Hospitals
Ben Coleman Excerpts(3 days, 6 hours ago)
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Helen Morgan
I will make some progress.
One of the main reasons those problems have not been rectified is successive delays from successive Governments. Shropshire is, again, a prime example. This is not related to the new hospital programme, but none the less, £312 million was granted for the hospital transformation programme in Shropshire back in 2018. Seven years later, while the country has been through five Prime Ministers and eight different Health Secretaries, Shropshire is still waiting for that transformation to take place. Opposition from both the Labour and Conservative councils that serve the area, along with the ridiculously lengthy process that capital expenditure has to go through to be signed off, means that desperately needed improvements have been horribly delayed as construction costs rise. As a result, the original plans have been scaled back and their value diminished.
Helen Morgan
I will give way to the hon. Member for Chelsea and Fulham (Ben Coleman) because he has tried to intervene before.
Ben Coleman
I am most grateful to the hon. Lady for her delayed response. I am struck by her lack of response to two of my colleagues. She did not acknowledge to my hon. Friend the Member for Hammersmith and Chiswick (Andy Slaughter) that in my constituency of Chelsea and Fulham, the Imperial College Healthcare NHS Trust is getting money from the Government as a precursor to rebuilding the hospitals promised to it. More importantly, she did not address the point made by my hon. Friend the Member for Calder Valley (Josh Fenton-Glynn) that we are all reaping the whirlwind of the decisions taken by the Conservative-Liberal Democrat coalition Government. The Liberal Democrats made a choice to go into that Government, to take on roles including as Chief Secretary to the Treasury and as Health Ministers, and to make those cuts and destroy the NHS. We are now reaping the whirlwind of the decisions that she and her colleagues made. Is it not a little bit cheeky of her to make some of the points and claims she is making today?
Helen Morgan
I am pleased that the hon. Gentleman’s hospital is being dealt with, but I am sure that the residents of Torbay will not feel the benefit of that. I am slightly surprised that he thinks that the decade since the Liberal Democrats were in power has had no impact whatsoever. I did address the point that when a party comes into government and has to clear up the appalling mess left by the previous Government, there are difficult choices to be made. His party knows that. Labour Members, for example, have voted to retain the two-child benefit cap and keep a quarter of a million children in poverty—something that no one in my party has ever voted for.
The last time I opened a Liberal Democrat Opposition day debate was in October, and the topic was primary care. I explained how the Government’s failure to invest in primary care was a false economy that increased pressures and costs in the critical parts of the system. The management of our hospital buildings displays that same false economy. Just as spending money on critical care instead of prevention and public health is a poor approach to managing a health service, waiting for the roof to collapse is an irresponsible way to manage NHS buildings. As problems are ignored and investment is poorly targeted, it is the patients and the hard-working staff striving to help them who are forced to suffer.
This is not just about the new hospital programme. Across the country, there are thousands of GP surgeries that need urgent improvement if they are to provide the care that patients deserve. More than 2,000 hospital buildings across England were built before the foundation of the NHS in 1948, while the state of GP surgeries varies wildly. Many surgeries are simply no longer fit for purpose, having been built in the 1950s. Prescott surgery in my constituency, for example, has long been recognised as somewhere that needs to drastically increase in size because the population of the village has increased drastically itself. Despite the land and the community infrastructure levy funding being available, there is no sign of a new surgery being built. As the delay continues, the costs are rising and the challenge grows for both the council and the integrated care board, which are already under immense pressure to cut their costs.
Instead of pursuing fantasies like the Conservatives or false economies like the Labour party, the Liberal Democrats would invest to save by starting construction now, and ending the epidemic of cancelled operations, closed-off wards and huge sums wasted on emergency repairs. That would save the taxpayer money in the long run and benefit patients much sooner.
Helen Morgan
There have been successive failures in NHS management that all parties need to hold their hands up for—that is a fair point. We should, though, focus on the task in hand rather than continually going back decades, either to the coalition Government or to the Blair Government before that. That is not helpful to our constituents, who want a solution now.
Helen Morgan
No. I have been very generous with my time and I am going to make some progress.
We are also campaigning for a review of outdated Government finance rules that prevent NHS trusts from investing the funds that they have raised into their own buildings. Even NHS managers struggle to access common-sense investment in their facilities due to overly complex rules and glacial processes. Trusts are prevented from using unspent funds on improving their buildings. We need root-and-branch reform, combined with our 10-year programme of investment, to bring our local health facilities up to scratch.
