Department of Health and Social Care

Judith Cummins Excerpts

Wednesday 5th March 2025 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

I want to try to get everybody in, so I will start with an immediate five-minute time limit.

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[Jen Craft]

I was indeed at that Committee, and I also remember the reflection that NHS England was incredibly grateful for the amount of money that was being given. It was the highest amount of money given to any Department at the Budget, and it was much, much more than has been given in previous years.

Waiting lists have fallen for the fourth month in a row—I hope the hon. Gentleman and his colleagues will welcome that—with 160,000 fewer people waiting for treatment than when Labour took office. That includes a member of my own family, so I am very grateful to see that happening. Extending the opening hours of community diagnostic centres, such as the one set to open in my constituency this summer, will be key in catching conditions earlier.

While I welcome those measures, I would like to make the key point that funding alone is not enough to change and save how our NHS operates, and we must turbocharge the left shift to community and neighbourhood healthcare. In my constituency, it is often the front door to the NHS that lets local people down, which drives admissions to A&E when there is no available alternative. We have some of the most acute GP shortages in the country, with an average of 3,431 patients per GP. The neighbourhood health hubs promised by the previous Government have yet to be delivered. People in Tilbury, one of my most economically deprived areas, are still waiting for a long-promised facility, which currently looks like a hole in the ground, and I would welcome a discussion with the Minister about how we can work to deliver it.

The record funding uplift for general practice, with £889 million of investment, is again welcome news, but it highlights the fundamental tension between tackling the crisis in acute care and driving the vital left shift to community care that will be fundamental in turning the tide on the NHS. We must not lose sight of the goal of creating a healthier population in order to reduce pressure on acute services in this country, creating better, healthier lives and delivering the right care at the right time that puts the focus on the individual.

Thurrock community hospital in my constituency delivers excellent integrated community care that brings together social workers from the local authority and NHS staff to meet people where they are, intervening early and reducing pressures on acute care. That is partly thanks to a real partnership between the local authority and the integrated care board, and it has removed the need to focus on which public body benefits and which public body pays. I have to point out that our local authority has one of the lowest spends on adult social care, partly due to measures such as this.

The real focus is on how to deliver for individual patients—what do patients need and how do they get to that place? I welcome the bold move in the recent planning guidance to drastically reduce the strict targets placed on integrated care boards, allowing more of this work to take place by giving ICBs independence to make decisions that are relevant to their local population. However, I have heard from ICBs, including mine, that there is a risk that a focus on the elective care target may draw attention away from prevention.

I would like to point out the removal from the planning guidance of the targets for annual health checks for people with learning disabilities. That community historically has been under-represented and has not had its health needs fully met. This population dies younger and does not access preventive care at the point at which it would be most beneficial for them. Blanket prevention measures do not cover such populations. People in this community need specific intervention that allows them to access the healthcare that they need, when they need it. While a blanket annual health check is not necessarily the right way forward, it is absolutely critical that historically overlooked groups who are not served as well as others by our healthcare system are not overlooked when we shift to community and prevention work.

I very much welcome the strong investment that the Government are making in our NHS; it is vital in order to turn the NHS around and ensure that it is there for generations to come. I would welcome the Minister’s thoughts on how we can incentivise prevention as well as providing acute care.

[Madam Deputy Speaker (Judith Cummins)]

I call the Chair of the Select Committee.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

I will start with an immediate four-minute time limit.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Order. Before I call the next speaker, Members may wish to know that, given the time remaining for this debate and the number of Members who wish to speak, I will be unable to get everybody in, even with a four-minute time limit.

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[Seamus Logan (Aberdeenshire North and Moray East) (SNP)]

I commend the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown) for introducing the debate, and I pay tribute to the retiring interim chief executive of NHS Grampian, Adam Coldwells, an outstanding public servant who will be sadly missed when he departs his post.

The revised departmental expenditure limit for the Department of Health and Social Care in England sees an overall increase in the estimates of around £10 billion, and I want to comment on how that affects Scotland generally and my constituency in particular. Lest we get giddy about the numbers, let us think about where that expenditure might be going: salaries and wages, price increases—particularly for fuel and food—and certainly more taxes. It is a new definition of the circular economy as I understand it.

Let us also consider how the changes affect our partners in the enterprise of health and social care. GPs, hospices and charities are already facing huge financial pressures from rising energy costs, staff retention issues and labour shortages. Staff morale is already low and will be further impacted by funding cuts to the vital services they provide, as money is diverted to meet rising costs. Then along comes the increase in employer national insurance contributions for those partners. When we look across the border into England, we see additional GP contract funding of close to £1 billion, which will cushion much of those additional national insurance costs.

