World AIDS Day

Florence Eshalomi Excerpts

Wednesday 27th November 2024 Westminster Hall

[Danny Beales]

I completely associate myself with my hon. Friend’s comments. Particularly in rural settings, if getting to a sexual health service means travelling for miles and sometimes for hours, a lot of people, especially on the lowest incomes, will put off getting the test until another day. Unfortunately, we are seeing persistent rates of late diagnosis and of undiagnosed HIV outside major cities. I completely agree with my hon. Friend.

What about those who make it through the complex online systems—the 8 am call queues, only on a Thursday—and actively go out and seek a test, or those who are fortunately now being found in our amazing opt-out testing pilot? If they are diagnosed with HIV, they are not always getting the support that they need to access HIV treatment in the long term.

We have some of the best—if not the best—HIV treatment and specialists in the world. HIV is now a treatable long-term health condition. “U = U. Undetectable = untransmittable.” We need to say that over and over again. In simple terms, it means that when someone is on HIV treatment, they cannot pass HIV on. That is a powerful and life-changing message. Despite the advances, 14,000 people living with HIV in England are essentially lost to the health system. They have been diagnosed with HIV but are not being seen by their clinic because of stigma, poverty and other barriers that are holding them back from getting that life-changing treatment.

[Florence Eshalomi (Vauxhall and Camberwell Green) (Lab/Co-op)]

I thank my hon. Friend for calling this debate and for his powerful speech. Does he share my concern that the communities that we need to come forward are the very same communities that are not accessing treatment because of that stigma? Organisations like the Fast-Track Cities network, Sophia Forum and One Voice Network are doing fantastic work reaching black women and other black and minority ethnic groups.

[Danny Beales]

I thank my hon. Friend for that comment and for her leadership on the all-party parliamentary group on HIV, AIDS and sexual health, on which I know she has been championing that issue and many others; I think she helped to host the important meeting and discussion about the recent report on disproportionality by the One Voice Network and the National AIDS Trust. If we look at the figures, the disproportionality of HIV is stark. We have made so much progress, including in access to PrEP, testing or treatment, but not all communities are benefiting in the same way. Particularly among black African and Caribbean communities in the UK, the rate of late diagnosis is far too high and the rate of accessing PrEP is far too low. It is completely unacceptable. We have to take on that disproportionality, those inequalities and the stigma that persists in holding people and communities back from accessing those vital measures.

From a public health perspective, the people who are not accessing successful treatment are potentially also passing on HIV and are at risk of getting seriously ill. Many already are. The rates of people not in treatment and not going to their clinic appointments have increased through the covid period. I hope that the future action plan will fill in the gaps in the last plan. One major omission was action on that very challenge.

There are already lots of examples of successful local projects that we can learn from, such as amazing outreach services with nurses going out to find patients lost to care. The value of consistent peer support comes through, time and again, from people living with HIV. We must ensure that every HIV team is proactively finding everyone lost to care and supporting them in a holistic way to overcome the barriers to continue with HIV treatment.

All of this, it must be said, takes place against the backdrop of a wider crisis in our national health service, which is putting historic strain on health services and affecting outcomes across the board. Our task is an immense challenge, but it is not insurmountable. Although we are not on track, it is still possible to end the epidemic in this country by 2030. We already have all the tools we need. This week, my old colleagues at the National AIDS Trust released a report with THT and the Elton John AIDS Foundation with some clear recommendations for the new HIV action plan in England. I am pleased that the Minister has already engaged with them, welcomed them and attended the report launch, which I am sure was much appreciated. It is a clear sign of leadership on the issue.

None of this is rocket science. We are talking about simple, deliverable actions. First, there should be a nationwide, year-round online HIV and STI postal testing service, which would be cheaper than the current patchwork of services that vary from place to place. Secondly, opt-out testing in all emergency departments should be expanded to other health settings, such as GP practices and termination-of-pregnancy services, and elsewhere so that we can find everyone living undiagnosed with HIV. Thirdly, we should broaden access to PrEP beyond sexual health services, starting with a digital service to ensure that those on long-term prescriptions get timely access to the medication. That will then reduce demand on sexual health services for appointments. Fourthly, we need an NHS England programme to find everyone already living with HIV and support them back into care, with proper care co-ordination, peer support and appropriately trained staff. None of this is unprecedented: it is happening or being piloted somewhere. We have all the tools we need; we must now implement them everywhere consistently.

