NHS England Update

Jeremy Hunt Excerpts

Thursday 13th March 2025 Commons Chamber

[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.

[Jeremy Hunt (Godalming and Ash) (Con)]

May I commend the boldness of today’s announcement? If the NHS is to be turned around, it will need radical reforms. If the result of today is to replace bureaucratic overcentralisation with political overcentralisation, it will fail. But if we move to the decentralised model that we have for the police and schools, it could be the start of a real transformation.

Will the Secretary of State give the House more detail about the changes he has in mind? Are we going to get rid of the central targets that make the NHS the most micromanaged system in the world and make it impossible for managers to deliver real change on the ground because they are working to about a hundred operational targets? If that is the case, and we are going to decentralise the NHS, does the Secretary of State agree that there remains a vital role for a reformed Care Quality Commission to call out poor care whenever it finds it?

[Wes Streeting]

I am grateful to the right hon. Gentleman for that thoughtful question. Let me say two things to him. First, democratic accountability matters, both in terms of patient outcomes and value for taxpayers’ money. One of the things that I, my Labour and many of my Conservative predecessors have reflected on a lot over many years is what the role of the Secretary of State, and Government, is in a national health service where clinical decisions should always be clinically led. It is the Secretary of State’s responsibility to be the champion for patients and for taxpayers and to ensure that the system as a whole delivers better outcomes for patients and better value for taxpayers.

The argument that I have started, however, which has ruffled some feathers within the NHS and even more so with some of our country’s most loved charities in recent months, is the fallacy that the Secretary of State can or should just fire endless instructions into the system, as if a Secretary of State or, for that matter, an NHS England could just pull some big levers and drive change in such a vast and complex system. That is a falsehood. Of course, we should set national strategic priorities on behalf of the public. We should ensure that there is more transparency and information so that patients, communities and staff can hold the system and themselves to account to improve performance. However, the overcentralisation has to stop.

In future, it will be for the Department and the NHS nationally to do the things that only the national health service can do, providing the enablers for the system as a whole. What we are presiding over and embarking on, however, is the biggest decentralisation of power in the history of our national health service. That will put more power into the hands of frontline leaders and clinicians, but even more fundamental and transformational, more power into the hands of patients. If we get that right, we will have an NHS that can truly be the envy of the world. If people continue to indulge in the fallacy that more targets from the centre or more—or indeed, less—political control is the answer, we will fail.

The right hon. Gentleman also mentioned the CQC. It has got itself into a terrible mess and I know that that is not what he intended when he rightly made the decision to create the Care Quality Commission. That is why Sir Julian Hartley knows that he has our full support, not just in turning around the CQC as it is, but in reforming it so that it can be the best guarantee and safeguard of quality that patients and the public deserve. Dr Penny Dash’s forthcoming review findings will also help to drive that reform agenda at pace.

Maternity Services

Jeremy Hunt Excerpts

Tuesday 25th February 2025 Westminster Hall

[Jess Brown-Fuller (Chichester) (LD)]

I beg to move,

That this House has considered maternity services.

It is an honour to serve under your chairmanship, Sir Christopher. I thank all the Members in attendance for their interest in this important topic and the Backbench Business Committee for allocating time to debate maternity services in England.

On average, a baby is born in England every 56 seconds, over 1,500 babies each day, most of them delivered in an NHS setting with the help and support of a maternity department or at home with an NHS community midwife by their side. That is over 500,000 babies every year. I contributed to that statistic in 2014 and 2019 when I gave birth to my children at St Richard’s hospital in Chichester. Two very different births that I will not spend my valuable time in this debate reflecting on, because there are far more important voices that need to be heard and considered. A person is at their most vulnerable moment when they or their partner go into labour. We put our health, safety, and the safety of our unborn child into the hands of professionals who work in that setting—the midwives, obstetricians, anaesthetists, and neonatologists—to support us in the safe delivery of our child and get us all home safe. And in the majority of births that is the case.

However, several investigations have revealed fundamental flaws in how maternity care is delivered across England. A Care Quality Commission inspection of 131 maternity units found that 65% were not safe for women to give birth in, with studies showing that one fifth of all causes of stillbirth are potentially preventable. The Ockenden report, led by Donna Ockenden, investigated the maternity services at the Shrewsbury and Telford Hospital NHS Trust, but it also highlighted the flaws in maternity care across England. The report laid out immediate and essential actions which are key to reforming maternity services and ensuring that every mother and baby receive the care they deserve and should expect. In her report Donna reflected that sometimes that spotlight can feel harsh to staff on the front line, who are doing their very best in what are often extremely challenging circumstances.

In conversation with midwives and others working in the maternity care sector, I recognise that each one I spoke to entered the profession as a the result of a calling, vocation, or passion for supporting mothers to bring their babies into the world. They are frontline NHS staff who often go above and beyond the call of duty to support and care for their patients in those extraordinary hours and days. Midwives in particular spend significant time with expectant mothers, supporting them through all stages of pregnancy and birth. They see women at their most vulnerable. They act as therapists, teachers, friends and maternal figures. Yet across the country, staffing levels are inadequate. In 2023, midwives and support workers worked over 100,000 hours of unpaid overtime every week. The pressure and stress on them is immense and this leads to burnout, absenteeism, high staff turnover and the loss of experienced professionals from the field, and that ultimately puts patient safety at risk.

