(2 weeks ago)
Commons ChamberWhat the shadow Minister neglects to mention is that the Chancellor has protected the winter fuel allowance for the poorest pensioners, and she has also put in place the warm home discount to assist people with their energy bills throughout the winter. If the shadow Minister does not support the decisions that the Chancellor took at the Budget and ahead of the Budget to raise vital investment for our health and care services, that is fair enough, but then she needs to tell people which NHS services she would cut or which other taxes she would increase.
In response to the report by Dr Penny Dash, we have made it clear that the CQC is not fit for purpose and requires significant reform. We have increased our oversight of the CQC to ensure implementation of the recommendations in Dr Dash’s review, and we will continue to monitor the CQC’s progress through this period of improvement. We are also supporting the swift and efficient recruitment of CQC leadership roles, including the new chief executive Julian Hartley, who started in December.
It is inarguable that the CQC needs improvement. Many who run care services in local authorities have little confidence in its performance. Does my hon. Friend agree that we could go some way to improving how it is viewed by looking at the use of single-word assessments, which create undue stress for social services leads? They were raised by the Dash review as insufficient to support local authorities to improve, promoting box-ticking over real improvement and giving little information to members of the public on the quality of social services provision.
My hon. Friend is right that confidence is the key word in the huge agenda that the CQC has to deliver. Dr Dash and Professor Mike Richards highlighted serious failings that need to be re-addressed. As one of our predecessors said, priorities are our language. Currently, a review of one or two-word ratings is not a priority, but it will be kept under review.
(2 weeks, 1 day ago)
Commons ChamberIt does. I was talking about the fact that working class people are often left behind in a two-tier system where those who can afford it pay to go private, and those who cannot are left behind. It is the determination of this Government to bring back to life the essential Bevanite principle of an NHS that is there for everyone when they need it: healthcare available to all on the basis of need, not on ability to pay.
I welcome the commission, which hopefully will lead to some certainty on the future of social care. However, a 2023 National Audit Office report found that 17% of local authority directors of social services were concerned about their ability to meet statutory obligations last year, and a further 18% are concerned about their ability this year. I have concerns about what will be done to fix the immediate crisis in social care. Will my right hon. Friend outline what he will do to guarantee the sustainability of our care system now, while we await the further structural reforms that we dearly need?
I am grateful to my hon. Friend for his question. That is why in the Budget the Chancellor delivered a big uplift in the spending power of local authorities, with £880 million ringfenced specifically for social care. We are also delivering through measures such as the disabled facilities grant to deal immediately with the pressures—[Interruption.] It is no good the right hon. Member for Beverley and Holderness (Graham Stuart) complaining. He voted against the investment, so he cannot very well complain about it.
(2 weeks, 1 day ago)
Commons ChamberI welcome this debate. Another winter and there are more severe backlogs—the causes are structural and predictable. The shadow of what Lord Darzi found weighs heavy on this debate, with 14,000 unnecessary deaths in A&E each year, waiting times for over-65s in emergency care having more than doubled to seven hours, and over 100,000 under-threes waiting more than six hours to be seen in 2023. Each one of those numbers is a devastated family, a patient at greater risk, or a patient enduring that long, nervous wait. This winter, my local hospital trust has seen average bed occupancy rates hit 98.5%. At one point in mid-December, only three out of 715 beds were free to use.
The crisis in our NHS that my constituents in Calder Valley face is not the result of a lack of work by our NHS staff—I hope everyone in this House can join me in paying tribute to those hard-working staff. Instead, this crisis has come about because of bad policy choices and warnings repeatedly ignored. In his report and when he came to the Health and Social Care Committee, Lord Darzi made it absolutely clear that the root cause of the problem is the Health and Social Care Act 2012, which was pushed through without precedent or preparation by the coalition Government amid repeated warnings from healthcare professionals. This disaster proves that to move forward, we have to learn from why bad health policy gets made: because of a focus on ideology over practicality, on efficiency savings over real improvements, and on treatment over prevention and later-life care.