In conclusion, the recent history of the NHS is one of short-term decision making and of the failure of successive Governments to grasp the nettle of long-term sustained investment in the things that matter: hospital buildings, GP services, dentistry, pharmacy and, crucially, the unspoken crisis of social care. The outcome is an organisation that is spending millions of pounds to go backwards. It truly is a false economy.
This Government have spoken warmly of the need to reform the NHS and improve productivity, and we support them in that, but we cannot expect to retain staff and provide high-quality care when so many doctors and nurses are negotiating leaking roofs and sewage backing up on the wards. Dealing with the new hospital programme is a matter of urgency, and I urge the Secretary of State to, at long last, grasp the nettle.
Dr Johnson
The previous Secretary of State made it clear that the hospital was fully funded and would be built. What has changed since then is that we have a new Government who made the choice not to build it. These are choices that the new Government must own.
When the Government came to power, the Secretary of State commissioned the Darzi review, which highlighted the need for more capital investment in the NHS, but decided not to prioritise the delivery of the new hospitals. To govern is to choose, and the Secretary of State has chosen not to deliver the hospitals. We set out our commitment to delivering them on time, with the agreement of the then Chancellor. Of course, spending decisions cannot be made for a future Parliament, but the Secretary of State has chosen not to make the same commitment.
Ben Coleman
It may be helpful I correct a couple of “facts” that the hon. Lady has given. In his election literature, my predecessor as Member of Parliament for Chelsea and Fulham made the clear statement that he had secured the funds for the rebuilding and refurbishment of Charing Cross hospital. When I spoke to the chief executive of the hospital, he said that he had received no such reassurance from the Government, and on coming to power we found that no money had been set aside for the guaranteed refurbishment.
Moreover, this did not just apply to Charing Cross hospital. Across the country, the last Government’s claims to have found the funding were discovered not to be true when we came to power. The right hon. Member for Melton and Syston (Edward Argar), who is talking to the hon. Lady at the moment, lives in my constituency, so he is well aware of the accuracy of what I am saying. [Laughter.] I know; I will get complaints about the bins again now. Would the hon. Lady like to reflect on the accuracy of what she is saying, in the light of the facts as I have set them out?
Dr Johnson
I am afraid that the hon. Gentleman is not correct. The previous Government, and the previous Chancellor, made a clear commitment to providing the money, and to the hospital building project, but the current Government have not chosen to meet that commitment. These are choices that are being made. For now, patients and staff are being denied the quality facilities that they have deserved for decades. For some hospitals, construction work will not even begin until 2039. Will the Minister write to me, giving the date on which each hospital will be completed?
We can see the Labour Government’s lack of ambition. There are 40 hospitals in waves 1 to 3 of their programme—40 hospitals over 15 years—but there are 515 acute, specialist and community hospitals in England. At this pace, the replacement of the NHS estate will require a cycle of nearly 200 years. That is the equivalent of a hospital built in 1825 not being replaced until this year. That is Labour’s ambitious programme.
We can all see the pressures facing the Chancellor as her economic mismanagement hits the country. We cannot tax our way to growth. Perhaps that is yet another reason why growth forecasts have been cut yet again. How do we know that Labour will not come for those already delayed new hospitals in a year or two, and that there will not be further delays or cancellations? The Government have made it clear that the new hospitals are not their priority. Will the Minister give us that guarantee?
Department of Health and Social Care
Ben Coleman Excerpts(1 month, 3 weeks ago)
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Sarah Bool
I want to encourage all our GPs to remain in the UK, giving back, so I am always fully supportive of anything we can do about that.
Sarah Bool
I will make some progress.
That key relationship and contact between a GP and their patient was reinforced by the Public Accounts Committee report on NHS financial stability, published in January, which concluded that a reallocation of funds was needed to focus attention from sickness to prevention.
I am a massive advocate of prevention. Many hon. Members will know that I talk about being a type 1 diabetic; if they have not heard me talking about it, they may have heard one of my sensors going off for a low blood sugar. There is so much we could do in preventative measures in the treatment of diabetes. Treatments can be expensive as an initial outlay, but they will solve many long-term problems. We cannot prevent type 1 diabetes, but we could have earlier testing in children, for example, so that we could avoid them being diagnosed when in a state of diabetic ketoacidosis, which can be fatal. Families could be prepared and ready, and children could avoid hospitalisation, saving costs to the NHS while also saving lives.
