Spending Review: Health and Social Care

Caroline Nokes Excerpts

Thursday 12th June 2025 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

With permission, I would like to make a statement on the outcome of the spending review for the Department of Health and Social Care.

This Government were elected on a manifesto to fix our broken NHS and make it fit for the future. Our job is twofold: first, to get the NHS back on its feet and treating patients on time again; and secondly, to reform the service for the long-term so that it is fit for the future. That is why, in her autumn Budget, my right hon. Friend the Chancellor took the necessary decisions to give health and social care a record uplift in day-to-day spending at the conclusion of the first phase of the spending review. The Department for Health and Social Care received a cash injection of £26 billion covering day-to-day spending and capital investment in 2025-26, compared with the 2023-24 out-turn.

All Opposition parties have rejected that investment and those changes to repair the damage done to our NHS and move it forward. They have rejected two above-inflation pay increases for our NHS staff, the recruitment of 1,700 more GPs and the agreement of a GP contract for the first time since the pandemic, the biggest investment for hospices in a generation, the biggest expansion of carer’s allowance since the 1970s, a boost for older and disabled people through the disabled facilities grant, and the biggest real-terms increase to the public health grant in nearly a decade.

We have also given pharmacies the biggest funding uplift in years, ensured that women across the country can access the morning after pill free of charge, frozen prescription charges for the first time in three years, enabled an extra 3.5 million appointments for operations, consultations, diagnostic tests and treatments—reaching and surpassing our manifesto pledge seven months early. I can update the House on waiting lists, which, as of this morning, have fallen by over 30,000 compared with last month, amid a reduction of 232,000 since this Government took office.

I could go on, but I have only 10 minutes, Madam Deputy Speaker, and I would not like to try your patience, so I will make this point briefly. To govern is to choose, and anyone who opposed the decisions that the Chancellor took in her Budget must tell us what they would have subtracted from that list. We cannot spend money if we do not raise it.

As the Minister of State for Secondary Care, I regularly hear appalling anecdotes from colleagues across the House whose local hospitals, GP surgeries and community services are crumbling, with rusty equipment, leaky pipes and buckets catching rainwater. Phase 1 of the spending review has allowed us to arrest 14 years of shocking neglect and undercapitalisation in the NHS, with a record capital investment of £13.6 billion in 2025-26. [Interruption.] The Conservatives do not like it, but I will go on. That money has gone towards repairing our crumbling hospitals, supporting over 1,000 GP surgeries to modernise their buildings, and installing state-of-the-art scanners across the NHS estate, including the latest linear accelerator machines. However, as my right hon. Friend the Secretary of State has made clear, investment must come with reform. This year we have unveiled our plan for change, our elective reform plan, our urgent and emergency care plan and a crackdown on agency spend in order to reinvest £1 billion into the frontline.

Yesterday, my right hon. Friend the Chancellor set out the conclusion of phase 2 of the spending review, setting budgets that will enable us to make firm plans to deliver on the people’s priorities in the coming years, while going further and faster on reform. Our settlement increases day-to-day spending on health, bringing the budget for my Department and our NHS up to £232 billion by 2028-2029. That means £29 billion more day-to-day funding for the NHS in England, in real terms, than in 2023-24. We have also secured the largest-ever health capital budget, with a £2.3 billion real-terms increase in capital spending by 2029-30, compared with 2023-24, representing a more than 20% real-terms increase by the end of the spending review period.

Let me hammer this point home: investment must be matched by reform. This will be a critical year for the NHS as we achieve better value for taxpayers, who must see their money being spent well and delivering results. We would rather take those difficult decisions now, to save our NHS so that it is there for future generations. NHS England is a top-down organisation—the biggest quango in the world—with a less efficient system than the previous Government inherited in 2010 and twice the headcount at the centre. That is why my right hon. and learned Friend the Prime Minister announced in March that we will bring together NHS England and the Department of Health and Social Care to form a new joint centre. That will put an end to duplication and enable substantial efficiency savings, while bringing the management of our NHS back under democratic control. We will also unlock £17 billion of savings over the spending review period through 2% annual productivity growth in the NHS—money that will be either reinvested in the frontline or used to support radical transformation to make the health system more agile and efficient.

Our elective reform plan set out how we will ensure that by the end of this Parliament 92% of patients will not have to wait more than 18 weeks for elective care. This settlement will drive us further towards that goal, with over £6 billion of additional capital investment over five years across new diagnostic, elective and emergency and urgent care capacity, which could deliver more than 4 million additional tests and procedures.

We will build on the record capital investment from phase 1 to repair the NHS estate. That means continuing the delivery of 25 new hospitals; investing £30 billion in maintenance and repairs, with £5 billion of it to address the most critical building repairs; and reducing by half the number of hospitals containing RAAC—reinforced autoclaved aerated concrete—over this Parliament.

This spending review provides for an increase of over £4 billion for adult social care in 2028-29 compared with 2025-26, including an increase in the NHS contribution via the better care fund. Local authorities with responsibility for adult social care will also benefit from wider reforms to better align funding with need, multi-year settlements and simplification of the funding landscape that enables them to plan more effectively. Last but not least, we have taken steps to simplify targets and better monitor delivery, and we will continue to work with local systems to improve financial and operational performance, to get the most from every penny.

A key part of our 10-year plan is driving progress on the three shifts: from analogue to digital, hospital to community and treatment to prevention. On digital, we will invest up to £10 billion in technology and transformation, to start making the NHS app a digital front door and deliver a single patient record. We will work in partnership with the Wellcome Trust to launch the world’s first health data research service, backed by £600 million, to accelerate the discovery of lifesaving drugs.

On primary and community care, we will invest in training thousands more GPs, helping to bring back the family doctor through millions of extra appointments a year; in 700,000 additional dentist appointments annually; in at least 8,500 extra mental health staff by the end of this Parliament; and in mental health support teams for every school within five years. Finally, on prevention, our world-leading immunisation programmes will be supported by £2 billion, and we will invest £80 million in tobacco cessation programmes and our Tobacco and Vapes Bill.

I want to end by thanking the Chancellor for her unwavering commitment to getting our NHS back on its feet. Fixing broken Britain will not be easy, but nothing that is worth doing ever is. Today I have set out how every penny from the public purse will be matched by reform, to make our NHS fit for the future. We remember we were elected on a manifesto to end sticking-plaster politics and do the hard yards of fixing our country, and we will never betray that promise to the British people. The public have a right to know how public money will be spent, and this is something we take extremely seriously. They can put their trust in this Government, because we have fixed the NHS before, and with the help of this Chancellor, we will fix it again. I commend this statement to the House.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Secretary of State.

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[Karin Smyth]

As my hon. Friend said, this is a health area that I know well, and he has been the most amazing campaigner for Gloucester and the health service there since he became the Member of Parliament. He is absolutely right: dentistry is a key worry. It is one of the key areas that the Conservative party neglected for 14 years. That is why it was a manifesto commitment, and why I was able to outline today that meeting the target of 700,000 is front and centre, and part of the plan as we go forward. I know that the Minister for Care, who is responsible for dentistry, is keen to meet many hon. Members, and I will make sure he has heard that request.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

[Dr Danny Chambers (Winchester) (LD)]

To reiterate: after years of Conservative mismanagement, the NHS is in crisis, with patients left waiting hours for ambulances, women giving birth in unsafe maternity units, and children turning up at A&E with rotting teeth because an NHS dentist cannot be found. That is the Conservative legacy, and they must never be trusted with our health service ever again. So yes, we welcome this funding boost—we really do—and we agree that funding must come with reform, because unless this funding is targeted properly, it will not bring the change that patients urgently need.

When it comes to reform we need to talk about fixing social care, because putting more money into the NHS today will be like pouring money into a leaky bucket. Last year, the Secretary of State for Health and Social Care stated that £1.7 billion a year is wasted because patients who are medically fit for discharge cannot leave hospital, simply because no care is available to support them at home. The hospital in Winchester that supports both your constituency, Madam Deputy Speaker, and mine has up to 160 people waiting to be discharged at any given time, and they would be better cared for with social care packages.