I emphasise that it would be an incredible achievement to meet our 2030 goal and become the first country in the world to end new HIV cases. Of course, that achievement would occur in the context of a deeply concerning global picture—with 1.3 million new cases in 2023 and 650,000 deaths from what is now a treatable long-term condition, as has been said. Much more work clearly needs to be done on the international front, so international development funding is vital.

Ending new cases in England would make a remarkable contribution to the global effort to eradicate HIV by providing a replicable road map to prevent transmission elsewhere—learnings that can be exported and shared. It would also simply show that it is possible. Britain has historically been a world leader on HIV treatment and sexual health. Now let us be a world leader on this too.

One of this Government’s key missions is to rebuild our NHS so it is there for everyone when they need it. Fixing HIV care and ending new transmissions must be an integral part of that vision. I am pleased that the public health Minister is already working on a new HIV action plan. I have seen at first hand the passion and determination of those working to make this happen—from campaigners to clinicians and MPs across the House. We now need that same determination from the new Government. The Government have a unique opportunity to make history, and I hope that they will seize it.

Children’s Cancer Care: South-East

Florence Eshalomi Excerpts

Wednesday 13th March 2024 Westminster Hall

[Munira Wilson (Twickenham) (LD)]

I beg to move,

That this House has considered children’s cancer care in the South East.

It is an honour to serve under your chairmanship, Sir Christopher. In 2020, Jackson’s parents received some of the worst news a parent possibly can: Jackson had been diagnosed with leukaemia, at just two years old. He soon began treatment at St George’s Hospital in Tooting; and after three years, in April 2023, he finally rang the bell that signified the end of his treatment. It was a very difficult experience for Jackson, but his family are extremely grateful for the treatment they received at St George’s Hospital. Reflecting on the experience, Jackson’s mum, Samantha, said:

“Thank you St George’s for being such a great hospital and to everyone who works there, you have made our journey so much easier to deal with because you’re the best team.”

Tomorrow, NHS England will make a decision about where to place a new children’s cancer centre, which will serve south-west London and the surrounding areas, such as Surrey, Sussex, Medway and Kent. NHS England will decide between two proposals: one submitted by St George’s Hospital, and the other by the Evelina London Children’s Hospital in Lambeth. After listening to staff, patients and others affected, I am here, with colleagues from both sides of the House, to make the case that children’s cancer care must remain with St George’s.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

I thank the hon. Member for making a powerful speech and for referring to Jackson. Does she agree that the independence of NHS England is important, that any decision it makes tomorrow has to be based on the clinical knowledge of medical experts, that the decision must be free from any political interference and that the world-class facilities at Evelina, which the hon. Lady has seen at first hand, should be considered alongside the other hospital? Does she agree that we must ensure that the decision is independent, and that we do not undermine the public reputation of NHS England or put undue pressure on it?

[Munira Wilson]

This is not about political interference; it is about ensuring that there has been a fair, balanced and transparent process. I will talk about the process in a moment, but that is the concern. The hon. Lady talks about clinical input. The consultation, albeit that it was run in a very flawed way, had 2,500 responses—some were from clinical experts, and many were from patients and their parents—and it provides very strong evidence that St George’s is best placed and that the Evelina has been predetermined. I have nothing against the Evelina, and in fact I was just about to sing its praises, because I have had personal experience.

To make myself clear, the Evelina is a brilliant hospital that does incredibly important work in treating children. My own daughter, who is nine, is currently undergoing treatment at the Evelina and has received outstanding care. This is not about pitting hospital against hospital; it is about looking at the process and the evidence before us. As the hon. Member for Vauxhall (Florence Eshalomi) has alluded to, I would like to personally thank the medical director at the Evelina, who showed me around its excellent facilities on Monday. However, as I have mentioned, the evidence overwhelmingly demonstrates that, in this case, St George’s is best placed to deliver for this highly specialist cancer service.

Before I come to that evidence, I want to raise serious questions about the decision-making process to date. [Interruption.]