Let me share a local example from Aberdeenshire council, on which I was an elected member for more than two years. The cost to the council of the additional NIC changes is about £11 million. The council’s estimated allocation from the Scottish Government to mitigate those additional costs is around £5.5 million. The difference is stark and cannot simply be written off as a Scottish Government responsibility. Indeed, as Wes Streeting constantly reminds us, all roads lead to Westminster when it comes to funding. Our joint enterprise partners, such as GPs and third sector organisations such as Marie Curie—I see Members are wearing a daffodil today—or Chest Heart & Stroke Scotland, and local GP surgeries in places like Longhaven and Cruden Bay, are paying the price.

Turning to hospices, the Minister for Care, Stephen Kinnock, stated that there will be no additional Barnett consequentials—

[Madam Deputy Speaker (Judith Cummins)]

Order. I remind the hon. Gentleman to refer to Members not by name but by constituency.

[Seamus Logan]

Thank you, Madam Deputy Speaker.

There will be no additional Barnett consequentials arising for Scotland for hospices. The Scottish Government are investing an additional £4 million in the hospice sector, but that wider sector faces a £2.5 million bill from the additional employer national insurance contributions. A flat exemption would mean that they would not have to pay that cost.

Perhaps also not evident from the estimates are the eye watering costs of agency staff, which is felt no less in Scotland, partly because of the regressive immigration policies of the last Government, which are now pursued by this Government. We have asked for those powers to be devolved to Scotland, but if Ministers cannot do that, there is an alternative approach—that has already been pointed out by the right hon. Member for Salisbury (John Glen). The Royal College of Radiologists tells us that workforce shortfalls in radiology are around 30%, and around 15% in oncology. It states that the most urgent task facing the NHS is to manage its workforce crisis by investing in an increase of 150 radiology training places and 45 clinical oncology training places, rather than relying on outsourcing and international recruitment. Of course training has costs, and it is every bit as expensive in Scotland as it is here.

In conclusion, through the Minister I say this to the Treasury: do not treat Scottish citizens as if they live in some vassal state; they are taxpayers too. Rather than expecting us to give you thanks, just get your chequebook out because of the pressures that I have listed.

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[Sarah Bool]

I will make some progress.

That key relationship and contact between a GP and their patient was reinforced by the Public Accounts Committee report on NHS financial stability, published in January, which concluded that a reallocation of funds was needed to focus attention from sickness to prevention.

I am a massive advocate of prevention. Many hon. Members will know that I talk about being a type 1 diabetic; if they have not heard me talking about it, they may have heard one of my sensors going off for a low blood sugar. There is so much we could do in preventative measures in the treatment of diabetes. Treatments can be expensive as an initial outlay, but they will solve many long-term problems. We cannot prevent type 1 diabetes, but we could have earlier testing in children, for example, so that we could avoid them being diagnosed when in a state of diabetic ketoacidosis, which can be fatal. Families could be prepared and ready, and children could avoid hospitalisation, saving costs to the NHS while also saving lives.

We can also ensure access to technology that can avoid huge complications. Poor blood sugar control can result in loss of eyesight and limbs, alongside heart and other conditions. Making continuous glucose monitors and even insulin pumps available across the country can significantly help the patient and, again, in the long term save the NHS money. At the moment there is a very unfair postcode lottery, so I ask the Minister to consider ways to tip the funding balance, to ensure both prevention and community care measures are properly funded.

Finally, any reforms to the NHS must consider the computer operating systems in place. Many of my constituents must go out of the constituency for their hospital care, be it to Northampton general hospital, the John Radcliffe hospital, Horton general hospital, Milton Keynes university hospital or Kettering general hospital, but all those trusts operate on different systems, with the result that my constituents often cannot have their scans or medical notes shared easily. That is frustrating for residents, and potentially fatal. One resident noted that his wife was nearly given a drug that she was allergic to, because her notes had not been able to be shared correctly—it was only his presence that saved her.

We must ensure that money is spent to look at that and to change the systems, which my hon. Friend the Member for North Cotswolds (Sir Geoffrey Clifton-Brown) has explained very conclusively. We owe it to our constituents to work across the House to better our healthcare and to support the fantastic work of our doctors and nurses.

[Madam Deputy Speaker (Judith Cummins)]

I will start to call Front-Bench speakers at 3.15 pm.

[Alex McIntyre (Gloucester) (Lab)]

In my last career, prior to entering this House, I was incredibly proud to represent our NHS and other healthcare providers, and I will continue to fight for our NHS now that I sit here as an MP. I saw at first hand the impact that Tory mismanagement had on our NHS, which breached one of the fundamental principles of medical ethics: “first, do no harm”.

I saw that at first hand this week in my constituency when I visited Gloucestershire Royal hospital. I also met with Gloucestershire ICB this morning, and earlier this year I visited the surgery in Tuffley. The challenges that they face will not surprise anyone in this House, as they were set out in stark terms in the Darzi report, and they are replicated across the country in many constituencies—maintenance backlogs, lengthy ambulance waiting times, recruitment challenges and an ageing and sicker population. What struck me most about my visits this week was the resilience of our NHS staff, who are committed to people in our county and in my city of Gloucester.

