NHS Dentistry: Recovery and Reform

John Redwood Excerpts

Wednesday 7th February 2024 Commons Chamber

[Victoria Atkins]

The hon. Lady alights on an important fact that is sometimes lost in this debate: although an NHS dentist may have an NHS contract, they may not work the whole of that contract. Some NHS dentists very much do so; others work a fraction of it. We are trying to encourage dentists who do not use their full contract to do so, because that in itself will bring in more patients. We are confident that alongside the new patient premium, that will help constituents such as hers to get the treatment they need.

[John Redwood (Wokingham) (Con)]

Wokingham has a fast-growing population based on building a lot of new homes. So as the Secretary of State rolls out her new plans, will she also ensure that there are incentives to provide dental services on the NHS in areas where a population is moving in and needs them?

[Victoria Atkins]

My right hon. Friend raises an interesting point. Indeed, that is exactly the sort of discussion I am having with my right hon. Friend the Levelling Up Secretary, because I am really interested in having that connected and joined-up approach between planning and health. I think it could bring dividends for us all.

International Health Regulations 2005

John Redwood Excerpts

Monday 18th December 2023 Westminster Hall

[Philip Davies (Shipley) (Con)]

It is a pleasure as always to serve under your chairmanship, Dame Maria. I am grateful to the hon. Member for Lancaster and Fleetwood (Cat Smith) for moving the motion and agreeing to the debate in her role as Chair of the Petitions Committee—it is very much appreciated. I also thank the 116,391 people who signed the petition, including 189 of my Shipley constituents, which helped secure this important debate.

In preparing for today’s debate, I looked back at the contributions made in April when another petition on this topic was debated here in Westminster Hall, as the hon. Member mentioned in her opening remarks. I have to say that I was disappointed by some of the rhetoric, when valid concerns were dismissed as an “overreaction and hysteria”. It is clear that this is—quite rightly, in my opinion—an important issue for the public. We can see that that is the case from not just the full Gallery, but the large numbers signing the petitions.

So what are we dealing with here? We have two international legal instruments, both designed to increase the WHO’s authority in managing health emergencies. The first concerns the amendments to the existing International Health Regulations 2005—the IHR—and the second is the World Health Organisation’s new pandemic treaty, which would support the bureaucracy and financing of the expanded IHR. Both instruments are designed to transfer decision-making powers to the World Health Organisation, with the admirable aim, no doubt, of improving how the world prevents and better prepares for disease outbreaks. However, in practice, what is being proposed could have a huge and detrimental impact on all parts of society and on our sovereignty. If the IHR amendments go through, countries will have undertaken to follow recommendations, not merely consider them: it is proposed to remove the word “non-binding” from article 1, while the regulations in article 42 are to be

“initiated and completed without delay”

by member states. Therefore, we can only assume that the intention behind the amendments is for them to be binding under international law.

I do not wish to over-egg the nature of the proposals, but I cannot help but be concerned by the thought of removing the word “non-binding”. There is much in the existing IHR that would suspend fundamental human and bioethical rights, such as requirements for vaccinations and medical examinations, and implementing quarantine or other health measures for suspect persons—in other words, mandates and lockdowns. It is all there in black and white under article 18. We may have become only too mindful of the harms of lockdowns, and I am sure that hon. Members will be aware of the latest findings published by the Centre for Social Justice about the harms caused by lockdowns. That is not to mention the non-existent science used to enforce wearing a face mask—the covid inquiry has also uncovered the fact that that was based on absolutely no science whatsoever.

At the debate in April, we were told by the then Minister that it is “simply not the case” that

“the instrument will undermine UK sovereignty and give WHO powers over national public health measures”.—[Official Report, 17 April 2023; Vol. 731, c. 34WH.]

I think it is worth revisiting this question, because I am not clear how national and parliamentary sovereignty can be upheld if the proposals are agreed. I draw attention to draft new article 13A, which calls for member states to

“undertake to follow WHO’s recommendations”

and to recognise the World Health Organisation not as an organisation under the control of countries, but rather as the

“coordinating authority of international public health response during public health Emergency of International Concern”.

