NHS Pensions

Chris Vince Excerpts

Tuesday 1st April 2025 Commons Chamber

[Karin Smyth]

As I outlined in my response and in the written ministerial statement, we have taken action. We were made aware of some of these problems when we came into office in July, and we have pushed the NHS Business Services Authority to move faster than it would have done under the hon. Gentleman’s Government, so that action is happening quicker than it would have done before. We do have faith in the NHS Business Services Authority to get on with this and ensure that there is no financial detriment, in line with the timetable outlined yesterday, and as I have further made clear today.

Madam Deputy Speaker, the hon. Gentleman could have asked me more about waiting lists, which have fallen for the last five months in a row. He could have asked me about the 2 million more appointments that have been provided to deliver for patients seven months early. He could have asked me about the hundreds more GPs who are now working in the health service, or the impact of cancelling the strikes on services for people, or the record funding. In fact, last week in the Chamber he spoke on behalf of the National Pharmacy Association; this week, he could have congratulated the Minister for Care, who is sitting next to me, on the agreement to produce more pharmacy services.

We are making improvements to the NHS every day. The Darzi report reported not only the breadth but the depth of the decline that we inherited. We are resolving that, and fixing the fundamentals of the NHS.

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

I thank the Minister for coming to the House and giving her response. We all know the issues she is talking about when she mentions the state of the NHS that we inherited, and I echo that with the issues I hear about from patients and staff at Princess Alexandra hospital in Harlow. On pensions, can she outline what the Government have done to mitigate the delays in the process?

[Karin Smyth]

It is important that people have confidence in the pension system. That is why we took action in July on coming into office to understand the depth of the problems that occurred under the previous Government. This is a complicated issue, which is why we want to be clear with people that there will be no financial detriment to them. We will continue to work with employers and trade unions to ensure that the issue is resolved as quickly as possible, in line with the timelines I have outlined.

Eating Disorder Awareness

Chris Vince Excerpts

Tuesday 1st April 2025 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Stuart. I thank the hon. Member for Bath (Wera Hobhouse) for securing this extremely important debate and for the work that she and others have done with the eating disorders all-party parliamentary group.

I have come to this debate to speak up on behalf of the many people who have suffered from eating disorders, both past and present. I confess to having a personal interest, as one of those people is my mum. Like many people who suffer from anorexia, my mum developed the disorder as a teenager; as with many people, it came from being bullied by her peers at school. I do not want to give away my mum’s age—that is something that she would never forgive me for—but hon. Members will appreciate that that was a little while ago, although I believe that it has a huge impact on her even today.

I can only begin to imagine the additional pressure that young people suffer now that abuse and bullying does not end at the school gate, but extends online, with negative comments, memes and unrealistic, sometimes AI-generated body images. It has worsened a great deal since the pandemic. Approximately 1.25 million people have some sort of eating disorder. One in eight 17 to 19-year-olds in England were reported to have had an eating disorder in 2023. Having spoken to a resident in Harlow who wishes to remain anonymous, I know that this is as much an issue in my constituency as it is anywhere else. I urge anyone who is struggling with an eating disorder in Harlow to reach out.

The service lead for eating disorders at the Essex partnership university NHS foundation trust has described eating disorders as typically developing in adolescence and early adulthood, leading to changes in a person’s brain, body and behaviour. He also says that early intervention is essential in reversing these changes and improves the likelihood of a full recovery. More recently, the Royal College of Psychiatrists said that services are struggling with demand. In February this year, the Government said that NHS England were processing an update to the commissioning guidance on eating disorders. Can the Minister tell us what the recent announcements on changes to NHS England will mean for the publication of that guidance?

Once again, I thank the APPG for its work on this important issue. I particularly thank Beat for publishing its report and for publishing some really important data on eating disorders. The hon. Member for Bath spoke about the lack of data and the lack of understanding about eating disorders; I have to say that when I was researching this debate, I found that the data for my constituency of Harlow was sorely lacking.