[Jeremy Hunt (Godalming and Ash) (Con)]

I congratulate the hon. Lady on bringing forward this debate and the excellent and persuasive way that she is making her case. On burnout, does she agree that one of the biggest issues is that when a tragedy happens, midwives and obstetricians often feel that if they speak out the risk is that they or their institution will get sued, or that they could get fired from their jobs? Does she agree that litigation reform to try and change the rules of the game, so that people are able to be open when they think they have made a mistake and learn from those mistakes, is one of the most important ways that we could improve the record on patient safety, which is as much a concern to her as it is to me?

[Jess Brown-Fuller]

I agree wholeheartedly that we need to change the way that we do litigation, because NHS trusts often argue that they want to learn and grow from poor experiences, but the litigation system means that they rarely have the opportunity to do so, because everybody is so afraid to speak out. We need to change that culture within maternity services and the NHS as a whole.

As a country, we are training more midwives than ever before, yet retention remains a problem and the pandemic exacerbated an already difficult situation, with highly trained midwives with families or caring responsibilities leaving the profession too soon.

Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 11th February 2025 Commons Chamber

[Jeremy Hunt (Godalming and Ash) (Con)]

Is the Minister aware of the brilliant work done by Mersey Care NHS foundation trust in reducing in-patient mental health suicides to zero, which is an extraordinary achievement. Under a former Health Secretary, who may be standing not a million miles away from where I am standing now, that became an objective for all mental health in-patient units across the NHS. Will the Minister look into whether that objective still stands? If not, can it be reinstated?

[Stephen Kinnock]

I am not familiar with the detail of the case that the right hon. Gentleman mentions, but it sounds like a positive and interesting development, and I would be happy to consider it further. The Government are committed to delivering the cross-sector suicide prevention strategy for England, published in 2023. The 8,500 new mental health workers who we will recruit will be specially trained to support people at risk.

Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 19th November 2024 Commons Chamber

[Wes Streeting]

I, too, pay tribute to Norman and to family carers like him, who play such a vital role supporting loved ones. Through the carer’s allowance uplift in the Budget, the Chancellor announced the largest increase to the weekly earnings limit since the introduction of carer’s allowance in 1976. As well as that investment, we will have a 10-year plan for social care, and I see the care workforce, care providers and family carers as all being important partners in building that plan.

[Jeremy Hunt (Godalming and Ash) (Con)]

I welcome the Secretary of State’s plans to reform the NHS, but may I caution against the idea that the answer is to fire more incompetent managers? The problem is not bad management: it is micromanagement from the centre that sees hospitals managed with more than 100 targets by NHS England, making ours one of the most micromanaged healthcare systems in the world. Will the Secretary of State’s plans allow managers more autonomy, helping them to innovate, save money and improve care for patients?

[Wes Streeting]

I am happy to confirm that it is my view that, when there are too many targets and everything is being measured, nothing ends up being measured. We need to give more freedom and autonomy to good leaders, including clinical leaders and managers in the NHS who are coming up with some of the best productivity gains in the system. That is why we have announced new support for, and investment in, the college of leadership for both clinical and executive leaders in the NHS. I would be delighted to meet the right hon. Gentleman to discuss those issues. He was a great Chair of the Health and Social Care Select Committee, but back in July, we saw a great example of how we can improve things by sacking bad managers.

Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 19th July 2022 Commons Chamber

[Mr Speaker]

I call the Chairman of the Health and Social Care Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con)]

May I recommend some scintillating summer reading to the Secretary of State: the study of 4.5 million patients that showed that people who see the same GP over a long period are 30% less likely to go to hospital and 25% less likely to die? Will he, after reading that, consider changing the GP contract to get rid of the micromanagement, and replace it with what doctors and patients want, which is the ability to have a long-term relationship?

[Steve Barclay]

I think my right hon. Friend knows me well enough to know that I will have a close interest in reading anything over the summer that is data driven. He highlights an extremely important issue. Just yesterday, I met with Andrea and Simon Brady, whose daughter tragically died of cancer at the age of 27. One of the key concerns that they raised with me was the lack of consistency when it came to the GP that Jessica went to see, and the fact that she kept seeing different people, and there was not continuity of care. Specific cases that I am looking into speak to this issue, and I am happy to look at the data that my right hon. Friend can share.

Ambulance Pressures

Jeremy Hunt Excerpts

Monday 18th July 2022 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the Chair of the Health and Social Care Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con)]

I congratulate my right hon. Friend on taking up his post as Health Secretary. Since no one ever thanks you for doing that job, I thank him for doing this tough job. I am delighted that someone with ministerial experience in the Department of Health, who therefore knows what he is talking about from the outset, is doing the job. I welcome his saying in his statement that the ambulance service is under pressure not just because of the heatwave. Does he agree that one of the main reasons for that pressure is that hospitals find it difficult to discharge patients who are fit to discharge into the social care system, and that it is financial madness to look after someone in a hospital at £300 a day when the social care system can often do it at £50 a day? Will he, in his new role, finish the job and put in place a 10-year plan for the social care system and the funding for local authorities needed to go with it?

