Oral Answers to Questions
Rachael Maskell Excerpts(1 week ago)
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Wes Streeting
It is because the Chancellor took the decisions that she did in the Budget that my Department has received £26 billion to reform and improve health and social care. As I said before the general election, all parts of the United Kingdom suffered under the previous Conservative Government, which is why I am sure that Members from across Scotland will welcome the extra £1.5 billion this year and £3.4 billion next year—the biggest funding increase since devolution. I am sure that the SNP Government will welcome the increase, and they certainly have no excuses now for not acting.
Rachael Maskell (York Central) (Lab/Co-op)
Fourteen years of neglect have left hospices in a perilous condition. They are dealing with the rise in national insurance contributions, pay and other cost pressures, so I welcome the fact that the Secretary of State is putting in place measures to ensure that the funding recovers. Will he assure me that integrated care boards not only will pass on that recovery from the increased costs to hospices, but will help them catch up from the Tory years of neglect of the whole sector?
National Insurance Contributions: Healthcare
Rachael Maskell Excerpts(1 week, 5 days ago)
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Karin Smyth
The hon. Lady makes an excellent point about the importance of GPs and primary care to the wider sector. Immediately after taking office this summer, we freed up the system to employ 1,000 extra GPs through the additional roles reimbursement scheme—which the previous Government refused to implement—because we recognised the need for that extra capacity. We will be talking to general practice as part of the contract reforms over the next few months, following the normal process, to determine allocations for next year.
Rachael Maskell (York Central) (Lab/Co-op)
If this Government’s ambition, stemming from Lord Darzi’s report, is to be realised, significant investment is required not only in primary care but in third sector organisations. However, these organisations are concerned about the increased cost pressures on their services. Will the Minister ensure that there is sufficient support within the trickle-down approach, which the Department will now have to apply, to maintain current service levels and facilitate the urgently needed transition across health services?
Karin Smyth
I respect my hon. Friend’s expertise in this area. She is right, and we understand that the pressures are real, which is why we have committed to supporting the NHS and the social care system with the additional funding that my right hon. Friend the Secretary of State for Health and Social Care secured as part of the Budget settlement.
We are also working closely with the NHS, in a new relationship, to understand its needs. That is a dynamic conversation, because we want to understand what is happening in local systems as we continue to invest in them.
Cancer Strategy for England
Rachael Maskell Excerpts(3 weeks, 5 days ago)
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Clive Jones
I absolutely agree with my hon. Friend. This is why we need a national cancer strategy. So many cancers do not get the resources they need. Everything is a bit too general; a lot of cancers need the focused, targeted resources that will lead to better outcomes.
Rachael Maskell (York Central) (Lab/Co-op)
I am grateful to the hon. Member for hosting today’s debate. In the last Parliament, the Health and Social Care Committee carried out an inquiry into future cancer. From all the evidence we received, we came to the conclusion that a bespoke future cancer strategy was needed to support the NHS, and that it should not be combined in a major conditions strategy, which frankly went nowhere under the last Government. I congratulate the hon. Member on his advocacy; will he read the Committee’s report and our letter about all the interventions that this Government could make to drive forward cancer care?
Clive Jones
I am aware of that report and will refer to it later in my speech.
The challenges will only grow. Experts state that one in two of us will get cancer in our lifetime. An expanding and ageing population means that the number of cancer cases is only going to grow. Cancer Research UK projects that there will be about 2.2 million new cancer cases in the current five-year parliamentary term, a 21% increase on the previous term. Cancer services are struggling now, and they will continue to struggle to keep up with demand. We have a greater number of people being diagnosed, but we have services that are not working. The challenge is stark, but there is a diagnosis for the problem. We now need to deliver meaningful action to recover England’s cancer care to full health.
The Liberal Democrats have made cancer care one of our top priorities for health. There are many policies that we think are crucial to boosting cancer survival rates. We are calling for the introduction of a guarantee for 100% of patients to start treatment within 62 days of urgent referral. We cannot just be content with replacing old radiotherapy equipment; we need replacements, but we also need more equipment. We are calling for the recruitment of more cancer nurses so that every patient has a dedicated specialist supporting them throughout their treatment.