[John Redwood (Wokingham) (Con)]

Does my hon. Friend share my concern about the lack of accountability? We are having an extensive and public examination of the Government’s response to covid, but there is no comparable examination of the important decisions and advice that the WHO offered to the whole world, and it probably had more influence.

[Philip Davies]

My right hon. Friend is, as ever, absolutely right. We should all be concerned about that and concerned that we do not end up falling into the same problems as we have had in the past, being in a position where there is nothing we can do about it and sleepwalking into a disaster.

We are talking about a top-down approach to global public health hardwired into international law. At the top of that top-down approach we have our single source of truth on all things pandemic: the World Health Organisation’s director general, who it appears will have the sole authority to decide when and where these regulations will be deployed. Let us not forget that the director general is appointed by an opaque, non-democratic process—and I think that is being rather generous.

Rather worryingly, in their response to this petition the Government have said they are

“supporting the process of agreeing targeted amendments of the IHR as a means of strengthening preparedness for and response to future health emergencies; including through increasing compliance and implementation of the IHR”.

They have also previously said that they support

“a new legally-binding instrument”

—that certainly sounds like a threat to parliamentary sovereignty to me. Will the Minister commit today to laying those plans before Parliament so they can be properly debated, and if I had my way, robustly rejected?

It is also vital to take a step back and understand what is driving this pandemic preparedness agenda. At a recent meeting of the all-party parliamentary group on pandemic response and recovery, Dr David Bell gave a briefing on how the World Health Organisation, with the backing of the World Bank, says these amendments are the only way to prepare for future pandemics that it says are getting more frequent, and where there is more risk from zoonotic—animal to human—spread. The reality is that the WHO’s figures do not tell the whole story. When we take into account population growth, significant natural pandemics are rare events. We also have to take into account that there has been a huge expansion of tests and genome sequencing over the last few decades. The invention of polymerase chain reaction testing, for example, has had a massive impact on the detection rate of those outbreaks that the World Health Organisation is now using to justify its agenda.

Since the Spanish flu over 100 years ago, we have only had two pandemics above the average yearly seasonal influenza mortality rates, thanks to antibiotics and advances in modern medical care. We hear a lot about disease outbreaks that actually have low mortality burdens when compared to other public health threats: for example, in 2003, SARS-CoV-1—severe acute respiratory syndrome —had the equivalent disease burden of about five hours of tuberculosis. Funnily enough, in its 2019 pandemic influenza recommendations, the World Health Organisation itself could find no evidence that serious zoonotic pandemics were increasing. What is undoubtedly increasing are the eye-watering costs of managing pandemics, with vast sums of taxpayer money being wasted on poorly conceived initiatives, such as locking down the economy for two years.

It seems to me that the World Health Organisation has no need to rush any of this—we have time to reassess and get it right—and it seems I am not the only one to think that. In recent weeks, we have seen signs that some countries, including Estonia, Slovakia and New Zealand, are looking to question the proposals. It is not clear if any member states have submitted formal notices to reject them and opt out, but New Zealand does appear to have lodged a reservation to allow the incoming Government more time to consider whether the amendments are consistent with a national interest test required by New Zealand law. That is entirely sensible, and I would like to see our own Government take a pause to apply some critical thinking to this situation before blindly supporting the World Health Organisation’s installation as our new global public health power.

It is absolutely essential that the Government make a clear and unambiguous promise that they will neither support nor abide by anything that in any way undermines our national sovereignty. We have not spent so many years battling to get out of the frying pan of the EU to jump straight back into the fire with the equally unaccountable, undemocratic and hopeless World Health Organisation.

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[John Redwood (Wokingham) (Con)]

I hope that the Minister will listen very carefully to the debate and the petitioners, because it would be a grave error were the Government to sign a treaty that gives away important powers over the future conduct of health policy. It is wrong to give to the WHO the sole power to decide when there is an emergency, and it is wrong to give away our powers of self-decision were such an emergency to be visited upon us.