We can also ensure access to technology that can avoid huge complications. Poor blood sugar control can result in loss of eyesight and limbs, alongside heart and other conditions. Making continuous glucose monitors and even insulin pumps available across the country can significantly help the patient and, again, in the long term save the NHS money. At the moment there is a very unfair postcode lottery, so I ask the Minister to consider ways to tip the funding balance, to ensure both prevention and community care measures are properly funded.
Finally, any reforms to the NHS must consider the computer operating systems in place. Many of my constituents must go out of the constituency for their hospital care, be it to Northampton general hospital, the John Radcliffe hospital, Horton general hospital, Milton Keynes university hospital or Kettering general hospital, but all those trusts operate on different systems, with the result that my constituents often cannot have their scans or medical notes shared easily. That is frustrating for residents, and potentially fatal. One resident noted that his wife was nearly given a drug that she was allergic to, because her notes had not been able to be shared correctly—it was only his presence that saved her.
We must ensure that money is spent to look at that and to change the systems, which my hon. Friend the Member for North Cotswolds (Sir Geoffrey Clifton-Brown) has explained very conclusively. We owe it to our constituents to work across the House to better our healthcare and to support the fantastic work of our doctors and nurses.
Helen Morgan (North Shropshire) (LD)
I thank the Chair of the Public Accounts Committee, the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown), for securing this debate and for his excellent opening speech.
We all know that we have reached a crisis point across the NHS and care sectors, with more patients than ever waiting for treatment. That is affecting not just those in need of care and treatment, but those who work tirelessly across the NHS and care sectors, who are feeling the full brunt of the crisis. The Conservatives have a legacy of hours-long waits for ambulances, treatment in crowded hospital corridors—captured in horrifying detail by the “Dispatches” documentary, which looked into the hospital that serves my constituents in North Shropshire—and communities grinding to a halt under the weight of all sorts of waiting lists and backlogs. We urgently need to move forward.
The Secretary of State has repeatedly outlined the need to shift from treatment to prevention and from hospital to community, and the Liberal Democrats absolutely support him in that endeavour—indeed, we called for many measures that would achieve that shift in our own manifesto. Stronger primary care and community services were the strong recommendations of Lord Darzi’s report, which was commissioned by the Secretary of State and has been broadly welcomed.
There has been a great deal of consensus across the House today that we need to take those measures, but I fear that these estimates paint a picture of an NHS that continues to pour money into the previous, failing model in which capital budgets are drained to pay for day-to-day services and a huge proportion of increased spending goes on NHS staffing, while community care and primary care providers wrestle with the huge increase in employer national insurance contributions.
When that is combined with the decision to scrap targets on mental health and community services for the sake of prioritising targets on elective care, we must ask: when will the stated objectives of the Secretary of State really be matched by actions? The latest estimates are an indictment of the broken state of the NHS after years of Conservative neglect, but we urge the Government to go further and faster to address the failure.
Ben Coleman
Having heard the hon. Lady’s comments and the comments of those on the Conservative Benches, may I share with her my confusion? She seems surprised that she has not heard the full solution of what this Government are going to do with the NHS, when it is quite clear that there will be the three shifts, a 10-year plan and a huge amount of reform coming down the line. As that seems to have escaped the Opposition’s attention, has it also escaped hers?
Helen Morgan
There is clearly a point in the debate at which we need to urge the Government to go further and faster. As a constructive Opposition, that is exactly what we will do.
Primary care providers are on their knees, and I am afraid to say that that has been made worse by the national insurance hike announced in the Budget. They cannot meet demand for local appointments as things stand, and in many cases the constraining factor is the estate in which they operate. Prescott surgery in Baschurch in North Shropshire wants to provide additional services to the community and keep people away from hospital, but the surgery is physically not big enough. A local developer has provided land for a new surgery, and the local council has community infrastructure levy funding for that building, but it cannot be done because the ICB will not pay the notional rent, which everybody has agreed to forfeit. It is crazy. I hope that the Minister can commit to finding some kind of easy solution to that kind of nonsensical situation that we find ourselves in.
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.
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.
New Hospital Programme Review
Ben Coleman Excerpts(3 months ago)
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Wes Streeting
I am very aware of the challenges in East Kent and the challenges of providing good-quality care and the facilities that people need. I am sure that Ministers will be happy to receive representations from the right hon. Gentleman.
The right hon. Gentleman asks about the Government’s commitment to building 1.5 million more homes. Let me reassure him and the House that the Deputy Prime Minister and I, as well as other members of the Cabinet, are discussing very carefully how we can make sure that alongside the new homes that our country needs, we have the infrastructure and the public services that people deserve.
