NHS Pensions

Andrew Murrison Excerpts

Tuesday 1st April 2025 Commons Chamber

[Karin Smyth]

My hon. Friend makes absolutely the right point. As I have said, Lord Darzi has helpfully outlined the breadth of the mess that we inherited back in July, and it makes for stark reading. We have still not had an apology from the Conservative party, so I am happy to take an intervention now if anybody decides to provide one. In these issues, we are seeing the depth of the destruction that the Conservatives have caused widely across Government. We will continue to fix that on behalf of the British people.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I declare my interest as a practising doctor and a public sector pensioner who has been through the McCloud process. Does the Minister understand that we will not improve productivity in the NHS as far as doctors are concerned if they continue to retire routinely in their mid-50s—in their prime? They do so because their accountants tell them that they would be foolish not to, given the fiscal environment and the structure of the NHS pension scheme.

[Karin Smyth]

I understand that point. Obviously, it is a source of much discussion. The change came about during the pandemic to encourage people to return to work, and it is a complex issue. We want to continue to use the skills of doctors at all stages of their careers, and we shall continue to work with them, the British Medical Association and others to make sure that there is no detriment to their returning to service in the NHS.

Prevention of Drug Deaths

Andrew Murrison Excerpts

Thursday 27th March 2025 Westminster Hall

[Several hon. Members rose—]

[Dr Andrew Murrison (in the Chair)]

Order. There is a lot of interest in this debate. I will not set a firm limit on speeches, but I suggest that an indicative three minutes should get most people in, but probably not all. I remind Members that if they want to speak, they have to indicate that they wish to do so.

[Grahame Morris (Easington) (Lab)]

It is a pleasure to serve under your chairmanship, Dr Murrison. I congratulate my good and honourable friend, the hon. Member for Strangford (Jim Shannon), on securing this really important debate. Not for the first time, I find myself agreeing with what he said.

Drug deaths are at a record high. They are mainly from opioids, but deaths from cocaine have risen by almost a third. As the hon. Gentleman said, synthetic opioids such as Fentanyl and the nitazenes present an increasing and alarming threat, which has not been properly quantified. We have seen the growth in the number of deaths across the Atlantic, and I suspect the problem is much bigger here than we think.

There is no doubt that this is a public health crisis. Sadly, the north-east of England has the highest rate of drug deaths in England—three times higher than London. In the latest stats, released in October 2024, the north-east recorded 174 deaths per million, compared with an England average of 90. Too often, in the communities I represent, I have seen people turn to drugs because of deprivation and despair. Once addiction takes hold, it often leads to crime. It is no coincidence that drug deaths are highest in the areas of greatest deprivation. The data is clear: communities struggling with poverty and inequality are those hit hardest by addiction.

This is not a new problem—certainly, it is complex—but it is being exacerbated by disinvestment in harm reduction and drug treatment programmes. If we are serious about tackling this problem, we need to do something different. To some, a tougher crackdown may seem the obvious response, but we have more than 50 years of evidence showing that punitive drug policies do not work. The war on drugs has failed, not just in the UK but globally. We cannot simply arrest our way out of this crisis. That is why today I want to offer a different perspective, which moves beyond outdated, one-size-fits-all approaches.

Abstinence-based recovery is one path, but it is not the only one. If we truly want to reduce drug deaths and support recovery, we must reduce harm, reduce stigma and invest in treatment provision, with protected, ringfenced and sustained long-term funding. That funding could support solutions such as opioid substitution treatment, which saves an estimated 1,000 lives annually; medically supervised overdose prevention centres, like the Thistle safer consumption facility in Glasgow; heroin-assisted treatment; and increased availability of drug testing. Those measures are crucial in addressing the current crisis and saving lives.

As chair of the drugs, alcohol and justice all-party parliamentary group—supported by treatment providers Via, Waythrough and WithYou—I recently had the honour of chairing a meeting at which Professor Sir Michael Marmot, the leading expert in health inequalities, laid out the stark reality. He told us:

“Social injustice is killing on a grand scale.”

