NHS Pensions: McCloud Remedy Implementation
Karin Smyth Excerpts(4 days, 2 hours ago)
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The Minister for Secondary Care (Karin Smyth)
On 31 March 2025, I issued a written statement on the delivery of remediable service statements to NHS pension scheme members affected by the discrimination identified by the McCloud judgment. In it, I set out the extended deadlines by which the NHS Business Services Authority, which acts for the Secretary of State as the administrator of the NHS pension scheme, must provide affected members with remediable service statements.
Those deadlines were informed by a delivery plan put forward by the authority. However, as statements have been produced, it has become clear that the resource required to implement that plan was significantly underestimated.
I regret to inform the House that the NHS Business Services Authority will not be able to meet a number of these deadlines, including for those members who were due to receive a statement by 1 July 2025. The authority has begun issuing these statements, and enacting members’ consequential decisions, and as of 27 June 2025, 1,359 have been issued.
I stated on 31 March 2025 that I will hold NHS Business Services Authority to account against those extended deadlines for the delivery of remediable service statements. I will be meeting with the chief executive of the NHS Business Services Authority this week to express my disappointment with the progress that has been made and will be asking the recently-appointed independent chair of the NHS Pension Board to review the capacity, capability and delivery plans of the authority’s McCloud remedy functions and report to me before recess. The NHS pension scheme is a key part of the reward package for NHS staff who should expect an excellent service.
When I have agreed a revised delivery plan with the authority, one which is endorsed by the authority’s board, I intend to set new deadlines, including for those members who were expecting a statement by 1 July 2025, and will update the House as soon as possible. It is important to me that members have realistic timeframes for when they will receive their statements, and that the Government fulfil their obligations to them at the very earliest possible opportunity.
I know this will be disappointing news to affected members and the organisations that represent them. I want to assure them that we will continue to prioritise members based on their likelihood of facing financial detriment, that the authority are continuing to issue statements while a revised delivery plan is developed, and that they will receive 8% interest on pension arrears they are owed following receipt of their statement and enactment of their choice.
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IVF Egg Donation: Young Women
Karin Smyth Excerpts(1 week, 2 days ago)
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The Minister for Secondary Care (Karin Smyth)
It is a pleasure to serve under your chairmanship, Mr Efford. I thank the hon. Member for Strangford (Jim Shannon) for securing this debate on egg donation in young women. He raises a number of important points, which the Government take seriously. I absolutely assure him that there are rules and regulations around egg donation in this country. Hon. Members in this debate have talked about the potential concerns of the long-term impact of egg retrieval, and the potential incentive of the compensation offered for egg donation, particularly for young women on low incomes. I hope to address those points in my remarks.
For people who are struggling to conceive, which may be for a variety of reasons, receiving donor eggs can be life-changing—as we have heard in this debate—and enable them to start a family of their own. Donating eggs should be a purely altruistic act, and choosing to become a donor is a complex decision. In the UK, the average egg donor is between 31 and 32 years of age. That average has remained stable since records began in 1991. Egg donors are typically UK-based, with around 3% of donor eggs imported from abroad. There were around 3,800 IVF cycles using donor eggs in 2023, which is an increase from around 3,600 in 2019. Those donors support around 2,000 to 3,000 people a year who would otherwise not be able to have a baby. I recognise their generosity, although, as my hon. Friend the Member for Newcastle upon Tyne East and Wallsend (Mary Glindon) said, we also recognise that egg donation procedures come with risks, and they should not be undertaken lightly.
The HFEA ensures that licensed fertility clinics are following law and guidance in relation to egg donation. The Government agree with the point made in this debate that young women should be fully informed of any risks when making the decision to donate their eggs, and that clinics must ensure that women are fully informed and supported throughout the egg donation process. It is mandatory for clinics to provide counselling to women before egg donation to ensure that they understand all the potential risks, and legal and social implications, of donation. Donating eggs is generally very safe, and most women do not experience any health problems beyond discomfort during the stimulation of the ovaries and the egg collection procedure.
I do not want to minimise that experience of discomfort, but where women wish to donate eggs, the HFEA and the Government are committed to making it as safe and accessible as possible. In the short term, there is a potential risk of having a reaction to the fertility drugs used for the donation procedure. If that happens, the effects are normally mild, and can include headaches, nausea or feeling bloated. Donors are advised to let their clinic know if they experience any of those side effects.
In some very rare cases, as we have heard, women develop OHSS. It is a serious and potentially fatal reaction to fertility drugs, which happens about a week after eggs have been collected. Fortunately, it is rare, occurring in less than 0.1% of cycles. Because of the serious nature of OHSS, all severe or critical cases must be reported to the HFEA within 24 hours by the patient’s clinic. They are categorised by the HFEA as grade B incidents. A grade B incident involves serious harm to one person, or moderate harm to many. The HFEA’s latest “State of the fertility sector” report found that fewer OHSS incidents were reported in 2023-24, with 53 severe and critical cases reported by UK clinics.
In recent years, there has been widespread interest in donation, and figures show that the number of egg donors is rising. We heard from my hon. Friend the Member for Newcastle upon Tyne East and Wallsend and the Opposition spokesperson, the hon. Member for Sleaford and North Hykeham (Dr Johnson), about the importance of having conversations and asking questions about the long-term impact on women’s health, which is generally an under-researched area. The Government recognise that and would welcome studies in this area. If there is anything I can add to that following this debate, I will follow up with hon. Members on the opportunities for understanding the wider long-term implications for women’s health in this area.
At the public board meeting last year, the HFEA discussed the rates of compensation offered to egg and sperm donors. Since 1 October 2024, egg donors have received £985, which is up from £750. That increase in donor compensation was the first since 2011, and reflects the rise in inflation. The compensation offered to them is intended to reflect their time and the nature of the procedure, rather than being an attempt to monetise donation in the UK.
I want to address some of the points raised by Members to do with the variability of access to fertility services more broadly. Infertility affects one in six women of reproductive age worldwide. It is a serious condition that impacts wider family, relationships and mental health, as we heard from the Liberal Democrat spokes- person, the hon. Member for Chichester (Jess Brown-Fuller). I congratulate her friends, Lottie and Marvin, on the arrival of their child.
This Government expect integrated care boards to commission fertility services in line with the National Institute for Health and Care Excellence guidelines. NICE is currently reviewing the fertility guidelines, and will consider whether the current recommendations for access to NHS-funded treatment are still appropriate. I look forward to the guidelines being published; we will work with integrated care boards to determine how best to improve their local offer and ensure equity of access for affected couples.