Those crucial policies all feed into the very first step we must take, which is to give England the dedicated cancer strategy that it needs. It beggars belief that we do not have one. A cancer strategy is the best route to delivering genuine improvements for patients, for their families and loved ones and for those who work in our health system to research, prevent, diagnose and treat cancer.
The recent announcement of a 10-year health plan for England and its aim to improve health outcomes for all is very welcome, but I fear that the plan for all could be a plan for none. For example, analysis from Bowel Cancer UK found that the existing NHS long-term plan failed to sufficiently address the barriers to early diagnosis for bowel cancer. That is the case for many cancers. The approach is just too broad. We need detail, we need political will to be focused and we need a rapid and urgent turnaround.
A dedicated cancer strategy would provide a huge opportunity to fix the entire system, not just for the present but for the future—for our children and our grandchildren. It will not be simple or easy: that is why a strategy requires political will and bold leadership to bring Whitehall together and make tackling cancer a priority.
It is clear that when there is strong, bold leadership, cancer strategies work. That is the case across the world. At present, internationally and across our four nations in the UK, England is an outlier in not having a cancer strategy. Comparable countries with a cancer strategy have seen greater improvements in survival rates. For example, having started from a similar position in the 1990s, countries such as Denmark have raced ahead of England in improving survival in recent decades. Denmark’s success is linked to a series of cancer strategies that successfully and strategically built on one another over a 20-year period to tackle critical issues facing cancer services.
Past cancer strategies in England have worked. The 2000 cancer plan for England set ambitious targets across research, prevention and care outcomes. A report by the National Audit Office found that that strategy had supported progress in most aspects of patient experience.
The last Conservative Government launched a consultation on a 10-year cancer plan for England in February 2022. They promised to wage a war on cancer, yet the then Health Secretary, the right hon. Member for North East Cambridgeshire (Steve Barclay), scrapped the dedicated cancer strategy, turning it into a broader major conditions strategy. Delays, delays and more delays meant that the strategy was never published. That is just another legacy of failure from the Conservatives.
In May 2024, the Health and Social Care Committee wrote to the Government and argued that it was a mistake for the Conservatives to abandon the 10-year cancer plan. The current Government have the opportunity to turn that around. Having a cancer strategy is very popular with the public. Almost eight in 10 people think that the Government need to develop a long-term and fully funded plan for cancer. Organisations ranging from Cancer Research UK and Breast Cancer Now to global biopharmaceutical companies and medical institutions support having a cancer strategy for England. Yes, this requires effort, cross-Government thinking and focus, and the ambition to make England and the UK a world leader in cancer outcomes and research. But that effort will mean that we have the chance to save tens of thousands of lives and that millions of people will not need to suffer the upset of losing a loved one or friend.
Last week, I tabled a private Member’s Bill—the National Cancer Strategy Bill—calling for the Government to implement a cancer strategy for England. But unlike other private Members’ Bills, mine does not need to be law for that to happen; the Government could make the decision tomorrow to kick-start the work to implement it. Indeed, if my interpretation of Hansard is correct, they may well be intending to do so. In response to a question from my hon. Friend the Member for North Shropshire (Helen Morgan), the Secretary of State for Health and Social Care recently said that the Government will
“work tirelessly through a national cancer plan to make sure that we deliver the cancer waiting time standards that the last Labour Government met”.—[Official Report, 15 October 2024; Vol. 754, c. 684.]
A national cancer plan sounds quite similar to a national cancer strategy, and I would like to use the final section of my speech to make some recommendations to the Secretary of State as to what his cancer plan could and probably should include, because if the Department is seriously considering doing this, it will need to get it right. Broadly, the plan needs to cover all aspects of cancer prevention, research and care. It requires political leadership to bring together stakeholders to develop a strategy and co-ordinate implementation. It requires dedicated governance. There must be a robust central oversight function with a mandate to bridge the gap between disconnected Government structures. It must clearly detail how it will implement the strategy, with measurable objectives and achievable timelines. It must have regular, robust and transparent reporting of implementation and, inevitably, it needs dedicated resources to enable the right change.
