NHS England Funding: Announcement to Media

Edward Argar Excerpts

Monday 25th October 2021 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

(Urgent Question): To ask whether the Government will make a statement on the announcement to the media of £5.9 billion for NHS England.

[The Minister for Health (Edward Argar)]

Mr Speaker, I hope that you will recognise that I seek to be assiduous in my accountability to this House and in adhering to its protocols and forms, not least as a former member of the Procedure Committee. I can reassure you that what you said just now will have been heard not just by me but by colleagues in my Department and in Her Majesty’s Treasury.

Just as we are determined to keep this country safe from covid-19, we also want to tackle the backlog that the virus has brought with it. We know that “business as usual” will not be enough, so we will do whatever it takes to ensure that people get the treatment they need as quickly as possible. In September, we announced plans to spend £8 billion to tackle the elective backlog over the next three years, in addition to the £2 billion this year.

The House will have seen the announcement of £5.9 billion to tackle the NHS backlog of diagnostic tests and procedures and to support the delivery of millions more checks, scans and treatments for patients across the country. This includes £1.5 billion for increased bed capacity, equipment, new surgical hubs to tackle waiting times for elective surgeries and at least a total of 100 community diagnostic centres to help to clear backlogs of people waiting for clinical tests such as MRIs, ultrasounds and CT scans, as well as £2.1 billion of investment to modernise digital technology on the frontline.

This is an historic package of investment that will support our aim of delivering around 30% more elective activity by 2024-25 compared with pre-pandemic levels. That of course comes on top of the work we are doing to strengthen the NHS workforce, who have performed so brilliantly throughout this crisis. All of this is vital if we are to help get our NHS back on track and ensure that no one is left waiting for vital tests or treatments and that we have the right buildings, equipment and systems so that our NHS is fit for the challenge ahead.

[Daisy Cooper]

Almost every elected Member of this House woke up this morning to see the announcement of extra cash for the NHS in England to reduce the covid backlog, although it contained absolutely no details at all. There were no details on where the money will come from, no details on what this means for the almost 6 million people still waiting for treatment, and no details on what it means for our exhausted NHS staff. The Minister has reportedly said that this money is new. Well, is it? How do we scrutinise that claim? Will the Minister set out clearly today—not on Wednesday—where the money is coming from?

Many hospitals in the Government’s so-called new hospitals programme, including those in west Hertfordshire, have been waiting months for funds to be released so that they can start renovation work. Is any of this so-called new money actually part of these existing commitments? There are almost 6 million people stuck at home in pain waiting for treatment. Senior medical staff are predicting thousands of early deaths if the Government fail to act. People are desperate to know how many more weeks they have to wait for their operation. Can the Minister tell them?

Finally, it is all very well announcing money for new diagnostic tests and medical equipment, but there are tens of thousands of vacancies in the NHS. Without the trained medical staff to use these new facilities, this plan is doomed to fail. Without a serious plan to recruit the NHS staff that we desperately need, England could face an epidemic of empty wards and shiny new scanners and superfast broadband going to waste because the staff who make our NHS what it is simply are not there any more.

[Edward Argar]

The hon. Lady is right that the waiting list is 5.7 million and growing. As she will have seen, the Secretary of State has made it clear that the number could grow to more than 13 million if all those who would normally have come forward in the previous year do come forward. That is exactly why we are taking these steps. Rather than expressing concern about the announcement, I would have thought she would welcome this investment, this new money, to help tackle those waiting lists. Of that 5.7 million, around 1.36 million—I may be slightly out—are waiting for diagnostic tests, which is why this is so crucial.

The hon. Lady asks where the money is coming from. She tempts me, but I am afraid she will have to wait until Wednesday’s Budget for the Chancellor to set out how he is funding each of the announcements.

The hon. Lady touched on the single most important element of our ability to tackle the pandemic and to respond to the consequences for the elective waiting list and, as I know she would, I put on record our thanks and gratitude to those staff. Radiologists and radiographers are the key people in this space, and since 2010 we have increased the clinical radiology workforce by 48% from 3,239 to 4,797 full-time-equivalent posts. The number of diagnostic radiographers is up by 33% since 2010.