Jim Shannon
I thank the Minister for her very comprehensive review. I have three quick questions. First, will the Government commit to undertaking a long-term study into the long-term health outcomes of women? That is one of the things I hope to see happen when it comes to egg retrieval. Secondly, will the Government review the safety of offering £985 per donation, which is sometimes said to be compensation? Thirdly—I hope I am not pressing the Minister too hard; I am quite happy for her to come back to us on this—everyone who has participated in the debate has expressed concern about the adverts, so we are keen to hear her thoughts on banning those.
Karin Smyth
I have addressed the issue of compensation. It rose in response to inflation, for the first time since 2011. We have no further plans to start a study specifically on health. As I said in my remarks to others, we understand that broader outcomes in women’s health is an under-researched area. Bringing forward trials is the usual response. If we need to add anything else to that, I will make sure we do so, but there are no other plans currently.
Advertising is governed in this country by the Advertising Standards Authority, which issued a joint enforcement notice in 2021 with the HFEA to ensure that fertility clinics and others were aware of the advertising rules and treating customers fairly. I am afraid I cannot comment on Scotland, where I understand there has been a large advertising campaign. That is not in my ken, although it is covered by the HFEA, which is a UK-wide body, so that is a bit of a complication. If there is anything to report back on with regard to Scotland, without me stepping on devolved issues, I will make sure we do so.
I again thank hon. Members for securing the debate and acknowledging the altruism of the women who choose to donate their eggs and help to give others a much longed-for baby. I assure Members that this Government will monitor the issues raised this afternoon. Women’s health and tackling inequalities are central to the priorities that we will take forward in the 10-year plan.
Department of Health and Social Care
Karin Smyth Excerpts(1 week, 4 days ago)
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The Minister for Secondary Care (Karin Smyth)
I thank the interim Chair of the Health and Social Care Committee, my hon. Friend the Member for Birmingham Erdington (Paulette Hamilton), for securing this debate, and all colleagues for taking part. I have been asked to condense my comments, so I hope that I can address her questions, but if I do not cover them, we will of course make sure that she has a written response.
We are honest about the challenges facing the health service, and we are serious about solving them. That is why we published the independent review led by Lord Darzi, which provided a full and frank assessment of the state in which the nation’s health service was left by the Conservatives after 14 years of government, aided in the first five years by Liberal Democrat colleagues. That investigation highlighted the critical challenges facing the NHS, and we have heard about more of them today. They include a significant increase in people living with multiple long-term conditions, and growing demands for mental health services, particularly among children and young people. That is why we are taking the steps that we are taking.
The investment we are already making in 2025-26, the outcome of the recent spending review and the forthcoming 10-year health plan will address these root causes by delivering our plan for change commitments, investing in preventive health care and modernising NHS infrastructure, so that we radically reform the NHS. We will deliver three shifts to ensure that the health service can tackle the problems of today—caused by the Conservatives—and of tomorrow. They are: shifting care from hospitals to community; shifting from analogue to digital; and shifting from sickness to prevention.
My hon. Friend the Member for Birmingham Erdington said that there were highly optimistic assumptions in the planning process, and that robust, detailed plans and efficiency savings were needed if we are to deliver on those assumptions. I agree. I am optimistic about our ability to deliver, but I am also realistic and very focused on delivery. Like my hon. Friend the Member for Chelsea and Fulham (Ben Coleman), I am already seeing improvements, as are most Members in their constituencies. May I wish him a happy birthday for July, while we are here? My hon. Friend the Member for Altrincham and Sale West (Mr Rand) rightly said that the Labour Government did this before, and we will do it again.
The estimates set the Department of Health and Social Care a resource spending budget of £208.1 billion and a capital DEL—departmental expenditure limit—budget of £13.6 billion, an increase from the 2024-25 supplementary estimates budget of £9.6 billion and £2 billion respectively. On capital, we have, as my hon. Friend the Member for Shipley (Anna Dixon) said, reversed the shocking decision by previous Governments to keep raiding capital budgets in order to keep the revenue going. That is why NHS buildings across our constituencies are in the state that they are in, and why we do not have the infrastructure that we need. I was pleased to visit Airedale hospital recently to see the work being done to repair it. On digital and tech, my hon. Friend the Member for Birmingham Erdington will notice that we have a £10 billion dedicated spend for the issues that she quite rightly raised.
The Department covers a wider family of organisations, and I can assure the House that we are focused on all parts of the departmental family to make sure that taxpayers’ money is spent as efficiently and effectively as possible. Everybody here has raised particular issues to do with the NHS, so I will briefly remind Members of the outcome of the spending review that my right hon. Friend the Chancellor recently announced. The spending review includes £29 billion more day-to-day funding in real terms than in 2023-24 and the largest-ever capital health budget; there will be a £2.3 billion real-terms increase in capital spending over the spending review period. That is our commitment to the British public. My hon. Friend the Member for Sunderland Central (Lewis Atkinson), with his great experience of the health service, said that we need to make sure that we have good public administration. The multi-year settlements can help the system to plan much better.
This record investment puts the NHS on a sustainable footing to deliver for the British people. We will cut waiting lists so that, by the end of the Parliament, 92% of patients will start consultant-led treatment for non-urgent health conditions within 18 weeks, delivering on the Prime Minister’s plan for change commitment to prioritise people’s health. We will support the shift from analogue to digital with the investment of £10 billion in NHS technology and transformation between 2026-27 and 2028-29—an increase of almost 50% from 2025-26. We will repair the NHS estate, continuing to deliver the 25 hospitals, with £30 billion over the next five years for day-to-day maintenance and critical safety risks, including the eradication of RAAC. None of that happened under the Conservatives.
We will enable 2% productivity growth per year, unlocking £17 billion of savings to be reinvested in frontline services. As well as delivery, the British people rightly expect us to ensure value from this huge investment in the health service. The Secretary of State has marked 2025-26 as a financial reset year with the publication of this year’s planning guidance. He has been clear that all systems must live within their means, exhausting all opportunities to improve productivity, tackle waste and take decisions on how to prioritise resources to best meet the health needs of their local population.
All systems are now planning to achieve a balanced financial position in 2025-26, recognising that £2.2 billion of deficit support has already been provided. We will therefore close the £4.4 billion initial gap in full. Financial plans support the delivery of key operational performance targets for elective, cancer, and urgent and emergency care at a national level set out in the guidance. We are working closely with NHS England on key aspects of delivering that. I assure the Chair of the Select Committee that I meet colleagues from across the Department of Health and Social Care and NHS England weekly to go through those plans in a robust manner.
There is a lot to get through, so I am sorry that we have lost a lot of time to respond to colleagues. We are particularly looking at productivity and efficiency targets. We are ensuring that the financial performance and improvement programme for 2025-26 learns the lessons of the past. We will focus on cost variation and on upskilling finance teams and wider leadership to ensure that there is good governance in our reporting practice. We will issue the NHS performance assessment framework and have a targeted approach to recovery because the current model does not work. We are looking at ICB reform, as has been discussed. We want to ensure there is a reduction in the variation of cost across the system so that we can get more care and support to the frontline. We are focusing much more on medium-term planning to have a long-term financially sustainable system for systems and providers.
