New Hospital Programme Review
Judith Cummins Excerpts(1 month ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
With permission, Mr Speaker, I would like to make a statement on the new hospital programme.
Of all the damage that the Conservative party did during their time in office—the broken public finances, the broken economy, the broken NHS—perhaps the most egregious was the broken trust between the British people and their Government, not just through their scandals or by breaking the rules they imposed on the rest of the country, but by making promises that they never intended to keep.
In 2019, the Conservatives told the British people that they would build 40 new hospitals over the coming decade, but there were never 40 new schemes and many of them were extensions or refurbishments. Put simply, they were not all new, some of them were not hospitals, and there were not 40 of them. Five years passed, start dates were delayed, spades remained out of the ground, and it became clear the announcement was a work of fiction.
Yet what did the Conservative party manifesto at last year’s general election say on the matter? It said:
“We will invest in more and better facilities, continuing to deliver 40 new hospitals by 2030”.
They repeated the promise even though the Department of Health and Social Care was putting contracts out to tender for hospital building that ran until 2035. They repeated that commitment even after the National Audit Office found that the Government
“will not now deliver 40 new hospitals by 2030.”
They repeated it even though the Government’s own infrastructure watchdog deemed it to be “unachievable.” No one thought that the promise would be met, yet the Conservative party made it anyway time and again.
Despite knowing this, when I walked into the Department of Health and Social Care on 5 July, what I discovered shocked me. The scheme was not just years behind schedule; the money provided by the previous Government was due to run out in March, just weeks from today. On 25 May 2023, the then Health and Social Care Secretary, the right hon. Member for North East Cambridgeshire (Steve Barclay), stood at this Dispatch Box and told the House:
“Today’s announcement confirms more than £20 billion of investment”.—[Official Report, 25 May 2023; Vol. 733, c. 480.]
The truth is that no funding had been set aside for future years; the money simply was not there. This was a programme built on the shaky foundation of false hope.
If I was shocked by what I discovered, patients ought to be furious—not just because the promises made to them were never going to be kept, but because they can see when they go into hospital how badly the health service needs new buildings. The NHS is quite literally crumbling. Lord Darzi’s independent investigation found that the NHS was starved of capital investment by the previous Government. Its outdated estate has hit productivity, with services disrupted at 13 hospitals every day during 2022-23. I have visited hospitals where the roof has fallen in and where pipes regularly leak and even freeze over in winter. The Conservatives literally did not fix the roof when the sun was shining.
On Thursday, the Infrastructure and Projects Authority published its annual report for 2023-24. Its assessment of the new hospital programme read:
“There are major issues with project definition, schedule, budget, quality and/or benefits delivery, which at this stage do not appear to be manageable or resolvable. The project may need re-scoping and/or its overall viability reassessed.”
That is what this Government have done.
Our review of the new hospital programme and the announcement I am making today will do two things: first, it will put the programme on a firm footing with sustainable funding, so that all the projects can be delivered; and, secondly, it will give patients an honest, realistic and deliverable timetable that they can believe in. This Labour Government are rebuilding our NHS, and as we do so, we will also rebuild trust in politics.
The seven hospitals built wholly or mostly from reinforced autoclaved aerated concrete—RAAC—were outside the scope of the review. These will be rebuilt at pace to protect people’s safety. Also out of scope were the hospitals already under construction or with an approved business case, where building works have continued without delay.
Working closely with my right hon. Friend the Chief Secretary to the Treasury, we have secured five-year waves of investment, backed by £15 billion of investment over consecutive waves, averaging £3 billion a year. That funding is in addition to the £1 billion that the Chancellor announced at the Budget to tackle dangerous RAAC and the backlog of critical maintenance, repairs and upgrades across the NHS estate. It is also in addition to the £1.5 billion we are investing in new surgical hubs, diagnostic scanners and beds. Together, it forms part of the £13.6 billion of capital investment announced at the Budget, which is the largest capital investment in our national health service since Labour was last in office.
I will now set out the new timetable. Projects in wave zero are already in the advanced stages of development and will be completed within the next three years. These are: the Bamburgh unit, phase 3 of the care environment development and re-provision, or CEDAR programme; the national rehabilitation centre in Nottinghamshire; Oriel eye hospital; Royal Bournemouth hospital; St Ann’s hospital; Alumhurst Road children’s mental health unit; and Dorset county hospital.
Wave 1 schemes will begin construction between 2025 and 2030. These include the seven RAAC hospitals: Leighton hospital; West Suffolk hospital; Frimley Park hospital; Hinchingbrooke hospital; Queen Elizabeth hospital; James Paget hospital; and Airedale general hospital. The other wave 1 schemes are: Poole hospital, Milton Keynes hospital; the 3Ts hospital—trauma, tertiary and training—in Brighton; the women and children’s hospital, Cornwall; Derriford emergency care hospital; Cambridge cancer research hospital; Shotley Bridge community hospital; North Manchester general hospital; and Hillingdon hospital.
Wave 2 schemes will now begin main construction between 2030 and 2035. They are: Leicester general hospital and Leicester royal infirmary; Watford general hospital, the specialist and emergency care hospital in Sutton; Kettering general hospital; Leeds general infirmary; Musgrove Park hospital; Princess Alexandra hospital; Torbay hospital; and Whipps Cross hospital, where I should declare an interest, as it serves my constituency.
Wave 3 includes nine schemes that will start construction between 2035 and 2039: St Mary’s hospital in London; Charing Cross hospital and Hammersmith hospital; North Devon district hospital; Eastbourne district general hospital, Conquest hospital and Bexhill hospital; Hampshire hospitals; Royal Berkshire hospital; Royal Preston hospital; the Royal Lancaster infirmary; and the Queen’s medical centre and Nottingham city hospital.
Following this statement, further details of the hospital building programme will be published on my Department’s website and a copy of the report will be placed in the House of Commons Library. In addition, the Minister for Secondary Care will hold meetings tomorrow, to which MPs of all parties are invited, to answer any further questions about these projects.
To ensure that every penny of taxpayers’ money is well spent and every hospital is delivered as quickly as possible, we will shortly launch a new framework for the construction of the new schemes. This will be a different way of contracting by working in partnership with industry to mitigate cost, schedule and delivery risks and saving money through a standardised design approach. That will speed up the process of opening new hospitals and provide a foundation for a collaborative supply-chain partnership. We will also appoint a programme delivery partner in the coming weeks to support the delivery of crucial hospital infrastructure across the country and provide programme, project and commercial expertise.
I know that patients in some parts of the country will be disappointed by this new timetable—they are right to be. They were led up the garden path by three Conservative Prime Ministers, all promising hospitals with no credible plan for funding to deliver them, and by Conservative MPs, who stood on a manifesto promise they knew could never be kept. We will not treat the British people with the same contempt. We will never play fast and loose with the public’s trust.
The plan that we have laid out today is honest, funded and can actually be delivered. It is a serious, credible plan to build the hospitals that our NHS needs. It is part of the biggest capital investment that the NHS has seen since Labour was last in office, delivering not just more hospitals but new surgical hubs, community diagnostic centres, AI-enabled scanners, radiotherapy machines, modern technology, new mental health crisis centres and upgrades to hundreds of GP estates. It will take time, but this Labour Government are determined to rebuild our NHS and rebuild trust in politics. I commend this statement to the House.