We need urgent action and a higher minimum wage for care workers. We need proper respite and financial support for family carers, and a clear commitment to conclude the social care review, hold cross-party talks, and deliver the real reform that the Minister has been talking about. We also need to tackle the crisis in primary care, because that is where prevention happens and where pressure on hospitals is eased. Will the Minister confirm that the funding boost will deliver the extra 8,000 GPs that are needed to guarantee everyone an appointment within seven days, or within 24 hours for urgent cases? Can she also confirm that the funding will bring dentists back into the NHS, and bring an end to dental deserts? That will not happen without urgent reform of the NHS dental contract, which is outdated, unworkable and driving dentists out of the system.

Finally, we cannot ignore the shocking state of NHS buildings, including our hospital in Winchester. It is an outrage that overcrowded hospitals must close operating theatres due to unsafe ceilings and other health and safety issues. I urge the Minister to spend the money where it matters: on primary care, on social care, and on ensuring that our existing NHS buildings are fit for purpose.

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[Karin Smyth]

I thank my hon. Friend for her question and for the work she does to support NHS dentistry as part of the all-party group. As I have said, this issue is of huge importance to our constituents, and the shocking state in which the Conservatives left dentistry is there for all to see—particularly the shocking state of children’s oral health. That is why we acted rapidly to introduce the toothbrushing campaign—which, if I remember rightly, was ridiculed by Conservative Members when we discussed it in opposition—and the arrangement with Colgate to ensure that we improve children’s oral health. We are absolutely committed to reform of the contract; the Minister for Care is working hard on that and he will continue to update the House regularly. It is our confirmed commitment, as I have reiterated today, to increase access to dental services.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Father of the House.

[Sir Edward Leigh (Gainsborough) (Con)]

Our spending on the NHS is now as much as the entire GDP of Portugal. We used to be a country with an NHS attached to it, but we are almost becoming an NHS with a country attached to it. Of course we would welcome this spending if we got the same outcomes that people get in civilised countries, like the Netherlands or Australia, but every time I mention fundamental reform, I am dismissed as wanting to bring in privatisation, so it is hardly worth raising that issue. Australia has an extremely successful pharmaceutical benefits scheme; I know that the Secretary of State for Health and Social Care went out there, and I have talked to Australian doctors about it. Will the Minister at least look at the successful outcomes, including some of the highest life expectancies in the world, that are being delivered in countries like Australia and the Netherlands, to see how we can deliver better outcomes? There is no point spending more money if people’s only right is to join the back of a queue.

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[Karin Smyth]

My hon. Friend is absolutely right that his constituents and constituents across this country will not forgive the Conservatives for the state in which they left the NHS. That is clear from Lord Darzi’s diagnosis. We have still had no comment from the Conservatives on whether they acknowledge that. We are determined to be about the future, and that is what this settlement and the Chancellor’s announcement yesterday are about. It is about putting that extra funding that we raised last year into services and into a reformed system that reaches all parts of this country. We will tackle health inequalities, making sure that people who have not had that access and people who suffer worse health than others are raised up. We must take the best of the NHS to the rest of the NHS.

[Madam Deputy Speaker (Caroline Nokes)]

After more than an hour of diligent bobbing, I call Chris Vince.

[Chris Vince (Harlow) (Lab/Co-op)]

Apologies for my premature bobbing earlier, Madam Deputy Speaker.

I thank the Minister for her statement today and for her ongoing commitment to the NHS. I welcome the growth in day-to-day spending on the NHS and this Government’s commitment to bringing down NHS waiting times. However, may I gently advocate for Harlow in respect of the future of the UK Health Security Agency? It has a business case, details, designs and a site ready to go, and the estimated timeframe has consistently been assessed as the best value for money and the quickest to deliver.

[Karin Smyth]

I like how my hon. Friend says “gently”, because honestly no day goes past without him talking about this issue or, indeed, his new hospital. He is right, and he is a fantastic campaigner for the people of Harlow. He has made his point again, and I cannot make any further comment today, but he will be hearing from the Secretary of State soon on that issue.

[Madam Deputy Speaker]

I thank the Minister for her answers this afternoon. I ask anyone who is leaving before the Select Committee statement to do so quickly and quietly.

Mental Health Bill [Lords]

Caroline Nokes Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Jim Dickson (Dartford) (Lab)]

I thank everyone who has taken part in the debate, from the Secretary of State onwards. It has been moving and inspiring to see the House united on the need for change. It has been particularly useful for me to benefit from the professional expertise and the personal experience of so many Members who have spoken. My hon. Friend the Member for Sittingbourne and Sheppey (Kevin McKenna), the hon. Member for Runnymede and Weybridge (Dr Spencer), my hon. Friends the Members for Ashford (Sojan Joseph) and for Thurrock (Jen Craft) and the hon. Member for St Neots and Mid Cambridgeshire (Ian Sollom) have all educated and moved me with their experience and knowledge.

It has long been known that the Mental Health Act 1983 is not fit for purpose, and I pay tribute to all the work that has been done so far, including the excellent review undertaken by Professor Sir Simon Wessely, commissioned by the former Member of Parliament for Maidenhead when she was Prime Minister. I know that the intent of the Bill both to strengthen the voice of patients and add statutory weight to their right to be involved in the planning for their care and to inform their choices about the treatment that they receive is strongly welcomed by Members on both sides of the House. Also welcome are the steps that the Government have taken since the election to start to transform mental health services with new funding—mentioned by the Secretary of State—and the plans to recruit 8,500 new mental health workers.

Before I deal with the substance of the Bill, may I ask the Minister whether, when he winds up the debate, he will be able to provide some reassurance about the future of the patient and carer race equality framework, which I believe is vital to the achievement of equality of outcome in mental health, and which I believe would be more effective as part of the Bill than simply as guidance? I know that that is the strongly held view of many of the experts by experience who have worked on PCREF.

One thing I know from my time in a previous role, when I helped to develop mental health services in Lambeth over two decades, is that a disproportionate number of people from African and Caribbean-heritage communities are detained under the Mental Health Act, as has been said by others. Figures highlighted by Mind show that rates of detention for black or black British groups are over three times those for the rest of the population. Similarly, black or black British groups are more than 10 times more likely than white groups to be subject to community treatment orders.

In Lambeth, working with organisations such as Black Thrive—set up by my great former colleague Dr Jacqui Dyer, among others, to radically change mental health services in south London and elsewhere—we showed that hearing people’s voices, early intervention, reducing stigma among African-Caribbean communities, and focusing on keeping people well via work and training provided by membership organisations, such as Mosaic Clubhouse, can prevent people from becoming ill and from tragically coming into the mental health system for the first time via the criminal justice system.

I welcome the changes in the Bill and the commitment from the Minister in the other place to improve data on outcomes and on patients’ experience of community treatment orders. Despite the passing of the Mental Health Units (Use of Force) Act 2018—otherwise known as Seni’s law—which was brought forward by my right hon. Friend the Member for Streatham and Croydon North (Steve Reed), the use of force in mental health settings remains too frequent, and that must be addressed as well.

Prevention work and intervention to address mental health needs at the earliest possible stage are critical, because if someone faces mental health problems when they are young, it can hold them back at school, damage their potential and leave them with lifelong consequences. That is why I warmly welcome the work that the Government are doing to bring vital services into schools so that they can intervene early, support pupils and help prevent conditions from becoming severe. It is really encouraging that mental health support teams should reach 100% coverage of pupils by 2029-30—the end of this Parliament.

Young people in Dartford, where I ran a well-supported engagement event last month, will absolutely welcome the introduction of Young Futures hubs in communities in England to deliver support for teenagers who are at risk of being drawn into crime or facing mental health challenges by providing open-access mental health support for children and young people in communities. I have seen that approach achieve excellent results at the Well Centre, a mental health centre run for young people in Herne Hill as part of Lambeth Together’s care partnership.

I very much look forward to seeing this legislation progress through the House and become law with the support of all Members. I will support it 100% as it does so.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Minister.

NHS Pensions

Caroline Nokes Excerpts

Tuesday 1st April 2025 Commons Chamber

[Karin Smyth]

My hon. Friend is absolutely right that we are on the road to recovery—and that, of course, is what the Opposition cannot stand. This is a complicated issue, as they well know. As I said, we inherited this complication in July, when we were made well aware of it. The Conservatives could have done more about it while they were in government, but it is yet another issue on which they have let people down—this time, it is staff.

We will ensure that we remedy that. The timelines are available in the written ministerial statement that I issued yesterday. We will continue to work with trade unions and employers to ensure that people understand. As my hon. Friend said, it is important that people do understand their own personal positions.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

I have to say that I am none the wiser about what exactly has happened. If we are to ensure that this will not happen again—that these deadlines will be met—we need to know how we got into this position. It may well be the fault of the previous Government. Will this Government commit to a full review of exactly how we got here, so that we can ensure that the published deadlines are met this time?