Thanks to this Government’s record investment, we are taking steps towards fixing the foundations of our NHS to make it fit for the future. We will set out more details on our plans shortly in the forthcoming 10-year plan, which will lead the NHS to meet the challenges set out in the plan for change and build an NHS fit for the future.
Incontinence
Karin Smyth Excerpts(2 weeks, 2 days ago)
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The Minister for Secondary Care (Karin Smyth)
It is a pleasure to see you in the Chair, Mr Deputy Speaker; you have done an excellent job of making sure that all Back Benchers get to contribute to this afternoon’s important debate. I will have to cut some of my comments, but hopefully I will get to address everybody’s points. We are having this debate during World Continence Week, and I congratulate my hon. Friend the Member for Dudley (Sonia Kumar) on securing it. There could not be a more appropriate time to raise awareness of this issue.
Millions of men, women, young people and children are living with bowel and bladder problems. Incontinence is an issue that robs people of their dignity, as we heard from my hon. Friends the Members for Chelsea and Fulham (Ben Coleman) and for Harlow (Chris Vince), and too many suffer in silence. As my hon. Friend the Member for Dudley rightly says, this subject is taboo, and I congratulate her on securing her first debate in the Chamber. It is great to have her expertise in this area.
All continence problems can be debilitating and life-changing. They affect a wide range of care groups, and can be a particular concern for older people. In recent years, public discussion and awareness has opened up. The advertising of products has become slightly more commonplace, helping people to normalise these issues, with which so many people live from day to day. However, we are still a very long way from being a society that supports people with incontinence to live without stigma.
As these issues affect people of all ages, we need to recognise that different approaches are required. We heard an excellent contribution from the hon. Member for Dumfries and Galloway (John Cooper), who raised that point, as did the hon. Member for Farnham and Bordon (Gregory Stafford). The hon. Member for Strangford (Jim Shannon) talked about children, and my hon. Friend the Member for Nuneaton (Jodie Gosling) talked passionately about people with learning disabilities.
There is no one-size-fits-all approach to managing incontinence, but dignity and compassion must be at the heart of the care provided. That is why we are introducing reforms to put the patient at the heart of the care pathway and the decision-making process around it. The 10-year health plan, and its focus on the three shifts needed to deliver a modern NHS—moving from hospital to community, from analogue to digital, and from sickness to prevention—will benefit people at risk of developing incontinence and those already living with it. For example, preventing type 2 diabetes or helping people into remission will help to reduce the number of people who develop continence problems as they go through life.
We have heard many contributions about women’s health. NHS England has established a perinatal pelvic health service, which focuses on the prevention, identification and timely treatment of a range of issues antenatally and for at least 12 months after birth. The initiative aims to support women who experienced trauma during childbirth, including conditions such as urinary incontinence and pelvic organ prolapse, as noted by my hon. Friend the Member for Gravesham (Dr Sullivan).
In addition to perinatal pelvic health services, continence services are provided more widely via women’s health hubs, and the core specification outlines that incontinence care is a key consideration for local organisations when establishing hubs. I commend my hon. Friend the Member for Wolverhampton West (Warinder Juss) for bringing his expertise and experience to this debate, and for supporting so many women. I know that in the last Parliament many Members of this House supported women through the horrors of mesh implants, and we are moving that issue forward.
By moving from sickness to prevention, the Government want to shorten the amount of time people spend in ill health and to prevent illnesses before they happen. Although prevention is extremely important, we must also ensure that those living with incontinence receive the best possible care, wherever they live. A key part of that involves the NHS providing high-quality guidance on how to care for people living with incontinence. The National Institute for Health and Care Excellence has published five guidelines on the management of urinary and faecal incontinence, which cover the management of urinary incontinence in people with neurological disease, the prevention and management of pelvic floor dysfunction, and pelvic organ prolapse in women. NICE has also published advice on a further 14 products for urinary incontinence, and on 12 products for faecal incontinence.
My Department has commissioned NICE to produce late-stage assessment guidance on one-piece closed bags for colostomies, and on intermittent urethral catheters for chronic incomplete bladder emptying in adults. These late-stage assessments will gather the views of clinical experts and patients to help NICE assess and compare the value of products in widespread use across the NHS. In addition to NICE’s guidance, the NHS must have regard to the “Excellence in Continence Care” guidance, published in 2018.
NHS England has also produced guidance on safer bowel care for patients at risk of autonomic dysreflexia, a serious medical condition that can affect people with spinal cord injuries. The guidance offers resources to support safer bowel care practice, and highlights the importance of implementing the excellent incontinence framework. In addition, the Nursing and Midwifery Council has professional standards relating to bladder and bowel nursing care. Its code places a strong emphasis on the principle of prioritising people, setting out the expectation that registrants should always respond to individual patient needs. NHS England is also developing a best practice catheter care pathway across all settings, which is to be completed by the end of this year.
The provision of suitable care, with the products necessary to deliver that care, is essential for minimising the physical harm related to complications and treatments for continence problems, which can lead to admission to hospital for extended lengths of stay. The NHS will commission pathways of care that ensure early assessment and effective management of incontinence, along with other bladder and bowel problems. These pathways will take account of the impact of urinary tract infections on social, physical and mental wellbeing to reduce expensive pad usage, high-cost complications, and unnecessary hospital and care home admissions.
As we have heard, our focus on the shift from hospital to community will drive more joint working in neighbourhoods between primary care, pharmacies, community healthcare and social care to help people manage incontinence at home. This will help them to access the right self-care and the right professional support so they are not passed from service provider to service provider. It will also reduce their need for emergency hospital admissions, as we heard from my hon. Friend the Member for Nuneaton.
My hon. Friend the Member for Penrith and Solway (Markus Campbell-Savours) made some excellent points about access to facilities, and I know he will keep pressing my hon. Friends in the Ministry of Housing, Communities and Local Government about that issue. His points were echoed by my hon. Friend the Member for Colchester (Pam Cox).
As I stated at the outset, shifting care into community settings is one of our three shifts, and we will shortly be publishing the 10-year plan. Once again, I thank my hon. Friend the Member for Dudley for bringing forward this debate to raise awareness of this important but often overlooked issue.
Prostate Cancer Treatment
Karin Smyth Excerpts(2 weeks, 4 days ago)
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The Minister for Secondary Care (Karin Smyth)
I thank my hon. Friend the Member for Ealing Central and Acton (Dr Huq) for securing the debate, and I thank the other Members who have spoken.