Ben Coleman (Chelsea and Fulham) (Lab)
My predecessor in Chelsea and Fulham claimed to have secured funding for Charing Cross hospital. That claim went out on election literature throughout the constituency. At the time, I doubted it. Today’s announcement confirms beyond any doubt that the money was not there. What he was saying was not true.
I welcome the honesty and realism of the Government’s statement today. It is about time the British people had a Government playing straight with them and telling them the truth. [Interruption.] Instead of laughing and jeering from the Conservative Benches, which is of no use to my constituents in Chelsea and Fulham who were promised the money for Charing Cross hospital when it was never there, I would like to see some contrition. On a more positive note, can the Secretary of State assure my constituents that the timetable that he has set out will be met?
Obesity: Food and Diet
Ben Coleman Excerpts(3 months ago)
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Ben Coleman (Chelsea and Fulham) (Lab)
I congratulate my hon. Friend the Member for Stroud (Dr Opher) on securing this hugely important debate.
When I was writing my maiden speech back in July, I did some research into my predecessors, as one does. It was fascinating to see that it had been nearly 120 years since the voters of Chelsea elected a non-Conservative MP. He was Mr Emslie John Horniman, lately of the Horniman museum. His father, Frederick Horniman, was an MP under Queen Victoria. I was thinking that Mr Horniman senior would find a lot of similarities between his time as an MP during the Victorian era and the job today. The main building is largely the same, although it was possibly even colder in those days; some of the rules and procedures are the same; and he would probably even find some familiar faces among colleagues in both Houses.
Thankfully, one of the big differences between Mr Horniman senior’s time and today would be the food. That is not just because the Victorians would not be enjoying the famous parliamentary jerk chicken, but because when it came to the food that people ate in Victorian times, the story was one of adulteration and contamination. Describing the Victorian history of adulteration and contamination of food, the US professor of history Anthony Wohl says:
“The list of poisonous additives reads like the stock list of some mad and malevolent chemist”.
If we had enjoyed a glass of beer here with Gladstone or Disraeli, we might also have been drinking strychnine and hallucinogens. With wine, we could have imbibed sulphate of copper. The mustard with our lunch would probably have come with added lead chromate. Our Gloucester cheese afterwards might well have owed its rosy hue to red lead. It is no wonder that indigestion cures in Victorian times were so popular.
Thank goodness things are so different today. Thank goodness we have food standards. Thank goodness we do not allow people to eat things that make them so ill—except that we do. Day in, day out, food manufacturers add substances to food that, on the scale at which they are eaten today, quite legally damage people’s health. Supermarkets promote them and sell them. As a result, obesity, type 2 diabetes and the many other medical problems to which my hon. Friend the Member for Stroud referred have become huge issues in this day and age.
John Glen
The hon. Gentleman is making a thought-provoking observation, but does he acknowledge that in times past, the proportion of income that any individual, from whichever class, spent on food was considerably higher than it is today? If we are to get to the heart of the matter, we have to address the wider challenge of our society’s expectations of how much money we should spend on food. Does he not agree that we are addicted to cheap food?
Ben Coleman
The right hon. Member makes an excellent point that I will come to in a moment.
The additives that cause so much harm today have simpler names: sugar, salt and fats. In moderation, all of those are fine, but the problem is that they are being shoved into our food willy-nilly in an effort to preserve it and—on the right hon. Member’s point—to make it cheap, alongside making it more addictive by design. As a result, we have what the House of Lords Food, Diet and Obesity Committee’s report rightly describes as a public health emergency. We now have one of the highest rates of obesity among high-income nations. Only tobacco shortens British lives more than poor diet.
Sir Alec Shelbrooke
The hon. Gentleman is making some very important points. I would add that adult obesity is not necessarily down to the kinds of food that he has outlined. When people are tired or feeling depressed, just the satiation of eating—even if it is healthy and they are eating more than they should—has the same effect. I used to have cigarettes, which did that, and sometimes people drink to do it, but it could also be done with healthy food. It is about quantities that cannot always be controlled, and there is a bigger link. I totally agree with what the hon. Gentleman is saying about these addictive substances, but they are not the only part of the puzzle.
Ben Coleman
I am grateful for the right hon. Gentleman’s comments. I was not attempting to put together the whole puzzle, but additives are an extremely important part of the puzzle. We do ourselves a disservice if we pretend that sugar, salt and fats—eaten in the quantities they are today—and the ready food that can be bought so cheaply are not poisonous, and not huge problems that we need to address.
