National Insurance Contributions: Healthcare

Debate between Karin Smyth and Jerome Mayhew

Thursday 14th November 2024 Commons Chamber

[Karin Smyth]

My hon. Friend makes an excellent point. As I said in my response to the hon. Member for Hinckley and Bosworth (Dr Evans), we faced a situation where we were told that we would have to reduce appointments by 20,000 a week. We have taken serious steps, and my right hon. Friend the Secretary of State fought hard for our Budget allocation so that we can have 40,000 extra appointments as promised in our manifesto, which was overwhelmingly endorsed by the British public. We are determined that we will bring change to the system and tackle the waiting lists.

[Jerome Mayhew (Broadland and Fakenham) (Con)]

Increased taxes for hospices, care homes, GPs and pharmacies. Is that a deliberate decision by the Labour Government or just a cock-up?

[Karin Smyth]

We understand the precarious situation that hospices are in—the precarious situation that they found themselves in before we came to power— and we are committed to talking to them and other affected providers. We will be going through the normal process of allocations in the next few months.

Healthcare Provision: East of England

Debate between Karin Smyth and Jerome Mayhew

Tuesday 3rd September 2024 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I will try not to be too evasive, and to be pleasant.

On his latter point, the hon. Member for Runnymede and Weybridge (Dr Spencer) might want to look at some of the speeches I made during the passage of the Health and Care Act 2022; accountability is writ large through them, although we may disagree about the form it takes. The previous Government had an opportunity to resolve some of these issues, and they did not take it. They destroyed accountability and, indeed, the foundations of the health service with the disastrous Lansley Act—the Health and Social Care Act 2012—which propelled me into coming to this place.

It is a pleasure to be here for the first Westminster Hall debate, and I thank my hon. Friend the Member for Norwich South (Clive Lewis) for securing it. I told my officials that it would be busy. Some of the people in this Chamber and some of those who have left are already my most frequent correspondents because of the state of the NHS in the east of England and more broadly. Getting the NHS back on its feet will be an enormous challenge, but we have the skill, motivation and commitment of our NHS staff. This Government will be unwavering in our support for them, and we will do what is needed to get the NHS back on its feet. We have committed to a 10-year plan because that is what it will take. We will deliver an NHS fit for the future. That is what we promised the British people at the election; that is what we were elected to do.

[Jerome Mayhew]

The Minister says she will deliver an NHS plan for the next 10 years. Does that include a full rebuild of the Queen Elizabeth hospital and the James Paget?

[Karin Smyth]

I will come on to those hospitals. As hon. Members will appreciate, we are in the early days of this, so “We will come back to people” may do a bit of lifting—I apologise for that.

We want to be clear and honest with Members of Parliament and the British people. We want to move the health service from treatment to prevention, which hon. Members have raised; from hospital to home, which is very important in the east of England, which has rural issues; and from analogue to digital. As a first step, my right hon. Friend the Secretary of State asked Lord Darzi to give us a raw and frank assessment of the state of the NHS, and these debates and the work that hon. Members are doing will inform that. This autumn, we will also launch an extensive engagement exercise with the public, staff and stakeholders to inform the plan.

I have at least eight questions from my hon. Friend the Member for Norwich South and a number of others. I will do my best to get through them in the next eight minutes, but I will of course respond to people if they want to come back to me on anything I do not pick up.

My hon. Friend talked particularly about prevention, and touched on climate change, dentistry and mental health, which are clearly important to many people. Prevention is a key part of the Government’s health mission and our mission across all Departments. We want to support people to stay healthier for longer. My hon. Friend said that we want the security of good health; the NHS was set up to provide that so that people can lead fulfilling lives. That promotes greater independence and shortens the time people spend in ill health. We have not touched on that much, but that is a critical target for this Government.

The NHS health check aims to prevent heart disease, stroke, diabetes, kidney disease and some cases of dementia among adults between 40 and 74 years of age. Thanks to the hard work of NHS staff, the programme engages more than 1 million people and prevents about 400 heart attacks or strokes, but take-up of the health check is low—hon. Members could perhaps encourage their constituents to take part. We want to improve access to the service and develop a new digital health check that people can use at home. We have now launched the next phase to develop the service, and I am pleased that Norfolk county council has been selected as one of the three pilot sites that are due to start in 2025.

