NHS Investment: Neighbourhood Health Centres and Digital

Karin Smyth Excerpts

Tuesday 25th November 2025 Written Statements

[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]

Oral Answers to Questions

Karin Smyth Excerpts

Tuesday 25th November 2025 Commons Chamber

[Gareth Thomas (Harrow West) (Lab/Co-op)]

3. What steps he is taking to improve cancer services in north-west London.

[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. 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?

[Mr Mohindra]

Mount Vernon is next door.

[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)]

5. What steps his Department is taking to reduce the number of people waiting for NHS treatment.

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[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)]

7. What assessment he has made of the potential impact of the time taken to deliver the new hospital programme on maintenance costs across the NHS estate.

[Clive Jones (Wokingham) (LD)]

22. What progress his Department has made on the implementation of the new hospital programme.

[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.

[Mr Speaker]

I call the shadow Minister.

[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?

[Karin Smyth]

I am sure this is leading somewhere else but, broadly, yes, I think I do.

[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.

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[Mr Connor Rand (Altrincham and Sale West) (Lab)]

14. What steps his Department is taking to improve cancer care.

[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)]

T1. If he will make a statement on his departmental responsibilities.

Uckfield Community Hospital Surgical Unit

Karin Smyth Excerpts

Tuesday 25th November 2025 Commons Chamber

[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.

Access to Healthcare: Bracknell Forest

Karin Smyth Excerpts

Wednesday 19th November 2025 Westminster Hall

[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

Tuesday 4th November 2025 Westminster Hall

[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.

[David Chadwick]

Will the Minister give way?

[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

Thursday 30th October 2025 Written Statements

[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]

Obesity and Fatty Liver Disease

Karin Smyth Excerpts

Tuesday 28th October 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate my hon. Friend the Member for Worthing West (Dr Cooper) on securing the debate. We have veered quite a long way into the public health arena in the last while, but that demonstrates how important it is. I pay tribute to the expertise that my hon. Friend brings to this House and everything that she is doing to promote public health, including sharing the news about the winter flu vaccine—I will get that in while I am here, Mr Efford, because it is so important.

As has been said by many, including the resident GP on these Benches, my hon. Friend the Member for Stroud (Dr Opher), we have all learned from this debate. Well done to the British Liver Trust for its fantastic campaigning and briefing, which has clearly paid dividends. My hon. Friend the Member for Worthing West has given me the chance to update the House on the Government’s efforts to tackle the obesity crisis. I am here on behalf of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), who is responsible for public health, but this issue concerns us all. Many of us have been involved in this area for some time, and it is one of the defining public health challenges of our time.

We heard today some of the facts. Obesity is a major risk factor for both fatty liver disease and cardiovascular disease; there are common risk factors such as high blood pressure, high cholesterol and type 2 diabetes. Non-alcoholic fatty liver disease now affects about one in three adults in the UK. Prevalence has increased with the rise in obesity rates. Currently, almost two thirds of the adult population in England are overweight or obese, and almost 29%—almost 13 million people—are living with obesity. When children in England start school, just over one in five of them are overweight or obese, and that rises to more than one in three by the time they leave primary education. Children living with obesity are five times more likely than other children to live with obesity as adults.

We have heard that there are major inequalities in how obesity is distributed across the United Kingdom. That was highlighted brilliantly by my hon. Friend the Member for Bootle (Peter Dowd), and by my hon. Friend the Member for Blackpool North and Fleetwood (Lorraine Beavers), who talked about the loss of her constituent Stuart. My hon. Friend the Member for St Helens South and Whiston (Ms Rimmer) spoke eloquently for Sara and her stepmother Dorothy on their loss of Stephen, which brought home to all of us the real impact of this disease on people’s lives.

