Department of Health and Social Care

Anna Dixon Excerpts

Wednesday 5th March 2025 Commons Chamber

[Nesil Caliskan]

My hon. Friend makes an important point, because health inequalities are determined by a multitude of factors and the work that local authorities do on public health is crucial too.

Compare the point I made about local authorities not being able to set deficit budgets with the situation in the NHS, where every year winter pressures mean that our NHS is at crumbling point and that despite the money poured in, the NHS overspends. Last year, that overspend was £1.4 billion, more than double the previous year. Those issues have not emerged in a silo; they are a result of years of mismanagement and failed leadership by former Ministers and by a Government who decided to allow the chaos of one year budget setting, hindering health leaders from being able to effectively plan for the future.

A lack of political commitment, coupled with a refusal to invest in the future, has led to awful consequences for patients. On the NHS estate, the National Audit Office report shows that since 2019, over 5,000 appointments, surgeries and other clinical incidences have had to be cancelled because of issues in buildings. That is absolutely shocking, so I take on board the points made by Members from across the House.

[Anna Dixon (Shipley) (Lab)]

On that point, will my hon. Friend give way?

[Nesil Caliskan]

I will not take any interventions at this point—actually, I will.

[Anna Dixon]

I thank my hon. Friend for giving way. It is always a pleasure to serve with her on the Public Accounts Committee under the leadership of the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown). She makes an excellent point about the raising of capital budgets. In my constituency, we have the RAAC-infested Airedale hospital. Does she agree that it is only with the new Labour Government and a properly funded and deliverable plan for new hospitals that we will see that put right, following the decision made by the Chancellor to ringfence capital funding?

[Nesil Caliskan]

I am very pleased to have accepted my hon. Friend’s intervention and I entirely agree with her. If we want to see an improvement in the estate of the NHS, we need to have money allocated to it.

When the NHS was at breaking point, my constituents had to feel the pain of not being able to get appointments for their sicknesses. The population I represent already has some of the worst health inequalities in the country, exacerbated by the lack of primary healthcare provision. Some wards in my constituency have no GPs at all, so I welcome the remarks made by Members from all parties about the importance of primary healthcare provision.

Without reform, the NHS is simply not financially sustainable, but alongside reform there must be a culture of change in NHS England. The Public Accounts Committee report highlights that last year NHS England failed to approve ICB financial plans until months after the financial year had begun. Working with local NHS bodies, we have seen examples of ICBs, as other hon. Members have said, talking a good talk on prevention and public health, but we see a lack of action from many areas on commissioning in a way that has a positive impact on prevention.

--- Later in debate ---

[Ashley Dalton]

Everyone knows that the previous Government’s promise of 40 new hospitals was a fiction: there were not 40, they were not new, and many of them were not even hospitals. We have put the programme on a firm footing with sustainable funding, so all those projects will actually be delivered.

In response to the Chair of the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran), I am more than happy to work with the Committee to clarify the funding for NHS providers. I understand that there is already quite of lot of information in the public domain, and I am more than happy to have that conversation with her.

On financial levers and incentivising prevention, the 10-year health plan is really the driver of all our shifts—from analogue to digital, from hospital to community, and from sickness to prevention. It will set out how we achieve transformational change. As part of that, the plan’s working groups are looking at how payment mechanisms, funding flows and contracting will need to change to build a health system that is fit for the future.

On ENICs, we have been here before. The Government will provide support to Departments for additional ENICs for public sector employees, and commissioned services are all subject to local negotiation with providers.

I want to move on to public health, in which I take a particular interest. I agree with hon. Members on the importance of public health investment. In 2025-26, through the public health grant and the 100% retained business rates arrangements for local authorities in Greater Manchester, we are increasing funding to £3.858 billion—a 5.4% cash increase, and 3% in real terms. It is a priority for this Government to confirm future year allocations as early as possible, and we will seek to do that. It is a priority of mine.

We have talked a lot about social care. Louise Casey commands great respect across political parties, the Government and the NHS, which is why she will lead the independent commission on adult social care as part of our critical first steps towards delivering a national care service. She will begin her work in April, drawing on people who need care and their families, staff, politicians, and the public, private and third sectors to inform the recommendations on how we rebuild adult social care.

[Anna Dixon]

I welcome the Minister to her place and congratulate her on her new role. On building a national care service and the Casey review, will she reassure me and other Members of the House that there will be a first-phase report in 2026 to inform the spending review, and that we will have action sooner than the 2028 final report?

[Ashley Dalton]

I can confirm that, as has already been stated, those interim reports will take place, with a view to informing spending reviews.

I want to pick up on the point made by the hon. Member for North Shropshire (Helen Morgan) about the cross-party talks. My right hon. Friend the Secretary of State wrote to colleagues from all the UK-wide parties to invite them to joint cross-party talks in February. Not everybody was able to take part—a significant number of people were not—and we think it is really important to have a wide range of views at such talks. We have taken the decision to reschedule them, but we will make sure that they take place. We are seeking to reorganise those talks at the earliest opportunity, and I can confirm that the intention is to go ahead with them.

We have committed to look at how we can further expand the role of pharmacies and better utilise the clinical skills of pharmacists, and we have now resumed our consultation with Community Pharmacy England regarding the funding arrangements for 2024-25 and 2025-26. I am unable to say any more on that until the consultation has finished.

To wrap up, we are undertaking the largest capital investment in our national health service since Labour was last in office, but if we are to deliver our promises to the British people, we must deliver faster improvement than even the last Labour Government achieved. Investment and reform are what we promised before the election, and investment and reform are what we are delivering. We will ensure that the NHS is there for people when they need it; we will tackle the big killers, such as cancer; and we will create a fairer Britain, where everyone lives well for longer, while making sure that every penny of taxpayer money is well spent. I commend the estimates to the House.