I am not wild about the term “obese” because of the negative, pejorative connotations that can make people feel awful about themselves, as has been said, but it is the best term we have at the moment. Over a fifth of children in this country—22.1%—are obese. The figure is even higher in my constituency, which contains some of the country’s richest people, as well as many residents living in poverty. In the London borough of Kensington and Chelsea, 23.4% of reception pupils, aged four to five, are obese. In the borough of Hammersmith and Fulham, 22.4% of reception pupils are classified as obese. This is a problem everywhere, not just in the poorest parts of the country. It is therefore hugely good news that the Government have identified a shift from ill health to prevention as one of the three major objectives of their health mission.
It is even better news that a cross-Government national food strategy is being developed. What would I like to see in that national food strategy? What should be done? I would like us to start by realising that it is time to stop placing excessive emphasis on individual responsibility. That may be hard to swallow for some people, but the Lords report makes it clear that 30 years of policies that rely solely on personal choice, rather than tackling the underlying drivers of unhealthy diets, have failed to shift the dial. Sadly, under successive Governments, these policies have contributed to widening health inequalities.
As my hon. Friend the Member for Bolton South and Walkden (Yasmin Qureshi) noted, the Lords report rightly praised the last Government’s sugar tax on soft drinks. Officially called the soft drinks industry levy, it was a significant public health success—people are consuming less sugar. While obesity remains an overall problem, it has fallen to an extent, particularly among girls aged 10 and 11 in the most deprived areas. Fewer children are having to go to hospital to have their decayed teeth pulled out. That brings me to the lack of dentists after 14 years of Conservative Government, but I will not go there now. The sugar tax has saved millions, possibly billions, of pounds in healthcare costs, as well as a lot of misery. It is a pretty good example to follow, so I support the call by my hon. Friend the Member for Stroud for the levy to be extended to more food products and for similar action to be taken on salt and fats.
I am glad that the Government are delivering on their manifesto pledge to give children the best and healthiest start in life by banning the targeting of junk food at children. Just as advertising restrictions contributed to a decline in the number of smokers, I hope that restricting the advertising of unhealthy foods will contribute to a decline in childhood obesity. I also agree that labelling food better, to distinguish between healthy and less healthy products, is essential. It already works, as allergy sufferers are benefiting from Natasha’s law, which requires food businesses to fully label their ingredients.
However, targeting unhealthy food is not enough. Even unhealthy food is better than no food, for those who cannot afford healthy ingredients, for those who cannot find healthy ingredients or for those who do not know how to cook them. I am not arguing that we should make crap food so expensive that people are forced to go elsewhere to buy even more expensive alternatives. As the hon. Member for Newbury (Mr Dillon) said, it is of fundamental importance that healthy food should be affordable to everyone and widely available wherever they live. At the moment, it is far from either. It is no good badgering people to eat five pieces of fruit and veg a day if they cannot afford to do so or if it is not available locally—that is just patronising.
Jonathan Davies (Mid Derbyshire) (Lab)
I am surprised that no one has mentioned the rise of food banks. Does my hon. Friend share my view that, although well-meaning people give produce to food banks, it is often tinned products or ready meals that people need to cook at home, which may be an inadvertent driver of this issue?
Ben Coleman
That is a very good point. The poverty in this country now and the cost of energy is causing people in my constituency to go to food banks and ask for foods that they do not have to cook. We are offering people food that might not always be of the best quality, and food banks tell me that a lot of healthy, fresh fruit and veg goes to waste because people are either worried about the cost of energy or simply do not know how to cook. These are addressable problems; these are things that we can do something about if we want to do so.
I strongly back the House of Lords report’s recommendation that the revenue from a salt and sugar reformulation tax should be used to make healthier food cheaper, particularly for those on low incomes. I would like some of the revenue to go to organisations such as Alexandra Rose, a charity operating in my constituency. It makes healthy food affordable and accessible to families on low incomes by handing out vouchers so that pregnant women and the families of children under five can buy fresh fruit and veg at local markets or independent shops.
In the heart of Fulham, 376 families and 587 children have enjoyed £85,200-worth of fresh fruit and veg from our wonderful North End Road market, which has operated since late Victorian times. Alexandra Rose tells me that, six months after starting the project, 64% of children are meeting their five-a-day target, compared with just 7% when it began. As the Government develop their food strategy, I encourage them to consider supporting such charities to extend their work through national action.