Kids in deprived areas are twice as likely to struggle with obesity as those in the least deprived, so this is an extremely serious matter. We are effectively hobbling the life chances of a little boy or girl before they have had a fair start. The Government cannot and will not look the other way as a generation of kids miss out on the best start in life. The points made by my hon. Friend the Member for Worthing West make sense, given that we both stood on a manifesto that committed to halve the gap in healthy life expectancy between the richest and poorest regions in England, and reverse the legacy left to us by the last Government. We share that goal. The question is: how do we get there?

On my hon. Friend’s calls for a liver strategy and a childhood obesity plan, our 10-year health plan sets out decisive action—we have heard about some of it in this debate—on prevention to tackle the obesity crisis head on and create a fairer, healthier food environment. We are looking at people as a whole: where they live, what services they need and how to prevent illnesses in their communities. That will help us to be better prepared for the changing nature of the disease and allow our services to focus more on the management of chronic long-term conditions. I will talk more about prevention later.

On my hon. Friend’s call to extend the levy model, we are taking steps to ensure that the soft drinks industry levy, which the Lib Dem spokesman, the hon. Member for Winchester (Dr Chambers), discussed eloquently and which colleagues know as a sugar tax, remains fit for purpose. On the request that my hon. Friend the Member for Worthing West made for an ICB pathway, we are working with partners including the British Liver Trust to raise awareness and address the stigma related to hazardous and harmful levels of alcohol use and viral hepatitis, which are key drivers of liver disease. We will continue to work with communities and help those most affected by liver disease through the community liver health checks programme.

[Peter Dowd]

This must be one of the safest places in the Palace, with at least three medics and a vet in the Chamber. My constituency has been designated a pride in place area. One of the aims of that programme is to create safer, healthier environments. Does my hon. Friend agree that there is a great opportunity in those areas, which include an area of her constituency, for funding to be used in a lateral way for local community initiatives such as those that have been highlighted during the debate? There is real opportunity for those initiatives to be tested out, with local people making local decisions.

[Karin Smyth]

My hon. Friend is absolutely right. The pride in place programme does just as it says on the tin, and it is important. The Government’s drive is to make sure that those communities, which know best what they need, are the drivers of how that is done. We will think laterally and bring together all that they know about why there is that level of deprivation in those communities. I know that, with his experience as chair of a primary care trust and as a local councillor, my hon. Friend is well placed to see what needs to happen for us to bring things together and think laterally. In my community, the legacy of the tobacco industry is the source of so much of the long-standing inequality.

The ICBs need to be tied into that community work and support it, and make sure that community health checks proactively identify people suitable for liver cancer surveillance. More widely, as my hon. Friend the Member for Stroud said, our shifts, and particularly the transfer to community and neighbourhood health, absolutely support that agenda. I know that hon. Members will make sure that that agenda is well delivered. This disease lends itself very much to that drive, which we are determined to make happen.

My hon. Friend the Member for Worthing West asked for us to be patient-ready for the next generation of liver disease medications. If my hon. Friend the Minister for Innovation, Lord Vallance, were here now, he would happily chew her ear off about everything that the Government are doing to ensure that the next generation of life sciences discovery is available to NHS patients. I will touch briefly on medicines later.

My hon. Friend also asked about local food partnership funding and action on food affordability. I cannot go into those points in detail here, but we absolutely recognise them, and we are working closely with my right hon. Friend the Secretary of State for Environment, Food and Rural Affairs to develop DEFRA’s cross-Government food strategy to provide healthier and more easily accessible food, particularly in deprived areas. I encourage my hon. Friend to ensure that she is completely aligned with that agenda, as I am sure she is. We want to make that work. On her call to enforce the 9 pm watershed, I will update the House on where we are in delivering our manifesto commitments.

Prevention is clearly an important part of this work, and our manifesto specifically promised to restrict advertising of junk food to children, along with banning the sale of high-caffeine energy drinks to under-16s. We are consulting until 26 November on that ban, and the restrictions on junk-food advertising will take legal effect on 5 January. I thank the advertisers and broadcasters who are doing the sensible thing in getting ahead of the regulations by applying the restrictions already.