We are, of course, members of the WHO, and I think we all agree that we should continue to be members of the WHO. We should share our information; we should draw on its research, and it will draw on research and knowledge in this country, where there is much medical and pharmaceutical company expertise, and together, as collaborators, we may get to better answers in the future. However, it would be quite wrong to vest the power of decision in people so far away from our own country who are not in full knowledge of the local circumstances.

Before any such power is vested in the WHO, there should be a proper inquiry and debate about how it performed over the course of the most recent covid pandemic. Why, for example, did the WHO seemingly concentrate on vaccines, rather than other methods of handling the problem? Why was there the delay or difficulty in testing existing drugs, which had already passed proper safety procedures and might have had beneficial or easing effects for those who got the condition? Why was more work not done on use of ultraviolet light behind the scenes in airflow systems, to clean up air when circulating? Why was more consideration not given to isolation hospitals and health centres, given that, unfortunately, quite a lot of the disease was spread through health premises. With the use of isolation, other healthcare could have continued during the course of covid treatment without so much cross-contamination within general hospitals. Why were there not recommendations and advice on isolation?

Why was there not more careful consideration of whether it would be better to concentrate on ensuring that those who were most vulnerable were protected from the presence of the disease as much as possible, rather than trying to lock down whole populations and then having to make exemptions so that we could keep the lights on and some food could be delivered to people’s homes? There was something rather arbitrary about who was allowed to go to work and who was not.

Why was more work not done by the WHO on cleaning up the data? We were given comparisons between countries, but when we looked beneath the data, we discovered that those countries were using very different definitions of what a covid death was. In individual countries, under the impact of the wave of the disease, there were often great difficulties in carrying out proper diagnosis of whether someone did have covid, or whether other medical problems that the person was suffering from were more likely to have caused the death. Some countries took a very tough line, saying that anybody with covid died of covid, even though they might have had lots of other conditions, so those countries had big figures, while other countries took a rather narrow view and said, “Well, this person was in their mid-80s and they were suffering from another a number of other conditions that might have led to the difficulties.”

[Andrew Bridgen]

Does the right hon. Gentleman share my concerns that the WHO refuses to conduct any review of the recommendations it issued during the covid-19 pandemic, so sure is it that its advice and recommendations were absolutely perfect? If we sign up to these instruments, we will only get more of the same.

[John Redwood]

That is one of my worries. We need more transparency, debate, discussion and challenge of those in the well-paid positions at the WHO, so that science can advance.

As I understand scientific method, it is not choosing a limited number of scientists and believing everything they say; it is having a population of talented and able scientists who challenge each other, because then we get more truth out of the challenge and exchange of ideas. We do not want an international body saying, “There’s only one way to look at this problem or to think about it.” We need that process of challenge, and we need it to be an accelerated process. When we have an urgent and immediate need of better medicines, vaccines, procedures and approaches to lockdown or non-lockdown, that is surely the time for healthy debate, constant review and sufficient humility by all of us who venture opinions, because time and events could disprove them very quickly. If that happens, we should learn from the process and be honest about it, rather than saying that we were right all along and there was only one possible approach.

That is all I wish to say, that I think we need much more accountability, exposure and proper debate. Yes, the WHO can make an important contribution and can be a forum for scientists, pharmaceutical companies and others who will be part of the solution should we get some future wave of infection, but please, Government, do not trust it with everything. Do not ensure that future Ministers are unable to act responsibly and well in response to public opinion and to medical opinion within our own country. Do not sell us short, because that would also sell the world short. This country has a lot to offer in these fields, and it will be best if we allow open debate, proper review and serious challenge.

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[Preet Kaur Gill]

We all know that Rwanda is just a gimmick by this Government, and I think that I have already set out my position very clearly. I will continue to make my remarks so that the Government are absolutely clear as to where we stand on this issue.

I am pleased that the zero draft highlighted that states must retain sovereignty, and that the implementation of the regulations

“shall be with the full respect for the dignity, human rights and fundamental freedoms of persons”.

