Oral Answers to Questions
Karin Smyth Excerpts(5 days, 14 hours ago)
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Rosie Duffield (Canterbury) (Ind)
The Minister for Secondary Care (Karin Smyth)
The PATHWAYS trial has undergone a thorough independent review and has received all the regulatory and ethical approvals. The sponsors of the study, King’s College London and South London and Maudsley NHS foundation trust, are working to ensure that it is conducted in compliance with the relevant regulations.
Rosie Duffield
The United States Department of Health and Human Services’ peer-reviewed report found that harms from paediatric medical transition are significant, long term and too often ignored and inadequately tracked, as testified by Keira Bell, who is here in Parliament today. What is the Government’s rationale behind medicalising yet more vulnerable children, given that we have no evidence of any benefit to this approach and, in fact, plenty of evidence of harm?
Karin Smyth
As the hon. Lady knows, the Government are acting on the recommendations of the excellent report from Hilary Cass, which I think she would agree is world-leading evidence, and moving the model away from medical intervention towards a more holistic approach to care. The Government will continue to be guided by that evidence, as the whole House will appreciate. The hon. Lady referenced Keira Bell, and I know that my hon. Friend the Member for Birmingham Edgbaston (Preet Kaur Gill) has asked the Secretary of State to meet clinicians and others who disagree with the trial. That meeting is being arranged, and we will continue to work under the guidelines for clinical evidence.
Nadia Whittome (Nottingham East) (Lab)
I remind the House that puberty blockers are still prescribed to young people who are not trans; I do not see some of my colleagues who are so exercised when puberty blockers are given to young trans people expressing the same concerns for their cisgender peers. Even Dr Cass herself acknowledged that puberty blockers are effective for some young trans people and recommended against a blanket ban. While the trial is ongoing, can the Minister outline what steps the Department is taking to increase funding and capacity for children and young people’s gender services to address the unacceptably long waiting times, which continue to cause enormous harm?
Karin Smyth
We need to be very careful about our language, in line with Dr Cass’s report. We are talking about children who are presenting with gender dysphoria and in gender distress. The Government support moving away from the medical intervention model towards a holistic approach to care based on the evidence, and that has cross-party support more generally, although I am not entirely sure of the position of the Liberal Democrats on supporting it. That is the model with which we are progressing. On the wider issues with regard to support for children and young people, particularly as they present across the board, this Government are investing much more than anyone else has indicated that they would in support for all services.
Gregory Stafford (Farnham and Bordon) (Con)
Part of the trial is to ask the child participants the Avon longitudinal study of parents and carers romantic relationships questionnaire. Is the Minister as concerned as I am that children under the age of 13 will be asked sexually explicit questions?
Karin Smyth
I think all Members across the House are concerned about the distress with which young people are coming forward for all of these services, and the need to support them and their families. Again, it is important that all parts of this trial follow clear ethical and clinical guidelines.
Jonathan Hinder (Pendle and Clitheroe) (Lab)
The Government were right to bring in the indefinite ban on puberty blockers due to concerns over the past 15 years about the gender services treatment that was being given. Over that time, 2,000 children who were questioning their gender identity have been given puberty blockers, so could the Minister explain why we are not following up on their long-term outcomes before we administer these powerful drugs to 200 more children?
Karin Smyth
I thank my hon. Friend for his question and his constructive work in this area on behalf of young people. I think there is a further question on this topic on the Order Paper. The Government are looking at how we can best use the data linkage study from that previous work. As I think hon. Members understand, that data was collected for different purposes—it is not of the quality that might be needed for this review—but we will continue to use all the evidence that is available, both in this country and in others, in line with the best clinical practice and under the guidance that Dr Hilary Cass prescribed in her review.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
The Secretary of State has previously said that he accepts all the recommendations in the Cass review. One such recommendation is that the Secretary of State mandate the release of data for the data linkage study. Can the Minister tell us what specific steps have been taken to mandate the release of that data?
Karin Smyth
We absolutely stand by that work, and we are working with NHS England to make sure it is mandated to do exactly that.
Edward Morello (West Dorset) (LD)
Aphra Brandreth (Chester South and Eddisbury) (Con)
The Minister for Secondary Care (Karin Smyth)
The Government will publish the 10-year workforce plan in the spring. This plan will ensure that the NHS has the right people in the right places with the right skills for patients when they need them, and we are engaging extensively with partners to ensure that this plan delivers for staff and patients.
Aphra Brandreth
I have been contacted by concerned doctors in Chester South and Eddisbury who, after five or six years at medical school and a further two years of foundation training, are now struggling to secure specialty posts and are being forced to consider leaving the NHS altogether. While I will reserve judgment on the medical training Bill to be presented later today until I have seen it in full, I welcome the fact that the Government are finally treating this issue with the urgency it deserves. Can the Minister set out how this legislation will be accompanied by a credible plan to expand training numbers, so that the number of places is sufficient to meet the NHS’s short, medium and long-term workforce needs?
Karin Smyth
I thank the hon. Member for her almost support for the Bill that we will present later to address much of this problem. Again, we are clearing up the mess we were left by her party, which, by changing the rules in delivering a workforce plan in 2023, essentially ramped up the supply of staff by extrapolating existing trends without any reference to the constraints or needs of the service. Our workforce plan will be different. We do hope for support for the Bill to remove some of the problem with foundation and specialty training places, and we look forward to rigorous debate on that subject.
Jen Craft (Thurrock) (Lab)
Unfortunately, my constituency is not unique in seeing long waits for diagnosis of neurodiversity. From 18 to 24 months is the expected waiting time in Thurrock, and some have to wait much longer. Given that, for a child, a wait of 18 to 24 months can sometimes be their whole lifespan or half their lifespan, will the upcoming workforce plan make sure that there is a plan for paediatric care, particularly for allied health professionals such as occupational therapists, speech and language therapists, and clinical physicians?
Karin Smyth
The services my hon. Friend outlines cover a number of different areas in different locations, and I think it is very important that the workforce plan we are bringing forward reflects a different model of care. We have seen more services going into secondary care and particularly hospitals, at the expense of community care and particularly primary care. That needs to change across the age spectrum, and the new workforce plan will be designed in lockstep with a new service design, more staff in neighbourhoods and more digital support, as well as to address the issues she outlines.
Joe Robertson (Isle of Wight East) (Con)
A study by the Health Foundation has found that the cost to the NHS of staff sickness and staff turnover is of the order of £12 billion a year. Will the Government’s new workforce plan cover the issue of excessive cost through the entirely avoidable turnover of staff?
Karin Smyth
Yes, because those issues are a result of the shocking staff morale as a result of the policies of the hon. Gentleman’s Government. As highlighted by Lord Darzi, staff morale, and issues around staff sickness and the huge increase in agency spending on their watch, are all signs of a system that is not functioning for patients or staff. We absolutely will bring forward measures to address those issues.
Josh Fenton-Glynn (Calder Valley) (Lab)
When the Secretary of State was in front of the Health and Social Care Committee, he recognised that we will not solve the workforce problems in the NHS without solving the workforce problems in social care as well. There are 150,000 unfilled posts in social care—three times greater than in the wider economy. What are we going to do to help solve this problem?