We have also restricted volume price promotions such as “buy one, get one free” on less healthy food and drinks, and given local councils stronger powers to block new fast-food outlets near schools. We will go further. Current promotion and advertising restrictions on less healthy food and drinks use an outdated nutrient profile model. That was formulated under the previous Labour Government, almost 20 years ago, because we also took this agenda seriously when we were last in government. We will update the standards that apply to the restrictions, and we will consult on their implementation in the coming year.

In a world first, as per our 10-year plan, by the end of this Parliament all large food businesses will be required to report against standardised metrics on sales of healthier food. That means that the large food companies will have to tell us regularly how healthy the food they are selling is, and whether that is improving. That will set full transparency and accountability around the food that businesses are selling, and it will encourage healthier products. We will also set new targets to increase the healthiness of food sales in all communities. Finally, with regard to liver disease, we are exploring innovative approaches to early detection, such as intelligent liver-function testing, to reach more people at a stage when liver damage can better be reversed.

Our focus is prevention—we have the shining example of the hon. Member for Strangford (Jim Shannon)—but we do need to treat the millions of people who already live with obesity in the UK, so let me say what we are doing for them. First, we are building relationships with the biggest pharmaceutical companies to expand access to weight-loss services and treatments across the NHS.

Secondly, obesity drugs can be game changers in supporting weight loss, and we are entering what could be a golden age for obesity drugs, with many more in the pipeline. Over the summer, the NHS started its roll-out of the weight-loss injection Mounjaro through GPs. About 220,000 people, prioritised by clinical need, are expected to receive Mounjaro on the NHS over the next three years.

Thirdly, our obesity pathway innovation programme, supported by industry, is testing new ways of delivering that care, including through pharmacy-led services in the community and through digital services—again, part of our shifts. We recognise that these drugs are not a replacement for good diet and exercise, as exemplified by the hon. Member for Winchester, and they are not the first thing for patients or the NHS to try. That is why we have committed to doubling the number of people who can access the NHS digital weight-management programme.

On hospital to home, we are providing treatment options for children by shifting care from hospital to community. That comes back to the point made by my hon. Friend the Member for Worthing West about the left shift. Earlier this year, the Government announced that we would support thousands of severely obese children to lose weight and live healthier lifestyles, thanks to the roll-out of specialist NHS clinics and new digital smart technology to deliver expert care at home. That game-changing tool is helping our specialists support and keep track of children’s weight-loss programmes, without those children needing to leave home, while offering regular advice to them and their parents to help build healthier habits.

I have set out how the Government are tackling the obesity crisis head on, especially when it comes to safeguarding our children’s future, but while we are shifting the focus of our NHS to prevention, we are also doing more to help people who are already affected by obesity and fatty liver disease, especially through medicines and new technologies and by shifting care from hospital to home. We remember that we stood on a manifesto that committed to tackle the root causes of ill health and to close the gap between the richest and the most deprived areas. That is exactly what we are focusing on through our 10-year health plan. This Government will not sit by and let ill children become ill adults—not on our watch. I thank my hon. Friend the Member for Worthing West for securing this debate.

Menopause and the NHS Health Check

Karin Smyth Excerpts

Thursday 23rd October 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

My noble friend the Parliamentary Under-Secretary of State for Patient Safety, Women’s Health and Mental Health (Baroness Merron) has made the following written statement:

Today I am pleased to be updating the House on a key step we are taking to support women who are going through the menopause.

Menopause is a major life event affecting all women in a variety of ways, both short and long term. Each year around 400,000 women in the UK enter menopause and around three quarters will experience symptoms, lasting an average of seven years.

While menopause is a natural stage of a woman’s life course, symptoms are common with one in four women experiencing the impact on every area of life, at home and at work with women's employment rates falling as the number of menopausal symptoms they report rises.

That is why we are taking action to ensure women are supported through this journey.

Every five years, people aged between 40 and 74 without pre-existing heart conditions are invited to an NHS health check, aiming to detect people at risk of heart disease, stroke, type 2 diabetes and kidney disease.