A cancer strategy also provides the opportunity for us to unlock innovation in the future. We are living in a golden age of cancer science. New types of cancer treatment, from immunotherapies to cell and gene therapies, are enabling clinicians to attack cancer from multiple angles. These advances are helping to improve cancer outcomes. Therefore, I implore the Government, if they do take up a cancer strategy, to look at how the National Institute for Health and Care Excellence can be reformed to unblock barriers to investment and to strengthen the current infrastructure to increase genomics and biomarker testing.
I could go on. We could discuss the historical lack of strategic direction in terms of having a national policy for blood cancer, or the fact that every day 12 children and young people hear the news that they have cancer. Sadly, 10 die every week, making cancer the biggest killer by disease of children and young people in the UK. Despite that, it remains overlooked in existing strategies and reviews. That reflects the scale of the challenge we face in English cancer services; it feels like a never-ending list of things that we need to fix.
I will use this opportunity to ask the Minister a few questions. Can he assure people living with cancer and cancer charities that the Government will address the current crisis facing cancer services and build long-term resilience through a dedicated cancer strategy? Will he give his support to my private Member’s Bill, which would put into legislation a requirement for the Government to establish a 10-year cancer strategy? Will he meet me and, more importantly, representatives of the cancer community to discuss the need for a cancer strategy? Finally, will he make the case to his colleague the Minister for Secondary Care that the Royal Berkshire hospital requires an urgent rebuild?
Rachael Maskell
The hon. Member is making an incredible and powerful speech. Will he add one more ask to his list: for the cancer strategy to be joined up with a life sciences strategy? The UK is fantastic at primary research around cancer, but there is work to be done in scaling that research and translating it into delivering a holistic product for the whole of cancer care, with the ensuing treatments and therapies.
Clive Jones
I thank the hon. Member for her very good intervention. We are lucky in this country to have many life science businesses, many of which would really like to work as part of a joined-up cancer strategy. I have several in my constituency that I know would really like to do that, so I thank her for making that very good point.
Let us utilise this crucial opportunity to fix our cancer services. Some 360 people will die of cancer in the Wokingham area in the next year, and there will be around 2,000 cancer deaths over the next five years of this Parliament. We need to do our best to ensure that that figure is not reached but comes down.
World Stroke Day
Rachael Maskell Excerpts(4 weeks ago)
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Sarah Dyke
The hon. Member makes a very good point, and I also celebrate those people, who do such hard work within their communities.
The UK knows how to deliver world-class stroke care, and some parts of England are doing that as I speak. Stroke is one of the few conditions that takes patients through the entirety of the health and social care system, from emergency services and acute care to social care, specialist rehabilitation support and end-of-life care.
Rachael Maskell (York Central) (Lab/Co-op)
I am really grateful to the hon. Member for securing this debate. Time is everything with regards to a stroke, particularly around diagnosis, but also if treatment such as thrombectomy is needed. Does she agree that we should be looking at ambulance response times in particular, and perhaps at recategorising stroke as a category 1 call-out?
Sarah Dyke
I thank the hon. Member for her intervention and for all the work she has done in this area. I will come to the issue of ambulance response times a little later in my speech.
Delays in urgent care are currently leading to high mortality rates, and post-stroke services that provide crucial emotional, practical and social support are often treated as optional, rather than essential.
Stephen Kinnock
I am a little wary of generalising too much, because I know that so many decisions have to be made in real time by our skilled ambulance drivers and paramedics and the many others involved, but my hon. Friend makes a valid point. In a general sense, he is absolutely right that stroke needs to take priority. The red thread going through this entire debate is the need for speed. It is all about prioritising and acting quickly; he is absolutely right about that.
In the past year, we have seen a 30% increase in the number of thrombectomies delivered in England. Alongside that, our 20 integrated stroke delivery networks are looking to optimise care pathways. The General Medical Council is addressing critical workforce gaps through its thrombectomy credentialling programme, and our national optimal stroke imaging pathway is improving information sharing.
