New Hospital Programme Review
Ben Coleman Excerpts(1 day, 7 hours ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
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(1 day, 7 hours ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
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(2 weeks, 1 day ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
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(2 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
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(3 months ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
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(3 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
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.