Perimenopause symptoms can often start from the age of 40, with most women starting the menopause between the ages of 45 and 55, so NHS health checks provide a key opportunity to reach and support these women.

We have listened to women, organisations like Menopause Mandate and the all-party parliamentary group on menopause who have long campaigned for the menopause to be included in the NHS health checks.

That is why we will ask all local authorities to introduce a new element to NHS health checks in 2026. This new menopause question included in the NHS health check will mean eligible women aged 40 to 55 can access advice about the menopause and perimenopause more easily.

We know that women have faced difficulty with access to NHS services being fragmented and through this change we are delivering on our commitment to women’s health, by personalising services to support individuals to manage their health, as set out in the 10-year health plan.

Together, we will ensure women feel supported and are able to access high quality information on the menopause, including advice on managing symptoms and where to seek support.

[HCWS989]

NHS Workforce Levels: Impact on Cancer Patients

Karin Smyth Excerpts

Thursday 23rd October 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairship, Mrs Hobhouse. I thank the hon. Member for Wokingham (Clive Jones) for securing the debate, and for getting through it—I hope he is well. I thank other hon. Members for their contributions. As others have noted, I am aware of the work that the hon. Gentleman has done, using his experience for good, on access to primary care, radiotherapy and cancer. He has campaigned on behalf of his constituents in Wokingham and people across the country, as the hon. Member for Strangford (Jim Shannon) said. He has been a keen advocate for the NHS workforce’s importance to delivering the health services we need.

I thank the wife of my hon. Friend the Member for Edinburgh South West (Dr Arthur) for her service and wish her well in her new role at the hospice. It is really good to have a voice from Scotland in these debates. My hon. Friend spoke about the shocking and deeply concerning waiting times that our friends and families in Scotland are experiencing. The Scottish people will have a chance to start reversing the situation next May. I hope they take that opportunity, and I look forward to joining my hon. Friend to try to make that happen.

I have my green jacket on, but I am sorry that I could not join today’s Macmillan coffee morning, which the hon. Member for Strangford mentioned. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), is working very closely with Macmillan and many other cancer charities as she develops the cancer plan. She is in good contact with them; they do great work, and we will ensure that we continue to talk through their many asks of the Government as she develops the workforce plan.

As many hon. Members said, half of us will have a cancer diagnosis in our lifetime. The health team has certainly taken our full part in that, as 50% of us have had a cancer diagnosis. Some of us are still undergoing treatment. Although more than three quarters of all people diagnosed with cancer in the UK are 60 and over—as hon. Members said, the population is ageing—I decided to get mine at 59. My hon. Friend the Member for West Lancashire is also younger than 60, and the Secretary of State would not forgive me for not reminding everybody that he is only in his early 40s. We make the point well: as other Members said, that although incidence will increase as a result of our ageing population, cancer can strike anybody at any age.

Diagnosing and treating cancer is a growing part of NHS elective activity, and responding to demand in a way that best suits patients is crucial. That includes the issues that the hon. Members for Wokingham and for Harrogate and Knaresborough (Tom Gordon) raised about the variability we often see even in a small geographical patch, and certainly between different cancers. The hon. Member for Wokingham talked about clinical nurse specialists. Mine were absolutely fantastic, and I did know who they were. The statistics he outlined are deeply concerning, so those points were very well made. Our mission to tackle cancer and the other biggest killers is underpinned by the 10-year health plan published earlier this year, focusing on those three shifts: from hospital to community, from analogue to digital, and from sickness to prevention.

On the workforce plan, we know that we need an effective and sustainable workforce to deliver better outcomes for everyone, including those with cancer. In the 10-year health plan, we set out that, to deliver a workforce fit for the future, we need a new, sustainable approach to workforce planning. Our 10-year workforce plan will be different. It will set out how we will create a workforce ready to deliver a transformed service for patients when and where they need it, with more empowered, flexible and fulfilled staff.