Does that mean we need to continue to do more? Of course it does, and she is right to highlight the need for continued investment in our workforce. She will have seen last month’s announcement of £12 billion of funding, a significant part of which will help to build that workforce, on top of the commitments we made at the last election and on which we are delivering.

[Mr Peter Bone (Wellingborough) (Con)]

The well-known journalist Michael Crick put out on Twitter:

“Tonight, in quick succession, I—& no doubt other reporters—received 6 Treasury press releases about what’s in next week’s budget—5 of them embargoed to various times over weekend… Whatever became of budget secrecy & announcing things to MPs first?”

The Government have put up a good Minister, so we cannot have a go at him for that, but why does he not go back and tell his friends in the Treasury, at the very least, to provide Members with copies of these embargoed press releases? If it is good enough for the media, it is good enough for us in this House.

[Edward Argar]

I am grateful to my hon. Friend, indeed my friend, and I understand and entirely appreciate where he is coming from. He is an assiduous parliamentarian and quite rightly, as Mr Speaker alluded to, he takes the role of this House extremely seriously, as do I. I suspect that what he says, just as what Mr Speaker said, has been heard loud and clear both in the Department of Health and Social Care and across the Government, including in the Treasury.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

Thank you for granting this urgent question, Mr Speaker. I remember a time when Chancellors went into purdah before a Budget. Perhaps that tradition needs to return.

Fortunately, I received the press release on Sunday. I should not have, but I was sent it, and obviously Members should have received it, too. Of course the NHS is in a desperate state and is under crushing, unsustainable pressure, partly because of a decade of under-investment in infrastructure, the cutting of thousands of beds and raids on the capital budget. It means that today, hospitals are facing a repair bill of £9 billion, and we have sewerage pipes bursting, ceilings collapsing and equipment breaking down. The number of safety incidents in hospitals as a result of these problems has increased by 15% in the last year alone. Not only is the equipment old and outdated but, on a head-for-head basis, we have some of the lowest numbers of computed tomography and magnetic resonance imaging scanners in Europe and the highest numbers of fax machines. Capital budgets have been raided throughout the last 10 years. Will the Minister confirm that, in what he is announcing, the total capital budget will be ring-fenced and not raided in the coming years?

The Minister has not mentioned mental health, but we have thousands of unsafe and undignified dormitory wards. Will there be extra capital investment to get rid of them? If so, by when? Will the diagnostics centres that he mentioned be provided and run by the NHS or run and supplied by private sector contractors? He said that we will clear the 1.3 million backlog in diagnostic tests by the end of the Parliament, but nobody wants to see ghost surgical hubs or new equipment standing idle. Who will staff the diagnostics centres? Who will staff the surgical theatres? Who will operate the new equipment?

The Minister mentioned diagnostics staff, but we are short of one in 10 of them. We are also short of 55% of consultant oncologists, short of radiologists and short of 2,500 specialist cancer nurses. Will he guarantee that the Health Education England budget will be not frozen or cut but properly funded to recruit the thousands of extra doctors, nurses and NHS staff needed to provide safe care and bring waiting times down?

[Edward Argar]

I am grateful to the right hon. Gentleman—my constituency neighbour—for his sensible and reasonable questions. I will endeavour to answer each of them in turn. On capital, he will know, not least because his local hospital—mine as well—is in that list to receive capital investment as part of the overall 40 new hospitals programme, that an initial £3.7 billion has been already allocated to the 40 hospitals that we are committed to delivering by 2030. That is investment not just in maintenance but in replacing old or outdated stock with new hospitals to minimise those longer-term maintenance bills. He is right that we must continue to support ongoing maintenance, as we have done. To take one example, we did exactly that by making an extra £110 million available to help support the maintenance of RAAC—reinforced autoclaved aerated concrete—plank hospitals around the country.