I ask the Minister to take this opportunity to update us on the progress being made in negotiations over the amendments and the draft text. Can he reassure our constituents that the Government would not sign up to anything that would compromise the UK’s ability to take domestic decisions on national public health measures?

[John Redwood]

I do not understand the hon. Lady’s argument. This amendment to the regulations would mean that the WHO could decide that there was a health crisis in our country, whether we thought there was or not. It could then tell us how we had to handle it in far more detail than its advisory work during the covid crisis—it would be mandatory. What does she not understand about that and why does she not disagree with it? [Interruption.]

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[Andrew Stephenson]

I do not believe it is right to name those civil servants. I am the overall lead on this in the Department of Health and Social Care. I am working closely and have already met with the Minister of State, Foreign, Commonwealth and Development Office, my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell). Many other Government Departments will also have a very clear interest in this, including the life sciences Minister, my hon. Friend the Member for Arundel and South Downs (Andrew Griffith). Any treaty agreed will of course be subject to cross-Government write-rounds in the usual fashion, to agree a UK-wide position. It is fair to say that there will not just be one pair of eyes from the ministerial ranks looking at this. There will be multiple pairs of eyes looking at this from across Government to ensure that when we get to a deal, it is a deal that can be agreed across Government and that we believe is in the UK national interest.

[John Redwood]

The possibility that the language may shift from saying “may” to “shall” is fundamental. I welcome all that the Minister has said about the current collaboration. I am glad it is working so well, but that is based on advice and urging, rather than requirement. It seems to me that this is just like the British people voting for the Common Market with the assurance that we had a veto on any law we did not like, but then somebody came along and took the vetoes away without seeking the British people’s permission, and the relationship went wrong from thereon. This could do exactly the same to the WHO, if we take away the veto.

[Andrew Stephenson]

I hear where my right hon. Friend comes from and I share his concern. As I hope he will recognise, the WHO is led by its 193 member states, which are currently negotiating this. All international health regulations to date have been agreed by consensus, and we would hope that any changes to the regulations are also agreed by consensus. As I say, there are many amendments and parts of the draft that we would not agree to in their current form. I believe these negotiations will hopefully get us into a position—because I believe it is in all our interests and in the national interest—to agree revisions to the IHR. That has to be done through negotiation and consensus. I think that having an approaching deadline focuses minds, and I think it is the right thing to do.

I will give another concrete example of why I believe this is important. During the pandemic, the genomic data shared by our friends in India and elsewhere helped us to tailor vaccines as new variants emerged around the globe. We all saw over the pandemic that, as the shadow Minister, the hon. Member for Birmingham, Edgbaston said, no one is safe until everyone is safe and that global problems require global solutions.

The best way to protect the UK from the next pandemic is by ensuring all WHO members can contain and respond effectively to public health events through compliance with strengthened IHR. Targeted amendments to the IHR will further strengthen our global health security, by helping Governments plan together, detect pathogens swiftly, and share data where helpful and necessary. The pandemic highlighted weaknesses in the implementation of the IHR for global health emergency response. For example, covid demonstrated that the IHR could be strengthened through a more effective early-warning system with a rapid risk assessment trigger for appropriate responses to public health threats.

NHS Strikes

John Redwood Excerpts

Monday 17th April 2023 Commons Chamber

[Steve Barclay]

We have agreed an offer with the Agenda for Change staff council. That is something that the staff council and the majority of trade unions have recommended to their own members, and that the largest health union has voted in favour of. I think we should allow that ballot to take place; it reflects meaningful and constructive engagement. That was reflected in the fact that trade union leaders themselves recommended the deal to their members. I hope that, when we come to the 75th anniversary, we can celebrate that.

[John Redwood (Wokingham) (Con)]

What actions are senior NHS managers taking to resolve non-pay issues for which they could offer better work experiences to doctors? What use can they make of flexibilities over pay increments, promotions and gradings so that good staff can be better rewarded?

