Income Tax (Charge)
Ben Coleman Excerpts(1 month, 2 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(2 months 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(2 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.