Elective Care Recovery in England

Edward Argar Excerpts

Monday 7th February 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the publication of his Department’s plan for elective care recovery in England.

[The Minister for Health (Edward Argar)]

The covid-19 pandemic has had a huge impact on healthcare systems everywhere. The NHS has performed incredibly, caring for covid and non-covid patients alike and delivering the vaccination programme that has helped us to open up this country once again. Throughout the pandemic, we had to take steps to ensure that we could treat those with the greatest clinical need and that we provided a safe environment for those who needed covid care.

As a result, there is undeniably a huge covid backlog that needs urgent attention. The number of people waiting for care in England now stands at about 6 million, and we know that that figure will get worse before it gets better. Furthermore, our best current estimate is that about 8.5 million people who would normally come forward for treatment have not done so during the pandemic. However, we are pulling out all the stops to help the NHS recover and ensure that patients are receiving the right care at the right time.

Hon. Members will be aware that the Government will have invested more than £8 billion in the NHS in the three years from 2022-23 to 2024-25. As part of the new health and social care levy, we will be putting huge levels of investment into health and social care over the coming three years, and all the time we are announcing new solutions to the problem of how we can ensure that the NHS is on the firmest possible footing for the future.

On Friday we launched a call for evidence that will inform an ambitious new vision for how we lead the world in cancer care. As the Prime Minister announced earlier today, we are setting out some tough targets for the NHS on cancer. We want to ensure that 75% of patients are diagnosed or have cancer ruled out within 28 days of a GP referral, and to return the backlog of people waiting more than two months for their cancer treatment to pre-pandemic levels by March 2023. Today the NHS has also announced the launch of a new platform, My Planned Care, which will provide patients and their carers with relevant and up-to-date information ahead of planned treatment, including information on waiting times for their provider.

I am under no illusions about the fact that our health system is facing an enormous and unprecedented challenge. That is why we are doing everything in our power to support the NHS and its patients, recovering services to reduce waiting times and deliver more checks, operations and treatments. We are faced with a once-in-a-generation challenge. We know that we must get this right. We are working with the NHS and across Government to deliver a targeted and far-reaching plan for elective recovery, and we will update the House at the earliest possible opportunity.

[Wes Streeting]

Thank you for granting the urgent question, Mr Speaker.

This is not a covid backlog; it is a Tory backlog. We went into the pandemic with NHS waiting lists already at a record 4.5 million, and now 6 million people are waiting on those lists—more than ever before. More than 1 million are waiting for scans and tests used to diagnose cancer, and the NHS itself is waiting—waiting for the Government’s plan to deal with the backlog. So where is it? It was due to be published today but was pulled last night. It is like something from “The Thick of It”, but the reality is worse than fiction—a photo op without a plan; the Government’s own NHS recovery plan just another cancelled operation. But there is no need to worry, because there is a website coming that will tell people that they are waiting a long time, even if there is no plan to ensure that they do not-.

Then there is the “reason” for the delay. Briefings from the Department for Health and Social Care claimed that the Chancellor had blocked the plan. As one Government official said,

“it’s pretty obvious it’s about Treasury reluctance to rescue the PM”.

Is this where the shambles of the Conservative party is taking us? Is the Chancellor seriously playing political games while 6 million people wait for care? No wonder the Health Secretary has not bothered to show his face this afternoon. He is probably still recovering from the embarrassment of this morning’s media round, where the big announcement was literally that there was no announcement. So it has been left to the Prime Minister to clear things up, which tends to go almost as well as breakfast television with the Culture Secretary. No wonder she has been dispatched to the middle east.

Let me turn to the “tough targets” that the Minister mentioned. Today the Prime Minister announced a new target that no one should wait longer than two months for cancer diagnosis, but there is already a target for the vast majority of cancer patients to be treated within two months of referral, and it has not been hit since 2015. Is this not just another example of the Conservatives lowering standards for patients because they consistently fail to meet them? The Prime Minister has also announced that three out of four patients should receive a cancer diagnosis within 28 days, but that is an existing target that was introduced last April and has never been met.