Oral Answers to Questions

Florence Eshalomi Excerpts

Tuesday 5th March 2024 Commons Chamber

[Andrew Stephenson]

I am happy to meet my right hon. Friend to discuss the matter. We have reached pay settlements with the “Agenda for Change” unions, and we continue to reach pay deals with other unions. We are also supporting non-NHS providers whose contracts are dynamically aligned. It is a complex area, so I am more than happy to meet my right hon. Friend to discuss his concerns.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

The Secretary of State will know that NHS England is expected to announce the decision about the primary children’s centre for cancer treatment in south London and south-east London. Evelina London Children’s Hospital in my constituency is one of the only specialist centres in south London. Does she agree that the final decision should be made as soon as possible in order to benefit staff, patients and families? Will she join me in visiting Evelina London?

[Victoria Atkins]

I thank the hon. Lady for her question. In fairness, colleagues from across the House have been raising this issue with me because it affects a large population of London and the surrounding areas. I must leave it to NHS England to finish its consultation process, but I would be very happy to visit not just the Evelina but our other wonderful hospitals that look after children.

Oral Answers to Questions

Florence Eshalomi Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Andrew Stephenson]

I join my hon. Friend in paying tribute to the enormous contribution made by internationally recruited staff to our NHS. As he will know, immigration policy and fees are a matter for my right hon. Friend the Home Secretary. However, our long-term workforce plan supports international recruitment. In addition to the new visa route, we are exempting health and care staff from the immigration health surcharge.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

The Minister will know that without our fantastic workforce, the NHS would not work. I pay tribute to all those hard-working nurses in all our hospitals and care centres, including at St Thomas’ Hospital in my constituency. Does the Minister recognise that in addition to recruiting staff we have to look at retaining staff, who talk about the workload, their mental wellbeing and the fact that the cost of living is having a big impact on them? Does the Minister agree that the Government need to come forward with a wide-ranging plan on addressing workforce planning, pay, training, staff wellbeing and retention?

HIV Action Plan Annual Update 2022-23

Florence Eshalomi Excerpts

Tuesday 18th July 2023 Westminster Hall

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

It is a pleasure to serve under your chairship this afternoon, Dame Caroline, in this really important and timely debate. I thank the hon. Member for West Bromwich East (Nicola Richards) for opening it so well and for outlining the importance of the action plan and what more the Government should do.

This issue is really important for me, because my constituency has one of the highest rates of HIV prevalence not just in London but in the whole UK. Forty years ago, the situation seemed hopeless, but we have seen life-changing improvements in treatment since then. With today’s medical advancements, someone on effective medical treatment cannot pass the virus on. That is vital, and we need to reiterate it loudly and clearly. What we have achieved is incredible and testament to the hard work of so many people in our life sciences industry and the NHS, and of the many charity and community groups that work behind and across the sector.

The HIV action plan, which was launched by the Government in 2021, is a comprehensive strategy aimed at tackling the HIV epidemic across the country. It focuses on four key areas: prevention; testing and diagnosis; treatment and care; and reducing stigma. However, the progress made in the last year is not equal across all areas—we have to be honest about that.

As part of the action plan, hospital emergency departments in London, Brighton, Blackpool and Manchester are testing people for HIV. I had the opportunity to visit Lewisham hospital a year and a half ago to see that work, to listen to the doctors and to see the results. The doctors told me that the oldest person tested for HIV in the A&E was an 85-year-old woman.

This programme has identified people living with HIV from groups who are less likely to test routinely, including women, heterosexuals and those of black ethnicities. That is crucial, as many people in those groups are currently experiencing poorer health outcomes due to late diagnoses.

The opt-out testing figures show that hundreds of people are being identified with HIV but are not currently engaged in treatment. Minister, that is simply not good enough. The longer that people are living with HIV, but without medication and support, the sicker they become, and they are still able to transmit the virus to others.

People are not able to engage in medical care for their HIV for a whole variety of reasons, but in each case more must be done to empower and support vulnerable people to access life-saving treatment that—most importantly—meets their individual needs. People should not be dying of HIV in the UK in 2023; that is the reality.

I want to echo the points made by the hon. Member for West Bromwich East on opt-out testing: it works, and the results are there. It is time to expand that programme to more hospital emergency departments across the country. Any further delay from the Government on expanding opt-out testing will mean missing the chance to diagnose hundreds of people across England. Everyone should have an equal chance to be diagnosed and to access treatment.