Karin Smyth
My hon. Friend and the Secretary of State are right to address the fact that we need to look across the whole span, and at people moving between those workforces. As he will know, the fair pay agreement, with the £500 million increase to support it, is part of our work to ensure those issues are addressed across the piece.
Jo Platt (Leigh and Atherton) (Lab/Co-op)
John Whitby (Derbyshire Dales) (Lab)
The Minister for Secondary Care (Karin Smyth)
I know that this is of great concern to my hon. Friend and his constituents. It is a matter for the commissioning officer at his local ICB. I recommend that he keeps talking with them about the best provision for his constituents.
Dame Caroline Dinenage (Gosport) (Con)
I was fascinated by the Minister’s earlier answer about the closure of pharmacies, because there has been fantastic news in Lee-on-the-Solent in my constituency: a new pharmacy wants to open there. Local people are desperate for a second pharmacy in Lee-on-the-Solent and the local GP practice supports it. The problem is that the Hampshire ICB has rejected it. Does the Minister share my disappointment that local people are not going to be served in the correct way by pharmacy provision, and will he meet me to discuss this?
Tracy Gilbert (Edinburgh North and Leith) (Lab)
I and a number of colleagues have concerns about the upcoming PATHWAYS trial. The Secretary of State has powers to use existing medical records for research purposes. Will he therefore consider using those powers to increase the evidence base and prevent the PATHWAYS trial from proceeding?
Karin Smyth
I thank my hon. Friend for her constructive approach to this difficult issue. She is right to challenge; we must have open and transparent debate. To be very clear—and to refer to my previous answer—the Secretary of State will use that power. We will have a retrospective data linkage study to identify the associations informing patient experience and outcomes, through the analysis of available digital information in health records and other nationally held databases. It will not establish causation but will be an important contribution to the evidence base.
Ben Obese-Jecty (Huntingdon) (Con)
Mr Speaker, I am not ashamed to say that I have had a finger up my bum—not like that! In all seriousness, as a black man in the target age range, and with a family history, I am a keen advocate for prostate cancer screening. One of my constituents has been told by his GP surgery that, as there is no national screening programme for opportunistic testing, they follow national guidance and patients cannot request a screening without GP authorisation. What advice does the Secretary of State have for those of my constituents who are struggling to get screening for prostate cancer? I say a big thank you to the team at Kingston hospital for their swift action in moving my dad from active surveillance to treatment—he raves about them.
Transgender People: Provision of Healthcare
Karin Smyth Excerpts(1 month ago)
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The Minister for Secondary Care (Karin Smyth)
It is a pleasure to serve under your chairmanship, Mr Turner. I thank and congratulate my hon. Friend the Member for North Warwickshire and Bedworth (Rachel Taylor) on securing this important debate. Without giving away any state secrets, we are roughly the same age; I am not gay, but I also marched and campaigned against section 28—I remember those days from very early on.
I want to say from the outset that this Government stand for the important principle in our healthcare system—which has been echoed this afternoon by many Members—that everyone in our country deserves access to first-class healthcare. I will not rehearse here the mess that we inherited from the last Government; we do not have time. However, we are determined to ensure that what I have set out happens. If we are to make good on that principle, we must take account of the diverse needs of our society. That of course includes trans people and the wider lesbian, gay and bisexual community.
Colleagues are right to say that transgender people experience significant and specific health inequalities throughout their lives. As we have been reminded again this afternoon and should always bear in mind when we have debates in this place, these are real people’s lives. Many people are with us today in the Public Gallery, and I am sure that many others are watching online. That is why this Government have commissioned NHS England to undertake a health evidence review, led by Dr Michael Brady, the national adviser on LGBT health, whom I met in advance of this debate. He has held the position of adviser since 2019 and works as a sexual health and HIV consultant at King’s College hospital. I am pleased that he is doing that review. The work is considering how we can better understand lesbian, gay, bisexual and transgender healthcare needs and will provide a clearer picture of what the problems are—the data, the evidence—and how we need to address them.
That is particularly important in relation to preventive healthcare and the inequalities space. The Government have been very clear about our commitment to reversing the shocking health inequalities in this country. My hon. Friend the Member for Walthamstow (Ms Creasy) highlighted where there is good practice across the country. In addition, it is important to highlight the fact that despite the umbrella term of LGBT, needs are different in this group, and equality terms are covered by different aspects of the Equality Act 2010. All of this needs to be clearly evidenced and brought forward in the work to which I am referring. Lots of people asked this question: we anticipate that the findings of the evidence review will be finalised in the new year. We will then be considering those very carefully.
We have talked this afternoon about the fact that trans people—they are the subject of this debate—have unique health needs and specialist services to support them. This Government are improving specialist gender services for children, young people and adults in England. I recognise that those wishing to access gender services are waiting far too long for a first appointment. We are determined to change that, which is why NHS England has increased the number of adult gender dysphoria clinics in England from seven to 12, with the roll-out of five new pilot clinics since July 2020. These clinics are helping to tackle long waits, but we know that waiting times for these services can be distressing and are having a real impact on people’s wellbeing. To support those facing long waits, the Department of Health and Social Care has tendered for a new Waiting Well pilot. That will run for 12 months and provide those on the waiting list for the gender dysphoria clinic in the south-west region with access to support and information before appointments. The aim is for the pilot to launch in early 2026 and to inform plans for a national offer, subject to effective evaluation.
It is vital that transgender people are able to access the high-quality healthcare that they deserve. As we have heard, NHS England has asked Dr David Levy to carry out a review of adult gender services, because that was a specific recommendation from the Cass review of children and young people’s gender services. As an independent chair, Dr Levy will examine the model of care and operating procedures of each service, and is carefully considering feedback and outcomes from clinicians and patients. To respond to a number of questions this afternoon, that includes issues relating to shared care prescribing and monitoring of hormone medication. Dr Levy has been supported in his review by independent senior clinicians and professional bodies. I expect the review to be published shortly, and I know that my right hon. Friend the Secretary of State will inform the House as soon as that has happened, but let me assure Members here, and people listening to or reading about this debate, that we will use the review as a basis to improve NHS adult gender services.
Issues relating to children have been raised this afternoon. I know that children and young people’s gender services are a sensitive topic that elicits strong opinions, some of which we have heard today. Let me be very clear: we will take an evidence-based approach when it comes to the health and wellbeing of all children and young people. Their safety is our primary concern. We are committed to implementing the recommendations of the Cass review, to ensure that children who access these services receive the same high-quality care as any other child or young person accessing NHS services. We believe that the Cass review remains an excellent, evidence-based report. I urge all hon. Members to use it as their guide when making assertions, including in their understanding of gender dysphoria. We welcome that report and accept its work; it is our guidance for navigating healthcare for transgender young people.
It is still my understanding that the report is not supported by the Green party, and not properly supported by the Liberal Democrats, so when we talk about evidence, colleagues perhaps need to check and go back to the source report, because we are determined to follow the evidence and great work done by Hilary Cass.