The waiting list crisis is the chickens coming home to roost after more than a decade of Tory failure. The Treasury blocked a plan for staffing and it is now blocking the plan to cut waiting times. Is it not now clear, amid the chaos, confusion and spectacular incompetence on display, that the longer we give the Conservatives in government, the longer patients will wait?

[Edward Argar]

I am grateful to the shadow Secretary of State. As he said, 2 million of those on the waiting list have entered that waiting list since the pandemic began. There is undoubtedly a huge covid backlog, as we had to put in place infection prevention and control measures and ensure the availability of beds for those with covid. I am with him, I suspect, on at least one point, which is that I, like him, entirely understand the impact that this has on people’s lives, their anxiety and their health outcomes. That is why this Government are determined to tackle that waiting list. As I said, this is a once-in-a-generation challenge and it is absolutely right that we make sure we get the plan right. We need to ensure that we have the right plan, delivering the right outcomes.

The hon. Gentleman mentioned delays, and I have to say that this plan is delayed. This is a plan we anticipated publishing in December. The reason that we did not do that was because of the omicron variant and the impact it has had on our health services over the winter. We have made sure that we get this plan right.

The hon. Gentleman also mentioned Her Majesty’s Treasury. I have to say, speaking as a Minister in the Department of Health and Social Care, that we could not wish for better partners than Her Majesty’s Treasury and this Chancellor. They have shown strong support to our health and care system throughout the pandemic, with record levels of funding to support it through the pandemic and to help performance to recover subsequently.

Even before the pandemic, when the current Secretary of State for Health was Chancellor, this Government had already put in place a £33.9 billion increase in funding, enshrined in law. It was one of the first pieces of legislation passed by this Government after the election. We have also set out our long-term funding plans through the health and care levy, which I recall the hon. Gentleman’s party did not support.

[Sir Peter Bottomley (Worthing West) (Con)]

We are grateful to the Opposition spokesman, the hon. Member for Ilford North (Wes Streeting), for his sub-leadership bid in raising this important topic. I say to the Minister that today was not an unusual day, in that a constituent wrote saying that she had nothing but praise for the hospital treatment she was getting. Can I pass on my thought, which is that instead of using the word “elective” we should use the words “planned care”, as my hon. Friend did in his response? Through him, I also remind the House that two years into the last Labour Government there was an edict saying that no hospital could do elective care—planned care—until two years past the time when it was booked. Things are much better now and most of us are grateful.

[Edward Argar]

I am grateful to the Father of the House, who once again brings his typical wisdom and experience in this House to our deliberations in the final point that he makes. He is absolutely right. I am happy to join him and his constituents in expressing gratitude to all those who work in the NHS for the work they have been doing throughout the pandemic and that they do every day, irrespective of the pandemic. I know that those on both sides of the House will share in that. The term “elective” is a technical term used within the NHS, but I take his point that it is easy for us in this House to use the technical terms used within our Departments or in the system, but that it is often helpful if we talk in rather more simple terms that mean something to all our constituents.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

As a survivor of breast cancer that was treated in 2019, I was grateful to be seen within 10 days of the referral by my GP and to start treatment within a month. It is frightening that in the months between April and November last year over 90,000 women who might have breast cancer were not seen by a specialist within the target of 14 days of being urgently referred by a GP, and that this year half a million people with suspected cancer will wait longer than the supposed two-week maximum to see an oncologist. The Minister will know that an early diagnosis can be life-saving. What does he think the impact for potential cancer patients will be of the delay to the NHS recovery plan when waiting times are spiralling so much?

[Edward Argar]

The hon. Lady and I often exchange views across the Dispatch Box, and she always asks sensible and reasonable questions. She is right to highlight the importance of cancer care, and that there are some illnesses and diseases like cancer where delay can have a significantly detrimental impact on the outcomes experienced by patients.

Between March 2020 and November 2021, more than 4 million urgent referrals were made for cancer, and over 960,000 people received cancer treatment. Thanks to the amazing work of NHS staff, we maintained cancer treatment at 99.7% of pre-pandemic levels in the latest month for which I have statistics, which is November 2021.