[Steve Barclay]

As ever, my right hon. Friend raises an extremely important point. As part of the negotiation with the AfC staff council, a number of non-pay issues were discussed. Job evaluation is one such issue. Likewise, for junior doctors, areas such as e-rostering are extremely important. I share his desire for investment in technology, and to look at the time spent by clinicians that could be spent by others in the skills mix or through better use of artificial intelligence technology and a better estates programme. That is why it is important that we continue to have that funding, as well as reaching the offer that we have with the AfC staff council.

NHS Strikes

John Redwood Excerpts

Monday 6th February 2023 Commons Chamber

[Will Quince]

I remember another Scottish National party Member making a similar comment in a previous urgent question, crowing about how Nicola Sturgeon, the First Minister of Scotland, was directly negotiating with the unions and that they had paused their industrial action, but only a handful of weeks later that industrial action was renewed. Pay is of course a devolved matter for Scotland and for Wales.

I will not make unfunded promises or pledges from this Dispatch Box. I want to have an honest and open dialogue with the unions about what is affordable for the NHS, where we recognise and reward NHS staff—who do the most incredible job day in, day out—with one eye to recruitment and retention, but it also has to be fair to taxpayers; and that is the spirit in which I approach this matter.

[John Redwood (Wokingham) (Con)]

Can senior managers of NHS England and its various trusts make more use of pay gradings, job evaluations, promotions and increments, using pay flexibilities so that staff who are doing a good job feel valued and can be paid more?

[Will Quince]

That certainly is an option. My right hon. Friend talks about NHS managers. Understandably, the Opposition focus on nurses and paramedics, but let us not forget exactly who we are talking about: the entire Agenda for Change workforce, which is 1.245 million people. That is exactly why every 1% equates to £700 million. My right hon. Friend is right that pay is a factor, but it is not the only factor, which is why we also focus on working conditions and environment.

Urgent and Emergency Care Recovery Plan

John Redwood Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

We are bringing times down; I think the current mean response for C2s is much more in the region of 25 or 26 minutes than it was in late December-early January, because across the UK there was a massive spike in flu. The hon. Lady will have seen exactly the same in the Labour-run NHS in Wales. Over December there was a 20% increase in 999 calls, for example. That is why we need to put in place greater resilience, as the plan I have set out to the House does.

[John Redwood (Wokingham) (Con)]

I strongly support the £1 billion for 5,000 additional beds and 800 more ambulances. I have long argued that, with a growing population and a growing elderly population, we need more capacity. Is it also possible to take some of the £14 billion of additional money to provide even more capacity? I think we are going to need it.

[Steve Barclay]

Within my right hon. Friend’s question is, I think, how we get more flow into hospital: once bed occupancy goes above a certain threshold, lack of flow is the key interaction that drives inefficiency within hospitals. That is why we are putting in the extra capacity. It is also a question of reducing the numbers going to hospital in the first place and speeding up the discharge of those who are fit to leave. Whereas at the moment someone might sit on a ward for three days because they have to have antibiotics every day, if one continuous dose of antibiotics can be administered through new kit at home, not only is that a much better patient experience but it relieves pressure on the wards.

NHS: Long-term Strategy

John Redwood Excerpts

Wednesday 11th January 2023 Commons Chamber

[Steve Barclay]

I do not think those are factors that affected what happened in Scotland, where the First Minister warned on Monday that the hospitals were almost completely full. Indeed, the Scottish Government are taking emergency measures, including cancelling some non-essential operations. I do not think that was a factor in France, where the French Health Ministry is saying that intensive care beds are at saturation point. I do not think that was a factor in Wales, where more than 54,000 patients are waiting more than two years for an operation. I am glad that the hon. Lady highlights the summer, because it was in the summer that we hit the first of our elective recovery targets in terms of the two-year wait, getting those below 2,000, in stark contrast to what we saw in Wales. The surge in flu has happened across the United Kingdom, not just in England, and it has also affected France, Germany and other countries in Europe.

