’s report yesterday. The recommendations in that report are really important for tackling that awful rare cancer.
I welcome the ambition in what has been presented, but the comparison with what my Edinburgh South West constituents face in Scotland could not be more stark. I have just come from a meeting in which, yet again, I have been trying to defend the mental health provision at Scottish Action for Mental Health’s Redhall walled garden; in contrast, I hear from the Dispatch Box real ambition to support people with mental health problems. People in Scotland are also jealous of the falling waiting lists they see in England, and hope that one day, they will arrive in Scotland. May I ask the Minister to keep on being ambitious, in the hope—because hope is all I have—that some of it will rub off on the Scottish Government?
As Madam Deputy Speaker is feeling a little generous, may I also say that Saturday will mark the 200th Oriam parkrun in my constituency? If we are serious about preventative healthcare activities, parkrun is a great example of how we can improve both our mental health and our physical health. The Minister is welcome to attend, of course.
Karin Smyth
I always shudder a little when I am invited to do any running, jogging, boxing or whatever else people get up to—we all have our own things we like doing. Although my hon. Friend’s fabulous city is a great place to be, I will not be able to join in this weekend, but I wish good luck to everybody taking part.
We all live in hope that the SNP might learn some lessons from what we are doing to fix our NHS. We remain willing to work with the SNP, and with anybody who wants to serve patients and get a better service for their taxes. If the SNP wants to get in touch, it can do so, but the best thing to do is to elect a Labour Government in Scotland, which will hopefully happen soon.
My hon. Friend makes an important point about mental health. We are committed, as we said in our manifesto, to 8,500 more people working in mental health, and to ensure that our schools and young people have the support they deserve.
Ian Roome (North Devon) (LD)
I thank the Minister for agreeing to visit North Devon district hospital very shortly, and I look forward to welcoming her to my constituency. Despite some welcome extra repairs under the estates safety fund, that hospital now faces many years of make do and mend. What provision have the Government put aside for those years of increasing maintenance costs?
Karin Smyth
I thank the hon. Gentleman for his question. His invitation has been a long-running one, and sometimes his diary has been busier than mine, but I think we finally have a date to go to North Devon, which I am looking forward to. It is a challenged system—we had a good debate yesterday in Westminster Hall about many of the problems in Devon, and I know he will review that debate carefully. Devon is one of the systems that we are looking closely at. It has had deficit funding this year, but we want to eradicate deficit funding from the system, so we are looking very closely at how every single system uses all of its money. I know that the hon. Gentleman will continue to support the Government in ensuring that his local taxpayers get the best service for their money.
Matt Turmaine (Watford) (Lab)
I welcome the comprehensive spending review and its focus on NHS funding. It will deliver on Labour’s election promise to get the NHS back on its feet, which will be of so much benefit to my constituents. Does the Minister agree that nearly one year on, this Labour Government are really tackling the disastrous Conservative-Liberal Democrat reforms introduced under the Lansley legislation?
Karin Smyth
My hon. Friend has been such a strong advocate for Watford since he came into this Chamber, and in particular for ensuring that that hospital is in the new hospital programme. I look forward to visiting his constituency soon, because I know we lost some time.
My hon. Friend is absolutely right. I do not know if he knows this, but others will have heard me say before that one of the terrible consequences of the Lansley reforms was that they made me so angry as a manager in the system that I decided to become a Member of Parliament, and here we are today. We have learned from the lack of focus on the frontline and on patient care. That is why we are so clear—whether in the reforms we have put forward on elective care and urgent emergency care, or in the planned reforms on dentistry and primary care, in the 10-year plan and on social care—that we have to keep a relentless focus not just on taxpayers’ money, but on patients. The people’s priorities are clear. They want the NHS to do better, but they are clear in their demands that we make it work better for them and make sure that every single pound of taxpayers’ money is working to the best effect.
Mr Adnan Hussain (Blackburn) (Ind)
I welcome the Minister’s statement and this Government’s commitment to investing in the NHS, but she did not address how that funding will be allocated across the country. My constituency of Blackburn has one of the worst GP to patient ratios, with more than 3,200 patients per GP. That is placing immense strain on primary care and pushing patients to an already overstretched hospital that is frequently on red alert. Will the Minister ensure that areas with such disparities, like Blackburn, receive targeted support? Will she meet me to address these long-standing imbalances in healthcare provision?
Karin Smyth
The hon. Gentleman makes an excellent point on primary care, which sees 90% of contacts with the NHS and is where most people experience the NHS. That is why it is very much in our sights to support that work. As part of our 10-year plan, we will bring forward the neighbourhood health service to make sure that people can be seen more locally. That will be built around using primary and community care to best effect. He makes a point about funding formulas. We had a long debate about that yesterday in Westminster Hall, and it is an area of huge controversy. He will see over the coming weeks how the funding is allocated. NHS England did issue—if he has not seen it, I will make sure that he has access to it—guidance on the funding formula and where the different systems are in relation to that. We want to move everybody towards that target, and I am happy to discuss that with him once he has had a look.