Finally, I want to pay tribute to my colleagues on the all-party parliamentary group on HIV and AIDS. I am proud to be one of the co-chairs. The APPG has been at the forefront of work on this issue for 36 years, as one of the longest-standing APPGs, ensuring that this important subject is high on the parliamentary agenda for all of us, regardless of our political background. I am proud of the work done by the APPG in looking at how the UK will be one of the first countries to end the transmission of HIV, and on helping those 106,000 people currently living with HIV in the UK. The APPG’s hope is that positive news from the HIV action plan galvanises the Government to go further with their HIV interventions. Our 2030 goals are achievable but by no means guaranteed.

Mental Health In-patient Services: Improving Safety

Florence Eshalomi Excerpts

Wednesday 28th June 2023 Commons Chamber

[Steve Barclay]

My hon. Friend is right to highlight the importance of pre-legislative scrutiny, into which he had a personal input. I am hugely grateful for his work and the work of Baroness Buscombe and others. I met Baroness Buscombe some months ago to discuss the outcome of that pre-legislative scrutiny. I do not have a date to share today, but I am happy to write to my hon. Friend with a further update.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

Many of my constituents depend on mental health services provided by the South London and Maudsley NHS Foundation Trust, which provides a range of services for very vulnerable people across a large part of south London. The in-patient service includes cleaning and catering facilities, and it is vital that those services are run well so that well-trained professional staff are able to treat mental health patients. Some of the trust’s staff are contracted to a company called ISS, and they have been on strike. Does the Secretary of State agree that ISS should come to the table and discuss the issues of the pay dispute so that staff can provide the cleaning services for mental health professionals to continue with their vital jobs?

[Steve Barclay]

We are investing more in mental health services as a whole, and that includes the important area of cleaning and catering services. Obviously, it would be inappropriate for me to comment on that specific contractual dispute, but industrial action, in its wider sense, is clearly disruptive and I am very keen for it to be resolved as quickly as possible, whether in the context of consultants or cleaning and catering services.

Mental Health Treatment and Support

Florence Eshalomi Excerpts

Wednesday 7th June 2023 Commons Chamber

[Neil O’Brien]

I join my hon. Friend in celebrating that unit and his advocacy for people affected by mental health.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

I thank the Minister for giving way, as I appreciate that he is trying to make progress. On the capital programme, one of the issues that my hon. Friend the Member for Tooting (Dr Allin-Khan) highlighted is Seni’s law, which will look at the treatment that patients receive in mental health units, where, sadly, restraint has led to deaths. The Minister talks about prevention, and we need to make sure that Seni’s law, which was enacted in November 2018, comes forward now. Does he agree?

Eye Health: National Strategy

Florence Eshalomi Excerpts

Wednesday 17th May 2023 Westminster Hall

[Marsha De Cordova]

My hon. Friend makes a really crucial point about special schools and about ensuring there is enough capacity to support children who have complex needs with sight loss. What is really troubling is that, in many instances, sight loss is not always picked up, so having specialist ophthalmologists in schools is crucial. There absolutely should be no way of reducing that provision—in fact, we need to build capacity.

To respond to the current crisis in eye healthcare, the Government must commit to a national eye health strategy for England, as set out in my Bill. The strategy would include measures to improve eye health outcomes, remove the postcode lottery of care, reduce waiting times, improve patient experiences, increase the capacity and skills of the workforce, and make more effective use of data, research and innovation. An eye strategy would ensure that, regardless of where someone lives, they can have access to good-quality eye healthcare, which would address eye health inequalities and ensure that there is more equity of access to eye care among different communities and people who are more at risk of sight problems but who may not be accessing NHS sight tests.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

I thank my hon. Friend for making such an important speech. I pay tribute to the staff in the eye health department at St Thomas’s Hospital in my constituency. Figures show that 650,000 people are on waiting lists in England and that 37% have waited for more than 18 weeks. If the Government had a strategy, would that not address the postcode lottery my hon. Friend highlighted?

[Marsha De Cordova]

I thank my hon. Friend, who highlights the fantastic eye care department at St Thomas’s Hospital. She is absolutely right: my strategy already sets out how to address the backlogs in eye healthcare, and the Government could just say, “Yes, we are going to take it on, reduce those backlogs and address the workforce issues.”