As my hon. Friend has said, more than 50,000 men are diagnosed with prostate cancer every year, and one in eight will be diagnosed with it during their lifetime. I commend her for raising an issue that I know is very personal to her, as she has articulated so well. I am sure that her late father is watching her carefully. She was also right to support her constituent Peter by raising this issue, which affects so many men, and to highlight the number of black and minority ethnic men presenting with the disease. That is something on which we have all campaigned very strongly.
Timely and equitable diagnosis and access to innovative medicines for the treatment of prostate cancer are of the utmost importance. To support faster diagnosis, NHS England has redesigned pathways to maximise capacity. We are also aware of very early-stage trials of the use of artificial intelligence in prostate cancer detection, and we look forward to a formal report on those trials, so that the evidence can be considered carefully.
Carla Lockhart (Upper Bann) (DUP)
The effects of prostate cancer have been well noted tonight, as has the number of men who are affected. About 12,000 die from it each year, more than 300 of them in Northern Ireland. Does the Minister agree that Northern Ireland should be included in the commissioning, and will she undertake to speak to the Health Minister in Northern Ireland about the issue? Does she also agree that this needs to sit alongside a UK-wide prostate cancer screening programme, targeting in particular people with a family history of the disease?
Karin Smyth
We talk regularly with our colleagues in Northern Ireland, and I am always happy to do so. As the hon. Lady knows, this matter is devolved, so it is a matter for Northern Ireland, and we respect the devolution settlement.
Our elective reform plan, published in January 2025, builds on the investments already made with an ambitious vision for the future of diagnostic testing. This will include more straight-to-test pathways, increasing and expanding community diagnostic centres, and better use of technology. With nearly 170 community diagnostic centres up and running, they can take on more of the growing diagnostic demand in elective and cancer care. We will also deliver additional capacity in 2025-26 by expanding some existing centres and building up to five new ones. We will address the challenges in diagnostic waiting times, providing the CT, MRI and other tests that are needed to reduce the elective and cancer waits.
Members know that the National Institute for Health and Care Excellence—we have heard a little about it this evening—is an independent body responsible for assessing whether new licensed medicines can be recommended for routine use in England, based on a thorough assessment of their clinical and cost effectiveness. The NHS is legally required to fund NICE recommended medicines, ensuring consistency of access for NHS patients wherever they live in England.
NICE is able to recommend promising new cancer medicines for use through the cancer drugs funds, which supports patient access while real-world evidence is generated to address clinical uncertainties. Through the cancer drugs fund, NHS patients also benefit from access to cancer medicines from the point of positive draft NICE guidance, accelerating access to clinically and cost effective medicines by up to five months. Through this process, many thousands of patients, including patients with prostate cancer, have been able to benefit from effective new treatments at prices that represent value to the NHS.
The drug that is the subject of this debate, abiraterone, is licensed, as my hon. Friend the Member for Ealing Central and Acton said. It is recommended by NICE for use in the treatment of certain types of metastatic prostate cancer, and it is now routinely available to NHS patients in England in line with the NICE recommendation. NHS England has recently put in place an interim commissioning policy that makes abiraterone available for men with high-risk, hormone-sensitive metastatic prostate cancer, pending the outcome of NICE’s update of its negative guidance. I am pleased that this approach was agreed between NICE and NHS England late last year to ensure uninterrupted access to abiraterone for men leaving the STAMPEDE trial.
My hon. Friend raised particular concerns about access to this drug for men with non-metastatic prostate cancer. First, it is important to note that abiraterone is not licensed by the MHRA for use in this indication, and it is therefore off-label. NICE does not evaluate the off-label uses of medicines, and the drug is also now off-patent and available generically, which means there is no single manufacturer that could sponsor an MHRA licence application or NICE evaluation. It is therefore for NHS organisations to take decisions on funding based on the available evidence.
NHS England considered abiraterone for the treatment of non-metastatic prostate cancer through its clinical prioritisation process last year. Through this process, NHS England concluded that evidence supported the routine commissioning of the drug in this indication. Approximately 7,000 men per year could be eligible for this drug, and it is estimated that it would cost an additional £20 million per year to fund that.
While, as my hon. Friend said, there may be some cost savings in the pathway from preventing the disease’s progression, these are unlikely to materialise for about five years and would not impact the up-front costs of the £20 million per year for the additional out-patient monitoring and drug cost. I had not heard the figures she outlined, but I will get back to her on some of the questions she asked, and it would be helpful to know where those figures are from.
Unfortunately, it has not been possible to identify the necessary current funding to support the commissioning of abiraterone for this purpose or any other treatments in this prioritisation round. I know that is disappointing for those affected, and I want to acknowledge that this is a really difficult and unusual situation. However, I want to assure my hon. Friend and other hon. Members that the funding position for this treatment does not mean that there are no treatment options. The NICE guideline on prostate cancer recommends the treatment of non-metastatic prostate cancer with surgery and radiotherapy.
I want to assure hon. Members that NHS England is keeping this position under review, and would reconsider funding for abiraterone for non-metastatic prostate cancer if the funding position changes. Earlier this month, NHS England met Prostate Cancer UK, which shared its financial model of the expected cost impacts. NHS England is reviewing this in more detail, and I encourage it to continue those discussions.
In closing, I recognise how hard it is when patients want access to effective treatments. I also recognise the distress and worry it causes not only for patients, but for their families and friends. The Government are committed to ensuring that we provide access to the most innovative and effective medicines, but it has to be in a way that is sustainable and affordable for the NHS. It is right that NHS England continues to engage with Prostate Cancer UK, and I know that my hon. Friend and other Members will keep an eye on this and similar issues with drugs coming forward. The national cancer plan will seek to improve every aspect of cancer care, to better the experience and outcomes of people with cancer. Our goal is to reduce the number of lives lost to cancer over the next 10 years. I am grateful for the opportunity to respond to the debate this evening.
Question put and agreed to.
Oral Answers to Questions
Karin Smyth Excerpts(2 weeks, 4 days ago)
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Sadik Al-Hassan (North Somerset) (Lab)
The Minister for Secondary Care (Karin Smyth)
Increasing the resilience of the UK medical supply chain is a key priority. I regularly meet the team to routinely take action to mitigate supply issues, including requesting additional stock, identifying alternative global sources and issuing management advice. Although the Department has no plans to conduct a specific review, we constantly work to identify and take forward further actions to reduce the impact of medicine shortages, including targeted winter monitoring.
Sadik Al-Hassan
Having worked in community pharmacies for nearly 20 years, I have witnessed at first hand the pain that medicine shortages can cause North Somerset patients and their loved ones. Will the Minister meet me, along with my hon. Friend the Member for Exeter (Steve Race) and other members of the all-party parliamentary group on pharmacy, to discuss the outcome of our inquiry into these shortages?