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[Karin Smyth]

One of our major priorities is ensuring that the entire NHS workforce are doing the work that they are trained and committed to do, so that they can get down those waiting lists and deliver an NHS that is fit for the future. The staff, as Lord Darzi has outlined, have felt very severely the detriment caused by the previous Government. They are working under really difficult conditions, and we want to make sure that, through the 10-year plan and the NHS Long Term Workforce Plan, we offer them hope, so that they are ready to deliver the services that they have been trained to deliver.

[Madam Deputy Speaker (Caroline Nokes)]

I thank the Minister for her responses this afternoon. I will allow a moment for the Front Benchers to swap over.

Down Syndrome Act 2022: Local Authority Guidance

Caroline Nokes Excerpts

Friday 28th March 2025 Commons Chamber

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

I thank the hon. Member for Windsor (Jack Rankin) for securing this debate on such an important topic. I am also grateful to him for his work with the all-party parliamentary group on Down syndrome.

People with Down syndrome should have the same opportunities to participate fully in society like everyone else, but we know this does not always happen. There is a pressing need to raise awareness of the needs of people with Down syndrome and how they can be met. While every person with Down syndrome is a unique individual, they often face common health risks.

For example, we know that almost half of children with Down syndrome are born with a heart condition. We also know that people with Down syndrome may need additional support with their speech, hearing or vision. And as the average life expectancy of a person with Down syndrome continues to rise—an increase I am very pleased to see—this means that more people require additional support in later life. This may be additional support with new, age-related health needs, as well as increased demand for social care services.

This Government are committed to ensuring that all people with Down syndrome receive the care and support they need to lead the lives they want in their communities, and we are taking action to achieve that by implementing the Down Syndrome Act. The Act lays the foundations to ensure that every person with Down syndrome can live a full and fulfilling life through accessing the health and care services they need, receiving the right education, securing appropriate living arrangements that work for them, and being supported into employment. We recognise that there is still much to do to achieve that, but I can assure the hon. Gentleman and the House that the Government are working on the implementation of the Act as a priority.

The Down Syndrome Act requires the Secretary of State for Health and Social Care to give guidance to relevant authorities in health, social care—including local authorities—education and housing services on what they should be doing to meet the needs of people with Down syndrome. Earlier this month, Minister Kinnock wrote to sector partners and the all-party parliamentary group on Down syndrome with an update on the development of the guidance, including the Government’s plan to put the guidance out for consultation by the summer. That followed a roundtable on 26 November, which Minister Kinnock—

[Madam Deputy Speaker (Caroline Nokes)]

Order.

[Ashley Dalton]

Oh, sorry!

[Madam Deputy Speaker]

Twice!

[Ashley Dalton]

I’m so sorry!

That followed a roundtable on 26 November, which the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock) convened to discuss with partners how we can improve life outcomes for people with Down syndrome and the opportunities that the guidance presents in support of that.

We appreciate that many of the issues that have been raised are borne out of a desire to ensure the guidance is as effective as possible and published as soon as possible. We know just how important the guidance is. I can assure the hon. Gentleman that a huge amount of work has been, and continues to be, carried out to develop the guidance. And we, like others, want to make sure the guidance is fit for purpose and impactful.

It has been vital that people with lived experience, and the organisations that work to support them, are involved at every stage of the work to develop the guidance. A range of sector engagement has taken place. That includes a national call for evidence, partner working groups, and a review of evidence to gain a better understanding of the specific needs of people with Down syndrome. Throughout the process, there have been differences in opinion on the scope of the guidance and how it should be drafted. Officials have worked hard to build consensus on these issues, but, as I am sure Members can appreciate, it is not always possible to resolve differing opinions quickly, especially on a topic as important as this. While that means the development of the guidance has taken longer than we all had hoped, it is only right that the issues are given the due consideration they deserve. The Minister responsible set out his position on the issues at hand in his recent letter to sector partners.

Our position remains that the guidance will be Down syndrome-specific, in accordance with the Government’s statutory duty under the Act. It is our intention to include references to where the guidance could have wider benefit. That is in line with the commitment made during the Bill’s passage through Parliament. This is not about moving the focus away from Down syndrome. The guidance is about meeting the needs of people with Down syndrome. It is about taking the opportunity, through the guidance, to help as many people as possible. Officials will continue to work with partners to ensure the guidance has the maximum benefit for all communities involved.

I can confirm to the hon. Gentleman that I have today secured a commitment that the Minister will work with sector partners to ensure that people with Down syndrome have direct access to, and are supported in taking part in, the consultation.

I would like to thank the individuals and organisations across the country who have worked tirelessly to help us develop the guidance. Their contributions have been invaluable throughout, and we appreciate their continued patience while we work to finalise the guidance for consultation. We would also welcome their support to ensure that the communities they represent are aware of the consultation and can share their views.

We are grateful to members of the all-party parliamentary group on Down syndrome for their engagement and can assure them that their comments on the guidance have been considered throughout the development process. The Minister in charge wrote to the APPG on 18 March. Officials will share a second draft of the guidance with sector partners for feedback in the coming weeks. I can assure the hon. Gentleman that I will pass on his comments to the Minister responsible, as requested.

On specific training, under existing legislation, Care Quality Commission-registered providers must ensure that staff receive the appropriate professional development necessary for them to carry out their duties, and must receive specific training on learning disability and autism appropriate to their role. We expect that providers should be considering whether specific training on Down syndrome is required for their staff. Officials will work with stakeholders to signpost that effectively in the guidance we are developing under the Down Syndrome Act.

I thank again the hon. Gentleman for securing this important debate.

Question put and agreed to.

NHS England Update

Caroline Nokes Excerpts

Thursday 13th March 2025 Commons Chamber

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Minister.

--- Later in debate ---

[Wes Streeting]

My hon. Friend is absolutely right about the need to improve procurement. One thing that Attlee and Bevan could not have predicted in 1948 is that the single-payer model of the national health service makes it ideally placed for this world of artificial intelligence, genomics, machine learning and big data. We must unlock that potential so that we have new treatments, new technology, productivity gains and efficiencies, but we also have to get the basics right on procurement. We have to change the culture of profligacy, routine deficits and routine over- spending. That is why, today, the leadership of NHS England has summoned to London chairs and chief executives from across the country to get an immediate grip on the £5 billion to £6 billion deficit that was already being baked in for the 2025-26 financial year. Those chairs and chief executives have just become so accustomed to the idea that Governments will just come in and bail them out.

I said before the election that there would be no release of money in winter, because winter is predictable. The NHS was given additional resources and it must learn to live within its means. Despite howls of outrage before and since the election, I have kept to my word. I said that there would be accountability for people who think that the Government are there to bail them out. Having come from local government, where that culture would never be tolerated, I and this Government are bringing that same financial discipline to the NHS. We will not tolerate deficits. It is important that we get better value for money, while also making sure that, nationally, we are providing support through the procurement platform. That is how we will help the system deliver better value, and we will liberate frontline leaders to focus on the things that really matter, which are services for patients.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

[Alison Bennett (Mid Sussex) (LD)]

The Secretary of State’s NHS shake-up is well under way. Many Members would agree that the NHS used to be the envy of the world, but years of Conservative failure have left patients suffering and unable to get the care that they desperately need. I and my Liberal Democrat colleagues therefore welcome steps to reform the NHS.

The new leadership of the NHS has much to do, but can the Secretary of State advise the House whether new legislation will be needed to scrap NHS England given that he told the shadow Minister that it will take two years to complete this merger? When will that new legislation, if it is required, be brought forward?

Any attempt to fix the NHS will ultimately fail if we also do not address the crisis in social care. The Secretary of State must show the same urgency in reforming social care as is being shown on the NHS. Where is that urgency? Long-promised cross-party talks have now been postponed indefinitely with no new date in sight. Care providers are hanging by a thread due to the rising cost of national insurance contributions. Does the Secretary of State agree that any attempt to fix the NHS will prove futile if we ignore the elephant in the NHS waiting room that is the crisis in social care? We will clear our diaries for cross-party talks, so will the Secretary of State give us a date today?