He made it clear that areas of the greatest deprivation suffered the deepest cuts during austerity, exacerbating addiction and its consequences. I encourage the Minister and all Ministers to consider how we as a nation can adopt the Marmot principles—principles that foster a fairer, more equitable society in which everyone is given the best possible start in life and we work to prevent “deaths of despair”.

I am conscious of the time, but I want to mention a dear friend of mine who is no longer with us—the late Ron Hogg, who was the police and crime commissioner in Durham. He was a true pioneer of drug policy reform. He was bold, compassionate and unafraid to challenge the status quo. He introduced heroin-assisted treatment and diversion schemes at a time when they were far from popular, but popularity was not his goal. He was seeking to reduce harm, save lives and ease the burden on our criminal justice system.

The evidence is clear: investment in treatment works; harm reduction saves lives; and tackling stigma is essential. We must stop seeing addiction solely as a criminal justice issue and instead treat it as a public health emergency.

[Dr Andrew Murrison (in the Chair)]

Short speeches mean that more colleagues get in.

--- Later in debate ---

[Leigh Ingham (Stafford) (Lab)]

It is a pleasure to serve under your chairmanship, Dr Murrison. I thank the hon. Member for Strangford (Jim Shannon) for securing this debate, as the prevention of drug-related deaths affects many in all our constituencies across the country.

Drug misuse is a complex problem with many causes and impacts, but one thing is clear: the current rates of death are completely unacceptable. In 2022, there were 7,912 alcohol-specific deaths. In 2023, 5,448 deaths related to drug poisoning were registered in England and Wales. That is the highest number since records began and a tragedy that has to stop. We cannot allow this crisis to continue unchecked.

In last week’s business questions, I spoke about how important community services are in supporting people with substance misuse issues. One example that stands out in my constituency of Stafford, Eccleshall and the villages is Chase Recovery, a truly innovative, community-based, peer-led rehabilitation programme. I recently had the privilege of visiting and saw at first hand the incredible impact the programme is having on the lives of those seeking recovery from substance misuse. It is not just a treatment programme but a lifeline for those who need it most. It offers a holistic, supportive environment where individuals can recover, rebuild their lives and develop new skills and confidence. Truly, I could not describe it as anything more than a really welcoming and supportive community.

During my visit I had the pleasure of meeting Paul and Cara, who run the organisation. They are incredibly passionate people who lead the programme with incredible dedication. Their drive and commitment to helping others is truly inspiring. They are making a difference every single day, and I have no doubt that the work they are doing is helping people to achieve long-term recovery and to rebuild their lives in a meaningful way.

Programmes like Chase Recovery prove how community- based, peer-led services can play a vital role in sustainable, long-term recovery, but those programmes need support from the Government to ensure that they can continue their vital work and reach even more people in need. It only takes one helping hand to change someone’s life. I encourage the Minister to outline what the Government are doing not only on prevention but on community-led treatment.

[Dr Andrew Murrison (in the Chair)]

That was commendably brief.

National Cancer Plan

Andrew Murrison Excerpts

Tuesday 4th February 2025 Commons Chamber

[Andrew Gwynne]

My hon. Friend makes a very good point, and it relates to not just cancer but a whole range of conditions, including cardiovascular disease, strokes and so many others—it is the same areas that have the worst outcomes, because there are endemic health inequalities that we have not shifted the dial on for decades. Life expectancy is much lower, and healthy life expectancy is much worse, than in less deprived areas. It is part of our health mission to drive forward better health outcomes for people living in the poorest areas, and our national cancer plan will be a key part of that.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

In his remarks yesterday, the Minister for Data Protection and Telecoms, the hon. Member for Rhondda and Ogmore (Chris Bryant), implied that he was discussing the future with AstraZeneca, which has had some bad news this week. AstraZeneca makes immunotherapies, among other things, and therefore is very important in allowing people to live better for longer. What discussion will the Minister be having as part of his plan with the pharmaceutical sector, since plainly the national health service cannot do this alone?