Ensuring that we have equity of eye health must also include people who are homeless and those with learning disabilities, as my hon. Friend the Member for Lewisham East (Janet Daby) mentioned. A strategy would focus on five areas. The first is the eye health and sight loss pathway, which outlines the care and support for those diagnosed with loss of vision. A pathway would focus on the physical and emotional impact of being diagnosed with sight loss. Research has shown that blind and partially sighted people are likely to experience poor mental health outcomes, such as depression and anxiety, in their lifetimes. As part of the pathway, more emphasis should be placed on the provision of non-clinical community support, which would complement the work of community optometrists, ophthalmologists in hospitals and rehabilitation officers. Where is the plan to improve non-clinical and community support as part of the eye health pathway?

The second area the strategy would aim to improve is collaboration between primary and secondary care, and it would emphasise integrated care systems to ensure timely and accurate referrals. Demand for eye care services is expected to increase by 40% over the next 20 years, so we need to pay more attention to joining up care to meet future demand. Some of the burden on hospitals from that increased demand could be eased through more investment in high street community optometrists and by changing the way services are commissioned, to make more use of resources and infrastructure in our communities.

Two million people attend NHS accident and emergency services each year with an injury to or disease of the eye, and over 65% of those cases could have been treated in primary care optometry, which is not only more accessible but saves money—it costs less. Despite that, only 23 out of the 42 integrated care boards commission a minor eye condition service, or MECS, consistently. Five have no MECS provision at all—patients must attend a hospital eye service either via their GP or A&E. That is unfair and inequitable, and it is a waste of NHS resources to have patients go to A&E when they could access something in the community, which is easier for the patient, improves outcomes and saves us money.

Covid Pandemic: Testing of Care Home Residents

Florence Eshalomi Excerpts

Wednesday 1st March 2023 Commons Chamber

[Helen Whately]

On the first point about the use of public health advice, the hon. Lady is wrong; all decisions were informed by public health advice. On her request about the public inquiry, that inquiry is independent of government, so I cannot do what she asks.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

To reiterate the point that my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) just made, every time there is a statement, every time there is a revelation, every time such an issue is raised, whether in this House or in the press, it triggers trauma for many people who have not healed from losing their loved ones, who were not able to go to funerals, and who were not able to seek closure. I hope that the Minister will reflect on her response in that context.

To come back to the public inquiry, Covid-19 Bereaved Families for Justice said that the revelations show why the inquiry must allow the bereaved families to

“be heard in the hearings and for our lawyers to cross-examine key people”—

including the former Secretary of State, the right hon. Member for West Suffolk (Matt Hancock)—

“so we can get full answers to our questions in the right setting instead of having to relive the horrors of our loss through exposés.”

Does the Minister agree?

[Helen Whately]

As I have said, we are talking about, very sadly, people’s lives being lost—people’s mothers and fathers, grans and grandpas, sons and daughters, and sisters and brothers. We should always remember the genuine and real human cost, as well as all those who worked in health and social care looking after dying people and who had a traumatic time themselves.

On the trauma that the hon. Lady talks about, it is Labour Front Benchers who have asked the urgent question and made this conversation happen in this forum rather than in the context of a public inquiry, which might encourage a more reasoned form of debate. I hope she will have noticed that my tone fully appreciates the points that she makes, but it is not for me to dictate who will give evidence to the public inquiry.

Future of the NHS

Florence Eshalomi Excerpts

Thursday 23rd February 2023 Commons Chamber

[Kate Osborne]

I will address my hon. Friend’s point in my remarks. This Government’s ideological commitment to the free market has led them to force through more and more privatisation of our national health service. Some Government Back Benchers are talking openly about moving to an Americanised healthcare system in which people are priced out of healthcare, and they have even mentioned it in this Chamber. We have seen corrupt contracts for cronies, and friends of the Government making millions while people suffer. The Government have allowed the private sector to run rampant, taking hundreds of billions out of the NHS budget over the last 10 years.

It is as if the Government are on a mission to destroy the NHS as we know it. They have even performed smash-and-grab raids on hospital repair budgets, taking £4.3 billion away and leaving hospitals crumbling, leaking and falling apart at the seams. Fifty per cent. of trusts now have structural issues with leaks, collapsing floors, raw sewage and unsafe wards.