Karin Smyth
I congratulate my hon. Friend and constituency neighbour on his dedicated career in community pharmacy, and thank him for the expertise that he brings to the work of the all-party parliamentary group to help Members understand the impact of this issue on patients and pharmacies. I am planning to hold a parliamentary event on the subject in the autumn, and I am keen to work with the APPG to make it a success for all Members.
Mr Richard Holden (Basildon and Billericay) (Con)
Supply chain problems are just one of the many issues that are having an impact on community pharmacies. My local pharmacy in Noak Bridge is one of them, but it is also being hammered with national insurance increases, and the combination of these issues means that its long-term viability is at stake. Will the review that the Minister has mentioned include all the impacts on community pharmacies that are affecting their long-term viability?
Karin Smyth
The long-term viability of pharmacies and, indeed, the whole NHS was under threat from the right hon. Gentleman and his party, but thanks to this Government, it is being made fit for the future. This is a serious issue for all our constituents, and we want to make the system work better. The right hon. Gentleman will see from the 10-year plan that we will make the NHS fit for his constituents, mine and those of every other Member.
Helen Morgan (North Shropshire) (LD)
Across the country, community pharmacies struggle not only with supply chain problems but with dispensing some of the critical medicines for our constituents at a loss. I was concerned to read that higher prices for United States pharmaceuticals are on the table for the next stage of trade negotiations with Donald Trump, because an additional £1.5 billion would cost both the NHS and our community pharmacies dear. What steps is the Department taking to ensure that the NHS, and the vital medicine supply on which we rely, will not be used as a bargaining chip in a trade deal with a highly unreliable US President?
Karin Smyth
The hon. Lady has asked an important question about the pharmaceutical industry, which is key to the country’s growth mission and to supporting all our constituents and the entire country. As we know, my right hon. Friend the Prime Minister is currently attending the G7 summit. We have good relationships with America, and the Department is working closely across Government to ensure that the same stability of supply remains for our constituents.
Naushabah Khan (Gillingham and Rainham) (Lab)
Olivia Blake (Sheffield Hallam) (Lab)
The Minister for Secondary Care (Karin Smyth)
The Sunbeds (Regulation) Act 2010 banned the use of commercial sunbeds for under-18s, requiring businesses to prevent under-age use. The Department has commissioned the Committee on Medical Aspects of Radiation in the Environment to review the Act, including the effectiveness of the under-18 ban.
Olivia Blake
According to Cancer Research UK, 86% of melanoma skin cancer cases are preventable. My constituent Charlotte, who has stage 4 melanoma, is leading a campaign alongside Melanoma Focus to get better enforcement for the ban on sunbeds for under-18s and to stop the use of harmful melanotan II products such as tanning nasal sprays and injections. For under-35s, just one session on the sunbed is enough UV exposure to increase the risk of melanoma to 59%. Prevention is better than cure. Will the Minister meet us to discuss the effectiveness of the ban and preventive measures such as access to free sunscreen at events?
Karin Smyth
As someone who was diagnosed myself with an earlier stage melanoma, I really commend the work of my hon. Friend’s constituent. I never used sunbeds and I spent holidays in my youth in Ireland, so I never saw much sun either—sorry to the Irish tourism board. As my hon. Friend says, it is an overwhelmingly preventable cancer, including by using sunscreen, better clothing, shading and no sunbeds. It is up to event organisers to provide sunscreen at events, but my hon. Friend is right. I want to personally thank Melanoma Focus for the support it gave me during my diagnosis. There are great charities out there to support people. I am sure a Minister will be in contact with my hon. Friend and her constituent soon to highlight the prevention aspects of this disease.
Cameron Thomas (Tewkesbury) (LD)
Until his recent death, my constituent Luke Webster had lived with alternating hemiplegia of childhood. His life was short and he spent much of it being moved between different care facilities, to the frustration of his family. At one such facility, Luke was abused. Will the Minister meet me and Luke’s mother to discuss improved safeguards—
Mike Martin (Tunbridge Wells) (LD)
The Minister for Secondary Care (Karin Smyth)
More patients are now getting world-leading testing technology in the NHS as part of our mission to revolutionise cancer care in this country. The Government are spending £600 million a year in capital on diagnostics, including for the first time funding for the automation of histopathology laboratories to improve productivity. We are also funding pathology networks to reach digital maturity by 2026, which will reduce unnecessary waits and repeated tests.
Mike Martin
My constituent Julian noticed that he had a mole on his chest that was growing and bleeding. Members of his family had died from skin cancer, so he was very concerned and went to his GP. He was referred to the Kent integrated dermatology service and was told that the results would come back in four weeks. They came back in 17 weeks. I know that this issue is of personal concern to the Minister, so would she please investigate what happened and write to me?
Karin Smyth
The hon. Member raises an awful case on behalf of his constituent. Of course, our targeting of waiting lists includes diagnostics. What happened in that case should not happen anywhere, and I will ensure that he gets a response as soon as possible.
Mr Bayo Alaba (Southend East and Rochford) (Lab)
Paulette Hamilton (Birmingham Erdington) (Lab)
The Minister for Secondary Care (Karin Smyth)
Reducing waiting times for cancer diagnosis remains a key priority. Under this Government, an extra 99,000 patients have had cancer diagnosed or ruled out. This has been supported by investment, including in Cancer 360—a digital innovation that brings patient data into one central platform—and in NHS England’s cancer innovation open call to fast-track cutting-edge interventions into practice. Our forthcoming national cancer plan will set out how we will speed up cancer diagnosis even further.
Mr Alaba
Our Labour Government have recently invested in a new state-of-the-art linear accelerator machine in Southend hospital. The machine is the first of its type in the country and will drastically improve cancer treatments. Please can the Minister outline how record levels of investment, such as in the LINAC machine and as announced at the spending review, will finally mean that the NHS will be there when we need it?
Karin Smyth
I am delighted that my hon. Friend’s constituents will benefit from the £70 million investment. These machines are game changing and will reduce the number of visits for his constituents. They are also more reliable, which gives more capacity to the system. That is better for staff, as there will be less appointment cancellations. That is exactly the sort of thing we want to see more of, and we are delivering that under this Government. It is the result of our drive to reduce long waits and treat more people quicker. That was reinforced in last week’s spending review, and it is exactly what his constituents deserve.
Paulette Hamilton
Early diagnosis of less survivable cancers is vital if survival rates are to improve. What assessment has the Department made of the report by the all-party parliamentary group on less survivable cancers that looks at earlier detection and faster diagnosis, and what steps are the Department taking to deliver on this?
Karin Smyth
My hon. Friend is right to highlight that issue. I commend her great work not just on the APPG but on leading the Health and Social Care Committee on behalf of its Chair, the hon. Member for Oxford West and Abingdon (Layla Moran). She is right to highlight that it is a priority for the Government to diagnose cancers earlier and improve survival rates. That is particularly important for the group of people with rare cancers. The APPG’s report will inform the development of our national cancer plan, which will seek to include all aspects of care throughout the entirety of the cancer pathway.
