Oral Answers to Questions

Karin Smyth Excerpts

Tuesday 9th June 2026 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

We inherited a decades-old system whereby patient voice was divorced from decision makers, with more than 20 organisations offering a place for patients and users to share feedback. The Health Bill will put the views of patients and users at the heart of decision making, ensuring that that directly informs those responsible for commissioning locally, and we will create a new patient experience directorate in the Department to ensure that patient and user insight directly shapes national policymaking.

[Steve Darling]

The abolition of Healthwatch will see the NHS and the Government effectively marking their own homework. Can the Minister please give some assurances about how the Government will ensure that the voice of those with learning disabilities, complex needs and dementia is heard?

[Karin Smyth]

The hon. Gentleman makes an important point about the variety of needs that local commissioners need to take account of. That is exactly what the Health Bill will try to do, not by outsourcing that role to an outside body but by putting those views at the heart of what all commissioners do, which includes making sure that under-represented or often unheard voices do have a voice.

[Munira Wilson]

When Boots decided to close two pharmacies in Hampton, leaving a large number of elderly and vulnerable residents without local pharmacy provision, Healthwatch Richmond played a crucial role in ensuring that we got a new community pharmacy in the area. That locally led patient voice cannot be replaced by officials in Whitehall or our local ICB, which is about to suffer cuts of over 50% in its operating budget. If the Minister is really serious about championing patients, will she think again?

[Karin Smyth]

The hon. Lady raises an interesting example of somewhere where local commissioners have failed to provide a service or recognise when a service disappears. They can do that by using very different voices, rather than outsourcing that responsibility. Through the Health Bill, we have to make sure that commissioners do their job properly, which includes taking account of patient voice at a very local level.

[Rachael Maskell (York Central) (Lab/Co-op)]

Replacing Healthwatch will mean that, ultimately, patients will not have confidence in the commissioners. We have just heard one example, and I can offer many examples from York. Healthwatch York, which is phenomenal and is led by Siân Balsom, has produced reports that have brought about change. I plead with the Government to review clauses 64 and 65 of the Health Bill to maintain Healthwatch. It should not be an either/or. We need commissioners to engage with the patient voice, but we also need Healthwatch to have the independence to advocate for patients.

[Karin Smyth]

I thank my hon. Friend for her comments about her local healthwatch. There are certainly examples of where this approach works well in local communities, and we need to understand those. However, it does not work well everywhere, and it means that local commissioners are not empowered and are not held accountable for their job of making sure that the patient voice and experience is held locally. There is also nothing to stop ICBs undertaking that role as they see fit in their local communities in the future, rather than our dictating how they should do it through one particular body.

[Mr Jonathan Brash (Hartlepool) (Lab)]

While I support the Government’s desire to drive out bureaucracy from the NHS and simplify systems for patients, Healthwatch Hartlepool has done an outstanding job in ensuring that patients’ voices are heard as systems and services are improved. What can the Minister do to ensure that local expertise is retained in any new system?

[Karin Smyth]

I thank my hon. Friend for his comments. If that works well for his local system, there is nothing to stop it. How the ICB undertakes its role has to be determined locally to make it most effective for local circumstances, and it can undertake that role as it sees fit.

[Graham Stuart (Beverley and Holderness) (Con)]

11. What assessment he has made of trends in the level of unreported removals from waiting lists.

[The Minister for Secondary Care (Karin Smyth)]

Over 85% of waiting list removals are made as a result of patient care, and since the end of the pandemic, unreported removals have been below pre-pandemic levels. Record levels of elective activity are being delivered by NHS staff, enabling us to cut waiting lists and meet our interim target of 65% of patients being seen within 18 weeks—the highest performance in over four years.

[Graham Stuart]

People in Beverley and Holderness want high-quality and speedy care, not massaged waiting list numbers that suit Labour narratives. Of course, Mr Speaker, you will remember that the last Labour Government had form on this as well, because the National Audit Office repeatedly found that the numbers were manipulated when waiting lists were similarly put on a pedestal. The Minister has the new Secretary of State by her side. Can she reassure people in Beverley and Holderness that we will have genuinely improved healthcare, rather than widespread manipulation and the cleansing of waiting lists to suit political purposes?