On mental health, the right hon. Gentleman is right to talk about capital investment. In the context of those new hospitals, mental health facilities and hospitals are included. They have not been left out; they have got their share.

The right hon. Gentleman also rightly talked about staff, which, as I said to the hon. Member for St Albans (Daisy Cooper), is a key point. We have seen significant increases in the number of doctors and nurses. He is right to highlight the need for continued increases in specialisms such as radiographers and radiologists. I highlighted the increases that we have seen, but we know just how valuable they are. I alluded to the £12 billion that the Secretary of State announced back in September, a significant part of which will go to support the workforce in the delivery of elective recovery.

On how community diagnostic centres and community diagnostic hubs will both be selected and operate, we are working closely with the NHS on exactly how to do that to ensure that the workforce are sufficient and that we do not impose burdens over and above those already imposed on them. I think that I have answered the right hon. Gentleman’s questions, but I am sure that his hon. Friends will come back if I have missed anything.

[John Redwood (Wokingham) (Con)]

Mr Speaker, you spoke for many of us in the guidance you gave the Government. I trust that they will follow it.

Given that in the last two years very large sums of money have been spent on test and trace, establishing a successful vaccine programme, Nightingale capacity and other one-offs for the pandemic, how much of that money will become available to spend on the other work that is now so desperately needed in the NHS?

--- Later in debate ---

[Edward Argar]

My right hon. Friend will know that by far and away the overwhelming majority of that money was one-off spending to tackle the pandemic in its most acute phase. We will need to continue to spend some of that on therapeutics, vaccinations and similar. On other things, such as the significant increase in infrastructure and understanding that we have built in test and trace and in testing and diagnostic capacity, I am looking at how a long-term legacy can be born of that and how we can transition the learnings and infrastructure from that to continue to deliver for patients in more normal times.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

This announcement goes to the very heart of what is wrong with the Union. Ministers make decisions from here in real time for England based on their perception of needs, while the devolved nations get the consequentials. The Health Secretary’s announcement mentioned that consequentials would be coming. Can the Minister tell us today exactly how much money is coming to Scotland and when the Treasury will send it?

[Edward Argar]

The hon. Gentleman is absolutely right that the Secretary of State said that there would be Barnett consequentials. The details of those will be set out on Wednesday.

[Theresa Villiers (Chipping Barnet) (Con)]

I warmly welcome the huge sums that the Government are devoting to the NHS, but I echo other people in saying that for the funding to work we need to have the people working in the NHS. Will the Minister set out what the Government are doing to improve the retention of doctors and nurses in our national health service, and particularly to persuade women to stay in the workforce because of the crucial roles that they play and the importance of having that capacity in the NHS?

[Edward Argar]

I am grateful to my right hon. Friend. We have rightly set out what we are doing to increase numbers through recruitment, but as she says a key part is retaining the skilled and dedicated workforce. We need to recognise that there is not a separate workforce who have been dealing with the pandemic and who will now to be dealing with elective recovery—they are the same NHS workforce, who will all have been working very hard. We have to be sensitive to the fact that they need the time to recover physically and emotionally after the pandemic. That is what we are seeking to do.

We are being realistic in setting expectations about how long it will take to clear the backlog. It is right that we do that with the public, because we must look after our workforce. One of the single biggest things we can to do help with retention is to be flexible with our workforce—recognising, exactly as my right hon. Friend says, the need for flexibilities, not just for female members of our workforce but for all our workforce, as well as the need for additional staff to come through and help ease the burden.

[Karin Smyth (Bristol South) (Lab)]

The waiting lists are now the longest we have ever seen, plus there are the 7 million people who did not come forward during the pandemic. That means that the validation of the lists is a mammoth task. The clerical validation is quite simple—phoning people up to see whether they still live at the relevant address, whether, sadly, they have died or whether they have moved on—but the clinical validation is now really important. What conversations is the Secretary of State having with clinical leaders about the criteria being used to validate these lists? Crucially, how are local people going to be involved in how and why clinical decisions are being made about who will be treated and in what order?

