(1 week ago)
Commons ChamberThis Budget is the moment we turn the page on 14 years of Tory neglect of our NHS, when we begin to fix the foundations of our public finances and public services, when we wipe the slate clean after 14 years of stagnant growth and under-investment, and when we start to rebuild Britain. This Government were elected to deliver change: from economic chaos to stability, from crumbling schools and hospitals to first-class public services, and from short-term sticking plasters to a decade of national renewal.
On Wednesday, the Chancellor took the tough decisions to set our country on a better path to a brighter future. Labour’s manifesto promised to protect the payslips of working people while asking the wealthy to pay more, and the Chancellor delivered. We promised economic stability through new fiscal rules, and the Chancellor delivered. We promised more teachers in our state schools paid for by ending tax breaks on private schools, and the Chancellor delivered. We promised to end the non-dom tax status to fund 40,000 extra NHS appointments a week, and the Chancellor delivered.
Our country, our economy and our NHS were crying out for change, and the Chancellor delivered. She did so against the backdrop of the most appalling inheritance faced by any Government since the second world war—and not just the £22 billion black hole in the public finances. Let me set out for the House exactly what I was greeted with in my Department alone when I walked through the door on 5 July.
The Conservatives had told the country that they were on track to build 40 new hospitals by 2030. The former Health Secretary told the House that the funding had been provided. Putting aside the fact that there were never actually 40 new hospitals planned, I was informed in July not only that the programme was years behind schedule but that the funding was to run out in March. The only place those hospitals existed was in Boris Johnson’s imagination.
The Conservatives promised to cap social care costs by October 2025, just 15 months after the general election, but there was not a single penny set aside to pay for it; the cupboard was completely bare. Within weeks of the general election, councils were warning that it would be impossible to implement the cap by next October because the preparations had not been made. Those were fantasy pledges that the Conservatives never intended on keeping.
On the new hospital programme, the Government committed in the Budget to move swiftly to rebuild reinforced autoclaved aerated concrete hospitals. The Queen Elizabeth hospital in King’s Lynn is keen to make progress with its plans. Will he meet me and the trust so that we can unlock the funding and get that hospital ready by 2030?
That is a commitment that we have made and a commitment that we will keep. I am happy to ensure that the hon. Member can meet the relevant Minister and project team as we get under way on delivering that project.
I did actually go back to check the pledges made by the Conservative party in its 2024 manifesto just to see how extensive the work of fiction was, only to find that the manifesto page on its website now reads “page not found”. The truth is, had the Conservatives won the election, it would have been deleted just as quickly.
That was not all I was told when I became Secretary of State in July. Despite 18 months of strikes in the NHS, there was no funding put aside to end the junior doctors’ dispute. What is more, the previous Health Secretary had not met the resident doctors since March—the Conservatives had given up even attempting to end the strikes. People should remember that this winter. For all the challenges that the NHS will face, this will be the first winter in three years when NHS staff will be on the frontline, not the picket line. That is the difference that a Labour Budget makes.
I was told that GPs would be qualifying this year with no jobs to go into. The Government found the funding and we are hiring an extra 1,000 GPs this year. That is the difference that a Labour Budget makes.
On the Budget, GPs, hospices and care homes have been found to be either exempt or not exempt from the national insurance contributions. Will he clarify whether hospices, care homes and primary care are exempt or not? That really matters to their costs.
I am grateful for that intervention for two reasons. First, it gives me an opportunity to say to GPs, hospices and other parts of the health and care system that will be affected by employers’ national insurance contribution changes that I am well aware of the pressures, we have not made allocations for the year ahead, and I will take those representations seriously.
Secondly, it gives me a chance to ask the hon. Member and the Opposition: do they support the investment or not? Are they choosing to invest in the NHS or not? They are now confronted with the hard reality of opposition. Just as when we were in opposition we had to set out how much every single one of our policies would cost and how those would be funded, they have to do that now. If they oppose the investment, they have to tell us where they would make the cuts in the NHS. If they oppose the investment, they have to tell us where they would make the cuts in school budgets. Those are the choices that we have made, and we stand by those choices. The Opposition will have to set out their choices, too.
I was told that because the Conservatives had run up huge deficits in NHS finances, I would not be able to deliver the 40,000 extra appointments a week that we had promised. In fact, I was told that we would have to cut 20,000 appointments a week instead. The Chancellor and I were not prepared to see waiting lists rise further. She put the funding in, and an extra 40,000 patients will be treated by the NHS each week. That is the difference that a Labour Budget makes.
It would be churlish of anybody in the House not to welcome the £22 billion that has been allocated to the NHS. Everyone across this great United Kingdom of Great Britain and Northern Ireland will benefit from that.
A number of my GP surgeries have contacted me about their national insurance contributions, which they see as a catalyst to perhaps not being able to deliver what they want to do for their patients. I understand that the Labour party and Government are looking at that in a consensual way. Can the Secretary of State please give me the latest position so that I can go back to my GPs and tell them, “This has been looked at and there will be something coming”?
I am grateful for that intervention. It is of course for the devolved Administrations to decide how to use the Barnett consequentials that the generous uplift in funding provided by the Chancellor will provide. We make no bones about it: we had to make some difficult choices in the Budget to plug the £22 billion black hole that we inherited, to deliver on our promises and to ensure that we are fixing the foundations of our economy and our public services. We have asked businesses and some of the wealthiest to make a contribution. I say to people right across the House that they cannot welcome the investment at the same time as opposing the means to raise it. If they do, they have to explain how they would find the money.
I congratulate my right hon. Friend on his success in getting this extra money for our national health service, which is incredibly needed. He spoke about the extra GPs that he is taking on. The doctors’ surgery in Staveley in my constituency has told me that surgeries in the most deprived communities see patients two or three times a year more than those in wealthier areas. Will he say something about how we ensure that the extra GPs we get look in particular at those more deprived communities that have greater health inequalities and need more appointments?
My hon. Friend is absolutely right about equity and fairness of access. The Government are determined to close the gap in healthy life expectancy and health inequalities that blight our nation. GPs and primary care are an important part of doing that. Unless we fix the front door to the NHS in primary care, we will not solve our NHS crisis. Unless we address the crisis in social care, we will not fix the NHS crisis. We will be able to do that only if we do so right across the country.
I fully understand the crisis that the Secretary of State inherited. He will be aware that most hospitals are running at a deficit, many have substantial debts and many are spending up to 15% of their income on servicing private finance initiatives. Is his Department prepared to make some kind of intervention to reduce that burden, perhaps by taking over the PFIs directly in order for our hospitals to be able to spend more on what they are there for, which is, of course, patient care?
I am grateful for that intervention. The right hon. Gentleman is absolutely right that we walked into a position of enormous deficits in the NHS, and an enormous black hole in the public finances was left by the last Government. That is why we have had to make some difficult choices. That is why we have to learn from the mistakes of the past and not repeat them in future. We are doing as much as we can as fast as we can. That is why it was important that the Chancellor made the bold choices she did in her Budget, so that, as well as plugging the black hole, we are fixing the foundations. Thanks to the fiscal rules adopted by the Chancellor, we will ensure that the Government do not repeat the waste, the profligacy and the irresponsible spending of our Conservative predecessors.
I will make some more progress.
Speaking of the Conservative party, I welcome the right hon. Member for Melton and Syston (Edward Argar) to his new position as the shadow Health and Social Care Secretary—the best job in the Opposition. In the two and a half years that I did his job, I faced five Health Secretaries. I am determined to make sure he faces only one. I had differing relationships with each of my predecessors. At best, we went hammer and tongs in this place, thrashing out our disagreements, but we would also get on the phone and work together in the national interest, particularly during covid when I had a particularly constructive working relationship with Sir Sajid Javid. I hope we can work together in that spirit. If he has any ideas to fix our broken NHS I am all ears—he just needs to go to change.nhs.uk, as hundreds of thousands of people across the country have already done. I must disappoint him, however: I will not be fired out of a cannon.
Choosing to serve is not always easy, especially in a job as thankless as being a member of His Majesty’s loyal Opposition. Let me applaud the right hon. Gentleman for stepping up to the plate. Having done his job until recently, I have some advice: first, it is easy to oppose for opposition’s sake, but the public will rightly expect him to have an alternative. The Leader of the Opposition refused to say at the weekend how Conservative Members will vote on the Budget. Apparently, whether they support or oppose £26 billion of investment in our NHS is, to quote her, “inside baseball”.
If the Conservatives finally decide to oppose the Chancellor’s measures, they will need to say what they would do instead. Would they keep our investment in the NHS? If so, how would they pay for it? Would they cancel our investment and the extra appointments, send doctors and nurses back out on strike or cause waiting lists to soar even higher? The Conservative party has to choose. At the moment, our only clue about the future of the party is the Leader of the Opposition’s comments about charging patients to use the NHS. She gave an interview to The Times just weeks ago in which, on the principle that the NHS should be free at the point of use, she said:
“we need to have a serious cross-party, national conversation.”
I am happy for the Conservative party to start that conversation any time. As far as I am concerned, it will be a short debate, and we will win: the answer is no. The Labour party will never surrender on the principle of the NHS being a public service, publicly funded and free at the point of use. It is time that the Leader of the Opposition made her position clear—although she has taken to opposition with such vigour, she tends to oppose things she said herself only days before.
I welcome the Leader of the Opposition’s call for honesty. The public have lost trust in politics, and we all have a responsibility to rebuild it. If we are not honest about the scale of the challenge and its causes, we have no hope of fixing them. Would it not be a welcome start to the role if the new shadow Secretary of State admitted what a mess his party made of our national health service and said sorry? It is not all the right hon. Gentleman’s fault; in fact, he and I have something in common. When he walked into the Department in 2019, he also inherited waiting lists already at record levels. It is true that waiting lists soared even further during the pandemic, but they were already at record levels before, and they continued to rise afterwards because of the damage that the Conservative party did to our NHS.
The Darzi investigation was clear about what is to blame: the top-down reorganisation, the chronic under-investment and the undoing of the last Labour Government’s reforms that saw NHS productivity fall off a cliff. Can the shadow Health and Social Care Secretary do what his predecessor could not, and accept the doctor’s diagnosis? Does this new Conservative leadership finally accept Lord Darzi’s findings? If the right hon. Gentleman cannot accept the work of an eminent cancer surgeon who has served both Labour and Conservative Governments, I wonder if he might agree with this damning assessment of his party’s record, made by one of his former colleagues:
“British citizens have the worst rate of life expectancy in western Europe. We have higher avoidable mortality rates than our neighbours. Survival rates for breast, cervical, rectal, lung, stomach and colon cancer are lower in the UK than in comparable jurisdictions. NHS patients who suffer heart attacks or strokes are more likely to die than in France, Spain, the Netherlands, Canada, Italy and New Zealand.
More than seven million people are on waiting lists...Every month, tens of thousands wait more than 12 hours for treatment after being admitted to accident and emergency wards. It is then no surprise that the number of (wealthier) patients opting to pay to be treated privately is at a record level...so we have a two-tier health system in this country in which the rich secure the best care, those in pain wait in agony and those with life-threatening conditions know their treatment would be better in Marseille or Madrid than in Manchester or Middlesbrough.”
The author of that quote was Michael Gove. If he can be honest about the mess the Conservatives made of the NHS, I hope the right hon. Gentleman can, too.
While the Conservatives work out what they stand for, we are getting on with cleaning up their mess, rebuilding our public services and reforming our NHS. As I said before the election, there is no point pouring more money into a broken system. Next week I will set out a package of reforms to make sure that every penny going into the NHS is well spent and benefits patients. Unless I am convinced that the money going in will deliver results, it will not get out the door.
Every bit of investment announced by the Chancellor last week will be linked to reform. The Budget will fund 40,000 extra appointments a week, and the appointments will be delivered through reformed ways of working. They are already being used in hospital across the river from here, where operating theatres are run like Formula 1 pit-stops. We will get hospitals motoring right across the country using that reformed way of working. We are investing not just in new scanners but AI-enabled scanners that diagnose faster and more accurately, increasing productivity and busting the backlog of 1.5 million patients waiting for tests and scans.
The investments in the Budget have fired the starting pistol on the three shifts that our 10-year plan will deliver. It increased the disabled facilities grant, to help people stay well, independent and out of hospital, funding an extra 8,000 adaptations to people’s homes. We are raising the carer’s allowance, worth an extra £2,300 to family carers so that they can stay in work while looking after their loved ones. That is the biggest expansion of carer’s allowance since the 1970s. We are expanding NHS talking therapies to treat an extra 380,000 mental health patients. We are investing in bricks and mortar outside of hospitals, opening new mental health crisis centres and upgrading 200 GP surgeries.
I congratulate the Secretary of State on the extra investment that he has secured for the national health service, in spite of the Chancellor. Does he agree that primary care needs to be diversified? Could he outline whether that includes walk-in centres? If it does, could I have a meeting to discuss a new walk-in centre at Fareham community hospital in my constituency?
I am not sure whether this is within the rules of the House—you will tell me if not, Madam Deputy Speaker—but I will do the hon. Member a deal: if he votes for the investment, he can have the meeting.
Turning to the second of the big shifts that we need, from analogue to digital, the Darzi investigation found that the Conservatives left the NHS 15 years behind the private sector on technology. This Budget invests £2 billion to arm the NHS with modern technology so that staff spend less time pushing paper and more time on the frontline. In 2024, that the NHS is still using paper records to store patients’ medical history is absurd and jeopardises patient safety. The investment in this Budget will provide every trust with electronic patient records, and upgrade the NHS app so that patients can access care with a few taps on their phone. We are backing British scientists and researchers to develop the treatments of the future, with record investment in the National Institute for Health and Care Research, support for life sciences innovation and strengthening the UK clinical trial network.
We are also shifting from sickness to prevention. Today, we have announced the biggest public sector health reform in a generation. We are raising the legal age at which people can buy tobacco by one year, every year, protecting children and people from the harmful effects of second-hand smoke outdoors as well as indoors. We are cracking down on the marketing and targeting of vapes at children, so that we can create the first ever smokefree generation. Unless we act on public health reform and public service reform, the demands and costs on the NHS will spiral and the service will become unsustainable. If we want the health service to survive, and we do not want to pay ever higher taxes to fund it, we have to help people stay healthy. Prevention is better than cure—that is why we are introducing the Bill. I hope it will continue to command cross-party support.
It is not just smoking; obesity costs the NHS almost £12 billion a year. That is why we have already introduced the motion to ban the targeting of junk food ads at kids. We are strengthening councils’ powers to stop fast-food shops setting up outside schools. In the Budget the Chancellor increased the soft drinks industry levy so that manufacturers continue to reduce their sugar content while we review the exemption for milk-based drinks.
Madam Deputy Speaker, as you know, it was a Conservative Chancellor who introduced the sugar tax and a Conservative Prime Minister who introduced the first Tobacco and Vapes Bill. Because he is sensible, I know the shadow Health and Social Care Secretary will support those measures, but I cannot say the same for the Leader of the Opposition, so trapped in the prison of ideological dogma is she, so scared is she of the Reform dog that is barking over their shoulders. I hope the shadow Health Secretary will continue to hold the torch for one nation conservatism, even as its light dims in his party. If we want to know when the Conservative party has changed, maybe we will know when they have learned once again to love George Osborne.
Fixing the foundations of the NHS starts with fixing its little foundations. Lord Darzi pointed to how the Conservatives raided capital budgets time and again to plug the gaps in day-to-day spending. Indeed, that is the position we found ourselves walking into this year. Lord Darzi called it a
“combination of austerity and capital starvation”.