As well as looking to the future with the announcement of community diagnostic hubs and a range of other measures, the plan is not necessary for us to do the work, as we are already doing it. The plan is important for mapping out the future direction of care, but we are not waiting for the plan to improve services, to build back better and to tackle the waiting lists.

[John Redwood (Wokingham) (Con)]

If the Treasury was not holding up the plan, can we be told what was holding it up? When will we get the plan?

[Edward Argar]

I am grateful, I think, to my right hon. Friend for his question. As I set out, it is important that this is the right plan and that it does the job for which it is intended. We are working closely with other Departments to make sure the plan, when it is published, does the job for which it is intended, and I look forward to its imminent publication.

[Grahame Morris (Easington) (Lab)]

It is essential that we address cancer treatment capacity. The Minister talks about diagnostics, which is important, but it is a horse and cart or a hand and glove. I know he is aware of the enormous unharnessed potential of high-tech radiotherapy as a solution to time-critical cancer backlogs, but it still receives only 5% of the cancer budget. Such investment could take enormous pressure off the NHS, especially at this time. Will he arrange a meeting with the Secretary of State so that we can explain to him the important role that advanced radiotherapy could play in tackling the cancer backlog?

[Edward Argar]

The hon. Gentleman and I have previously met to discuss this issue, and I share his view on the value of radiotherapy in helping to tackle the cancer backlog, and more broadly as a treatment. Ministers and I are always happy to meet him.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

My hon. Friend spoke earlier of this Government’s record level of investment in the NHS, but each patient waiting for cancer treatment is undergoing a very long and frightening experience as they wait longer than needed. As he focuses on reducing this backlog, how will he ensure that the record level of investment is focused directly only on measures that will reduce the backlog and is not wasted?

[Edward Argar]

My hon. Friend knows of what she speaks, as a serving consultant in our NHS. She is right that investment is important but that the outcomes are what really matter. We have set out measures such as the community diagnostic hubs, which are bringing diagnostic capacity to local communities and making it more accessible. That is just one example of how we will ensure that the money delivers the required outcomes.

[Daisy Cooper (St Albans) (LD)]

Health conditions do not wait until a medic or a bed is available. They deteriorate, often very quickly, and every single one of the 6 million people on the waiting list will have to rely on their GP for extra appointments and extra treatment, and they will possibly rely on their GP to deal with severe complications. What support will there be for primary care while all these people are waiting for their planned secondary care?

[Edward Argar]

The hon. Lady makes a very important point, and I take this opportunity to put on record my gratitude to all those in general practice for the amazing work they have been doing over the past two years. Again, they are the front door to the NHS for patients and all our constituents. Last year we set out the additional funding being made available to help general practice recover from the changes that had to be made during the pandemic, and we continue to look at the system as a whole, not in its component parts. She is right that general practitioners are often the people our constituents go to if their operation is delayed or if they need additional care while waiting for an operation, so it is important that we provide support to general practice, too.

[Dr Jamie Wallis (Bridgend) (Con)]

Given that health service waiting lists are higher in Labour-controlled Wales and that my Bridgend constituents are being told that they are going to have to wait until at least 25 March to find out what Labour’s plan is in Wales, does my hon. Friend agree that much of what the Opposition have said here today would be better directed down the M4 towards their Welsh Labour colleagues?

[Edward Argar]

I am grateful to my hon. Friend, who puts his finger on an extremely important point. I believe that one in five in Wales is on a waiting list. This Government have put in place measures already to help bring down waiting lists, and the plan is due to published imminently, but we are still waiting to see what the Welsh Government intend to do—or whether they even have a plan.

[Chris Bryant (Rhondda) (Lab)]

May I urge the Government to abandon this talk of a “war on cancer”? It was Richard Nixon’s term and it was thought to be outdated back then. To many people, when Ministers talk about fighting cancer and how somebody has been particularly plucky or courageous for fighting cancer, it feels as though they are telling off the people who do not survive for not being courageous enough. I know that that is not what anybody means, so may we completely change that language? As I understand it, the Prime Minister has also announced another cancer target today: to get to 75% of all cancer diagnoses being made at stage 1 or stage 2. How on earth is he intending to get to that?

