Ministry of Defence

Debate between Geoffrey Clifton-Brown and Chris Vince

Wednesday 4th March 2026 Commons Chamber

[Sir Geoffrey Clifton-Brown]

The hon. and gallant Member has great experience in these matters. I think he must have been reading my speech. If he is patient, I think he will get exactly what he wants.

The PAC recommended more than two years ago that the Government should set up a sensitive scrutiny committee to examine confidential military expenditure. I am grateful to the Secretary of State for Defence and the Minister on the Front Bench today, the Minister for Defence Readiness and Industry, for their careful consideration of that matter. I hope it will now be possible to make real progress, but as the Minister will remember, I raised this matter in the estimates debate in June last year. I hope it will not be necessary to raise it again in another year’s time.

There is a commitment to increase defence expenditure from 2.2% of GDP to 2.5% by 2027, followed by an increase to 3.5% of GDP by 2035. In the Government spending review, the current budget is expected to increase by 18.2%, or £11.3 billion by 2028-29. Minister, we really do need to see those numbers incorporated into the Government’s expenditure plan in the autumn Budget so that we can be absolutely certain about them.

Many Members will know—certainly the Chair of the Defence Committee knows, because I have been a guest on his Committee—that the MOD has been reorganised into the Quad: the permanent secretary Jeremy Pocklington; the Chief of the Defence Staff, Air Chief Marshal Richard Knighton; the National Armaments Director, Rupert Pearce; and the Chief Of Defence Nuclear, Madeleine McTernan. I sincerely hope, given their new powers, they will radically reform how the MOD functions. We need to take a more strategic view of systems that we procure—going to the point made by the hon. Member for Plymouth Moor View (Fred Thomas)—and consider above all the capability and speed we are able to acquire them.

Why is it, I say to the Minister, that the Japanese can procure their version of the highly sophisticated Type 26 frigate, a Mogami class, in a third of the time that we do? The consequence of that is that the Australians have just struck a deal for £10 billion to purchase those ships from the Japanese. Why is it that the Israelis can procure their military equipment with just 1,000 people, yet our procurement body, Defence Equipment and Support, employs 12,500 people? Our procurement system is far too slow, subject to mission creep, usually late and usually over-budget. As the Chair of the Defence Committee said, Ajax is a classic example of all those problems. We need to learn those lessons, move on and make sure they do not happen in future.

Last week, as the hon. Member for Oldham West, Chadderton and Royton (Jim McMahon) mentioned—he is no longer in his place—I joined a group of 20 MPs who visited Ukraine. We were in air raid shelters several times during our visits to Odessa and Kyiv. On one night the Russians fired 290 drones: 220 were destroyed but 70 got through, causing a significant amount of damage, and a few injuries and fatalities as well. Ukraine’s technology and digital capability in tracking and destroying those drones is some of the most sophisticated in the world. The drone operators’ experiences are directly and rapidly informing their procurement decisions. The Ukrainians are able to change the specification of their drones within a week. I suggest that it would probably take us some months to do the same thing.

One of the top Ukrainian military experts told us that the future of warfare was following three domains: drones, cyber/electronic and space. I think, hearing those words, that some of our capabilities in those areas need bolstering pretty rapidly. We and NATO need to learn the lessons of the war in Ukraine. Without being too specific, there are severe gaps in NATO’s anti-drone technology.

The experts also made the telling point that modern main battle tanks can cost between $4 million to $9 million per unit, but they can be destroyed by a swarm of drones costing less than $20,000 each. They say that tanks are effectively redundant. The Ukrainians inform us that 80% of their kills are as a result of drone strikes. Modern warfare is changing rapidly, and the MOD needs to be sufficiently agile to adapt.

From the recent activity in Cyprus, and other lessons learned from the conflict in Ukraine and ongoing war in the middle east, we need to invest in comprehensive counter-drone systems and training across our armed forces. As an example, we use the Sky Sabre air defence system, which can shoot down drones, but can cost up to £250,000 a shot. We need to invest further in anti-drone technology to ensure we can do this far more rapidly and cheaply.

As I am sure the Minister is aware, last Thursday the PAC visited RAF Marham, which houses two F-35 squadrons. I have four main takeaways from that visit, all of which stem from the lack of urgency to be ready for war according to General Walker’s three-year timescale. First, the accommodation for our servicemen needs urgent upgrading. It is a disgrace that servicemen can be sent on long tours while their families do not have proper accommodation.

My second takeaway was the effect that has on retention. We were told that pilots and training instructors for the F-35 programme are 50% below optimum levels, which is highly unsatisfactory for a project of this importance.

Thirdly, it is difficult to plan the whole operation when the timing and procurement of the additional 27 F-35s are unclear. Hopefully, that will be revealed in the defence investment plan when it is published.

Fourthly, one of the squadrons had recently returned from the highly successful Operation Highmast to deploy around the world, ending up in Japan. Now, in a matter of a week or two, they have had to redeploy to the middle east. This is a good illustration of how some of our servicemen face considerable stretch. This is to be expected in wartime, but more resources must be deployed to support them and their families. Another example of that is that our submarine crew on HMS Vanguard recently served a 204-day deployment.

The MOD budget is going to grow considerably, but the money is not going to purchase military hardware in the most strategic or cost-effective way. That will happen only if the Quad radically reforms the way the MOD has been run, especially with smarter recruitment of personnel and procurement of equipment.

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

It is really interesting to hear the hon. Gentleman speak about personnel. We have spoken a lot about spending in the MOD, in particular on the need for improved technology; I wonder whether he could touch on spending on personnel and the support we give them. What more does he think we could do to support our service personnel, who obviously do a brave job every day?

[Sir Geoffrey Clifton-Brown]

The hon. Gentleman raises an important point. In the reorganisation of the MOD into the Quad that I have talked about, the critical person is the Chief of the Defence Staff, because he has now assumed responsibility for all personnel matters. I am sure that he will be looking at this very carefully.

We need to look at recruiting people with different skills from those we have recruited for in the past. To operate drones, for instance, as the hon. Gentleman knows, we need people with good computer and dexterity skills. That may mean recruiting youngsters, who have the brains to be able to do this work, but who are not necessarily the people we would traditionally have recruited to be running around the battlefield 100% of the time. It might mean different things; it might mean retraining some of our existing personnel to operate these new weapons.

Above all, our armed forces are at the lowest they have been for decades—the Army in particular. We will need to bolster the numbers somewhat because of the reason I have just given: the overstretch of our personnel. We cannot go on doing that to them. We need to have enough people available on rotation so that next time a long deployment comes around, different people—different regiments and different squadrons—are deployed.

There are a lot of things we need to think about when it comes to personnel. One is that we must have a pipeline in the future. The PAC did an inquiry into reserves and cadets, and it seems to me that we need to do a little better in both categories. [Interruption.] I can see that you are urging me to finish, Madam Deputy Speaker. I have overrun, but I did not wish to try your patience. Simply put, we cannot go on doing what we did in the past. We need to do things differently and better in the future.

Department of Health and Social Care

Debate between Geoffrey Clifton-Brown and Chris Vince

Wednesday 5th March 2025 Commons Chamber

[Sir Geoffrey Clifton-Brown]

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

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

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

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

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

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

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

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

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

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

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

[Sir Geoffrey Clifton-Brown]

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

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

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

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

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

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

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

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

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

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

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

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