The Budget will begin to rebuild our NHS with the biggest capital investment since Labour was last in office, including £1 billion to tackle dangerous RAAC—reinforced autoclaved aerated concrete—and the backlog of critical maintenance and repairs across the NHS estate, keeping staff and patients safe and boosting productivity.
In conclusion, we cannot fix 14 years of mismanagement and neglect in one go, but the Budget marked an historic turning point for our country. For years the Conservatives pretended that the problems facing Britain did not exist, leaving them to grow. This week, the Chancellor ran head first into those challenges, taking the tough, difficult decisions on tax, spending and welfare because the choice was stark: we could stick to the status quo of 14 years of underinvestment that has knee-capped our economy and crippled our NHS, or we could begin to fix the foundations, kick-start the economy and rebuild our health service. The choices the Chancellor made will give the NHS the investment and reform it desperately needs to cut waiting times, rebuild crumbling buildings, arm NHS staff with modern technology, get more out of the NHS for what we put in, and fix the foundations and rebuild Britain. That is the change the country voted for; that is the change this Labour Budget delivers.
I will make a little progress, but then I will happily give way to my hon. Friend.
Apart from the press releases and the reviews, where is the action? We need to see where the £22 billion will be spent. What plans does the Secretary of State have for additional investment for the NHS this winter? He knows, as I knew when I was a Minister, that winter in the NHS is always challenging. I look forward to him setting out what additional investment he plans.
I will give way to my hon. Friend the Member for Hamble Valley (Paul Holmes) in a second. Nice try, Secretary of State.
Is the right hon. Gentleman directing where that NHS funding goes himself, or will it be for his officials or NHS England to set the priorities for that, and who will be held accountable for ensuring that it is prioritised in the right places?
(3 weeks, 1 day ago)
Written StatementsOur NHS is broken, but not beaten, and we have made it our mission to fix the NHS. But we cannot do it without the help of the people who use it, and so today I am launching Change NHS: A health service fit for the future—a national conversation to develop the 10-year Health Plan. This is the next chapter of the NHS’s story and how we will make it fit for the future.
One of my first acts as Secretary of State was to commission an immediate investigation into the performance of the NHS in England, to start an open and honest conversation about the state of our health service and the reforms needed to ensure its longevity, and that it is fit for the future.
On 12 September, Lord Darzi published his independent review, which revealed the scale of the challenge we face. Our NHS is under rising pressure; we are diagnosing ill health too late and not doing enough to prevent it in the first place. It is too hard for people to get an appointment, hospitals are overcrowded, NHS workers are overstretched and costs are escalating.
I am determined to reverse record levels of public dissatisfaction with the NHS and deliver a health service that is there for everyone who needs it. We have already taken important steps, starting with plans to fix the front door of the NHS by providing funding to support the recruitment of an additional 1,000 GPs by the end of the financial year and settling the pay dispute with resident doctors.
For decades, there has been broad consensus that to overcome the challenges facing the NHS, we must focus on providing more care in the community, so hospitals are able to treat the sickest patients, make better use of technology, and do more to prevent ill health. Despite this consensus, successive Governments have failed to deliver.
We need a different approach to make these crucial shifts and deliver an NHS fit for the future. I want the public and staff to be at the centre of reimagining the NHS, as well as experts from across the health and care landscape. The best ideas are not going to come from above. They have to come from all of us. So, from today, everyone can provide their experience and views at www.change.nhs.uk to help us fix our broken NHS.
[HCWS147]
(3 weeks, 6 days ago)
Commons ChamberI thank the hon. Gentleman for his intervention. I have talked about the challenges the NHS faces. I will come shortly to the achievements of the Labour Government so far in the Department of Health and Social Care.
Turning back to technology, I was saying that I agree with the Secretary of State on how technology can improve NHS services. Over the last few years, in my professional capacity, I have seen improvements in making communication between primary and secondary care and within secondary care much more efficient. As a patient, I have used the askmyGP service, which is an excellent way to communicate with a GP, particularly for working people. I have also used the NHS app, which millions of people have downloaded and which has huge potential. I hope he intends to build on that potential and harness the benefit of AI for diagnostics in particular.
The Secretary of State and I also agree on the importance of prevention. It is vital to make the NHS accessible to those who need it, but it is even better if people stay healthy in the first place. Before the election, he was supportive of measures to protect children from the dangers of vaping—measures I campaigned for actively. In fact, he was quite critical that it had not been done sooner, as in some respects was I. Given that the legislation has already been written and that it passed both Second Reading and Committee stage with the support of his friends on the Labour Benches, why is it taking him so long to produce a tobacco and vapes Bill? Can he guarantee that he will deliver it, like a present, in time for Christmas—for clarity, I am hoping for this Christmas?
Have you been naughty or nice?
I have been a good girl, thank you, Secretary of State.
Furthermore, can the Secretary of State explain how cancelling dozens of new hospitals will reduce pressure on general practice? Can he explain how cutting the winter fuel payment for millions of pensioners will help the NHS? The End Fuel Poverty Coalition predicts that Labour’s winter fuel payment cut will result in an additional 262,000 pensioners needing NHS treatment because they are cold, resulting in a great deal of suffering and millions of pounds of additional cost to the NHS. Does he agree with that assessment? I have asked repeatedly, in both oral and written questions, if the Government will conduct a proper impact assessment of the policy on the NHS and on the wellbeing of vulnerable older people. Will he commit to producing and publishing such as report?
Further on the issue of prevention, the right hon. Gentleman will know that folic acid supplementation can prevent neural tube disorders, such as spina bifida and anencephaly. The previous Government brought forward regulations on the matter. What conversations has the Secretary of State had with the Department for Environment, Food and Rural Affairs about ensuring that that work is continued?
Our approach to dentistry was also underlined by prevention. We introduced the Health and Care Act 2022, which gave the Secretary of State the power to introduce water fluoridation schemes. Those powers have since been used to extend existing schemes, particularly in the north-east of England. Does the Secretary of State intend to continue that work and exercise the powers the previous Government gave him? He knows that I am passionate about dentistry. I have raised the issue many times in the House, including by securing an Adjournment debate on dentistry in Lincolnshire. It troubles me greatly that children are coming to hospital for multiple dental extractions due to rotten teeth. It is worth noting that the issue is not a shortage of dentists overall or, as the hon. Member for North Shropshire (Helen Morgan) says, a shortage of money, but a shortage of dentists doing NHS work rather than private work specifically.
The previous Government were encouraging dentists to take up NHS work with a range of measures, including golden hellos for dentists in underserved areas, dental vans going out to rural communities, and tie-ins for new dental graduates. We were also in the process of broader contract reform after a small change in the units of dental activity rate when we went into the election. Let us look at Labour-run Wales in comparison. Wales is delivering only 58% of pre-pandemic dental activity. It is burdened with the highest proportion of NHS dental practices not accepting adult patients and the longest waiting lists in the UK. One in four Welsh residents is currently on a waiting list. The new Secretary of State for Wales has said that the Government “will take inspiration from” Labour-run Wales on dentistry. Given their woeful record in office, I sincerely hope that that is not the case.
Before the election, when I listened to the Secretary of State for Health and Social Care say that Labour had a plan to reform and modernise the NHS, I believed him, but in Monday’s debate on the Lord Darzi report, we uncovered that his plan was not really a plan at all, but a list of desired outcomes and a proposal to make a plan if he got into office. It is unclear how long this plan will take to develop. The Minister for Secondary Care said that it is a listening exercise like we have never seen before, but how much will that cost, and had Labour not been listening already?
(4 weeks ago)
Written StatementsOn 28 November 2023, the report of phase 1 of the Fuller Independent Inquiry was published. Phase 1 of the inquiry looked into how David Fuller’s appalling crimes in the mortuaries at Maidstone and Tunbridge Wells NHS trust remained undetected for so long.
I wish to express my deepest sympathies to the victims’ families and reassure them that lessons will be learnt.
The inquiry found highly concerning failings in the trust’s running, management, and oversight of the mortuaries, and that it was due to this uncontrolled environment that David Fuller was able to offend undetected. Management, governance and regulation failures, alongside poor compliance with standard policies and procedures, and a persistent lack of curiosity, all contributed to the creation of the environment in which David Fuller was able to offend for 15 years without ever being suspected or caught.
The 17 recommendations—16 for the trust and the remaining one for Kent county council and East Sussex county council—made by the inquiry in phase 1 aim to prevent anything similar happening again at the trust.
Today I am updating the House on the response to those recommendations. The trust published an assurance statement in February 2024 on the implementation of the recommendations from the phase 1 report. This sets out the progress made to implement the inquiry’s recommendations.
The range of actions taken by the trust include requiring that non-mortuary staff and contractors are always accompanied by another staff member when visiting the mortuaries; controlling access to mortuaries using swipe cards; mandating contractors to renew security clearances every three years; and installing CCTV coverage monitoring access to and from mortuary areas. The trust board is also providing greater oversight and assurance of legally regulated activity in the mortuary.
I am also reassured that NHS England’s south-east regional team held monthly oversight meetings with the trust between November 2023 and April 2024—in partnership with Kent and Medway integrated care board—to ensure progress against the inquiry’s recommendations and to review evidence of the trust’s progress in delivering its action plan. Ongoing compliance with the inquiry’s recommendations will be monitored by NHS England through regular regional oversight meetings with the trust, and through other channels as appropriate.
Kent county council and East Sussex county council have reviewed contractual arrangements with the trust and confirmed that the contracts include terms requiring that licensing and regulatory requirements are met to ensure the deceased are at all times treated with dignity and respect.
Phase 2 of the independent inquiry will consider whether procedures and practices in hospital and non-hospital settings, where deceased people are kept, are sufficient to safeguard the security and dignity of the deceased.
In light of the disturbing events in Hull earlier this year, which brought into sharp focus the lack of regulation and oversight in the funeral sector, we have agreed that the inquiry will today publish an interim report on the findings from its funeral sector module. This will provide recommendations on safeguarding the security and dignity of the deceased in that sector.
The Government are committed to preventing any similar atrocities happening again and ensuring that the deceased are safeguarded and treated with dignity.
[HCWS132]
(4 weeks ago)
Written StatementsThe full findings of the review into the operational effectiveness of the Care Quality Commission (CQC), conducted by Dr Penny Dash, have today been published on www.gov.uk. I would like to place on record my sincere thanks to Dr Dash for the swift and thorough job she has done on the review.
An interim report of Dr Dash’s work, published in July 2024, summarised her emerging findings to allow for early conversations on the necessary changes to improve the CQC. Those findings were shocking, and led to my conclusion that the organisation was not fit for purpose. This full report expands on that work and incorporates feedback from recent discussions with user groups and a larger number of staff.
The findings of the review highlight 10 key conclusions and provide specific recommendations for improvement, which I fully support. Notably, the review recommends that the CQC should:
Rapidly improve its operational performance.
Rebuild expertise within the organisation and relationships with providers in order to resurrect credibility.
Review the single assessment framework to make it fit for purpose.
Clarify how ratings of providers are calculated and make the results more transparent.
Continue to evolve and improve its assessments of local authorities.
Formally pause its assessments of integrated care systems (ICSs).
The review also recommends that the Department of Health and Social Care should strengthen its arrangements for sponsorship of the CQC, a recommendation upon which my Department has already acted.
Significant work is already under way to act on these findings. Last week, the CQC announced that Sir Julian Hartley will be appointed as the new chief executive of the CQC. This is a significant step forward as Sir Julian’s experience of turning around large, complex health organisations will be vital as the CQC embarks on its improvement plan. He will be supported by sector expertise through the appointment of a number of chief inspectors.
Following the publication of the interim report, the CQC commissioned Professor Sir Mike Richards to undertake a review of the single assessment framework. Findings from the first part of Sir Mike’s report will also be published by the CQC today so that both reports can be read together.
In response to the recommendations that are additional to the interim report, we are working with the CQC and the adult social care sector to ensure that local authority assessments evolve in a way that maximises their value in driving outcomes for people who draw on care and support, and their carers. I agree with Dr Dash’s recommendation to pause ICS assessments, which have not yet launched, to allow the CQC to focus on getting the basics right before introducing new functions. I am working on next steps.
By implementing Dr Dash’s recommendations, the CQC will be better positioned to fulfil its mandate of ensuring that everyone receives safe, high-quality care. A strong regulator is critical to the safety and effectiveness of our health and care system, and I am personally determined that its performance improves so that it can regain the confidence of both the public, and the health and care system.
Following the conclusion of this review, I have asked Dr Dash to lead a review of patient safety in the wider health and care landscape in England, for which I am also publishing the terms of reference today on www.gov.uk. The primary task of this review is to assess whether the current range and combination of patient safety organisations delivers effective leadership, listening, learning, and regulation to the health and care system in relation to patient and user safety.
Subject to the outcome of this second review, I will also ask Dr Dash to conduct a third review on quality and its governance. Further detail on this third review will be forthcoming in due course.
[HCWS133]
(4 weeks ago)
Commons ChamberWaiting times are wholly inadequate in our country. That is because the previous Conservative Government took a golden inheritance of the shortest waiting times and the highest patient satisfaction in history and left behind the worst crisis in the NHS’s history. What is more, they accept no responsibility and cannot even bring themselves to say sorry.
I pay tribute to my own family GP, Dr Islam at the East Hull family practice, who goes above and beyond for his patients. However, I know that GPs are troubled by the amount of time patients have to wait to see them. The disparity between GP numbers in different areas is utterly shocking. In Kingston upon Thames, for example, a GP looks after 1,800 patients, but in Kingston upon Hull it is more than double that number. What is my right hon. Friend doing to sort out the Tory mess of the last 14 years?
May I first, through my hon. Friend, say thank you to Dr Islam and to GPs right across the country who, against the backdrop of the extraordinary challenges they are working through, have none the less managed to deliver more appointments now than when there were thousands more GPs? My hon. Friend is right to point out that we do not have enough GPs in this country. That is why, within weeks of taking office, this Government found just shy of £100 million to put into the frontline to employ 1,000 more GPs who will be seeing patients before the end of this financial year. That will make a real difference, and the shadow Secretary of State should have the humility and to grace accept that.
Patient waiting times are reduced dramatically through the recruitment and retention of more GPs, so will the Secretary of State welcome the work of the Anglia Ruskin medical school in Essex, and perhaps have a conversation with myself and neighbouring MPs about how that medical school could be expanded to do much more to support the recruitment and training of more MPs—more GPs in Essex?
I am sure that the right hon. Lady does want more Conservative MPs in Essex. She has raised an entirely constructive point, which I strongly welcome. This Government are committed, as we were in opposition, to doubling the number of medical school places, and that means real opportunities for local medical schools such as hers. As ever, I would of course be delighted to meet her to talk about what more can do with her local university.
The news that we are recruiting more GPs is very welcome. I spent an afternoon shadowing a local GP and saw just how stretched the services were. Will the Secretary of State give a commitment that we are moving towards investment in primary care services and moving from a national health service to a focus on neighbourhood health services?
I am grateful to my hon. Friend for raising that question. When in opposition, I was delighted to spend time with a whole group of GPs from across Sheffield who showed us what primary care reform could look like. We are committed to increasing primary care as a proportion of the NHS’s budget, which will be important, and also to building exactly the kind of neighbourhood health service she describes, with more care closer to people’s homes. General practice has a key role to play in that.
What we measure is often what we end up improving, and one of the great assets of Lord Darzi’s report is the technical annex with its 330 analyses. It is incredibly useful; it is a baseline. Will the Secretary of State make sure that it is updated yearly?
That is a great constructive challenge. I am absolutely committed to transparency and to keeping that dataset updated in the way that the hon. Lady requests. We are not going to get everything right and sometimes we are not going to make progress as fast as we would like, but where that is the case we are never going to duck it or pretend that things are better than they are. The reason that we will succeed where the previous Government failed is that we are willing to face up to the challenges in the NHS rather than pretend that they do not exist.
