Department of Health and Social Care

Ashley Dalton Excerpts

Wednesday 5th March 2025 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

Let me begin by thanking the Chair of the Public Accounts Committee, the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown), for opening the debate. As a Public Accounts Committee alumna, it is my pleasure to have my first outing at the Dispatch Box for this debate.

I also thank all other colleagues for taking part. The number of right hon. and hon. Members who have contributed today speaks to the significant interest in our health and social care services not only in this House but in the country. The wide range of issues raised shows how broad and overarching our NHS and social care services are. I will try to cover as many of those issues as I can, and if I miss anything, I will happily pick it up with hon. Members afterwards. I will also attempt to respond to all hon. Members who have spoken, but if I miss anyone, I hope they will forgive me, because we have had so many contributions.

The Chair of the Public Accounts Committee, as well as the hon. Member for St Ives (Andrew George), my hon. Friends the Member for Poole (Neil Duncan-Jordan) and for Sheffield South East (Mr Betts) and many other Members, talked about social care. Productivity was a key point mentioned by the Chair of the Public Accounts Committee, as well as by the right hon. Member for Salisbury (John Glen), the hon. Member for Farnham and Bordon (Gregory Stafford) and my hon. Friend the Member for Barking (Nesil Caliskan). Prevention in public health was raised by many Members—as the Minister responsible for those areas, I am delighted to discuss that.

My hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) talked about dentistry, and shifts were mentioned by many hon. Members. My hon. Friend the Member for Barking talked about the work not only of public health but of local government, and the role of ICBs. It was great to hear my hon. Friend the Member for Gloucester (Alex McIntyre) talk about his pride in the NHS. This Government will always stand by our NHS and will always keep it free at the point of use.

In her autumn Budget, the Chancellor took the necessary decisions to put our NHS on the road to recovery, with an increase of more than £22.5 billion in day-to-day health spending and over £3 billion more in the capital budget over this year and the next. Thanks to her, we are taking the first steps towards fixing the foundations of our NHS and making it fit for the future. I say to the shadow Minister that yes, this will make a difference, because it is not just about the money but about making the right choices.

[Gregory Stafford]

Will the Minister give way?

[Ashley Dalton]

I will, but very briefly, because we have very little time.

[Gregory Stafford]

I thank the Minister, and welcome her to her place. This, I think, is the fundamental point that Conservatives are making. We all accept that we want to see a shift from acute hospital provision to social care, but when the Chancellor’s Budget does not reflect that and when the national insurance rises hit the social care end of the spectrum, how can the public have faith that what the Minister says is anything more than rhetoric?

[Ashley Dalton]

I am coming to all of that.

Since coming into office, the Government have made choices. We have ended the resident doctors strike. We have published our elective reform plan, which will cut maximum waiting times from 18 months today to 18 weeks by the end of this Parliament. We have introduced investment and reform in general practice to fix the front door to the NHS and bring back the family doctor. We have started to get waiting lists falling, and we have kept the promise in our manifesto to deliver an extra 2 million appointments in our first year, a target that we have actually smashed in the first seven months. Anyone who thinks the Chancellor was wrong to make the necessary decisions and trade-offs must explain what they would cut from that list. Anyone who thinks they could have achieved everything we have done in less than a year without the autumn Budget is living in cloud cuckoo land.

Today we are setting out our supplementary estimates to the House. Funding will help the NHS to deliver 40,000 extra elective appointments a week, and to make progress on reducing the number of patients who wait longer than 18 weeks between referral and consultant-led treatment. We will publish our departmental budgets for the next financial year in the spring through phase 2 of the spending review.

[Ben Coleman]

Will my hon. Friend give way?

[Layla Moran]

Will the Minister give way?

[Ashley Dalton]

I will give way very briefly.

[Layla Moran]

The Minister will have noted, on page 53 of the estimates, a £1 billion decrease in capital spending in the departmental accounts. Will that be explained, and can the Minister explain now how new hospitals constitute day-to-day spending?

[Ashley Dalton]

I will be coming to that, but I thank the hon. Lady for raising it.

We have talked about productivity, an issue that has been raised by many Members including the Chair of the Public Accounts Committee. I am delighted that Members on both sides of the House, including Conservative Members, have now recognised and accepted the value of the Darzi report, which this Government commissioned.

We are committed to meeting a 2% productivity target by 2025-26. To help us to achieve that, there is a £2 billion investment in NHS technology, allocated to freeing up staff time, ensuring that trusts adopt electronic patient records—we have heard a great deal about old-fashioned paper today—and enhancing cyber-security measures, while also improving patient access to services via the NHS. The current measures of health productivity data do not capture all the outputs and outcomes adequately, and NHS England is working with the Office for National Statistics and the University of York to refine those metrics. Reform is at the heart of our 10-year plan.

We are rebuilding our capital-starved NHS through £1.6 billion of national capital funding in 2025-26, which will help us to achieve constitutional standards. The money will help to deliver more than 30,000 additional procedures and more than 1.25 million diagnostic tests as they come online through investment in new surgical hubs and diagnostic scanners, new beds across the estate, and a £70 million investment in new radiotherapy machines to improve cancer treatment. Questions have been asked about the shift from capital to revenue. Some of investment has met historic need, including capital funding for technology and new hospitals programmes, but because of the nature of the funding it needed to be defined as revenue. It is still being spent on those programmes. The autumn Budget included a commitment to ban shifting from capital to revenue, and I can confirm that no shifts of that nature have taken place since then. I will now give way.

[Ben Coleman]

I am most grateful to the Minister for giving way to me and not to an Opposition Member this time, splendid though they are.

The Minister probably shared my great disappointment when the last Government put no money into the new hospital programme and threw Charing Cross hospital, in my constituency, out of the programme. May I share with her my delight that the Government have put Charing Cross back into the programme and are funding it, with a timetable that the last Government failed to deliver?

[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.