NHS England has opened three new services in the north-west, London and the south-west, as we have heard. Those services operate under a fundamentally different and new clinical model, in which children and young people get the tailored and holistic care they need from multidisciplinary teams of experts in paediatrics, neurodiversity and mental health. A fourth service in the east of England is expected to open early in the new year. NHS England aims to open service provision in every region of England by 2026–27. That will help to further reduce waiting times and bring these services much closer to the homes of the children and young people who need them.
On puberty blockers and the pathways trial, the Cass review was clear that better quality evidence is critical to understanding the effects of puberty-suppressing hormones. That is why the NHS has removed them from children’s gender services, and why the Government have indefinitely banned them in private supply.
Dr Cass also recommended a clinical trial to understand the effects of these hormones, which is why the pathways trial has been established. In this controlled study, puberty suppression will be offered solely within the context of the comprehensive assessment and psychosocial support now offered by the NHS. The trial has undergone comprehensive review, has received independent scientific, ethical and regulatory approvals, and will soon open to recruitment.
I know that many hon. Members have strongly held views about this research. However, I want to be really clear that safeguarding the children and young people participating in this trial is our absolute priority. In response to the hon. Member for South West Devon (Rebecca Smith) on detransitioning, I will add that NHS England has called for evidence from people with lived experience and from professionals; I understand that the consultation closes on 28 December.
Karin Smyth
I will finish.
I met Dr Sullivan recently to understand her report and how it impacts on the Department of Health and NHS England. My understanding is that each Department is looking at the recommendations of her review, and that it is important to have accurate data. I will ensure that the hon. Member for Sleaford and North Hykeham (Dr Johnson) gets an answer on whether there will be a formal Government response.
This Government were elected on a manifesto to bring down inequality. We are doing so through a number of different measures—on the soft drinks industry, free school meals, the generational ban on smoking and Awaab’s law. In her Budget, the Chancellor lifted half a million children out of poverty at the stroke of a pen.
We are determined to ensure that no one falls through the cracks of our health system, and we will give transgender people the care they deserve. I hope the actions I have set out today demonstrate our commitment to that goal and our focus on improving healthcare provision for transgender people, across all ages, based on good clinical scientific evidence. We will cut waiting lists for gender services, along with all other waiting lists, and ensure that healthcare is always evidence-based, improving health outcomes for trans people and the wider community.
NHS Pensions: McCloud Implementation
Karin Smyth Excerpts(1 month, 1 week ago)
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The Minister for Secondary Care (Karin Smyth)
On 1 July 2025, I issued a written statement on the implementation of the McCloud remedy for affected NHS pension scheme members. I informed the House that a number of deadlines by when the NHS Business Services Authority was required to provide remediable service statements to members would be missed. I explained that I was commissioning Lisa Tennant, independent chair of the NHS pension board, to lead a review of the capacity, capability and delivery plans of the NHS Business Services Authority’s McCloud remedy functions.
The review has now provided me with an interim report on the capability and capacity of the authority to enact the remedy and recommendations for its effective delivery. Key findings include that significant progress has been made in remedy delivery planning but that governance arrangements must be strengthened with enhanced assurance measures put in place, and detailed capacity planning and supplier arrangements need to be finalised. A final report will be published in line with the Government’s commitment to transparency.
Since my previous statement, the NHS Business Services Authority has been undertaking a significant replanning exercise for the delivery of the remedy. This exercise has now entered its final stage and the authority and my Department are implementing recommendations from the interim report. It is anticipated that the review will conclude its assurance of the revised delivery plan early in 2026. After this point, I will publish the final report and set new statutory deadlines by when the authority must provide remediable service statements, based on a complete and robust plan which has been independently assured and endorsed by the authority’s board.
The revised plan will continue to prioritise retired members who are likely to be facing financial detriment as a consequence of the discrimination identified by the McCloud judgment. RSS and remedial pension savings statements continue to be issued. The authority expects that their capacity to produce RSS will increase materially when software to automate a significant proportion of the calculations required comes online in spring 2026.
I want to reaffirm this Government’s commitment to delivering the remedy for public service pension scheme members affected by the discrimination caused by the coalition Government’s decision making. I will continue to keep this House informed of progress in the implementation of the remedy for the NHS pension scheme.
[HCWS115]
Cancer Services: North-west London
Karin Smyth Excerpts(1 month, 2 weeks ago)
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Karin Smyth
Thanks to our investment and modernisation of the NHS, the Government are putting cancer services on the road to recovery by opening up community diagnostic centres on evenings and weekends, building new surgical hubs and investing in new radiotherapy machines… This year, an extra 193,000 patients received a timely diagnosis or the all-clear compared with the previous year.
[Official Report, 25 November 2025; Vol. 776, c. 194.]
Written correction submitted by the Minister for Secondary Care, the hon. Member for Bristol South (Karin Smyth):
Karin Smyth
Thanks to our investment and modernisation of the NHS, the Government are putting cancer services on the road to recovery by opening up community diagnostic centres on evenings and weekends, building new surgical hubs and investing in new radiotherapy machines… This year, an extra 193,000 patients received a timely diagnosis or the all-clear compared with the year before the election.
NHS Investment: Neighbourhood Health Centres and Digital
Karin Smyth Excerpts(1 month, 3 weeks ago)
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The Minister for Secondary Care (Karin Smyth)
At the Budget on Wednesday, the Chancellor will set out how the Government will take the fair choices to deliver on the country’s priorities to cut NHS waiting times, cut debt and cut the cost of living. The Chancellor is rightly boosting investment in the NHS after we inherited a health service on its knees—with Lord Darzi’s investigation uncovering a £40 billion black hole.
As part of this investment, I am confirming the delivery of hundreds of new neighbourhood health centres that will deliver healthcare direct to people’s doorsteps across the country. The 250 new health one-stop shops will bring the right local combination from GPs, nurses and pharmacists together under one roof to best meet the needs of the community.
Neighbourhood health centres fundamentally reimagine how the NHS works—bringing care closer to home and making sure the NHS is organised around patients’ needs, not the other way round.
The new neighbourhood health service will move more care out of hospitals, and these centres will provide space for clinics in communities across the country—bringing an end to the postcode lottery of access to healthcare.
The services will initially focus on improving access to general practice and supporting people with complex needs and long-term conditions—like diabetes and heart failure—in the areas of the highest deprivation. As the programme grows, it will expand to support other patients and priority cohorts.
The first 120 are due to be completed by 2030, 50 through the repurposing of existing estate and 70 new builds delivered through public-private partnerships, with a smaller proportion through public capital.
Our new NHS neighbourhood rebuild programme will give the health service the investment it needs, repurposing and building a new generation of neighbourhood health centres across the country. It will go hand in hand with reform and efficiency—ensuring proper value for money for taxpayers.
This will include improved incentives to make sure these NHS facilities are delivered on time and on budget—so patients across England get faster treatment in new and convenient buildings. By delivering through a combination of private and public investment the Government will be able to build further evidence and compare different models of delivery while updated accounting treatment will ensure these are recognised up front in public accounts, a fundamentally different approach to previous approaches, such as when PFI was used in the 2000s.