Josh Fenton-Glynn (Calder Valley) (Lab)
This Government have made phenomenal progress on the elective care waiting lists left by the last Government, but the progress on mental health waiting lists has been stubbornly slow, with 1.2 million people still waiting for treatment. That includes 62,000 people covered by the West Yorkshire ICB that serves my Calder Valley constituency, which I think is the second-highest figure in the country. Can my hon. Friend please assure me that we will use this settlement to redouble the work we have done on elective waiting lists, while also putting a real focus on mental health waiting lists?
Karin Smyth
My hon. Friend makes an excellent point on mental health, which is of great concern to all Members. He is right that elective care and mental health are measured in different ways, but we are committed to supporting mental health services with 8,500 extra staff. We are making sure in particular that young people in schools are supported. We know that the situation has been terrible for young people in our country, and we will continue to provide that relentless focus.
Jim Shannon (Strangford) (DUP)
The Labour Government have committed more money to the NHS, and that has to be welcomed. For that reason, I thank the Minister for her statement today. The Chancellor yesterday announced some £50 million—this does tie in to health—for Casement Park. However, the Government were clear that that was dependent on funding from the Northern Ireland Executive. Does the Minister expect the Northern Ireland Executive to take extra moneys granted to the Northern Ireland Assembly through Barnett consequentials and divert them to a sports stadium? Are the moneys for the NHS ringfenced and protected? If not, how do I look parents in the eye in my constituency of Strangford, when their child cannot receive cutting-edge medical technology because money has to be found for a sports stadium?
Karin Smyth
The hon. Gentleman is an experienced parliamentarian, and he understands how the funding settlement for the Department of Health and Social Care is allocated through the Barnett formula to Northern Ireland.
Josh Newbury (Cannock Chase) (Lab)
This investment is so welcome, because my constituents in Cannock Chase have been struggling to access urgent care between their GP and accident and emergency since our hospital’s minor injuries unit was temporarily closed in March 2020. Despite the welcome investment in Rawnsley surgery, Chadsmoor medical practice and Red Lion surgery in my constituency, our ICB plans to kibosh any hope of our MIU reopening. Does the Minister agree that this Government’s huge investment in our NHS needs to be felt in the parts of the country, such as my towns and villages, that were so badly let down by the Conservatives? Will she meet me to discuss the worrying urgent care reform proposals for Staffordshire?
Karin Smyth
I thank my hon. Friend for welcoming the extra support for GP and primary care. I am sure he understands from our urgent and emergency care plan that we have a number of arrangements for making sure that people are seen urgently in local community settings. It is for local ICBs to decide on the best way, within that urgent emergency care plan, for people to be seen locally and treated within the available resources. I am happy to meet him, perhaps at an upcoming surgery, to discuss that further.
Chris Webb (Blackpool South) (Lab)
My constituents in Blackpool South will never forgive or forget that the previous Government left us with the worst health outcomes in the country. We have an ICB having to make £350 million of cuts. The hospital that my son and I were born in has been left inadequate and one of the worst in the country. We have dental deserts. People cannot get access to mental health counsellors or GPs. I welcome the millions of pounds allocated to Victoria hospital and to health outcomes in my constituency by this Government, and we are seeing waiting lists finally coming down. Does the Minister agree that we need to continue on this path and give deprived areas, such as Blackpool, more support to get our waiting lists down to an acceptable level?
Karin Smyth
My hon. Friend is absolutely right that his constituents and constituents across this country will not forgive the Conservatives for the state in which they left the NHS. That is clear from Lord Darzi’s diagnosis. We have still had no comment from the Conservatives on whether they acknowledge that. We are determined to be about the future, and that is what this settlement and the Chancellor’s announcement yesterday are about. It is about putting that extra funding that we raised last year into services and into a reformed system that reaches all parts of this country. We will tackle health inequalities, making sure that people who have not had that access and people who suffer worse health than others are raised up. We must take the best of the NHS to the rest of the NHS.
Madam Deputy Speaker (Caroline Nokes)
After more than an hour of diligent bobbing, I call Chris Vince.
Chris Vince (Harlow) (Lab/Co-op)
Apologies for my premature bobbing earlier, Madam Deputy Speaker.
I thank the Minister for her statement today and for her ongoing commitment to the NHS. I welcome the growth in day-to-day spending on the NHS and this Government’s commitment to bringing down NHS waiting times. However, may I gently advocate for Harlow in respect of the future of the UK Health Security Agency? It has a business case, details, designs and a site ready to go, and the estimated timeframe has consistently been assessed as the best value for money and the quickest to deliver.
Karin Smyth
I like how my hon. Friend says “gently”, because honestly no day goes past without him talking about this issue or, indeed, his new hospital. He is right, and he is a fantastic campaigner for the people of Harlow. He has made his point again, and I cannot make any further comment today, but he will be hearing from the Secretary of State soon on that issue.
Madam Deputy Speaker
I thank the Minister for her answers this afternoon. I ask anyone who is leaving before the Select Committee statement to do so quickly and quietly.