Another issue is the accessibility of food, and I do not think this point is addressed enough. Many parts of this country are healthy food deserts. In his annual report, Professor Sir Chris Whitty, the chief medical officer, said that
“families in inner-city areas are less likely to have access to healthy, affordable food options”
and as a result they will have shorter and unhealthier lives. We have to ensure that good food is available at an affordable price. I hope the food strategy will look at that, as well as at teaching basic cookery in schools—that is another important point.
Change will take time, but it can be done. It just needs the political will. I hope we will reach a position where, if Mr Horniman could come back to see us, he would be delighted. After all, we must remember that he took immense pride in the tea his family produced; it was one of the very few to be declared free of chemicals and safe to drink in the 1850s. Let us hope we can say the same about our food in the future.
Health and Adult Social Care Reform
Ben Coleman Excerpts(3 months, 2 weeks ago)
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Mr Speaker
May I suggest that we help each other by asking short questions—with short, punchy answers, I am sure? Ben Coleman will set a good example.
Ben Coleman (Chelsea and Fulham) (Lab)
Mr Speaker, I take that personally, in a positive way.
This is a very encouraging statement. It is great to start the new year with some good news and to be so clear that we are keeping our promises as a Government. It is also very good that we are taking the necessary time to create this cross-party consensus on social care while keeping the show so firmly on the road. Carers will be supported to carry out more health tasks, as they do already in my constituency with wound dressing and medicine management. The problem is they do not have any possibility of career progression. [Interruption.] I am sorry, Mr Speaker, I forgot your initial encouragement; I will bring this to a close.
Does the Secretary of State agree that as carers are encouraged to do more health tasks, they need proper opportunities for career progression even within the NHS, in collaboration with local authorities?
Wes Streeting
Brevity was not my hon. Friend’s new year’s resolution, but at your encouraging, Mr Speaker, it is mine. We will provide more training to care professionals to deliver a wider range of tasks in the home, making better use of their skills and the career progression that my hon. Friend describes. Crucially, that career progression must be in status and in pay. That is what we will work with the staff to deliver.
Income Tax (Charge)
Ben Coleman Excerpts(5 months, 3 weeks ago)
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Joe Powell (Kensington and Bayswater) (Lab)
In July, I was proud to be elected the new Member of Parliament for Kensington and Bayswater—a fantastic community but one that has, like so much of the country, suffered 14 years of low growth, stagnant wages and crumbling public services. We have some of the highest health inequalities in the country. The major local hospitals have the largest high-risk repair backlog of any NHS trust in England. Much of my casework involves people in substandard temporary accommodation battling damp and mould and slow repairs, and victims of no-fault evictions and overcrowding.
What compounds that dreadful inheritance is false hope. The fantasy new hospital programme told people in my community that they would have a brand new St Mary’s hospital, as well as overhauls of Hammersmith and Charing Cross hospitals, but it was never budgeted for. Instead of taking responsibility, the Conservatives overspent, avoided the tough choices and signed off cheques that they knew would never have to be cashed. I welcome the Budget, and especially the investment to meet our election commitment to reducing waiting list and expanding surgical capacity and diagnostic hubs. I also look forward to the 10-year plan for the NHS, and I hope that the Chief Secretary to the Treasury will set out in the spending review plans to build a new St Mary’s and invest for the long-term to get people healthier, improve productivity and deliver an NHS that we can all be proud of.
Of course, our housing crisis is directly linked to challenges in our NHS, so I welcome the investment in the affordable homes plan and the warm homes plan, and the reduction in right-to-buy discounts with councils keeping receipts. The damning National Audit Office this week laid bare the cost of inaction on building safety, so I welcome the Chancellor’s support for speeding up the remedial work. The NAO said that, on current trends, the last building will not be fixed until 2037—20 years after Grenfell. That is unacceptable, and I look forward to the Government’s plan to speed up the remedial work.
Trust in politics has collapsed to an all-time low after the covid VIP lanes, the lobbying scandals, and the Liz Truss mini-Budget, for which my constituents have still not received an apology.
Ben Coleman (Chelsea and Fulham) (Lab)
I am sorry for interrupting my hon. Friend at the very last minute, but he raised the important issue of the rebuilding of St Mary’s. May I suggest to him that that should come alongside the full refurbishment of Charing Cross hospital and Hammersmith hospital, as they all form part of the Imperial College healthcare NHS trust?