To further support the drive to reduce waiting lists there will be £300 million of additional capital investment in NHS technology to boost productivity, support staff and improve patient outcomes, driving the shift from analogue to digital. This builds on up to £10 billion announced at the spending review, and will ensure seamless navigation and communication between primary and secondary care through the NHS app. By guiding patients to self-care, primary care and urgent care through a single user-facing service, their information will be made readily available across all providers. This funding will also close the gap in patient access to digital health records, so patients can make informed choices about their care.
[HCWS1095]
Uckfield Community Hospital Surgical Unit
Karin Smyth Excerpts(1 month, 3 weeks ago)
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The Minister for Secondary Care (Karin Smyth)
Duly noted, Madam Deputy Speaker. It is a pleasure to respond to the hon. Member for East Grinstead and Uckfield (Mims Davies). I begin by recognising the genuine concern of the residents of East Grinstead and Uckfield, which she has articulated so well, about the future of that local surgery unit. Such local facilities are really important to all our constituents, and it is right that we, as Members of Parliament, advocate on their behalf. She has ensured that her constituents’ voices have been heard both in Parliament and through her engagement with the NHS Sussex board and the integrated care board. We understand that it is difficult to keep pursuing such changes, but as we are all told in the House, we are used to being persistent.
Reducing waiting lists is a central part of the Government’s health mission. I reassure the hon. Lady and other colleagues that we are committed to putting patients first, ensuring timely treatment and bringing care closer to where people live. That is why in December 2024 we published our plan for change, setting out our commitment to return by March 2029 to the NHS constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment.
We are seeing improvements, with more than 5 million additional appointments—more than double our election pledge—and working with the NHS we have cut waiting lists by over 230,000 since we came to office and delivered 135,000 more cancer diagnoses. In August, we confirmed that 100 community diagnostic centres across the country are offering out-of-hours services 12 hours a day, seven days a week, meaning that patients can access vital tests, scans and checks around their busy lives. There are also new surgical hubs, as we have heard, to help tackle the backlog.
Currently, the waiting list stands at 7.3 million patient pathways, with 6.2 million people waiting. That is what we need to change with our elective reform plan—our 10-year health plan is built on that—which has a key focus on improving access to healthcare for everyone and prioritising patient experience, ensuring that wherever people live in England, they will be seen, diagnosed and treated in a timely way, no matter what they earn. To help achieve that, we are investing £6 billion of additional capital investment over the next five years in diagnostic, elective, urgent and emergency capacity in the NHS.
I join the hon. Lady in thanking her local NHS staff for their work to make sure that these improvements are felt by local people. On her specific concerns regarding the trialled closure of the day surgery unit, which as she said is run by East Sussex healthcare NHS trust, I understand how unsettling the decision feels for many people, including the public and, as she articulated, the staff. In preparation for the debate, I met the local NHS leaders. I am grateful to them for their time and their briefing on these issues. It is important to hear from people on the ground on these matters.
Our 10-year plan commitment to move care into the community is a priority for the Government, as the hon. Lady said, but it does need to be coupled with pragmatism and what is best for patients. In this case, according to the latest data held by the trust, almost 90% of patients accessing relevant services at Uckfield live closer to the two main hospitals in Hastings and Eastbourne, and the proposal was therefore to relocate the day surgery unit activity to those two hospital sites. According to the trust, for most patients that would mean treatment closer to home than under the existing offer.
Secondly, the change was expected to increase the overall number of day surgery procedures available to more people, including the residents of Uckfield, so that they could receive surgery more quickly. Local leaders have taken that decision because it is critical to increase productivity in the NHS. By using both hospitals, local and general anaesthetic procedures can be offered in the same place, with greater provision for higher risk patients or those who need overnight stays.
I come on to the findings from the trial to date. Decisions to reorganise local provision are often a disappointment and difficult for many people. It is important that there is a strong case that the move is better for patients, productivity and value for taxpayers’ money. Following a six-month trial, the trust has found that patients did not report any decline in their experience following the move, and concerns were not raised about travel or access. I am told that the patient advice and liaison service has reviewed complaints from the pilot period and has had no negative feedback related to the pilot. The evaluation showed that the trust was able to increase capacity for elective procedures, improve the timeliness of pre-assessment, and provide greater flexibility to prioritise urgent, cancer and general anaesthetic cases. The initial analysis indicated that 88.3% of sampled patients were treated closer to their homes, with an average reduction in travel distance of 10.3 miles per journey.
The responsibility for delivery, implementation and funding decisions on services ultimately rests with the appropriate NHS commissioner rather than with the Government, working closely with providers and local stakeholders, and that includes local Members of Parliament. The ICB has a duty to consult the relevant local authority health overview and scrutiny committee about substantial changes to health services, and I have been informed that the trust is looking to share a paper with the committee in December.
All substantial planned service change should be subject to a full public consultation and meet the Government and NHS England’s tests to ensure good decision making. The hon. Lady made her points extremely about the League of Friends and its great work across the country and in her area. As well as putting this issue on the record, as she has done here, I will ensure that the local NHS addresses the issues that she has raised this evening.
It is important to note that the changes only affect the day surgery unit. I am assured by the local NHS that other services at Uckfield community hospital, which she outlined in her speech and which are central to our plans to make care more local and to provide neighbourhood services, will continue. The opening of the new Sussex surgical centre, which the hon. Lady talked about, backed by £40 million of investment, means that the trust will be able to provide better care for more patients closer to where most of them live.
In closing, may I add my thanks for the great work of the League of Friends? I thank the hon. Lady for raising this important issue and for her ongoing support for the Uckfield community. I know that she will continue to work with the local NHS on behalf of her constituents and we are happy to continue that discussion with her.
Question put and agreed to.
Oral Answers to Questions
Karin Smyth Excerpts(1 month, 3 weeks ago)
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Gareth Thomas (Harrow West) (Lab/Co-op)
The Minister for Secondary Care (Karin Smyth)
Thanks to our investment and modernisation of the NHS, the Government are putting cancer services on the road to recovery by opening up community diagnostic centres on evenings and weekends, building new surgical hubs and investing in new radiotherapy machines. We are diagnosing cancer faster and treating it sooner. This year, an extra 193,000 patients received a timely diagnosis or the all-clear compared with the previous year.[Official Report, 4 December 2025; Vol. 776, c. 12WC.] (Correction) I am pleased to report that cancer services in north-west London rank among the best performing in England, and we are committed to further improvement.
Gareth Thomas
Northwick Park hospital is the acute hospital serving my constituents. It benefits from having excellent cancer clinicians. They are determined to go ever further to improve the speed of diagnosis and the quality of support for those diagnosed with cancer, and are developing plans for a cancer centre for the hospital. As part of the roll-out of the national cancer plan, would my hon. Friend be willing to visit and meet those clinicians, and perhaps bring the Secretary of State’s chequebook with her?