[John Redwood (Wokingham) (Con)]

I am very conscious that this Government have put a lot of extra money into the health service, and that Ministers have consistently wanted to get waiting lists down so that we have the extra capacity we need. Will the Secretary of State share a little of the thinking of senior management, who run the NHS day to day, in not using more of that resource for extra beds and extra staff to back them up?

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[John Redwood (Wokingham) (Con)]

No one can deny that the health service is under extreme pressure. No one can look at it and not realise that there has been a big surge in extra demand, that there are problems from the hangover of covid when a large waiting list for less urgent treatments built up, and that we are short of doctors and nurses, not because Ministers will not authorise their appointment but because there are vacancies to be filled. As one of those who has been urging for some time to see a published workforce plan, I welcome the decision of Ministers to insist on that, and the sooner we get it the better. However, I am quite sure that there are a whole series of workforce plans already in the many dozens and hundreds of working trusts and quangos that constitute the NHS. It is about aggregating and making sense of those plans.

[Dr Caroline Johnson]

We often talk about the shortage of doctors. We know we cannot create a doctor overnight. It takes a substantial amount of time to train them. The Chancellor, a former Health Secretary, invested in five new medical schools to increase the number of doctors in training. Does my right hon. Friend agree that the Chancellor, with the Health Secretary, needs to invest more money in more medical schools and medical school places, but also look at how we increase the number of doctors by reducing the amount of bureaucracy and paperwork they have to fill in, so that they can spend more time doctoring and less time filling in forms?

[John Redwood]

Yes, indeed. From my hon. Friend’s own expertise, I am sure she is right. When people talk about productivity, they do not believe that hard-pressed staff have to work harder; they are saying there must be smarter working, making jobs more manageable or enabling them to concentrate on the things they are most skilled at, with more relief for the other necessary record keeping, which may indeed need slimming.

My hon. Friend is right that we could expand our training places further, but as we have heard there has been a big increase in educational provision and it takes seven years for it to flow through. I am glad we are getting to the point where we will see some benefits from that. We need more homegrown talent. Many people are attracted to the privileged career of being a doctor and the more we can allow to do that, the better. However, given the immediate urgency of needing more capacity, and therefore more doctors and nurses, the most obvious place is to look at all those who have already had the training and have left the profession or the NHS for one reason or another. Some may be in early retirement. That is probably not something my hon. Friend wants to change because she enjoys her new job, but there are many others who are not in a very important job like her who might be attracted back. I hope the Treasury will be engaged in the review, because I hear from doctors, as many do, that the quirk in the tax system at just over £100,000 where some of the better paid doctors are resting, producing a more penal 60% rate, is an impediment to extra working. I also hear about the pension problems that have been cited on both sides of the House. The Government need to take those issues more seriously if they wish to accelerate returns.

Ministers have very clearly set out that they want more NHS staff and have obtained much larger budgets in the last three years to help bring that about. They have also said very clearly that the public’s priority—and indeed the Opposition’s priority—is to get more treatments and get those waiting lists and waiting times down for those needing more urgent or emergency care. Those Ministers must translate that through the senior health service managers into ways of spending that extra money. If it needs a bit more extra money, there is always some extra available—every time we meet another additional sum is announced—but it has to be well spent. It has to be spent on motivating and recruiting the medical workforce.

[Aaron Bell]

Will my right hon. Friend give way?

[John Redwood]

I had better not, because we are very short of time for colleagues.

The money has to be well spent and I hope that senior managers, as they give us a published workforce plan, will share more of their thinking. It is not good at the moment that there is such a breakdown in relations with talented and important staff in the health service. There is a complex system of pay reviews, increments, promotions and gradings of activities. All those things have flexibility within them. I look to the senior managers on six-figure salaries to take their responsibilities seriously and get the workforce back on side, using those flexibilities within the system, because we deeply need them to be.

We need more supply because there is excess demand, for understandable reasons. Huge sums of money were tipped into the system to deal with covid. Not all of it was well spent, but that was understandable given the unknown nature of the beast at the beginning, and the obvious pressures in this place and elsewhere to get instant results with personal protective equipment, testing and so forth. That is now behind us, but unfortunately it disrupted normal hospital work and normal GP work and created backlogs.