Since we launched our call for evidence on 26 September, we have been struck by the huge enthusiasm of staff, the sector, stakeholders and colleagues in sharing their thoughts and ideas with us. Many have said that they would like more time to have those conversations, to test ideas and to work together to deliver a truly reformed service. I am grateful to them for raising that, and it is why we have made the decision to give more time to that process. We will now publish the plan in the spring of 2026. A spring publication will allow us to have more detailed discussions with partners, hon. Members and other stakeholders, not just to listen but to work in a truly joined-up way to deliver for staff and patients.

The shadow Minister helpfully outlined all the decisions that were made by her Government over the last few years—decisions that essentially led to many of the workforce problems we now have. We are trying to resolve those problems, and we will. She informed the House that the resident doctors committee has now decided to go on strike again, which is, of course, deeply disappointing. It will be damaging for the work we want to do, and we urge it not to go ahead. However, we will continue to commit to ensuring that the workforce is fit for purpose, including to diagnose and treat cancer. We will progress with the work that we have already started.

In July 2025, there were over 5% more staff in the key cancer professions of clinical oncology, gastroenterology, medical oncology, histopathology, clinical radiology and diagnostic and therapeutic radiography than in July 2024. There were also more doctors working in clinical oncology and more radiology doctors, compared with last year.

My hon. Friend the Member for Edinburgh South West asked particularly about haematology. NHS England has invested in expanding specialty training posts in high-demand disciplines, including haematology, and is supporting local systems to retain and develop multidisciplinary teams. That includes increased medical training posts in haematology, and enhancing the scientific workforce supply through other initiatives.

We have also ensured that the cancer-facing workforce are put on a more stable footing to ensure they have the stability they need to continue to provide the care that patients need. In 2025, we provided grant funding to the Royal College of Radiologists to encourage foundation and internal medicine trainees to specialise in clinical oncology. That work is currently under way and involves a series of webinars as well as targeted engagement. In 2024-25, around 8,000 people received training either to enter the cancer and diagnostic workforce or to develop in their roles. As part of that, more than 1,600 people were on apprenticeship courses, with more than 270 additional medical specialty training places funded. More than 1,000 clinical nurse specialist grants were made available to new and aspiring CNS workers, and it is a really valuable service.

[Tom Gordon]

I thank the Minister for giving way. As ever, she is most generous with her time. She has outlined the positive steps that the Government are taking to address the workforce challenge. Could she elaborate on the points I made about the inequalities between the north and the south in the NHS and the cancer workforce?

[Karin Smyth]

I do not have those numbers to hand but, as we outlined in the 10-year health plan, we are particularly committed to people in rural and coastal communities with regard to workforce and access to many other services. If there is anything specific the hon. Gentleman is not aware of, I am happy to furnish him with more information. We are, however, minded to rectify the variability across the country, even within towns and cities, let alone rural and coastal communities, whether that be in the north, south, east or west.

We will ensure that ongoing investment in practice education continues to enhance clinical supervision, education and training across cancer and diagnostic workforces. That will increase placement capacity, support staff retention and contribute to high-quality patient care.

We will not only ensure that the cancer workforce have the numbers to succeed, but also the skillset. Training academies in imaging, endoscopy and genomics are all being delivered across regions to provide intensive skills development and to support new models of care. We will also ensure that staff have the skills to adopt the treatments needed by cancer patients. Adoption of innovative cancer treatments is often clinician-led and self-identified, with doctors seeking out specialist training opportunities themselves. This may include overseas fellowships or short courses, after which skills are cascaded locally through continued professional development, multidisciplinary teams and peer-to-peer learning.

The complex challenge of tackling the cancer and workforce issues we face will not be solved with a single solution, which is why the Department will be publishing a national cancer plan in the new year. The plan will have patients at its heart and will cover the entirety of the cancer pathway from referral and diagnosis to treatment and ongoing care, as well as prevention, research and innovation. The national cancer plan will build on the progress of the 10-year health plan to improve survival rates and reduce the number of lives lost to the biggest killers.