Karin Smyth
As my kids would say, that is a bit boomer, but I take the point. My hon. Friend is a tireless campaigner for Northwick Park and his constituents, and he has long campaigned for the improvement of cancer services. Any reconfiguration or change to services needs to be clinically led by local decision makers, following engagement with patients and stakeholders. I am sure that the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), who is developing the cancer plan, would be happy to meet him to discuss services in his constituency.
Mr Gagan Mohindra (South West Hertfordshire) (Con)
Mount Vernon hospital is a cancer specialist hospital in north-west London. Following the recent closure of the Mount Vernon urgent care centre and the delay to the new Watford general hospital until at least 2032, both of which I have previously raised in the Chamber, uncertainty regarding the future of Hemel Hempstead hospital now looks set to further restrict access to vital healthcare services for my constituents. What steps is the Minister taking to ensure that my constituents receive the adequate access to healthcare that they deserve?
Karin Smyth
This question is about services across north-west London. We are working with all integrated care boards to ensure that they work with local Members of Parliament about service configuration. It is a matter for them to determine. I have spoken to the hon. Gentleman previously. We are determined to ensure that we have the best services for people in their local areas based on clinical need. Today I have been talking about neighbourhood health services, for example. As we develop the health service plan and put right the mistakes of the past in getting the new hospital programme on to a sustainable footing, all of this will be considered in the round. I am happy to keep talking with him.
Elaine Stewart (Ayr, Carrick and Cumnock) (Lab)
The Minister for Secondary Care (Karin Smyth)
We inherited a crumbling NHS estate. Many hospitals, including Doncaster Royal infirmary, are in a state of disrepair, thanks to the shocking record of the last 14 years. When I visited Doncaster Royal, I saw at first hand the outstanding care staff are providing despite significant infrastructure challenges. That is why the Government have supported Doncaster and Bassetlaw trust with £19.8 million in national funding to redevelop the critical care unit, and another £3.2 million from the estate safety fund for fire safety work. We have also provided nine years of certainty for maintenance budgets, allowing trusts to plan strategically and deliver further improvements.
Sally Jameson
As the Minister outlined, Doncaster was badly let down under the previous Administration, when after much fanfare and promise we were left off the new hospital programme. Since then, the trust has been working on revised capital projects to keep it going in the interim period, including a much-needed rebuild of the east block. Will the Minister continue to work with me and the trust to deal with the critical state of DRI?
Karin Smyth
My hon. Friend has been the most tireless campaigner on this issue since coming to the House in July 2024, so of course I will continue to work with her to support her local hospital. The previous Government neglected the NHS: those buildings were left to crumble and their new hospital programme was neither affordable nor deliverable. We are committed to reversing that decline and repairing hospitals like Doncaster Royal infirmary. That is why the trust will receive over £105 million in operational capital across the next four years to be allocated to local priorities, including repairs at Doncaster Royal infirmary.
Dr Neil Hudson (Epping Forest) (Con)
Clive Jones (Wokingham) (LD)
The Minister for Secondary Care (Karin Smyth)
In January we published an honest, realistic and deliverable plan that puts the programme on a sustainable footing, ensuring that taxpayers get the maximum value for money. We are committed to delivering all the schemes and are moving at pace, with funding in place for design work, construction and business case development. Outside the new hospital programme, we are investing £30 billion in day-to-day maintenance repairs of the NHS estate across this spending review period.
Dr Hudson
As my constituency neighbour, the Health Secretary will know that both his constituents and mine rely heavily on the Princess Alexandra hospital in Harlow and Whipps Cross in Leytonstone. Before the election, he promised the rebuild of the Princess Alexandra hospital and he supported the Whipps Won’t Wait campaign, yet under Labour it appears that both Princess Alexandra and Whipps must wait. Whipps Cross now faces an estimated £170 million in backlog maintenance, one of the highest figures in the country. Does the Health Secretary agree with me that rising maintenance costs must be taken into account when prioritising the new hospital programme?
Karin Smyth
Again, what the hon. Gentleman says is really quite astonishing: like everybody else, he knows that no money was allocated by his Government to the new hospital programme beyond last March. The Conservatives know that and they need to start being honest with their constituents—[Interruption.]
Mr Speaker
Order. Dr Mullan, I want you to set a better example—I expect better from you.
Karin Smyth
I think that the Conservatives’ constituents know exactly what their promises were built on: sand. That is why there are very few Conservative Members in the House and a lot of Members on the Labour Benches. We took hold of the programme and put it on a sustainable and credible footing, and we will deliver it.
Clive Jones
Frimley Park hospital is in wave 1 of the new hospital programme, with construction expected to start in 2028-29. Many of my constituents use the hospital, and they are rightly concerned about possible delays to its build, especially with the issue of reinforced autoclaved aerated concrete. Patients and staff cannot be expected to work in an unsafe environment longer than necessary, if at all. Will the Minister reassure my constituents and confirm that the construction on Frimley Park hospital will begin no later than 2029?
Karin Smyth
The hon. Gentleman is an assiduous campaigner on behalf of Royal Berkshire hospital and now of Frimley Park hospital. I met with Members of Parliament last week who are involved in the RAAC schemes, which are progressing to plan. We are absolutely on target with progressing that plan, and we look forward to the proposals coming through from the local integrated care board.
Maya Ellis (Ribble Valley) (Lab)
My constituents in Ribble Valley have been directly impacted by the delays to the new hospital programme, with the rebuilding of Royal Preston hospital being put back by almost a decade. Just last week, I received the disappointing news that Longridge community hospital, which is much loved and valued by local residents, will be closed for safety upgrades for the next six months. This Government’s impressive 10-year health plan rightly notes that they expect a shift from hospital to community. With that in mind, can the Minister confirm that she expects integrated care boards, such as Lancashire and South Cumbria ICB, to keep community hospitals open? That is opposed to centralising, which not only takes services away from communities but, in our case, transfers them to vastly inferior hospital buildings. Will she join with me and Longridge residents and say that she hopes the essential repairs are completed quickly at the community hospital?
Karin Smyth
I congratulate my hon. Friend on getting a lot of estates questions into that one point. The point is that local people value the local facilities that they have known for a very long time. That is why we are committed to reversing the decline in capital investment under the last Government—Lord Darzi outlined the shocking £40 billion black hole on capital. Part of our move towards neighbourhood health services is exactly about getting services closer to people’s homes, and we look forward to having further conversations with my hon. Friend and her constituents.
Bill Esterson (Sefton Central) (Lab)
Rowan View mental health hospital at Maghull health park in my constituency is benefiting from lower costs from the installation of solar panels from GB Energy. May I encourage the Minister to support Maghull health park’s bid for an innovation and research facility so that we can address the Government’s priority of giving parity of esteem to mental health and physical health?
Karin Smyth
My hon. Friend makes an excellent point about working across Government with GB Energy to support local health systems in reducing health costs. That is an important part of our efficiency drive. He is a strong advocate for a local facility at Maghull, and we are absolutely committed to working with the ICB so that it develops the most efficient services where people are actually located, rather than expecting them to go to and fro and get bounced around the health system. I hope he can see further progress on that issue.