I rarely speak in a Westminster Hall debate without mentioning young carers. This issue has an impact on them as well. I echo the valid point from the hon. Member for Horsham (John Milne) that support for people with eating disorders is a postcode lottery. For families who have to travel long distances, such as to Glasgow, to care for a loved one with an eating disorder, there is a huge cost. There is a disproportionate impact on those who are living in poverty and on low-income families.

I will finish by saying a massive thank you to the hon. Member for Bath for bringing forward the issue. I look forward to hearing the Minister’s response.

Oral Answers to Questions

Chris Vince Excerpts

Tuesday 25th March 2025 Commons Chamber

[Stephen Kinnock]

I know that the hon. Member has met my right hon. Friend the Secretary of State about at least one of those constituency cases. NHS England has asked mental health trusts to review the care of high-risk patients and has published national guidance on the standards of care that are expected. Ultimately, the Mental Health Act is there to protect people and provide the necessary powers to enable clinicians to manage and support such patients—and to do so, where possible, in the community.

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

Yesterday I met Essex partnership university NHS foundation trust and spoke to it about the need to support the families of those suffering with mental health issues in Harlow, and particularly those with caring responsibilities. Will the Minister consider how mental health services can better identify and support young carers?

[Stephen Kinnock]

My hon. Friend will be aware that we are bringing forward the Mental Health Bill, and an important part of that legislation will enable family members—when they are chosen as a nominated person—to have powers to request assessment under the Act, challenge decisions and request considerations of discharge in line with the nearest relative powers.

NHS England Update

Chris Vince Excerpts

Thursday 13th March 2025 Commons Chamber

[Wes Streeting]

The Government have come in with an ambitious reform agenda. As we embark on that reform, we are cutting NHS waiting lists—we have done that five months in a row. We are reforming the GP contract—those negotiations have successfully concluded. We are about to conclude community pharmacy, too. We have put in place a transformation team who are experienced frontline leaders with demonstrable track records—particularly in the case of Sir Jim Mackey—of delivering those changed outcomes. There will always be people who say that it is too hard, too difficult or a distraction, but that is how we have ended up with this status quo; that is how the Conservative party presided over the longest waiting lists and the lowest patient satisfaction on record while spending staggering amounts of public money. More money and no reform is not the answer; the lesson of the previous Labour Government is that investment plus reform delivers results. That is what this Labour Government are doing.

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

I thank the Secretary of State for his statement and pay tribute to NHS professionals in Harlow, particularly those at the Princess Alexandra hospital, for their incredible hard work every single day. Does he agree that NHS staff, who work incredibly hard, are failed by an overly bureaucratic and fragmented system, and that spiralling staff costs are partly a result of the need for additional agency staff?

[Wes Streeting]

We absolutely need to reduce the cost of agency staff in the NHS. That costs the taxpayer billions, and that money could be better spent on ensuring that we have the right staff in the right place, on better terms and conditions, and with permanent contracts. Where we do need flexibility, we should drive it through the NHS bank. We are determined to reform the way that works and deliver better staffing, better outcomes for patients and better value for taxpayers.

Department of Health and Social Care

Chris Vince Excerpts

Wednesday 5th March 2025 Commons Chamber

[Sir Geoffrey Clifton-Brown]

I agree entirely with the hon. Lady. She has obviously been reading my speech— I will cover the announcement later in my speech, at which point she will hear exactly what it says.

As I say, the NAO has confirmed that productivity levels have dropped by 23%. I welcome the Government’s commitment to a 10-year plan for the NHS. We have also repeatedly warned that, with an ageing and increasingly sick population, the NHS will struggle to cope with the ever-increasing multiple complex demands of our population.

I wish to split this speech into three sections: how productivity could be improved in the NHS; funding; and, as the hon. Member for Stafford alluded to, technical advancements and a shift into community care.

The Department of Health and Social Care’s day-to-day spending—RDEL—is set to increase by £10.9 billion—from £187.9 billion to the main estimate as produced today of £198.5 billion. The capital spending is, however, set to decrease by around £1 billion, from £12.5 billion to £11.5 billion—a decrease of 8%. That is worrying as it shows that more and more funds are being redirected from long-term investment—for example, in the new hospitals to which the previous Government had committed themselves. I welcome the new Treasury guidelines that have stopped the practice of the past few years of redirecting up to £1 billion from capital spending to day-to-day spending. That should help to make more money available.