Draft Mental Health Bill

Jeremy Hunt Excerpts

Monday 27th June 2022 Commons Chamber

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

[Jeremy Hunt (South West Surrey) (Con)]

I commend my right hon. Friend’s courage in talking about his family’s tragedy, which is one of the most difficult things to do in politics. I also thank my right hon. Friend the Member for Maidenhead (Mrs May) for her commitment to mental health, which is unparalleled among any Prime Minister I have known in this place; it made an enormous difference to me when I was Health Secretary.

I support wholeheartedly what the Health Secretary has said today. I hope that he does not mind my saying that in one instance it does not go far enough: there are still 2,000 people with autism and learning disabilities in secure institutions, effectively incarcerated, even though they would be better off in the community. It is a human rights scandal. As part of the remedy, would he consider changing the rules on sectioning so that, after a short period, anyone who wanted to keep someone in a secure unit would have to reapply for sectioning every week or two, so pressure is put on the system to find a better solution?

[Sajid Javid]

We are determined to reduce the number of people with learning disabilities and autism who are in mental health hospitals. As part of those plans, we will shortly publish the cross-Government “Building the right support” plan to drive progress; I will have more to say about that shortly. I listened carefully to my right hon. Friend’s suggestion and would be happy to meet him to discuss it further.

Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 14th June 2022 Commons Chamber

[Mr Speaker]

I call the Chair of the Select Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con)]

Has the Secretary of State read the study in the British Journal of General Practice that says that people who see the same GP over many years are 30% less likely to go to hospital, 30% less likely to need out-of-hours care and 25% less likely to die? If he has, will he consider changing the GP contract to restore individual patient lists and reverse the change of two decades ago so that everyone has their own family doctor?

[Sajid Javid]

I have not read that review, but now that my right hon. Friend has mentioned it I will certainly take a look at it. He raises an important point about access to GPs. He is right to say that many people would want to see the same GP again and again—that would be their preference. One can see how that may lead to better clinical outcomes, but I hope he will respect the fact that others do not mind if they do not see the same GP and just want rapid access. It is important that we get the right balance.

Health and Social Care Leadership Review

Jeremy Hunt Excerpts

Wednesday 8th June 2022 Commons Chamber

[Mr Speaker]

I call the Chair of the Select Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con)]

I thank the Health Secretary for this excellent report and commend Sir Gordon Messenger and Dame Linda Pollard for all their work in putting it together. It has some very important recommendations. People who run hospitals are doing one of the most difficult jobs in Britain today, and anything we can do to give them better support in their careers will help all of us.

Does my right hon. Friend agree that the elephant in the room is that one thing that makes their job most difficult: we have more national targets in the NHS than any other health system anywhere in the world? That means not only that there is a risk of patients turning into numbers, but that we remove the autonomy from managers to show the leadership that Sir Gordon is advocating in this report. So as my right hon. Friend implements the recommendations, will he look at the role of national targets in the NHS and whether we need to simplify and reduce them?

[Sajid Javid]

I thank my right hon. Friend for his support of the report. Of course he speaks with incredible experience. He is right to raise the issue of the importance of targets, and sometimes targets can have unintended consequences. The report does talk a bit about the importance of that issue. I can assure him that as we make changes and work with our colleagues in the NHS to make reforms, we will certainly be taking that into account.

North East Ambulance Service

Jeremy Hunt Excerpts

Monday 23rd May 2022 Commons Chamber

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

[Jeremy Hunt (South West Surrey) (Con)]

I thank the Minister, who is a practising nurse, for her profound commitment to patient safety. What happened to Peter Coates, Quinn Evie Beadle and others was a terrible tragedy for them and their families. No doubt the paramedics made mistakes, but everyone makes mistakes in the course of their work. What is unforgivable is the cover-up by the North East Ambulance Service, and the fact that we made the families go through such hell to get to the truth.

At the heart of this is that we still make it far too difficult for everyone involved in such cases to distinguish between ordinary human error and gross negligence, with the result that the organisations responsible for people’s care default to a defensive, covering-up position. Will the Minister take this up with the Ministry of Justice to ensure much clearer delineation between the ordinary human errors that we all make and gross negligence, which is never forgivable?

[Maria Caulfield]

I thank my right hon. Friend for making those points. Several safety measures were started when he was Secretary of State for Health, including the duty of candour. There is supposed to be a culture in place where, if mistakes happen, the health service is open and honest about that. The Healthcare Safety Investigation Branch was introduced. There is independent investigation. Anyone can report concerns to that body and an investigation will take place. There is the early notification system in maternity, where if mistakes or incidents happen the process is first and foremost to say that to relatives and family and to start a lessons-learned process. The patient safety commissioner is to be appointed shortly. We are doing everything we can not just to improve patient safety, but to improve openness and learning within the system to change the culture within the NHS.