I am aware of the reconfiguration in the constituency of the hon. Member for Glastonbury and Somerton. NHS Somerset integrated care board has decided to close the hyper-acute stroke unit at Yeovil hospital and to establish a single hyper-acute stroke unit at Musgrove Park hospital in Taunton to provide 24/7 emergency treatment. All service changes should be based on clear evidence that they will deliver better outcomes for patients. A high bar is set out in guidance for intervening in contested reconfiguration cases, and the reconfiguration of services should be a matter for the local NHS. I would expect all avenues of local resolution to have been exhausted before a call-in request is made. The Department has received a formal request to call in NHS Somerset ICB’s decision, and Ministers will make a decision on whether to use their call-in powers in due course.
Unfortunately, there is still significant variation across the country in access and outcomes in relation to stroke. For example, the percentage of suspected stroke patients who received the necessary brain scan within an hour of arrival at hospital varies from 80% in Kent to only around 40% in Shropshire. That variation needs to change, and we need to bring the best of the NHS to the rest of the NHS. That will be one of the central challenges for the Government going forward.
The Government have a profound ambition to improve the lives and health outcomes of people who survive a stroke. At this point, I would like to pay tribute to my hon. Friend the Member for Stratford and Bow (Uma Kumaran) and to the man in the Public Gallery for what they have been through and for their fortitude. It was certainly not easy for my hon. Friend to come to this place and to have to go through the extremely difficult situation that she did. I also pay tribute to all the key partners and stakeholders who worked with her and her family to get through it. That really is a tribute to the immensely important work they do.
Rachael Maskell
As well as looking at acute triage to rapidly diagnose people who have had a stroke, it is important to invest in rehabilitation—something I did for 20 years in the NHS. I would be grateful if the Minister could set out how he proposes to have integrated rehabilitation teams that not only see people through the immediate aftercare, but continue to provide a top-up for them so that they do not backslide in their rehabilitation.
Stephen Kinnock
I can say a word about our national service model for an integrated community stroke service, which involves a number of specific projects aimed at improving delivery of psychological rehabilitation. The ICSS model is vital to support psychological recovery, return to work and improved quality of life, and I would be more than happy to discuss it further with my hon. Friend.
Before I close, I want to recognise the remarkable work of the charities that help people across the country to rebuild their lives after a stroke. Once again, I thank the hon. Member for Glastonbury and Somerton for this important debate, and I encourage every Member of the House to go to change.nhs.uk and to get involved in the biggest conversation about our health and care service since its foundation in 1948.
Question put and agreed to.
Oral Answers to Questions
Rachael Maskell Excerpts(1 month, 1 week ago)
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Wes Streeting
The decision on the winter fuel allowance is not one that the Government took lightly, but we inherited a £22 billion hole in the nation’s finances. We continue to stand behind vulnerable households by increasing the state pension with the triple lock, delivering the warm home discount and extending the household support fund to support the most vulnerable pensioners.
Rachael Maskell (York Central) (Lab/Co-op)
Andrew Gwynne
My hon. Friend is incredibly knowledgeable about public health matters both at national and local level. Lord Darzi’s investigation into the NHS set out the impact of past reductions in local government public health funding. We will confirm public health grant allocations for the next financial year as part of the forthcoming spending review, but the points she made have been made loudly and clearly.
Mental Health Support
Rachael Maskell Excerpts(1 month, 2 weeks ago)
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Rachael Maskell (York Central) (Lab/Co-op)
It is a pleasure to see you in the Chair, Mr Dowd. I think we all agree that, in introducing this debate, my hon. Friend the Member for Ashford (Sojan Joseph) gave an incredible speech, as all contributors have.
I want to talk a little bit about the transitional approach that we are taking in York, following the Trieste model. It is seeing a real transition, in the way the Health Secretary has described, from secondary care, which we know is just not able to cope with the capacity and demand that is placed on it, into a more primary-care and socialised setting. It is really transformative for the people in my city.