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[Wes Streeting]

I do think that is the case. I also think that this is not just about form and function but about the opportunities for productivity gains through modern technology and practices. One of my frustrations is that whenever we talk about the exciting frontiers of life sciences and medical technology—this country’s competitive advantage, and how we need to build on that position— I am greeted with a weary sigh from poor frontline NHS staff, and managers for that matter, who say, “That’s lovely, and we agree with you, but we’d just like a machine that turns on reliably, and it would be nice to use systems that do not require seven passwords to deal with a single patient.” I feel their pain. We will prioritise that investment in technology.

Finally, we do want to liberate the frontline, and I am grateful for the leadership that GPs have shown in agreeing a contract with the Government for the first time since the pandemic, which contains substantial reform to benefit them and, even more importantly, their patients. We also have to liberate management in the NHS. As Lord Darzi said, it is not the case that there are too many managers, but there are layers and layers of bureaucracy between me as the Secretary of State and frontline staff. We have to liberate frontline staff and managers to help them be more effective, to manage their resources more efficiently and, most importantly, to deliver better and safer care.

[Madam Deputy Speaker]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

This is a bold change indeed. The job of my Committee is to help the Secretary of State to do it, so let me start by asking him to come in front of the Committee as quickly as possible—certainly before Easter—because there is a lot of detail that we need to drill down into.

On a more substantive point, the right hon. Member mentioned the financial reset that Sir Jim Mackey announced to integrated care boards just yesterday, which means that they need to cut their running costs by 50%. I am concerned that when my Buckinghamshire, Oxfordshire and Berkshire West ICB struggled with money, the first thing it cut were the place-based teams. If we are to deliver the neighbourhood NHS that the Secretary of State and I both want, those are not the teams to cut. Will he send a signal to ICBs that cost savings should not be at the expense of the broader shifts in the 10-year plan?

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[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Order. I gently ask right hon. and hon. Members, and indeed the Secretary of State, to keep their questions and answers short so that I can get everyone in.

[Amanda Hack (North West Leicestershire) (Lab)]

Two GP practices have told me that they are waiting for section 106 money to be released so that they can improve their facilities, but that it has been stuck between decision-makers. Will the Secretary of State outline how the changes will help to release those kinds of delays and finally allow North West Leicestershire residents to get the facilities that they deserve?

National Cancer Plan

Caroline Nokes Excerpts

Tuesday 4th February 2025 Commons Chamber

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

With permission, I wish to make a statement on the national cancer plan. Today is World Cancer Day. Almost everyone in our country has been affected by cancer, either themselves or through a friend or relative. Having lost both my parents to cancer, I am so grateful to the Prime Minister for giving me this job. He has given me the chance of a lifetime to do my parents proud by creating the kind of compassionate and humane healthcare that all our constituents deserve.

I am also pleased to be led by a survivor of kidney cancer, my right hon. Friend the Secretary of State for Health and Social Care. His experience as a patient will be invaluable to us in the months ahead. I pay tribute to the amazing cancer charities who do fantastic work to help people live with cancer, support bereaved families and drive vital research in this area—Macmillan, Cancer Research UK, Cancer52 and Marie Curie to name just a few.

Lord Darzi’s investigation set out the scale of the challenges that we face in fixing the NHS, and how desperately we need to improve cancer diagnosis rates, waits and outcomes. He found that

“the UK has substantially higher rates than our European neighbours, Nordic countries, and countries that predominantly speak English”.

There were close to 100,000 more cases of cancer in 2019 than in 2001. While survival rates at one year, five years and 10 years have all improved, the rate of improvement slowed substantially during the 2010s.

Lord Darzi also noted important inequalities in the provision of cancer care; people in the most underserved areas are more likely to present as an emergency. As Cancer Research UK pointed out in its submission to the investigation, the 62-day target for referral to treatment has not been met for almost 10 years. Last May, performance was at just under 66%, with more than 30% of patients waiting longer than 31 days to start radical radiotherapy.

For all those reasons and more, we do not have a second to waste. That is why the Prime Minister kicked off this year with our elective reform plan, setting out how we will cut the longest waiting times from 18 months to 18 weeks. From March next year, around 100,000 more people every year will be told if they have cancer or not within 28 days, and around 17,000 more people will begin treatment within two months of diagnosis. That is why this year, we will spend £70 million on replacing older radiotherapy machines with newer, more efficient models. That is why in the King’s Speech we put forward an improved Tobacco and Vapes Bill, helping to reduce around 80,000 preventable deaths and putting us on track to a smoke-free UK.

While around 40% of cancers are caused by avoidable factors such as smoking, the backdrop is one of an ageing society. Cancer Research UK has forecast half a million cancer cases each year by 2040. We are preparing for the future now, with our 10-year health plan for the NHS. The plan will set out the framework of reforms that we need to ensure better outcomes and to meet the growing challenges that we face in the fight against this dreadful disease. The plan will play to Britain’s strengths as a global leader in the development of advanced therapies, using our strong academic and life sciences industry.

We should remember that the NHS was the first health service in Europe to commission CAR-T cellular therapy for blood cancer patients. On this World Cancer Day, I can announce that we will build on that legacy by investing in a cutting-edge, world-leading trial to transform breast cancer care through artificial intelligence. Nearly 700,000 women will take part in this trial, testing how cutting-edge AI tools can be used to catch breast cancer cases earlier. Thirty testing sites across the country will be enhanced with the latest digital AI technologies, ready to invite women already booked in for routine screenings on the NHS to take part.

The technology will assist radiologists by screening patients to identify changes in breast tissue that show possible signs of cancer, with referral for further investigations if required. If the trial is successful, it has immense potential to free up hundreds of radiologists and other specialists across the country to see more patients, tackle rising cancer rates and save more lives. It is just one example of how British scientists are at the forefront of transforming cancer care, and of the promising potential of cutting-edge innovations to tackle one of the UK’s biggest killers.

This Government know that unless we do things differently, our NHS will remain in the dire state in which we inherited it. That means proper reform, from doing away with burdensome process that holds back frontline staff to handing more power to local leaders so that they can deliver for the communities they know best. It also means embracing new technologies, including AI, to transform the way we deliver care and to improve patient outcomes. Today’s trial is yet more evidence of this Government taking action to bring in the reform that is desperately needed. As the Prime Minister set out last month, our plan for change will put the UK on the front foot, unleashing AI to drive up health services and shift the NHS from analogue to digital, as part of our 10-year plan.

Our 10-year plan will ensure that the NHS is there for our grandchildren and future generations, but we believe that the increasing number of cancer cases and the complexity of cancer care mean that we need a specific approach to cancer. We are determined both to bring down the number of lives cut short by cancer and to ensure that many more people go on to lead a full life after their treatment. That is why I am today announcing a call for evidence for our new national cancer plan that we will publish following the 10-year plan in the second half of this year. We will look at the full range of factors and tools that will allow us to transform outcomes for cancer patients while improving their experiences of treatment and care. We will make the United Kingdom a world leader in cancer survival by fighting the disease on all fronts—through better research, diagnosis, screening, treatment and prevention. However, we cannot do this alone, and that is why we are launching this call for evidence from patients, doctors, nurses, scientists, our key partners and other members of the public on what should be included.

To support that work, we will relaunch the children and young people’s cancer taskforce, co-chaired by the hon. Member for Gosport (Dame Caroline Dinenage) and Professor Darren Hargrave, with Dr Sharna Shanmugavadivel as vice-chair. I’ve put my teeth in—apologies if I pronounced that wrong. The taskforce will bring together the country’s top experts to set out plans to improve treatment, detection and research for cancer in children, which will feed into the plan. At every stage, we will ensure that patient voices are heard. I look forward to updating the House on the progress of the plan, the taskforce and the trial throughout the year.

Many of us on the Government Benches remember with pride the previous Labour Government’s record in the fight against cancer. We introduced landmark legislation to ban smoking in public places, protecting a generation of children from the harms of second-hand smoke, while putting record sums into smoking cessation programmes. At the dawn of the millennium, we launched a national cancer plan, which led to faster cancer diagnosis and treatment times, increased funding for cancer services, equipped the national health service with radiotherapy machines—many of which are still there—and expanded cancer research funding, so that a new generation of scientists could answer the call. What did that plan lead to? Survival rates went up. The number of patients diagnosed and treated on time went up. The number of lives lived well after cancer went up. That was our record in government, and we will do it again. I commend this statement to the House.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Minister.