The Prime Minister has repeatedly stressed the importance of preventing people from taking up smoking, as one of his priorities to improve the nation’s health, reduce waiting lists and lessen demand on the NHS, and we agree. The Government like to talk about the record of their first 100 days in office but, according to data from Action on Smoking and Health, 280 children under the age of 16 take up smoking in England each day. That is 28,000 children in England during the Secretary of State’s first 100 days. Why has he not yet reintroduced our Tobacco and Vapes Bill? How many children need to take up smoking before he makes this a priority?
Perhaps the shadow Minister would like to give us the figures for the entire 14 years that his party was in government. By the way, just to set the record straight, not only did I propose the measures in that Bill during an interview with The Times earlier last year, but if it was such a priority for the Opposition, why did they leave the Bill unfinished? Why had it only had its Second Reading? And why did we go into the general election with that Bill unpassed? I will tell him why: because his party was divided on the issue, and the then Prime Minister was too weak to stand up to his own right-wingers who are now calling the shots in his party. The smoking Bill will be back, it will be stronger and, unlike the previous Government, we will deliver it.
My constituent Mel Lycett has terminal cancer. After repeated visits to her GP, she was referred to a two-week urgent pathway in May. She was not diagnosed until the end of July, and she still has not started treatment. Every single target for her diagnosis and treatment was missed. That is not uncommon in Shropshire, and it is not uncommon in the rest of the country. Can the Secretary of State reassure me of what he is doing to deal with this terrible legacy left behind by the Conservative Government? How will he ensure that cancer patients are treated in a timely manner?
I welcome the hon. Lady to her role. I am afraid that this case is just one of countless stories of people whose lives might have been saved had the NHS been there for them when they needed it. It is bad enough when people receive a late diagnosis that equates to a death sentence; it is worse still when people in that position are not given the fighting chance of urgent, life-extending treatment.
The inheritance we have received is truly shameful. I assure the hon. Lady, as a cancer survivor myself—because the NHS was there for me when I needed it—that we 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, and that are sorely needed today.
I must declare an interest, because Whipps Cross hospital serves my constituents, as well as those of the right hon. Gentleman. On that basis, I am well aware that we desperately need the proposed redevelopment of the hospital. That is why, in common with so many Members across the House, I am furious that the previous Government’s new hospitals programme had a timetable that was a work of fiction and money that will run out in March. The assurance I can give to the right hon. Gentleman, his constituents, my constituents, and the constituents of every right hon. and hon. Member across the House whose constituents are waiting for news on the new hospitals programme, is that we will deliver on a timetable that is credible and a programme that is funded, giving our constituents the clarity and consistency they deserve, and rebuilding by placing the Government among our construction industry supply chain.
The Secretary of State knows that we have campaigned together for the redevelopment of Whipps Cross hospital, and whether that is delivered by a Labour or Conservative Government makes no difference to me. I want to drag him to the reality of a specific point about the hospital: it was granted £1.2 million towards undertaking a business case, which it received in August, but that money has run out. A total of £5 million is required to be ready when the decision is made; if it is not available, the hospital will lose the architects and builders. Will he go back to the Department and ensure that the hospital receives that money, so that managers can be ready with the full, detailed business case the moment the decision is made? Otherwise, it will cost £50 million extra over the next year to get the architects and builders back. I beg the Secretary of State—I literally beg him—to look at that carefully.
I am grateful to the right hon. Gentleman for his question. Those practical considerations are very much part of the review. I say to the poor project managers across the country who have had to deal with the previous Government’s stop-start approach that we are not going to make that mistake. We are going to come forward with a credible plan that is also funded, not the work of fiction or the £22 billion black hole that the shadow Secretary of State left in her wake.
Whipps Cross hospital is in my constituency and it is my constituents who have had to endure five years of the previous Government organising photo opportunity after photo opportunity, not putting the contracts in place for the project to be up and running and ready to go. Does my right hon. Friend agree that only a fully costed, long-term approach from this Labour Government can deliver the modern healthcare that my constituents need?
My hon. Friend, my constituency neighbour, is absolutely right. He has been doing an outstanding job of representing the people of Leyton and Wanstead since his arrival. What our constituents, and indeed constituents right across the country, deserve is honesty, clarity and consistency. That is how we will turn the new hospitals programme from a press release into reality and how, in doing so, we will restore trust in politics and, for businesses, the construction industry and the supply chain, restore confidence in public sector procurement.
Many Leicestershire residents are concerned about the Government’s review of the new hospitals programme, which would have seen two new hospitals, a midwifery-led unit and a multi-storey car park in the city. What representations has the Minister made to the Chancellor to retain this vital investment for the NHS in Leicestershire?
The hon. Gentleman asks what representations I am making to retain the funding. If only that were the case. The funding was not there. The Conservative party went into the general election with a programme timetable that was a work of fiction and a claim to have a funded programme that was simply not true. What we arrived to find was a timetable that was a load of rubbish and a £22 billion hole in the public finances that the party hid from the country because it did not want to confront the hard truths. This Government are facing the facts and answering the challenges.
I am probably the only MP in this current Chamber who has recently used Whipps Cross hospital, which also serves my community in Walthamstow, because I had both my children there, so I know at first hand how desperately it needs redevelopment and how poor the facilities are that the amazing staff are having to use. Does my right hon. Friend agree that finally getting this project moving under a Labour Government will also deliver thousands of much-needed homes in our local community? It is a win-win situation, which is why it is such a travesty that, for years, Conservative Ministers came and took photos, but we never saw any diggers or spades in the ground. Does he agree that Labour can change that?
My hon. Friend is absolutely right. This is about not just the necessary hospital projects, but the growth that will come through construction, getting these projects up and running and, of course, the role that the NHS plays as an economic anchor institution in communities, as some of these projects will necessarily unlock new housing sites and a local transport infrastructure. We are mindful of all of that. The most important thing is that we come forward with a timetable that is credible and a programme that is funded, and that is exactly what we will do.
Today, I am publishing the full findings of Dr Penny Dash’s review of the Care Quality Commission. Her interim report made it clear that the CQC was not fit for purpose, with fewer inspections being carried out, urgent follow-ups being neglected and patient safety being put at risk. Today, she makes seven recommendations for improvement, and I have made sure that the CQC has begun urgently putting them into practice. We are also publishing a review of the CQC’s deeply flawed single assessment framework today. Sir Julian Hartley will shortly begin as its new chief executive, with my full support.
My constituent Mark has been unable to find an NHS dentist for his 19-month-old child, even at the seventh time of trying. My right hon. Friend well understands the crisis he has inherited. Will he meet me to discuss the shortage of dentistry in Stockton North and across Teesside?
I am sorry for my hon. Friend’s constituents, and so many others who are dealing with the consequences of the Conservatives’ failure on dentistry. I would be delighted to meet him to discuss the challenges in his area.
I congratulate all nominees and winners in the NHS parliamentary awards yesterday. Their success was richly deserved, and the awards were a very good example of the House coming together to celebrate those who work so hard in our health service and social care services.
In the past five weeks, I have asked the Secretary of State 29 questions at this Dispatch Box, yet he has managed to answer only one. For the rest, he has tried to bluster his way out of his policy decisions, as we have seen this morning. Let us try again. When will be the first week in which we see delivery of his promised 40,000 more appointments?
After the performances I had to put up with when the right hon. Lady was at the Government Dispatch Box, she has some brass neck complaining at the Opposition Dispatch Box that I am not answering her questions. She will know that we are working at pace to stand up 40,000 more appointments every week as our first step, as promised in our manifesto, and we will deliver. More than that, we will go into the next election with a record of which the right hon. Lady can only dream.
After 14 years of opposition—two and a half of which the Secretary of State spent on the Front Bench and travelling around the world, funded by other Governments, to look at their healthcare systems—and more than 100 days in government, the right hon. Gentleman does not even know the start date of his own flagship policy. He is no Action Man; he is Anchorman.
Let us deal with Labour’s cruel decision to slash winter fuel payments, which will add pressure not only to patients, but to the NHS. The NHS’s deputy chief operating officer—
Order. I gave the right hon. Lady a hint to come to an end and not to carry on fully. It is unfair to Back Benchers, who I am trying to represent. I want a short answer.
The shadow Secretary of State questions the budget for this winter, but it was set by her Government. Is that finally an admission of failure on her part? Something else that we will have this winter, which we did not have last winter or the previous winter is no—
In England, 4.4 million children have not seen a dentist for at least a year. Meanwhile, in Shropshire, Telford and Wrekin integrated health board, £1 million of dental funding went unspent in 2022-23. The system is clearly broken. When can we expect the Secretary of State to fix it?
It is precisely because of the situation the hon. Member describes—the poor services and, ironically, the underspends in the dentistry budget—that we will work not only to stand up the 700,000 urgent and emergency dental appointments we promised, but to do the prevention work for children in our schools.
Whatever stage the Bill got to, it was not completed, was it? We will bring back a tobacco and vapes Bill that is stronger than the Conservatives’ and I look forward to seeing if they support it.
I absolutely take the point the hon. Gentleman is making about the importance of place-based leadership. That is why one thing we will be looking to do, as part of the 10-year plan process, is to clarify roles and responsibilities in different parts of the system to ensure that we have better strategic place-based leadership.
Labour’s cut to the winter fuel payment will cause 262,000 cold pensioners to seek NHS treatment, according to the End Fuel Poverty Coalition. Do the Government agree with those figures, and if not, what are their own estimates?
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.
Can the Secretary of State update the House on the status of Alan Milburn? Does he still attend meetings in the Department and have access to confidential information? Does he now have an official role in the Department? Does he still have private sector interests in the healthcare sector?
The right hon. Alan Milburn is alive, he is safe and we are treating him well.
October is Breast Cancer Awareness Month, and I stand here today as someone who was diagnosed, treated and cured of breast cancer this year by the amazing staff in the north-east, but not enough women are taking up their breast screening appointments. Will the Minister do more to raise awareness of, and access to, breast screening appointments, and may I urge all women to check themselves regularly?
A significant impediment to improving adult social care is the split of budget and responsibility and policy between the Secretary of State’s Department and the Ministry of Housing, Communities and Local Government. Will he and colleagues work to remove that hurdle, to have better outcomes more cost-effectively delivered to improve the lives of all our constituents?
The hon. Gentleman is right to raise that risk. I assure him and the House that I and the Deputy Prime Minister, herself a former care worker, are working in lockstep to align strategy, policy and delivery.
(1 month ago)
Written Statements I am pleased to be able to inform the House that on 16 September 2024, the Government and the British Medical Association’s Resident Doctors Committee (BMA RDC), formerly known as the BMA Junior Doctors Committee, agreed a deal on pay for resident doctors—this includes those previously referred to as doctors and dentists in training. This follows BMA RDC agreeing to put the offer to its members.
We will now move to implement the deal, putting an end to strikes which have had a catastrophic impact not just on the country’s economy—with NHS strikes costing the taxpayer almost £1.7 billion in the 2023-24 financial year—but to patients and the nation’s health, with over 1.5 million appointments cancelled.
Resident doctors are a vital part of our NHS and go on to become the consultants and GPs we need tomorrow. This deal is the first step in rebuilding trust between the Government and the profession. This is a Government that cares for those who care for others.
In the deal, resident doctors will receive:
an average investment of 4.05% into 2023-24 pay scales effective from 1 April 2023 with a payment to reflect backpay. This is on top of the average 8.8% uplift they have already received for 2023-24; and
a further consolidated uplift of 6% plus £1,000 in 2024-25, in line with the recommendations of the Review Body on Doctors and Dentists Remuneration (DDRB).
This deal will increase the base salary for a full-time doctor starting foundation training in the NHS to over £36,600 compared to around £32,400 before this deal. A full-time doctor entering specialty training will see their basic pay rise to over £49,900 from around £43,900 before this deal. On average, resident doctors earn around one third additional to their base salary in overtime and out-of-hours payments.
As agreed in the deal, we have now instructed the DDRB to consider, as part of its pay recommendations, the overall reward package and a career progression for resident doctors to ensure that medicine is an attractive and rewarding career choice to deliver our consultants and GPs of the future.
The Government have also committed to improve the current exception reporting process and to work in partnership with the BMA RDC and other health organisations to review the current system of training and rotational placements.
The BMA RDC will withdraw the rate card for doctors and dentists in training in England with immediate effect.
The Government recognise the significant challenges that affect resident doctors. While this deal has agreed to review parts of the training system, we are also committed to addressing challenges, for example through initiatives under NHS England’s Working Lives programme, to improve the working and learning experience of resident doctors in the NHS. We continue to encourage local employers to engage with these policies to address these issues better locally.
This deal marks a significant step forward in fixing the NHS, rebuilding a relationship of trust with doctors and delivering better patient care.
[HCWS113]
(1 month ago)
Commons ChamberI beg to move,
That this House has considered Lord Darzi’s independent investigation into NHS performance.
I am pleased to have the opportunity to open this debate on Lord Darzi’s investigation into the national health service, not just so that we can debate the past and what went so badly wrong, but so that the House can also debate the future of our NHS, how it needs to change and the many reasons to be optimistic about what our health service can be.
We have to start with honesty. For too long, Conservative Governments swept problems under the carpet, more interested in scapegoats than solutions. [Interruption.] I know; it is terrible. That is why I asked Lord Darzi to conduct an independent investigation into our national health service. He is an eminent cancer surgeon, with 30 years’ experience in the NHS, yet what he found shocked even him: some 100,000 toddlers and babies were left waiting for six hours in A&E last year; more than one in 10 hospital beds are taken up by patients who do not need to be there; children are less healthy today than they were a decade ago; adults are living longer but getting sicker sooner; conditions such as diabetes and high blood pressure are rising relentlessly; mortality from preventable causes is far higher than in other advanced countries; almost 3 million people are off work sick; and waiting lists are at record highs while patient satisfaction is at a record low.
The fundamental promise of the NHS—that it will be there for us when we need it—has been broken for a decade. Why? Because of four knock-out blows. First, a decade of under-investment means NHS staff are forced to use pagers and fax machines, with fewer cancer scanners than Greece and buildings literally crumbling. That is not to mention the disgrace that the previous Government’s new hospitals programme was written according to fictitious timetables, with the funding running out this coming March.
Secondly, there was Andrew Lansley’s disastrous 2012 top-down reorganisation that nobody voted for, cost billions and took years. It was an enormous waste of time, talent and money that should have been spent on caring for patients.
Thirdly, there was a failure to reform. The reforms made by the last Labour Government, which delivered the shortest waiting times and highest patient satisfaction in history, were ditched—a golden inheritance squandered.
Fourthly, there was coronavirus. Lord Darzi found that the NHS was hit harder than any other comparable healthcare system because of the damage the Tories had already done. It is not just that they did not fix the roof when the sun was shining; they doused the house in petrol, left the gas on and covid just lit the match. That is why millions are stuck on waiting lists, ambulances do not arrive on time and people cannot see their GP. Never forgive, never forget and never let the Tories do it again.
Lord Darzi’s report was utterly damning about the treatment of children in our health system. He said that too many children were being let down, and pointed out that they account for 24% of the population, but only 11% of NHS expenditure, and that over 100,000 children wait for over a year to be assessed for mental health treatment. He said we must do better, so will the Secretary of State commit to putting children front and centre of the 10-year plan, and to making them a priority, because for a decade, the Tories let our children down?