[Karin Smyth]

If anyone has forgotten, the last Labour Government left the NHS in a better state than it was in under successive Governments. That is not in dispute in terms of waiting list targets or, indeed, patient satisfaction. The right hon. Gentleman might want to look again at the record.

The point that the Conservatives seem to be intent on following up forever is an important one. Some 85% of the activity is a result of direct patient care. Validation, both clinical and clerical, is a long-standing routine practice of waiting list management. At roughly 15%—it was slightly higher before the pandemic—the rate is no different now from what it has been before, so it is not the case that something different is going on here. What we are doing is making sure that the right hon. Gentleman’s constituents—I appreciate that there are many other local problems in his system at the moment—can be clear that we have the right people on the right list for the right care in the right place by the right clinicians. That is what we are determined to do.

[Lewis Atkinson (Sunderland Central) (Lab)]

I commend the Minister for her work in reducing waiting lists for GP referral to first treatment, and they are genuinely coming down. She will be aware, however, that that statistic does not capture the entire picture, particularly for people who require subsequent follow-up care—for example, women with endometriosis or women waiting for breast reconstruction following mastectomies. Could she say a little about any plans she has to capture those waiting lists?

[Karin Smyth]

My hon. Friend is someone who does understand the way waiting lists are managed and so on. We do not have any plans to add any new targets to those to which we have already committed to give confidence to the British public that we can fix the NHS and get waiting lists down. However, he raises an important point about how we support patients to understand where they are in the system and where their care will be provided. Part of our commitment in the elective reform plan, which we outlined last year, is that patients are kept up to date about where they are being treated and why they are being referred to perhaps a more local service, and we will continue to try to do that.

[Mr Speaker]

I call the shadow Minister.

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

Last month, the Health Service Journal reported that the elective waiting list target was met largely—largely—because a record number of patients were removed from waiting lists in March without receiving treatment. Can the Minister tell the House how many patients were removed in March and what happened to them, and whether she is satisfied that they definitely did not need treatment?

[Karin Smyth]

As I have said, I am still a bit perplexed about why the Conservatives are perpetually highlighting their inadequate management of the health service, and the idea that patients are simply referred to a waiting list and then left there for a couple of years, which is what happened on their watch. It is important that patients know why they are on a waiting list, and obviously that they get the best clinical care as quickly as possible.

I do not have to hand the exact figure for March, which will be published as part of the normal process of publishing the waiting list figures. However, I can tell the hon. Gentleman that completed pathways were 5.9% higher in the 21 months from July 2024, when we took office, to March 2025 than in the previous 21 months. Patients, as they deserve, are getting the right care in the right place under this Government.

[Dr Evans]

It is not just the Conservatives who are raising this issue; it is patients and the Health Service Journal. The answer is that 350,000 people—a city the size of Coventry—were wiped off the waiting list with no treatment, and that is 100,000 more than the month before. If there is genuinely nothing to hide, the Government should not worry about putting out the figures. Will the Minister commit to a review to find out what has happened to those 350,000 patients, or does she believe that waiting list targets should be met by removing patients from the figures rather than actually treating them?

[Karin Smyth]

This is an established way of managing waiting lists and waiting times. We are making sure that there is adequate clerical and clinical validation of the lists, and that patients are treated where they need to be, which may often be closer to home and in more local circumstances. Of course, we have committed to greater transparency than there was under the previous Government, and we will continue to provide that. I did not quite follow the hon. Gentleman’s question, but I am obviously very happy to look at anything arising from it. We are confident in the data that is coming out—as I have said, this is standard practice—and the figure is roughly 15%, as it has been over many years.