Wes Streeting
My hon. Friend is absolutely right: I think that will be a unique representation this afternoon. I can already hear the vultures swooping, looking for that capital allocation and slot in the pipeline. She has made the case repeatedly, forcefully and with conviction that these services should remain in a community with high levels of deprivation and high need. I know that the Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth), has already committed to meeting her, and we are very happy to have those conversations with her.
Dr Danny Chambers (Winchester) (LD)
In Hampshire and across the country in 2019 and 2024, Conservative MPs stood on the promise of delivering new hospitals, including one for Hampshire. However, it turned out that there was never any funding for that, and that those were just false promises to try to get votes. I have fought tirelessly to save and improve Winchester’s A&E and consultant-led maternity unit. With the announcement that construction of a proposed new hospital in Hampshire will not even start until between 2037 and 2039, we absolutely need to ensure that the current services are invested in and improved so that they remain fit for purpose.
Given that the new hospital programme is delayed, it is more urgent than ever to increase capacity by fixing social care, so that those who are well enough to leave hospital can be cared for in the community, thus freeing up beds immediately. We cannot endure both insufficient social care packages and crumbling hospitals. Given this delay to the new hospital programme, will the Secretary of State commit to prioritising more social care packages now, rather than waiting three years for a review to be complete?
Although the Health Secretary is not responsible for the state of the NHS or the state of the economy, which the Government inherited, the new hospital programme was seen as part of the solution to the crisis in the NHS, and people across the sector have warned that delaying the programme will only mean more treatments cancelled and more money wasted plugging holes in hospital buildings that are no longer fit for purpose. We are therefore concerned that one of the biggest announcements to affect the NHS over the next few years is coming out right now, during Donald Trump’s inauguration, because it will not get the media attention it deserves. Liberal Democrats therefore urge the Health Secretary to promise to release a full impact assessment on how the delays to the new hospital programme will affect patients and NHS staff.
Wes Streeting
First, I thank my hon. Friend for his strong representations on behalf of his constituents, not just since his election, but before it. Between the by-election and his election to this place, he did not give up; he continued to fight for his community.
I stood outside Hillingdon hospital, having had a good look around at the state of the hospital and the plans for the reconstruction of the site. I am delighted to have kept my promise and this Government’s promise, so that construction at Hillingdon hospital will begin in 2027-28. My hon. Friend is quite right to say that his predecessor and his predecessor’s predecessor made claims about Hillingdon hospital that were not true. This Government will not make those mistakes. We will keep our promise. What we have set out for all schemes in the new hospital programme is a credible, realistic, funded timetable that this Government, for as long as there is a Labour Government, will actually deliver.
Sir Edward Leigh (Gainsborough) (Con)
Will the Secretary of State forgive me if I give the House a few seconds’ respite from the blame game by trying to make a positive suggestion? Everyone accepts that the real problem facing our hospitals is the number of frail and elderly people who do not need to be in hospital and should be in some sort of care facility. Does the Secretary of State agree that while building brand-new, all-singing, all-dancing hospitals is very expensive, there is a future for smaller cottage hospitals such as the one in Gainsborough and a case for opening other facilities so we can move elderly, frail people out of those big hospitals into a caring environment and free up space?
Several hon. Members rose—
Madam Deputy Speaker (Judith Cummins)
Order. Members will have seen how many people are on their feet wanting to ask the Secretary of State a question. Could I ask Members please to try to keep their questions and answers quite short? I want to try to get everybody in, if at all possible.
Graham Stringer (Blackley and Middleton South) (Lab)
My right hon. Friend’s statement stands in sharp contrast to that made on 25 May 2023 by the previous Secretary of State, when he completely forgot to put in his statement, both written and verbal, North Manchester general hospital. I am pleased that North Manchester general hospital is today in the first wave, but I would be grateful if my right hon. Friend could spell out in detail when the work will continue, because in one of the areas of the country with the worst health outcomes, it is not only a hospital scheme; it is an urban regeneration scheme, and some work has started. Will that work be allowed to continue? Can he give me some details, please?
Several hon. Members rose—
Madam Deputy Speaker (Judith Cummins)
Order. I plan to run this statement until 6 o’clock, so I ask Members to please help each other out by keeping their questions and answers short.
Rosie Wrighting (Kettering) (Lab)
My predecessor told my constituents that the work on Kettering general hospital was ready to go. It is shameful that, in reality, the Conservatives had no credible plan, and the money was going to run out in March this year. Does the Secretary of State agree that people in Kettering are right to be angry at the previous Government for breaking their promises, and can he reassure my constituents that they will see a realistic, deliverable timeframe for the rebuild of our hospital?
Health and Social Care: Winter Update
Judith Cummins Excerpts(1 month ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
With permission, Madam Deputy Speaker, I would like to make a statement on winter pressures.
I start by saying that my thoughts, and I am sure the thoughts of the whole House, are with the nurse who was stabbed in a horrific attack at Royal Oldham hospital on Saturday. Nurses are the backbone of our NHS. They should be able to care for their patients without fear of abuse or violence. As she goes through treatment for her injuries, we pray for her speedy and full recovery and that she will be left to recover in peace.
I want to thank our NHS and social care staff for their remarkable effort, stamina and care in the most challenging of circumstances. Over the past few weeks, I have seen at first hand that staff are doing their level best in hospitals and care homes across our country—in the south-west, Essex, London, South Yorkshire and the north-west. Even when patients are left waiting far longer than they should be, and in conditions they should never be made to endure, they are still at pains to stress that the staff are doing their best.
I said on day one in this job that I would never gloss over problems in the health service and I would not pretend that everything is going well when it is not. The experience of patients this winter is unacceptable. I visited one A&E department over Christmas where I was told on the way in that I was lucky as I had come on a quiet day. Yet, as I walked through the hospital, I saw patients on trolleys lining the corridors where they were being treated, without the dignity or safety they should expect as a minimum. I saw frail elderly people on beds in the emergency department, many with dementia, crying out in pain and confusion because, ultimately, they were in the wrong place for their care needs. That was supposedly a good day.
The King’s Fund has said:
“The NHS is facing a toxic cocktail of pressures this winter”,
and it is right. Fourteen years of under-investment and a lack of effective reform have combined with a tidal wave of rising pressures. This has been the busiest year on record for our ambulance and accident and emergency services. We have had severe cold snaps, with temperatures as low as minus 15° in some parts of England. There are 5,100 patients in hospital beds with flu—more than three times the number at this point last year. Alongside the impact on patients, the rise in respiratory infections saw 53,000 NHS staff forced off work sick in the first week of the year. The result has been patients let down by ambulances that do not arrive on time, A&E departments that leave them waiting 12 hours or more, and the continued normalisation of corridor care. This is not the level of care staff want for their patients, and it is not the level of care this Government will ever accept for patients.