Alison Bennett (Mid Sussex) (LD)
Part of a successful cancer journey is swift cancer treatment as well as swift diagnosis. My constituent Catherine was diagnosed last year with stage 3 breast cancer. She had a mastectomy and went through chemotherapy. She was then meant to begin a course of radiotherapy in December, but as of May that still had not begun. What can the Department do to ensure that those unacceptable delays do not happen and lives can be saved?
Karin Smyth
Many hon. Members across the House rightly highlight the actual experience of people throughout the entire pathway. We have heard about the investment we are making in machines and in staff to ensure, on exactly this point, that people get not just that faster diagnosis—that is so important, particularly if cancer is ruled out—but faster care across the entire pathway. The majority of people on waiting lists are on them for diagnostics, which is exactly why we are investing more in capital and investing in staff to ensure that the process is quicker and better for patients. If the hon. Member wants to write to me about any particular issues, I will obviously respond to her.
Tom Gordon (Harrogate and Knaresborough) (LD)
Every 17 minutes, someone in Yorkshire is told that they have cancer. Tomorrow, I will be launching a report for Yorkshire Cancer Research, which is based in my constituency, that will set out key recommendations. Will the Minister meet us to talk about how we can feed them into the national cancer plan?
Karin Smyth
The work that the hon. Member is doing locally with that group is essential. I will ensure that we have a good response for him, whether it is meeting me or a colleague.
Daniel Francis (Bexleyheath and Crayford) (Lab)
The Minister for Secondary Care (Karin Smyth)
I thank my hon. Friend for that important question. The Government are carefully considering the work of the patient safety commissioner and her report, which sets out the options for redress. This is a complex issue involving input from different Government Departments. We will provide a further update on the commissioner’s report soon.
Graham Leadbitter (Moray West, Nairn and Strathspey) (SNP)
My constituency, in Scotland, has a significant shortage of health and social care workers, despite extensive efforts to advertise recruitment to get people in, as replicated in parts of England, Wales and Northern Ireland. The rug has been pulled out from under that by the changes to immigration policy and visas for that sector. Will the Secretary of State commit to pushing this harder in Cabinet to ensure that we can have more geographic and sectoral visas?
Peter Lamb (Crawley) (Lab)
Karin Smyth
Such contraceptives are an emerging technology that will be subject to clinical and other relevant assessment before being considered for use in England. The Government remain committed to ensuring that women can access their preferred method in a timely manner. A range of contraception is available free of charge from a range of settings. That includes a copper coil, which is a non-hormonal, non-steroidal contraceptive device.
Sarah Bool (South Northamptonshire) (Con)
In Prime Minister’s questions last week, I raised the need for a universal national screening programme for type 1 diabetes. Will the Secretary of State agree to meet me to discuss this, so that it could form part of the 10-year plan, given that it fits so neatly into prevention of issues such as diabetic ketoacidosis over treatment?
Alice Macdonald (Norwich North) (Lab/Co-op)
Infertility is a medical condition that affects one in six couples in the UK, but access to NHS treatment is a postcode lottery, with less than 10% of ICBs in England offering the recommended three cycles of IVF. Does the Minister agree that we need to end that postcode lottery, and will she meet me and campaigners such as Fertility Action to discuss how we can end it for good?
Karin Smyth
In the light of the broader pressures and changes in the NHS, we have been considering the ambitions on fertility services and fairness for all couples. The National Institute for Health and Care Excellence is reviewing its fertility guidelines, which will be the clinical standard for the future. I know that my hon. Friend will ensure that she and the group she talks about keep an eye on that, and that she will work with them. I am happy to keep working with her on how we best support ICBs to improve their local offer.
Mr Joshua Reynolds (Maidenhead) (LD)
I have raised with Ministers before my concerns about the closure of St Mark’s walk-in urgent care centre in Maidenhead. Frimley ICB has confirmed yet again that it will not reopen the centre, against the will of the majority of Maidenhead residents. Will the Secretary of State meet me and local campaigners to see how we can finally get St Mark’s walk-in centre back open after five years of closure?
Will Stone (Swindon North) (Lab)
Will the Minister look into minimising the pain of patients going through hysteroscopy and biopsy procedures by requesting that medical professionals fully brief them on anaesthetics and pain relief in advance of procedures to ensure that they can plan accordingly?
Karin Smyth
My hon. Friend raises an important question. We are committed to improving women’s experience of gynaecological procedures, including hysteroscopies. Women should be provided with information prior to their procedure so that they can make an informed decision about the procedure and pain relief options, including local or general anaesthetic. He will probably make further representations, which we will certainly look at.
Lincoln Jopp (Spelthorne) (Con)
One of the ways in which the Secretary of State has reduced the waiting list is by turbocharging the use of the private sector since January, meaning that half a million people have been treated in irreducible spare capacity. Has that experience elicited any learnings that the Secretary of State is able to take into the wider reform agenda for the NHS?
Spending Review: Health and Social Care
Karin Smyth Excerpts(3 weeks, 2 days ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
The Minister for Secondary Care (Karin Smyth)
With permission, I would like to make a statement on the outcome of the spending review for the Department of Health and Social Care.
This Government were elected on a manifesto to fix our broken NHS and make it fit for the future. Our job is twofold: first, to get the NHS back on its feet and treating patients on time again; and secondly, to reform the service for the long-term so that it is fit for the future. That is why, in her autumn Budget, my right hon. Friend the Chancellor took the necessary decisions to give health and social care a record uplift in day-to-day spending at the conclusion of the first phase of the spending review. The Department for Health and Social Care received a cash injection of £26 billion covering day-to-day spending and capital investment in 2025-26, compared with the 2023-24 out-turn.
All Opposition parties have rejected that investment and those changes to repair the damage done to our NHS and move it forward. They have rejected two above-inflation pay increases for our NHS staff, the recruitment of 1,700 more GPs and the agreement of a GP contract for the first time since the pandemic, the biggest investment for hospices in a generation, the biggest expansion of carer’s allowance since the 1970s, a boost for older and disabled people through the disabled facilities grant, and the biggest real-terms increase to the public health grant in nearly a decade.
We have also given pharmacies the biggest funding uplift in years, ensured that women across the country can access the morning after pill free of charge, frozen prescription charges for the first time in three years, enabled an extra 3.5 million appointments for operations, consultations, diagnostic tests and treatments—reaching and surpassing our manifesto pledge seven months early. I can update the House on waiting lists, which, as of this morning, have fallen by over 30,000 compared with last month, amid a reduction of 232,000 since this Government took office.