--- Later in debate ---

[Andrew Gwynne]

I am very grateful to my hon. Friend for her question. Those of us who knew Margaret miss her very much; she was such a towering figure in the Labour party for so many years, and we on the Labour Benches have a lot to thank her—and, indeed, my hon. Friend—for.

My hon. Friend is absolutely right on research. This is one area where, quite frankly, we have not done well enough. We have not made any progress. I know she will continue to champion more research. With our new national cancer plan, I hope that she will be pushing on an open door, because this is one area we absolutely have to do much better in.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

[Jess Brown-Fuller (Chichester) (LD)]

Nearly every family has a cancer story, whether it is a personal fight or that of a loved one. A 10-year plan from the Government is a welcome step, as the previous Government broke their promise to implement a 10-year cancer strategy that would have made a real difference to patients. We on the Liberal Democrat Benches are very proud that our cancer campaigner, my hon. Friend the Member for Wokingham (Clive Jones), secured from the Government a commitment to introduce such a plan.

Testing for cancer, diagnosing and starting treatment quickly reduces stress and anxiety. Also, if the cancer is caught early, it is more likely to be treated successfully. Yet the target of 85% of people receiving their diagnosis and starting treatment within 62 days of an urgent referral has not been met since December 2015. In my constituency, one third of cases fall short of that target and 1,000 families lose a loved one every year to this cruel disease.

Lord Darzi’s review laid out very clearly that the UK has appreciably higher cancer mortality rates than other countries and that more than 30% of patients are waiting longer than 31 days for radical radiotherapy. A quarter of England’s 280 radiotherapy machines are now operating beyond their recommended 10-year lifespan, and in some areas, such as West Sussex, there is no access to radiotherapy at all. That is why we welcomed the £70 million investment announced in October to start to replace the older radiotherapy machines.

Will the Minister confirm whether there will be further rounds of funding to keep pace with available radiotherapy technology? Will he look to support those at the mercy of a postcode lottery by ensuring that radiotherapy is available in all areas? What is the expected timeline for reversing the damage done by the previous Government, and when can all patients expect to start their treatment within the 62-day urgent referral target?

Women’s Health Strategy

Caroline Nokes Excerpts

Thursday 30th January 2025 Commons Chamber

[Mims Davies]

For too long, a woman’s experience of the health service has been one of being pushed from pillar to post. Crucially, women’s voices have been ignored and responses to their pain, suffering, poor sex lives and traumatic births have been too slow. Overall, women have a sense of being forgotten. Some 2.4 million more women were in work under our Conservative Government. Pain and suffering were affecting too many women and their ability to remain in the labour market, resulting in early retirement or not having their true career potential fulfilled.

We took direct action, crucially, by listening to women’s experiences. We had almost 100,000 responses to our call for evidence on the gender health gap. We appointed Dame Lesley Regan as the woman’s health ambassador, and Helen Tomlinson as the cross-government menopause ambassador to find out the experience of women employed in different sectors. We delivered and funded new women’s health hubs and created joined-up services in the community. The Royal College of Obstetricians and Gynaecologists estimates that removing the requirement of integrated care boards to have a woman’s health hub will impact 600,000 women on waiting lists in England, creating longer waits, disease progression that could be prevented, and resulting in more women attending A&E, unable to work, care or live a fulfilled life.

Labour’s manifesto said that it will prioritise women’s health. Women are now reported to be a lobby group, relegated to being unheard once again. Will the Minister confirm whether it is true that the targets to deal with women’s needs will be dropped? If so, what is her justification for that? Will she be delivering on the roundly welcomed women’s health strategy from 2022?

A total of 1,300 families gave evidence to the all-party group on birth trauma. What are the plans to drive up maternity safety standards across the country? Will there be a response to that? Will Dame Lesley Regan be sacked, will she remain the women’s health ambassador, or will she be replaced, as Helen Tomlinson was, by someone who seems more interested in selling books than in delivering on the ground for women? What steps are being be taken on sex-specific language in health communications and guidance—

[Madam Deputy Speaker (Caroline Nokes)]

Order. The shadow Minister will know that there is a time limit, which she has exceeded. I have been very generous. I call the Minister.

[Karin Smyth]

I addressed most of those points in my outline statement. I think the shadow Minister wrote her comments when the Opposition thought that we were cancelling things, only to find out that we are not cancelling things. I have made clear our commitment to the women’s health strategy and how we seek to instruct the system at a local level to serve the needs of women and particularly prioritise those waiting lists. As I have outlined, the targets have already been achieved. Unusually, I will give a bit of credit to the other side, because a lot of this was rolled out and it was good practice, and the system still thinks that it is good practice, so sometimes Opposition Members should take a win. We are committed to that, it is embedded in the system, and we look forward to outcomes being improved for women.

[Madam Deputy Speaker]

I call the Chair of the Women and Equalities Committee.

--- Later in debate ---

[Karin Smyth]

I thank the Committee Chair for her question. I think she was congratulating the previous Committee and Chair rather than those who are now in opposition. I was very pleased to witness some of that work when we were in opposition, and she is absolutely right about it. The work of many women Members when in opposition, and, to be fair, of many women in the previous Government, have made sure that issues around endometriosis have risen up the agenda; indeed, we had a good debate in the Chamber recently. We are committed to taking forward the strategy. We think the health hubs, for example, are doing a good job, but there is a lot of learning to be done on them, and we will continue to do that.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Dr Danny Chambers (Winchester) (LD)]

Nearly 600,000 women are waiting for treatment on gynaecology waiting lists in England; the longest waits are leading to preventable diseases progressing and it is one of the worst specialties for long waits. The Care Quality Commission has investigated and reported that 65% of maternity units are not as safe as they should be. That high number could almost be considered a public health crisis, and it has led to the highest amount of negligent payouts due to avoidable injury and even death. This absolutely needs to be addressed.

Many women, such as my partner Emma, have had to fight for years to get just a diagnosis for endometriosis, let alone any treatment, having been told for years that the symptoms are completely normal and do not need investigating. In the Government’s—

[Madam Deputy Speaker]

Order. I know I am being difficult on time limits, but the Liberal Democrat spokes- person should have one minute in an urgent question, which the hon. Gentleman has already far exceeded. Perhaps he will come up with a question in one sentence for the Minister.

[Dr Chambers]

Apologies, Madam Deputy Speaker. Yes, in one sentence: the Government’s manifesto rightly said that

“Never again will women’s health be neglected”.

Can we have assurances that we will not remove the ICB requirement to have women’s health hubs?

Tobacco and Vapes Bill

Caroline Nokes Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Wes Streeting]

That is a very helpful intervention because it gives me the opportunity to say thank you to my counterparts in Wales, Scotland and Northern Ireland. This is a genuinely four-nations Bill, and through it, we have an opportunity to create a smokefree generation in every corner of our country.

I say to people who have an ideological objection to the Bill that if they believe in lower taxes, as they say they do, and in maintaining a national health service, as they say they do, they cannot duck this simple equation: an ageing population plus a sicker society equals more spending on the NHS, paid through higher taxes. The Bill is just one measure, but it will make a significant difference to the health of our society, and to the balance of that equation.

The question that opponents of the Bill must answer is this: if they want our health and care services to continue having to spend £3 billion every year on the symptoms of smoking, are they willing to accept that that means higher taxes or higher healthcare charges for their constituents? Are they happy for their constituents to shoulder the welfare bill for smokers falling out of the workforce? Those are the consequences of what we are voting on today. Higher taxes and higher welfare are not the Labour way.

There are arguments about liberty from those who oppose based on libertarian belief. They say that the state should not deny individuals the choice to smoke if they want to, but three quarters of smokers want to stop and wish they had never started. It takes a smoker an average of 30 attempts to quit before they manage it. By definition, an addict is not free; there is no choice, no liberty and no freedom in addiction. Nor is choice afforded to anyone inhaling second-hand smoke. Tobacco is not only highly addictive but uniquely harmful. Yes, some smokers can quit, but most who want to cannot. Those who have help to quit are three times more likely to succeed. That is why the Government are, as I said, investing £70 million in smoking cessation services—an investment that will pay for itself several times over—but prevention is better than cure, and that is why we are taking action, through the Bill, to stop the start.