We are setting up community mental health hubs in my city. We have one, and we are going to have two more to follow, with one working 24/7. The model is co-produced and multi-agency, and is moving to provide open-access support to help people to manage their own mental health challenges, with interventions from health professionals, social prescribing and peer support, and to look at issues around welfare, debt and employment support.
Particularly in respect of community outreach, the hub is taking people who feel so neglected, because there just is not the capacity, into a space where they can get support and then progress on with their lives. It is centred around a café where people are encouraged to engage and talk. The café is run by service users, so it is a wholly-owned model, and it is incredibly successful.
The Trieste model is considered one of the best models of service provision in the world because of its emphasis on integration with the whole community and with the self, with professional support at hand if needed. In Trieste, very few depend on secondary care or acute psychiatric care, and residential placements are few and far between. We need to look at that, particularly in respect of the transitions and the Government’s ambition. Following a social model means we do not pathologise mental health but deal with it and help people to build on their strengths and to build resilience into the future.
Our programme is linked with the local university, York St John University, which runs the Converge programme that enables people to use education not only as a way to deal with their mental health issues but to learn new skills and feel included in our community. It contrasts so much with the traditional model, which we know just is not functioning given the demand on services. I therefore urge the Minister to have a look at what is happening in Trieste and to come and have a look at what is happening in York. Let us put this into a model in which people live with mental health as opposed to struggling with it.
NHS Performance: Darzi Investigation
Rachael Maskell Excerpts(1 month, 2 weeks ago)
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Victoria Atkins
I think the hon. Lady did not hear me; I said that cancer is the biggest killer of children under the age of 14, not 40. I know only too well how that terrible brain cancer has hurt her family, and the great loss that she has suffered. I know that she has ambitions for the work that we were doing to get cancer treatments, particularly new cancer treatments, as quickly as possible to patients who are getting towards the end of their life. We will of course support anything that the Government do to help people such as the hon. Lady’s sister; again, I come back to the fact that we all want this to work.
Victoria Atkins
I will make some progress, because I know that I am trying your patience, Madam Deputy Speaker.
Lord Darzi says that prevention is better than cure. We agree. The Government say that they are committed to prevention, but actions speak louder than words. Scrapping the winter fuel payment for millions of pensioners will undoubtedly come at a cost to the NHS. The equality analysis estimates that 780,000 of the most vulnerable pensioners who are eligible for pension credit will miss out this winter, and the cut will result in 262,000 pensioners needing NHS treatment because they are living in cold, damp homes, at an additional cost of £169 million in a year. How has the Secretary of State stood by as the Chancellor made that appalling decision, which will affect vulnerable pensioners in his constituency, as well as the NHS?
Finally, we have heard the words that the right hon. Gentleman has used about the NHS in England; it is surprising, to say the least, that he has not used those same words times 100 to describe the state of the NHS in Labour-run Wales. On almost every measure, the NHS performs the worst in Wales, where one in four people is on an NHS waiting list. Wales has the longest waiting times; Welsh patients wait on average seven weeks longer than in England. More than 23,000 people wait longer than two years, compared with just 120 people in England. Given the Secretary of State’s rhetoric about NHS England, why has he not asked Lord Darzi to take a cold, hard look at how Labour has run the NHS in Wales for 25 years?
In conclusion, we Conservatives want to support good reforms and good policies for the better health of the nation, but this backward-looking report will not improve productivity. Headlines will not drive better outcomes for patients, and speeches will not improve the life chances of our constituents. This Government need to move from words to action quickly.
Rachael Maskell (York Central) (Lab/Co-op)
Is a real pleasure to follow the new hon. Member for St Neots and Mid Cambridgeshire (Ian Sollom). I am sure that he will be a rising star on the Liberal Democrat Benches. It is a pleasure to follow all hon. Members who have made their maiden speech today.