I said coming into this winter that 14 years of failure cannot be turned around in six months. It will take time to fix our broken NHS. Since July, we have done everything we can to prepare the NHS for winter. Following four months of silence from the previous Government, I called the British Medical Association on day one, met it in week one, and within three weeks negotiated a deal to end the junior doctors’ strike with a new deal for resident doctors. For the first winter in three years, staff are on the frontline, not the picket line. The Chancellor made immediate in-year investment in the NHS to fill the black hole we inherited and prevent us from having to cut back on services.
We have introduced the respiratory syncytial virus vaccine, and more than a million people and counting are protected against that virus. In total, 29 million vaccines have been delivered for flu, covid-19 and RSV, and more patients are protected against flu than at this stage last winter. If anyone is yet to get themselves vaccinated, it is not too late to protect themselves, their family and the NHS. They can check if they are eligible and book through their local GP or pharmacy.
We are working hand in hand with NHS England and care leaders, and I continue to meet regularly with senior leaders in social care, NHS England and the UK Health Security Agency. We have an excellent national operations centre running seven days a week. Its data allows us to zoom in—not just on individual hospitals but on individual patient waiting times—to respond in real time to spikes in pressures, and to manage threats as they emerge. The NHS is now using critical incidents proactively to focus minds and get the system responding to de-escalate and steer back to safer waters. I am happy to report that there is currently one live critical incident, down from 24 last week.
However, I do not pretend that that is good enough. It will take time to get back to the standards that patients deserve, but it can be done. That will require a big shift in the focus of healthcare—out of the hospital and into the community—to free up beds for emergency patients and to prevent people from having to call an ambulance or go to A&E in the first place. That is the reform agenda that the Government are enacting.
In recent weeks, we have announced steps to begin rebuilding general practice, and immediate and long-term action in social care. When we came into office, we inherited a situation in which qualified GPs could not get a job, while patients could not get a GP. That is why, within weeks, I found just shy of £100 million to recruit 1,000 more GPs by April. We have recruited hundreds of GPs to the frontline already, and we will recruit hundreds more in the months to come. We have announced an extra £889 million in funding for general practice, which is the biggest funding uplift in years, alongside a package of reforms to bust bureaucracy, slash unnecessary targets and give GPs more time to spend with their patients—our first step towards bringing back the family doctor.
Ten days ago, I visited a care home in Carlisle that was offering intermediate step-down care for NHS hospitals. It was able to give patients en suite bathroom facilities in care homes, with rehab, all at half the price it was costing the taxpayer to keep patients in a hospital bed up the road. That is better for patients and less expensive for taxpayers. Yet there are 12,000 patients in hospital beds today who do not need to be there but cannot be discharged because appropriate care is not available. That is why the Government are making up to £3.7 billion of extra funding available for local authorities that provide social care. It is why we are delivering an extra 7,800 home adaptations through the disabled facilities grant this year and next year. It is why we have delivered the biggest increase in carer’s allowance since the 1970s, worth an extra £2,300 to family carers. It is why are introducing fair-pay agreements to tackle the 131,000 vacancies in social care. And it is why we have appointed Baroness Louise Casey to help build a national consensus on the long-term solutions for social care.
From visiting emergency departments, monitoring the performance of the NHS over this winter and noting the variation in performance across the country, I know that we can clearly get our ambulance and A&E services working better. Before the spring, we will set out the lessons learned from this winter and the improvements that we will put in place ahead of next winter.
Finally, let me be clear on corridor care, which became normalised in NHS hospitals under the previous Government: I will never accept or tolerate patients being treated in corridors. It is unsafe, undignified and a cruel consequence of 14 years of failure on the NHS, and I am determined to consign it to the history books. I cannot and will not promise that patients will not be treated in corridors next year. It will take time to undo the damage that has been done to our NHS, but that is this Government’s ambition.
Annual winter pressures should not automatically lead to an annual winter crisis—indeed, there were no annual winter crises by the end of the previous Labour Government. That is why this Government are investing an extra £26 billion in our health and care services, and undertaking the fundamental reform that both services need. That will take time, but we will deliver an NHS and a national care service that provide people with care where and when they need it. I commend this statement to the House.
Wes Streeting
I wholeheartedly agree with my hon. Friend, and thank her for the work she has been doing this winter on the NHS frontline, providing support to her colleagues at her local hospital—literally rolling her sleeves up and looking after people. She is absolutely right that we need an urgent and emergency care plan to make sure we see continued year-on-year improvements. I can reassure my hon. Friend that that plan is already being written; we are learning the lessons from this winter in order to apply them next winter. As I should have said to the shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar), I took the same approach when I was shadow Secretary of State: the very first meetings I held on winter planning were ahead of the general election in access talks with the Department. The first briefing I received on winter preparation was on my first day in office. Throughout the past six months heading into winter, I continued to talk to staff in the Department, NHS England and social care leaders to ensure that we were as well prepared for this winter as we could be. Right now, we are learning the lessons to prepare for next winter.
Helen Morgan (North Shropshire) (LD)
I associate myself with the comments of the Secretary of State and the shadow Secretary of State regarding the abhorrent attack in Oldham.
The pressure on our hospitals this winter brutally demonstrates the scale of action needed after years of Conservative neglect of the NHS. Across England last month, 71% of A&E patients were seen within four hours, but that statistic varies wildly depending on where one happens to live. At Shrewsbury and Telford emergency departments last month, ambulances had to wait an average of over two hours to hand over their patients. Just 50% of patients were seen within four hours, and nearly 1,500 patients were left stuck on a trolley for more than 12 hours.
Statistics like these often fail to have much impact now, because we have heard them so regularly—particularly since winter crises have become normalised—but it is very important that we consider who is behind them. It is patients such as my constituent Emma, who having been diagnosed with sepsis spent 48 hours in a fit-to-sit area and then 12 hours on a trolley in an X-ray corridor before finally being admitted, alongside a horrifying delay in the medication required to deal with her life-threatening condition. Yet we often have to wait weeks for data that fully explains what is happening in our hospitals, and no official data is collected about the number of critical incidents. This leaves patients potentially ill-informed, and it makes scrutiny and support in this place, in particular, difficult to provide.
Will the Secretary of State commit to introducing faster and more detailed reporting about the live state of play in our emergency departments, including the number of critical incidents and the temporary escalation spaces, and give a timeline for reporting that information? Will he publish information that shows the impact that delays are having—for example, by looking at the number of deaths in emergency departments—and will he act on the long-term Liberal Democrat request to publish localised data on ambulance delays so that support is provided in areas, such as Shropshire, where it is most needed?
Wes Streeting
I thank my hon. Friend for that question. The conditions she describes at her local hospital are truly shocking. As I have said, and this is often quoted by the SNP, all roads lead to Westminster, and I am happy to report that up that road from Westminster to Holyrood lies a record uplift in funding for the Scottish Government. They have no excuses for inaction. They need to grip the crisis in the NHS in Scotland, as we are here. The difference, as my hon. Friend states, is that they have a record of 18 years that they cannot defend, and I hope people will consider that record very carefully when they decide who should govern in Scotland at the next set of Scottish elections.
