UK Health Security Agency: Porton Down

Chris Vince Excerpts

Wednesday 21st May 2025 Commons Chamber

[John Glen]

I am grateful, as ever, to the hon. Gentleman for his support this evening, and he anticipates some of the points I will make later on.

I want also to refer to the Public Accounts Committee, which opened an inquiry into the UKHSA health security campus last year. The Committee heard evidence from the outgoing chief executive Professor Dame Jenny Harries and Shona Dunn, the second permanent secretary, but it was unable to publish a full report owing to the Dissolution of Parliament and instead published its conclusions and recommendations in a letter in May last year. There is a lack of clarity over where we are with these plans, and my simple purpose today is to secure the Government’s assessment of where we are now, 10 months into the new Administration.

Since that Adjournment debate in 2010, four general elections have been fought and I have had five years as a Parliamentary Private Secretary and seven as a Minister in four roles, but since 2015 I have never been offered any briefing on the future of the facility at Porton and on whether that initial decision, given the events of recent years and a sixfold increase in the costs—rather more than inflation—will be followed through on. As the constituency MP, I am eager to get to the bottom of the matter, and in seeking an update from the Minister this evening—and I certainly do not hold her individually responsible, given that she has only been in post for just over 14 weeks—I do want to seek an understanding about the financial obligations of the programme.

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

Will the right hon. Gentleman give way?

[John Glen]

I am happy to give way to the Member representing Harlow.

[Chris Vince]

I thank the right hon. Gentleman, who will know why I am here. Obviously I will sing the merits of relocation to Harlow, but I think we would both agree that we really want a decision on this and to know whether there will be a move or not, because the constituents both of us represent are currently in limbo.

[John Glen]

I thank the hon. Gentleman who is very gracious in the way he puts over his point. It would be helpful for everyone in both our constituencies and for the country as a whole to know what is happening.

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

I thank the right hon. Member for Salisbury (John Glen) for securing this important debate and for his passionate advocacy on behalf of his constituents for the vital work conducted by the UK Health Security Agency at its Porton Down site. I also take the opportunity to recognise the intervention from my hon. Friend the Member for Harlow (Chris Vince) and his passionate advocacy on behalf of his constituents.

Before I come to the decision-making process, I want to use this opportunity to reference some of the incredible work that takes place on the site. Whether it is advancing vaccine development to address global health threats, such as Mpox, or leading the world in evaluating vaccines to ensure that we have effective programmes that save countless lives, Porton Down stands as a pillar of excellence in our national health security infrastructure.

Through the UKHSA science strategy, we are committed to securing health and prosperity with partners in industry and academia. That is why we established the vaccine development and evaluation centre on the Porton Down site, securing learning from the pandemic and advancing our critical research on vaccines. Porton Down’s diagnostics capabilities are equally vital, providing the UK’s only 24/7 service for detecting rare and imported pathogens, including life-threatening diseases such as Marburg virus, Ebola and Lassa fever. The site also plays a unique role in environmental microbiology and biosafety, helping us to understand better how infections spread in real-world settings.

Porton Down’s role does not stop at healthcare. It reaches into our ecosystems, our food chain and our environment. Porton Down is a national leader in medical entomology, including the surveillance of invasive mosquitoes and ticks. Its work ensures that the UK can rapidly detect and respond to vector-borne diseases, protecting the public from threats before they gain a foothold. The site’s food, water and environmental microbiology teams provide additional expertise that is critical to national resilience and the Government’s work on climate change; but, crucially, the work of those globally leading teams requires the best facilities.

As the right hon. Member will know, many facilities on the site are ageing, and I appreciate that the people who work there need clarity on its future as quickly as possible. The Government are thoroughly assessing options for securing the facilities that are required for these highly specialist functions and services in the future.

[Chris Vince]

I could talk about the benefits of the Harlow site for a long time, and I often do, but on this occasion I will be brief. May I ask the Minister, when the Government are making those decisions, to take account of the fact that the Harlow site is very much shovel-ready and is ideally located, given its strong infrastructure and travel links and its proximity to existing health clusters? The site would very much future-proof this important work.