American news agency CNN said last week:

“Britain’s NHS was once idolized. Now its worst-ever crisis is fueling a boom in private health care.”

The number of people paying privately for operations is up 34% in 2022. If that trend continues, it will embed a two-tier service in our NHS and price many people out of healthcare. My constituent Christine was referred to a private health company by her GP, while another constituent, Ray, was told that he could no longer get a service from the NHS and that he would need to pay privately, at a cost of £50. Ray said to me:

“As I am 74 years old and rely on my state pension it makes it very difficult for me in the current economic climate to pay this amount. Having paid national insurance contributions for 50 years, I don’t understand. Why do I have to pay again?”

I look forward to receiving a response for Ray from the Minister.

Ray is correct, of course. As Nye Bevan said:

“No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.”

As with any crisis, companies step in to exploit the situation and make money.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

I thank my hon. Friend for making such a powerful speech on a really important issue. A fantastic GP surgery in my constituency, the Waterloo Health Centre, is closing because the landlord is selling to a private developer. Many people who have used that GP service for decades are now worried about where they will register. A number of people across the country are waiting to register with NHS GPs, and waiting lists continue to grow. Does she agree that that is another example of the private sector coming in and making it really difficult for our NHS system?

[Kate Osborne]

Yes. We have all seen for ourselves and heard from our constituents how difficult it is to get an appointment, and the private profiteers are driving that.

--- Later in debate ---

[Matt Hancock]

No, that is not right. There are record numbers in training, and the opening of the new medical schools that were put in place by my right hon. Friend who is now Chancellor of the Exchequer is another Conservative achievement in that space.

However, given the record numbers of nurses and doctors, the record numbers of training places, the record numbers of GPs coming out of training places and the record funds going into the NHS, there is still a record-scale problem. I do not at all deny the scale of the challenge, but that challenge demonstrates to me the vital importance of reform of the NHS—we cannot support its long-term future without supporting reform. My experience of the NHS and of being Health Secretary tells me that the single most important thing that has to happen for the NHS to be as effective as possible in the future is the widespread and effective adoption of the use of technology and data, so that the NHS can be more efficient, giving clinicians back—as Eric Topol put it when he launched his review in 2019—“the gift of time”.

The inefficiency of the NHS because of poor use of data leads to appointment letters being sent out that arrive after the appointment date has passed. Who gets a letter these days for an appointment, anyway? We all use modern technology instead.

[Florence Eshalomi]

Will the right hon. Member give way?

[Matt Hancock]

I will in a moment.

That inefficiency means that different parts of the NHS cannot talk to each other, and indeed cannot talk to social care. It means that a person can end up going into hospital for a serious procedure, but their GP will not know that they have had that procedure, because they went in urgently rather than through that GP. It means that there are people right now who go into an NHS hospital and find that their records, which are on paper, cannot be adequately analysed. Service provision is worse as a result, which directly impacts people’s health. The poor use of data is the No. 1 factor holding back the effective use of the resources that we put into the NHS—not only the cash but, crucially, the staff. They find it deeply frustrating that they have to work with these terrible IT systems when every other organisation of any scale in this country, or in any developed part of the world, uses data in a much more efficient, effective and safe way.

[Matt Hancock]

I will make one final point before I give way to the two hon. Members who are seeking to intervene, which is that the inefficiency in the NHS is best exemplified by its ridiculous continued use of fax machines. Those machines are totally inefficient and completely out of date, and are also terrible for privacy and data protection, because one never knows who is going to be walking past the fax machine. When the Minister sums up, I would like him to set out what he is doing to not just get rid of those fax machines—I tried to do it and made some progress, but did not manage to finish the job—but, more importantly, drive the use of high-quality data, data analytics and digital systems throughout the NHS. Investment in that is the single best way to ensure that all patients can get the service that they need.

[Florence Eshalomi]

To bring the right hon. Member back to the point he made about digital data and making sure that patients are accessing services, I hope he will agree that for a number of my constituents, and probably his constituents as well, access to the internet is a luxury that they cannot afford. A number of people I represent cannot afford a monthly broadband connection because they are choosing between heating their home and paying their rent. They do not have monthly broadband, so they cannot log on to book online appointments; they want to see a GP, but they cannot.