I could go on, but I have only 10 minutes, Madam Deputy Speaker, and I would not like to try your patience, so I will make this point briefly. To govern is to choose, and anyone who opposed the decisions that the Chancellor took in her Budget must tell us what they would have subtracted from that list. We cannot spend money if we do not raise it.
As the Minister of State for Secondary Care, I regularly hear appalling anecdotes from colleagues across the House whose local hospitals, GP surgeries and community services are crumbling, with rusty equipment, leaky pipes and buckets catching rainwater. Phase 1 of the spending review has allowed us to arrest 14 years of shocking neglect and undercapitalisation in the NHS, with a record capital investment of £13.6 billion in 2025-26. [Interruption.] The Conservatives do not like it, but I will go on. That money has gone towards repairing our crumbling hospitals, supporting over 1,000 GP surgeries to modernise their buildings, and installing state-of-the-art scanners across the NHS estate, including the latest linear accelerator machines. However, as my right hon. Friend the Secretary of State has made clear, investment must come with reform. This year we have unveiled our plan for change, our elective reform plan, our urgent and emergency care plan and a crackdown on agency spend in order to reinvest £1 billion into the frontline.
Yesterday, my right hon. Friend the Chancellor set out the conclusion of phase 2 of the spending review, setting budgets that will enable us to make firm plans to deliver on the people’s priorities in the coming years, while going further and faster on reform. Our settlement increases day-to-day spending on health, bringing the budget for my Department and our NHS up to £232 billion by 2028-2029. That means £29 billion more day-to-day funding for the NHS in England, in real terms, than in 2023-24. We have also secured the largest-ever health capital budget, with a £2.3 billion real-terms increase in capital spending by 2029-30, compared with 2023-24, representing a more than 20% real-terms increase by the end of the spending review period.
Let me hammer this point home: investment must be matched by reform. This will be a critical year for the NHS as we achieve better value for taxpayers, who must see their money being spent well and delivering results. We would rather take those difficult decisions now, to save our NHS so that it is there for future generations. NHS England is a top-down organisation—the biggest quango in the world—with a less efficient system than the previous Government inherited in 2010 and twice the headcount at the centre. That is why my right hon. and learned Friend the Prime Minister announced in March that we will bring together NHS England and the Department of Health and Social Care to form a new joint centre. That will put an end to duplication and enable substantial efficiency savings, while bringing the management of our NHS back under democratic control. We will also unlock £17 billion of savings over the spending review period through 2% annual productivity growth in the NHS—money that will be either reinvested in the frontline or used to support radical transformation to make the health system more agile and efficient.
Our elective reform plan set out how we will ensure that by the end of this Parliament 92% of patients will not have to wait more than 18 weeks for elective care. This settlement will drive us further towards that goal, with over £6 billion of additional capital investment over five years across new diagnostic, elective and emergency and urgent care capacity, which could deliver more than 4 million additional tests and procedures.
We will build on the record capital investment from phase 1 to repair the NHS estate. That means continuing the delivery of 25 new hospitals; investing £30 billion in maintenance and repairs, with £5 billion of it to address the most critical building repairs; and reducing by half the number of hospitals containing RAAC—reinforced autoclaved aerated concrete—over this Parliament.
This spending review provides for an increase of over £4 billion for adult social care in 2028-29 compared with 2025-26, including an increase in the NHS contribution via the better care fund. Local authorities with responsibility for adult social care will also benefit from wider reforms to better align funding with need, multi-year settlements and simplification of the funding landscape that enables them to plan more effectively. Last but not least, we have taken steps to simplify targets and better monitor delivery, and we will continue to work with local systems to improve financial and operational performance, to get the most from every penny.
A key part of our 10-year plan is driving progress on the three shifts: from analogue to digital, hospital to community and treatment to prevention. On digital, we will invest up to £10 billion in technology and transformation, to start making the NHS app a digital front door and deliver a single patient record. We will work in partnership with the Wellcome Trust to launch the world’s first health data research service, backed by £600 million, to accelerate the discovery of lifesaving drugs.
On primary and community care, we will invest in training thousands more GPs, helping to bring back the family doctor through millions of extra appointments a year; in 700,000 additional dentist appointments annually; in at least 8,500 extra mental health staff by the end of this Parliament; and in mental health support teams for every school within five years. Finally, on prevention, our world-leading immunisation programmes will be supported by £2 billion, and we will invest £80 million in tobacco cessation programmes and our Tobacco and Vapes Bill.
I want to end by thanking the Chancellor for her unwavering commitment to getting our NHS back on its feet. Fixing broken Britain will not be easy, but nothing that is worth doing ever is. Today I have set out how every penny from the public purse will be matched by reform, to make our NHS fit for the future. We remember we were elected on a manifesto to end sticking-plaster politics and do the hard yards of fixing our country, and we will never betray that promise to the British people. The public have a right to know how public money will be spent, and this is something we take extremely seriously. They can put their trust in this Government, because we have fixed the NHS before, and with the help of this Chancellor, we will fix it again. I commend this statement to the House.
Madam Deputy Speaker (Caroline Nokes)
I call the shadow Secretary of State.
Edward Argar (Melton and Syston) (Con)
Yesterday, yet again, we saw the Chancellor do what the Labour party always does: default to high spending, more borrowing and higher taxes, leaving the public finances vulnerable. The Minister has spoken of additional funding for the NHS. To use the same comparison as the NHS England chief executive, the NHS budget will now be roughly the equivalent of the entire GDP of Portugal, yet we are still none the wiser as to how the Government actually intend to use most of the money—there is no real detail and no real plan. Just last September, the Prime Minister pledged that there would be no more money without reform. Despite the Minister’s words, that is exactly what the Government have done. There is still no plan for reform, and the Secretary of State is unwilling to set out the bold reforms that are needed.
Despite 14 years in opposition and nearly one year in government, the Labour party has failed to come up with a plan for the NHS, with the exception of the abolition of NHS England, which will not happen for years and appears to be delayed and in chaos. Ministers respond to every written parliamentary question about it by saying they cannot set out the savings, how the people will change or how the structure will change at this stage—yet again, there is still no plan. We have been very clear that where the Government are wrong, we will oppose it, but where they get something right, we will work constructively with them. That includes reform, but there is still no reform for us even to consider supporting.
Can the Minister tell us where the £29 billion she set out will be spent? The chief executive of the NHS Confederation said yesterday that increases in NHS staff pay will
“account for a large proportion”
of the funding increase. The former NHS chief financial officer echoed that view at the Health and Social Care Committee in January, saying that pretty much all the last tranche of additional spending was absorbed by pay rises, national insurance and inflation. Can the Minister confirm how much the pay offers from the independent pay review bodies, alongside increased national insurance, will cost, how much of this funding will have to go to cover that and how much will actually make it to the frontline to improve patient services?