In conclusion, this Bill marks the start of a decade in which we will shift the focus of healthcare from treatment to prevention; take serious action on not just smoking, but obesity; reform the NHS, so that it catches problems earlier and gives patients the tools that they need to stay out of hospital; harness the revolution taking place in life sciences; and fundamentally transform the NHS, so that it predicts illness and prevents it from ever taking hold. That is the future available to us, and it is the future we must realise if we are going to put our welfare system, health service and public finances on a sustainable footing. It starts with this Bill. Smokers are more likely to need NHS services, be admitted to hospital, drop out of the workforce and on to welfare, and need social care years earlier than if they did not smoke. By taking the measures set out in the Bill, we are putting the UK on the road to becoming smokefree, building a healthier, wealthier nation with a health service fit for the future and leading the world as we do so. I commend this Bill to the House.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Secretary of State.

Infected Blood Inquiry

Caroline Nokes Excerpts

Tuesday 19th November 2024 Commons Chamber

[Nick Thomas-Symonds]

I can indeed confirm that. The authority is working in a way that will allow it to scale up as quickly as it possibly can. The need for speed in delivering compensation payments is paramount.

Memorialisation will be really important in how we remember the victims of this scandal. Sir Brian Langstaff makes a compelling case about the need to recognise what happened to people, and for it to be recognised by future generations. Officials have begun the necessary work to respond to Sir Brian’s recommendations on memorialisation, and we recognise that this is an incredibly sensitive issue that we need to get right.

Sir Brian Langstaff’s recommendations call for fundamental changes to the way that politics and Government operate, and for one of the largest compensation schemes in UK history. That is entirely in line with the scale of the injustice that he has uncovered. Given the scale of the recommendations, I am committed to updating formally on them within the 12-month timeframe set out by Sir Brian Langstaff, but I assure Members of this House, and, indeed, the infected blood community, that we will drive forward this vital work. We will deliver the changes that are needed, which will stand as a testament to the bravery and determination of people who have been so badly failed.

I pay tribute to all those who fought so hard to bring us to this moment. Their efforts are monumental, and we commit again today to ensuring that they have not been in vain. I commend the motion to the House.

[Madam Deputy Speaker (Caroline Nokes)]

Before I call the shadow Minister, I wish to make a short statement about the House’s sub judice resolution. I understand that several legal cases relating to contaminated blood products have not yet concluded. However, given the public interest in this issue, Mr Speaker has exercised his discretion to allow reference to specific proceedings where necessary, as they concern issues of national importance.

I call the shadow Minister.

--- Later in debate ---

[Ian Lavery (Blyth and Ashington) (Lab)]

In the past three years alone, I have spoken in this House at least 10 times about the delays that the victims of contaminated blood have faced in obtaining the justice and compensation they deserve. Progress has been painfully slow and, as my right hon. Friend the Paymaster General said, there is much anger, frustration and mistrust for us to deal with, as it has not gone away. It has not been diluted by the general election, and those seeking compensation are rightly angry and mistrustful.

In May 2024, the inquiry found that more than 3,000 people had sadly died as a result of this scandal. Roughly one victim dies every two days, many without receiving compensation. I would not like to calculate how many people have died since I first spoke about contaminated blood in the House. My right hon. Friend mentioned further legislation and, between now and then, more people will sadly pass on as a result of this scandal.

I appreciate that my right hon. Friend has had only a few months to try to rectify the consequences of the previous Government’s slow response to Sir Brian Langstaff’s demands. Again, I urge my right hon. Friend to do everything in his power to ensure that the Infected Blood Compensation Authority hires the staff needed to address the challenges and to design the procedures required with the utmost urgency. I am sure that my right hon. Friend has got the message.

I have spoken in the House many times of my constituent Sean Cavens, who was one of the youngest people in the country to be infected with hepatitis C as a result of being given contaminated blood. He has campaigned tirelessly on behalf of fellow victims of the scandal. Many people have died waiting for justice.

At the current rate of settling claims, which is another huge issue, victims and others are concerned that many more people will die without seeing a ha’penny of compensation for themselves or their families. They question whether the Government are acting quickly enough, with only 270 claims expected to be dealt with by the end of the financial year and more than 4,500 claims in limbo. I share their concerns; I am not sure if that is good enough.

Sean is now 43 years of age. He was infected with hepatitis C and other viruses in 1983. He wonders where he fits in the selection process. He will not be alone in wondering whether he must simply hang on and hope to survive long enough to see justice done for him and his family.

While the scheme currently has no effect on payments made through the infected blood support schemes, that will cease to be the case in the new financial year. I hope my right hon. Friend the Minister will review that approach and extend the deadline, so that people who receive payments after 31 March 2025 do not see that deducted from compensation through the new scheme. Will my right hon. Friend the Minister consider that point?

Fundamentally, Sean and others are concerned that those currently on the infected blood support schemes are not automatically being offered the core route payment. They wonder why they cannot be offered a lump sum payment equivalent to payments up to the average life expectancy of 86. They are also concerned that the rates of compensation to be offered are rumoured—I emphasise the word “rumoured”—to be only 20% of current annual payments. I am sure that will be outlined by my right hon. Friend in his winding-up speech.

The uncertainty about the compensation scheme’s date of infection criteria is causing concern for victims. The burden of proof for those who were infected after screening for relevant viruses began is deemed by the Infected Blood Compensation Authority to be “higher”, but without any clarification on what that actually means in practice. Will the Minister provide such clarification? Screening began for HIV in November 1985 and for hepatitis C in September 1991, but for hepatitis B it was as early as December 1972. As I mentioned, Sean was infected with hepatitis B in 1983. He needs to know how that will affect his final compensation. For instance, will the IBCA take into account that the screening test for hepatitis B in 1983 is estimated to have been only 43% effective? Will the IBCA recognise that victims were treated for hepatitis C with the retroviral drug Interferon, which has well known serious side effects on patients’ mental health? Will that be reflected in their compensation?

Will the Minister confirm that Sir Brian Langstaff’s recent guidance, contained in his letter dated 13 November 2024, regarding the siblings of victims who deserve compensation, will be accepted by the IBCA and reflected in any compensation scheme that it designs? Will, as Sir Brian has recommended, any family member whose relationship was “so close” to the victim that damage to their own mental or physical health caused by witnessing their sibling’s suffering was “reasonably” foreseeable receive full compensation, if they were so damaged? It has been reported that the IBCA will only compensate siblings of victims if they lived with the victim in the family unit for a full two years. Will the Minister ensure that that arbitrary restriction is not contained in any IBCA compensation scheme?

Will the Minister confirm that the family of any victim who dies before his or her application to the IBCA has been completed will receive full compensation? There are indications that the IBCA interpreted the inquiry’s final report as saying the contrary—that it intends to pay only those who live long enough to receive a final reward. That cannot, in any way, shape or form, be correct. It is not fair and it is not just.

Will the Minister ensure that those who, as children, were purposefully infected with contaminated blood in the name of medical research are awarded enhanced punitive levels of compensation, to reflect the country’s abhorrence at such horrific criminal behaviour, carried out by medical professionals who had sworn to dedicate themselves to healing the sick? That is one thing I just cannot understand. The whole tragic scandal is an absolute disgrace, but it is really abhorrent that this great country of ours experimented on little children. Those children, many of whom have not survived, deserve the compensation. How much they should be awarded is obviously to be determined, as has been stated, but bearing in mind the abhorrent nature of what we have done as a nation, I ask the Minister to ensure it is enough.

The infected and contaminated blood scandal is just one of far too many injustices in the UK in recent decades, in which powerful people have treated institutional reputations, career prospects and, in a number of cases, profits as being more important than working-class lives. Hillsborough, Orgreave, the postal service Horizon scandal and Grenfell all share this shameful characteristic: each one sent out a message that ordinary working-class lives do not matter. The Minister can take this opportunity to show that this Labour Government think that the lives of ordinary people matter by ensuring that the victims of contaminated blood products receive just and meaningful compensation without any further unconscionable delay.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Liz Jarvis (Eastleigh) (LD)]

I am grateful for the opportunity to speak in this incredibly important debate. I begin by paying tribute to all those who had their life destroyed by the infected blood scandal, and everyone who has campaigned for justice. They include my constituent Gary Webster. For those who are not familiar with his story, Gary was born with haemophilia, and at the age of nine he was sent to Treloar’s college, a specialist boarding school in Hampshire. His parents hoped that the school’s on-site medical facilities would enable Gary to lead as normal and happy a childhood as possible. All the boys at the school and their parents trusted the doctors who saw them implicitly, but in fact, the boys were being given contaminated factor VIII blood products imported from the US. Gary was in his final year at school when he was told that he had been infected with HIV/AIDS and hepatitis, and that there was no guarantee that he would be alive in six to 12 months. Of the 122 haemophiliac boys who attended Treloar’s between 1973 and 1986, 80 have since died.