Hon. Members are right that access to dentists is a pressing issue facing patients. We all knew that before the election campaign, and that is why that is a core part of our commitment to the British public. Only 40% of adults have seen an NHS dentist in the past two years. My hon. Friends the Members for Luton North (Sarah Owen) and for Lowestoft (Jess Asato), in particular, highlighted what we all see when we visit primary schools to look at young people’s oral health. Hon. Members have read our manifesto and know what our plans are. To be clear, the Secretary of State and the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock), met the British Dental Association immediately on taking office and are meeting it regularly to resolve the issues with the contract. We will provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. We will rebuild dentistry for the longer term by reforming the contract.

I cannot go into too much detail on the proposal from the UEA. It is a place close to my heart, as it is where I went, almost exactly 40 years ago, to university. It is where I fell in love and got married, but sadly I had to leave the east of England. That is a fantastic hospital. I know it is supported by the local ICB, and I understand that individual Members are seeking to meet with the Minister for Care. I hope we will be able to update Members on that shortly.

My hon. Friend the Member for Norwich South talked about the dire state of the mental health service and the Norfolk and Suffolk NHS foundation trust. To update Members—although most will know—the trust has been in the recovery support programme since July 2021, after the CQC’s inspection report of “requires improvement”. To address quality and safety, the trust has implemented and completed a range of actions from that inspection report. In July it published the “Learning from Deaths” report, which was commissioned by the chief executive to review every death that occurred from April 2019 to October 2023. To improve the culture, the trust has launched Listening into Action, a trust-wide programme to improve how staff work together and listen to each other. In April, NHS England formally agreed a revised timeline for the trust to exit the recovery support programme at the end of 2024, and transition planning for post-exit has commenced. Obviously, we will be paying attention to that very closely, and I know hon. Members will also do so.

In response to the concerns about hospital buildings, we are all in no doubt about the inheritance that we have received from the last Government, particularly on capital, and about the state of our hospital estate. Each trust with a hospital with RAAC issues has invested significant levels of NHS capital to mitigate any safety risk. The safety of our patients must always come first. It is clear that the last Government’s promise to deliver 40 new hospitals by 2030 was not achievable, and it did not have the funding required to deliver it. That is why we are reviewing the programme to put it on a sustainable footing, which means a realistic timetable for delivery and clarity of funding. We will be honest with the British people and transparent about what we can deliver, and we will update the House and hon. Members on the programme’s next steps as soon as we can.

My hon. Friend the Member for Norwich South touched on climate change. This is a really big issue for the east of England. I will not have time to go into some of the issues but personally, and, as far as this Government are concerned, the impact of climate change on health and the provision of the health service is a serious issue, with surges in demand for services during periods of extreme weather and heat-related disruption to utilities, such as power outages. We are cognisant of those, and I do think it is an important issue for the health service. The NHS is doing well to become on target to reach net zero by 2040, and all trusts have targets. That is something we will watch closely.

I will give some rapid fire responses. We are not going to look at changing structures. We want to work with the system that we have inherited. It has to work, it has to bring people together, and it has to bring services into neighbourhoods. We have talked about the contract as well. We are keen to work together with local services in the ICB structure. We all know in our own areas that geographies are never quite perfect, but we do not want another reorganisation. We think that detracts from what we need to get on with.

The matter of productivity raised by the hon. Member for Broadland and Fakenham (Jerome Mayhew) is an issue—the concern about what we measure and how we measure it, and making sure that every taxpayer’s pound is used well within the NHS. Part of the issue is the breaking of the foundations of the system. Locally, that has meant it is very difficult for the service to deliver. That is why we are looking at this on a 10-year basis. The foundations need fixing.

Let me finish by once again thanking colleagues for bringing their own insights into heath and care in the east of England. Many new Members have come here from all parties. These are important debates, and it is important for Ministers such as myself to hear directly from Members’ constituents. Many of the issues are symptomatic of an NHS that is broken. That is why we are ending the sticking plaster politics. As the Prime Minister said a week ago, that is worth doing. It will be harder, and it takes more time. We are not going to give deadlines that we cannot meet. I hope that after just about two months in this role, I given answers today that show that we understand the scale of the issues that we face, and that this Government are committed to tackling them. If I have missed anything in particular, I will of course, correspond with hon. Members.