Oral Answers to Questions
Debate between Caroline Johnson and Wes Streeting(1 month ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
Given the findings of the Sullivan review on patient and health safety, which came about as a result of inaccurate and poor data collection, can the right hon. Gentleman confirm what meetings he has had with Secretary of State for Science, Innovation and Technology to discuss the reliability of the data on sex that is intended to be used by the digital verification platform in the Data (Use and Access) Bill?
Wes Streeting
I am grateful to the shadow Minister for her question. I speak to the Science Secretary on too frequent a basis—on a daily basis. He and I are both looking very carefully at the findings of the Sullivan review and working through its implications for both the health and care services, for which I am responsible, and for the Government digital and data services, for which he is responsible.
Dr Johnson
The UK Health Security Agency, for which the Secretary of State is responsible, publishes health statistics. This includes data on sexually transmitted infections, which is published by sexual orientation and sex. However, a footnote states that women are defined in the dataset as “women and trans women”, which does somewhat undermine the value of the data. What will the Secretary of State do to ensure that data is not just collected properly, but published and presented in a way that is most clinically useful?
Wes Streeting
The shadow Minister raises a good example of how conflation of sex and gender identity is not helpful both in terms of data analysis and of recognising health inequalities. It is also not helpful in making sure that we understand variances between people based on their different backgrounds and characteristics and that we provide targeted, personalised and effective healthcare that deals with healthcare inequalities. That is why we are carefully studying the recommendations made by Professor Sullivan, with a view to making sure that we are meeting the needs of everyone, including the trans community, who I understand, not least because of the way that the debate has been conducted in recent years, are anxious about the implications of the report. However, I genuinely think that the report will lead to better, more inclusive and fairer outcomes for everyone, including the trans community.
NHS England Update
Debate between Caroline Johnson and Wes Streeting(1 month, 2 weeks ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
I thank the Secretary of State for advance sight of his statement. It is disappointing, once again, that it was not made to the House first; in recent days, there have been numerous media briefings about this potential restructure.
Under new leadership on the Conservative Benches, we believe in a leaner and more efficient state. That means using resources effectively, reducing waste and preventing duplication, spending money where it is most beneficial. After all, the public understandably want to see the focus on patient care and not on backroom managers. Therefore, we are supportive of measures to streamline management, and we do not oppose the principle of taking direct control, but we need to know what steps will be taken to meet targets while all the upheaval happens. We need to know the specifics of what is being planned.
What are the timeframes for the abolition of NHS England? By what date will it be completed? How many people will be moved into different roles? How many people will lose their jobs altogether? How much money is that expected to save? Labour runs the NHS in Wales, which has the highest waiting lists and the longest waiting times in Great Britain. What lessons has Labour learnt from its failure in Wales?
NHS England, as the Secretary of State said, has just lost much of its leadership. Is that because they no longer had confidence in the Secretary of State, or because he did not have confidence in them? Perhaps he can tell the House whether Alan Milburn will keep his job in the upheaval. We also need to be clear that moving people into different roles will not fix the challenges that face the NHS.
The Secretary of State has spoken about taking direct control. That may help him ensure that the NHS stops wasting money on expensive diversity, equity and inclusion staff, and ensures that it provides dignity and privacy for female staff and patients, but what does it mean for clinical prioritisation? Will conditions that are less common and have less glitzy campaigns and fewer celebrity backers suffer because the Secretary of State now has political considerations? Does the Secretary of State have the bandwidth for this, given he has such a busy role already? How does the centralisation of power measure up with the commitment to give more powers to regional bodies and local integrated care boards?
In the first six months after entering office, the Government announced 14 reviews, consultations and calls for evidence, all of which require more staff. Are those jobs at risk, or are other pre-existing roles set to be cut? This announcement comes the same week as Labour’s Employment Rights Bill passes through the Commons. Is the Secretary of State getting a move on because he knows that red tape and bureaucracy will dramatically increase afterwards and make the decisions he has to take more difficult to deliver?
A drive to improve efficiency in the civil service and the management of the health service is welcome, but what about the NHS itself? The Government slimmed down our productivity plan and delivered a 22% pay rise in return for no modernisation or reform. How will those decisions improve efficiency? I asked the Department what proportion of people with a nursing qualification working in the NHS are in patient-facing roles, but the Minister said that they did not know. How can he use the skills and resources effectively if he does not know where those skills and resources are?