What a difference a Labour Government are making with more investment in our NHS. Waiting lists locally are already coming down, and patients are now able to access emergency dental treatment, rather than pulling their teeth out at home. We have more midwives and dentists and a new GP contract that will help to bring back the family doctor. That is what we can do in eight months—imagine the impact that we could have if we had 14 years, as the Conservative party did.

From a personal perspective, I have seen how important that work is. I used to joke on the doorstep that I should be a poster boy for why prevention is better than cure—it will not surprise Members that I may have a few extra pounds that I could afford to lose. Sadly, the prevention piece came too late for me; I was diagnosed with type 2 diabetes earlier this year. The treatment I have received since then has been phenomenal. I am now on the path to remission programme—available in Gloucestershire, but not across the country—which has already brought my blood sugar levels down and helped me to lose 3½ stone. [Hon. Members: “Hear, hear!”] Thank you very much. It will help countless others across Gloucestershire and across the country. As we move to prevention work, it is so important that we also look at public health measures around diabetes; I echo the comments made by the hon. Member for South Northamptonshire (Sarah Bool).

I also thank all the staff who looked after my little boy last year when he was really sick. We need to ensure that when we look at investment in our NHS, we prioritise maternity services and services for the youngest in our society to ensure they get the healthcare they need.

We have talked about British values a lot in this place over the last few months. When people ask me what makes me proud to be British, I point them to our NHS—a system without comparison in the world that means that everyone can access healthcare, regardless of their wealth. I know that Reform Members are not in their places today, but they say that all options are on the table. I would like the Minister to make it clear in her remarks that standing against our NHS and its principles—being there for everyone, regardless of their wealth—is the opposite of being patriotic and that their options are not on the table.

I welcome the record investment in our NHS and the shift from analogue to digital and from cure to prevention. I would also welcome the Minister’s comments on how we can ensure that we deliver on the people’s priorities in Gloucester.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

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[Helen Morgan]

I fundamentally agree. There are many such instances, and I chose that one because I spoke to the providers there recently.

I will come on to community pharmacy, because I am particularly concerned about pharmacies, which are a key pillar of care in the community, dispensing prescriptions and providing over-the-counter medicines and advice. Critically, they also provide Pharmacy First, but they are closing at an alarming rate. Analysis by the National Pharmacy Association predicts that another 1,000 pharmacies will close—900 of them by the end of 2027—if the current rate of closures continues. That is because of a 40% real-terms cut in their funding since 2015.

In fact, community pharmacies are essentially subsidising the NHS by making a loss on many of the prescription drugs that they dispense. In a few weeks’ time, in April, they will be clobbered by not only the NICs hike, but the increase in business rates, which will affect high street retailers. Shamefully, they have not even had their funding rates for the current financial year confirmed—the one that ends in three weeks’ time.

Pharmacy First, the flagship plan to move care into the community, has not had its funding confirmed beyond the first week of April this year, which is in just a few weeks’ time, according to the National Pharmacy Association. In her remarks, will the Minister confirm the future of Pharmacy First? Is there a funded plan to deliver that service? What steps are being taken to keep our community pharmacies in business? If we want to see care in the community, it is essential that we support them.

I want to mention dentistry. In Shropshire, Telford and Wrekin, the number of NHS dentists fell by 12.3% from 2019-20 to 2023-24. Many of my constituents cannot access a dentist, and the Government have committed to improving the situation, so can the Minister confirm when the negotiations on the new dental contract will begin?

The crisis that the social care system faces is daunting, not least because of the additional national insurance hike that will take place in a couple of weeks’ time. Last week, caring organisations launched an unprecedented day of action, with thousands of people marching on Westminster to highlight the precarious state of the organisations that provide care. The Darzi review found that people waiting to access social care account for 13% of NHS hospital beds. We all understand the urgency of tackling social care, but the cross-party talks collapsed last week—they have not started. There is no date for a new meeting, and there are no published terms of reference. We think that 2028 is far too late to resolve this problem, so can the Government urgently reinstate those talks and act now to deal with the social care crisis?

Before I conclude, I will talk about mental health. As Lord Darzi has said,

“There is a fundamental problem in the distribution of resources between mental health and physical health. Mental health accounts for more than 20 per cent of the disease burden but less than 10 per cent of NHS expenditure. This is not new. But the combination of chronic underspending with low productivity results in a treatment gap that affects nearly every family and all communities across the country.”

He is dead right. By April 2024, about 1 million people were on a waiting list for NHS mental health services, of whom 340,000 were children. My casework is full of children who wait months and months for the diagnosis and treatment that they need. The Government have removed the targets for mental health waiting lists; I urge them to reinstate those targets, so that we have parity between mental and physical health in our health service.

I am very conscious of time, so in conclusion, I will just reiterate our asks. Those are to ensure that social care talks start immediately; to deal with the problems with pharmacies; and to make sure that mental health and social care receive parity.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Minister.