[Andrew Gwynne]

The right hon. Gentleman makes a very good point. I have certainly had a number of roundtables with the pharmaceutical sector in the UK about how we can support it, how we can grow our life sciences sector and how Britain can be at the cutting edge of new treatments and clinical trials. Indeed, we had a Delegated Legislation Committee yesterday on regulations to make it easier to carry out clinical trials in this country. Some of the latest advances in pharma are quite remarkable; I think particularly of the work being done on mRNA technology to look at having specific cancer treatments pertinent to a person’s genomics—it could be a game changer.

Health and Adult Social Care Reform

Andrew Murrison Excerpts

Monday 6th January 2025 Commons Chamber

[Wes Streeting]

I am grateful to my hon. Friend for his question. That is why in the Budget the Chancellor delivered a big uplift in the spending power of local authorities, with £880 million ringfenced specifically for social care. We are also delivering through measures such as the disabled facilities grant to deal immediately with the pressures—[Interruption.] It is no good the right hon. Member for Beverley and Holderness (Graham Stuart) complaining. He voted against the investment, so he cannot very well complain about it.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

The previous Labour Government did a hatchet job on community hospitals, including in Wiltshire, with a consequent uptick in the amount of delayed discharges in the acute sector, notably at Bath, Salisbury and the Great Western in Swindon. Will the Casey commission look at that and find ways of unpicking the damage that was done?

[Wes Streeting]

The previous Labour Government delivered the shortest waiting times and the highest patient satisfaction in history.

NHS Backlog

Andrew Murrison Excerpts

Monday 6th January 2025 Commons Chamber

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

I thank the hon. Member for North Shropshire (Helen Morgan) for securing this important and timely debate. I must begin by declaring my interests: I am a non-practising NHS consultant psychiatrist and my wife is an NHS doctor.

Christmas and the festive period is always a taxing time for the NHS, especially for those working on call, as indeed it is for all those in the various emergency services and those outside the public sector who are on call. It is important to pay tribute to them for all their hard work over the past couple of weeks.

Much of the correspondence that I have received from constituents over the past few years has concerned the difficulty of obtaining GP appointments. Interestingly, the demand for GP appointments has risen since before the pandemic, following the advent of virtual appointments and different means of contact. Patients are now finding it more difficult to see someone in a general practice, although overall performance in general practices has improved since before the pandemic. It is important that we support our GP practices as much as we can, to ensure that they deliver the high-quality care that our patients expect. Our local practices are fantastic: they are working very hard, in tricky circumstances, to deliver for patients.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

My hon. Friend is, of course, absolutely right. Does he agree that part of our duty is to support our general practices? Our constituents often say, “I cannot see my GP”, but if we probe, we find that it is a question of whether they are prepared to accept a telephone consultation, which is probably just as good for most of them. Radiology was mentioned earlier. The issue for the future, surely, is embracing technology rather than outsourcing. In many cases, AI reading of films and scans is probably as good as, if not better than, a reading by a radiologist in India, Shropshire or anywhere else.

[Dr Spencer]

I entirely agree with my right hon. Friend about the use of AI to improve productivity in the NHS, and with what he has said about general practices.

I generally take a neutral, honest-broker approach when people raise concerns about general practices. Of course it is important for us to ensure that our practices are performing well, to support them, and to respond to our constituents’ concerns more broadly. However, given that the bulk of care is coming through general practice—and I was interested to hear, in recent days, about the renewed focus on patient choice, particularly in respect of secondary and tertiary care—I think that one of the challenges posed by our current general practice system relates to the absence of patient choice. Effectively, general practices, which, as the Minister will know, are private organisations, have a monopoly in terms of the patients who are in their catchment area. It is very difficult for patients to move to different practices when the ones that they are currently using are not meeting their needs: when seeking an appointment with a GP, they are stuck with their own practice, or else they must go through various mechanisms to obtain care elsewhere.