I strongly agree with the hon. Member. I will talk about the 10-year plan shortly, but I can guarantee that children and paediatric care will be front and centre of that plan. We can do much more to shine a spotlight on paediatric waiting lists, as well as doing much more in practice. She mentioned children and young people’s mental health, on which our parties strongly agree. We will deliver our manifesto commitment to put mental health support in every primary and secondary school in the country, as well as providing walk-in services in every community, so that young people receive the mental health and wellbeing support that they need and do not get to the crisis point reached by far too many of our children.
The hon. Member’s intervention is an example of why I am looking forward to the debate. I hope to listen to contributions and to challenge from all sides of the House. Before I take any interventions from Conservative Members, I advise them that if they want to get a hearing on the NHS ever again, then the first word that should pass their lips is, “Sorry”. Only last week, at the Conservative party conference, we did not see a single shred of remorse or contrition for their appalling record. Indeed, when it comes to the shadow Secretary of State and her party, it seems that sorry is the hardest word.
The NHS is broken. NHS staff do not want to accept that, but it is. According to YouGov, that is what the vast majority of patients say. It is also what staff tell me every time I am on the frontline, but I understand why some people find the word difficult. In the past few weeks, I have met some of the NHS team who happened to be on duty on Monday 29 July. I have listened to paramedics describe the scene they walked into at the community centre in Southport. Children and adults who had been dancing to Taylor Swift were lying bleeding and, in some cases, tragically dying as a result of an unimaginable, senseless, mindless attack. Those paramedics had to make split-second decisions about who to treat and in what order to give the injured the best chance of survival. Security teams cleared busy hospital corridors to shield as many people as possible from the horror. Lab teams mobilised blood supplies. Receptionists fielded calls from panic-stricken patients. Surgical teams across multiple hospitals worked together, fighting to save those young lives. Even now, months later, mental health staff are picking up the pieces for families who are either grieving or going through the unimaginable challenge of supporting their children through what they witnessed.
On that day, those NHS responders—the whole team involved—were the best of humanity confronting the worst. That is who NHS staff are. That is what they do. Let me be clear: the NHS may be broken, but NHS staff did not break it. I want to be clear about this too: what is broken can be fixed. While the NHS may be in the midst of the worst crisis in its history, the biggest asset that we have is the people who work in it. They are up for the challenge, and up for change. The NHS is broken, but it is not beaten. Together with the 1.5 million people working in the health service, this Government will turn our NHS around, get it back on its feet, and make it fit for the future.
Across my constituency, my constituents are struggling to see the GPs they need; indeed, we see that across the whole nation. On Friday, I visited the Park View surgery, where the GPs do not have the necessary resources and cannot move into the premises that they need to be in to treat their patients. Can the Secretary of State assure me that he will follow Lord Darzi’s recommendations and invest in primary care, so that my constituents get the GPs they need and the Park View surgery can move into the premises that it needs, with the capital expenditure that it requires?
I am grateful to my hon. Friend for his intervention. Of course it is not just in Loughborough that we have a challenge with access to general practice; it is right across the country. I want to be clear, because GPs come in for a lot of criticism: primary care may be broken, and the front door to the NHS may be broken, but GPs did not break it. In fact, there are fewer GPs now than there were in 2015, yet they are providing more appointments. They have worked hard to improve the productivity of general practice, but they are under-resourced. That is why we are committed, as I told the Royal College of GPs just last week, to delivering the shift that we need out of hospitals and into the community—to growing primary care, including general practice, as a proportion of the NHS’s budget, so that we have the GPs needed to treat patients on time.
Saturday was World Meningitis Day, but in the last year we have seen an almost doubling of meningitis cases in the UK. Does the Secretary of State think that the meningitis vaccination take-up rate is where it should be?
I am grateful to the hon. Member for her question. No, I do not think that the take-up rate is where it should be. That is why in the short time we have been in office we have put more effort and energy into vaccine take-up, but there is more to do. I welcome her to the House, and will not have a go at her for the record of the people who sat on the Government Benches just before the general election.
At the end of September, a large GP federation serving patients across Sussex suddenly went bust, causing 130 redundancies; patient care was severely affected. The federation reported that the cause was a failure to obtain long-term contracts from any of its major clients, and the erosion of the real-terms value of contracts with both primary care networks and NHS Sussex. Does the Secretary of State agree that protecting continuity of service is key to public confidence in primary care, and will he meet me to discuss this case?
I am grateful to the hon. Member for her intervention. I wish that this was a challenge only in her constituency; it is a challenge right across the country. As I said to the Royal College of GPs last week, it will take time to rebuild general practice, so that it is back where we want it to be. We would be delighted to hear more from her; I will ensure that my Department makes contact, and that a Minister is in touch about the challenge in her constituency.
I thank the Secretary of State for today’s debate. The whole House, and indeed the whole of the United Kingdom of Great Britain and Northern Ireland, wishes him well in bringing forward the changes that we wish to see. An issue that comes to my attention regularly is research and development. We hear in the press every day about new advances in treating diabetes, heart disease, cancer, Alzheimer’s, dementia and rare diseases. When we look at the bigger picture of the NHS, we see the big problems, but sometimes there are smaller issues. Will he reassure us that research and development will be encouraged?
I strongly agree. Although health is devolved, I look forward to working constructively and closely with Governments right across the United Kingdom of Great Britain and Northern Ireland, because every part of the health system in every part of the UK is going through challenges. We are determined to do that. [Interruption.] I think the hon. Member wants to come in again.
National Institute for Health and Care Excellence recommendations go from here to Northern Ireland, and then we endorse them; if we do not get them from here to start with, we cannot make people better. That is the point that I was trying to make.
The hon. Member’s point is taken.
The NHS stands at a fork in the road. There is a choice before us, and the parties represented in the House have different opinions on the best way forward. The first option is for the NHS to continue on its current path—to head down the road to ruin, on a mismanaged decline, with a status quo so poor that patients are forced to raid their savings to go private, and with the worst yet to come, because many Opposition Members believe that all patients should have to put their hands in their pockets when they fall ill. Reform UK has openly stated that it wants to change the funding model and replace it with an insurance-based system, and plenty in the Conservative party want to head in the same direction, chasing Reform UK down the hard-right rabbit hole.
That is nonsense.
The shadow Secretary of State says that it is nonsense. She is very upset about it, so let me point out to her that earlier this year, the Conservative former dentistry Minister, who served in her team, under her leadership, proposed a monthly £10 insurance fee to see a dentist. That is what the Conservatives were planning before the election. [Interruption.] If the hon. Member wants to intervene, I will give way.
I will happily intervene. That is simply incorrect. There are a couple of points that the Secretary of State has made that are completely wrong, which I will have to correct in my speech. He is no longer in opposition. He needs to be careful what he says on the record. That is not right.
Honestly, Madam Deputy Speaker, “brass neck” springs to mind. Once again, the hon. Member gets to her feet and fails to say the word “sorry”. If she wants to correct the record, how about she stands up and corrects the abysmal record that she and her predecessors lumbered this country with? They took the NHS from being the very best—that is how it was left in 2010—to being the very worst; that is how she inherited it. If she wants to talk about humility, she might like to start demonstrating some before her time in Parliament comes to an end.
If the hon. Member wants to distance herself from her former dentistry Minister, let us turn to the candidate seeking to lead her party who is head and shoulders above the rest with its membership, the right hon. Member for North West Essex (Mrs Badenoch). She wants to go even further. On whether the NHS should be free at the point of use, she told The Times last month:
“I think we need to have a serious cross-party, national conversation.”
That is what she said about whether the NHS should be free at the point of use. I suspect that she has blamed the journalist for her own words since, but just so that Government Members are clear, that will happen over my dead body. This Labour Government will always defend our NHS as a public service that is free at the point of use, so that whenever someone falls ill, they never have to worry about the bill.
The problem is not, and has never been, the fair, equitable model of funding. It is the same model that we had in 2010, when the last Labour Government delivered the shortest waiting times and highest patient satisfaction in history. A universal, single-payer health service is the fairest, most equitable way to provide healthcare. More than that, in a way that could never have been predicted in 1948 by Attlee and Bevan, it makes the NHS the best placed healthcare system in the world for the revolution taking place in genomics, technology and life sciences. The NHS has the right funding model, but it is not taking advantage of the opportunities in front of it. That is what we need to change.
Under the previous Government, poor investment and a lack of respect for NHS workers, particularly in primary care, resulted in Portsmouth North having over 3,000 patients per GP. That has resulted in over 1,800 people waiting more than a month to see a GP. Despite that, Lord Darzi notes that many of the solutions can be found in parts of the NHS in our constituencies. Will the Secretary of State acknowledge the fantastic initiative and hard work of GPs in Portsmouth North, as they work alongside trainee GPs from King’s College London, and look to push that across the country?
My hon. Friend is right. In Portsmouth and right across the country, there are people who, against the backdrop of the previous Government, have none the less tried to innovate, do things differently and improve services for patients. Especially given that they sent her to represent them here in Parliament, I am sure they are relieved that they now have a Labour Government on their side.
Chapter 5 of Lord Darzi’s report is about where and how the money should be spent. I know from previous experience that there is a lot of money that can be spent in the national health service, but does the Secretary of State agree that we have to invest to save? We cannot simply move about the money that we currently have in the health service. Investment is needed to allow us to go into the greater detail that Lord Darzi talks about in respect of moving from analogue to digital and from primary care back into the community. That needs investment; it cannot be done simply with the budget that is there.
I strongly agree with the former Minister. I will take that as a representation for the forthcoming Budget and spending review, and ensure that his comments are sent straight to my right hon. Friends the Chancellor and the Chief Secretary to the Treasury. Without pre-empting future fiscal events, we have been clear for some time that it is investment and reform that deliver results. That is how the last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history. If people are in any doubt about what investment minus reform does, they need only look at what Darzi says about our hospitals: after 2019, lots of resource was poured in, particularly in relation to staffing, but productivity fell. It is investment and reform that deliver results, and this Labour Government will deliver both.
One of the moments before the last general election that I will never forget was turning up at Milton Keynes hospital with my 91-year-old grandmother, who we suspected was having a heart attack, only to be told that the average waiting time at that moment was nine and a half hours. Milton Keynes has some of the longest NHS waiting lists in the country, because of the damage done by the last Tory Government. Does my right hon. Friend agree that we all deserve an apology from the Conservatives, not just for the state they left our NHS in, but for going into the election promising a new hospital for Milton Keynes even though they clearly did not have a plan to deliver it?
I was delighted to visit Milton Keynes hospital with my hon. Friend before the general election. It is doing incredible work in the conditions that he describes; in particular, its innovation in the application of smart, everyday, practical technology to improve patients’ experience is to be commended.
I share my hon. Friend’s anger, his constituents’ anger and the anger of people right across the country in every community—including mine, by the way, where a hospital upgrade was promised. We were told there was a plan and a timetable, and we were told that the programme was fully funded. Then we came into government to find that the timetables were a work of fiction and that the funding runs out in March. That is something else that the shadow Secretary of State should apologise for, and I look forward to hearing her apology. People across the country are owed an apology.
Let me say to every hon. Member who is in the same position that I, my hon. Friend and people across the country are in that we will not play fast and loose with the public’s trust, and we will come forward with a plan for the upgrade of hospitals that is credible, achievable and funded. That is the difference between the way that this Labour Government will behave, in terms of both public trust and public money, and the way that the previous Conservative Government behaved, which was a total disgrace.
On top of coming clean to the public and making a change from the way the previous Government treated the country, will the Secretary of State also assure the House that the Government will establish a proper, effective and honest workforce plan? After the years of Johnsonian bluster, when there was no effective workforce plan, the nurses who are the backbone of the NHS are still being paid £29,000 a year at grade 5. As the Royal College of Nursing says, it is about retention of staff, not just recruitment. They are leaving in droves because they cannot stand the unsafe circumstances in which they are operating.
The hon. Member is right to raise the issues of recruitment and retention. My message to staff who are thinking of leaving the NHS, or who perhaps have left the NHS in recent years because of working conditions and because there was no light at the end of the tunnel, is to stay—or indeed return—and help us to be the generation that takes the NHS from the worst crisis in its history, gets it back on its feet and ensures that it is fit for the future.
On the workforce plan, let me just say that it was regrettable that it was only at 5 minutes to midnight that the previous Government published such a plan. We were highly flattered by the fact that so much that underpinned that plan was Labour party policy commitments, such as doubling the number of medical school places and increasing the number of nursing and midwifery clinical training places. We are committed to those headline commitments. We will inevitably want to update the workforce plan in the light of the 10-year plan and some of the analysis that underpins Darzi. We are clear that that kind of long-term workforce planning is essential, and we are committed—
I must make some progress; I will try to take more interventions shortly.
The public are clear that they do not want the NHS to be sacrificed. They gave Labour our marching orders at the general election to rescue the NHS and turn it around, and that is what we will do. I appreciate that the shadow Health Secretary must be embarrassed by all this, not just by the state that she and her Conservative predecessors left the NHS in, but by what Conservative Members have been saying. I was going to say, “Members who are sat behind her,” but they are actually not—I think they are hiding in shame. [Interruption.] The shadow Health Secretary says from a sedentary position that we have already had this discussion. The Conservatives would rather we just moved on and forgot their abysmal record. Well, I am afraid that we are not ready to do that just yet. At least some of her Back Benchers now say what they refused to say when they were in office: that the NHS is broken. Some of them even admit that only Labour can fix it.
When the shadow Secretary of State stands up, I wonder whether she can tell us whether she agrees with the hon. Member for Mid Norfolk (George Freeman), who said:
“I applaud Wes Streeting for having the political courage. I think only Labour can really say this. The NHS is sort of their thing…I really hope that we can get behind him”.
It is not just Back Benchers. What about the shadow Foreign Secretary, the right hon. Member for Sutton Coldfield (Mr Mitchell)? He said:
“I’m very supportive of what Wes Streeting is saying… The Conservative government put a lot of money into the NHS, the record is there for all to see… I’m not one of those who is seeking to attack…the Labour Party on the NHS.”
He is going for my vote, but sadly—or gladly—I am not qualified to vote in that particular election. Perhaps the shadow Health Secretary can tell us what the shadow Foreign Secretary meant when he said we were not—[Interruption.] She is clearly enjoying this. Was the shadow Foreign Secretary speaking for the shadow Cabinet? [Interruption.] No, he was not.
Let me move to my favourite comments on the NHS from a Tory MP. This right hon. Member said:
“We were not obsessed with how we can ensure that it actually delivers the experience that patients actually deserve…Out of fear of our opponents mischaracterising our efforts, we shirked the difficult decisions…If Wes Streeting comes forward with genuine reforms I think we should back him.”
Those are the words of the candidate that the shadow Health Secretary is backing to lead her party, so does she agree with the right hon. Member for Newark (Robert Jenrick)? Will she finally apologise for her part in the Tories’ abysmal record and have the humility to admit that when it came to NHS reform their cupboard was bare, and that actually they quite agree with our efforts to clean up the mess that they left behind?
For all the agreement with our diagnosis and praise of our plans, the problem is that there is no apology. Of the four leadership candidates and eight former Health Secretaries, not a single one has apologised for the state they left the NHS in. Would the shadow Health Secretary like to correct that record today and finally say sorry? I expect that we might have to wait a long time. While the Conservatives continue the longest leadership election in history, we are getting on with the job of cleaning up their mess.
The reform that we desperately need includes the so-called “left shift” out of hospitals and into primary care. Yet under the previous Government, the amount of money spent on hospitals went from 47% to 58% of the NHS budget. According to Age UK, every day 2,000 people are admitted to hospital who could be treated elsewhere and earlier. Does my right hon. Friend agree that the only way to fix the NHS is to get more and better care in the community?
My hon. Friend is absolutely right, and that brings me to our reform agenda.