Madam Deputy Speaker (Judith Cummins)
I call the Chair of the Health and Social Care Committee.
Layla Moran (Oxford West and Abingdon) (LD)
May I press the Secretary of State on that data point? It is not just the Liberal Democrats making these representations; the Royal College of Nursing, the Royal College of Physicians, the Royal College of Emergency Medicine, HealthWatch, the British Medical Association, Age UK and many others also want the data. This matters, because the situation causes moral injury to staff and compromises patient safety—and the problem is not just corridor care; it encroaches on to other wards. Will the Secretary of State commit to releasing that data before the NHS England board meeting on 4 February? In addition, what assessment has he made of the impact of this winter on less urgent care, and on elective waiting lists?
Several hon. Members rose—
Madam Deputy Speaker (Judith Cummins)
Order. Members will be aware that we have pressure on time today, so I will finish this statement at around 3.15 pm.
Rachael Maskell (York Central) (Lab/Co-op)
Triaging patients into virtual wards will not only protect the front door of the NHS, but be far better for patients. What is the Secretary of State doing to hold integrated care boards to account and ensure that they are putting money into primary care, as opposed to where everyone always looks, which is secondary care?
Several hon. Members rose—
Madam Deputy Speaker (Judith Cummins)
May I ask Members to keep their questions and answers sharp, please?
Mrs Sharon Hodgson (Washington and Gateshead South) (Lab)
Under the last Conservative Government, strikes cost the taxpayer millions of pounds and 1.5 million appointments were cancelled, so may I thank the Secretary of State sincerely for making it his day one priority to sort that out? He called the junior doctors and found a deal within three weeks, ending the strikes. All of us across the House thank him for sorting that out. For the first winter in three years, staff will be on the frontline, not the picket line, as the Secretary of State so rightly said. Does he agree that that is just one example of what Labour Governments do in office? We always have a laser focus on making the NHS better, unlike the Conservatives, who seem to have a laser focus on making it fail.
Hospice and Palliative Care
Judith Cummins Excerpts(1 month, 1 week ago)
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Several hon. Members rose—
Madam Deputy Speaker (Judith Cummins)
Order. Members will see that we have some pressure on time this evening, and I want to get everyone in. Before I call the next speaker, I suggest an informal four-minute time limit.
NHS Backlog
Judith Cummins Excerpts(1 month, 2 weeks ago)
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Several hon. Members rose—
Madam Deputy Speaker (Judith Cummins)
Order. I am now imposing an immediate four-minute time limit, to try to get everyone in.
Josh Fenton-Glynn
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.
Madam Deputy Speaker (Judith Cummins)
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.
Ellie Chowns (North Herefordshire) (Green)
Thank you, Madam Deputy Speaker. I would like to thank the hon. Member for North Shropshire (Helen Morgan) for securing this debate on the vital area of NHS backlogs, which is of great importance to me and my constituents. We are short of time so I will not talk, as I wished to, about the need to tackle the crisis in social care and the need to invest heavily in public health. I will focus my comments on responding to the Government’s announcement today on elective care.
I hope the Minister will be able to respond in a moment to some of the questions I want to pose, because it is one thing to use spare capacity in the private sector to tackle the absolute crisis we have with waiting lists and backlogs—I can understand that as an emergency measure—but it is quite another to propose in effect long-term outsourcing from the NHS to private providers. To be honest, I fear that today’s announcement could essentially be a form of creeping back-door privatisation of aspects of NHS care, and specifically those in which is easiest for private sector providers to make a profit. We only have to look at PFI to understand the dangers of that approach.
I have read today’s partnership agreement between the NHS and the independent sector, and I am afraid I find it the opposite of reassuring. I will briefly canter through some of the reasons why. Section 2 indicates that the Government do envisage increased private provision of both surgical and diagnostic services.
There is some text in section 3 about trying to seek assurance that those private providers will not essentially cherry-pick the most attractive, easy and profitable patients. However, all it says is that the independent sector will review its patient criteria; there are no teeth there.
There is nothing in section 4 about measures to protect the NHS from the risk of private providers making excessive profits from the services they provide. We have recently heard in this Chamber cases of that happening in the social care sector and the children’s social care centre. Is there not a real risk that that could also happen in the healthcare sector if this is not actioned?
Finally, there is nothing in section 5 to address the risk of transferring services to private providers leading to leaching of staff from the NHS services into the private sector. How can we be guaranteed that there is not going to be excessive competition in a workforce that is already extremely stretched?
For the Green party and myself, the profit motive has no place in our NHS. I hope the Minister will provide assurances that the NHS will continue to be publicly owned and publicly run for public benefit, and that the concerns I have highlighted will be addressed so that the agreement between the NHS and the independent sector has teeth.
Madam Deputy Speaker (Judith Cummins)
I now call the Liberal Democrats spokesperson, Jess Brown-Fuller.
Jess Brown-Fuller (Chichester) (LD)
I thank my hon. Friend the Member for North Shropshire (Helen Morgan) for introducing this important debate on our first day back after Christmas. I also thank all hon. Members from across the House who have contributed to the debate, and specifically the hon. Members for Runnymede and Weybridge (Dr Spencer), for Ashford (Sojan Joseph) and for Bury St Edmunds and Stowmarket (Peter Prinsley), who always bring really valuable contributions because of their background and current professions; it is very much appreciated when talking about the NHS.
My hon. Friend the Member for North Shropshire highlighted in her opening remarks that backlogs are not just about NHS waiting lists, but that there are also problems with mental health backlogs, handover delays, A&E waits, poor access to dentistry, GP appointments, cancer treatment waiting times and staff that are being driven from the NHS because they cannot provide the care they want to give.
Our healthcare system remains the No. 1 issue that I am contacted about. It is not unreasonable for my constituents and people across the country to expect to receive the care they need when and where they need it. I doubt there are many people who have not been affected or know somebody who has been affected by NHS backlogs. Indeed my dad struggled for months to get a face-to-face GP appointment for what he believed was a return of a hiatus hernia. By the time he saw his GP and was referred, the oesophageal cancer that he had was so progressed that palliative care was the only option for him and he passed away shortly after being diagnosed in 2021.
When I asked my constituents to get in touch with examples of personal experiences of the NHS backlogs, I was inundated with emails from people across Chichester, and I will share some of those with the House.
I have Jane, who was at high risk of bowel cancer due to living with ulcerative colitis. She is meant to see her consultant every six months but has not had an appointment since 2019, despite her GP trying on her behalf on multiple occasions. She has no idea if the polyps discovered in 2017 have turned cancerous and is living in constant fear of her health deteriorating further.
Ian got in touch after waiting over a year to receive a scan after he experienced extreme chest pain. The scan revealed heart disease, but the lack of any follow-up appointments has left him anxious and uncertain about his health.
I will also mention a good friend of mine, Rylee, who noticed irregular bruising and a physical change on the back of their leg in 2021 and was finding it harder to walk. After visiting the GP, who sent an urgent referral to the hospital, Rylee waited for months only to discover when chasing the hospital that the referral had gone to the wrong place. They then got added to the waiting list and were told the wait would be between 40 and 50 weeks. We are four years on from the initial changes to Rylee’s leg, and they are finally being treated by leading specialists as Rylee can no longer walk unaided. Amputation of their leg is now being considered. If Rylee had been seen within the expected window of an urgent referral, they would not be facing the prospect of losing their leg in their mid-20s.