NHS Dentistry

Andrew Murrison Excerpts

Thursday 20th October 2022 Commons Chamber

[Peter Aldous (Waveney) (Con)]

I beg to move,

That this House is concerned by the growing crisis in NHS dentistry; notes that nine out of ten dental practices in England do not accept new NHS patients; regrets the number of dentists moving away from NHS practice; welcomes the Government’s commitment to levelling up health outcomes and dental health across the country; calls on the Government to take urgent steps to improve retention of NHS dentists and dental accessibility for patients; and further calls on the Government to report to the House on its progress on the steps it has taken to address the NHS dentistry crisis in three months’ time.

I thank the Backbench Business Committee for granting this debate, and the hon. Member for Bradford South (Judith Cummins) for her work in helping to secure it. I also highlight e-petition 564154, signed by 11,067 people, calling for an independent review of the NHS dental contract.

Colleagues have been securing debates on the state of NHS dentistry for the past two years. This crisis has been brewing for a long time, and the situation can be likened to that of a house built on shallow and poor foundations that has come crashing down with the earthquake of covid. The King’s Fund describes NHS dentistry as being on “life support”, while the British Dental Association describes it as undergoing a “slow death”. In its monthly report for October, Healthwatch repeats that NHS dental care continues to be one of the main issues it hears about from the public, who across the country are clamouring for NHS dentistry that is both affordable and accessible.

In Suffolk, there are 70 dental practices with NHS contracts, but not one is taking on new patients. Locally, there has been some welcome support in that, in Lowestoft, a local practice was granted additional units of dental activity that allowed it to see emergency patients until the end of September, and in July the Dental Design Studio was awarded a contract to deliver NHS dentistry for up to eight years. However, very quickly both practices were fully booked up and have had to turn away patients. There is a need for root and branch reform, and I shall briefly set out the issues that need to be included in a blueprint plan for NHS dentistry.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I congratulate my hon. Friend on securing this debate. Would he agree with me that the fundamental problem with NHS dentistry at the moment is the 2006 contract and the units of dental activity? Does he share my disappointment at the statement made in the summer about how to resolve the situation based on the consultation launched last year, and furthermore, does he hope that UDAs will be expunged from all of this so that dentists can be properly rewarded for the job they do and thus return to the NHS?

[Peter Aldous]

I thank my right hon. Friend for that intervention, and I agree wholeheartedly with him on that point. I will come on to it as I set out what I believe needs to be done to improve the situation, but I think he and I are very much on the same page on that issue.

First, I will address the issue of funding. There is a need to secure a long-term funding stream. In recent years, the NHS dental budget has not kept up with inflation and population growth. Since 2008, NHS dentistry has faced cuts with no parallel elsewhere in the NHS, and the British Dental Association states that it will take £880 million per annum to restore the service to 2010 levels. I acknowledge the budgetary challenges that the Chancellor faces, but the reform process is doomed from the start without an appropriate level of investment. There is a need for a protected budget, and any funding that is clawed back must be kept in dentistry.

Secondly, a strategic approach should be adopted towards recruitment and retention, with a detailed workforce plan being put in place.

Access to GP Services and NHS Dentistry

Andrew Murrison Excerpts

Tuesday 21st June 2022 Commons Chamber

[Sajid Javid]

My hon. Friend is campaigning passionately for primary care services in his constituency, and he points to some fantastic practices. I congratulate all the people involved in delivering that and support him in his work with his local commissioners to make sure that they are getting even better local primary care.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

Does my right hon. Friend recognise that the crisis in NHS dentistry, which affects my constituency as it does his, well predates the pandemic, and indeed goes back to at least 2006 when the then Labour Government changed the way in which dentists are paid? Will he undertake to look at the units of dental activity system, which disincentivises dentists from providing dental work particularly in the most disadvantaged communities?

[Sajid Javid]

My right hon. Friend is absolutely right in his analysis, and I can give that undertaking. I will say a bit more about that in a moment.

If the hon. Member for Ilford North wants to talk about funding for the NHS, I am happy to oblige. Under the last NHS long-term plan, before the pandemic, we made a historic commitment of an extra £34 billion a year. Because of the pandemic, we then necessarily put in £92 billion of extra funding. At the last spending review, we increased funding still further so that the NHS budget will reach £162.6 billion by 2024-25, supported in part by the new health and social care levy.