[Edward Argar]

The hon. Lady and I have spent many days in recent weeks sitting opposite each other in the Health and Care Bill Committee, and she knows of what she speaks given her background in the NHS. She is right about the validation of those lists and then the prioritisation, but although it is absolutely vital that we ensure that patients and those on the waiting lists are kept informed and included in the decisions and discussions about their care, her key point was about clinical decision making. In this context, the decision making and prioritisation must be clinically led.

I have spoken with the Royal College of Surgeons and others of the royal colleges about how we approach the issue. We should look at a number of factors. Is it possible with these new approaches to deal quickly with a large number of high-volume, low-complexity treatments that impact on quality of life? Equally, there are very complex treatments for which a month, a week or even a day longer can lead to more adverse clinical outcomes.

It is right that we go for clinical prioritisation. Although I am keen that we should keep people informed and engaged as participants in the process, it is vital that we see this issue as clinically led.

[Mr Mark Harper (Forest of Dean) (Con)]

I warmly welcome the funds that have been provided to the NHS to deal with the backlogs, particularly for those who stayed away from the NHS during the pandemic. Does the Minister agree that this is effectively a deal—a contract, if you like—with the NHS? We are providing the resources, which we voted for; it is the job of NHS chief executives to take those resources and now turn them into the healthcare that our constituents need. It is not their job to send their representatives on the radio to try to get us to shut down the economy. If we do not have an economy to generate the wealth, we will not have the resources that we need to fund our NHS.

[Edward Argar]

I always listen with great care to my right hon. Friend. He is right that we in this House, on behalf of taxpayers, provide the resources to the NHS and others to deliver the outcomes that we want for all of our constituents, but it is absolutely right that the NHS and others set out their plans for doing so, and that we hold the NHS to account for delivery against those plans. Ministers will draw up those plans in tandem with the NHS because, quite rightly, just as I will hold the NHS to account, I know that my right hon. Friend will hold me to account in this House. A key element of those plans for tackling the backlog must also be reform and innovation rather than simply more of the same.

[Chris Bryant (Rhondda) (Lab)]

I honestly despair. This announcement will not make the blindest bit of difference to the backlog. There will not be the kit in place anywhere near in time to make sure that people get their biopsies back in the next 18 months or two years. There will not be enough staff, because we are not training enough this year even to backfill the number of people who are leaving all of these professions this year. The problem will get worse, not better, unless the Government can tell us how they will make sure that more doctors, oncologists, pathologists and dermatologists stay in the profession and that more of them do more additional sessions a week, for instance, by increasing their overtime payments. The Government might want to sort out the pension problems, which mean that many people are leaving. They might want to provide some kind of golden staying-on bonus for people and make sure that they have a few extra days’ holidays. Most of them are not desperate for money; they are desperate for just a moment to be able to draw breath so that they can do a decent job. However, if we do not have the people, this is all a waste of money.

[Edward Argar]

I know that the hon. Gentleman genuinely feels strongly about this issue. He and I discussed it in a recent debate in Westminster Hall, and I think I am due to meet him to discuss the 10 points that he flagged up then as genuinely practical suggestions to help improve both retention and recruitment in the NHS workforce. He knows that I am always happy to do that. Hopefully, my office will have been in touch with him. If it has not been in touch, it will be, because I want to have that conversation with him.

On the hon. Gentleman’s key point, there are number of things. This is about not only tackling the urgent backlogs now, but building a system that is resilient for the future and that can actually tackle the broader challenges that we as a society face. That means more diagnostic capacity and more diagnostic capacity at an earlier stage, as some other countries have. I am quite happy to acknowledge that, under Governments of both political complexions, we could have done more, and that is why we are doing more now, and I say that to him gently. He talks about urgency; he is right. He also makes a very important point, which I tried to allude to in my earlier answer. If I did not land it clearly, I will attempt to do so now. He is absolutely right to highlight the risk of burn out and exhaustion, for want of a better way of putting it. As I said, it is very easy for people to say that X specialty was not working during the pandemic because that surgery was not happening, but you can bet your bottom dollar that the people involved were probably helping out—the anaesthetists and theatre nurses were—so we do need to address that point. I will be happy to see the hon. Gentleman.