The NHS estate, as we all know from our constituencies, is in desperate need of investment, and our capital investment programme is running behind schedule. The problems with reinforced autoclaved aerated concrete have only added to the necessity of upgrading our hospitals, and I hope the Minister will listen to this plea.

The latest NAO report on the DHSC annual report and accounts shows that local systems, such as integrated care boards and NHS providers, reported a year-end overspend of £1.4 billion. This has nearly doubled from £621 million in 2022-23. This was despite an extra £4.5 billion of additional funding during 2023-24, which was to support pay deals for non-medical staff, mitigate any impacts from industrial action and provide money to address the costs of new pay arrangements for doctors and dentists.

What I do not think is acceptable is the glacial pace of agreeing priorities and approving final budgets for the local systems. In November, our Committee was shocked to hear that, in the past two years, those local systems—ICBs and others—had not had their financial plans approved by the Department until June and May respectively. That is up to three months after the start of the financial year. How can our poor local systems plan efficiently when these final allocations and guidance are so late? If the Department’s own accounts were finalised much sooner, our local systems would be able to have the money allocated in a more timely way, making wastage and inefficient spending less likely.

I welcome the Secretary of State’s prognosis that the NHS is far too big and complicated. There should be a shift towards allowing NHS trusts more control of their own budgets, as clarified in the 2025-26 priorities and operational planning guidance published in January. Moving more funds directly to NHS trusts, ICBs and local systems will improve accountability and give them a level of flexibility about how their funds should be better spent, rather than just focusing on targets and directives. For example, if they were to run a surplus because they had run their operation so well, they could reinvest the money in desperately needed capital projects rather than returning it to Whitehall. That must also go hand in hand with a need to improve productivity. Between 1996 and 2019, the NHS averaged a measly 0.6% a year increase in productivity.

Since the pandemic, productivity has now fallen by 23%. In March 2024, the Conservative Government announced that the NHS would receive £3.4 billion of capital investment for digital improvements between 2025-26 and 2027-28, which begins to address the point that the hon. Member for Stafford mentioned. As part of that investment, NHS England committed to achieving ambitious average productivity improvements of 2% per year through to 2029-30. However, those digital improvements, presaged by that additional £3.4 billion, have not yet been fully actioned.

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

I thank the hon. Gentleman for his speech and, importantly, for his scrutiny of the NHS. He reflected on the fact that productivity has worsened since the pandemic. Does he not think that is to do with the mental health of staff? To support our NHS professionals to be as productive as possible, should we not be considering looking after their health, including their mental health?

[Sir Geoffrey Clifton-Brown]

The hon. Gentleman is exactly right. The NHS employs an enormous number of staff—more than 1 million people, I think—and their conditions of work are really important if we are to retain them. That does mean that their mental health needs close attention, especially when they have problems. If the NHS cannot help with mental health issues, who can? The hon. Gentleman has hit on a really important point.

One reason that productivity is not improving more is that there are 19% more staff in the NHS, but they are seeing only 14% more patients. At our hearing, NHS officials stated that this was due to more complex and acute health needs, meaning longer stays in hospital. I also understand that it was due to staff sickness, absences and the then ongoing workforce industrial action that affected most patients last year, making targets more difficult to meet. I do not know about other hon. Members, but I am still getting emails from constituents whose appointments and operations were cancelled at the last minute due to that industrial action and who are still waiting for their procedures to be rearranged.

Along with staff, technology plays a big role in improving efficiency and productivity. The 2025-26 priorities and operational planning guidance stated that the NHS organisation

“will need to reduce their cost base by at least 1% and achieve 4% improvement in productivity.”

I understand that these figures are hard to pin down due to the NHS still negotiating with bodies such as the ONS on the definition of productivity and how it can be measured. I say to the Minister that, even if the numbers are disputed, we have still not seen a plan for how these productivity gains can be achieved, and the Committee believes that NHS England has produced unrealistic estimates. We need to have a realistic estimate from the Department of what productivity gains can be achieved over the next few years.