The infected blood inquiry report by Sir Brian Langstaff found that

“deaths, illness and suffering were caused needlessly to people with bleeding disorders by…Treating children at Treloar’s with multiple, riskier, commercial concentrates, prophylactically and as objects for research”

and

“Treating children unnecessarily with concentrates (especially commercial ones) rather than choosing safer treatments.”

One can only imagine the pain of the survivors and all the families, and it beggars belief that it has taken so long for them to get justice.

The thousands of victims of the infected blood scandal and their families from across the UK have been waiting far too long for justice, accountability and compensation. The Liberal Democrats welcome the introduction of the infected blood compensation scheme. We are glad that it will bring the victims of this gross miscarriage of justice, including those who were infected and those who have been affected, closer to the justice that they deserve. It is crucial that this compensation scheme is implemented as quickly and effectively as possible. We are also backing calls by the survivors for a duty of candour on all public officials.

The infected blood scandal campaign organisation Factor 8 has highlighted that the guidance on the Infected Blood Compensation Authority website states:

“Should an eligible affected person die during the application process to the Scheme, their compensation award will not be paid. This is in line with the Inquiry’s recommendation.”

However, Factor 8 has examined the inquiry’s second interim report, and in the summary of conclusions, on page 14, at conclusion t), Sir Brian Langstaff says:

“Where an affected person who has not made a claim dies, the sums that they might have received if they had claimed should not become part of their estate.”

The key wording is

“who has not made a claim”.

Will the Government update their policy and ensure that all affected persons who make an eligible claim have their claim honoured? That is important for those affected who are elderly or ill, and are concerned that they may not live to see the end result of the claim process. I hope the Minister will look at that as a matter of urgency.

The infected blood scandal has highlighted the importance of robust blood safety measures and tools. Will the Government look into the merits of pathogen inactivation technology to ensure that no one else unnecessarily suffers from infected blood, and that we have a safe, reliable supply of blood products?

I spoke with Gary Webster on Friday, and as he put it,

“the whole process needs speeding up”.

After so many years of secrecy, deceit and delay, the Government must ensure full transparency about the progress of the scheme, and open, ongoing communication with all those affected. As for the families who have been impacted by this appalling scandal, please give them a national memorial, and reassurance that measures will be put in place to ensure that nothing like this can ever happen again.

[Madam Deputy Speaker (Caroline Nokes)]

I call Michael Payne to make his maiden speech.

--- Later in debate ---

[Amanda Martin (Portsmouth North) (Lab)]

We must always remember that at the heart of any public scandal, there are people. So many of my hon. Friends this afternoon have told tragic stories, but also stories of courage and humility. Alongside other brave, courageous victims and their families, Becca, Jess and their siblings have campaigned for justice for people infected and affected, in loving memory of their father, Joe. Like me, they welcome the decisiveness and commitment from this Government. With families like them in mind, I would like to ask the Minister to outline when he expects the second set of regulations to be laid before Parliament, how victims and their families can continue to be involved and informed of progress, and how claims can be made.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Minister.

Income Tax (Charge)

Caroline Nokes Excerpts

Tuesday 5th November 2024 Commons Chamber

[Edward Argar]

I gave way to the hon. Gentleman earlier. I am afraid I want to conclude my remarks, because I am keen for others to have a chance to speak.

That offer to the Secretary of State stands. I am always happy to work constructively with him when he is willing to work constructively with me. He knows that we have done that before, not least as we emerged from the pandemic, when I was still a Minister in the Department.

Unfortunately, despite the rhetoric, I fear that the Budget was a missed opportunity that will not achieve the ambitions the Government have set out. As I have said, we cannot tax our way to growth, and without growth we cannot sustainably fund public services. I urge the right hon. Gentleman to be brave, to stand up to those in his party who would have him back down or water down reform, and to deliver a genuinely radical plan for the future of our NHS and for social care that works for those who work in it, but also, crucially, for all the people who rely on it. Our constituents deserve nothing less from him.

[Madam Deputy Speaker (Caroline Nokes)]

I call Kate Osamor.

--- Later in debate ---

[Kate Osamor]

I thank the hon. Member for her intervention. I would add that it is important that patients, doctors and everyone else are listened to. I am assured that the Secretary of State will be listening to all voices.

NHS data is a public asset. Its management should be rooted firmly within the NHS, not placed in the hands of private interests, especially those controlled by an individual who is so hostile to the principles of public healthcare. Our NHS thrives due to the work of everyone in the system, from nurses to administrative staff and healthcare assistants, who each play a critical role in patient care. We must listen to all NHS staff, not just those in the highest-ranking medical roles, as everyone brings valuable frontline perspectives on improving efficiency, patient experience and accessibility.

I especially draw attention to the hard-working staff who provide out-of-hours services for our communities, often doing so on top of their normal hours. The Government must ensure that those professionals receive not only recognition, but the resources and support they need to continue serving our communities in this vital way. Staff in out-of-hours services often only work in such settings part time. However, they are often the last resort for people who are unable to get appointments with their GP or access the care they need.

We must also address the postcode lottery in healthcare. For various conditions, disparities persist in access to specialists, waiting times and outcomes in relation to area, ethnicity and gender.

The stark reality is that mental health services remain woefully inadequate. We face a mental health crisis, especially among young people, and this impacts on personal wellbeing and ruins life chances. We urgently need targeted investment in mental health services, and I look forward to supporting the Government in ensuring that the crisis in mental health support is treated with the seriousness it demands.

This Budget is a strong step in the right direction, but we must go further to ensure that the NHS remains public, that mental health is prioritised and that all NHS staff have a voice in shaping the future of our health system. I ask the Secretary of State to focus on all those areas, because I believe that if we have consistent investment throughout this Parliament, we can ensure that we make progress towards an NHS that works and in which everyone is able to access the quality and timely care that they justly deserve.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Members will be aware that this is a very heavily subscribed debate, so a time limit will be coming, but not until after we have heard some maiden speeches. I call Juliet Campbell.

--- Later in debate ---

[Esther McVey]

I will carry on for a little longer.

To put that into context, it dwarfs the UK’s annual defence spend, which stands at £55 billion. This is money being wasted instead of being spent on public services.

And if all that was not bad enough, the Office for Budget Responsibility has downgraded its growth forecast to a measly 1.5% for the years running up to the next general election. So much for Labour saying this would be a Budget for growth. This Labour Budget has taken our country back to the 1970s, with crippling taxation, unsustainable levels of borrowing and the trade unions in control. The Budget has also broken virtually every economic promise Labour made during the election. In fact, even worse than the economic misery this Budget will bring might be the further mistrust in politicians it will cause.

Labour ruled out tax hikes on working people more than 50 times, and it ruled out changing the fiscal rules to fiddle the figures. Mark my words, on top of the betrayal of pensioners with the scrapping of the winter fuel allowance, this Budget will be a nail in this Government’s coffin, only four months after they secured a huge majority.

At the weekend, the Chancellor eventually came round to admitting that Labour will be taxing workers, but I am afraid that saying it now, having denied it at the general election, does not wash. It is way too late to be admitting it. All it has done is expose the fact that this Labour Government were elected on a false premise and therefore do not have a mandate for this Budget. [Laughter.] Laughing after not telling the public what they were going to do is why I certainly will not be supporting this Budget.

[Madam Deputy Speaker (Caroline Nokes)]

I call Lewis Atkinson to make his maiden speech.

[Lewis Atkinson (Sunderland Central) (Lab)]

It is pleasure to follow my hon. Friend the Member for Broxtowe (Juliet Campbell), who spoke movingly about her experience in the NHS, as well as the barriers she has ignored and, indeed, knocked down.

I start by paying tribute to my predecessor, Julie Elliott, who not only worked with commitment for Sunderland Central, but provided political leadership and mentorship across the north-east. Julie understood that organising and advocating on a regional basis is often the best way to deliver for our communities. I hope to follow her example. It is the honour of my life to be in the House of Commons representing the city by the sea that I love.

