NHS England Update

Debate between Jen Craft and Wes Streeting

Thursday 13th March 2025 Commons Chamber

[Wes Streeting]

First, I give the Chair of the Select Committee my assurance that I would be delighted to appear in front of her Committee at the earliest opportunity —that means soon. I appreciate that it will want to scrutinise these changes in more detail, and I would welcome the constructive challenge that it offers. I also reassure her that the direction that we are giving to frontline leaders is to deliver the three big shifts in our 10-year plan, and to ensure that as we take immediate steps to bring the finances under control, we do so in a way that lays the firm foundations for the future of the NHS that we need to build.

My cautionary note to Members across the House is that when we ask frontline leaders to reform and to change ways of working, sometimes that requires not just changes to the bureaucracy as it were—the easier and lower hanging fruit—but service reconfiguration in the interests of patient outcomes and better use of taxpayers’ money. Sometimes, they get those changes wrong. I have successfully campaigned against closures of services such as the King George accident and emergency department, which should not have closed and where we won the case on clinical grounds.

Sometimes, let us be honest, the public can get anxious, and Members of Parliament feel duty bound to act as megaphones and amplifiers for public concerns. It is important that we support and engage with local NHS leaders. By all means, we should scrutinise, challenge and ask questions, but we must give local leaders the support to do the task that we are asking of them on behalf of patients and taxpayers. The powers that I have to intervene in those frontline service reconfigurations are ones that I will use only in the most exceptional and necessary cases, and that is why I have not used them once in the past eight months.

[Jen Craft (Thurrock) (Lab)]

The crisis in our NHS goes deep. I am sure that the Secretary of State agrees that it is an existential crisis that poses a threat to the future of the NHS if fundamental change does not happen. While I strongly welcome today’s statement, what assurances can he give me and the House that the right people will be in the right place in leadership positions to drive the fundamental change that is necessary?

[Wes Streeting]

That is an excellent question. We are building an outstanding transformational team with Sir Jim Mackey, which will be announced very shortly. It will bring together some of the best leaders across the country, and expertise from outside the NHS, to drive the scale and pace of transformation that is necessary. My hon. Friend is right to say that it is existential, because we cannot allow the curve of cost and demand to continue to rise to the extent that it is. The NHS’s long-term workforce plan has one in nine people in our country working for the NHS. On the current trajectory, in 50 years’ time, 100% of the public would be working for the NHS. That is clearly not a sustainable position.

I tell people who resist this reform out of love for the NHS not to kill it with kindness. We have to bend the curve of cost and demand to ensure that our health services are sustainable for the long term on the equitable foundations of a public service, free at the point of use, that we will always defend. I also say to my hon. Friends on the Government Back Benches that if we do not get this right, goodness knows what will come next. The Leader of the Opposition says that she wants a debate on the funding model for the NHS. The leader of the Reform party—I am not sure whether he is the Leader of the Opposition yet—says that he is up for anything. I am sure he is. That should worry us.

To those who want to debate the funding model of our NHS and the equitable principle of it being a public service, free at the point of use, I say that we are happy to have that debate but the Government are unequivocal: under Labour, the NHS is not for sale. It will always be a public service, free at the point of use, so that when people fall ill, they never have to worry about the bill.

Health and Adult Social Care Reform

Debate between Jen Craft and Wes Streeting

Monday 6th January 2025 Commons Chamber

[Wes Streeting]

The right hon. Gentleman is right to say that we need a debate as a country about the balance of financial contribution between the individual, the family and the state. I well understand why David Cameron was so concerned about catastrophic care costs and people having to sell their homes to pay for their care and the problem he was trying to solve. With every Government since, the issue has been seen as less urgent than others, but that does not mean it does not matter or that we should not consider it as part of the Casey commission. We need to consider all these issues in the round and, as much as we can, build a consensus not just in this House, but throughout the country about the balance of financial contribution and what is fair, equitable and sustainable.

[Jen Craft (Thurrock) (Lab)]

Just before Christmas, one of my constituents visited my surgery and gave me pause to reflect on the massive, often lifelong impact on loved ones who have someone in the social care system, and the devastating impact on their ability to work and to live healthy, fulfilling lives. Does the Secretary of State agree that the commission will lay the foundation for real change so that people in the social care system and their families can live the healthy, fulfilling lives they deserve?

[Wes Streeting]

I strongly agree with my hon. Friend, who has done much already in the past six months to champion social care. Whether people are in residential care home settings or we are doing everything we can to ensure that they can stay in their own homes, everyone deserves to live comfortably, well supported, with independence and with dignity. That is why the steps we are taking, particularly through the disabled facilities grant, will be immediately impactful on thousands of people across the country in just the next three months. We have so much more to do, and that is why I am genuinely excited by the work of the commission.