NHS England Update

Julian Lewis Excerpts

Thursday 13th March 2025 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right: if we just replicate NHS England as it is with all the challenges in its set-up in ICBs across the land, we will have failed. Frankly, if we replicate NHS England and the Department as they are today just in one organisation, we will have failed to meet the challenge of change. It needs to feel and act like a completely new organisation, culture and way of working to modernise the state, so that if Disraeli, Gladstone, Churchill or Attlee walked into Whitehall at the end of this Government, it would not look so much like the Government they worked in during the 19th and 20th centuries. That is the reality of Whitehall today; it is not a reflection on the people who work in it, but it shows why it needs to change, and that is also true of the NHS. I look forward to working with ICB leaders to reform their ways of working, clarify their priorities, give them clearer marching orders and ensure that they can deliver.

Finally, my hon. Friend mentions the staff of NHS England—indeed, this affects staff in my Department, too—and I thank her for the care she has shown. Change is always disruptive and it can be scary, and of course that is particularly the case when job losses are involved. I want to acknowledge that on the Floor of the House, as I have to staff across both organisations this morning. I know that the Permanent Secretary and the chief executive of NHS England have done so in recent days, and I will be holding a town hall with staff next week. This really is not a reflection on them. In fact, I think they will recognise in my description of our ways of working the many things that frustrate them. None the less, they are dedicated and talented people, and some of the best people I have ever worked with in any walk of life or career work in this system. I look forward to working with them in the coming weeks and months with the same dedication and professionalism they have always shown, so that we can all look back on this time with pride, knowing that we were part of the team that took the NHS from the worst crisis in its history to getting it back on its feet and making it fit for the future.

[Sir Julian Lewis (New Forest East) (Con)]

Does the Secretary of State agree that one of the worst and most intractable problems that the founders of the NHS had to deal with was the involvement of medical practitioners and consultants who were used to receiving a private income in a national service where they would not receive anything like the same remuneration? If he agrees, would he accept that there is a similar situation with NHS dentistry today? The Darzi report said:

“There are enough dentists in England, just not enough dentists willing to do enough NHS work, which impacts provision for the poorest in society.”

How does he think his reforms will help address that particular crisis, on which Members like myself and my right hon. Friend the Member for New Forest West (Sir Desmond Swayne) are being consistently and rightly lobbied by such formidable organisations as the New Forest branch of the women’s institute?

[Wes Streeting]

NHS dentistry is in a terrible state and, in fact, in many parts of the country it barely exists. There are lots of reasons for that, and it is a source of constant astonishment to me that the dentistry budget was underspent year after year despite that situation. The Minister for Care is working with the British Dental Association to reform the contract. I know that Members are frustrated at the pace, and so am I. We are trying to clear an enormous challenge; it is not going to be easy, but we are committed to working with the profession. We are rolling out the 700,000 urgent dentist appointments and supervised toothbrushing, as we promised and as the BDA has welcomed, but we have a lot more to do. That requires working with the profession—not simply tinkering with the system as it is, but fundamentally rethinking it and how we rebuild it into an NHS dentistry service that we can be proud of.