Without significant productivity gains, the NHS will not substantially reform waiting times and achieve the best value for the large amount of money that we spend on it. On average, there is a 4% real terms increase in our spending each year, when the economy is growing by only 1%, which is unsustainable in the long term. If we go back to 2013, the Health Secretary had set the NHS a challenge of going paperless by 2018. Clearly, as we all know, that has not happened, because the NHS is still using fax machines. In a digital age of AI, that lack of modernisation produces a risk to both patients and employees in the NHS. Investing in better technology would help with the Government’s ambition to shift more care into the community.

Community healthcare can take many forms, from GP surgeries and community hospitals to pharmacies, dentists and social care. I fear that when we talk about the NHS budget, we predominantly focus on hospital care, rather than the care that most of our constituents need every day. Indeed, Lord Darzi’s report, which was commissioned by the Government last year, said that

“the NHS budget is not being spent where it should be—too great a share is being spent in hospitals, too little in the community, and productivity is too low”

This is where I would like to pay tribute to our GPs and all their staff across the country, especially in the North Cotswolds. Our GP surgeries are usually the first point of contact with our NHS, from antenatal services to blood tests and vaccinations. They also offer a number of services that could be termed preventive care.

As a Committee, we questioned NHS officials on their prioritisation of preventing ill health rather than treating it, thus avoiding much more expensive hospital interventions in the future and a much better patient experience. Their reply was that they had little additional headroom to grow preventive services, yet the public health grant used by local authorities to commission preventive measures, such as health visitors and drug and alcohol services, is expected to fall in value next year by £193 million, despite the Government’s commitment to maintaining it in real terms. I cannot stress enough how I believe that we should be paying much more attention to prevention rather than cure; it is just so important.

NHS England said that, rather than moving funds, there should be a focus on the role of GPs and how they can advise their patients. However, according to the Royal College of General Practitioners, although more than 90% of patients’ direct experience of the NHS is through primary care and GP practices, less than 10% of the total budget is currently spent on primary care. I say gently to the Minister that we are getting our priorities wrong there.

As a Committee, we have recommended that the Government clearly define what counts as health prevention spending within the next six months and track that spending annually. ICBs should be given more flexibility in how they spend their money, which might include redirecting services to more community settings that are closer to patients. It might also include redirecting funds to help manage discharges from hospital. According to the House of Commons Library, the latest data shows that last year an average of 12,340 patients a day remained in hospital despite being clinically fit to be discharged. Even though there is a slight decrease of 1.2% from last year, more can be done to ensure that patients who are well enough can leave hospital for the community and be closer to their families. That will require better working between social care and hospitals.

Women’s Health

Chris Vince Excerpts

Thursday 27th February 2025 Westminster Hall

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

Thank you for your chairmanship, Dr Huq. I thank my hon. Friend the Member for Hastings and Rye (Helena Dollimore) for securing this really important debate.

In my first MP surgery I spoke to Debbie, a victim of the pelvic mesh scandal. I was horrified by her story, and by how thousands of women like her not only suffered enormous, life-changing pain, but many felt they were left without a voice, that their concerns were dismissed and that they were not being taken seriously. Since then, half a dozen women from Harlow constituency have come to me with similar stories.

The issue of women not being listened to goes far further than the pelvic mesh scandal. In fact, it probably goes far further than the issue of women’s health. I am deeply disappointed—I would go as far to say I am ashamed —to hear so many women in my Harlow constituency and beyond tell me that their chronic pain is going undiagnosed. They are being told terrible things like, “It’s just your period,” or, “It’s just your hormones,” or, “You’ll be fine. Go home, put your feet up, have a paracetamol”—despite the fact that 10% of women worldwide suffer from endometriosis.

The NHS website describes the symptoms of endo-metriosis as

“severe period pain, that stops you from doing your normal activities”,

and

“heavy periods, where you need to change your pads or tampons every 1 to 2 hours, or you may bleed through to your clothes”,

and pain when going to the toilet. The World Health Organisation describes how endometriosis can

“decrease quality of life due to severe pain, fatigue, depression, anxiety and infertility.”