[Dr Luke Evans (Bosworth) (Con)]

To answer one of the points just raised, one of the key problems with driving productivity is that about 10% of a clinician’s time is spent on chasing admin. Can the Minister confirm that some of this money will be put into dealing with the primary and secondary care interface, for example, so that people do not have to spend their time chasing letters and appointments and finding out what has been happening? Those things should happen as easily as they do in our phones.

[Edward Argar]

My hon. Friend is absolutely right, which is why part of this figure—£2.1 billion—is allocated for things such as ensuring that digital patient records and shared care records are rolled out across every trust. There has been an extensive roll-out, but there is more still to do.

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba)]

I hate to tell the Government but there has been a shortage of clinical radiologists for at least 20 years. It takes 12 years to train a clinical radiologist, three to six years to train a radiographer, three to five years to get a specialist nurse and the same for a biomedical scientist. While the investment in the infrastructure is welcome—I would never shy away from welcoming investment in the NHS—there is a very real problem with staffing these centres. What assistance will be provided to NHS trusts to mount an international recruitment drive, because we will have to go to the international market to recruit the staff to these centres?

[Edward Argar]

I am grateful to the hon. Gentleman for welcoming the capital and for his tone. Quite rightly, he highlights the workforce point again. I go back to what I said to the hon. Member for St Albans (Daisy Cooper): on the basis of the figures that I have, since 2010, we have increased the clinical radiology workforce by 48% and the number of diagnostic radiographers is up by 33%. We continue to build on that. The hon. Gentleman is right about the long lead time, which is why it behoves me to say that the increase in numbers is a reflection not just of this Government, but of the previous Government’s investment in this space.

[Chris Grayling (Epsom and Ewell) (Con)]

It is certainly true that vast numbers of NHS staff have done an amazing job in the last 18 months in my constituency and elsewhere, and in secondary and primary care. It is right that we are committing these extra resources to help them to get the job done, and it is certainly the case that in the past we have not trained enough professionals in this world. However, I echo the comments of my right hon. Friend the Member for Forest of Dean (Mr Harper): it is simply not right to have the profession at this stage—when we are all, as taxpayers, making a big new commitment to the health service—demanding more lockdowns and more restrictions. We have got to live with this virus. It is also not right, when these large amounts are found by taxpayers—with some doubts from some of them—that we hear the same representatives still turn around and say, “It’s not enough.”

[Edward Argar]

I entirely appreciate where my right hon. Friend is coming at this from. I hope that, in answering my right hon. Friend the Member for Forest of Dean (Mr Harper), I was clear that we hugely value the amazing work done by all our NHS workforce. This is about providing them with the money and resources they need to do the job, but also stimulating reform and innovation alongside that. The final point made by my right hon. Friend the Member for Epsom and Ewell (Chris Grayling) was about the calls by some for particular policy approaches to this winter by Her Majesty’s Government. He will have heard my response to that on various media outlets on Thursday morning.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

We are all agreed across the Chamber on the importance of the workforce in the NHS and social care. Will the Government consider—alongside a decent pay rise—a covenant to protect and support our NHS and social care staff, akin to the one that they are introducing for the police and the one that we already have for the armed forces?

--- Later in debate ---

[Edward Argar]

The right hon. Lady makes a good point. It is an interesting idea and I will certainly reflect on it.

[Andrew Selous (South West Bedfordshire) (Con)]

Thousands of new homes are being built to the east of Leighton Buzzard and to the north of Houghton Regis. Does my hon. Friend agree that those residents deserve a plan for a rational and budgeted increase in general practice capacity?

[Edward Argar]

My hon. Friend is coming back for a second bite of the cherry after Health and Social Care questions last week. I am well aware that there is significant housing development in his constituency and in many others. We need to ensure that the GP and broader health facilities follow that development, and do so in a way where the local health system can predict it and plan to deliver on that basis.

