NHS England Update

Debate between Julian Lewis and Wes Streeting

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.

Puberty-suppressing Hormones

Debate between Julian Lewis and Wes Streeting

Wednesday 11th December 2024 Commons Chamber

[Wes Streeting]

Very heavy consideration—of all the considerations, it is the one that has weighed most heavily. As I said in my statement, trans people too often find themselves at the wrong end of the statistics on mental ill health, self-harm and suicide. I take those issues very seriously indeed.

What I would say to my hon. Friend, Members of this House, and campaigners—particularly online actors—is that a number of claims have been made about the data that are not borne out by the facts. In fact, I asked Professor Louis Appleby, the Government’s suicide prevention adviser, to examine the evidence for some of the claims made that there has been a large rise in suicide. His paper, published on 19 July, concluded as follows:

“The data do not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock.

The way that this issue has been discussed on social media has been insensitive, distressing and dangerous, and goes against guidance on safe reporting of suicide.

The claims that have been placed in the public domain do not meet basic standards for statistical evidence.

There is a need to move away from the perception that puberty-blocking drugs are the main marker of non-judgemental acceptance in this area of health care.

We need to ensure high quality data in which everyone has confidence, as the basis of improved safety”.

I would add that it is important that we make sure that these children and young people have access to good-quality mental health support, and I am working with NHS England to make sure that this is the case. This area is one in which all Members should tread carefully when engaging in debate.

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

I do not think anyone who has listened to the Secretary of State today could be in the slightest doubt about the responsibility that he has borne and the personal empathy that he has injected into his handling of this very difficult question. I personally thank him for it.

I was told a long time ago that one should never ask a question in the House to which one does not already know the answer, but I think I will break the rule this time. What about surgical procedures? One hears about irrevocable steps such as so-called top surgery—the removal of healthy breast tissue from young females. Where does the law stand on that issue at the current time?

[Wes Streeting]

The only thing worse than a Member not knowing the answer to their own question is the Minister not knowing the answer. Happily, in this case, I can say that surgical intervention for trans people does not apply to children and young people.

Tobacco and Vapes Bill

Debate between Julian Lewis and Wes Streeting

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Wes Streeting]

We want to work in a genuinely collaborative and cross-party way, and I know that is true right across the House. As I look at the Opposition Benches, including Conservative Benches, I see long-standing campaigners for action on smoking and vaping. We want to listen and engage.

I feel strongly about the matter, as does the Prime Minister. In our manifesto, we set out Labour’s mission to improve the health of the nation. We will be far better served as a country if this is a truly national mission, and if we come together in common cause for action on public health.

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

rose—

[Wes Streeting]

In that spirit, I will give way to the hon. Gentleman—and then to some of my hon. Friends.

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

Can the Secretary of State tell us if there is any place for vapes as a step-down, in the context of the addictive aspects of tobacco? I seem to remember that when vaping first came along, it was heralded as a way to help wean people from their tobacco addictions. Sadly, it has turned into something else, as he describes, and starts children on the road towards nicotine addiction, but does it have a role as a step-down?

[Wes Streeting]

The right hon. Member is right to make that distinction. As a stop-smoking tool, vaping has a part to play. For smokers, vaping is a better alternative—a route away from smoking. We do not want to throw the baby out with the bathwater. What we are interested in tackling is the scourge of youth vaping and the extent to which young people have been cynically addicted. It is important to say that we do not yet know the full extent of the harms caused by vaping, but we do know two things: first, it is better to vape than to smoke—that is why we are striking the balance in this legislation—and secondly, vapes are harmful. Ask any teacher in the country; they will talk about the signs of nicotine addiction that they see in their pupils, and about having to monitor school toilets to stop children congregating to vape. It is urgent and necessary to act today to protect this generation of kids from a new addiction, and that is exactly what we will do.

Public Health

Debate between Julian Lewis and Wes Streeting

Tuesday 14th December 2021 Commons Chamber

[Wes Streeting]

I strongly endorse what the hon. Gentleman said. Infection control is going to be a real challenge this winter because of the nature of the omicron variant. By ensuring that the NHS workforce is fully vaccinated, we will protect not only patients but staff, who already put themselves in harm’s way enough. As the hon. Gentleman, who speaks with real knowledge and expertise, said, this is not a new precedent: NHS staff are already required to inoculate themselves against other diseases. It is a professional duty. The NHS clearly believes that the April deadline gives sufficient time to persuade the workforce to protect themselves, their patients and their loved ones without there being an exodus of staff.

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

I supported the requirement for people working with vulnerable people in care homes to be vaccinated or, if they would not be vaccinated, to be removed from direct contact with vulnerable people. Can the hon. Gentleman tell me—I did not get a chance to ask the Secretary of State—whether this proposal for members of the NHS who have not been vaccinated will affect only frontline staff who interact with the vulnerable, or whether it will apply to people throughout the NHS who might have no contact with the vulnerable? That will affect the way I cast my vote today.

[Wes Streeting]

I hope I can reassure the right hon. Gentleman that it will not be a case of saying to people, “If you don’t take up the jab, that’s it—you’re out.” There will also be the opportunity for redeployment to other roles where vaccination would not be mandatory. I hope that gives him the reassurance that he needs.