On 4 February, we launched a call for evidence on the national cancer plan, which closed on 29 April. We received over 11,000 responses from individuals, professionals and organisations who shared their views on how we can do more to achieve our ambition. We have worked with crucial industry figures in the development of the national cancer plan, including the Royal College of Radiologists. The submissions are being used to inform our plan to improve cancer care. As I said, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire, is working hard on that issue.

I thank the hon. Member for North Shropshire (Helen Morgan) for her recognition of the improvements being made at Shrewsbury and Telford and for her contribution, and that of other local MPs, in supporting that trust. Those are very welcome improvements.

On research, the life sciences sector is critical to this Government’s growth mission and we want to make this country the best place to do life sciences. Of course, the Department is working closely with colleagues in the Department for Science, Innovation and Technology, the Department for Business and Trade, and His Majesty’s Treasury to make that happen.

Finally, through this Government’s action on workforce and cancer capacity, we will ensure the NHS has the staff it needs to treat cancer patients safely across the country. I thank the hon. Member for Wokingham for securing this debate.

Oral Answers to Questions

Karin Smyth Excerpts

Tuesday 21st October 2025 Commons Chamber

[Steve Darling (Torbay) (LD)]

5. What progress his Department has made on the implementation of the new hospital programme.

[The Minister for Secondary Care (Karin Smyth)]

The Conservative Government’s promise of 40 new hospitals by 2030 was a fantasy—there was no funding beyond last March. In January, we published a realistic plan that put the programme on a credible and sustainable footing. We are committed to delivering all the schemes in the programme and are moving at pace with funding in place for design work, construction activity and business case development.

[Steve Darling]

The Conservatives still have not apologised for the appalling state that they left our NHS in. Torbay hospital is the third oldest hospital in the United Kingdom. It has a tower block wreathed in scaffolding to stop bits of it falling off rather than it being under repair, and it has sewage leaks throughout. Sadly, it needs significant investment, which has been kicked into the long grass. A senior manager described the situation only this week as “dire”. Will the Minister meet me and hospital representatives to explore how we can achieve the investment to turn this round?

[Karin Smyth]

The hon. Member makes an excellent point; it was echoed by Lord Darzi in his report about the state of our hospitals, and I know many hon. Members have similar problems. I have visited many such hospitals and would be happy to discuss the matter with him further. I remind him that, of course, the Torbay and South Devon NHS foundation trust has been provided with £7.3 million from the estates safety fund for works at the hospital, and we are absolutely committed to ensuring that it will be developed in line with the programme.

[Rebecca Smith (South West Devon) (Con)]

6. What recent progress he has made on reorganising the NHS.

[The Minister for Secondary Care (Karin Smyth)]

We are putting the final nail in the coffin of the hon. Member’s party’s disastrous Lansley 2012 reorganisation—so bad that it made me become an MP. We are abolishing the world’s biggest quango, NHS England, along with 200 other bodies. The question is: why did the Conservatives not do that when they had the chance?

[Rebecca Smith]

Yesterday I met Lila, a sixth-form student at Coombe Dean school, who raised the issue of long waiting lists for mental health services for children and young people across Devon. What action has been taken as a result of the Government’s policy of reorganising the NHS to reduce the unacceptable delays in mental health diagnosis and treatment for children and young people, particularly in constituencies such as South West Devon?

[Karin Smyth]

All of us as constituency MPs are fully aware of the state of mental health services, particularly for young people, which is why my hon. Friend the Minister for Care is working at pace on our manifesto commitments to support young people, particularly through schools. We also understand the difficulties that her ICB in particular has with its financial situation—something we are also targeting as part of our reforms to ensure that ICBs develop services for local people in line with the expectations that we have set them.

[Rachael Maskell (York Central) (Ind)]

Likewise, in York, children and adolescent mental health services are just not working for children, who are left on waiting lists often with no management or treatment. In order really to achieve reorganisation in our NHS, would our Government look at local authorities commissioning mental health services, to deliver such services and to meet the holistic needs of young children’s development and mental health wellbeing?