The Prime Minister is making a lot of noise about productivity and cutting waste, but he still refuses to set a target for cutting the civil service headcount. Thanks to the decisions he and the Chancellor took at the Budget, the size of the state is growing rapidly, not shrinking, while changes to national insurance contributions have diverted funding away from the frontline into compensating the Treasury. Ultimately, any restructure will be challenged by the Government’s continued failure to tackle immigration. While steps to improve efficiency in the healthcare service are welcome, these words ring hollow across Government.
Wes Streeting
I will take the more serious questions from the shadow Minister first. On timeframes, we will work immediately to start bringing teams together, as we have done with the one-team culture we have been building over the past eight months. I want the integration of NHS England into the Department to be complete in two years.
The shadow Minister asks about the reduction in the number of officials. NHS England has 15,300 staff; the Department of Health and Social Care has 3,300. We are looking to reduce the overall headcount across both by 50%, which will deliver hundreds of millions of pounds of savings. The exact figures will be determined by the precise configuration of staff, and we will obviously keep the House updated on that.
The shadow Minister asks about clinical leadership. One change we will be making with the transformation team is to have two medical directors succeeding Professor Sir Stephen Powis, whose departure from NHS England was planned long before these changes. There will be one medical director for primary care and one for secondary care, underpinning our commitment to the shifts we have described. I must say, there are enormous improvements to be made in clinical leadership for patient outcomes, patient safety and productivity, and I am demanding stronger clinical leadership to drive those improvements to productivity. Frankly, many consultants and clinical teams on the frontline will welcome that liberation—they are hungry for change.
The shadow Minister asks about the workforce data and complains that we have not been able to give her the precise answers. I agree: it is frustrating not having that precise information at my fingertips. I would gently remind her, though, on this as on so many things, that her party was in power for 14 years. She cannot very well complain eight months in given that they left us a woeful, embarrassing data architecture and infrastructure.
The shadow Minister asks about efficiency. Once again, she refers to the resident doctors deal as if it was a failure. The actual failure was leaving doctors on the picket line, not on the frontline, and wasting huge amounts of taxpayers’ money, with cancellations and delays to patients’ appointments, operations and procedures. We stopped that within weeks of coming into office. The deal does include reforms to improve productivity—if she is any doubt about the results, she should look at the fact that despite winter pressures, NHS waiting lists have fallen five months in a row.
Once again, we get the facile points about my right hon. Friend Alan Milburn, who is the lead non-executive board member for my Department. I honestly do not know why he bothers to pay for a mortgage; he lives rent-free in the Conservatives’ heads. They need to move on. By the way, just for the record: Alan Milburn has a record on the NHS that the Conservatives cannot even begin to touch.
The shadow Minister asks about confidence. I am delighted to be introducing a new transformation team. Different leadership challenges require different leadership skills. As I say, I have been really pleased to work with Amanda Pritchard for the past eight months, including on this transition; people should have no doubt about the confidence I have in her skills, talents and abilities, and I think she has a lot still to contribute to our NHS. We do not need to ask about confidence in the Conservative party; it is reflected in the scarce numbers on the Opposition Benches.
What is the lesson from Wales? The lesson is that when there is a Conservative Government in Westminster, the national health service suffers in England, Wales, Scotland and Northern Ireland. That is why we are creating a rising tide to lift all ships. I am sure we will see improvements across the United Kingdom. SNP Members, who are not in their place, do not have any excuses now. As I said before the election, all roads lead to Westminster, and the biggest funding settlement since devolution began is going down the road to Holyrood. There are no hiding places there for the SNP. If people want real reform of the NHS in Scotland, they should vote for Scottish Labour under Anas Sarwar and Jackie Baillie.
People can see here in Westminster the difference that new leadership provides. The shadow Minister laughably referred to new leadership in the Conservative party. Well, it is certainly leaner and meaner, but it is the same old Conservative party. The only thing that the Conservatives have shrunk is their own party. The only jobs that they have laid off are those of their poor party staff. The only thing that they are capable of changing—[Interruption.] Well, come to think of it, I do not think that there is anything they are capable of changing. Instead they look over their shoulder at a party leader who cannot even manage a five-aside team, let alone a country. The Conservatives are just so diminished as a party. I appreciate that it must be so painful for them to watch a Labour Government doing the things that they only ever talked about: reducing bloated state bureaucracy; investing in defence; reforming our public services; and bringing down the welfare bill. The public are asking: “What is the point of the Conservative party?” I bet they are glad that they chose change with Labour.