I am really grateful for the analysis that Lord Darzi has set out for us. The NHS has never been under such duress, nor have its staff, but following a diagnosis, we need a prescription. That is what I want to talk about today. We live in an ageing society, and while we celebrate the medical advances since Labour was last in power—in diagnostics, treatments, digital and technology—we know the urgency with which we need to apply them. Transformation has to be central to the agenda. I congratulate the Secretary of State on his focus on the NHS bringing about the transformation that is needed.
However, before we can look at that, we need to look at the financial flows in the NHS, which are not working, and the governance structures. I am not talking about reorganisation; I am talking about having one controlling mind in the right place in the service, overseeing the system. At the moment, there is too much focus on secondary care. That is sucking resources and work into that part, and driving inefficiency. Moving services into primary care is the key to unlocking the productivity and savings that are needed. It will improve health as well.
In the short time that I have, let me point to two examples in my community. First, in mental health, 30 Clarence Street is set up to be open access, so that there are no more long queues to see mental health practitioners, and multidisciplinary, with the public sector and the voluntary sector working hand in hand to meet people’s needs. I invite the Secretary of State to come and see that service, because it is what we should be doing across our NHS. Two more hubs are to be set up in my constituency, leading the way on mental health. Then there is the work of Nimbuscare in primary care settings; it is pulling out from the NHS all the services that do not need to be in the secondary part. It is unplugging the backlog at the front door of the health service, while ensuring that we are looking after people at the back door. That is the transformation that our health service truly needs. I wanted to share those examples, and set out how they can be extended to build the NHS of the future.
Madam Deputy Speaker (Ms Nusrat Ghani)
I call Susan Murray to make her maiden speech.
NHS: Independent Investigation
Rachael Maskell Excerpts(2 months, 2 weeks ago)
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Wes Streeting
Of course we seek to work constructively with all trade unions representing staff across our health and care services, and also with the royal colleges. We want to work in a spirit of partnership, and we are only able to do so because people sent Labour MPs to Parliament to replace the Conservatives.
Rachael Maskell (York Central) (Lab/Co-op)
I agree with my right hon. Friend: this is the most devastating analysis that I have read of the NHS in over 30 years. It just shows the challenges that lie before him. Talking of challenges, will he challenge the integrated care boards to focus on moving resources into primary care? In particular, will he look at what is happening in York, where Nimbuscare has been able to pull out services from the acute sector and deliver work in the community?
Wes Streeting
I am really grateful to my hon. Friend for her question. She has a huge amount of expertise in health and care, and she is absolutely right about the need for that shift. I have made it very clear to ICB leaders and to trusts across the country that I want more focus on secondary prevention, which means much more activity in the neighbourhood. I know that she will keep on championing these causes. She is a good critical friend, and I know that she will hold my feet to the fire to ensure that I deliver.
Oral Answers to Questions
Rachael Maskell Excerpts(4 months ago)
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Stephen Kinnock
The hon. Gentleman was doing so well at the start, and then he kind of blew it a bit towards the end. It is absolutely right that we put country before party, and we will work with whoever has the best interests of rebuilding our public services at heart. The issue that he raises specifically sounds interesting. What I would say is that unless we get the bigger picture sorted, and unless we make NHS work pay for dentists, we will not be able to rebuild the NHS dentistry system that we should be cherishing and seeking to reform. I am of course always open to conversations with him.
Rachael Maskell (York Central) (Lab/Co-op)
Just 39.2% of my constituents were able to access an NHS dentist over the past two years. That is an absolute disgrace, but the Health and Social Care Committee put together a report into NHS dentistry, setting out a blueprint for how to resolve the challenges, including access, looking at tie-ins and ensuring that we get more dentists registered. Will the Minister look at that report and follow its recommendations?
Stephen Kinnock
I congratulate my hon. Friend on her re-election; it is wonderful to see her back in her place. She is absolutely right that the tie-in consultation deadline was 18 July. We are considering those responses with an open mind. On the broader issues that she mentions, our rescue plan is 700,000 more appointments, incentives for new graduates to go to under-served areas, reform of the dental contract and making work pay for dentists. That plan is at the heart of the reforms that she mentioned and that is what we will be doing.