These are just a few examples of what is a much larger picture of the NHS, with caring and compassionate staff working within it who are overstretched and overburdened and, as my hon. Friend the Member for North Shropshire said, who cannot provide the care they desperately want to because of a system that cannot meet the demand.
The Liberal Democrats recognise that this is an inherited problem; indeed, the key NHS waiting times standards have not been met for some years. The number of patients waiting longer than four hours in A&E rose consistently between 2015 and 2020. The 62-day waiting time for standard cancer treatment has not been met in recent years, and the consultant-led treatment target in England of 18 weeks has not been met in 2016.
The last Conservative Government left emergency care in a deep crisis. The Darzi review stated that 800 working days were lost every day to handover delays in 2024. Last winter, ambulances across England collectively spent a total of 112 years waiting outside hospitals to hand patients over. In 2024, more than 1 million patients faced waits of more than 12 hours in A&E. The Liberal Democrats welcome new investment in the NHS, but instead of spending money firefighting crisis after crisis, we would invest to save taxpayers’ money in the long run. We would do that by investing in the front door and the back door: in primary care, with GPs and dentists, and by reforming social care.
Some of my constituents would like it noted that they will not be counted on any statistics regarding backlogs, because they cannot get a GP appointment to even get on the backlog list. That is why the Liberal Democrats are calling for everyone to have the right to see their GP within seven days, or 24 hours if it is urgent, with a 24/7 booking system to end the 8 am phone-call lottery to get an appointment. We would also ensure that everybody over the age of 70 and those with a long-term condition have access to a named GP.
We would fix the back door and address the social care crisis now, rather than spending another three years commissioning a report that will find out what we already know: social care is in urgent need of reform. The Darzi review showed that inadequate social care accounts for 13% of hospital bed occupancy, meaning that people who desperately want to get home cannot because of the lack of social care packages available and that others deteriorate at home, because they cannot access the social care they need. In the past year, more than half of all requests for social care were unsuccessful. We would strengthen our emergency services to reduce excessive handover delays by increasing the number of staffed hospital beds and calling for a qualified clinician in every A&E waiting room to ensure that any deteriorating conditions are picked up on to prevent tragic avoidable incidents.
I once again thank the hon. Friend the Member for North Shropshire for bringing forward this incredibly important debate, and I thank those Members who contributed to a conversation that matters to my constituents in Chichester and to people across the country.
Karin Smyth
I would like to, but I am afraid I need to adhere to the time limit.
In closing, on Second Reading of the National Health Service Act 1946, Nye Bevan warned us against following abstract principles that work on paper but not in the real world. This Government are interested only in what works, and we know we must do things differently, because the backlog began to build before the pandemic. NHS constitutional standards have not been met for more than a decade. Whatever the last Government were doing, it was not working. That is why our elective reform plans will do things differently, giving patients more choice and more control over their treatment, making greater use of technology—including the NHS app—to give patients the convenience of a seven-day diagnostic service.
In response to the hon. Member for North Herefordshire (Ellie Chowns), we will use private sector capacity to help—supporting patients is what matters. As the party that founded the NHS, we will always be committed to a publicly funded NHS that is free at the point of use. We are going hell for leather to get waiting lists down, rebuild our NHS and ensure that it is there for us when we need it once again. None of this will happen overnight, but we are not asking to be judged by our promises; we will be judged by our results, and we are determined to succeed.
Puberty-suppressing Hormones
Judith Cummins Excerpts(2 months, 1 week ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
With permission, Madam Deputy Speaker, I shall make a statement on puberty blockers.
At the outset, I wish to make clear the principles that drive the Government’s approach to this issue. First, children’s healthcare must always be led by evidence. Medicines prescribed to young people should always be proven to be safe and effective. Secondly, evidence-led, effective and safe healthcare must be provided to all who need it, when they need it. Thirdly, this Government believe in the dignity, worth and equality of every citizen, and recognise that trans people too often feel unsafe, unrecognised and unheard, and that must change. None of these simple ambitions has been achieved in recent years. Medicine has been provided with insufficient evidence, and young people have been left to go without the support and care that they need. This Government are determined to change that.
The Cass review made it clear that there is not enough evidence about the long-term effects of using puberty blockers to treat gender incongruence to know whether they are safe or beneficial. That evidence should have been established before they were ever prescribed for that purpose. It is a scandal that medicine was given to vulnerable young children, without proof that it was safe or effective, or that it had gone through the rigorous safeguards of a clinical trial.
Following the Cass review, the NHS ceased the routine use of puberty blockers to treat gender incongruence in children. In May, the previous Government issued an emergency order to extend these restrictions to the private sector. In Opposition, my party and I, as shadow Health and Social Care Secretary, supported those decisions. Since coming into office, I have renewed this order twice, continuing restrictions until the end of this year. That was done jointly with the Health Minister in Northern Ireland, and I updated the House via a written statement.
While the temporary ban was in place, I asked the Commission on Human Medicines to look at the current environment for prescribing puberty blockers, and we launched a targeted consultation. The commission is an independent body, made up of leading clinicians and epidemiologists, that advises on medicine safety. It took evidence directly from clinical experts, consultant paediatric endocrinologists and patient representatives, including representatives of trans people, young people and their families. After thoroughly examining all the available evidence, it has concluded that prescribing puberty blockers to children for the purposes of treating gender dysphoria, in the current prescribing environment, represents “an unacceptable safety risk”. Of particular concern to the commission was whether these children and their families were provided with enough time and information to give their full and informed consent. The commission found that children had received prescriptions after filling out online questionnaires and having one brief Zoom call with prescribers from outside the UK.
Consequently, the commission has recommended that the Government extend the banning order indefinitely, until a safe prescribing environment can be established for these medicines. On the basis of those findings, I am acting on the commission’s advice and putting in place an indefinite order to restrict the sale or supply of puberty blockers to under-18s through a prescription issued by either a private UK prescriber, or a prescriber registered outside the UK. This is on the advice of expert clinicians, the independent Commission on Human Medicines—advice based on the best available evidence—and follows the cautionary and careful approach recommended by Dr Cass. The legislation will be updated today, and will be reviewed in 2027, when there will be an updated assessment of the safety of the prescribing environment for these medicines.
We are working to grow a thorough evidence base for puberty blockers. The National Institute for Health and Care Research is working closely with NHS England to establish a clinical trial on puberty-supressing hormones. The NIHR is now contracting the team that will deliver the study and is working tirelessly towards recruiting the first patients by spring. The trial is the first of its kind the world over. It will help us better understand the effects of puberty-suppressing hormones on young people, providing the robust evidence required.
The Cass review also made clear recommendations to the Government and NHS England on improving healthcare services for children with gender dysphoria. I will now provide an update on the progress made. NHS England has published its implementation plan, which will transform its services. It has also published a new services specification, to ensure that children and young people experiencing gender incongruence have an appointment with a paediatrician or mental health professional before being referred to specialist services. Dr Cass was clear on the need for the model of care to change and take account of children and young people’s holistic needs.