I urge the Government to understand that part of the answer is having more bed spaces in hospitals, with the staff to back them up. I do not know why so many senior health executives never want to admit that. They always say that there are lots of bottlenecks and other issues. Yes, of course we need to move people on from hospital as soon as it is safe to do so, and of course we need more capacity in social care, but I say to Ministers that it would be great to have a bit more capacity in the main hospitals to give us extra flexibility and take some of the pressure off. Could not some of the extra £20 billion, £30 billion, £40 billion or £50 billion that has been found in recent years be spent on the combination of physical capacity and the staff to support it that we so need?

Access to GP Services and NHS Dentistry

John Redwood Excerpts

Tuesday 21st June 2022 Commons Chamber

[Wes Streeting]

Even in the context of the pressures that we see right across primary care—I think every GP practice would acknowledge they face challenges—the case my hon. Friend has just described sounds extreme. We cannot allow the decade or more of mismanagement we have seen from this Government to excuse that kind of care, or indeed absence of care, for patients, and that brings me on to the next point I want to make.

We know why patients are forced to wait: Conservative Governments have cut 4,500 GPs over the last decade, they have closed 300 practices since the last election and they have failed to provide any meaningful reform of the system. The public are sick and tired of waiting. Public satisfaction with GP services stands at the lowest level on record as patients become ever more frustrated with not getting an appointment when they need one, or in a manner to suit them.

It says so much about the NHS at the moment that, while we have the lowest level of patient satisfaction since 1997, when we ask the public whom they trust, nurses and doctors are right up at the top of the list. The public understand that the staff who work in the NHS are trying to grapple with the biggest crisis in its history. Of course, the Government will want to pin that simply on the pandemic, but that does not explain why we went into the pandemic with NHS waiting lists already at record levels, with 100,000 staff vacancies in the NHS and with a decade or more of under-investment, leaving us ill-prepared for the pandemic—or, in the words of the Culture Secretary, “found wanting and inadequate”—but also now struggling to get the recovery from the pandemic that we need to build the health and care service we need for the future.

[John Redwood (Wokingham) (Con)]

The shadow Secretary of State says that we need GP reform. What kind of reform does he have in mind? What does he think should be the right balance between in-person, online and telephone consultations?

[Wes Streeting]

I am grateful to the right hon. Gentleman for that intervention. I will conclude my speech by talking about what a Labour Government will do, but let me answer his direct point about the range of options through which people should be able to access their GP. I value patient choice. Thinking back to my experience of accessing NHS services last year—as many people know, I did quite a lot of mystery shopping on the NHS—I had a range of interactions with GPs. Some were face-to-face. Some interactions at my GP surgery were not with my GP but with a nurse, which was entirely appropriate and much appreciated. Some of my engagements with my GP were over the telephone. I also had a video consultation with a dermatologist. I really valued that flexibility and range of approaches.

I think that the future for primary care has to be different courses for different horses. Of course, people should have a right to see their GP when they want to see their GP—I am clear about that—but there is also a range of ways in which we can offer more flexible access to GPs, particularly for working people who do not necessarily want to traipse down to the GP surgery in the middle of the afternoon if it is something that could be dealt with over the phone or on a video call.

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[Sajid Javid]

We are seeing record investment in the workforce, and we are seeing record increases. For the first time ever, the NHS is also coming up with a 15-year long-term workforce strategy, which I hope the hon. Lady welcomes.

The Government have always been on the side of patients and the people who care for them. I pay tribute to everyone working in primary care and dentistry for the difference they make day in, day out to their patients’ lives. I know that the pandemic has brought some unimaginable pressures, and equally I know that many of those pressures have not gone away now we are living with covid.

The hon. Member for Ilford North talks as though he does not know where the pressures have come from—as though he has had his head under a rock for two years. The NHS has said it believes that between 11 million and 13 million people stayed away from the NHS, including their GPs and dentists. Rightly, many of those people are now coming forward for the treatment they need—and I want them to come forward.