Dr Luke Evans (Hinckley and Bosworth) (Con)
When it comes to hospital provision, the Conservatives believe that we should continue to use private providers to improve access and reduce waiting times. We believe the Government should not let spare capacity go to waste on ideological grounds; we should continue to make use of private-sector capacity to treat NHS patients where available. Does the Minister agree?
Dr Evans
I am pleased to hear that the Minister does, given that it is her current policy. The last time the Government brought in private finance, they brought in the private finance initiative, which brought in £13 billion of investment. The problem was that it cost the taxpayer a whopping £80 billion, and hospitals are still paying decades on. This time around, will the Government give a cast-iron guarantee and complete confidence to the public that this is not Labour’s version of PFI mark 2?
Karin Smyth
Yes, I can give the hon. Gentleman that guarantee. The last Government could have learned the lessons of some of the PFI schemes that were very costly and did not run. Why did they not learn those lessons? Why did they not take action to reverse some of the decline? Why did they not take control of the system and do something about it? We have learned the lessons from those schemes, thanks in part to the great work done by parliamentarians on Committees such as the Public Accounts Committee. The new system to build the new neighbourhood health centres, which are fundamental to our drive to shift care out of hospital, will be different and will be publicly owned; they will revert to the public. The schemes are fundamentally different, and I am very happy to talk about it in more detail.
Mr Connor Rand (Altrincham and Sale West) (Lab)
The Minister for Secondary Care (Karin Smyth)
We are committed to transforming cancer care, having already invested £70 million in new radiotherapy machines to help patients to be treated more quickly. We are investing £26 million in the NHS, opening community diagnostic centres in the evening and at weekends to catch cancer early, and our national cancer plan will have patients at its heart—from referral to diagnosis, treatment and ongoing care.
Mr Rand
My constituent Mike lost his wife to cancer, but as well as battling the physical symptoms, she faced devastating mental health effects, becoming deeply depressed after her terminal diagnosis. Despite that, she never received appropriate mental health support, and this significant issue for cancer patients should be addressed as part of our welcome reforms to palliative care. Could the relevant Minister meet me and Mike to discuss his campaign to improve mental health support for those with a terminal diagnosis?
Karin Smyth
Of course, I am sorry to hear about the loss of my hon. Friend’s constituent’s wife, and our thoughts are with him and his family. My hon. Friend raises an excellent point, and we are supporting people with cancer who are experiencing poor mental health care by expanding access to psychological therapies through NHS talking therapies. I am sure that the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), will be happy to talk to him as she develops her cancer plan to ensure that these issues are incorporated.
Dame Caroline Dinenage (Gosport) (Con)
A constituent of mine recently had successful high-intensity focused ultrasound treatment for prostate cancer, which was at Charing Cross hospital because it is not even offered to men at Portsmouth hospitals, despite being a less invasive treatment with fewer long-term health implications. As if to underline that inequality, imagine his surprise when he turned up at the hospital and found that the same doctor who had diagnosed him in Portsmouth was actually carrying out the procedure in London. What more are the Government doing to ensure that there is no postcode lottery when it comes to HIFU, and what will the Minister do to ensure that more men can access it?
The Minister for Secondary Care (Karin Smyth)
I thank the hon. Lady for that question and for her work on this issue. She makes a really important point about consistency of care. We understand that services are different in different parts of the country—sometimes the needs are different—but we want to ensure that, where there is good practice and proven evidence, care is rolled out. As we say, bring the best of the NHS to the rest of the NHS. I am sure that the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), will take note of that point.
Sarah Olney (Richmond Park) (LD)
Access to Healthcare: Bracknell Forest
Karin Smyth Excerpts(1 month, 4 weeks ago)
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The Minister for Secondary Care (Karin Smyth)
It is a pleasure to serve under your chairmanship this afternoon, Mr Mundell. I congratulate my hon. Friend the Member for Bracknell (Peter Swallow) on securing this important debate. He has made absolutely sure that the voice of Bracknell Forest is heard loud and clear, both here and at the Department of Health and Social Care. We know that the NHS faces pressure all over the country, including in Bracknell Forest and the south-east of England. I also thank his brother and sister-in-law for their work to ensure that people get a good service.
Our 10-year health plan is a plan to fix the issues, with the three shifts improving access to healthcare for everyone, no matter where they live or how much they earn. We are seeing improvements, with 5 million more elective appointments, 135,000 more cancer diagnoses within the 28-day target, and waiting lists cut by more than 230,000 since we came into office. Ambulance response times are down, including in Bracknell Forest, which has seen significant improvements in category 2 response times compared with last year. Twelve-hour waits in A&E are also down nationally and there are 2,500 more GPs. Over 100 community diagnostic centres have been opened at weekends and evenings, and new surgical hubs are helping to tackle the backlog.
Let me turn to the important local issues that my hon. Friend raised. First, on RAAC, the safety of our patients and staff will always come first, which is why we continue working to eradicate RAAC across the NHS estate, backed by £440 million this year. It is because of that investment that we can continue to invest in crucial RAAC mitigation safety work at Frimley Park hospital. However, our investment in local hospitals goes significantly further, with a new Frimley Park hospital being planned. Since he became a Member of Parliament, my hon. Friend has been very assiduous and active in meeting me and those in the Government talk about this issue. I know he has been working closely with local leaders as well; I was able to meet them in advance of this debate, to understand their position.
I am pleased to say that that work is progressing and remains on track against the timeline set out in the new hospital programme plan for implementation, with construction expected to commence between 2028 and 2029. I also assure my hon. Friend, other local Members and the public that we are working closely with the Frimley Park trust on the location of the new hospital. I know that he appreciates that we are currently in a commercially sensitive phase of the process, but the trust expects to be able to provide further updates soon. My hon. Friend’s constituents will also have an interest in the Royal Berkshire hospital, so let me be clear that we remain firmly committed to its delivery in wave 3 of the programme.
My hon. Friend raised special educational needs, and I know from my constituency that this affects Members across the House. I acknowledge the concerns about SEND support in Bracknell Forest, and I welcome the urgent local plans that are in place to address the issue in the region. It is right that my hon. Friend met the SEND Minister. At the national level, the Government are determined to deliver meaningful reform that stands the test of time, rebuilds the confidence of families with lived experience and puts partnerships at the heart of our solutions.
Furthermore, our 10-year health plan sets out the core principle of early intervention and support—including without the need for diagnosis—for children and young people with SEND. We are also accelerating the roll-out of mental health support teams in schools and colleges to reach full national coverage by the end of this Parliament. Going further, the first 50 young futures hubs will bring together services to support children and young people with early access advice and wellbeing intervention.
The Government recognise the pressures on elective care. That is why we are delivering millions of additional appointments and reducing waiting lists up and down the country, and the local picture is promising. I am pleased to report that, since July 2024, Frimley’s acute trust has lowered its referral-to-treatment waiting lists by over 17,000 and more than halved the number of patients waiting for over a year. Local people will welcome that, but there is much more to be done. It is a vital first step in improving those services.