[Matt Hancock]

Of course, it is critical that people do not have to use a computer to access a universal service. Many people will never use a computer in their lives, but the fact of the matter is that well over 95% of us use technology every single day. We can get enormous gains through the use of technology, which allow us to give better provision to the tiny minority of people who do not use technology. The point that the hon. Lady makes is absolutely valid, but it is no argument for not using data and digital services effectively. On the contrary, we can make it easier for the very small minority of people who cannot, will not or cannot afford to use digital technology by using data more effectively for the rest of us.

One example that shows this can be done is the vaccination programme, which was built on a high-quality data architecture. People could book their appointment, choosing where and when to get vaccinated—where else in the NHS could they do that? They should be able to do it everywhere in the NHS. Hardly anybody waited more than 10 minutes for their appointment; it was one of the most effective and largest roll-outs of a programme in the history of civilian government in this country, and we started with the data architecture. We brought in the brilliant Doug Gurr, who previously ran Amazon UK, to audit it and make sure that it was being put together in a modern, dynamic, forward-looking way. It was brilliant, so anybody who says that data cannot be used more effectively is fighting against history.

Of course, a tiny minority of people did not use the IT system to get vaccinated. That was absolutely fine, because that high-quality data system meant that everybody else could, leaving resources free for people who either needed to be phoned or needed a home visit in order to get the vaccine.

--- Later in debate ---

[Liz Twist (Blaydon) (Lab)]

First, I congratulate my hon. Friend the Member for Jarrow (Kate Osborne), my constituency neighbour, on securing this debate, which is hugely important. I listened to the former Secretary of State for Health, the right hon. Member for West Suffolk (Matt Hancock), speaking about data and so forth, and there are clear points there, but I want to focus on the experience that my constituents, my family and my friends have of the NHS. Let me declare an interest in this debate as a Unison member and a former Unison health representative, which I am glad to say hugely informs my interactions on this subject.

There has never been a more urgent need to talk about our NHS. All of us from across the House regularly attend drop-ins with cancer charities and other medical charities, and they tell us about the situations that they face and the backlogs. We all make arguments about those things, but we cannot just see them in isolation: we cannot look just at cancer figures or mental health figures; we need to look at the NHS as a whole system and at how we can make it better.

I want to refer to some of the figures after 13 years of Tory Government. We know that satisfaction with the NHS is at a 25-year low of 36%. That is a drop from 70% in 2010, when Labour left government. Some 7.2 million people are waiting to start planned NHS treatment, which is nearly three times the figure when Labour left power. Before the pandemic, the number was already 4.6 million, so this is not just a covid-related issue, though covid clearly made things difficult—the figure was increasing anyway. Just 80% of patients with an urgent GP referral for suspected cancer saw a specialist within two weeks, which means that more than 42,000 people wait too long.

[Florence Eshalomi]

I thank my hon. Friend for making such a powerful speech, and I declare that I am also a proud member of Unison. Cancer Research UK recently held a drop-in session in Portcullis House, and I must say I was quite surprised to see the statistics for my constituency. We have a world-class hospital quite close to a world-class cancer treatment centre, but even in my constituency of Vauxhall over 300 people have missed the 14-day window and have been waiting longer. Does she not think that this is a big issue right across the country and something the Government need to get a grip on?

[Liz Twist]

I most certainly agree that that is a shocking figure. We need to make sure that we are really addressing all those issues very urgently. Those cancer waits are really important for what happens when undertaking treatment and the possibility of cure, so we really need to get on top of that.

When we look at accident and emergency, which has been much in the news, we see that 11,000 patients died after waiting more than 11 hours in A&E in 2021-22. The Government have just changed the target to 76% of patients waiting less than four hours in A&E by March next year, but we really need to return to the original target. Just changing the figures does not mean that people get better or that fewer people die; it means that the figures have been changed, and people understand that. My constituents know that.

More than 1.5 million people are waiting for key diagnostic tests such as MRIs, which is an increase of 95,500 from this time last year, whereas in May 2010 just 536,262—actually, that still sounds like a big figure—were waiting for key diagnostic tests. We need to get better, not worse, at doing these things.