To deliver the Government’s reform agenda, we will have to take on both left and right-wing orthodoxies—for simplicity’s sake, we will call them The Guardian and the Daily Mail. The Daily Mail agrees on the need for health service reform, but attacks proposals for public health reform as “nanny state”. The Guardian loves prevention, but all this talk about health service reform makes it very nervous. The truth is that the Daily Mail and The Guardian are half right and half wrong. We all need to face up to the challenges of today. Our society is getting older and living longer but becoming sicker sooner. Those rising tides of demands and costs are combining to form a perfect storm that threatens to shipwreck the NHS.
I must make progress.
The right must accept that without reform on public health, we will pay a heavy price, with higher taxes and poorer quality of life—exactly the sort of dependency culture that the right rails against. The left must accept that investment without reform of the health service would be killing the NHS with kindness, with more cash and poor results until the public give up altogether.
I must make more progress.
That is the choice: public health reform or higher taxes; NHS reform or no NHS. The Tories did neither; Labour will do both. It really is reform or die, and we choose reform. That is why this month we will begin formal engagement with NHS staff and patients, who will help to write the 10-year plan for our NHS—a plan that will deliver the change and modernisation that our health service is crying out for—with three big shifts in its focus.
First, a shift from hospital to community will turn the NHS into a neighbourhood health service as much as a national health service, so that patients get more of their tests, scans and healthcare on high streets and in town centres in their own community, and from the comfort of their own home. It will ensure that patients can easily book appointments to see the GP they want to see in the manner that they choose, and it will bring back the family doctor, rebuild NHS dentistry and build a national care service.
I must make progress. There are lots of speakers and little time.
Secondly, there will be a shift from sickness to prevention. It will mean that we take action to give our children a healthier and happier life, flattening the curve of rising pressures that threaten to overwhelm the NHS by building a healthier society, which will help to build a healthier economy.
Thirdly, there will be a shift from analogue to digital. Upgrading the NHS app will give patients real choice and control over their own healthcare, creating a single patient record owned by the patient and shared across the system so that every part of the NHS has a full picture of the patient that they are treating. Getting the NHS working hand in glove with our country’s leading scientists will put modern technology and equipment in the hands of NHS staff, and patients at the front of the queue for the latest treatments.
I must begin to conclude my remarks, Madam Deputy Speaker, but I see that the Chair of the Select Committee on Health and Social Care is seeking my eye. Given that I will be before her Committee soon and know where my bread is buttered, I give way.
The Secretary of State is very kind indeed. I can take no credit for what I am about to say, which comes from reports on prevention and digital transformation published by the previous Select Committee, which he would do very well to look at. What those reports say is very much echoed in Lord Darzi’s report—particularly that the place-based narratives about embedding the NHS into our communities are key, as is reform of Government as a whole, and embedding health in every Department. Will he say a bit more about reform in Government, and not just reform in the NHS?
I strongly agree with the Chair of the Select Committee and commend the work of the previous Committee, to which she refers. She has certainly given me some revision for the first meeting that I will attend. To answer her question, she is absolutely right that digital transformation and place-based healthcare planning are key. This Government will have a much sharper focus on health inequalities than the previous Government did. In fact, if we consider the NHS over the past 30 or 40 years, even when it has performed well overall, and patients in every part of the country have received access to timely care, some health systems have still been more challenged than others. We need to be honest about the structural challenges in those areas. Secondly, she is absolutely right that, if we are serious about health and prevention, we need a serious cross-Government approach. That is why I am delighted that the Prime Minister’s mission-driven approach has already seen Departments coming together with a focus on prevention. That will deliver fruit.
This is the major surgery that our national health service needs over the next decade to make it fit for the future. There is no time to waste, so we have hit the ground running. We inherited a Care Quality Commission that is not fit for purpose. I was genuinely stunned to learn that one in five health and care providers has never been inspected; some hospitals have been left uninspected for a decade; and inspectors were sent to care homes when they had never met someone with dementia. The Conservatives did not think that patients would like the answers, so they stopped asking the questions. This Labour Government are different: we will be honest about the problems facing the health service, and serious about solving them. Our policy is radical candour.
Today I am delighted to announce that Sir Julian Hartley has been appointed the new chief executive of the CQC. He is a proven reformer with a track record of turning around large organisations, and I am confident that he will provide the leadership that staff in the CQC need to address this crisis, improve patient safety and restore confidence in the regulator. Sunlight is the best disinfectant, so this Government are taking action to turn the regulator around. That is the difference a Labour Government make.
We inherited the farce of newly qualified GPs facing unemployment. Patients could not get a GP appointment, while GPs could not get a job, so we cut red tape, found the funding and are recruiting an extra 1,000 GPs. That is the difference a Labour Government make. We have tabled a motion to ban junk food ads targeted at children —our first step towards making our country’s children the healthiest generation that has ever lived. That is the difference a Labour Government make. Just this week, the Secretary of State for Science and Technology and I announced funding to produce new cutting-edge cancer treatments: a new blood test that can detect 12 different cancers. We are backing Britain’s scientists to save lives. That is the difference a Labour Government make.
Of course, strikes in the NHS have cost taxpayers billions. Patients saw 1.5 million operations and appointments cancelled. The Conservatives saw strikes as an opportunity to scapegoat NHS staff, so they let the strikes rage on. In fact, the shadow Health Secretary had not even bothered to meet the junior doctors since March. This Government do not exploit problems; we solve them. I called the junior doctors on day one and met them in week one, and in just three weeks, we had negotiated a deal to end the strikes. That is the difference a Labour Government make.
Those are just our first steps. Rebuilding the NHS will not be easy and it will take time, but we have done it before and we will do it again. Along with the millions of dedicated staff in health and social care across our country, this can be the generation that takes the NHS from the worst crisis in its history to build an NHS fit for the future—an NHS that is there for us when we need it, with world-class care for the many, not just the few. That is the change that Britain voted for; that is the change we will deliver together; and that change has already begun.
Before I bring in the Opposition Front Benchers, the House should be aware that over 50 Members wish to speak in the debate, so I ask you to help each other. On this occasion, I will impose a three-minute limit on Back-Bench speeches, with the exception of maiden speeches and that of the Chair of the Health and Social Care Committee. I call the shadow Secretary of State.
I will help the hon. Gentleman, because I appreciate that he is new to this place. If he had been listening carefully to me, he would have heard that I am and have always been—in fairness, I hope the Health Secretary would acknowledge this as well—very open about the fact that the NHS needs reform. In fact, I said as Secretary of State that I wanted to reform our NHS to make it faster, simpler and fairer.
By the way, I speak with personal experience. I know there are some Members on the Back Benches who are new to this place and perhaps have not quite moved on from the natural competitiveness of a general election campaign, but I was diagnosed with type 1 diabetes at the age of three. I have seen the very best of the NHS, but I have also seen some of its darkest corners. The NHS is genuinely one of the reasons why I came into politics, and one of the most damaging things about political discourse and the healthcare system in this country is when people seek to attribute to others a lack of care or commitment to our healthcare system, just because we have different ways of tackling these challenges and different solutions.
This is why—I will say this again, because I am not sure that the right hon. Gentleman is listening—I will work constructively with him to improve the health service, but we have to do this on the facts. Some of the suggestions he made in the debate today and in his discourse during the general election campaign and so on are not accurate, and this is where I will pull him up. For example, he has not mentioned the introduction of Pharmacy First or the 160 community diagnostic centres. Just to help him, those were backed by the largest central cash investment in MRI and CT scanning capacity in the history of the NHS. Those, as well as the new surgical hubs that we introduced, are not only putting healthcare into the community but, critically, helping to improve the numbers of chest checks and scans going through the system, which means speedier diagnosis.
The right hon. Lady mentions Pharmacy First. How many pharmacies went bust on her watch?
As the right hon. Gentleman knows, because I imagine he will have got exactly the same briefing I used to get when I was in his shoes and being advised by exactly the same civil servants—and I am having to let this flow back into my memory here—the average person in England is within walking distance of their pharmacy. He will know that in many high streets in our market towns, as well as in London and other urban areas, there is a density of pharmacies. We want to support those pharmacies to ensure they are able to provide the services that they can provide, and in fairness, to enable pharmacists to work at the top of their licences. He supported Pharmacy First when I introduced it, so I am a little surprised that he appears to be casting doubt on it, but I am grateful for his intervention.
The next point is that our women’s health strategy—it does not have the attention from his ministerial team that it should have at the moment, and I hope that will improve over the coming months—is seeing the roll-out of women’s health hubs across England into every integrated care board area by the end of this year, ensuring that women’s health issues receive the attention they deserve.
Of course, there are parts of the NHS that need to change and do much better. The NHS needs to reform for the future of healthcare, and our focus must be on improving outcomes for patients, not protecting structures, bureaucracy and vested interests in the NHS. As I have said repeatedly, we will scrutinise constructively and support any meaningful efforts to reform the NHS to improve outcomes and experiences for patients, because we all want the NHS to thrive.
However, after nearly 100 days, there has not been anything yet for us to scrutinise or indeed support from this Government. [Interruption.] The Secretary of State says he has just given me a list. Interestingly, I am pretty sure that three out of those four were started under my Government. [Interruption.] I am pretty sure that I was the Secretary of State who ordered the review of the Care Quality Commission, precisely because I was so concerned. He will be able to build on that report, and quite rightly so, but he should please be careful of his facts. Disappointingly, it is the right hon. Gentleman’s fondness for parties and concerts that has made the news recently, rather than his health policies. This Government need to sober up and start taking responsibility for their choices.
I am going to make some progress.
One of the choices facing the Health Secretary is whether he will fight for the investment required from the Treasury to implement the productivity plan. At spring Budget, the Conservatives announced more than £3.4 billion of investment to upgrade IT systems, expand services on the NHS app and make better use of artificial intelligence, in order to reduce bureaucracy for staff and free up clinical time for doctors and nurses. Alongside the long-term workforce plan—the first ever in the history of the NHS—this plan will see productivity grow by 2% a year by the end of the decade and unlock £35 billion of savings, yet the productivity plan is not mentioned anywhere in this 163-page report.
This plan was made in partnership with NHS England and funded by the Conservative Government. While the right hon. Gentleman has talked a good game on productivity, we are still waiting for him to confirm his commitment to deliver the plan that was drawn up with NHS England to help improve productivity. I asked him three weeks ago whether he was cancelling this plan, and he failed to answer. I am very happy to give way now if he wants to commit to it. The whole NHS would like to know.
I am delighted that the shadow Secretary of State has so generously given way. I am not going to pre-empt the Chancellor’s announcements at the Budget and the spending review, but I say to her that the reason why so many of the things she said at this Dispatch Box as Secretary of State were a pile of nonsense is that they were plans built on a pillar of sand—a £22 billion black hole for which she and her party are yet to apologise. Will she do that now?
As the right hon. Gentleman knows, calculations were made in the Treasury for this economic inheritance, but the Treasury cannot even explain how it has arrived at those calculations. If I were him, I would be a little bit careful of relying on that figure, because I fear it may trip up his Chancellor in due course. Perhaps the reason why he cannot answer the question about whether he is in fact committed to the productivity plan is that his friend the former Health Secretary, who has been walking in and out of the Department for Health with all of his private healthcare businesses, has not told him whether he plans to accept it, but we will find that out in due course.
The Secretary of State’s silence continues with new medicines, technology and trials. These will be at the forefront of the reforms needed in health services across the world, let alone the NHS, yet the Darzi report mentioned NICE only once in 163 pages. Even worse, I am hearing from the life sciences sector that he and his team are refusing to meet these businesses, putting at risk the hundreds of millions of pounds of investment that the Conservative Government secured, as well as the highly skilled jobs they provide and the life-enhancing treatments they promise our constituents. It is his responsibility to persuade the Chancellor to continue supporting and investing in this innovation for the future, because patients will not thank Labour if it refuses to engage in the medical revolution with these businesses.
Another choice that the right hon. Gentleman must make—we perhaps have a precursor of what he is going to say—concerns the workforce. We know that NHS staff are at the heart of our healthcare services, and that training, retaining and developing our workforce is critical to the future of the NHS. The Conservative Government created the first ever long-term workforce plan for the NHS—again, a plan that was asked for and welcomed by the whole NHS, and developed hand in hand with NHS England to train the doctors, nurses, midwives and other healthcare staff that we need now and in the future. The plan was described by NHS England’s chief executive as
“one of the most seminal moments in our 75-year history.”
Crikey, even the right hon. Gentleman supported it. Yet this supposedly independent investigation failed to mention the plan once. Will the right hon. Gentleman confirm that this Government stand by this plan and will fund it as the Conservatives would do? [Interruption.] He says that he talked about it, but he did not give an answer, because his job is to ask the Chancellor for this funding—has he done so?
Right, okay. We have that on the record now and we will wait to see what happens at the Budget.
It is also striking that the report mentions pay and wages only twice in 163 pages, despite the fact that staff costs account for 65% of provider operating costs a year. If the report and the Secretary of State do not acknowledge the single biggest cost pressure for providers, how can they claim to have the answers on reform? He claims to have sorted out industrial action in the NHS, and I must again correct him on something. He keeps referencing when I last had a conversation with the junior doctors committee, as it then was. What he neglects to tell us is that we entered mediation with junior doctors in May—he never thinks to mention that when he is holding forth at the Dispatch Box.
(2 months ago)
Commons ChamberOn a point of order, Madam Deputy Speaker. We are all passionate about our hospices, our hospitals, our GP practices and the other health services that our constituents get. Coming to this place is not for the faint-hearted, but is it appropriate for the Secretary of State for Health and Social Care to adopt the tone that he brought to the Chamber earlier? As I say, we are all passionate, but perhaps his tone—his bedside manner, may I say—needs a new approach on occasion. I noted his more collegial tone later in the statement, but to tell Opposition hon. Members—we are all hon. Members in this place—to sit down and listen, or to liken some previous holders of his role to arsonists and similar paraphernalia, is not befitting of this Chamber.
Further to that point of order, Madam Deputy Speaker. I like the hon. Lady very much, and I will just say two things in response: first, she has been around in this Chamber a long time. Conservative Members cannot sit and heckle, then get cross when Ministers respond robustly. Secondly, I think that was a perfectly legitimate analogy; indeed, I might say that the arsonists should not complain about the fire brigade.
I remind all hon. Members that good temper and moderation are the characteristics of a good debate.
(2 months ago)
Commons ChamberWith permission, I would like to make a statement on Lord Darzi’s investigation into the NHS.
Unlike the last holders of this office, this Government will be honest about the problems the NHS faces and serious about fixing them. That is why I asked Lord Darzi, an eminent cancer surgeon who served both Labour and Conservative-led Governments with distinction, to conduct an independent investigation into the state of our national health service. I am sure the whole House will want to join me in thanking him for producing this expert, comprehensive report, a copy of which I have placed in the Libraries of both Houses.
I told Lord Darzi that we wanted hard truths, warts and all. His findings are raw, honest and breathtaking. He says:
“Although I have worked in the NHS for more than 30 years, I have been shocked by what I have found”.
He has uncovered an enormous charge sheet, too long to list in this statement, so these are just a few: the NHS has not been able to meet its promises to treat patients on time for almost a decade; patients have never been more dissatisfied with the service they receive; waiting lists for mental health and community services have surged; 50 years of progress on cardiovascular disease is going into reverse; and cancer is more likely to be a death sentence for NHS patients than for patients in other countries. It is not just the sickness in the NHS that concerns Lord Darzi, but sickness in society. Children are sicker today than a decade ago and adults are falling into ill health earlier in life. That is piling pressure on to the NHS and holding back our economy.
Those are some of the symptoms; the report is equally damning on the causes. First, a decade of under-investment left the NHS 15 years behind the private sector on technology, with fewer diagnostic scanners per patient than almost every comparable country, including Belgium, Italy and Greece, and in 2024 mental health patients are treated in Victorian buildings with cockroach and mouse infestations, where 17 men are forced to share two showers.