[Edward Argar]

I am grateful to the hon. Gentleman for his remarks. He speaks often on this topic from experience, and it is right that we listen carefully to him. I take his point about the importance of language and how different terms and approaches to it will be interpreted by people who are undergoing treatment or a diagnosis for cancer, and I take the point in the spirit in which he meant that observation. On the Prime Minister’s target, the Prime Minister is unapologetically ambitious in seeking to tackle waiting lists and improve performance on cancer care. That is why we are investing record levels in our NHS and bringing forward new diagnostic hubs. It is also why the hon. Gentleman will see measures in the plan, when it is published imminently—coupled with the plan that the Secretary of State set out on Friday—that will help to reassure him, but I am always happy to talk to him about these issues.

[Mr Andrew Mitchell (Sutton Coldfield) (Con)]

My hon. Friend is surely absolutely right, first, to prioritise this vital catch-up programme for our constituents and, secondly, to ensure that we deliver real value for money. At a time of high taxation overall, my constituents want to ensure that for every pound of hard-earned taxpayers’ money spent on this vital programme they are really getting 100p of value as a result in delivery. I assume it is for that reason that this programme is slightly delayed.

[Edward Argar]

The reason this plan is delayed is, as I have alluded to, the omicron variant and the impact it had on our NHS. My right hon. Friend makes an important point about our prioritising tackling waiting lists and waiting times. He is also absolutely right: this is a once-in-a-generation challenge, and it is right that we get the right answer—the right outcomes for patients and for taxpayer. That is what we will do with this plan.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

These waiting times are misery, pain, frustration and agony for my constituents, and then there is the mental anguish of not knowing what is happening or going to happen. I have constituents who are begging and borrowing the money to go private because they cannot stand the pain. Is that the Minister’s plan for the NHS: driving people into the private sector? If it is not, what is his plan?

[Edward Argar]

The hon. Lady is right in some of what she says. We can all appreciate what she says about the impact that a wait for treatment can have on those waiting, in terms of health outcomes and, as she rightly mentions, challenges for people’s mental health as they worry about their diagnosis or when they are going to receive the treatment they need. That applies not only to those who are diagnosed with a life-threatening condition, but to those who have a life-limiting condition or who need orthopaedic surgery, eye surgery or similar, where it has an impact on their quality of life, their ability to work and so on. She makes an important point about that.

As I have set out to the House, we have already made significant strides, as we have come out of this pandemic, in setting out—through the community diagnostics hub and through our approach to surgical hubs—how we can rapidly ramp up the number of planned surgeries that are undertaken. We have to be honest with people that that list will get worse before it gets better, because people who have not come forward will do so. Equally, the golden thread running through is our NHS workforce, and we have to recognise that the people who will be tackling this waiting list are the same people who were working flat out through the pandemic. We have to make sure we give them the space and the support to recover physically and emotionally.

[Holly Mumby-Croft (Scunthorpe) (Con)]

I thank my hon. Friend for his work on this matter. He will know that in order to tackle waiting lists, our NHS staff need the very best buildings and equipment. We have seen some fantastic investment in Scunthorpe General Hospital, but will he meet me to discuss our plans for a longer-term investment in and upgrade to the hospital?

[Edward Argar]

My hon. Friend is a champion in this House for Scunthorpe General Hospital, and since her election she has never ceased to lobby, politely but firmly, on its behalf. I am delighted to agree to meet her.

[Clive Efford (Eltham) (Lab)]

If we are going to deal with this backlog, we need to deal with vacancies in the NHS. That means we do not have time to wait for doctors and nurses to be trained; we need qualified staff now. Can the Minister say where he is going to get those staff? Is he looking abroad? Where is he going to find them?

[Edward Argar]

The hon. Gentleman makes a sensible and serious point. As I said earlier, it is about the workforce. Buildings and technology are fantastic, but it is the people who operate them who really make the difference. I can offer him the reassurance that we are already well on target to meeting our 50,000 nurses pledge from the 2019 manifesto. In October 2021 there were thousands more doctors and thousands more nurses in our NHS compared with October 2020. We continue to grow that workforce from a whole range of sources, including the additional medical school places that this Government delivered a few years ago.