[Ashley Dalton]

I can assure my hon. Friend that the benefits of all options will be considered.

Mental Health Bill [Lords]

Chris Vince Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Jen Craft]

I thank the hon. Member for his intervention. I would welcome the opportunity to discuss this issue in more detail with him, although we will probably continue to disagree. People with learning disabilities and autism can suffer from mental health conditions as much as the rest of the population, but they have a unique set of challenges. I point out as a note to policymakers in general that they should not conflate learning disability and autism as one and the same thing. That is vital.

At the end of January 2025, 2,065 in-patients in locked mental health facilities were autistic or living with a learning disability. As one of my hon. Friends said earlier, the average length of stay for these patients is nearly five years. For those with a learning disability or autism, a locked mental health ward can be a living hell. For someone with sensory issues, a reliance on routine, a need for a specialist diet or equipment or myriad other needs, being in a busy, over-stimulating environment—often with strip lighting and minimal privacy—often means they are set up to fail from the very beginning.

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

My hon. Friend is making an important speech, and I know that her experience in this issue is almost second to none. She is making a point about how those with learning disabilities being confined in the way she suggests could add to their mental health issues. Supporting them in the community would alleviate a lot of those mental health issues. In the long term, that is better for them and for the community.

[Jen Craft]

I will come to that point a little later, but that confinement is detrimental to their mental health. It can sometimes be hard to pick apart a co-existing or co-occurring mental health condition from the behaviour exhibited within that environment. This is part of the reason that it is all but impossible for some detained individuals, in the circumstances they are in, to demonstrate the behaviour change they need to prove they have become sufficiently well to be released.

My attention was drawn last year to the case of a young woman called Bethany, who was detained for the best part of half a decade under the Mental Health Act. She is an autistic young woman whose parents believed that her entering a secure unit was the best choice. However, she ended up being locked up for days, weeks and then months on end in a room with only a mattress on the floor. She was unable to see her family or her support network, and her parents were absolutely devastated at being unable to get her out of that environment and seeing her continually deteriorate. It is hard to imagine the anguish of people seeing someone that they love go through this. When this happens to someone or their family, how on earth can they ever again trust the system that put them there? Learning disabled people and autistic people who have been through that have their confidence in accessing support taken away. In turn, that can create a vicious cycle.

I strongly welcome the moves that this Bill makes towards removing learning disability and autism as a reason alone for detention. However, similar to my hon. Friend the Member for Sittingbourne and Sheppey (Kevin McKenna), I note that the Government have said that these changes to detention criteria will only be switched on when systems can demonstrate a sufficient level of community support. That is a source of real concern. As the NHS Confederation has warned, the

“success of the reforms will be dependent on the wider infrastructure to support”

the Bill. As others have said, there is no clarity on what a sufficient level of support means in practice. We do not know where we are heading or when we will have got there.

The most successful support for learning disabled and autistic people to live independently in their communities is integrated care that encompasses health, housing, occupation and much more besides. I would welcome the Minister’s assurances on how that will be delivered in the timescales set out and how we get from where we are now to where good is. The continual detention of people in this way should shame us all, and an end to that cannot come fast enough.

I sound a note of caution—I think this is fairly similar to that of the hon. Member for Runnymede and Weybridge—that the legislation continues to allow for the co-occurrence of mental health conditions to be a reason to detain someone with a learning disability and autism. That in and of itself could lead to this continual cycle where people are detained for longer than is necessary for their treatment while in an environment that is entirely counterproductive to them becoming well. We also need those with a specialism in learning disability and autism to be present in assessing whether an individual also has a co-occurring mental health condition.

Finally, I put a plea in to the Minister that there is a real need for those who live with a learning disability or autism to be properly consulted. A number of disabled people’s charities that are run by people with a learning disability, such as the “Bring People Home from Hospital” campaign, which is operating under the auspices of Inclusion London, do not feel that they have had sufficient opportunity to input. A very minor point is that some relevant documents related to this legislation have not been printed in easy read. If they have, it has taken a while for them to arrive. People who have a lived experience of these conditions are unable to contribute in a meaningful way.