Secondly, there was the disastrous 2012 top-down reorganisation overseen by Lord Lansley. Lord Darzi’s assessment is damning:
“A calamity without international precedent…it took a ‘scorched earth’ approach to health reform”.
“By 2015…ministers were…putting in place ‘workarounds and sticking plasters’ to bypass the legislation”.
“Rather than liberating the NHS, as promised, the Health and Social Care Act 2012 imprisoned more than a million NHS staff in a broken system for the best part of a decade”.
“the effects…are still felt to this day.”
Just imagine if all the time, effort and billions of pounds wasted on dissolving and reconstituting management structures had instead been invested in services for patients—clearly, the NHS would not be in the mess it finds itself in today.
Thirdly, there was coronavirus. Everyone can see the lasting damage caused by the pandemic, but until now we did not know that the pandemic hit the NHS harder than any other comparable healthcare system in the world.
The NHS cancelled far more operations and routine care than anywhere else. As Lord Darzi writes:
“The pandemic’s impact was magnified because the NHS had been seriously weakened in the decade preceding its onset.”
In other words, it is not just that the Conservatives did not fix the roof while the sun was shining; they doused the house in petrol and left the gas on, and covid just lit the match. That is why waiting lists have ballooned to 7.6 million today. [Interruption.] If I were an Opposition Member, I would not complain about the diagnosis. I would take responsibility.
Fourthly—this sits firmly at Opposition Members’ door, so they should sit and listen—there was the failure to reform. From 2019 onwards, the previous Government oversaw a 17% increase in the number of staff working in hospitals. Did it lead to better outcomes for patients? No. At great expense to the taxpayer, the NHS has instead seen a huge fall in productivity. We paid more, but got less—a deplorable waste of resources when so many parts of our health and care services were crying out for investment. As Lord Darzi has put it:
“British Airways wouldn’t train more pilots without buying more planes.”
Doctors and nurses are wasting their time trying to find beds for their patients and dealing with outdated IT when they ought to be treating patients.
Too many people end up in hospital because they cannot get the help that they need from a pharmacy, a GP or social care. The effective reforms of the last Labour Government, which drove better performance and better care for patients, have mostly been undone, and that is why patients cannot get a GP appointment, an operation or even an ambulance when they need one today. That is what the Conservatives did to take the NHS from the shortest waiting times and highest patient satisfaction in history to the broken NHS that we see today.
Lord Darzi has given his diagnosis. Now it is over to us to write the prescription, and we have three choices. The first is to continue the Conservatives’ neglect, and allow the NHS to collapse. That is the path on which they set the NHS, and the path that it is on today. Or we could—as some of my critics on the left demand—pour ever-increasing amounts of money in without reform, wasting money that is not there and that working people cannot afford to pay. That would be wasteful and irresponsible, so we will not take that path. This Government are making a different choice: we choose recovery and reform. We are taking action today to deal with the immediate crisis by hiring 1,000 GPs whom the Conservatives had left without a job while patients were going without an appointment, and agreeing an offer to end the strikes that they allowed to cripple our health service.
At the same time, we will introduce the fundamental reforms needed to secure the future of our NHS. Earlier today, my right hon. Friend the Prime Minister confirmed that the Government would publish a 10-year plan for change and modernisation, on the foundation of Lord Darzi’s report. Our plan will deliver the three big shifts needed to make our NHS fit for the future. The first is from analogue to digital, giving patients proper choice and control over their own healthcare, and finally realising the untapped potential of the NHS app. There will be fully digital patient records so that your surgeon can see the notes that your GP writes. By marrying our country’s leading scientific minds with the care of more than 1.5 million NHS staff, we will put NHS patients at the front of the queue for cutting-edge medicines and treatments that we can only imagine today.
Secondly, there is the shift from hospital to community, turning our NHS into a neighbourhood as much as a national health service so that patients can get their tests and scans on their high streets and be cared for from the comfort of their own homes. That means bringing back the family doctor and building a national care service that can be there for us when we need it, able to meet the challenges of this century.
Thirdly, there is the shift from sickness to prevention, which means taking the decisions that the Conservatives ducked to give our children a healthy, happy start in life. It means stopping the targeting of junk food ads at children, banning energy drinks for under-16s, reforming the NHS to catch illness earlier—starting by offering health checks in workplaces and on smartphones—and delivering the Tobacco and Vapes Bill that the Conservatives failed to pass, to tackle one of society’s biggest killers.
Lord Darzi’s diagnosis is that the NHS is in a “critical condition”—unless we perform major surgery, the patient will die—but he also finds that
“its vital signs are strong”:
an extraordinary depth of clinical talent, and a shared determination to improve care for patients. This is a public service, free at the point of use, so that whenever we fall ill we never have to worry about the bill. The NHS is broken, but it is not beaten. Every person I have met in the NHS during my first two months as Health and Social Care Secretary is up for the challenge. It will take time, but this party—the party that created the NHS—has turned the NHS around before, and we will do it again. I commend this statement to the House.
On a point of order, Mr Speaker.
Thank you, Mr Speaker. I thank the Secretary of State for advance notice of his statement.
The NHS belongs to us all, and we all care about it, so let us stop the political posturing and talk constructively about its future. We all know that our healthcare system faces significant pressures, as do all health systems around the world. We are living longer, and with multiple and complex conditions. We have wider societal pressures, such as the impact of social media on the development of some young minds, as well as the cost pressures of miracle drugs developed by our world-class life sciences sector for their treatment benefits, and the shock of the pandemic has had catastrophic impacts on the NHS and its productivity.
I believe there is much to be proud of in the NHS. Its dedicated staff look after 1.6 million people a day— 25% more people than in 2010. It has more doctors, more nurses and more investment that at any point in its history. It is delivering tens of millions more out-patient appointments, diagnostic tests and procedures for patients than in 2010, and we delivered the fastest roll-out of vaccinations for covid in the world, freeing our society more quickly than other countries. We have more healthcare in the community, with the opening of 160 community diagnostic centres—the largest central cash investment in MRI and CT scanning capacity in the history of the NHS—and 15 new surgical hubs; and the launch of Pharmacy First, helping to free up 10 million GP appointments for those living with more complex conditions. [Interruption.] I say to the Secretary of State that I paid him the courtesy of listening to him in silence, so I hope he will do the same for me.
The right hon. Gentleman was chuntering from a sedentary position. We on the—[Interruption.]
Order. I am sorry; I meant that you were to conclude now, not to continue with the rest of the speech. I call the Secretary of State.
The first word that the shadow Secretary of State for Health and Social Care should have said was “sorry”. She says that she never pretended everything was fixed, and that is true, but it is about time that she admitted that it was her party that broke the NHS in the first place.
In fact, it has been a feature of debate in the House since the general election that the Opposition have taken absolutely no responsibility for the mess they left our country in, including a £22 billion black hole and the new hospitals programme that the right hon. Lady referred to, in which the timetables were a work of fiction and the money ran out in March. She knew that when she went to the country to claim that the programme was fully funded. She talks about the decisions made by NICE; that was a new Labour reform and modernisation—one that thankfully survived the last 14 years.
The right hon. Lady has endorsed the right hon. Member for Newark (Robert Jenrick) in the Conservative party leadership election. I wonder what she makes of his admission that the Conservatives failed to make the tough reforms that the NHS needed because they were afraid of what Labour might say. Is that not the most derisory excuse for 14 years of neglect?
My predecessor does not bear responsibility for everything in the Darzi report—this crisis was more than a decade in the making—but I wonder when the right hon. Lady will show some humility on behalf of her party and apologise for the mess that her Government made of our national health service. Otherwise, why should anyone trust what the Conservatives have to say ever again?
This Government were given a mandate for change, and nowhere is that more needed than in our NHS. The report must mark the beginning of the long, hard work of change. It is the platform from which we will launch a decade of reform that will make sure that the NHS can be there for us when we need it—for us, our children and our grandchildren. It must draw a line in the sand, so that we never go back to the pain, fear and misery that the Conservative party inflicted on millions of patients.
Thank you, Mr Speaker. I will rise to the challenge.
I welcome the Secretary of State’s statement. In 2008, the previous Labour Government commissioned a report from Sir Michael Marmot on the state of society and health, and he found that there was health inequality, particularly in deprived areas. Ten years on, his second report found that health inequality had become even worse against the backdrop of an underfunded NHS. Does that not demonstrate the urgency of the need to invest in those communities under this Government? What can my right hon. Friend do to direct resources into the most deprived communities in order to turn around those health inequalities?
My hon. Friend is absolutely right that our country has stark health inequalities. It is not right that people who live in different parts of the country have such different chances of living well. A girl born in Blackpool can expect to live healthily until she is 54, whereas a girl born in Winchester can expect to live healthily until she is 66. That is why, with the Prime Minister’s mission-driven approach, we will not just get our NHS back on its feet and make sure it is fit for the future; we will also reduce the cost and burden of demand on our national health service by attacking the social determinants of ill health.
Much of the content of Lord Darzi’s report has been known for some years. None the less, today’s report is a scathing summary of the complete devastation that the Conservatives have wrought on our health services and on the health of our communities. We Liberal Democrats have long argued that we need to shift healthcare from hospitals to high streets, and from treatment to prevention, because doing so improves health outcomes and saves taxpayers’ money. It is a win-win.
But the report is long on diagnosis and short on prescription, so may I invite Ministers to read our fully costed manifesto to fix public health and primary care by recruiting 8,000 GPs, ending dental deserts, boosting public health grants by £1 million, implementing our five-year plan to boost cancer survival rates, and putting a mental health expert in every school?
Does the Secretary of State accept that there is an elephant in the room: social care? Will he meet me to discuss the Liberal Democrat plans for social care, starting with free personal care? This bold idea would prevent many people from going into hospital in the first place, as well as enabling them to be discharged from hospital faster. Does he accept that it is a truth universally acknowledged that we cannot fix the NHS if we do not fix social care too?
As for the dire state of our hospitals and primary care estate, well, the Conservatives have left it to fester like a wound. Will the Secretary of State give the green light to hospitals that are ready to rebuild, such as mine in west Hertfordshire? Will Ministers look to reform outdated Treasury rules that are preventing our integrated care boards and hospital trusts from spending and investing their funds in the GP practices and hospitals that we need? This Government say that they want growth. Well, health and wealth are two sides of the same coin, which is something the Conservatives do not understand. If Labour wants economic growth, fixing our health and social care must be its top priority. And it must be a priority without delay.
How refreshing to have constructive opposition in the Chamber. It was clear throughout the election campaign that my party and the Liberal Democrats have much in common, both in the commitments we made, which in some cases were identical, and in our shared areas of emphasis: the link between health and wealth, the importance of prevention and the importance of social care.
As the Prime Minister reiterated again this morning, we are absolutely determined to address both the short-term crisis and the long-term needs of the century in our social care system. We want to work on a cross-party basis wherever possible, so I would be delighted to meet the Liberal Democrat spokesperson.
Hundreds of thousands of operations, including dozens of my own lists, were cancelled because of the strikes in the NHS over the past two years. Does the Secretary of State agree that the Conservatives’ refusal to negotiate with the doctors contributed to the terrible state of the health service, and that ending the strikes is the first step towards fixing the NHS?
It sticks in the craw to hear the carping and criticism from the Conservatives, and their obvious bitter resentment that we were able to do in three weeks what they failed to do in over a year. All the while they complain about the costs of solving the strikes, they say nothing about the costs they racked up—the direct financial costs of covering the strikes, as well as the untold costs of misery to patients whose operations, procedures and appointments were cancelled, even as the shadow Secretary of State for Health and Social Care and her Ministers had not even bothered to meet the junior doctors since March this year. The Conservatives have no grounds to complain.
I thank those who daily work in NHS services across our country. If the Secretary of State is truly serious about assisting and supporting the whole of our NHS in England, across all our constituencies, “warts and all”, as he says, will he explain thoroughly why the health outcomes and experiences of families across Wales, over the last 25 years, do not merit this attention equally? Is it perhaps because Wales is Labour-run?
I have never denied, nor have the Welsh Government, that our health and social care systems are in crisis across the United Kingdom, and that waiting times and patient outcomes are not where they should be. [Interruption.] The Conservatives do not wish to acknowledge the truth, and even now, without a shred of humility or acceptance of the responsibility of their record in government, they carp from the sidelines. They will not admit or accept that different parts of the United Kingdom have different strengths and weaknesses.
Regardless of the fact that there is a Scottish National party Government in Scotland or a unique arrangement in Northern Ireland, as well my friends in the Welsh Government, I am proud that in my first weekend as Secretary of State for Health and Social Care, I made it my business to phone my counterparts in Scotland, Wales and Northern Ireland. I made it clear that we will always work constructively, whatever our parties and however hard we will fight each other at the ballot box. Rather than pointing fingers at other parts of the United Kingdom, as the Conservatives did when they were in government, this Government are determined, just as the last Labour Government were, to create a rising tide that lifts all ships. I look forward to working with every devolved Administration to improve health and care outcomes across the whole of our United Kingdom.
The Secretary of State is right that the future of our NHS lies in reform, and not waiting until people get sick before we intervene to keep them well, but we cannot do that without money. He says we cannot waste money that is not there, but we are wasting money that is there on the contracts we have with the private sector. He knows I feel strongly about this issue. Millions of pounds are being paid to private equity-backed funds to run sexual health centres in the NHS—the iCare clinics. Billions of pounds are being lost to the legal loan sharks of our NHS—the private finance initiative companies—and some trusts are spending more on PFI payments than on drugs. As part of the process, will he commit to an urgent review of the way in which the NHS has worked with the private sector, because reform must also include restructuring our debt?
My hon. Friend has done a lot of work in this area and I would be delighted to meet her. Let me give the Conservative party a lesson in humility. However proud I am of the last Labour Government—and I am incredibly proud of what they did to our health estate, the investment they brought in, through a range of different types of private financing, and the impact that had; I can see the benefits in my own constituency— I have never shied away from what we did not get right. At the same time as celebrating what we got right in government, we must reflect on what we did not get right and genuinely learn those lessons, which is what we did in opposition. It took us too long to get back into government—we will learn from that for the future—but it has been really interesting to listen to Conservative Members over the past nine weeks. They have not learned anything, they have not got the message and they are not going to change.
As Labour embarks on a reform programme, may I ask whether the Secretary of State has read the report of the Mid Staffordshire public inquiry, which looked at the shocking patient neglect last time Labour was in charge? Reading it might temper the hubris that he is showing in the Chamber today, in the face of the challenges that his colleagues in Wales have certainly not managed to overcome.
I gently point the hon. Gentleman to the bold claims made by the now shadow Chancellor, the right hon. Member for Godalming and Ash (Jeremy Hunt), about patient safety. He might like to reflect on every subsequent patient safety scandal. In fact, he might want to walk into maternity services across the country and ask himself whether the Conservatives bothered to learn lessons on patient safety.
Pharmaceutical producers Auden Mckenzie and Actavis UK charged excessive and unfair prices for hydrocortisone tablets. NHS spending on those products rocketed because producers gamed the system. How will my right hon. Friend ensure that future procurement processes deter the rigging of drug prices?
My hon. Friend makes a great point, and he has given great service to the Public Accounts Committee of this House by drilling into waste, inefficiency and exploitation of the public purse. I want to work with the great life sciences sector and pharmaceutical industry in this country and globally, but in a spirit of genuine partnership. A really good working relationship requires social responsibility; it certainly involves not ripping off the taxpayer.