Since April, NHS England has opened three new gender identity services—in the north-west, in London and in Bristol—with a fourth expected in the east of England by the spring. That puts us on track to open services in every region by 2026. These services offer a fundamentally different clinical model. They bring together clinical experts in paediatrics, neurodiversity and mental health, so that care can be tailored to patients’ needs. At first, the new services were prioritising patients registered with the old Gender Identity Development Service, but I am delighted to report that the north-west and Bristol services are now taking patients off the general waiting list.
On the waiting list, Dr Cass’s review painted a picture of a service unable to cope with demand. Children and young people face unacceptably long waits for care, with some children passing into adulthood before their first appointment, leaving them facing a dangerous cliff edge. I am pleased to tell the House that NHS England is working with potential partner organisations to explore establishing a much-needed follow through service for 17 to 25-year-olds, as Dr Cass recommended. Young people’s distress or needs do not vanish when they turn 18, and neither should their healthcare.
We do not yet know the risks of stopping pubertal hormones at this critical life stage. That is the basis on which I am making decisions. I am treading cautiously in this area because the safety of children must come first. There are some who have called on the Government not to go ahead with the clinical trial recommended by Dr Cass. Others on the opposite side of the debate want the Government to ignore the recommendations of the independent expert Commission on Human Medicines. We are taking a different approach. The decisions that we take will always be based on the evidence and the advice of clinicians, not on politics or political pressure.
Finally, there are many young people in this country who are desperately worried and frightened by the toxicity of this debate. This has not been helped by some highly irresponsible public statements, which threatened to put vulnerable young people at risk. In the past few months, I have met young trans people, who either have been, may be, or will be affected by the decisions that I and my predecessor have taken. I have listened to their concerns, fears and anxieties, and I want to talk directly to them. I know it is not easy being a trans kid in our country today. The trans community is at the wrong end of all the statistics for mental ill health, self-harm and suicide. I cannot pretend to know what that is like, but I do know what it is like to feel that you have to bury a secret about yourself, to be afraid of who you are, to be bullied for it, and then to have the liberating experience of coming out. I know it will not feel like it, based on the decisions that I am taking today, but I really do care about this, and so does this Government.
I am determined to improve the quality of care and access to healthcare for all trans people. I am convinced that the full implementation of the Cass review will deliver material improvements in the wellbeing, safety and dignity of trans people of all ages, and the Government will work with them to help them live freely, equally and with the dignity that everyone in our country deserves. I commend this statement to the House.
Wes Streeting
I can certainly give my hon. Friend that assurance. Better-quality evidence is critical if the NHS is to provide reliable and transparent information and advice to support children and young people, and their parents and carers, in making potentially life-changing decisions. That is why we support the setting up of the study into the potential benefits and harms of puberty-supressing hormones as a treatment option. The study team’s application for funding is going through all the usual review and approval stages ahead of set-up—including peer review, consideration by the National Institute for Health and Care Research funding committee, and ethical approval processes. We want the trial to begin recruiting participants in spring 2025. I am confident in the robust, appropriate and ethical way in which the trial is being established.
Helen Morgan (North Shropshire) (LD)
I thank the Secretary of State not only for the content of his statement, but for its tone and his recognition of the importance of such a tone in this place. For too long, children and young people who are struggling with their gender identity have been badly let down by low standards of care, exceptionally long waiting lists and an increasingly toxic public debate.
Before GIDS closed, more than 5,000 young people were stuck on the list for an appointment and waited, on average, almost three years for their first appointment. For teenagers going through what is often an incredibly difficult experience, three years must feel like an eternity, so change is desperately needed.
The Liberal Democrats have long pushed to ensure that children and young people can access the high-quality healthcare that they deserve. We welcome the NHS move to create multiple new regional centres, but those centres must get up and running as quickly as possible. Will the Secretary of State outline what steps the Government are taking to ensure that happens in every region, and will he give a timetable for that work? Tackling waiting lists and improving access to care must be priorities.
I understand why today’s news is causing fear and anxiety for some young trans people and their families, who have been badly let down for so many years—not least those I have met in my constituency, who have highlighted the catastrophic mental health impacts of the situation. It is crucial that these sorts of decisions are made by expert clinicians based on the best possible evidence. Will the Secretary of State publish all the evidence behind his decision, including the results of the consultation, to give those families confidence that this is the right move for them?
We welcome the announcement of a clinical trial. We need the NHS to build up the evidence base as quickly as possible, and the Government to provide certainty that they will follow evidence and expert advice on behalf of those children.
Tobacco and Vapes Bill
Judith Cummins ExcerptsTuesday 26th November 2024
(2 months, 3 weeks ago)
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Mary Kelly Foy (City of Durham) (Lab)
I declare an interest as the co-chair of the all-party parliamentary group on smoking and health. Just over a year ago, I welcomed the previous Government’s Tobacco and Vapes Bill. As the House may know, I have called for a smokefree generation for many years. I was not best pleased when the Conservatives voted down my amendments to the Health and Social Care Bill in 2021. Those amendments called for a ban on flavours and packaging targeted at children, which the shadow Secretary of State has just brought to the House’s attention. If they had not been voted down, we would already have regulations to protect children from smoking and vaping.
I join the Secretary of State in congratulating the former Prime Minister, the right hon. Member for Richmond and Northallerton (Rishi Sunak) on bringing the Smoking and Vapes Bill forward, but it was regrettable that the previous Government did not fast-track it in the wash-up before the general election. Nevertheless, I am grateful to the Labour Government for bringing this Bill forward. It is stronger than the previous legislation, and it responds to many of the issues that I and others raised in Committee with the previous Bill.
The comprehensive regulation of all vaping and nicotine products is important for addressing the concerns that vaping has become too widespread among young people. I strongly support regulations to reduce the appeal of such products, but we must ensure that the regulations are enforceable, robust and fit for purpose. My first of many questions to the Minister is this: will he confirm that a detailed policy paper will be forthcoming, setting out the policy objectives on vaping and how the new regulations will deliver against the objectives?
The Labour manifesto made a bold commitment on halving the gap in healthy life expectancy between the richest and poorest regions in England. Tobacco control is the best way to close the gap. We cannot say it enough: the range of diseases that smoking causes is extraordinary, from stillbirths and asthma in children to heart disease, stroke, dementia in old age, poor mental health and many cancers.
It will never cease to amaze me that there are people in this place who are happy to be lobbied by the tobacco companies—including, I am guessing, the shadow Secretary of State—some of whom we have heard from already, knowing full well the damage caused to individuals, families and communities, as well as to our health services. That includes communities such as mine in the north-east of England, where smoking is still the key driver of health inequalities and has been the cause of 26% of all deaths in the last 50 years and the cause of 125,000 deaths since 2020.