More broadly, I welcome the legislation’s attempt to make progress in putting patient voice at the heart of care, particularly through advance choice documents, but there is scope to go further. The Royal College of Psychiatrists is advocating for a statutory right to an advance choice document, which the pre-legislative scrutiny Committee also recommended. That would ensure that all patients who would benefit from one would get one, with the aim of reducing detentions and involuntary treatment. While I recognise the importance of this step and this legislation alongside the Government’s investment in mental health crisis centres, a pledge to recruit 8,500 mental health staff and the Secretary of State’s commitment to the mental health investment standard, there is a desperate need to transform community mental health services to put patient voice and experience at its heart and avoid the need for detention orders in the first place.

As a member of the Health and Social Care Committee, I have had the privilege of hearing from some extraordinarily courageous individuals who shared their experience of living with a serious mental illness. It is in that same spirit that I will share my own experience now. I hope that it offers an insight into the limitations of our current system.

I was diagnosed with obsessive compulsive disorder as a teenager, and with bipolar disorder in my 20s. In two and half decades with these conditions I have received good care, but sadly that is the exception and not the rule. I have never been asked what it is that I want from treatment, what it is that I want for my life, and how I can be helped to get there. I have received care that is patronising, reductive, inconsistent and non-existent. During mental health crises I have had to tread a fine line between proving that I am ill, and sometimes extremely ill, and proving that I am not so ill that I need to lose my liberty, because I know that more often than not, treatment is based not on therapeutic care but on risk management. Like thousands of others, I have had to create my own care package and my own route to treatment, because I made the decision that I deserved to live, and I deserved to live well—and also that my children deserved their mum. However, I am very aware that my ability to do this is based on a number of privileges, in no small part a very supportive family, which so many do not have.

While I welcome the Bill for its advances in reducing the amount of detention and increasing the agency of those who are detained, I must call for a significant overhaul of community mental health services to prevent crises from occurring in the first place. We know that we can and must do better. I ask all Members to note that when we discuss people’s serious mental illnesses, we often talk as though they were “others”, which they are not. Let me say this: “There is someone standing here among you, a Member of Parliament, who has a serious mental illness. It does not prevent me from doing my job or from living my life; in some ways, it makes me better at it.” While the Bill continues its passage through Parliament, can we please bear in mind that we are talking about individuals, and individuals who will be affected by it, and that what we seek to do—and what I hope we will accomplish—is give people who live with serious mental illnesses the ability and the right to live the best lives that they possibly can, with all the support that we can make available?

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[Josh MacAlister]

I thank my constituency neighbour for suggesting the types of solutions that we should look at. Some areas of the country have much higher rates of suicide than others, and we know far too little about why those areas have those trends.

Around half of children in care are expected to have some sort of mental health disorder, and they are estimated to be four to five times more likely than the rest of the child population to have a mental health need. Despite that, children in care are disproportionately rejected for support from CAMHS services, and this builds up unmet mental health needs for which we as a country are paying the price in social and economic costs further down the line.

Just one example of that is the surge in deprivation of liberty orders that we have seen in recent years. In 2017-18, there were 103 applications; in 2024, the figure was 1,280. Deprivation of liberty order applications often leave judges in our family courts with impossible choices over the secure accommodation option for children. Young people who grow up in the care system should receive the very best that our country has to offer, with help being speedy and tailored. Although wider changes are needed to make that a reality, humanising our mental health legislation in the ways set out in this Bill will make a difference.

[Chris Vince]

My hon. Friend has talked with real passion and expertise about children in care, and he makes some really important points. Does he agree that the mental health support we give to young carers—young people who support a family member—is equally important? They make such a huge difference to our communities and the NHS, and they too should be supported.