I welcome the report. The previous Government left this Government with NHS and care services in the worst crisis in their history. The Secretary of State led by emphasising the decade of underinvestment; that needs to be coupled with pointing out the very weak workforce planning. When he meets the Liberal Democrats, will he review our costed plan to raise the investment necessary to address the issues highlighted in the report and to strengthen workforce planning in order to deliver services?
Fiscal policy is a matter for the Chancellor. I know on which side my bread is buttered, so I will not write her Budget or spending review now, but let me reassure the hon. Gentleman that, notwithstanding the £22 billion black hole that the Conservatives left in the public finances this year and the weak foundations of our economy that we have inherited, the Chancellor knows as well as I do that it is investment and reform that will deliver results. It will take time—we cannot reverse more than a decade of underinvestment in a single Budget or even a single spending review—but at least we have a Government able to face up to the hard choices and capable of making them.
I very much welcome Lord Darzi’s report, which exposes how our country was let down by the previous Government. In my Bassetlaw constituency, I will be asked when people who need a GP appointment will get one, and when the 2,000-person dental waiting list will come to an end. I am listening to my GPs and my dentists so that I can work with them to tackle this crisis. I will be meeting them shortly. What is the Secretary of State’s message to them all?
My hon. Friend, who I am delighted to see representing Bassetlaw, is already showing herself to be an outstanding champion for her community. She raises a really good challenge that we all face as constituency MPs: the public recognise that change takes time and that we cannot fix more than a decade of problems in the immediate future, but they want to know that at least we are hitting the ground running and getting the job done.
I can reassure my hon. Friend’s constituents in Bassetlaw that within our first couple of months, this Government employed 1,000 more GPs on the frontline who had been left unemployed by the previous Conservative Government. We did that pretty much immediately. We have settled—I hope; we await the outcome of the ballot—the junior doctors’ dispute, so we can remove the cost of disruption and industrial action and start work on getting the waiting lists down. We will be working at pace to deliver 40,000 more appointments every week so that we can cut waiting lists, and 700,000 urgent emergency dentistry appointments so that we can ensure that people get the care they need. Every single promise in our manifesto, notwithstanding the challenges in the public finances, was a fully costed, fully funded promise that we will keep and that the country can afford.
May I urge the Secretary of State to learn from what is working well in the NHS, as well as from what has gone wrong? In reference to the Health and Care Act 2022, paragraph 14 on page 121 of the report states:
“The result is that the basic structure of a headquarters, regions, and integrated care boards (ICBs) is fit for purpose.”
I draw the Secretary of State’s attention to the Suffolk and North East Essex ICB, which is one of the most successful in the country. Can we learn from that success, and build it into other areas?
I thank the hon. Gentleman for his constructive approach. The tragedy of the Health and Care Act 2022 was that a large part of its focus was on trying to correct the enormous damage done by Lord Lansley through a top-down reorganisation that nobody wanted and that the country could not afford. That is why I have said very clearly that we will not repeat the mistakes of top-down reorganisation. With the architecture of the system, we will take an approach of evolution rather than counter-revolution.
On the hon. Gentleman’s point about learning from what is working well in the NHS, what gives me great hope for the future of our national health service is that every day there are amazing people providing great-quality care, reforming, innovating and showing us what the future looks like. It is the responsibility of this Government to take the best of the NHS to the rest of the NHS. That is exactly what we will do.
Lord Darzi’s report makes grim reading and lays bare the failure of the last Government. NHS staff up and down the country will recognise everything in it. Does the Secretary of State agree that much more needs to be done on retaining, recruiting and compensating the NHS workforce and making sure that we have a workforce fit for the future?
For all the innovations that modern technology will bring—the revolution in big data AI, machine learning and medical advances that we will see very soon but can scarcely imagine today—health and social care will always be fundamentally a people-based service. If you do not value your people, you lose them and end up in the appalling situation that we are in today. We have invested so much money and time in training people who imagined a long future for themselves in the NHS but who, because of the reality to which they were subjected by the previous Government, are now packing up and moving into different careers—or to other continents. We are determined not just to recruit the great staff we need, but to value and retain the brilliant staff we already have.
The Secretary of State will know that cancer is the biggest cause of death by illness for children under 14 in the UK, and that this is Childhood Cancer Awareness Month. He will not know that it is also the third anniversary of the death of my constituent Sophie Fairall, who was 10 years old. With Sophie’s mum Charlotte, I have been campaigning for the past three years for the children and young people cancer taskforce to be set up. The taskforce was set up at the beginning of this year with the stated aim of meaningfully changing detection, treatment and care for children with cancer. I have listened carefully to the Secretary of State and have heard him passionately set out that he wants to focus on prevention and early intervention, yet this month we learned that he is pausing the taskforce. Parents of children with cancer are deeply disturbed by that announcement, as am I. Can the Secretary of State set out why it was made?
Absolutely. I thank the hon. Member for the way she put her question. I send my deepest condolences to Sophie’s family on what will inevitably be a difficult day—I suspect just the latest of many difficult days—on the imaginable pain, grief and loss that they have suffered. I thank the hon. Member for her work over many years campaigning on children’s cancer in this House on behalf of her constituents and so many other families affected by young cancer.
The pause is because we are looking at the breadth of the work of the Department to make sure that we have the right vehicles to deliver the outcomes that we want. That is why we have paused rather than cancelled, slammed or criticised the work that she was doing. I would be delighted to meet her to talk about the genesis of the taskforce and how we can take forward the outcomes that she wants to see. What we are trying to avoid is a plethora of taskforces, and the risk that there has sometimes been—this is not a party political point, because this spans successive Governments—of taskforces being an alternative for action. I know that she wants action, so let us meet and see what we can do together.
When I grew up in Stretton under the last Labour Government, I could get an appointment with my family doctor the next day. After 14 years of the Conservatives, Stretton residents now often have to travel more than six miles to a GP surgery in another village just to get an appointment for which they have already waited weeks. Does the Secretary of State share my view that this is unacceptable, and that it falls to this Government to fix the Conservatives’ mess?
My hon. Friend is absolutely right. We need to make sure that we have the right staff in the right place and an equitable distribution of access to NHS services right across the country. We also want to shift from the hospital-centred NHS that we see today to a neighbourhood-centred service. That is why we have acted immediately to put 1,000 more GPs on the frontline before the end of this year. I am looking forward to working with GPs to expand access to primary care right across the country, especially in communities that are particularly under-served.
This review highlights the need for capital investment in the NHS. The question that NHS staff and patients in North West Norfolk have is urgent: are the Government committed to replacing their hospital, which is affected by reinforced autoclaved aerated concrete, with a new Queen Elizabeth hospital in King’s Lynn by 2030—yes or no?
I can absolutely reassure the hon. Member that RAAC-impacted hospitals are a priority. We are putting safety first, and it is just a shame that when his residents had a Prime Minister in their backyard, the Conservative Government did not fix the problem.
For the sake of openness and transparency, I will just mention that I am a former chair of an NHS trust and a public health academic. I recognise the real issues that are raised in the findings of the Darzi rapid review. I am grateful to Lord Darzi for referring in particular to the inequalities that we have experienced, and how those inequalities were laid bare during covid. Will the Health and Social Care Secretary expand on the cross-departmental work that he is doing? I agree with my hon. Friends the Members for Walthamstow (Ms Creasy) and for Eltham and Chislehurst (Clive Efford) that people’s socioeconomic circumstances drive their health status. We do not want a situation where, for every 1% increase in child poverty, six additional babies per 100,000 live births do not reach their first birthday.
I thank my hon. Friend for her question and congratulate her warmly on her election to the Chair of the Work and Pensions Committee. I am looking forward to sharing, through the Secretary of State for Work and Pensions, the work that our Departments are doing together, particularly on the link between mental health and unemployment and on integrating pathways. She is right about the social determinants of ill health. That is why I am genuinely excited that, through the mission-driven approach that the Prime Minister has set out, we are already bringing together Whitehall Departments, traditionally siloed, to work together on attacking those social determinants. The real game changer is genuine cross-departmental working, alongside business, civil society and all of us as active citizens, to mobilise the whole country in pursuit of that national mission, in which we will be tough on ill health, and tough on the causes of ill health, as someone might have said.
I greatly respect the Secretary of State, and, as an older person who relies on the NHS, I support his radical zeal. I repeat what he said in his statement: cancer is more likely to be a death sentence for NHS patients than for patients in other countries. We have had this conversation previously, but can he at least look at the health systems in other countries, particularly those in the Netherlands, Australia, France and Germany? Those countries, which have wonderful health systems protecting the vulnerable, use a mixture of social insurance and public and private funds to maximise inputs into their health services.
Every time the right hon. Gentleman praises my zeal for NHS reform, Labour Members get very nervous. Let me reassure him that I have looked at other countries, and I will definitely continue to do that. I genuinely do not think that it is the model of funding that is the issue—the publicly funded, public service element. I hope that he knows me well enough to understand that if I did think so, I would be more than happy making, and would quite enjoy taking on, the argument, but I think that the equitable principle that underpins our NHS is one that we should cherish and protect. The single-payer model has enormous potential for the century of big data, AI, and machine learning. There is huge potential there that we must unlock, but that does not mean that we cannot learn from the way that other countries organise care, particularly in the community and particularly social care. This week, I met virtually with my friend the Health Minister in Singapore. I will continue to work with my international counterparts to learn from other countries whose health outcomes are far better than ours.
In my constituency of North Warwickshire and Bedworth, patients wait far too long for GP appointments. The Conservative party has presided over sticking-plaster solutions, papering over the cracks in our health service rather than making it fit for the future. Does the Secretary of State agree that today’s report is a chance to get the right diagnosis of the problems, so that this new Labour Government can come up with the right prescription, and my constituents can once again get the treatment that they so desperately need?
I am delighted to see my hon. Friend in her place. She is absolutely right. We will take Lord Darzi’s diagnosis to write the prescription and ensure that our reform agenda benefits every part of the country—not just big cities and the wealthiest communities—so that every person, wherever they are from, grow up and live, has access to the very best health and care services.
A key finding in the Darzi report is that NHS staff morale is low. The Medical Defence Union of medical practitioners stated recently that more than 44% of NHS staff will reduce the number of hours that they work, because of low morale. Will the Secretary of State meet representatives of the union to explore those issues and work out ways of improving staff morale?
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.
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?
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.
I declare my interest as the husband of an NHS doctor; I also served as a non-executive director of my local NHS trust. The last time that Lord Darzi was brought into service was by a Labour Government, shortly before they appointed him to the House of Lords. Will the Secretary of State take steps to ensure the widest possible input from senior clinicians? It is clear that some, including Professor Sir John Bell, do not share Lord Darzi’s prescription for the improvement of the NHS. Will he also apologise to my constituents for the doubt that he has cast over the future of the new Hillingdon hospital, on which work had already started under the previous Government?
I am not sure that is a fair characterisation of Sir John Bell’s position. I have a huge amount of respect for him. I am grateful to Lord Darzi for writing the diagnosis. Given that the Conservative party was in government for 14 years, repeatedly promised to rebuild Hillingdon hospital and left my Department in a position where the money for the new hospitals programme ran out in March, the hon. Member has some brass neck to point the finger at us while he is in opposition.
In 2016, the Horton hospital in my constituency lost its consultant-led maternity unit—a temporary downgrade that ended up being made permanent three years later. Is it not about time that someone from the Conservative party apologised for the damage done to Banbury’s hospital, as well as to the NHS as a whole?
I am delighted to see my hon. Friend here. His constituents can already see that he is not backwards in coming forwards. He will stand up and champion their interests in this House as a great constituency MP. When it comes to the Conservative party, sorry seems to be the hardest word.
I welcome the announcement of the Secretary of State about the shift from hospital to community care. My fellow Liberal Democrats and I fully believe that fixing social care is part of the solution in getting the NHS back on its feet, so I also welcome the announcement of a national care service. Part of care in the community is of course the hospice sector. I recently met the chief executive of St Catherine’s hospice, which is in the constituency of the hon. Member for East Grinstead and Uckfield (Mims Davies). He highlighted to me that, although the hospice has 24 beds, it is currently using only 12 of them. What assurance can the Secretary of State give me, and people right across the country, that fixing the hospice sector will be part of the solution as we take the NHS forward?
I am so grateful for that question, not least because it gives me the chance as a constituency MP to say a huge thank you to St Francis hospice and Haven House children’s hospice for the care they provide to constituents, like so many other hospices around the country. I know that the sector is under real pressure. We look forward to working with the sector throughout the period of the spending review and the 10-year plan, not only to support our hospices but to improve end-of-life care, which is pertinent to debates that I know this House and the other place will have about how we ensure a good death for everyone, in every part of the country.
On Tuesday, I was at the Birmingham children’s hospital. Will the Secretary of State join me in congratulating the excellent staff on their work and their commitment to each individual patient who goes through the door? That evening, I was also with a local GP at Sparkbrook health centre whose frustration was with the outdated computer system. If he could get one message across to the Secretary of State, it would be that he has to reboot his computer numerous times a day. Will the Secretary of State put resources in to ensure that the IT is up to date?
First, my hon. Friend is right that we should celebrate and thank staff who are doing an outstanding job against a very difficult set of circumstances. On his second point, we have to ensure that, on the tech side, we unlock productivity in the system. Having literally sat looking over the shoulder of GPs at their IT systems, I well understand those frustrations. For the benefit of all observers, there is sometimes a perception that I am up against NHS staff when it comes to reform. Actually, it is staff who are crying out for change.
One aim of the Lansley reforms was to transfer from Ministers to clinicians decisions on the day-to-day running of the health service. It is not clear from his statement whether the Secretary of State intends to change that process, but let me give him a constructive proposal that he might take on board, which is to streamline the business planning side of the NHS. Staff have to go through multiple bids and preparations of business plans before decisions are made. That means that more money is spent on employing business consultants than consultants in hospitals. I have campaigned for this change for many years. Will he take that on board? [Interruption.]
The Minister for Secondary Care was whispering in my ear that it was her frustration with exactly the bureaucratic processes that the hon. Gentleman describes that led to her seeking election as a Member of Parliament to sort them out, so I defer to her on this one.
On a serious note, he is right that wherever we find waste and inefficiency designed in, we must deal with it. I want to see an NHS that is more clinically led, free from political interference. We must also be honest: as it is such an enormous part of the public sector, which the public pay an enormous price for and value so much, there will always need to be an accountability relationship. What I have tried to build with NHS England in the last couple of months, with real joy in the process, is a real team between the Department of Health and Social Care and NHS England, as well as the team across the country. I look forward to continuing to galvanise that team as we embark on the 10-year plan process.
In my constituency, a staggering 28% of patients said that it was “not easy at all” to get through to someone at their GP practice. Worse, the figure for patients who said that doing this was “generally easy” was far below the national average. Does the Secretary of State agree that the Conservatives have pushed the NHS to breaking point, and only this Government can get the NHS fit for the future?
I am delighted to see my hon. Friend in her place, standing up for her communities in Penistone and Stocksbridge. In opposition, it was very frustrating watching successive Ministers promise better hold music for people trying to get through to their GP, rather than solving the problems of access. Fixing general practice, and building general practice so that it can meet the needs of this century, will be a vital part of our 10-year plan process.
May I make the Secretary of State a little more nervous? The Darzi report makes seven high-level recommendations, the fourth of which is to drive productivity in hospitals. From 2017, in south Essex we saw a merger of Basildon, Chelmsford and Southend hospitals to create the Mid and South Essex NHS Hospital Trust. It has not been an unmitigated success. As local MPs, we were promised significant back office savings that could be channelled into patient care. In fact, the reverse has been true, and there has been such a turnover of senior managers in that trust in recent years it has been like a game of musical chairs. The trust is now trying to appoint three permanent managers and directors for each hospital to provide stability, which makes sense, but is offering a salary of £200,000 for each post, which is more than the Prime Minister earns to run the country. Now that this is on his watch, will the Secretary of State take a personal interest? We should pay a good rate for that job, but £200,000 sends the wrong signals to all the other very hard-working people in the trust.