One in seven people cannot get a GP appointment when they try to do so. All of us know, as constituency MPs, that one of the issues people consistently raise with us is that they are unable to get appointments in a timely fashion, so something that needs seeing to now is perhaps only seen to in a few weeks’ time. That is despite the really heroic efforts by a lot of our GP practices and surgeries, and the staff working in them, to try to make sure that people can get the advice they need when they need it. We know there is a shortage of GPs. Just in my constituency, people talk to me about that regularly. I regularly discuss with the NHS and with the new integrated care boards what is happening in that area, and things are really difficult for us at the moment.

At the same time, there are huge numbers of nursing vacancies in the NHS, with 47,000 posts unfilled, according to the latest figures. Some 40,000 nurses and 20,000 doctors left the NHS in the past year, and only 7,000 of those people retired. Surely, we must agree that patients need care and the NHS needs staff, and that it must be a priority to resolve this situation. That is why I am so pleased to see that Labour has a plan to address those workforce issues, because those workforce issues are at the heart of the difficulties within our NHS. It is not problems with NHS staff or that people are not working hard; they are working hard and, if anything, really becoming burnt out.

--- Later in debate ---

[Rob Roberts]

I invite them to come to Wales and view the conditions in the north Wales health board, where only 62% of buildings are operationally safe and where the hard-working staff, including friends and family of mine, are working in impossible conditions. In England, one in 20 people—5% of them—have been waiting more than a year on waiting lists. In Wales, the number is one in four—25%. The NHS in Wales performs worse in virtually every measurable area than the English equivalent. Labour Members are not shouting any more—how interesting. Currently, only 51% of red call patients are responded to within the target eight minutes. These are the second longest ambulance wait times ever. Only 23% of amber calls, which include strokes, were reached within 30 minutes.

The hon. Member for York Central (Rachael Maskell) mentioned dentistry in an intervention. Only 7% of dental practices in Wales are accepting new patients. Where is the outrage? Where are the demands for better? For every one pound spent on healthcare in England, there is almost £1.20 available in Wales—it is not a money problem—but for markedly worse outcomes in all areas. Where is the outrage? Instead, the Leader of the Opposition, in a speech last year in Wales, described the Welsh Government as providing

“a blueprint for what Labour can do across the UK”.

Well, good luck to the rest of the UK if it chooses to install the right hon. and learned Gentleman into Downing Street next year on that basis.

I am not helping the discussion with these statistics at all. I am guilty of the very thing I always tell others not to do—to stop blaming people, stop trying to score silly political points, and stop wasting everybody’s time by saying that different Administrations are to blame. There is no prospect of an open debate on the actual issues—the real, fundamental problems—if all we focus on is finding blame. It is easy, it is lazy and it gets us nowhere.

The NHS across the United Kingdom is in difficulty. It is in difficulty in England, Scotland, Wales and Northern Ireland. It is not in difficulty for political reasons; it cannot be, because there are three very different Administrations running health services in all those parts of the UK, and the same problems occur in all of them. We need to ask why there is so much waste in the NHS and why there are nurses graduating from universities with degrees who—as the RCN agreed with me recently—cannot draw blood or insert a cannula into a vein. It is not their fault; as with everything, it is the systems that let them down—systems that mean that health boards across the UK spend hundreds of millions of pounds sending graduates on courses to learn the clinical skills that they were not taught on their degrees.

I commend the shadow Health Secretary for something he said recently. He said that he would be prepared to use private sector resources to bring down waiting lists faster. He asked the question: “How can I look someone in the eye as a prospective Health Secretary and tell them that I have a way to provide them with a better outcome, but my ideology is standing in the way of their recovery?” He was lambasted for that view from his side of the aisle but, while he and I will disagree about almost everything else, I have to say that my respect for him went up significantly with that intervention.

The NHS health boards across Wales are sending people to private facilities, which is costing hundreds of millions of pounds. I commend them, because it is all about outcomes. We get so caught up on process and procedure—on who does what, when—that we lose sight of the outcomes for people. One of my most hated phrases in politics is “political football”. It is used almost exclusively in discussions about the NHS, but the bottom line is that things such as the health service have to be run by political decisions; otherwise, who could be held accountable to the public? If we take decisions out of the hands of politicians, who should make them and how can they be held to account?

[Florence Eshalomi]

I thank the hon. Member for making—a speech. He says that this is a political issue. Does he agree, then, that his Government have failed politically by not getting around the table sooner to avert some of the strikes that we have seen up and down the country?