[Josh MacAlister]

Absolutely. We need to support young carers and young people in care. One of the common challenges facing both of those populations is that services sometimes fail to look at what support can be provided to the whole family unit, so I take my hon. Friend’s point.

Finally, I will say a few words about a sensitive issue that is a growing trend. Most weeks, I visit a school in my constituency, and there is a growing theme: teachers, and now parents, are raising concerns about the potential over-diagnosis or misdiagnosis of ADHD and mild autism. I raise this point for two reasons: first, because the risk is that the scale of the increase in diagnosis is so great that it may take away much-needed mental health services from those with acute and genuine need; and secondly, because we have yet to grasp the potential negative impacts of treating what may be social challenges as medical disorders.

Some 400,000 children are currently awaiting an ADHD assessment, and rates of diagnosis have risen sharply in recent years. Diagnosis varies dramatically depending on where someone lives, who does the assessment and, worryingly, the socioeconomic background of the individual.

NHS and Care Volunteer Responders Service

Chris Vince Excerpts

Monday 19th May 2025 Commons Chamber

[Karin Smyth]

We are learning so much about each other this afternoon, are we not? I am pleased to hear that that is how my hon. Friend started her journey, and I am so impressed that she is continuing to do that. I was out with the ambulance service last week talking to staff, who highly praised those community first responders. The work that she and others are doing is valuable, and I know she will continue to use that knowledge to feed into the work we want to do in the future.

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

I thank the Minister for answering the urgent question.

May I pay tribute to the many volunteers in Harlow, both those who supported people during the pandemic and, in particular, the Butterfly Volunteers who support people receiving end of life care at Princess Alexandra hospital? I feel emotional just thinking about that they do. We found that it was best to seek volunteers locally in Harlow, both through Rainbow Services and through the volunteer co-ordinator Della Nash, who is wonderful but who, sadly, was made redundant by the last Government. How can local charities and other organisations feed into the Government portal once it is up and running?

[Karin Smyth]

I thank my hon. Friend for what he has said, and I thank the Butterfly Volunteers. Supporting people at that really important end of life stage is hard and critical work, and I commend them for it. The local link is also critical: we need to ensure that people can be directed from the national system to local systems, through NHS England and perhaps—if it is appropriate, Mr Speaker—through the House. It is in the interests of local Members of Parliament for us to ensure that what we have learnt from the national scheme is continued into the local scheme, and, as my hon. Friend says, we need the local co-ordination and infrastructure about which we have heard this afternoon.

Hospitals

Chris Vince Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Stephen Kinnock]

I am sure the hon. Lady will appreciate the fact that we have now come forward with a programme built not on sand or smoke and mirrors, but on reality, and the hospital she mentioned will be a part of that. She is very welcome to write to me with any further representations.

The situation I have described is the dog’s breakfast that we inherited from the Conservatives. This is genuinely not a partisan point, because when the previous Government did the right thing—for example, on the Tobacco and Vapes Bill—we were more than happy to support them, but where they failed, fibbed, and fobbed off Members of this House, we will not pretend that they were acting in good faith. It now falls to us to level with the British people about why their hospitals will not be fixed on time.

Our constituents are understandably furious, because our national health service is quite literally crumbling. As Lord Darzi found in his investigation, over the past 14 years our NHS has been starved of capital, with a staggering £37 billion under-investment over the course of the 2010s. I know that we will hear today from hon. Members about many examples of hospital roofs failing or falling, leaky pipes that freeze over in the winter and buckets for catching rainwater in corridors, and I know that capital spending is needed now more than ever.

Although we are deeply shocked by the neglect and incompetence of the Conservatives, it has not prevented us from rolling up our sleeves and clearing up the mess that they left behind. That is why we immediately commissioned a review, which had two core objectives. The first was to put the programme on a firm footing with sustainable funding, so that all the projects can be delivered to a realistic and affordable timetable. The second was to give patients a realistic, deliverable timetable based on facts rather than fantasy.

