NHS Backlog

Adam Jogee Excerpts

Monday 6th January 2025 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

I wish you, Madam Deputy Speaker, and all hon. Members a happy new year. I thank the hon. Member for North Shropshire (Helen Morgan) for securing this debate. I am delighted to be able to respond. It has been a passionate and well-informed debate, and I am genuinely grateful for the opportunity to build on what the Secretary of State said in his oral statement today, because we have a great deal to say about our plans to build more capacity and give patients more power over their care.

Colleagues across the House have set out how 14 years of failure have damaged their constituents, letting down the people we represent and breaking the NHS. That was starkly illustrated by my hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley), who should have been doing something else this morning but was not. That is a loss to his patients. It was also highlighted by the hon. Members for Epsom and Ewell (Helen Maguire) and for Wokingham (Clive Jones). The Lib Dem spokesperson, the hon. Member for Chichester (Jess Brown-Fuller), outlined how it impacts on her own father as well as her constituents.

Years of neglect, lack of funding and unresolved industrial action meant that this Government inherited an appalling backlog of people waiting for treatment—the 7.5 million-strong waiting list. I gently remind the hon. Member for Farnham and Bordon (Gregory Stafford) and the Opposition spokesperson, the hon. Member for Sleaford and North Hykeham (Dr Johnson), that that waiting list stood at 4 million people before the start of the pandemic. The Darzi investigation described how these waits were becoming the new normal, with patients waiting far too long for treatment. As a result, public satisfaction with one of our most beloved institutions is at an all-time low. That was eloquently put by my hon. Friend the Member for Carlisle (Ms Minns), who highlighted the figures from 2010 and now, as they affect her constituents.

On average, 58% of people do not receive treatment within 18 weeks of referral. The NHS constitutional standard sets out that 92% of patients should receive treatment within this timeframe, but that has not been met consistently for almost a decade. In other words, there are people today younger than me who would have no memory of the NHS working efficiently and delivering a timely service.

Colleagues are right to point out the impact on our constituents, with people putting their lives on hold while they wait for a diagnosis, for a new hip or for eye surgery. If the human tragedy were not enough, the economic and social effects of waiting times are almost incalculable. That is why today the Prime Minister set out our plans to tackle hospital backlogs and finally meet the NHS standard of 92% of patients in England waiting no longer than 18 weeks for elective treatment. I confirm for my hon. Friend the Member for Bury North (Mr Frith) that that is an average. I also wish his grandmother well—that is unfortunate for her time of life, and I hope she is getting good care.

Our elective reform plan sets out a bold package of productivity measures and reforms to deliver fundamental change for patients by building a health service defined by patient choice and patient control. I agree with the hon. Members for Runnymede and Weybridge (Dr Spencer) and for Farnham and Bordon about local accountability. My own comments on the 2022 Act, which I think the Government at the time should have done more on, are well-made. I regularly encourage all hon. Members to engage proactively with their ICBs. It is incumbent on ICBs to engage with elected representatives on behalf of all our constituents. I certainly have always done with mine, and I commend everybody else to do the same.

Under our plan, NHS care will be increasingly personalised and digital. We will focus on improving experiences and convenience, empowering people with choice and control over when and where they will be treated. Different models of care will be more widely and consistently adopted, following on from the work by the hon. Member for Farnham and Bordon on Getting It Right First Time, which I also commend. We will roll out artificial intelligence and other technology to boost capacity and deliver excellent care consistently across the country.

I will not have time to go into the details of all the drivers of the backlog, but we recognise the pressures on primary and community care and social care. That is why last month we were able to put forward proper proposals for a new GP contract, with extra money to slash red tape and bring back the family doctor—the biggest funding boost to primary care that we have seen. I have been really impressed by some of the fantastic work going on in women’s health hubs. We continue to welcome the cross-party support for our proposals on social care, and I hope we build that cross-party support for Baroness Casey’s work. Social care was highlighted by my hon. Friends the Members for Ashford (Sojan Joseph) and for Calder Valley (Josh Fenton-Glynn), among others.