[Karin Smyth]

Again, I echo comments on the state of mental health services, as the hon. Member has done. As it says in our manifesto, we are committed to those 8,500 extra mental health support workers in local areas such as hers. It is important that commissioners work closely with their local authorities on mental health services, and I know my hon. Friend the Minister for Care is ensuring that that happens as part of the reforms we are undertaking.

[Mr Speaker]

I call the shadow Minister.

[The Secretary of State for Health and Social Care (Wes Streeting)]

We have.

[Karin Smyth]

As my right hon. Friend has just said, we have delivered on that commitment. The hon. Member talks about the reorganisation being a distraction. If her party had focused taxpayers’ money on patient services rather than ballooning bureaucracy, with costs increasing both among providers and through ICBs, we would not have inherited the mess that we did, and would be able to roll out programmes more effectively. We have committed to doing that.

[Dr Caroline Johnson]

I thank the hon. Lady for her answer, but I would like her to check and perhaps update the guidance for GPs and the websites that continue to say that it is only available to 80-year-olds who turned 80 after 1 September 2024, which is not all people over the age of 80.

Reorganisation is affecting delivery elsewhere, too. The Secretary of State also promised that the continued roll-out of fracture liaison services would be one of his first priorities. How many new fracture liaison services have opened since the general election?

[Karin Smyth]

On the hon. Lady’s first point, this Government, unlike the previous Government, do believe in experts, and we follow the clinical advice that we are given. On her second point, as she is so keen on reading our manifesto commitments, the commitment was to do that by 2030. It is currently 2025. Our reforms to ICBs and providers, bringing NHS England inside the Department of Health and Social Care to make it more democratically accountable for taxpayers, will reverse the shocking increase in funding that the previous Government put into a leaky bucket. We are fixing the foundations of the NHS. We are targeting resources at people in line with our 10-year plan.

[Natasha Irons (Croydon East) (Lab)]

7. What assessment his Department has made of the potential impact of NHS online on waiting times.

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[Ian Lavery (Blyth and Ashington) (Lab)]

12. What steps he is taking to ensure that frontline NHS services are supported following the potential introduction of new public-private partnership contracts.

[The Minister for Secondary Care (Karin Smyth)]

Let me be clear: this Government will always protect the NHS and have the service free at the point of use for everyone. This Government are determined to shift health out of hospitals and into the community, as set out in the 10-year plan, and neighbourhood health services will be fundamental to delivering this shift, so it is right that we look at a range of options to provide the best care for people across the country. Let me reassure hon. Members that all proposals are subject to robust, value-for-money assessments to ensure taxpayers get the best possible return on investments in our health services.

[Ian Lavery]

May I begin by congratulating the Secretary of State on his actions in trying to repair our cherished NHS following 14 years of Tory destruction? We must learn from past mistakes. The private finance initiative was a huge, expensive mistake—an absolute disaster—with £80 billion repaid for an investment of £13 billion. Will the Minister reassure the House that the lessons of PFI have been well learned, and that they are well and truly in the past and in the dustbin?

[Karin Smyth]

I thank my hon. Friend for his words of encouragement and congratulation. I assure him that lessons have been learned; we will ensure value for taxpayers’ money in all future proposals.

[Pippa Heylings (South Cambridgeshire) (LD)]

I meet regularly with GPs in my constituency, and they have highlighted that they do not yet have clarity or certainty about the role and resources that they will have in the roll-out of services from hospitals to communities and neighbourhood health services. Will the Minister meet me to provide that clarity to our GPs and assure them that they will be at the table during that roll-out?

[Karin Smyth]

It is absolutely the role of the hon. Lady’s local integrated care board to ensure that it involves all partners, particularly primary care, in the exciting roll-out of neighbourhood health services, which I think they welcome. I am happy to discuss that further with her.