I am pleased that my first debate contribution is about the budget and the NHS, for what is our purpose here if not to improve the economic conditions of our constituents and the care available to those we serve? Health and wealth have always been linked—twin assets—as families like mine, forged in the Durham coalfield, know well. My grandparents were only able to toil at the pit, in the munition factory or in the home for as long as they were healthy. Working-class communities have always feared illness and injury, not just in its own right but because the resulting inability to work was disastrous for family finances. The introduction of the NHS and national insurance by the Attlee Government was intended to protect against such calamities. We have important work to do to repair and renew those civilising protections today.

The link between inequalities of health, wealth and power has been impressed upon me by the privilege of working for two decades in NHS North East. Whether managing dentistry, mental health or cancer services, I saw at first hand how the poorest generally experience the poorest health outcomes. I intend to spend some of my time in this place working to right that situation.

The qualities of innovation and hard work have always been the building blocks of Sunderland’s economy. From the introduction of glassmaking in Britain at Bede’s monastery of St Peter’s, through the education of lightbulb inventor Joseph Swan, to becoming the UK’s leading digital smart city, Sunderland has always been a home of innovation. We have always made things. For 600 years, that meant ships. At our peak, the people of Sunderland were hard at work “macking” a quarter of all ships produced globally each year, and we were likely dubbed “Mackems” as a result. Wealth from shipyards and pits built Sunderland, but such work often caused a thirst, so it was handy that the most popular stout in the country was produced in the centre of town, at the Vaux brewery, until the second world war interrupted production.

In that war, as in others before and since, the patriotic people of Sunderland answered their country’s call. This weekend, I will be honoured to play a small part in what is thought to be one of the largest Remembrance services outside London, reflecting the high number of veterans in our city and the sacrifices made by so many, including my constituents who served in Iraq and Afghanistan.

While the bravery and fortitude of Sunderland’s people has never been lacking, too often they have faced the headwinds of economic change without a Government on their side. By the end of my childhood, the pits, the shipyards and even Vaux had all gone. But the people’s spirit and an understated determination remained, and it is thanks to them that our city is now on the up.

I am not just referring to top-of-the-Championship Sunderland AFC, a football club that has provided me with more agony and ecstasy than even the Labour party has managed. Our Stadium of Light stands on the site of the Monkwearmouth colliery, but now instead of coal we produce a rich seam of talented players, such as Jill Scott, Jordan Pickford, Lucy Bronze and Chris Rigg.

I also celebrate the workers at the most productive car plant in Europe, Nissan, which although not in my constituency is the modern cornerstone of our city’s economy, continuing our advanced manufacturing heritage and skills.

Elsewhere around the city, where there was previously decline we now see new beginnings. On the banks of the Wear, we no longer have shipyards, but we do have the Crown Works studio site, ready to be transformed into a landmark film studio. Where the brewery once stood, we have cranes in the sky for Riverside Sunderland, the most ambitious city centre regeneration project in the UK. We have our excellent university, with particular strengths in media and healthcare, and we have a city that loves a good time, where growing hospitality and cultural businesses provide plenty of decent days and nights. It might be a show at the Sunderland Empire, a meal at one of our many excellent British-Bangladeshi restaurants, or a gig at one of our independent venues.

Where passion and identity are strong, there is music—and Sunderland is a music city. Having produced talent from Dave Stewart to the gone-too-soon Faye Fantarrow, our city’s artists reflect who we are, honour our proud heritage and point towards our bright future as an inclusive city.

Nowadays, we celebrate that Mackems are found in mosques and churches, our community centres, our gurdwara and our social clubs, and now there are even two Mackems in the Cabinet. All my constituents, no matter what their background, deserve a strong economy and quality public services. Because Sunderland was built on hard work, its people rightly expect nothing less from their politicians. It is in that spirit that I recognise the privilege of being in the House on behalf of our entire community. I will do what I can to serve them and repay the trust they have placed in me.

[Madam Deputy Speaker (Caroline Nokes)]

I call Adam Dance to make his maiden speech.

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[Luke Myer (Middlesbrough South and East Cleveland) (Lab)]

On a point of order, Madam Deputy Speaker.

[Madam Deputy Speaker (Caroline Nokes)]

It is not the time to make a point of order.

I call Cat Eccles to make her maiden speech.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Order. I propose to put a four-minute time limit on contributions after the next speaker.

--- Later in debate ---

[Bradley Thomas (Bromsgrove) (Con)]

It is not just public services that we need to focus on: the third sector provides vital services that many of our constituents rely on, particularly children’s hospices. I would like to highlight to the House the Acorns children’s hospice in my constituency, which provides vital support to many local families in a really acute moment of need. In 2019, NHS England decided to increase the children’s hospice grant—

[Madam Deputy Speaker (Caroline Nokes)]

Order. That intervention was far too long.

[Jess Brown-Fuller]

I thank the hon. Member for his intervention. He will be pleased to know that I am going to mention hospices later in my speech.

To fix the NHS, we must fix both the front and the back door. Taking the pressure off secondary care can only be achieved by properly funding primary care. That is why the decision to increase employer’s national insurance contributions is a significant mistake, as it risks worsening the crisis in the NHS and care sector. Increasing that rate will drive up GP surgery costs, significantly raising the annual expense of GP practices. Those practices are not eligible for the employment allowance that protects our small employers, so surgeries in Chichester and across the country will bear the full weight of that rise—a burden that they and my constituents simply cannot afford. Surgeries such as Southbourne surgery, Langley House surgery and Selsey medical practice have already reached out to me with concerns about their ability to continue providing services amid those financial challenges. They all agree that this increase will directly undermine patient access and care.

Charities have long suffered the burden of failing statutory services. Chichester boasts some of the most amazing charitable organisations, and one of the great pleasures of my role is to spend time with the people at the heart of those organisations. Charities such as Stonepillow, which works to prevent homelessness in our area, face an increase in costs of £125,000. I also visited St Wilfrid’s hospice after the Budget announcement—an incredible hospice that provides palliative care for hundreds of people every year, both in the hospice and in the community. It now faces an increased bill of £175,000—money that it needs to find annually, with only 17% of its annual budget covered by the NHS. I urge the Government to consider exempting the health and social care sector from the national insurance rise, so that the Treasury is not giving with one hand and taking with the other.

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[Mr Will Forster (Woking) (LD)]

I am surprised to be called so quickly, so thank you, Madam Chair. I was really pleased by the statement that the Secretary of State is looking at how to compensate those in the health and social care sector for national insurance rises. I have in my constituency Central Surrey Health, a not-for-profit, employee-owned group. It serves much of Surrey, and it stands to lose £500,000 as a result of the proposed changes. It delivers community services across Woking and Surrey, including most of the services in my constituency. It would be awful if we lost services as a result of measures introduced by the Government in a Budget that is supposed to invest in the NHS. I welcome the Government’s investment in the NHS, but they must not make the mistake of increasing national insurance on social care firms, health partners and GPs.

I am concerned about the elephant in the room: social care. Local authorities and our health system are really struggling, but social care helps to fix things. It is a more efficient use of our money to invest in social care and prevention than spend on primary care in hospitals. The Government are rightly investing in the NHS, but they have failed to invest in our social care system. Surrey county council is under huge pressure, and Woking borough council has effectively gone bankrupt. It is reported that without further support, almost 50% of local authorities could go under. If the Government do not invest in social care, I fear that they will make the mistakes that the Conservatives made, which we do not want. We need to invest in social care, so I hope that the Government will agree to a cross-party social care agreement that tackles those issues.

I want to touch on the cost of living. The Government have to turn around an awful record from the previous Government. They have introduced some good measures and have suggested that they would increase the tax threshold—something for which we have long campaigned —but I am concerned about the national insurance rises, which will hit small businesses hard. I met many small businesses this morning in Woking, and they are really concerned about the impact of those rises. I like the rhetoric from the Prime Minister and the Government about this being a Government of service, and a Government who want to promote growth. They are using the correct wording, but good rhetoric needs to be followed up with good announcements. The Government say that they are going for growth, but their actions do not support that. They are ignoring Brexit, they are ignoring social care, which undermines our local authorities, and they are undermining small businesses.

The Budget is better than the Budgets of the previous Government, but that is nothing to shout about. It should be a lot better for my constituents in Woking, and for constituents of Members across the House.

[Madam Deputy Speaker (Caroline Nokes)]

There will be a reduction in the time limit to three minutes after the next speaker. A note: when I am in the Chair in the Chamber, I am Madam Deputy Speaker, not Madam Chair; that is for Westminster Hall, or when the Chamber is in Committee. I call Richard Burgon.