We must also learn that to rebuild our NHS we cannot be top-down, but must build on a foundation of decent social and community care that is close to home and respects the skills of those who work throughout the system. That brings me to my next point, which is about social care. The scale of the crisis in the NHS means that it will not be fixed overnight—indeed, the Secretary of State talks about a 10-year plan—but we know that problems are solved easier and earlier if patients are treated closer to home. Yet the failure to plan health and social care together over the past 14 years means that more than one in 10 NHS hospital beds are filled by people who simply do not have the right care.
In my constituency, Bradford council’s Home FAST—first assessment support—scheme aims to get people home from hospital more quickly and to be assessed for any onward care services when they are at home. Since its launch, there has been a large reduction in the need for intermediate care facilities after hospital care. Does my hon. Friend agree with me that such innovations need to be at the heart of the Government’s 10-year plan, ensuring that we integrate health and social care, as he was saying, but perhaps also looking to revise the better care fund so that it delivers both rapid discharge and rehabilitation, which are obviously both critical to tackling NHS backlogs?
In fact, the better care fund works best in West Yorkshire when it works to hasten people’s journey out of hospital, and that sounds like a very good example.
In my own local hospital trust, the figure for people on the transfer of care list is even higher: 20% of beds are taken up by people who could be treated at home. That is almost 150 patients in hospital rather than getting social care where they need to be. Even well-run trusts are finding the wait for transfer of care too great, proving again that we cannot fix our health service without fixing 14 years of Tory mismanagement or without fixing social care.
In closing, while this Government face problems not of our own creation, we must still learn from what has gone before. In this regard, I absolutely welcome the announcement on progress in social care today, but I gently express to the Minister, as I did to the Health Secretary at his Committee appearance, that we need to see action on the ground solving our social care crisis earlier than 2028. In 2023, the National Audit Office told us that nearly four in 10 directors of adult social services were worried about meeting their statutory obligations. On top of that, we have a provider crisis because of this instability. The electorate gave this Government a term of five years to take bold steps to reverse the crisis in our NHS. They rejected the previous Government because they wasted each of their terms over 14 years of failure to enact a solution on social care, leaving people in hospital instead of being able to receive care among family and friends. I look forward to this Government acting on that mandate.
Order. We will start the Front-Bench the Front-Bench speeches at 9.35 pm, so our very last Back-Bench speaker is Ellie Chowns.
(1 month ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Does the Minister agree that the amazing staff at Overgate hospice in my constituency should be focused this Christmas on caring for their patients and not on funding? Will she confirm that this funding allows them to do so? Also, in April I will be running the London marathon for the Overgate hospice’s big build appeal. Will the Minister sponsor me?
That is possibly one of the cheekiest questions I have ever heard asked here, and I am obviously going to have to say yes. Frankly, rather him than me, but good luck to my hon. Friend on doing that. I know that many hon. Members raise money for their local constituencies and that the marathon is an important part of that.
We understand how different hospices are funded differently throughout the country. We want to make sure that end of life care, with all the different options that people have in their local systems, is well supported. It is really important for people to have some of that security, and I know that this announcement will be welcomed by my hon. Friend’s local hospice, as it is by the sector today.
(1 month ago)
Commons ChamberLast week, Calderdale and Huddersfield NHS foundation trust’s bed occupancy was at 99.6%. Some 20.1% of those beds, because of the failure of social healthcare and community care, were taken up by people who could be treated elsewhere. All I want for Christmas is a reassurance that, next Christmas and next winter, social care will be on a more secure footing.
My hon. Friend is absolutely right to highlight those shocking levels of bed occupancy. As I said earlier, running consistently at that high level of occupancy is something we should never have got used to. That discharge rate is demoralising for staff, very bad for patients and a sign of the pressure in the system. We absolutely must ensure the system is incentivised and works properly to make our hospital-to-community commitment, one of our three shifts, operate in practice. People do not want to be in hospital when they do not need to be and it is not the best place for them to be. We will be saying more about that in the new year.
(2 months, 1 week ago)
Commons ChamberWell, really. I am quite dumbfounded by the hon. Gentleman’s response. I respect him for his professional practice, and he knows the state of the NHS that we inherited from the previous Government, as reported in Lord Darzi’s report. He talks about joy, but there was no joy when we inherited the mess they left back in July. He talks about people being tipped to the brink, and they absolutely were, as Lord Darzi made clear.