Joe Powell
I thank my constituency neighbour for that point. The Imperial College trust has the highest major repair backlog of any NHS estate in the country, so we hope that it will, on merit, be a strong candidate in the Secretary of State’s review of the new hospital programme.
As the shadow Minister, the hon. Member for Brentwood and Ongar (Alex Burghart) would know from our work together on open government and international transparency, I welcome the Chancellor’s focus on tackling corruption, fraud, tax avoidance and waste; the ending of the non-dom tax regime; the additional guardrails to ensure that public investment is well spent; and the appointment of a covid corruption commissioner to uncover which companies used a national emergency to line their own pockets. Taxpayers want that money back.
Four months ago, this Government were elected with a mandate for change. The Budget marks the end of the short-term cycles of chaos and mismanagement, and the start of a serious plan to build a fairer and more prosperous Britain.
Access to Primary Healthcare
Ben Coleman Excerpts(6 months, 1 week ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
As a doctor myself, I wish to start by recognising the substantial work ethic and expertise of my primary care colleagues and thank them for all that they do.
Saying what is wrong with the NHS is very easy; solving problems takes much longer and is far more difficult. Rather than the next few hours being filled with constructive ideas, I expect that we will simply hear complaints about the challenges faced by the NHS, perhaps some party political jibes and a wish list of promises and the things that people want to see, but no concrete plans on how to deliver them beyond more money. I hope that I am wrong about that, but I suspect that I am not.
Our NHS is facing significant challenges. We have an ageing population with more complex health needs, a rising demand for services and a rapidly growing population. We also have the legacy from the pandemic, which many are quick to forget. Although we were the first country to deliver a vaccine, there are many persistent problems stemming from the pandemic. Let me give the House an example. Before the pandemic, in 2019, there were 54 women who had been waiting more than a year to see a gynaecologist, but due to the reduction in elective activity during the lockdown, by the time the pandemic was over that number was more than 40,000. This is, of course, replicated across other medical specialties. Although my secondary care colleagues have been working extremely hard to reduce those numbers—and, indeed, they have fallen—the individuals concerned will, on average, visit their GPs more while they are waiting and that inevitably puts more pressure on primary care services.
The simple truth is that we gave the NHS more money than it has ever had and, as a result, it has delivered more clinical activity than ever before, but the ageing population, the rising demand for services and the legacy of the pandemic have meant that, in places, that has not been enough. Many people are not being seen as quickly as we would want them to be.
The previous Labour Administration did not do enough to train new doctors, and the reality is that we cannot train one overnight. The Conservative Government built five new medical schools, and the graduates of those medical schools have recently started work. The Secretary of State says that he will double the number of medical students. That is an item on his wish list with which I agree, but I do have a few questions. Will he build new medical schools, expand the old ones, or do both? If he is going to build new ones, where will he build them? [Interruption.] The Minister for Secondary Care is talking about primary care. I believe that doctors are a part of primary care.
The UCAS deadline to apply for most medical school places to start next autumn was yesterday, so when does the Secretary of State expect these new places to be available and those new students to start? On the broader primary care workforce, we expanded the number of primary care professionals in GP practices, such as dietitians and physiotherapists, and we delivered 50 million more GP appointments last year than in 2019. We also saw the launch of Pharmacy First, which delivered more care in the community while easing pressure on GP appointments. I was pleased to hear the Liberal Democrat spokesman acknowledge the success and the benefits of that programme.
I have a few questions for the Secretary of State. The Conservatives produced the first NHS workforce plan. Can the right hon. Gentleman say whether he will proceed with those plans or write a new one? What are the timescales for his plan? In the spring Budget, we had the NHS productivity plan, with £3.4 billion to improve NHS productivity. Does the right hon. Gentleman still intend to follow that? The Minister for Secondary Care said that she was recruiting 1,000 GPs. Can the Secretary of State tell us how many have been recruited so far?
The Secretary of State and I also agree on the ability of technology to improve NHS services.
Ben Coleman (Chelsea and Fulham) (Lab)
As a new Member, I am learning how this place works, so I am interested to see how much you expect the Labour Government to have achieved in 100 days. Why is it, after 14 years, that you left the country with the longest waiting lists ever and small children having to get their rotten teeth seen at A&E? What can you say that is helpful to us in understanding why the failure of 14 years of Conservatism took place, and do you feel any remorse about that?