[Sarah Champion (Rotherham) (Lab)]

Minister, any investment in the NHS is welcome, but let us be honest: this is just a drop in the ocean compared with what has been taken out over the last 11 years. I am very concerned that there is still a lack of parity between mental health and physical health. In Rotherham, the longest wait time for a child’s mental health assessment is 204 weeks; that is nearly four years. What will the Minister do to speed the process up and ensure that there is parity of funding?

[Edward Argar]

The hon. Lady knows that I have a huge amount of respect for her and her work in this House. She is absolutely right to highlight the need for parity of esteem not just to be a phrase, but to be made a reality in our constituencies and on our streets. That is why we have significantly increased funding for mental health not just in revenue terms, but in the capital terms about which we are speaking today—as I alluded to in response to the shadow Secretary of State, in terms of investing in eliminating mental health dormitories, but also in terms of new hospitals. I suspect that the hon. Lady was possibly alluding to child and adolescent mental health services. I am always happy to discuss that issue with her, as is the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan).

[Steve Brine (Winchester) (Con)]

My good friend and the very excellent Minister is going to help me out here, because he said that we will hold the NHS to account for these plans. He knows that I have raised this matter in the House before, when we announced the £12 billion of funding. I know that there is a plan for the catch-up; I know that it has been agreed with the Department and I know that it has been agreed with the Treasury, because a Treasury Minister has told me from the Dispatch Box. How can we all hold our local health trusts to account when we have not seen that plan? Please can it be published?

[Edward Argar]

My hon. Friend asks a key question. I can reassure him that he will see that plan published in the coming weeks. I know that he will both study it carefully and hold me and the NHS to account on what is in it.

[Alex Cunningham (Stockton North) (Lab)]

The new money is very welcome, but North Tees and Hartlepool NHS Foundation Trust is having to spend millions of pounds every year just to keep University Hospital of North Tees safe and operating. It is doing a grand job. But the Minister knows the facts of this: we really do need a new hospital in Stockton. So will the new one be announced any time soon?

[Edward Argar]

I am grateful to the hon. Gentleman. Everyone loves a trier in this place, particularly on behalf of their constituents. I have met him to discuss this, as he alludes to. I think I am overdue giving him an update letter on where we are. As he will be aware, we have had significant numbers of expressions of interest in the opportunity to be one of the next eight hospitals. We look forward to making an announcement on them in the spring of next year. I cannot say any more than that—but, as ever, he makes the point on behalf of his constituents.

[Simon Fell (Barrow and Furness) (Con)]

I warmly welcome this funding announcement. A few weeks ago, I visited the biochemistry department in Furness General Hospital. It is one of the best in the country, so I am glad that there is this focus on diagnostics capacity. Can the Minister confirm that funding will go to centres that already have capacity and the will to do more, rather than creating additional units that may draw it away from them?

[Edward Argar]

My hon. Friend makes an interesting and important point. These will be new diagnostic hubs, but he alludes to a central point. For example, there could be a hub in the car park of an existing hospital where these services are delivered to allow it to deliver them in a covid-free environment, rather than having the same front door for A&E or similar. We are working through the exact detail of how these new hubs will be delivered, but we will be looking at how they can potentially fit with existing services.

[Cat Smith (Lancaster and Fleetwood) (Lab)]

Capital investment in our hospital estate is desperately needed at Royal Lancaster Infirmary—an incredibly old hospital site, which comes with its challenges. Does the Minister agree that closing two hospitals—Royal Lancaster Infirmary and Royal Preston Hospital—to make one new hospital is not creating a new hospital but is in fact a net loss of one hospital? He has a letter on his desk from me asking for a meeting to discuss the future of the hospital site at Royal Lancaster Infirmary. Does he agree that my constituents in Lancaster, which is a growing city, need to have a hospital that they can access?

[Edward Argar]

The hon. Lady will know that, while her local clinical commissioning group—her local health system—may well be considering various options, it has not put any particular option forward to me in that context. I look forward to seeing her letter, but I am certainly happy to meet her if that pre-empts my reply.