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

My hon. Friend talks about realistic timelines, which are really important. My constituents in Harlow were promised a new hospital when there was clearly no money, no business plan and not even a site made available for it. Does he agree that this work is so important for the trust that we want to have from our constituents? Certainly in Harlow, we have a realistic timeframe and plan that we can actually meet.

[Stephen Kinnock]

My hon. Friend is also a doughty champion for his constituents. With each brick we build in the new hospital programme, I hope that we will start to rebuild some trust between his constituents and this place. He is absolutely right to point out that it is much better to have a realistic programme, rather than one built on smoke and mirrors.

Officials reported on the review in the autumn and set out a range of options for a more realistic timetable for delivery. In January, my right hon. Friend the Secretary of State for Health and Social Care announced five-year waves of investment, backed by up to £15 billion of investment over consecutive five-year waves, averaging £3 billion a year from 2030. Our programme is a balanced portfolio of hospital schemes at different development stages, being delivered now and into the future. It is the most efficient and cost-effective way of giving our NHS the buildings it needs, while also giving the construction sector the certainty that it needs to deliver.

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

In all sincerity, I thank the Lib Dems for bringing the debate to the House. It is fair to say that Labour Members are more than happy to discuss the NHS and the new hospital programme at any opportunity. I would again like to put on the record my thanks to all the staff at Princess Alexandra hospital in Harlow. I also pay tribute to the staff of the East of England ambulance service, who go back and forth to the hospital.

I often visit the Princess Alexandra—I actually visited it today—and I see a workforce who work incredibly hard in difficult circumstances. They are a credit to not only my town of Harlow, but the NHS as a whole. As has been mentioned, the new Princess Alexandra hospital was one of 40 new hospitals that only existed in the mind of the former Prime Minister Boris Johnson. When I was elected, I found a project without any funding, without a business plan and without even a site to build the new hospital on. The idea that it would be built by 2030 was an absolute pipedream. The current Princess Alexandra site is too small. The corridors and wards are too small, the A&E department is crammed, and it is literally falling apart. We have seen sewage leaking into the wards and we saw the roof of the ICU falling down. Fortunately, nobody was injured. [Interruption.] My speech is so riveting that I have woken Jennie up, so I apologise for that.

I support the Government’s amendment and pay tribute to the work already done by this Labour Government. Waiting times are down, and we finally have a realistic, achievable and fully funded timetable for a new Princess Alexandra hospital and at least £1.5 billion of investment in our town. In the meanwhile, of course the Princess Alexandra hospital will need funding. I have met the chief exec a number of times and will meet him again next week to discuss the matter. I know that the Minister is already preparing herself for the lobbying she will get from me in the Tea Room next week.

I would like to end my speech on something that there will be consensus on across the House.

[Charlie Dewhirst (Bridlington and The Wolds) (Con)]

Does the hon. Member agree that the new hospital programme is just one part of the jigsaw and that facilities such as Bridlington district hospital and Alfred Bean hospital in Driffield in my constituency are much under-utilised resources? We should be making the most of every NHS facility by bringing community services back into those places.

[Chris Vince]

I thank the hon. Member for his intervention. As a fellow Leeds United supporter who is celebrating this week, I took his intervention just to have the opportunity to mention that. I add that Harlow Town were also promoted on Monday.

The hon. Member makes a valid point, and a hospital like Princess Alexandra is only part of the jigsaw. Just over the road, there was the walk-in centre, which was sadly closed in 2013. Ideas such as care in the community, which mean that fewer people need to go to hospital, need to be looked at. At Princess Alexandra hospital, one of the biggest issues is the number of people who need to go to the A&E department. We need to consider how we can avoid that and free up more medical staff to do other things, so I absolutely take his point.

I will end on another area of consensus. This is an issue that Members who have hospitals in their constituencies will all be aware of: NHS nurses, doctors and staff suffering abuse at work. I would like to put on the record that NHS staff are absolute heroes and that any abuse, be it physical or verbal, is totally unacceptable. I am sure that that is something we can all agree on across the House.

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.

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.

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.