[John Redwood]

When the Secretary of State does the much-needed manpower review, will he ensure that a fast-growing area such as Wokingham with lots of new houses gets proper provision for that growth? Will the manpower plan also address how we recruit the doctors we have authority to get?

Health and Social Care Leadership Review

John Redwood Excerpts

Wednesday 8th June 2022 Commons Chamber

[Sajid Javid]

The short answer is that, yes, the hon. Lady is right to talk about the importance of retaining and recruiting more nurses. When it comes to nurses’ pay, she will know that we gave a 3% rise last year when there was a freeze for the public sector workforce generally. This year, we will be listening carefully to what the independent recommendation is.

[John Redwood (Wokingham) (Con)]

How many directors and chief executives of health bodies are there in the NHS, and what performance requirements are built into their contracts? We want them to deliver high-quality care with falling waiting times.

[Sajid Javid]

I cannot give my right hon. Friend the exact number that he is asking for, but I can answer the latter part of his question. I agree that we want to see a massive improvement in appraisal and performance standards; I am sure that, when he gets to see the report in detail today, he will be pleased by what he reads.

Health and Care Bill

John Redwood Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Edward Argar]

I am always happy—or the relevant Minister is always happy—to meet my right hon. Friend on any matter relating to the Department’s work.

Turning to the Health Services Safety Investigations Body—HSSIB—and patient safety, we intend to support the development of a learning culture across the NHS. With that in mind, I would like to turn to Lords amendments 66 and 109. The related clauses concern how we balance the need for those who speak to the HSSIB to feel safe to speak openly and candidly to HSSIB staff, while ensuring that coroners can fulfil their judicial functions. This has been, throughout the passage of the Bill, a difficult balancing act with no perfect answer, which has been given much thought and attention, and on which reasonable people can come to equally valid but different views. However, I have concluded that there is significant strength of feeling in both this House and the other place on whether coroners should have access to protected material held by the HSSIB.

I am grateful to my colleagues in the Ministry of Justice, in particular the Under-Secretary of State for Justice, my hon. Friend the Member for Corby (Tom Pursglove), and to the Chief Coroner for considering the different views judiciously. Recognising that, the Government have decided to accept their lordships’ amendment, which removes the ability of senior coroners to access protected material held by HSSIB through relying on certain powers under the Coroners and Justice Act 2009. We hope that will give reassurance and strengthen the ability of the HSSIB to deliver what we all want across this House, which is to support an open learning culture across the NHS.

This group of amendments also includes a substantial number of amendments to improve public health. In the other place, we brought forward amendments to enable the smooth and effective implementation of restrictions on the advertising of less healthy food and drink. I urge the House to accept Lords amendments 101, and 123 to 128, which allow the necessary preparatory work to take place before the restrictions are due to come into force on 1 January 2023. They also introduce the ability to delay that implementation date via secondary legislation, should that be deemed necessary.

[John Redwood (Wokingham) (Con)]

I welcome very much what the Minister said on the previous Lords amendment concerning safety culture. Can he tell us a little more about what other actions will be taken in lieu of legislation, which is not always the best answer, to encourage the learning, safety and quality culture which is so vital to a great service?

[Edward Argar]

I am grateful to my right hon. Friend, who is absolutely right. We heard in this House, a little earlier this afternoon, the Secretary of State for Health and Social Care present a statement on the Ockenden review. The review has a number of—not recommendations specifically, but urgent action points. Donna Ockenden was very clear on that and my right hon. Friend accepted all of them. One of the themes that came out in that context is people’s fear of speaking up. We believe that the HSSIB will play an important part in stimulating that culture of openness and transparency, and people coming forward without fear. That is why we reflected very carefully and accepted their lordships’ amendment.

Elective Care Recovery in England

John Redwood Excerpts

Monday 7th February 2022 Commons Chamber

[Edward Argar]

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

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

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

[John Redwood (Wokingham) (Con)]

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

[Edward Argar]

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