Community health services also play a critical role in reducing pressures across the system; my hon. Friend made that point and paid tribute to the Admiral nurse and the role of Dementia UK in his constituency. We are working closely with NHS England to improve access to community health services, including in Bracknell Forest, helping to deliver our shift from the hospital to the community. That is important work with the voluntary and community sector, and those third sector organisations are crucial to that. We are seeing tangible results. My hon. Friend talked about the multimillion-pound Skimped Hill development in the town centre, opening in February 2026. That will see new community health services, including maternity services and a new GP practice serving the people of Bracknell Forest. It is a real trailblazer for the sorts of thing that we expect in neighbourhood health services, so well done to all those making that happen for local people.
My hon. Friend mentioned pharmacies, which are an absolutely integral part of the community. That is why in 2025 and 2026 we have increased funding for the core community pharmacy contractual framework to more than £3 billion, representing the largest uplift in funding of any part of the NHS at that time.
Improvements to primary care do not stop there. I am pleased to report that we are investing over £1 billion extra into GP services, including in the primary care workforce and funding for infrastructure improvements, ensuring that places such as Bracknell Forest get the resources and GPs they need. The local picture relating to access to GPs is strong, with more than 90% of people in Bracknell seeing a GP within 14 days of requesting an appointment. That figure is reinforced by the positive feedback that practices are receiving from their patients. The opportunity to request appointments online, which has been available since 1 October, is also helping with that 8 am scramble; I was able to take advantage of that myself in my own patch. That online access is a real benefit for local people. If there are any particular local issues—as I know there are—it is the role of the ICB to work with local practices to make sure that those are resolved, which is what local people expect.
As a result of these broad national and local efforts, over 10 million more appointments have been delivered in England this year compared with last year. Dentistry is an issue across all our constituencies and my hon. Friend is right to raise it. We are recruiting more dentists in the areas that need them most to improve the oral health of children and to deliver additional dental appointments in places such as Bracknell Forest, where I am pleased to report that an additional 3,300 appointments have been commissioned across 2025 and 2026. All of that will deliver better dental care for everyone in England, including in my hon. Friend’s constituency.
I welcome and share my hon. Friend’s enthusiasm for the single patient record. A key thing that came out of our consultation on the 10-year plan was the desire of patients not to have continually to repeat their story and the desire of clinicians to be able to see more of the patient’s record. If staff providing care can see a single, accurate and up-to-date record that draws together the key information from different services, wherever that is needed, that will deliver significant benefits not just for my hon. Friend’s constituents, but for everyone in England, not least in the time and effort saved and the greater accuracy and appropriateness of treatment. We are currently building three proofs of concept to test the different technical ways that we might deliver the single patient record and to prove a clear pathway to taking that forward. I am happy to engage with my hon. Friend on that.
I thank my hon. Friend for bringing this debate to Parliament on behalf of his constituents. It is hard to cover everything that affects local people, but I think we have done a pretty good job. I hope that my response shows that the Government are seriously committed to addressing the important issues that he raised on behalf of his constituents. I assure him that we are embracing that challenge. We are determined to deliver innovation, and we have the ambition to make the health service fit for the future. That is the manifesto commitment that he and I were elected on, and that is what the Government are absolutely determined to do. I look forward to working further on making these services better for the people of Bracknell Forest.
Question put and agreed to.
Cross-border Healthcare
Karin Smyth Excerpts(2 months, 2 weeks ago)
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The Minister for Secondary Care (Karin Smyth)
It is a pleasure to serve under your chairmanship, Mr Dowd. I am grateful to the hon. Member for Brecon, Radnor and Cwm Tawe (David Chadwick) for securing this important debate. I knew that hon. Members from across the United Kingdom would come here for it, and so it has proved. There are no end of technicalities that devolution has brought us, but we respect devolution and difference while recognising that we are all citizens of the United Kingdom. On the initial point made by the hon. Member, I gently remind him that an extra £1.5 billion has been allocated by the Welsh Government to public services in Wales, to put Wales on a path back to growth, undoing the damage of the last 14 years. That money includes an extra £600 million for health and care, which was voted against by the Welsh Conservatives and by Plaid Cymru. That is the difference made by having a Labour Government at one end of the M4 and a Labour Senedd at the other. Let us hope that arrangement can continue into next year so that we can get on with resolving those issues for the people of Wales.
I am very proud of my Irish heritage, with family on both sides of the Irish border, and I represent a city just across the Severn from Wales, so I am no stranger to the issues that arise from sharing a border. I spent many years in the British-Irish Parliamentary Assembly and on the Public Administration and Constitutional Affairs Committee, looking at constitutional issues across the United Kingdom. As my hon. Friend the Member for North Northumberland (David Smith) said, given the reality of people’s lives across our borders, we need to be better at joining those dots, and—as my hon. Friend the Member for Carlisle (Ms Minns) said—at remembering those people who live at the edge of some people’s maps.
To assure everybody, with my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock) as the Minister for Care and with my hon. Friend the Member for Glasgow South West (Dr Ahmed) as the Minister for Health Innovation and Safety, on whose behalf I am speaking, we in the Department of Health and Social Care are well served by all voices in the United Kingdom. I reaffirm our commitment to ensuring that all patients on both sides of borders can access timely, high-quality care. Healthcare is devolved but patients cannot be left to navigate a fragmented system or face delays just because of where they live.
I assure hon. Members, in response to points made by the Opposition spokesperson, the hon. Member for East Grinstead and Uckfield (Mims Davies), that officials meet regularly. That co-operation is happening, and they will continue to meet. My colleagues and I also meet members of those Governments. However, I will come on to that at the end when discussing the requests for my colleague, the Minister for Health Innovation and Safety, to meet with hon. Members.
The spiritual home of the NHS is Tredegar. This Government will not leave anyone behind, not least patients in Welsh border communities who rely on services in England—the point of the debate. My hon. Friend the Member for Montgomeryshire and Glyndŵr (Steve Witherden) raised problems with data sharing and patient record transfer, confusing and inconsistent referral pathways and some of the disputes across borders. However, as we have heard, such disputes sometimes happen within countries and over more local borders. As we heard from the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont), they happen internally as well, so let us not underestimate how hard it is to resolve such disputes.
Around 30,000 people who live in England have a GP in Wales, and vice versa. That is why the statement of values and principles for cross-border healthcare was published in 2018. That statement remains the foundation for our approach. It sets out clear expectations that patients living in defined border areas, whether they are registered with a GP in England or in Wales, should receive care without delay or administrative burden. Emergency care is available to all patients, regardless of residency or GP registration. We expect both integrated care boards in England and local health boards in Wales to consider the impact of commissioning decisions on cross-border communities.
The hon. Member for Brecon, Radnor and Cwm Tawe raised the issue of waiting times for residents in Powys who seek treatment in England. Waiting times on both sides of the border are falling. Whenever I appear in the media or speak in a debate, I hear people still saying, even to their television, “Well, where’s my appointment?” Nevertheless, it is the case that waiting times are falling, which is helped by the allocation of money from the Welsh Government to reduce waiting lists.
Karin Smyth
I will get through all the points, if I can, because I know there are lots of issues to address.