Some individuals with endometriosis experience debilitating pain that prevents them from going to work or to school. It is fair to say that a lay down and a paracetamol does not quite cover it. The situation is made worse by the fact that some women are having to wait for up to eight years for a diagnosis. The negative impact on women’s mental health is unimaginable—it can result in the need for antidepressants—and, as we heard in previous speeches, young girls in particular are ignored. Nicola, an acupuncturist in my constituency, told me that a number of women patients had come to her feeling that they were being ignored. Frankly, in 2025, that is just not right.

My ask to the Minister is to let this Government be the Government who take women’s health seriously. Let us have a charter that says that the concerns of women suffering from chronic pain cannot be dismissed.

Oral Answers to Questions

Chris Vince Excerpts

Tuesday 11th February 2025 Commons Chamber

[Stephen Kinnock]

The Chair of the Committee will have seen that we have made an explicit commitment to the mental health investment standard—we are absolutely committed to that. In addition, we have to drive reform in the system so that it is about not just the amount of investment going in, but how we ensure that it is working properly. I am absolutely confident that the commitment to 8,500 new specialists, the Young Futures hubs and having a mental health specialist in every school will facilitate the delivery of services in a far more effective way than is currently the case.

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

I thank the Minister for his continued commitment to supporting mental health in this country. Does he also recognise that mental health involves supporting NHS frontline staff? I had the wonderful opportunity of spending time with the East of England ambulance service on Saturday morning. They work incredibly long hours and work incredibly hard. Obviously, we need to think about their mental health as well.

[Stephen Kinnock]

We in this Chamber should, whenever possible, pay tribute to the people providing those frontline services, who every day work heroically in very difficult circumstances. My hon. Friend is absolutely right about the pressures on the workforce—we are very conscious of that. We will bring forward a workforce plan in the summer, and we are working at pace to recruit the 8,500 mental health workers.

National Cancer Plan

Chris Vince Excerpts

Tuesday 4th February 2025 Commons Chamber

[Andrew Gwynne]

I thank my hon. Friend. I always call him my hon. Friend because I see more of him than I see of my wife. [Laughter.] Usually because we are in the same debates.

The hon. Member makes an important point about research, which will be a crucial aspect of the national cancer plan. Advances in technology, science and pharmaceuticals do not happen by accident; they happen because we fund the research to get to that point. We need to do much better in researching some of the rarer and less survivable cancers. Those scientists and charities must have access to the funds that are available so they can carry out the research we need.

As for where the 30 sites will be, that is above my pay grade. There are criteria, but I will take it back to my officials and see what we can do.

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

I thank the Minister for his statement, and I thank every Member on both sides of the Chamber who has shared their personal stories.

I was nine years old when I lost my grandmother, Grace, to cancer. That was a long time ago, but it still has a profound effect on me. Does the Minister agree that early detection is vital for survival rates? In particular, I emphasise the point about the importance of ensuring that women are taken seriously when they visit their GP.

I thank my constituent Sir Rod Stewart for the support he gave to the radiography department at Princess Alexandra hospital. Does the Minister agree that this national cancer plan will mean that we do not have to rely on the good will of rock legends such as Rod Stewart to support everyone in our society?

[Andrew Gwynne]

Talk about name-dropping; if only I had such famous constituents. Burnage was once home to the Gallagher brothers, and Denton was home to Mick Hucknall—I do not think any of them live there any more.

My hon. Friend makes an important point that women, in particular, have to be taken seriously by their GPs. The symptoms of some of these cancers could indicate a multitude of different things but, knowing from my mum’s bitter experience, I would sooner that GPs erred on the side of caution and got people diagnosed. If the diagnosis turns out not to be cancer, what a wonderful result that is. If it is cancer, we can get them on the treatment pathway sooner rather than later.

New Hospital Programme

Chris Vince Excerpts

Wednesday 22nd January 2025 Westminster Hall

[Helena Dollimore]

rose—

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

rose—

[Dr Mullan]

I will not give way yet.

Yet that is exactly what the Government have done again and again, breaking not only that pledge but a series of pledges they made during the election—that they would not say in government that they had been forced into a particular situation. That was the Chancellor’s specific pledge. It was clear from the Secretary of State’s statement this week that the Government intend to continue making the issue a political football.