[Paul Bristow (Peterborough) (Con)]

My constituents in Peterborough will be thrilled with the £5.9 billion to clear the backlog and the extra cash for diagnostic services, but they will also be keen that that money is spent well. Will the Minister ensure that many more clinicians practise at the top of their licence doing the things that we need them to do, rather than spend their time doing things that clerical staff and more junior colleagues would be better placed doing?

[Edward Argar]

We need to make sure that our NHS workforce, which is diverse in terms of its skills and background, is able to work where those skills are most effectively deployed to deliver the best outcomes for patients. My hon. Friend is absolutely right: where are there are administrative tasks, which I do not in any way denigrate, that are better performed by an administrator than a clinician, we should be looking to deliver that.

[Jim Shannon (Strangford) (DUP)]

I commend the Minister for being assiduous and incredibly dedicated. We welcome money wherever it comes from because it is important to have it. In Northern Ireland we are very keen to see what that money will mean. Will similar money be provided for Northern Ireland through the Barnett consequentials? Will there be any direction as to how the money is spent—for example, to address this year’s non-elective surgery waiting list to give people their sight back, their ability back, and indeed, for some, their lives back? What discussions have taken place with Robin Swann, the Health Minister, in relation to that?

[Edward Argar]

I am grateful to the hon. Gentleman —my hon. Friend—for his question. The Chancellor will set out the detail of Barnett consequentials in due course. The hon. Gentleman knows that I speak to Robin Swann, to whose work I pay tribute, at regular intervals—almost fortnightly—about a number of things. I have not yet discussed the detail of this matter with him, and it will be for him as a devolved Health Minister to make those decisions, but I will of course discuss it with him.

[Mr Philip Hollobone (Kettering) (Con)]

My constituents in Kettering will welcome the extra NHS investment in diagnostics and elective care, but the best way to permanently increase elective capacity in Kettering is for permission to be given for the go-ahead for the redevelopment of Kettering General Hospital. In that regard, will the Minister impress on NHS England and NHS Improvement the urgent need to approve and give permission for the strategic outline case for the hospital redevelopment?

[Edward Argar]

For a brief moment, I thought my hon. Friend was not going to mention the new hospital at Kettering. Yes, I am very happy to have that conversation with NHS England colleagues as I continue to discuss the new hospital in his constituency with them at regular intervals.

[Rachael Maskell (York Central) (Lab/Co-op)]

Workforce planning failures have brought us to this point, but many of the patients on the elective waiting lists will be showing up in primary care, and with greater acuity as they wait longer for their treatments. What additional support will the Minister give primary care to manage people on all these waiting lists?

[Edward Argar]

The hon. Lady is right to highlight that primary care and GP practices are often the front door for the vast majority of these people on the waiting lists, and I pay tribute to the hard work of GPs up and down the country over the past year and a half to two years. She will have seen the announcement a few weeks ago by my right hon. Friend the Secretary of State, in which he set out further support that would be made available to help GP practices.

[Alexander Stafford (Rother Valley) (Con)]

Our GPs have done an amazing job across the country, but especially in Rother Valley, whether that is the Dinnington Group Practice, Swallownest Health Centre or the Stag Medical Centre. I note that there has been a 35% increase in the amount of junior doctors wanting to become GPs. Can we make sure that some of those new GPs and new applicants are in Rother Valley?

[Edward Argar]

We should make sure that general practice is an attractive career for newly qualified doctors wherever they are in the country. I suspect it will be for those individuals joining the profession to determine where they wish to practise, but I suspect my hon. Friend will do a very good job of explaining to them the joys of working in Rother Valley.

[Catherine West (Hornsey and Wood Green) (Lab)]

There are very worrying press reports about a lack of midwifery. Can the Minister put his hand on his heart and tell us that every single trust in the country has a safe ratio of staff to women giving birth?