Madam Deputy Speaker (Caroline Nokes)
Order. Before I call on the shadow Minister to return to the Dispatch Box—
Ben Coleman
I apologise, Madam Deputy Speaker. I used the word “you” instead of “the hon. Member”.
Madam Deputy Speaker
Yes, several times. It is not me; I have never been a Health Minister. I reiterate that interventions will have to be short. I will be imposing a time limit, as we have to hear from an enormous number of Members this afternoon.
NHS Performance: Darzi Investigation
Ben Coleman Excerpts(6 months, 2 weeks ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
I am mindful of the need to be brief, but I wish to congratulate the hon. Members for South Norfolk (Ben Goldsborough), for South West Norfolk (Terry Jermy), for Esher and Walton (Monica Harding), for Gloucester (Alex McIntyre), for St Neots and Mid Cambridgeshire (Ian Sollom), for Mid Dunbartonshire (Susan Murray), and for Basingstoke (Luke Murphy) on excellent maiden speeches.
When I first heard that the Government had commissioned Lord Darzi to conduct a report on the NHS I wondered two things: why has this report been commissioned, and why has a former Labour Minister been asked to do it? The answer to the first question is still somewhat unclear after this debate. Much of the information is publicly available, and Labour had access to the civil service for six months before the general election, as is routine to help with planning. Before the election, in its manifesto Labour claimed to have a plan, and the Secretary of State said that he and the Government have a 10-year plan to reform and modernise the NHS. In the draft speech that I brought to this debate I was going to say that I assume that is the case, so where is that plan and when will it be published, but during the debate the Secretary of State said that he will soon meet to engage with patients and staff who will write the plan. Does it exist, or is it yet to be written? Given that Lord Darzi specifies that policy suggestions are outside the remit of his report, and notwithstanding the amount of time and dedication he has put into it, what primary purpose does it serve? Is it simply a political statement to cover the right hon. Gentleman’s plan and an increase in taxes in the Budget when it comes?
Dr Johnson
I will not because there is not much time. A potential answer to the second question of why a former Labour Minister has been asked to conduct the report is its silence on a number of issues, for example on increasing the number of medical students. I could not find any reference in the report to the five additional medical schools that were commissioned and opened by the former Conservative Government, and whose first new doctors have recently graduated. Indeed, I found no mention of the NHS workforce plan at all.
My constituency mailbag, no doubt much like that of Members across the House, is full of letters from elderly people who are frightened that their homes will be cold this winter, and that they will become ill, or perhaps even die, as a result. It is notable—again, perhaps this answers my second question—that despite being published two months after the Government’s announcement about the winter fuel allowance, the Darzi report appears to be silent on the subject. The chief medical officer said that,
“cold homes and fuel poverty are directly linked to excess winter deaths”
in his annual report from 2023. Is it remarkable that this report by a former Labour Minister does not mention cold homes? Perhaps it does not recognise the impact of such a decision because no impact assessment has been made.
On 29 July, I asked the Chancellor of the Exchequer what estimate she had made of the impact that her winter fuel payment changes would have on the NHS. Her answer implied to me that that was something that had not been given enough consideration. On 5 September I submitted a written question to the Secretary of State, asking whether he would make an assessment of the winter fuel payment changes on a range of factors relating to the NHS and the health of elderly people, including hospital admissions, deaths, GP appointments and so on. The answer to whether he will do something or not is clearly “yes”, “no”, or “I have already done it”, but it seems the Government struggled to answer that question and I would be grateful if the Minister could do so today: will the Secretary of State make an assessment of the various effects of the changes to the winter fuel allowance and the consequent cold homes on the NHS and the health of elderly people?
Earlier, the Secretary of State said that investment without reform would reduce productivity. He even said that it was “killing with kindness.” Actions, however, speak louder than words, so what substantial productivity gains come with the junior doctors’ 22% pay rise? None. What productivity benefits arise from a significant increase in the wages for train drivers? None. The NHS and the Government are now facing potential future industrial action from groups seeking similar pay deals. The Government’s willingness to take money from pensioners and give it to already well-paid train drivers suggests that such union demands will be successful, further creating a vicious cycle of industrial action that will ultimately be damaging to patients.
I fear that the Labour party sees the Darzi report as a political bludgeon rather than as a blueprint for any meaningful reform. There are undeniable challenges within the NHS—something that I as a doctor see—and we must be honest about them, but instead of a constructive conversation on policy, Labour brings partisan attacks to the table. We now need real leadership, specific reforms, and the courage to make the tough decisions that will keep the NHS suitable for generations to come.