As I said, we will go through the allocation of additional funding in the normal process, which will be faster than under the previous Government because we are committed to giving the sector much more certainty. The normal process, as the hon. Gentleman should know from his time in government, is to go through the mandate and the planning guidance and to talk to the sector about the allocations due next April, as I said in my opening statement.
Does my hon. Friend join me in welcoming the Opposition’s new interest in social care? Does she further agree that the problems that social care faces owe more to the previous Government’s failure to do anything with Andrew Dilnot’s 2011 report than they do to anything that is happening now with national insurance?
My hon. Friend makes an excellent point. When I joined this House in 2015, I remember that the first act of the new, non-coalition Conservative Government was to take the legs from underneath that social care commitment by postponing the Care Act 2014. They cynically said at the time that they would bring it forward by 2020, which they thought would coincide with the next general election. We all saw how that went.
(2 months, 2 weeks ago)
Commons ChamberI welcome the hon. Lady to her place as well. I think this is the first opportunity I have had to respond to a intervention or question from her.
In fact, we put record funding into the NHS—£164.9 billion per year—and on top of that we recruited more doctors and more nurses. We did not do that by piling tax hikes on hospices and general practices, among others. I am not sure how hitting primary care, social care or charities supporting NHS services will help the Secretary of State to deliver his aim of cutting waiting lists. I hope that the Chief Secretary will tell the House what steps the Treasury is taking to ensure that those organisations are not hit by these changes.
Let me take a moment to consider what was not included in the Budget.
I will make a bit of progress, if I may.
There were no plans for social care reform after the Chancellor broke Labour’s promise to deliver the cap on social care costs. I hear what the Secretary of State says about a willingness to work on what is a challenge facing our whole country and society: with an ageing population, how do we address the challenge of social care? There were no further detailed plans for NHS dentistry, despite the election pledge to deliver more dental appointments. There was no support for pharmacies or for the day-to-day running of general practice, and there were still no additional resources for the NHS this winter—or, indeed, the details of reform to go with them.
(3 months ago)
Commons ChamberI am glad that this debate has been called. Across the House, stories of failings in primary care are too familiar and, frankly, too distressing. The Darzi report makes it clear that since the announcement in the late 2000s of the so-called left shift—the shift from hospital care to care in the community—we have seen the number of people treated in hospitals rising. Indeed, 58% of the NHS budget is now spent on hospitals compared with 47% in the late 2000s. As Darzi said, there is no left shift, just a “right drift”.
Let us be clear: GPs work hard and do a fantastic job. Just a few weeks ago, I visited the fantastic Hebden Bridge group practice in my constituency. The 13 doctors conduct about 2,000 appointments a week, and while they are fantastically efficient, that is taking its toll. The General Medical Council’s national training survey—I used to be proud to work on that report every year—found that 68% of GP trainers said they always felt worn out at the end of the day. This is simply unsustainable.
We see the impact of the unsustainable model and the underfunding in our constituencies every week. In my constituency, the Calder community practice in Todmorden closed with over 2,800 patients on its books because there simply was not anyone able to take it on. The Darzi report makes it clear that we need to prioritise primary care and care in the community. The left shift must not be a slogan, but create real action. It cannot be right that, last year, 2,000 patients each day were admitted to hospital for something that could have been treated elsewhere and closer to home.
I look forward to supporting the Government amendment, and to working across the House week in and week out to make sure that we rebuild the NHS and get it the support it needs.
(3 months, 2 weeks ago)
Commons ChamberI must make some progress; I will try to take more interventions shortly.
The public are clear that they do not want the NHS to be sacrificed. They gave Labour our marching orders at the general election to rescue the NHS and turn it around, and that is what we will do. I appreciate that the shadow Health Secretary must be embarrassed by all this, not just by the state that she and her Conservative predecessors left the NHS in, but by what Conservative Members have been saying. I was going to say, “Members who are sat behind her,” but they are actually not—I think they are hiding in shame. [Interruption.] The shadow Health Secretary says from a sedentary position that we have already had this discussion. The Conservatives would rather we just moved on and forgot their abysmal record. Well, I am afraid that we are not ready to do that just yet. At least some of her Back Benchers now say what they refused to say when they were in office: that the NHS is broken. Some of them even admit that only Labour can fix it.