Oral Answers to Questions
Debate between Caroline Johnson and Wes Streeting(2 months, 2 weeks ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
There were almost 67,000 cases of serious antimicrobial-resistant infections in the United Kingdom in 2023. War is increasing such infections globally; 80% of patients in one Kyiv hospital in Ukraine are said to have such infections. The Conservative Government had a plan to tackle that. Do the Labour Government plan to follow that plan, are they on track to meet those targets, and if not, what will the Secretary of State do about it?
Wes Streeting
I am delighted that Dame Sally Davies continues her work on antimicrobial resistance. That is an absolutely critical issue, and I pay tribute to the previous Government, particularly Minister Quince, for their work on it. It is in the national interest that we maintain not just the national focus but the international focus on antimicrobial resistance, which is why UK leadership in those global fora is so important.
Dr Johnson
Another time when it is important to work together is during a pandemic, such as by sharing research. Unfortunately, recent history tells us that when Labour negotiates, Britain loses out. Can the Secretary of State confirm that, whatever emerges from discussions with the World Health Organisation, he will not reduce the UK’s capacity to take decisions in the interests of the British people.
Wes Streeting
May I just say how regrettable it is that a sensible shadow Minister is sent along to parrot the absurd lines of her leader?
Oral Answers to Questions
Debate between Caroline Johnson and Wes Streeting(3 months, 2 weeks ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
Thank you, Mr Deputy Speaker. [Interruption.] I am sorry—that is the last time I will get called. Thank you, Mr Speaker.
Yesterday, in relation to the elective backlog, the Secretary of State said:
“Where we can treat working people faster, we will, and we make no apology for doing so.”—[Official Report, 6 January 2025; Vol. 759, c. 597.]
Labour politicians have struggled to define what they mean by working people, but his words have caused anxiety. Will he reassure those with disabilities that prevent them from working and retired elderly people who have worked all their lives that they will not be pushed to the back of the queue and that treatment will continue to be provided in the NHS on the basis of clinical need?
Wes Streeting
Of course, clinical need is paramount and must always drive decision making about who to treat when and the order in which people are treated. That is why I find the question posed so deeply disingenuous. [Interruption.] We inherited NHS waiting lists at record levels and waiting times that are frankly shameful. The shadow Minister should be apologising for her party’s record, and she should also apologise for the two-tier healthcare system that sees those who can afford it paying to go private and those who cannot afford it—working-class people—being left behind. That is the two-tier system that the Government are determined to end.
Dr Johnson
The Secretary of State needs to be careful with the words he uses, as you said, Mr Speaker, because his words did cause anxiety among people. It was not a disingenuous question; it was a genuine question to make sure that people are reassured.
It will not have escaped the Secretary of State’s notice that it is cold outside. Removal of the winter fuel allowance has reduced elderly people’s ability to follow the advice that he gave last week, which was to turn the heating on. What assessment has he made of the number of additional admissions caused by his removal of the winter fuel allowance? What effect is that having on the Government’s ability to deliver their reduction in elective backlogs?
Wes Streeting
What the shadow Minister neglects to mention is that the Chancellor has protected the winter fuel allowance for the poorest pensioners, and she has also put in place the warm home discount to assist people with their energy bills throughout the winter. If the shadow Minister does not support the decisions that the Chancellor took at the Budget and ahead of the Budget to raise vital investment for our health and care services, that is fair enough, but then she needs to tell people which NHS services she would cut or which other taxes she would increase.
Oral Answers to Questions
Debate between Caroline Johnson and Wes Streeting(5 months, 1 week ago)
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Wes Streeting
I am grateful to my hon. Friend for her question. I am looking carefully at the pressures on hospices. In fact, only last Friday I visited Saint Francis hospice, which serves my constituents and people right across east London and west and south Essex. I saw at first hand the brilliant work it is doing on end of life care, but also the pressures it is under, and I am taking those pressures into account before deciding allocations for the year ahead.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
I have tried repeatedly through written parliamentary questions to get an answer to this without success, so I will try asking it face to face: will the Secretary of State tell the House how much his Chancellor’s changes to national insurance contributions will cost the NHS?
Wes Streeting
The hon. Member talks about the employer national insurance contributions as if they were a burden on the NHS. It is thanks to the decisions taken by the Chancellor that we can invest £26 billion in health and social care. The Conservatives welcome the investment but oppose the means of raising it. Do they support the investment or not? They cannot duck the question; they have to answer.