[Steve Brine (Winchester) (Con)]

There is no question but that the waiting list is impacting on my constituents’ quality of life, but I fail to see how taking £36 billion out of the system would help. Can I ask my hon. Friend to look further upstream and tell me how the very welcome 10-year cancer plan announced on Friday will improve our health and prevent more complex future interventions? Will he confirm that the 28-day cancer standard, which does sound familiar—I left office three years ago next month—is a maximum, not a target? In other words, we always want to do much, much better, because we know that the quicker cancer is caught, the better the outcome.

[Edward Argar]

I am grateful to my hon. Friend for touching on the 10-year cancer plan. He is absolutely right that the earlier the diagnosis, the better the outcome, as a rule, in cancer treatment. Yes, we set targets, but we always hope to exceed them. It has been incredibly challenging to do that over recent years, and that is why we as a Government are not only investing the resources, but putting in place the reforms that are needed to achieve these targets.

[Kim Johnson (Liverpool, Riverside) (Lab)]

I start by thanking all the NHS workers, who have done a tremendous job throughout the pandemic. My mum has been waiting for shoulder replacement surgery for more than two years, and the delay in this plan means that she will live with excruciating pain. Can the Minister give us assurances that this backlog will be dealt with in a timely fashion, and that that work will be adequately resourced and funded?

[Edward Argar]

I join the hon. Lady in gratitude towards all those working in the NHS. I am sure that every Member of this House will receive correspondence from constituents who are in the position she outlined. Understandably, they will be distressed and often in pain. This plan is not a necessary precursor for work to be done to bring that waiting list down and get it under control; such work is already under way. As I said, not only is record investment in resources going into it but, while the Government focus to a degree on that, we also focus on what that taxpayers’ money does in delivering outcomes for people—hence why we have already announced the community diagnostic hubs and set out plans for surgical hubs. We are very grateful to all the charities and campaigning organisations that have, over recent months, engaged with us to help to advise on interventions that they think can make a genuine difference to waiting lists, but also to keeping patients informed and supported while they do wait.

[Dr Julian Lewis (New Forest East) (Con)]

How much greater would the backlog be if we had not successfully resisted the entreaties of those modellers, and indeed politicians, who wanted another shutdown over the Christmas period?

[Edward Argar]

It is always hard to prove a counterfactual, as my right hon. Friend will know, but we do know that the necessary measures we took during the pandemic to help to tackle this dangerous virus inevitably had a significant impact on waiting lists. Due to infection prevention and control measures and a range of other things, normal levels of surgery and planned surgery were not able to go ahead. He may be able to extrapolate from that, but, as I say, it is slightly difficult to come up with a detailed counterfactual.

[Mr Toby Perkins (Chesterfield) (Lab)]

My mother died prematurely of lung cancer in her early sixties, so I know, as many others in this House do, that when it comes to cancer, waiting times do not just inconvenience; they literally mean the difference between life and death. I agree with the Minister that this is about not just investment but outcomes, and it is purely on outcomes that this Government are failing. Does he agree that the briefings from his Department suggesting the political games at the top of the Conservative party—“Who’s up, who’s down, who’s going to be the next leader?”—are influencing and impacting on the Government’s ability to get this plan out, and that that will not be forgiven by those people who are waiting for cancer treatment right now?

--- Later in debate ---

[Edward Argar]

I am grateful to the hon. Gentleman for his willingness to share with the House his personal experience in respect of his mother. I think that in doing so he probably speaks for a number of Members of this House, and certainly a number of our constituents. He said it is important that we focus on cancer, and he is absolutely right. Clinical prioritisation will be a key part of how we address bringing the waiting lists down, because it is right that we focus on the illnesses and diseases where the longer the delay, the greater the risk of not making a full recovery or of a negative outcome. He is right to highlight the focus on cancer as on certain other key areas. On his final point, I do not share that view. I believe it is right that we get this plan right so that it delivers the outcomes we need. As I have said to a number of hon. and right hon. Members, I do not believe that the plan is a necessary precursor for getting on with taking a number of steps, as we have done as a Government, to start to bring the waiting lists down.