When the shadow Secretary of State stands up, I wonder whether she can tell us whether she agrees with the hon. Member for Mid Norfolk (George Freeman), who said:
“I applaud Wes Streeting for having the political courage. I think only Labour can really say this. The NHS is sort of their thing…I really hope that we can get behind him”.
It is not just Back Benchers. What about the shadow Foreign Secretary, the right hon. Member for Sutton Coldfield (Mr Mitchell)? He said:
“I’m very supportive of what Wes Streeting is saying… The Conservative government put a lot of money into the NHS, the record is there for all to see… I’m not one of those who is seeking to attack…the Labour Party on the NHS.”
He is going for my vote, but sadly—or gladly—I am not qualified to vote in that particular election. Perhaps the shadow Health Secretary can tell us what the shadow Foreign Secretary meant when he said we were not—[Interruption.] She is clearly enjoying this. Was the shadow Foreign Secretary speaking for the shadow Cabinet? [Interruption.] No, he was not.
Let me move to my favourite comments on the NHS from a Tory MP. This right hon. Member said:
“We were not obsessed with how we can ensure that it actually delivers the experience that patients actually deserve…Out of fear of our opponents mischaracterising our efforts, we shirked the difficult decisions…If Wes Streeting comes forward with genuine reforms I think we should back him.”
Those are the words of the candidate that the shadow Health Secretary is backing to lead her party, so does she agree with the right hon. Member for Newark (Robert Jenrick)? Will she finally apologise for her part in the Tories’ abysmal record and have the humility to admit that when it came to NHS reform their cupboard was bare, and that actually they quite agree with our efforts to clean up the mess that they left behind?
For all the agreement with our diagnosis and praise of our plans, the problem is that there is no apology. Of the four leadership candidates and eight former Health Secretaries, not a single one has apologised for the state they left the NHS in. Would the shadow Health Secretary like to correct that record today and finally say sorry? I expect that we might have to wait a long time. While the Conservatives continue the longest leadership election in history, we are getting on with the job of cleaning up their mess.
The reform that we desperately need includes the so-called “left shift” out of hospitals and into primary care. Yet under the previous Government, the amount of money spent on hospitals went from 47% to 58% of the NHS budget. According to Age UK, every day 2,000 people are admitted to hospital who could be treated elsewhere and earlier. Does my right hon. Friend agree that the only way to fix the NHS is to get more and better care in the community?
My hon. Friend is absolutely right, and that brings me to our reform agenda.
To deliver the Government’s reform agenda, we will have to take on both left and right-wing orthodoxies—for simplicity’s sake, we will call them The Guardian and the Daily Mail. The Daily Mail agrees on the need for health service reform, but attacks proposals for public health reform as “nanny state”. The Guardian loves prevention, but all this talk about health service reform makes it very nervous. The truth is that the Daily Mail and The Guardian are half right and half wrong. We all need to face up to the challenges of today. Our society is getting older and living longer but becoming sicker sooner. Those rising tides of demands and costs are combining to form a perfect storm that threatens to shipwreck the NHS.
(4 months, 1 week ago)
Commons ChamberI truly learned to appreciate the NHS when I became a parent and saw the care given to my family and children. It therefore horrified me, having sat in A&E with an ill child, to see in Lord Darzi’s report that 100,000 infants waited for over six hours in A&E last year. Does the Secretary of State agree that that is a shocking state in which to leave the NHS? Will he commit to bringing the numbers down and making sure that parents do not have to endure that terrible wait?
I am delighted to see my hon. Friend representing Calder Valley. He has captured the fear and anxiety about the length of the wait experienced by far too many parents when they access A&E departments. It is a terrifying experience, particularly for parents with small children, to be in that situation. Frankly, the lack of focus on paediatric waiting lists and waiting times, whether in A&E or for electives, really is shameful. We have got to put children first and that is exactly what this Government will do.