In my constituency of City of Durham, smoking costs us over £95 million a year, and more than £3 million is spent on healthcare. In County Durham, smoking costs us over £500 million a year, and over £21 million is spent on healthcare. In the north-east, the cost is over £2 billion, with healthcare costs at over £93 million. Nationally, smoking is still the greatest cause of preventable death, still the leading cause of premature death and disability, and still responsible for half the difference in healthy life expectancy between the rich and poor. That is why I have asked time and again in this Chamber for action.
It is a tragedy when we consider the further health implications. According to Cancer Research UK, the most deprived communities will not be smokefree until 2050. I urge the Government to restate their intention to publish a road map to a smokefree country and outline how support will be targeted at those who most need to quit. Smoking is also directly and indirectly linked to poor mental health. Nearly 40% of those who have a severe mental health problem smoke, and smoking accounts for two thirds of the reduction in life expectancy among that group.
I want to touch on the “polluter pays” levy. The Darzi review found that our health service is in real trouble. The Secretary of State is right that to rebalance supply and demand in our healthcare system, we need a major shift from sickness to prevention. The Khan review and the all-party parliamentary group on smoking and health have advocated for a “polluter pays” levy, which could raise £700 million a year to create a smokefree fund. That would ensure that the tobacco companies—not the public—pay for the harm that they inflict. Will the Minister consider that approach to fund the work needed to reduce smoking across society and to protect the NHS?
I should add that public health initiatives to tackle smoking are remarkably good value for money and that failing to fund efforts to tackle smoking is a false economy. Initiatives such as Fresh—the north-east’s tobacco control programme—have led the way in tackling smoking in our region. Fresh and others could provide best practice for the Department.
The Minister will know that the UK Government are party to the World Health Organisation framework convention on tobacco control. Article 5.3 seeks to protect policymaking from industry influence, but we have already seen that influence even at this stage of the Bill. Will the Minister confirm that the Government will live up to their obligations under the FCTC and commit to protecting the Bill from industry influence throughout its parliamentary process and the following regulations?
I am proud to vote for a Bill that will improve people’s lives and extinguish the injustice that smoking causes to individuals and society. Smoking is never about choice, and it is pathetic that some Members have argued that this is an issue of freedom; it is absolutely nothing of the sort. Tobacco companies target children and young people. Smoking is an addiction, and the only free choice is that first cigarette. When someone is in hospital, struggling to breathe because of smoking-induced lung cancer, where is their freedom? Today, we have the opportunity to give people the freedom to live healthy lives, free from disease and the inequalities that smoking causes.
Several hon. Members rose—
Madam Deputy Speaker (Judith Cummins)
After the next speech, I will impose a six-minute time limit.
Infected Blood Inquiry
Judith Cummins Excerpts(3 months ago)
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John McDonnell (Hayes and Harlington) (Ind)
On a point of order, Madam Deputy Speaker. I apologise for raising a point of order out of sequence, and I will explain why I am doing so. It relates to the case of Mr Alaa Abd el-Fattah and a point of order that I raised over a week ago. Some Members may recall that he is a British citizen who was imprisoned for his human rights campaigning in Egypt. He has served his sentence of five years and should have been released in September, but was not. His mother, a well-known academic at Cairo University, has been on hunger strike for 50 days. Anyone who has had any experience of hunger strikes knows that this is a critical period.
A number of us wrote to the Foreign Secretary over 10 days ago about this case, urging him to make further representations to the Egyptian Administration to secure Mr el-Fattah’s release. As of close of play today, we have not received a response. Through you, Madam Deputy Speaker, could I urge the Foreign Secretary to respond and, more importantly, take action? I am now fearful for the life of Laila, Mr el-Fattah’s mother, because as I said, the hunger strike has entered its 50th day.
Madam Deputy Speaker (Judith Cummins)
The very serious matter raised by the right hon. Member is not one for the Chair, but he has placed his concerns on the record in the hearing of the Foreign Office.
Income Tax (Charge)
Judith Cummins Excerpts(3 months, 2 weeks ago)
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Jas Athwal (Ilford South) (Lab)
Our NHS is literally a lifeline for so many of us across the country. Last year, I witnessed that at first hand. From riding 85 miles on a Sunday, I went for precautionary tests on the Monday. To my horror, the arteries around my heart were completely blocked. It was an incredibly difficult time for me and my family, but the NHS was there for me: the doctor, the cardiologist who told me the news in such a nice way it felt as if nothing was wrong, the surgeon who operated on me very urgently because that needed to be done quickly due to the potential impact it could have had on me, and the nurses who nursed me back when I needed the care the most. Like so many in this Chamber and across the country, the healthcare professionals—the doctors, nurses and administrative staff—are the reason I am able to stand here today in good health to address the Chamber. Among them are the very neighbours who took care of me during my time in hospital.
As Members are all too well aware, however, the NHS is far from perfect. Tory austerity decimated the NHS and the covid mismanagement added fuel to the burning fire engulfing the NHS. Our waiting lists are at record levels: 7 million people waiting for elective treatments; 10% of patients now waiting 12 hours or more in A&E; and 350,000 people a year waiting for mental health support. This is the worst crisis for our NHS since its formation 76 years ago.
Protecting our NHS is crucial, so that people can get the treatment they need, when they need it. Whether it is a heart bypass like mine, a transplant or cancer treatment, this Labour Budget delivers a decisive shift from the disastrous—
Several hon. Members rose—
Madam Deputy Speaker
Order. Before I call the next speaker, I gently remind Members that we are on a three-minute time limit. Also, when I am standing, Members should please sit down.
Mr Angus MacDonald (Inverness, Skye and West Ross-shire) (LD)
It is appropriate that I am following the words of the hon. Member for Stafford (Leigh Ingham) about the palliative care sector. I am grateful for the substantial settlement for the NHS, especially as Scotland will get £3.4 billion, which will make an enormous difference. The Belford hospital in Fort William has been condemned, effectively, for 25 years. Unfortunately, I have very little confidence in the Scottish Government to spend that £3.4 billion well.
I recently spoke with Kenny Steel, the chief executive officer of Highland hospice in Inverness, who told me that the changes to employer national insurance are expected to add an unaffordable £177,000 to its annual salary bill. That comes on top of the need to remain competitive with the 5.5% salary increase awarded to NHS staff. Marie Curie anticipates that the NI increase will cost it £3 million a year—money it does not currently have.
The Government’s planned increase in employer NI contributions to 15% from April 2025 is an impossible amount for the palliative care sector. If those essential care providers cannot absorb the additional cost, their survival is at risk. If hospices fail, the patients they support will inevitably turn to the NHS, placing greater pressure on an already overstretched system. If the Minister could listen to me and put his phone down for a moment, I would be grateful—can you listen to me, just for a second?
Madam Deputy Speaker (Judith Cummins)
I remind the hon. Member not to address other people in the Chamber as “you”, as he is actually addressing me. Please continue.
Mr Angus MacDonald
Palliative care charities are essential partners that deliver compassionate, dignified end-of-life care on behalf of, and much cheaper than, the NHS. Organisations that provide healthcare for the NHS should be treated like NHS bodies in these decisions. Increasing NI contributions for hospices but not the NHS places those providers in a critical financial position, and firmly indicates that the Government regard organisations such as Highland hospice as second-class.