[Mark Pawsey (Rugby) (Con)]

Does the Minister agree that there must be an important role in this programme for smaller hospitals such as St Cross in Rugby, where on a recent visit I saw some brand new operating theatres providing important extra local capacity?

[Edward Argar]

I am grateful to my hon. Friend for his shout-out for his local hospital. He is absolutely right: we need to utilise the resources and the capacity of the whole system, and this is the approach we are adopting. Often, the debate can focus on the large, acute district general hospitals, but he is absolutely right that smaller hospitals, community hospitals and indeed community facilities all have a part to play in helping to tackle this waiting list.

[Carol Monaghan (Glasgow North West) (SNP)]

Long delays in diagnosis and inappropriate and sometimes outdated treatment are typical for those living with the condition ME. As chair of the all-party parliamentary group on ME, I was pleased to see the new National Institute for Health and Care Excellence guidelines on treatment of the condition. Can the Minister detail what steps are being taken to implement those and to ensure speedy diagnosis and appropriate treatment?

[Edward Argar]

The hon. Lady raises an important point. I know that the House is grateful for her work on this important issue. She highlights the NICE guidelines, which are an important step forward. We continue to work with NHS England on how to most effectively ensure that patients with ME get the early diagnosis and treatment that they need. I or the relevant policy Minister will be happy to meet her to discuss progress and her and the APPG’s thoughts and ideas in that space.

[Mr Peter Bone (Wellingborough) (Con)]

The Minister is right in what he says again and again. I remember a few years ago, a close relative had liver cancer. They went to see the consultant and were given a one in three chance of surviving but managed to pull through. At the same time, another Government plan for the NHS was announced. I said, “What about that?”, and they said, “Well, we just ignore it, because they’ll change it again in a few years. What we actually do is get on and do best practice now.” I think what the Minister is saying is happening at the moment. What the Government could do in the plan is cut red tape in the NHS, which might speed up the construction of the hospital that we need in Kettering, which is so welcome.

[Edward Argar]

I am grateful to my hon. Friend not only for his well-timed plug for his local hospital in Kettering but for his important point. The NHS and the Government have been getting on with improving things and trying to bring service levels back to pre-pandemic levels. Notwithstanding his comment about plans more broadly, it is important for us to have a clear long-term strategic approach to it, because the sums of money involved are significant. The waiting lists and the impact on those are significant. It is right to ensure that we have a clear plan and clear metrics to show how that public money will deliver the outcomes that we all want to see delivered and that those patients want to see.

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

Waiting lists for joint replacements are at a record high. I have been contacted by dozens of constituents with arthritis who are waiting in a lot of pain. What can the Minister say specifically about joint replacements to the more than 600,000 people who are waiting for them nationally? Has he met Versus Arthritis about the issue?

[Edward Argar]

The hon. Lady makes an important point. Orthopaedic surgery, for want of a better way of putting it, is a hugely important part of the planned care and surgery that the NHS does. Although it does not have a direct impact on someone’s life chances in the same way that oncology does, it certainly affects their quality of life and their ability to enjoy it. I hope that I can give her some good news: I believe that I am due to meet Versus Arthritis, with which I have spoken in the past, later this week to discuss its work in this space and its ideas on how we can incorporate that in our work.

[Alun Cairns (Vale of Glamorgan) (Con)]

One in nine people in England are on a waiting list, which is clearly too high. I take confidence from my hon. Friend’s statement and the constructive tone with which he is responding. The figure in Wales is one in five. Does he share my disappointment and dismay at the tone that has been taken by the shadow Front-Bench team in particular, when waiting times in Wales are much longer and the number of people waiting is much higher?

[Edward Argar]

My right hon. Friend makes an important point, which was made by my hon. Friend the Member for Bridgend (Dr Wallis) earlier. I am sure that the shadow Secretary of State will be asking his colleague in the Welsh Government where their plan is.