[Richard Burgon (Leeds East) (Lab)]

14. What steps his Department is taking to tackle wasteful spending in the health service.

[The Minister for Secondary Care (Karin Smyth)]

As well as the record investment that we put into the NHS, we are ensuring that we get a better bang for the taxpayer’s buck. Under the Conservatives, for example, the NHS was paying £3 billion to recruitment firms for agency shifts. We have cut agency spending by a third and are abolishing it altogether, with the savings reinvested in staff pay and treatment for patients. That is just one example of how our reform agenda is good for patients and for taxpayers.

[Richard Burgon]

Private finance initiative deals did huge damage to NHS budgets. Despite receiving just £13 billion in assets, NHS trusts were saddled with more than £80 billion in PFI debts—most of that is still being paid back. We have even seen some hospitals spending more on PFI debts than on medicines. If they really want to cut out waste and avoid a PFI-style disaster 2.0, will the Government rule out using private finance for the new network of new NHS clinics, as has been floated?

[Karin Smyth]

As I answered in response to my hon. Friend the Member for Blyth and Ashington (Ian Lavery), we will absolutely ensure that we learn the lessons of the last Government’s failure.

[Tim Farron (Westmorland and Lonsdale) (LD)]

Does the Minister agree that it is completely wasteful to make cancer patients who need to go for chemotherapy in Carlisle on a Wednesday but who live in, say, Kirkby Stephen to have to travel to Carlisle on the day or on the day before to get their bloods taken? Why is that? Because the local hospital will no longer fund the local GP surgery in Kirkby Stephen or Appleby to take their bloods there. Is it not wrong that those GP surgeries can no longer provide secondary healthcare blood services in their own settings in people’s own communities?

[Karin Smyth]

As he often does, the hon. Gentleman highlights in his own very rural constituency some of the fundamental problems at the heart of our NHS. That is why we are reforming it, ensuring that we move hospital services from hospitals into the community and developing neighbourhood health services. We are also looking at the financial flows in the system that lead to these sorts of perverse incentives and funding arrangements, which do damage to his constituents, as they do to many others and to rural and coastal communities. That is why we highlighted that in the 10-year plan. We need to see the end of such examples.

[Josh Newbury (Cannock Chase) (Lab)]

15. What steps he is taking to ensure that women have access to menopause treatments on the NHS.

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[Naushabah Khan (Gillingham and Rainham) (Lab)]

T4. A Channel 4 “Dispatches” documentary recently went undercover at an ambulance centre in my constituency of Gillingham and Rainham. It showed exhausted staff working under difficult circumstances—the result of years of Tory neglect and mismanagement of our NHS. Does my right hon. Friend agree that after the chaos under the last Government, this Administration will put staff and patients first? Will the relevant Minister come to my constituency to meet healthcare providers and discuss our local challenges?

[The Minister for Secondary Care (Karin Smyth)]

We know that there have been issues with the urgent emergency care response. We are absolutely committed to supporting ambulance trusts to continually improve the patient experience. The urgent emergency care plan for 2025-26 is backed by nearly £450 million of funding. I am happy to discuss that further with my hon. Friend.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

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[Leigh Ingham (Stafford) (Lab)]

In my constituency of Stafford, Eccleshall and the villages, I recently ran a survey, which had a whopping 99% response rate, in support of an urgent treatment centre in my constituency. Would the Minister agree to meet me to discuss urgent treatment provision in my constituency?

[Karin Smyth]

My hon. Friend does an excellent job in her constituency. I meet her regularly to discuss issues in her constituency, and I am very happy to discuss the provision of urgent care centres with her.

[James Wild (North West Norfolk) (Con)]

Greater transparency about NHS data should be used to drive improvements, so what assessment has the Health Secretary made of the impact on the Queen Elizabeth hospital in King’s Lynn of being forced to make savings of £18 million this year? What impact will that have on the need to reduce waiting times for A&E and cancer treatment, as identified in the league table that he published?