I thank the right hon. Gentleman for that question. He is not too far away from me geographically, but he is miles away from me politically, and I always get nervous when he stands up to praise me. We have to keep a sharp eye on value for money. The Darzi report presents some politically challenging messages about NHS management. I could be wildly popular with the country if I stood up and said, “I’m going to take the axe to management across the country and sack loads of managers.” What we need is better management and a sharp eye on value for money. The NHS would not work without good leadership. We have to ensure that we have the right people in the right place, delivering against the public’s expectations, so it is a more nuanced position, but I am sure that what he says will have been heard by his local trust. I will certainly keep an eye on value for money across the country.
The Darzi report rightly says that prevention is better than cure, and that public health interventions that protect health are far less costly than tackling the consequences of illness and ill health. Does my right hon. Friend agree that the recklessness and incompetence of the 14 years of Conservative government, stripping millions of pounds from local authorities, which deliver the public health work, has contributed to children being sicker than they were 10 years ago, and adults getting iller sooner?
My hon. Friend is right, and at some point the Conservatives will have to take responsibility for it. We learned through bitter experience that if we did not change as a party, the country would not choose to change the Government. Long may the Conservatives continue, therefore, with their head in the sand, and long may we continue to get on with the job of clearing up their mess and building an NHS that is fit for the future.
The relationship between the NHS and local government, and between my Department and local government, is of particular importance in relation to social care, which is why I was especially delighted that the Prime Minister chose this week to appoint Tom Riordan, the chief executive of Leeds city council, as second permanent secretary. He is an outstanding public servant with a demonstrable record on health and care integration, public health and prevention. I look forward to having that local government perspective, and local community delivery perspective, at the heart of our Department.
I think the whole House agrees with what the Secretary of State said in his statement: the NHS needs reform. In reality, when I speak to people in the NHS, almost all of them say that this is not about a shortage of money, but about the legendary levels of waste, bureaucracy and mismanagement. Indeed, the report refers specifically to the huge number of regulators, accountants and bureaucrats from the top down. Is there recognition among the NHS senior leadership that management reform is a critical part of improving healthcare in the United Kingdom?
I welcome the hon. Member to his place and thank him for that question. I am always cynical about huge volumes of regulation. We reassure ourselves as legislators and regulators that putting regulations in place means that we have dealt with the issue. But the problem is that if we fail to deliver, we put another regulation in place, then another, and then more, and before we know it, we have drowned the people responsible for delivery in so much regulation that they cannot sort the wheat from the chaff or see the wood for the trees, compromising standards and patient safety. That is why I welcome the work that Penny Dash has done in relation to the Care Quality Commission, and we will continue to work with her to reduce the burden of regulation, focus on the things that really matter and free NHS staff from red tape. I hope that he finds that reassuring. I plead with him not to send his party leader to agree with me as well, or I really will be in trouble.
I declare an interest as the mother of an NHS nurse. It is important that we remember what is at the centre of this issue: people. Three individuals came to my Carlisle surgery last week because they were at the end of their tether about the care that their loved ones had received, or not received, at our local hospital. One is the husband of a woman who has profound physical disabilities and cannot leave the House unaccompanied. She now has no trust in her local hospital because, among other things, her recent care involved her being fed food that she was known to be allergic to.
I also saw the parents of a young woman who has epilepsy, a physical disability and profound anxiety. The failure to put in place a care plan to account for all that means that she is now self-harming. The other case was that of an elderly woman whose husband was discharged from the hospital without her consent. He is now in a care home 20 miles away, and she cannot visit him. Will the Secretary of State assure those people that this Government will not only fix our NHS, but restore their broken trust in it?
I am so grateful to my hon. Friend. I enjoyed visiting her Carlisle constituency ahead of the general election campaign, and I look forward to working with her to improve health services there and across the north-west, especially in the rural and coastal communities that rely on the hospital in Carlisle, as well as on more local neighbourhood services. I must warn new Members that one of the most depressing things about the last nine years has been constituency advice surgeries, where people would come to see us about the consequences of the failure of Government and the failure of this place. We owe it to them to do better—better integration of health and care services, better access and outcomes, and better joined-up care. As she has painfully described, if we do not tackle the problems early, they become multiple, higher-cost and personal tragedies. We have seen enough of that.
Famously, the House has not seen an impact assessment of the withdrawal of the winter fuel allowance from frail 85 and 90-year-olds on low incomes. Has Lord Darzi or the Secretary of State seen an assessment of the impact of that decision on NHS bed capacity over the coming winter?
The hon. Member is an experienced Member of this House, as both a former Chair of the Treasury Committee and a former Treasury Minister, so she knows how impact assessments are done at the Treasury. She knows that impact assessments of all the Chancellor’s fiscal decisions at the Budget and the spending review will be published at that time. She also knows, I suspect, that despite the withdrawal of the winter fuel allowance from some pensioners—it will be targeted at those most in need—they will still be better off because the Government have committed to maintaining the triple lock and to extending the warm home discount scheme and the available hardship support, so that pensioners are not left behind as we clean up the £22 billion mess that the Conservatives left behind.
Lord Darzi’s report lays bare the scale of the challenges that our NHS faces. Does the Secretary of State share my deep concern that because of the Conservative party’s dismal record, the progress made by the previous Labour Government on heart disease and stroke—of which I have had recent personal experience—is now in reverse? The number of people in England dying from cardiovascular disease before the age of 75 has risen to its highest level in 14 years.
I am delighted to see my hon. Friend in the House representing my old east end stomping ground. I wish her and her husband well in his recovery, and for their recovery, as a family, from his experience. Let me reassure her that, when it comes to the future of health and social care, we will clean up the mess that the Conservatives made. That will take time. The reverse in the progress made on cardiovascular disease, and the early warning signs of an uptick in smoking, are why we must put public health and prevention at the forefront. That is not just about what is good for the individual, their health and their chances; look at what the Office for Budget Responsibility says today about the long-term cost to the Exchequer. We have no choice but to act.
A key conclusion of the report is the absolute necessity of focusing on productivity and not just throwing money at the NHS; I think we all agree on that. Ministers are constantly telling us that government is about making difficult decisions—something that that we already knew. Why, then, on one of his first opportunities, did the Secretary of State do the absolute opposite of that? In solving the doctors dispute, he took the easy option of throwing money at it, and did not require productivity enhancements and changes. Will he reassure me that in future he will practise what he preaches?
I like the hon. Gentleman very much, but what audacity to criticise this Government for cleaning up the Conservatives’ mess. He fails to acknowledge the cost to the Exchequer and to patients in delayed and cancelled operations, appointments and procedures. More than £1 billion has been lost and more than 1 million appointments cancelled because of the Conservatives’ gross incompetence and failure to understand the difference—they are penny-wise and pound-foolish. That is why they have been sent into opposition and Labour has been trusted to clean up their mess.
There can be no greater example of the previous Government’s failure than the shocking outcomes for our children and young people, as Lord Darzi’s report highlights. Our children now have some of the worst health outcomes in Europe, with higher rates of obesity, diabetes and asthma, and poor oral and mental health. From head to toe, they have been failed. Will the Secretary of State ensure that the Government’s long-term plan for our NHS will give young people’s health the priority that it deserves?
I am delighted to see my hon. Friend in her place. She might be from the wrong side of the river, but she is absolutely right about the importance of prioritising children’s health. As the Prime Minister said this morning, it is shocking that the No. 1 cause of hospital admission among children aged between six and 10 is tooth decay. I was criticised by the shadow Secretary of State, who said that I called our children “short and fat”; she is more outraged by my calling out the scourge of childhood obesity that her Government fuelled than she is by the scourge of child obesity itself. That is why we will act and why the Conservatives failed.
I welcome the fact that the Health Secretary talks about a shift from hospital to community care; that builds on Lord Darzi’s finding that 13% of beds are occupied by people who are waiting for care in more appropriate settings. Caring for patients in community hospitals is much more cost-effective than caring for patients in big acute hospitals like the Royal Devon and Exeter hospital where I live. What thought has the Secretary of State given to the use of community hospitals that have lost beds in the last decade, such as Seaton, Axminster, Honiton and Ottery St Mary?
The hon. Gentleman is absolutely right about the value of community hospitals, step-down accommodation and care close to people’s homes—or, better still, wherever possible, in their homes, so long as it is clinically safe and the right support and care is available. The shift from hospital to community will be at the heart of our 10-year plan for reform and modernisation. Like lots of his colleagues on the Liberal Democrat Benches and lots of those on the Government Benches behind me, the hon. Gentleman has already done a good job of putting his local lobbying of Ministers on the record in the House.
A recent survey of staff at East Kent Hospitals University NHS foundation trust showed that less than half of employees would be happy for their loved ones to be treated at an east Kent hospital. That is a devastating verdict from staff, showing the impact on their morale and on confidence in the community for the care that people need. Does the Secretary of State agree, however, that a broken NHS is not the fault of staff like them, but down to the previous Government’s decade of austerity and top-down reorganisation of the NHS?
I am delighted to see my hon. Friend in her place. She is absolutely right. I feel really sorry for NHS staff for what they have been put through over more than a decade of mismanagement and political incompetence, and we will work with them to clean up the mess. She establishes exactly the right test, which is whether we would want our loved ones to be treated in our local health and care services, and whether we would have confidence that, in every case, on every occasion and in every interaction, they would have access to the best-quality care. The truth is that we do not have that certainty, and too often it feels like chance. That is why we will always put the patient voice, the patient interest and the patient experience at the heart of our reform and modernisation programme.
I thank the Secretary of State for the honesty in his statement, and for his contact with the regional Minister responsible at the Northern Ireland Assembly. Those are the first actions of a Secretary of State who, I suggest, does not run away from issues but takes them head on. I congratulate him on that.
I appreciate the terminology used in the report, which outlines the seriousness of conditions in the NHS but also highlights the fact that the vital signs are still strong. Will the Secretary of State outline how he intends to address the fact that the NHS in devolved regions is in an arguably worse condition? Will he confirm that the review will incorporate Northern Ireland and will he ensure that the findings, new practices and standards will be in place for Northern Ireland, along with increased funding in a new funding formula?
I thank the hon. Gentleman for what he said; coming from him, that means a great deal to me. I reassure him that I am committed to working with Ministers in all devolved Administrations to improve health outcomes for everyone in every part of our United Kingdom. I know that the system is particularly pressed in Northern Ireland and I will do whatever I can, working with Ministers in Northern Ireland, to help that situation and create the rising tide that lifts all ships right across the UK.
I truly learned to appreciate the NHS when I became a parent and saw the care given to my family and children. It therefore horrified me, having sat in A&E with an ill child, to see in Lord Darzi’s report that 100,000 infants waited for over six hours in A&E last year. Does the Secretary of State agree that that is a shocking state in which to leave the NHS? Will he commit to bringing the numbers down and making sure that parents do not have to endure that terrible wait?
I am delighted to see my hon. Friend representing Calder Valley. He has captured the fear and anxiety about the length of the wait experienced by far too many parents when they access A&E departments. It is a terrifying experience, particularly for parents with small children, to be in that situation. Frankly, the lack of focus on paediatric waiting lists and waiting times, whether in A&E or for electives, really is shameful. We have got to put children first and that is exactly what this Government will do.
My constituents in Bournemouth West have faced rising NHS waiting times; we have GP surgeries closing despite rising populations and health burdens; there are no dentists accepting any NHS adult patients and residents are being told to go to Southampton; and the junior doctors and nurses I meet are devastated that they cannot deliver the quality of service that they want to. Does the Secretary of State agree that although the road ahead is long, Lord Darzi’s frank and raw assessment is the first step to recovery under a Labour Government?
I am delighted to see my hon. Friend in her place representing the people of Bournemouth. The great thing about where we are at this moment is that, for the first time in a long time, there is a feeling of hope and optimism about what the future could be. We are determined to build on that and give staff and patients the confidence of knowing that the best days for the NHS lie ahead.
Lord Darzi’s report highlights the use of capital expenditure to cover in-year spending by successive Tory Governments. Money intended for long-term investment has been redirected over and over, and that has exacerbated the extremely serious and urgent problems that the Secretary of State so rightly raises today. Does he agree that that has stopped us making progress on capital projects that would enable big productivity improvements and improve access to care for all, particularly those in my constituency of Leyton and Wanstead?
I am delighted to see my parliamentary neighbour in his place; he has big shoes to fill and he will certainly do that. The Chancellor and I are determined to break the vicious cycle in which ballooning costs and overspends in day-to-day spending see raids on capital and tech budgets to fund the shortfall. The £22 billion black hole that we have inherited is a direct example of exactly where Conservative short-termism leads. That is why, in respect of the spending review, I assure my hon. Friend that productivity, tech and capital will be my focus in my representations to the Chancellor and in the work we will do together to fix the mess that the Conservatives left behind.
To return to a subject close to the Secretary of State’s heart, does he agree that people’s actual experience is how we will measure whether the NHS has been improved? One of my children’s grandparents, who was diagnosed under a Labour Government, had 12 great years of cutting-edge treatments and 12 years with their grandchildren. Their grandfather, who was diagnosed under a Conservative Government, had 12 weeks.
I am grateful to my hon. Friend for the work she does championing Milton Keynes. Therein lies the challenge: it cannot be right that delays in diagnosis lead to the difference between life and death. I am very lucky that my cancer was caught early. It was diagnosed quickly and treated quickly. Not everyone is fortunate, and I am so sorry that my hon. Friend’s family is bearing the consequences of what happens when things go wrong.
Despite the damning analysis of the state in which the Conservatives left the NHS, Lord Darzi says that its vital signs remain strong. Does the Secretary of State agree with the case for the health service being taxpayer funded, free at the point of use, and based on need and not the ability to pay?
I am delighted to see my hon. Friend from Dudley. I agree wholeheartedly, 100%, unequivocally.
In a recent conversation, a nurse in Brunswick Village in my constituency shared her damning experience of the increasing number of black alerts in her hospital. Does the Secretary of State agree that, although her experience is no surprise to many who have used the NHS recently, the Tories have pushed our NHS to the brink and it is up to Labour to fix it and make it fit for the future?
The amazing NHS staff in my constituency work tirelessly, day in and day out, in our local hospitals and surgeries. Will my right hon. Friend join me in thanking them, and will he be clear that Lord Darzi’s shocking findings are not on them, but on the appalling legacy of the Conservatives, who still have not apologised?
NHS staff did not break the NHS—the Conservatives did—and this Labour Government will mobilise them to help fix it.
It was great to see the Prime Minister speaking this morning at the King’s Fund, where I worked as director of policy for a number of years. In my constituency, I met a man who had been told he needed urgent surgery on his leg, but was still waiting 18 months later and had had to give up work. It is clear from today’s report that too many people have been stuck on NHS waiting lists and locked out of work. Does the Secretary of State share my view that a healthy nation is critical to a healthy economy, and will he work with his colleagues in the Department for Work and Pensions to deliver that?
My hon. Friend is absolutely right: the health of the nation and the health of the economy are inextricably linked. Under this Government, the Department of Health and Social Care is a Department for growth as well as a Department for health and care, and the Chancellor understands those linkages too. I can say to my hon. Friend and all of her friends at the King’s Fund—we were delighted to see them host the Prime Minister this morning—that unlike our predecessors, this Government cannot get enough of experts.
That concludes the statement. We have had more than 45 contributions from Back Benchers, so I thank you for your patience.