[Munira Wilson (Twickenham) (LD)]

The Minister will be aware of the shocking 77% rise in the number of children needing specialist mental health care for suicidal thoughts and self-harm between 2019 and 2021. Headteachers in my constituency cite that as a No. 1 issue, but their staff simply cannot cope with the numbers and severity of need. Parents are beside themselves as their children in crisis are sometimes waiting a year to access treatment. As it is Children’s Mental Health Week, will the Minister make a commitment to children, young people and their parents up and down the country that children’s mental health will be an urgent priority alongside all the urgent operations that need to be done?

--- Later in debate ---

[Edward Argar]

Since the hon. Lady was elected, she has had a long track record of interest and campaigning on that issue. She is absolutely right to raise children’s mental health. Before I was a Minister, I took a close interest in eating disorders, which are an element of that—I worked with Beat the eating disorder charity—and in the challenges that parents face in getting access to child and adolescent mental health services for a first consultation and for the required treatment. I absolutely reassure her that mental health, including children’s mental health, remains a priority for the Government.

[Henry Smith (Crawley) (Con)]

I very much welcome the record high levels of funding the Government are putting into the national health service and the rolling out of rapid-diagnostic centres throughout the country. May I seek an assurance from the Minister that the diagnosis and treatment of blood cancers will be a key element of that rapid diagnosis?

[Edward Argar]

I can give my hon. Friend that reassurance. The clinical decision making will rightly inform the approach we adopt to the diagnosis and treatment of cancers, as my hon. Friend would expect, but he is absolutely right that we cannot neglect blood cancer in that context, and nor will we.

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

The elective recovery fund had perverse thresholds written into it, so those hospitals that really struggled and battled with the pandemic were the very ones that did not get any money. Will the Minister ensure a fair distribution of funding in his plan, so that hospitals such as my local one in York that are still battling with very high levels of covid get the resources they need?

[Edward Argar]

I am happy to reassure the hon. Lady that our approach, and that of NHS England and Improvement, is designed to ensure that all hospital trusts can make progress—hopefully rapid progress—in tackling their waiting lists and get the resources they need to do that.

[Jacob Young (Redcar) (Con)]

A key way in which we could get more money directed towards frontline services and elective care would be to fix Labour’s disastrous private finance initiative deals. Will the Minister meet me and the South Tees Hospitals NHS Foundation Trust so that we can look into how we can fix Labour’s PFI debt at hospitals such as the James Cook?

[Edward Argar]

My hon. Friend is right to draw attention to the huge financial challenges that trusts were saddled with following Labour’s PFI deals and I am of course delighted to agree to meet him to see what we can do to try to untangle the worst of them.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his answers, which reflect the fact that he understands the need to do better and wants to improve. Will he outline what discussions have taken place among the devolved Assemblies and the Government here to prevent healthcare from becoming a postcode lottery in the UK? Does he acknowledge the fact that, although waiting lists for appointments were worsened by the covid crisis, they were poor beforehand, so all regions need to work together to address the issue of recovery?

--- Later in debate ---

[Edward Argar]

I am being open and honest at the Dispatch Box about the scale of the challenge and about the challenge for us in tackling it, and the hon. Gentleman is right to highlight that. In respect of the devolved Administrations, I regularly speak to—I would like to meet in person but we regularly meet remotely—the Northern Ireland Health Minister, Robin Swann, whose work in this space I pay tribute to. We talk about a range of issues, not just waiting lists and the impact of covid, but the hon. Gentleman is absolutely right and I am always happy to have conversations with my opposite numbers in the devolved Administrations.

[Tom Hunt (Ipswich) (Con)]

I appreciate the fact that 2 million people have been added to waiting lists throughout the pandemic—it is foolish to try to pretend that that has not made a big difference—and I also appreciate the Government’s £12 billion-a-year plan to help to address the situation. Needless to say, many of our constituents continue to wait in pain for elective surgery, including hip and knee replacements. The Minister will know my views about orthopaedic services in Ipswich and some of the concerns I have had about the new centre in Colchester. It could be that the increased capacity in Colchester cuts waiting times, but there is still an issue about people getting to Colchester so that surgery can take place. Will the Minister meet me to update me on how he is ensuring that Ipswich people are at the heart of all future developments when it comes to the hospitals trust?