On the key drivers, in diagnostics we will reduce the waits for scanners by extending the work of community diagnostic centres to seven days a week. Patients will be able to receive same-day tests and consultations, direct referrals from primary and community care, new consulting rooms and at least 10 straight-to-test pathways by March 2026. Pathway improvements will get us only so far, though. We are also setting clear expectations that funding must be used responsibly to provide the best value for money for both patients and the taxpayer. That is why, under our plans, money will follow the patient and the organisations that do the best will get the most reward, so that incentives drive improvement.

I will just say gently to the Opposition spokesperson that many places do offer online access—I get texts regularly from my hospital, because I, too, am a patient. However, it is not universal, and that was the Conservatives’ failure in government. We want to take the best of the NHS to the rest of the NHS.

On cancer, the 62 and 31-day cancer waiting time standards were last met in 2015 and 2020 respectively. Cancer is a priority for this Government: cancer patients are waiting too long for a diagnosis and for treatment, and we are determined to change that. We will get the NHS diagnosing cancer earlier and treating it faster so that more patients survive. I assure the Lib Dem spokesperson, the hon. Member for Chichester, that we remain committed to all three targets. We know that swift diagnosis is key to improving outcomes and ensuring that patients get a diagnosis and treatment quickly, which is why expanding CDCs is a core plank of achieving those standards. We recognise that a cancer-specific approach is needed to meet the challenges in cancer care, which is why, after the 10-year plan, we will follow up with a dedicated national cancer plan, which will help us to go further for cancer patients.

This Government are tackling challenges beyond routine elective care, such as the crisis in emergency care. Last month, a quarter of the 2.3 million people who attended A&E waited for more than four hours; in November, the average ambulance response time stood at 42 minutes, which is more than double the NHS constitutional standard. These figures do not come close to the safe operational standards set out in the constitution. It will take time to turn things around, but our action to quickly end the junior doctors strike means that, for the first time in three years, NHS leaders are focused on winter preparedness and not planning for strikes. NHS England has set out a national approach to winter planning and is managing extra demand, with upgraded 24-hour live data centres, strengthening same-day emergency care and offering more services for older people.

As we have heard, mental health waiting lists are far too long. We want to build on our mission and ensure that we recruit 8,500 additional mental health workers to reduce delays. We will also provide access to specialist mental health professionals at every school in England, roll out young futures hubs in every community and modernise the Mental Health Act 1983. As the hon. Member for Guildford (Zöe Franklin) highlighted, young children and young families are being particularly badly affected. The Chancellor backed our plans in the Budget with an extra £5.6 million over the next two years to open new mental health crisis centres and help reduce pressure on A&E services.

[Adam Jogee (Newcastle-under-Lyme) (Lab)]

Will the Minister give way?

[Karin Smyth]

I would like to, but I am afraid I need to adhere to the time limit.

In closing, on Second Reading of the National Health Service Act 1946, Nye Bevan warned us against following abstract principles that work on paper but not in the real world. This Government are interested only in what works, and we know we must do things differently, because the backlog began to build before the pandemic. NHS constitutional standards have not been met for more than a decade. Whatever the last Government were doing, it was not working. That is why our elective reform plans will do things differently, giving patients more choice and more control over their treatment, making greater use of technology—including the NHS app—to give patients the convenience of a seven-day diagnostic service.

In response to the hon. Member for North Herefordshire (Ellie Chowns), we will use private sector capacity to help—supporting patients is what matters. As the party that founded the NHS, we will always be committed to a publicly funded NHS that is free at the point of use. We are going hell for leather to get waiting lists down, rebuild our NHS and ensure that it is there for us when we need it once again. None of this will happen overnight, but we are not asking to be judged by our promises; we will be judged by our results, and we are determined to succeed.