[Edward Argar]

The hon. Lady asks a very important question. Patient safety, including in midwifery and births, is central to what we are about in this Government and in NHS England. That is one reason why we have seen more than 9,000 more nurses, midwives and health visitors recruited, but we need to continue to do more, and we will continue to do so.

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

I am certain my constituents will warmly welcome this additional funding. There is currently unprecedented demand on health and care services in Cornwall, more now than at any point in the pandemic. The Royal Cornwall Hospital in Truro has escalated its operational level from operational pressures escalation level 4, or OPEL4, to “internal critical incident”. I welcome the meeting that the Cornish MPs had with the Minister last week. I have written to the Secretary of State to ask how we can get some additional support to help us to de-escalate this unprecedented situation.

[Edward Argar]

As my hon. Friend alludes to, I met her and other hon. Friends from Cornwall last week to discuss this matter. I appreciate the pressures facing the NHS in Cornwall, particularly after the pressures it faced over the summer, when other parts of the system may have experienced slightly less pressure, because of all the holidaymakers who rightly go to visit Cornwall. I look forward to working with her further on this and thank the staff of the trust for what they are doing. We recognise the challenges, which is why we are providing this extra capital funding, including capital funding from previous pots, to her trust. I am happy to have a further meeting with her and her chief exec, if she feels that would be helpful.

[Wera Hobhouse (Bath) (LD)]

The Royal College of Radiologists reports that, as of today, another 1,675 consultants are needed to keep up with current NHS demand. The Minister pointed earlier to a recruitment drive and said that 48% more have been recruited. Still, 1,675 consultant staff are needed. If he cannot give us the answer today, how on earth will he recruit these important people very soon? Will he come back with a statement very soon on how this situation will be resolved?

[Edward Argar]

What I said in response to the hon. Member for St Albans (Daisy Cooper) and other hon. Members was that we have seen the number of radiographers and radiologists grow steadily since 2010, and it continues to increase. I appreciate the point made by the hon. Member for Bath (Wera Hobhouse) about the rate of growth, but it is growing. We are recruiting and training more, so I think we are on track to continue recruiting more into that space.

[Robert Halfon (Harlow) (Con)]

I strongly welcome the new money for the national health service on top of the £34 billion that will be spent. Is it not the case that the new money—the many billions being spent on the NHS—is one of the reasons why we will be able to fund our new hospital programme, including the new Princess Alexandra Hospital in Harlow?

[Edward Argar]

The Princess Alexandra Hospital in Harlow has no greater champion that my right hon. Friend. I reassure him that, as he knows, it is on the list of 40 new hospitals that we are committed to building before 2030.

[Henry Smith (Crawley) (Con)]

I, too, welcome the significant extra resource for our national health service as we tackle the covid backlog. I seek an assurance from the Minister that more difficult to detect conditions, such as blood cancers, will be at the heart of what those diagnostic hubs will deliver.

[Edward Argar]

The purpose of the investment in diagnostic capacity is not only to tackle the backlog but to provide a long-term solution to allow diagnostic tests to take place for more people earlier in the illness and to detect illnesses at an early stage. We know that is a key part of tackling illness, preventing serious illness and aiding recovery.

[Duncan Baker (North Norfolk) (Con)]

I welcome the funding for the NHS, and I ask the Minister whether the funding will get down to our ambulance trusts too. Around the country, including in my constituency, waiting times are under huge pressure. What help will there be for winter ambulance pressures, particularly in North Norfolk?

[Edward Argar]

The funding is capital funding for diagnostic hubs and surgical hubs, which will ease pressure by allowing day surgery to continue but without taking up beds in acute settings and while allowing the flow of patients through A&Es. On my hon. Friend’s specific point, we have already announced and provided £55 million to aid our ambulance trusts this winter.

[Mr Speaker]

Can I say thank you to the Minister? In fairness, he had to answer the urgent question because of the actions of others. Hopefully the message has gone back to the Treasury that it ought to ensure that the House hears first. Hopefully there is a lesson that may have been learned; if not, we will continue with the same lessons.