Dr Johnson
The right hon. Member speaks of ducking questions, but it is worrying that three weeks after the Budget he still does not know, or will not tell the House, how much it will cost the NHS. Of course, changes to national insurance contributions affect not just the NHS directly, but suppliers, contractors, charities and other NHS care providers. I know you are a great supporter of your local air ambulance service, Mr Speaker, as I am of the Lincs & Notts air ambulance, which now needs to raise £70,000 extra just to fund this Government’s ill-advised changes to NICs. That £70,000 is a lot of cakes to sell, cars to wash and fun runs to complete, and that is just one example of pressures placed on lifesaving services right across the country. Will the Minister confirm that he will meet the Chancellor, explain the disastrous effects of the policy and insist that she reverses it?
Wes Streeting
Again, we have not yet announced how we are allocating the budget for the year ahead, but I remind the Conservatives that it is thanks to the choices the Chancellor made in her Budget that she is able to invest £26 billion in health and social care. Would they cut the £26 billion this Labour Government are investing in the NHS? If not, how would they pay for it? Welcome to opposition.
Access to Primary Healthcare
Debate between Caroline Johnson and Wes Streeting(6 months, 1 week ago)
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Dr Johnson
I thank the hon. Gentleman for his intervention. I have talked about the challenges the NHS faces. I will come shortly to the achievements of the Labour Government so far in the Department of Health and Social Care.
Turning back to technology, I was saying that I agree with the Secretary of State on how technology can improve NHS services. Over the last few years, in my professional capacity, I have seen improvements in making communication between primary and secondary care and within secondary care much more efficient. As a patient, I have used the askmyGP service, which is an excellent way to communicate with a GP, particularly for working people. I have also used the NHS app, which millions of people have downloaded and which has huge potential. I hope he intends to build on that potential and harness the benefit of AI for diagnostics in particular.
The Secretary of State and I also agree on the importance of prevention. It is vital to make the NHS accessible to those who need it, but it is even better if people stay healthy in the first place. Before the election, he was supportive of measures to protect children from the dangers of vaping—measures I campaigned for actively. In fact, he was quite critical that it had not been done sooner, as in some respects was I. Given that the legislation has already been written and that it passed both Second Reading and Committee stage with the support of his friends on the Labour Benches, why is it taking him so long to produce a tobacco and vapes Bill? Can he guarantee that he will deliver it, like a present, in time for Christmas—for clarity, I am hoping for this Christmas?
The Secretary of State for Health and Social Care (Wes Streeting)
Have you been naughty or nice?
Dr Johnson
I have been a good girl, thank you, Secretary of State.
Furthermore, can the Secretary of State explain how cancelling dozens of new hospitals will reduce pressure on general practice? Can he explain how cutting the winter fuel payment for millions of pensioners will help the NHS? The End Fuel Poverty Coalition predicts that Labour’s winter fuel payment cut will result in an additional 262,000 pensioners needing NHS treatment because they are cold, resulting in a great deal of suffering and millions of pounds of additional cost to the NHS. Does he agree with that assessment? I have asked repeatedly, in both oral and written questions, if the Government will conduct a proper impact assessment of the policy on the NHS and on the wellbeing of vulnerable older people. Will he commit to producing and publishing such as report?
Further on the issue of prevention, the right hon. Gentleman will know that folic acid supplementation can prevent neural tube disorders, such as spina bifida and anencephaly. The previous Government brought forward regulations on the matter. What conversations has the Secretary of State had with the Department for Environment, Food and Rural Affairs about ensuring that that work is continued?
Our approach to dentistry was also underlined by prevention. We introduced the Health and Care Act 2022, which gave the Secretary of State the power to introduce water fluoridation schemes. Those powers have since been used to extend existing schemes, particularly in the north-east of England. Does the Secretary of State intend to continue that work and exercise the powers the previous Government gave him? He knows that I am passionate about dentistry. I have raised the issue many times in the House, including by securing an Adjournment debate on dentistry in Lincolnshire. It troubles me greatly that children are coming to hospital for multiple dental extractions due to rotten teeth. It is worth noting that the issue is not a shortage of dentists overall or, as the hon. Member for North Shropshire (Helen Morgan) says, a shortage of money, but a shortage of dentists doing NHS work rather than private work specifically.