I will reiterate the important context behind the challenges that we are seeing in NHS capital backlogs. When we came into Government in 2010, £1 in every £4 being spent by the Government was borrowed, which was clearly unsustainable. If the Labour party thinks that its current economic inheritance presents challenges for public spending, let me remind it of what we inherited. Unemployment was higher; inflation was higher; the deficit, or the black hole as Labour Members like to call it, was higher; and economic growth was lower. Even in that context, however, we prioritised NHS spending.

--- Later in debate ---

[Perran Moon]

rose—

[Chris Vince]

rose—

[Dr Mullan]

I will give way to the hon. Member for Camborne and Redruth (Perran Moon), who stood up first.

--- Later in debate ---

[Chris Vince]

I thank the Minister for the Secretary of State’s statement on Monday, in which £1.5 billion of Government funding was dedicated to Princess Alexandra hospital. At my local hospital in Harlow, it is not just an issue of funding: in fact, the land was not purchased and the business plan was not completed. The idea that the hospital would be completed by 2030 was a pipe dream, was it not?

[Karin Smyth]

I thank my hon. Friend; I am happy to take interventions, but I need to finish by half-past 4, so I am conscious of time. He is absolutely right, and I will come on to his point.

We need to be very clear and honest with people about what was ready and about the different stages of these programmes, which we are very keen to do. Staff and patients deserve better. That is why the Secretary of State asked officials to review the programme and put it on a firm footing with sustainable funding so that all the projects can be delivered.

I thank the hon. Member for Bexhill and Battle for his service to the NHS and his experience. I agree that it is appalling for staff. We all understand that he and I disagree in our political analysis, but he made some really well-informed points about models of care and future models of care, all of which we need to take into account in the delivery of this programme and other parts of the capital programme—and we will.

As the Secretary of State announced to the House on Monday, we now have a realistic plan to deliver the programme. I am pleased that we can be honest with people as we start a new chapter setting out a new commitment to deliver these hospitals, which are so important to all our constituents, that is realistic and backed with funding. We have worked closely with the Treasury to secure five-year waves of investment, backed by £15 billion of investment over consecutive waves, averaging £3 billion a year. This will ensure a balanced portfolio of schemes at different development stages being delivered now and into the future.

The new delivery plan sets out the order and the waves of investment in which each new hospital will be constructed. Hospitals included in a wave will begin construction, while forthcoming schemes will be undertaking pre-construction work to prepare planning permission and secure business cases. With this approach, we can ensure that schemes are ready to be built as soon as possible. A list of the schemes in each wave has been published on gov.uk and in the plan for implementation.

For reference, I will briefly outline the timeline for delivery. [Interruption.] Actually, I think we have seen all the waves, and the hon. Gentleman wants us to move on to Bexhill and East Sussex.

Winter Preparedness

Chris Vince Excerpts

Wednesday 18th December 2024 Commons Chamber

[Karin Smyth]

I thank the right hon. Lady for her question. We have discussed this issue a number of times in this place. We absolutely understand the impact of cold and heat on the system and on people. It is something we need to address more generally. She will be aware that discussions on this issue are continuing with the DWP. If there are specific examples she wants to raise with me or the Department, I am very happy to look at them.

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

I welcome today’s statement and take a moment to thank emergency services in Harlow and across the country who are giving up spending time with their families at Christmas to keep us all safe. East of England ambulance service has set up a new process to support paramedics and Princess Alexandra hospital, which will give them a direct line to a GP who can triage patients and send them to the right department straight away. What is the Department of Health and Social Care doing to work with ambulance services across the country to learn from that and share good practice?

[Karin Smyth]

Again, my hon. Friend is already representing the people of his constituency so well by getting to the heart of what is happening on the ground, learning it for himself and bringing such examples to the House. He is absolutely right that there are such examples across the country, working differently in different systems, which are challenging other systems to look at that practice. That is why we say we want to bring the best of the NHS to the rest of the NHS. That is exactly what we mean. I am confident in the work happening centrally at NHS England. It is learning from such examples and wants to go around the country to ensure that we spread those sorts of ideas to other places. We are looking at them all very closely.