[Edward Argar]

I am always happy to meet my hon. Friend. Following his election in 2019—a fantastic result in Ipswich—he was one of the first new colleagues I was able to visit and, with him, I saw Ipswich Hospital for myself. He makes an important point: in looking at the healthcare system in Ipswich and Colchester, it is important that we ensure that the people of both Ipswich and Colchester get access to the best possible facilities, which is exactly what my hon. Friend campaigns for.

[Selaine Saxby (North Devon) (Con)]

I thank the Minister for the work he and his Department are doing to support our NHS. Can he confirm that the 100 new community diagnostic hubs will speed up referrals processes, particularly in coastal communities with historically poorer health outcomes, ensuring that residents receive diagnoses and treatments swiftly?

[Edward Argar]

My hon. Friend is exactly right in what she says. The whole purpose of these community diagnostic hubs is to bring cutting-edge diagnostic facilities to the heart of our towns, our rural communities, our seaside communities and our cities to make it much easier for people to access the diagnostic tests they need.

[Duncan Baker (North Norfolk) (Con)]

Cromer Hospital is the jewel in the crown of our hospital facilities in North Norfolk, but as my hon. Friend will know, it is 25 miles from the nearest main hospital, the Norfolk and Norwich, and I have many older residents. Will he meet me to discuss the viability of an urgent treatment centre? That would not only be a huge benefit to my demographic, but would go hand in hand with tackling the elective backlog.

--- Later in debate ---

[Edward Argar]

I am always cautious to caveat any example with “subject to funding available and Her Majesty’s Treasury”, but I am always happy to meet hon. and right hon. Members to discuss their ideas in respect of their local communities and the services those communities need, because it is hon. and right hon. Members who know their communities best.

[Ruth Edwards (Rushcliffe) (Con)]

I draw the Minister’s attention to an exciting new proposal for a model surgical hub in the east midlands, which would tackle the backlog by focusing solely on elective surgery. The plan is being developed by surgeons in Derbyshire, Nottinghamshire and Leicestershire, including my constituent Dr Tony Westbrook. Will the Minister join me in welcoming this innovative plan and thanking everyone involved in drawing it up? Will he join me in calling on regional health authorities to give it serious consideration?

[Edward Argar]

My hon. Friend makes an important point. What we have seen throughout this pandemic, and we continue to see it now as we look to tackle the waiting lists, is people across the health and care system innovating and coming up with exciting new ideas and new ways to achieve the outcomes that we desire. I will certainly look into the specifics that she talks about, and I congratulate all those involved on their willingness to innovate and come up with new ways of doing things.

[Stephen Metcalfe (South Basildon and East Thurrock) (Con)]

I welcome today’s statement, and I take this opportunity to thank all those healthcare workers who have worked on the frontline throughout the pandemic, particularly nurses, who have worked so hard to keep services operating. I am therefore reassured that we have seen a 21% increase in nursing applications in the past year alone. Will my hon. Friend confirm first that that will help us meet our manifesto commitment to recruit 50,000 extra nurses, but, more importantly, that it will help make their lives easier by reducing their workload somewhat?

[Edward Argar]

My hon. Friend is right on a number of counts: first, to pay tribute to the work of nurses up and down the country during this pandemic; and, to highlight the significant progress we have made on the trajectory to meeting our 50,000 nurses manifesto commitment. The reason we made that commitment is exactly as he says: we know we need more nurses in the NHS, and we are committed to recruiting them, which will have a positive impact on all those already in our NHS as they are joined by many newly qualified professionals to help share that load.

[Scott Benton (Blackpool South) (Con)]

Blackpool was one of the first areas to receive additional funding to tackle the NHS covid backlog, and this funding is already making a difference on the ground for my constituents. When further moneys are allocated, will the Minister commit to prioritising those areas, such as Blackpool, that have some of the worst health outcomes in the entire country?

[Edward Argar]

My hon. Friend is a strong champion and a strong local voice for Blackpool in this House. We are clear in this Government that in the investment decisions we make, we are committed to making sure that we level up across this country and that that money goes to where it can make the greatest difference in improving outcomes for all patients and all those who use our NHS.