The previous Government were encouraging dentists to take up NHS work with a range of measures, including golden hellos for dentists in underserved areas, dental vans going out to rural communities, and tie-ins for new dental graduates. We were also in the process of broader contract reform after a small change in the units of dental activity rate when we went into the election. Let us look at Labour-run Wales in comparison. Wales is delivering only 58% of pre-pandemic dental activity. It is burdened with the highest proportion of NHS dental practices not accepting adult patients and the longest waiting lists in the UK. One in four Welsh residents is currently on a waiting list. The new Secretary of State for Wales has said that the Government “will take inspiration from” Labour-run Wales on dentistry. Given their woeful record in office, I sincerely hope that that is not the case.
Before the election, when I listened to the Secretary of State for Health and Social Care say that Labour had a plan to reform and modernise the NHS, I believed him, but in Monday’s debate on the Lord Darzi report, we uncovered that his plan was not really a plan at all, but a list of desired outcomes and a proposal to make a plan if he got into office. It is unclear how long this plan will take to develop. The Minister for Secondary Care said that it is a listening exercise like we have never seen before, but how much will that cost, and had Labour not been listening already?
Oral Answers to Questions
Debate between Caroline Johnson and Wes Streeting(9 months ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
I congratulate the right hon. Gentleman on his position. I should declare that I have been working in the NHS for 23 years, currently as an NHS consultant paediatrician. I look forward to using that experience in my new role as shadow Minister of State to scrutinise the Government constructively.
Under the new hospital programme, the previous Government had already opened six hospitals to patients, with two more due to open this financial year and 18 under construction. The Government are now putting that at risk by launching a review of that work, delaying those projects, which are vital to patients across the country. Could the right hon. Member please confirm when the review will be completed?
Wes Streeting
First, I welcome the hon. Lady to her new post. I must say I preferred her much more as a Back-Bench rebel than a Front-Bench spokesperson, but I have enormous respect for her years of contribution to the NHS and the experience that she brings to this House. I always take her seriously.
However, on this one, once again I say to the Opposition that they handed over an entirely fictional timetable and an unfunded programme. The hon. Lady might not know because she was not there immediately prior to the election, but the shadow Secretary of State, who is sitting right next to her, knows exactly where the bodies are buried in the Department, where the unexploded bombs are, and exactly the degree to which this timetable and the funding were not as set out by the previous Government.
Access to GP Services and NHS Dentistry
Debate between Caroline Johnson and Wes Streeting(2 years, 10 months ago)
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Wes Streeting
I wholeheartedly agree with my hon. Friend; it is the trend with this Government to seek division, sow division, pass the buck, devolve the blame and not take responsibility for anything. What Opposition Members would not give for just one day of being able to govern in the interests of the people in this country! This Government want to give the appearance of being in office but not governing at all. That is what is happening on their watch. If that is not bad enough, against a difficult economic backdrop, with scarce resources, not only is the way in which they manage and govern bad for patients, but it is squandering taxpayers’ money.
Wes Streeting
I will give way in just a moment. The problems in general practice are storing up problems for the rest of the NHS; as we have heard, people are presenting in accident and emergency because they cannot see a GP. That failure is costing the taxpayer dearly. A GP appointment costs the NHS £39, but a visit to an urgent care centre costs it £77 and a visit to the emergency department costs it £359. The Government’s failure to invest in new GPs may be penny-wise but it is pound-foolish. It is wasting money and inconveniencing patients, and it is not the way to manage the NHS. One of my constituents wrote to me yesterday to say that if she wants a same-day appointment for her baby, her GP sends her to A&E. She wrote:
“I was sent to A&E to check a newborn baby’s suspected ingrown toenail that had no sign of infection. How is going to A&E for a non-urgent matter a good thing for anyone.”
Yet that is what our constituents are forced to do, because they cannot get a GP appointment. I hope the hon. Member for Sleaford and North Hykeham can give us some insight as to why.
Dr Johnson
As part of that, I suggest that the hon. Gentleman remembers that GPs take 10 years to train. He is right to say that we have been in government for 12 years, but most of the current GP shortage is because the previous Labour Government did not train those GPs at the time. One of the first things the Conservative Government did was to set in train the opening of five medical schools to increase the number of medical students. We had enough doctors but they do take 10 years to train. The reason I stood up to intervene on the hon. Gentleman was to say that one of the challenges that doctors—I refer to my entry in the Register of Members’ Financial Interests, as a doctor—and members of staff face is being abused in a surgery. I wonder whether he would like to apologise for some of the comments he has made on social media—