We have made sure the NHS has the right level of resourcing to face the future with confidence, but we must also be alive to the consequences. The British people expect every pound spent to be spent well, and they expect us to be honest with them that every extra pound the hon. Gentleman calls for will be a pound less spent on education, infrastructure, housing and perhaps defence. I believe in a fair deal for the British people, and especially for our young people. We will be making plenty of changes alongside this funding.

Health and Social Care Leadership Review

Andrew Murrison Excerpts

Wednesday 8th June 2022 Commons Chamber

[Sajid Javid]

The place-based working that the hon. Gentleman talks about is also at the heart of the integration White Paper that the Government presented recently.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I welcome Gordon Messenger’s review, but does the Secretary of State not agree that in the history of the national health service, reorganising senior management has often been a distraction? Will he prioritise the area that would make a real change to health and care—the interface between the two—and focus on career progression and development for care workers in particular, who hold the key to unblocking the awful problems that we have in both sectors?

[Sajid Javid]

I know my right hon. Friend speaks with experience, and I appreciate that he will not have had time to look at the report in detail yet, but I think when he does read it he will find that it is precisely what he has just asked for. This is not a reorganisation; it is all about strengthening management, and the report sets out in quite some detail how that can work.

Integration White Paper

Andrew Murrison Excerpts

Wednesday 9th February 2022 Commons Chamber

[Edward Argar]

The hon. Lady will have seen yesterday the announcement and publication of our plan to tackle waiting lists caused by the covid pandemic, the investment that underpins that, the approach to the workforce and how we will bring those waiting lists down. This White Paper builds on that; they are complementary and work together. This is about looking to the future to improve how our systems work together, but we set out a clear and comprehensive plan yesterday to do exactly what she speaks of.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I declare my interest as a doctor. I wonder what the practical consequences of this will be. Can I suggest to my hon. Friend, whom I admire greatly, that one of those practical consequences might be to end the awful business of people waiting for weeks and weeks in acute hospital beds for discharge to more appropriate settings in the community? It does them no good, it is massively expensive to the system, and it prevents them moving on to places that can better care for them and give them what they need while allowing the acute sector to do what it can do, which is to manage people who are acutely unwell. At the moment we have 10,000 people in the system waiting for discharge. That will not do, and I would be interested to know from my hon. Friend how these proposals will help.

[Edward Argar]

I am grateful to my right hon. Friend in this respect. Discharge of people from hospital safely, either into a care home setting or back to their own home with support, is vital not only for their own health outcomes but for the flow of patients through our acute hospitals to enable A&Es and other parts of the system to function effectively. Through the national discharge taskforce and through the work we have done throughout the pandemic, we are bringing together acute hospitals and local authorities, and we have made huge strides together within localities in improving this and learning lessons. This White Paper sets out a way in which they can be embedded to ensure that they continue to deliver long-lasting benefits.

Elective Treatment

Andrew Murrison Excerpts

Tuesday 8th February 2022 Commons Chamber

[Sajid Javid]

I agree with the hon. Gentleman about the importance of the workforce, especially in the context of specialisms, and pathology is a really good example. That is why we are putting record amounts of investment into the workforce and training. It is also one of the reasons why, to get a more joined-up plan in health, I have decided that Health Education England should be merged with the NHS. This will enable more joined-up thinking and much better planning for the future, especially in specialist areas.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I declare my interest as a doctor. Will the Secretary of State look again at how we structure doctors’ pay and remuneration? At the moment, we are training lots of doctors—more and more of them—which is a great thing, but typically they leave in their late 50s, so we are losing a whole decade of productive medical time. That cannot go on. Will he look again to see how we can disincentivise early retirement of medical professionals?

[Sajid Javid]

My hon. Friend speaks with great experience and raises a really important issue. The short answer is yes. We have fantastic doctors throughout the NHS and more in training in medical schools than ever before, but we should also focus on retaining talent throughout the NHS. I assure him that that work has already begun.