As I was about to say, too many people are still waiting, but we are committed to working with the Welsh Government to keep the cross-border arrangements fair, transparent and patient-centred.
Patients also face challenges in accessing specialist services. NHS England commissions a number of these services on behalf of the devolved nations and we are willing to explore further contract arrangements with NHS Wales to improve access to them.
As we have heard this afternoon, travel to appointments can be a barrier. In England, patients referred for specialist NHS treatment may be eligible to claim a refund of reasonable travel costs under the healthcare travel costs scheme, and a similar scheme exists in Wales. I join my hon. Friend the Member for Shrewsbury (Julia Buckley) in welcoming the tremendous changes that we are seeing at Shrewsbury and Telford hospital, which are starting to benefit not only her constituents but people travelling from Wales. That is really good to see. It is a long way for people from Wales to travel, but we are still very pleased to see those changes being made.
The hon. Member for Brecon, Radnor and Cwm Tawe also raised the issue of digital interoperability. Again, I wish I could say that that was only a problem for hospitals on the border between England and Wales, but I am afraid that it is an issue for trusts across the country and across each country. It does not help that, after 14 years of under-investment, IT in the NHS lags behind IT in the private sector by at least a decade. That is why this Government are investing £10 billion into improving how patients access services through technology. My hon. Friend the Minister of State for Science, Innovation, Research and Nuclear, Lord Vallance, is currently giving the NHS the biggest digital makeover in its history as part of our 10-year plan.
I can also tell the hon. Member for Brecon, Radnor and Cwm Tawe that NHS England is working with NHS Wales to improve interoperability, especially through the shared care record and technical collaboration on the so-called fast healthcare interoperability resources, or FHIR for short, which allows systems from different manufacturers to exchange messages and data, regardless of the setting that care is delivered in. I commend my hon. Friend the Member for Montgomeryshire and Glyndŵr on meeting leaders in the local cross-border system to understand that issue better. However, I gently say to him that we cannot get very far without the private sector working with us, not only across genomics and future healthcare but in IT and the way that we develop some of these services.
In October, the chief information officers across all four nations agreed to start looking at digital architecture and standards. They are exploring what we can do to improve how we use shared systems, common standards for better communication, which was raised by nearly everyone this afternoon, and the potential of future alignment. This work should lead to some progress in the short term, ahead of our long-term ambition of building a single patient record.
We are also making cross-border billing arrangements easier. Although the NHS payment scheme applies only to services in England, we sat down with the Welsh Government and agreed that Welsh commissioners will pay English tariff prices for Welsh patients who are treated in England. For English patients who are treated in Wales, local agreements are in place and we are open to making those agreements more efficient through the provision of clearer guidance.
As for our constructive co-operation with devolved Governments, the Government were elected on a manifesto to reset our relationship with the devolved Governments, and from day one that is what we have been doing. In that spirit, and without downplaying many of the issues that the hon. Member for Brecon, Radnor and Cwm Tawe and others, including the hon. Member for Ynys Môn (Llinos Medi), have raised today, I will highlight some of the positive examples of collaboration between our healthcare systems.
In many areas along the border, NHS staff in England and Wales are showing the rest of the UK how joined-up care is done. For example, patients in south Wales regularly access paediatric intensive care services in my home city of Bristol, and there are long-standing arrangements for cancer care, renal services and mental health support that cross the border seamlessly. Such partnerships are a testament to the professionalism and dedication of our NHS workforce, but cross-border healthcare is just one part of our partnership.
First, we have seen immense progress through the Interministerial Group for Health and Social Care, which met last September. Such meetings are really important. They bring together all four nations to find common ground on key priorities, such as elective recovery for those on waiting lists, innovation and health reform, and we look forward to continuing these discussions at the next meeting in December.
Secondly, all four nations are working to protect our kids through the Tobacco and Vapes Bill, which is UK-wide in scope but tailored to the specific needs of each nation. If the representative of the Opposition, the hon. Member for East Grinstead and Uckfield, could indeed talk to her colleagues in the House of Lords, who are battling very hard to get some of this legislation through, we could start making this generation the first smoke-free generation and support kids with this public health measure.
Thirdly, the Mental Health Bill that applies to England and Wales has been a masterclass in constructive engagement between compatriots who want to put their differences aside and get stuff done. May I echo the words of the hon. Member for Strangford (Jim Shannon) and add my support to the hon. Member for South Antrim (Robin Swann) in his efforts to ensure progress on that often forgotten part of the Good Friday/Belfast agreement that deals with healthcare? It is not easy. If they can do it over there, it is not beyond the rest of us to do it in Scotland, Wales and England. I was so grateful when my own mother was being cared for at Altnagelvin hospital during the covid crisis in 2021 to see the co-operation across the border and staff just getting on with treating the patients wherever they came from. We have a lot to learn from our colleagues in Northern Ireland.
In conclusion, I want to assure colleagues that the UK Government remain committed to supporting cross-border healthcare arrangements that work for patients. I will not offer hon. Members lots of individual meetings, but what I have heard today is that there is a lot of good work going on among officials. People here have issues to raise, including things from the past. I will take that up and share that more widely. I will also endeavour to write to the hon. Member for Strangford on the issue he raised to do with university students.
We are building bridges with Wales to work through our issues in the national interest, but I am afraid to say that although waiting lists are falling in England and Wales, in Scotland they are rising, which is a great shame. My friend Anas Sarwar, a former NHS dentist, is committed to resolving that. The NHS is in his DNA, given his own professional work. Getting waiting lists down will be his No. 1 priority, should Labour be successful in Scotland next year. It is a shame for Scottish people to see waiting lists rising while we make progress in England and Wales.
The greatest Welshman in history, Nye Bevan, founded our national health service. The hon. Member for Brecon, Radnor and Cwm Tawe might want to dispute that and give the title to Lloyd George—we will politely disagree on that one. But the serious point is that Bevan’s vision was for a health service where no one was left behind, not least in his own country of birth. Working in partnership, we will fix the NHS across the United Kingdom and make it fit for the future.
Early Pandemic PPE Procurement
Karin Smyth Excerpts(2 months, 2 weeks ago)
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The Minister for Secondary Care (Karin Smyth)
During the gathering and review of evidence for module five of the covid-19 public inquiry, officials at the Cabinet Office concluded in April 2024 that another supplier, Luxe Lifestyle Ltd, should be on the list of suppliers identified as having been processed through and awarded a contract from the “high priority lane” for personal protective equipment procurement in 2020. This addition takes the total number of companies awarded contracts through this route to 52.
The Department of Health and Social Care agrees with the Cabinet Office’s findings, and notes two other corrections that are to be published. The corrections amend the referral details for another supplier, P1F Ltd, replacing the previously named person with “FCO Donations Team”, and correct a spelling error for another (Inivos Ltd, previously misspelled as Invios).
These changes and the corrected lists will be published on a new gov.uk page, which will supersede the original page published on 17 November 2021 by the previous Government. This new page will carry any subsequent amendments that might arise. Corrected lists can be found at: http://www.parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2025-10-30/HCWS1006/
[HCWS1006]