Access to Primary Healthcare
Judith Cummins Excerpts(4 months ago)
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Monica Harding (Esher and Walton) (LD)
I am proud to speak today about our NHS, which looks after my constituents in Esher and Walton—young, old and in the middle—every day. But after years of neglect and failure by the previous Government, my constituents too often struggle to access primary healthcare, which we believe should be a right. The NHS was denied necessary reforms and resources, and it has not been prepared for an ageing population with increasing rates of chronic and complex conditions. The extra strain is demonstrated in the ratio of patients per GP and in the daily lives of my constituents, who suffer long waits or are unable to get appointments. I recently received a letter describing how a GP appointment for a constituent’s elderly mother was cancelled at short notice and had not been rescheduled after a month, despite several emails. Problems like this are far from being one-offs.
In my constituency, residents often struggle to get same-day GP appointments, and too many wait more than a week. Our personal citizen contract with the NHS is implicit in being British, but that contract is fraying. Being able to access a GP in a timely manner is an essential expectation that my constituents still have, which is why enshrining the Liberal Democrat guarantee of access to an appointment within seven days as a right in the NHS’s constitution is so important. It reflects the duty of the Government to ensure that one’s local GP is always accessible.
The excessive wait times are intimately connected with the Conservative failure to recruit and retain GPs. In the previous Government’s 2019 manifesto, they committed to recruit more than 6,000 GPs; instead, there are fewer GPs than there were five years ago. Since then, however, the population has continued to rise and age, and conditions have become more complex. The broken Conservative promise—yet another failure—means that in the last eight years, the number of patients per fully qualified GP in the Surrey heartlands has risen to 2,163, even though the UK has one of the lowest ratios of doctors to people, recently ranking 22nd out of 33 OECD countries. Even when people can get an appointment, it is often not with a GP, often unknowingly.
As my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) pointed out, the policies pursued by the previous Government, including the restrictions on the recruitment of GPs under the additional roles recruitment scheme, have resulted in incidents of GPs in Esher and Walton being offered voluntary redundancy, even as residents struggle to get an appointment. Our most vulnerable patients have a particular need for security and stability, and this belief under- pins the Lib Dem conviction that everyone over the age of 70 or with a long-term physical or mental health condition—
Madam Deputy Speaker (Judith Cummins)
Order. I call the Liberal Democrat spokesperson.
NHS Performance: Darzi Investigation
Judith Cummins Excerpts(4 months, 2 weeks ago)
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Wes Streeting
I strongly agree with the Chair of the Select Committee and commend the work of the previous Committee, to which she refers. She has certainly given me some revision for the first meeting that I will attend. To answer her question, she is absolutely right that digital transformation and place-based healthcare planning are key. This Government will have a much sharper focus on health inequalities than the previous Government did. In fact, if we consider the NHS over the past 30 or 40 years, even when it has performed well overall, and patients in every part of the country have received access to timely care, some health systems have still been more challenged than others. We need to be honest about the structural challenges in those areas. Secondly, she is absolutely right that, if we are serious about health and prevention, we need a serious cross-Government approach. That is why I am delighted that the Prime Minister’s mission-driven approach has already seen Departments coming together with a focus on prevention. That will deliver fruit.
This is the major surgery that our national health service needs over the next decade to make it fit for the future. There is no time to waste, so we have hit the ground running. We inherited a Care Quality Commission that is not fit for purpose. I was genuinely stunned to learn that one in five health and care providers has never been inspected; some hospitals have been left uninspected for a decade; and inspectors were sent to care homes when they had never met someone with dementia. The Conservatives did not think that patients would like the answers, so they stopped asking the questions. This Labour Government are different: we will be honest about the problems facing the health service, and serious about solving them. Our policy is radical candour.
Today I am delighted to announce that Sir Julian Hartley has been appointed the new chief executive of the CQC. He is a proven reformer with a track record of turning around large organisations, and I am confident that he will provide the leadership that staff in the CQC need to address this crisis, improve patient safety and restore confidence in the regulator. Sunlight is the best disinfectant, so this Government are taking action to turn the regulator around. That is the difference a Labour Government make.
We inherited the farce of newly qualified GPs facing unemployment. Patients could not get a GP appointment, while GPs could not get a job, so we cut red tape, found the funding and are recruiting an extra 1,000 GPs. That is the difference a Labour Government make. We have tabled a motion to ban junk food ads targeted at children —our first step towards making our country’s children the healthiest generation that has ever lived. That is the difference a Labour Government make. Just this week, the Secretary of State for Science and Technology and I announced funding to produce new cutting-edge cancer treatments: a new blood test that can detect 12 different cancers. We are backing Britain’s scientists to save lives. That is the difference a Labour Government make.
Of course, strikes in the NHS have cost taxpayers billions. Patients saw 1.5 million operations and appointments cancelled. The Conservatives saw strikes as an opportunity to scapegoat NHS staff, so they let the strikes rage on. In fact, the shadow Health Secretary had not even bothered to meet the junior doctors since March. This Government do not exploit problems; we solve them. I called the junior doctors on day one and met them in week one, and in just three weeks, we had negotiated a deal to end the strikes. That is the difference a Labour Government make.
Those are just our first steps. Rebuilding the NHS will not be easy and it will take time, but we have done it before and we will do it again. Along with the millions of dedicated staff in health and social care across our country, this can be the generation that takes the NHS from the worst crisis in its history to build an NHS fit for the future—an NHS that is there for us when we need it, with world-class care for the many, not just the few. That is the change that Britain voted for; that is the change we will deliver together; and that change has already begun.
Madam Deputy Speaker (Judith Cummins)
Before I bring in the Opposition Front Benchers, the House should be aware that over 50 Members wish to speak in the debate, so I ask you to help each other. On this occasion, I will impose a three-minute limit on Back-Bench speeches, with the exception of maiden speeches and that of the Chair of the Health and Social Care Committee. I call the shadow Secretary of State.
Debbie Abrahams
As a former public health consultant, I would obviously agree with my hon. Friend. I have similar health inequalities across Oldham. I was about to talk about the impact of other issues, such as social security cuts, which meant greater poverty, including in-work poverty and children from working families living in poverty. That has had a consequential impact on our health as a whole. We have flatlining life expectancy, and in areas such as mine, life expectancy has got worse. That impacts on our productivity and the wealth of our country.
I will briefly mention a couple of points that I know my right hon. Friend the Secretary of State recognises, and might want to consider. An annual report on the state of our health and the state of our NHS, presented to Parliament before each Budget, would pick up on the points that have been raised about cross-departmental impacts on health. We should have a prospective assessment of the impacts of the Budget and the Finance Bill on poverty and inequality, and subsequently on health and the NHS. That can be done; others are doing it. We should have a strategy to identify and address health equity issues in the NHS. We have seen a bit of that through covid, in the inequity around the use of oximeters. We should introduce something like “Improving working lives” for our staff. That had a massive effect on staff when I worked in the NHS. We need a clear commitment to the 1948 principles of the NHS, under which it is funded from general taxation, and a funding allocation based on need.