[Mr Luke Charters (York Outer) (Lab)]

12. What steps his Department is taking to improve the provision of NHS health visitors.

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[Lewis Cocking (Broxbourne) (Con)]

15. What steps he is taking to improve accountability in the health service.

[The Minister for Secondary Care (Karin Smyth)]

The NHS modernisation Bill will clarify and strengthen accountability in the NHS. It ends the fragmented accountability that we inherited on coming into government, and the reforms will restore clear democratic accountability, with the Secretary of State directly accountable to Parliament and the public. We will enhance local autonomy, ensuring NHS organisations are good partners and deliver for their local populations.

[Lewis Cocking]

We need more local accountability in the NHS. In Broxbourne we have seen thousands of new houses built, but when I and local Conservative councillors have pushed for new healthcare facilities to cope with the new demand, we have been refused. Can the Minister explain who will be accountable for that under the Government’s new system?

[Karin Smyth]

The hon. Gentleman highlights a situation familiar to many of us. One of the many problems that we inherited from the last Government was the fragmented landscape, so I thank him for his question. A key part of the responsibility of integrated care boards is commissioning for their populations to improve access to healthcare and reduce inequalities. For the first time, ICBs will be held accountable through the outcomes framework.

[Helena Dollimore (Hastings and Rye) (Lab/Co-op)]

Jules Fielder from Hastings was diagnosed with stage 4 terminal lung cancer after doctors missed her symptoms, mistaking them for tennis elbow. As a non-smoking young woman, she did not meet the stereotype of what lung cancer patients often present with, but she was determined to channel her own tragedy into change. She campaigned for better, earlier awareness of symptoms among clinicians and members of the public, and she took that message to everyone she could. Together, we convinced Boots to roll out on-shelf awareness labels in the cold and flu medicine section to raise better awareness. Sadly, Jules passed away last month. Will the Minister join me in paying tribute to all of Jules’s campaigning, and commit to continuing her vision in the Department of Health and Social Care by ensuring we use every possible avenue to raise better awareness and catch cancer earlier?

[Karin Smyth]

I thank my hon. Friend for raising that example of tremendous public service in the face of adversity. We are sorry to hear of Jules’s passing, and our thoughts are with her friends and family. My hon. Friend highlights the way in which people can access and determine outcomes and the fact that it is the responsibility of those working in local health services—in this case, the ICB in particular—to involve people and use their experience to drive the change that we want to see as part of the Health Bill.

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[Peter Swallow (Bracknell) (Lab)]

T2. One of the biggest barriers to accessing community healthcare in Bracknell Forest is constituents not being able to get routine diagnostic procedures done at their local GP or health centre, and instead having to travel. One constituent with cancer was told that he had to go to Guildford for a simple blood test. How will the introduction of a single patient record help to break down some of those barriers?

[The Minister for Secondary Care (Karin Smyth)]

The single patient record will give clinicians timely access to a single trusted record so that decisions can be made more efficiently, avoiding duplication, allowing them to spend more time with patients. The system makes all information on a patient accessible in a single place and will allow the sharing of patient data among different settings, as my hon. Friend outlines, and provide more flexibility in where services are made available.

[Mr Speaker]

I call the shadow Secretary of State.

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[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

T9. There is overwhelming evidence that marketised health systems, as the NHS has become, increase health inequalities. Will the Health Secretary consider amendments to the Health Bill that will tackle the rising inequalities in existing health policies, including allowing local NHS organisations to determine if they need additional private sector capacity?

[Karin Smyth]

I commend my hon. Friend for her experience in this area. She tempts me to look at amendments in that space, but we do not have plans for that at the moment. The changes we made to NHS England placed the responsibility regarding health inequalities in all our policies firmly at the Secretary of State’s door. I am happy to talk to my hon. Friend about her other ideas on that. The Bill transfers that responsibility to the Secretary of State and we have no plans to make any changes in that area.

[Alison Griffiths (Bognor Regis and Littlehampton) (Con)]

T7. Thousands of people in West Sussex are unable to access an NHS dentist and many constituents in Bognor Regis and Littlehampton tell me that they have been unable to secure an appointment for years. What specific steps is the Secretary of State taking to increase NHS dental capacity in coastal communities, and when does he expect patients to see a measurable improvement?