The Minister touched on the aim of meeting the NHS 18-week target for hospital waiting times within this Parliament. Of course, we wish the Government well in achieving that and hope they succeed, but just yesterday The Times reported that internal departmental modelling showed they are not on track and could only come close to meeting the target with “implausible” and “over-optimistic” assumptions. The independent Institute for Fiscal Studies agreed. Can the Minister set out how the Government will meet that target? Again, where is the plan? We need a plan, not empty rhetoric.
It is clear that the NHS needs reforms, not just more funding, so when will the 10-year plan finally be published? Will it be before the one-year anniversary of the Labour party being in government? Will it be like their elective reform plan: simply a reheat of the plan that Sajid Javid brought forward in 2022, with nothing new? The Secretary of State needs to be more ambitious—words that I suspect will never be echoed by the Prime Minister or his team in No. 10.
The capital budget remains broadly flat in real terms from this year onwards. The Minister has said she wishes to continue with the new hospitals programme and invest in technology to boost productivity, but it is unclear how that can be achieved with this settlement. These are not my warnings but those of respected independent think-tanks, including the Nuffield Trust and the King’s Fund. The Chancellor’s plan is clear—indeed, not one Treasury Minister has ruled it out: more tax rises are coming.
Finally, and importantly, we have seen social care largely neglected again by this Government. There were just two sentences about it in a four-page statement. Social care deserves better. The Minister knows very well that we cannot improve the NHS without social care working well. Earlier today I met with social care providers. They want to see reform, yet the Government have apparently abandoned cross-party talks on social care reform for an independent commission led by the very able Baroness Casey, who is still doing her Home Office work on grooming gangs and is yet to be full time on this commission, which has a deeply unambitious finishing time of 2028. When will Baroness Casey be full time on the commission? These providers were clear that they want a seat at the table when better care funds are distributed by the NHS—they want to have their voices heard in decision making on that funding. Will the Minister agree to that?
Finally, the Chief Secretary to the Treasury said he has modelled his assumptions on continued trends in local government finance and local government precepts —in other words, a 5% uplift in the precept. However, a large number of counties are now controlled by Reform—whose Members are, as ever, notably absent from the Chamber when we talk about health and social care—who have pledged no tax rises whatsoever in their councils. If they do that, what is the Minister’s plan to make sure social care is funded? As ever, the Government have gone for the headline announcement, but sadly without a plan, without delivery and with no real reform to benefit patients.
Karin Smyth
I am entirely unclear, after that run-through of a number of different issues, whether the Conservatives welcome the extra investment in the NHS or oppose it. We know they oppose the means of funding it, but after that, I have no idea. At some point, they have to make up their mind whether they support that extra investment or not. As I said in my statement, if they do not, what out of the list of the improvements that we have already made would they not do?
As Lord Darzi made clear, under the Conservatives’ watch for 14 years the NHS was broken. Staff were left with out-of-date equipment and unable to do the job they needed to do. We agreed with Lord Darzi’s diagnosis, but Conservative Members have still not said whether they agree with it, or apologised for the state they left the system in. I do not know whether the right hon. Member for Melton and Syston (Edward Argar) has not been able to read the elective reform plan or the urgent emergency care plan that we published recently. It is up to him to read those plans properly and try to understand what is happening.
The right hon. Gentleman has started to do my job for me again, because he cites various think-tanks and people who have said that this cannot be done. Well, I can tell him that we were told, for example, that waiting lists would not drop in April because of seasonality, but we have shown—by keeping a relentless focus on the system, working closely with leaders on the frontline and being clear with officials in the Department—that it can be done. That is what we heard this morning.
We are taking a relentless approach to spending, line by line, throughout the NHS and the Department of Health and Social Care. We have rolled up our sleeves and we will not accept putting more and more taxpayers’ money into a leaky system, which is what happened under the right hon. Gentleman’s Government. If he had read the patient satisfaction survey, he would know that taxpayers across the country, in all our constituencies, love the NHS. They understand that the Tory party broke it and that it will take long time to fix. They also know that they are paying more taxes for it and getting a worse service, and they expect us to do much better. That is what we have already shown we are doing, and what we will continue to do.
I have outlined the capital that is going into the new hospital programme, which we are committed to, and we have already seen increases in diagnostic capability and surgical hubs throughout our constituencies. We will continue to do more of that. I agree with the right hon. Gentleman that it is critical to ensure that social care is supported alongside the NHS. That is why £4 billion is going into social care through our colleagues in the Ministry of Housing, Communities and Local Government, and as he knows, Louise Casey will publish her interim report next year.
We are clear that fiscal responsibility does not stop at the Treasury or down in Victoria Street with the Department of Health and Social Care. It is important that everybody in the NHS is aware that we are determined to fix the NHS and put it back on a sustained footing. There is record investment; that is our commitment to people, and I know from the people I worked with in the health service over many years that they are determined to make it better. Morale sank to an all-time low under the Conservative party, but we are raising that morale, and we will continue to work with the system to make sure that it is fit for the future.
Alex McIntyre (Gloucester) (Lab)
I welcome my hon. Friend’s statement about the record funding going into our NHS. We are already seeing the benefit in my constituency, with millions of pounds going into investment in our hospital; that is so desperately needed to get waiting lists down. People were left behind by the Conservative party, and I note that there is still no apology to any of my residents who were left in pain and agony for years and years under their watch—not one word of an apology.
One of the big challenges facing my constituents is accessing an NHS dentist—my hon. Friend knows about that from the time she came to visit me during my campaign. I am campaigning to get new dentists for my constituents in Gloucester, so will she help me to get a meeting with the relevant Minister to ensure that some of this record funding comes to Gloucester to get an NHS dentist for all my constituents?
Karin Smyth
As my hon. Friend said, this is a health area that I know well, and he has been the most amazing campaigner for Gloucester and the health service there since he became the Member of Parliament. He is absolutely right: dentistry is a key worry. It is one of the key areas that the Conservative party neglected for 14 years. That is why it was a manifesto commitment, and why I was able to outline today that meeting the target of 700,000 is front and centre, and part of the plan as we go forward. I know that the Minister for Care, who is responsible for dentistry, is keen to meet many hon. Members, and I will make sure he has heard that request.
Madam Deputy Speaker (Caroline Nokes)
I call the Liberal Democrat spokesperson.
Dr Danny Chambers (Winchester) (LD)
To reiterate: after years of Conservative mismanagement, the NHS is in crisis, with patients left waiting hours for ambulances, women giving birth in unsafe maternity units, and children turning up at A&E with rotting teeth because an NHS dentist cannot be found. That is the Conservative legacy, and they must never be trusted with our health service ever again. So yes, we welcome this funding boost—we really do—and we agree that funding must come with reform, because unless this funding is targeted properly, it will not bring the change that patients urgently need.
When it comes to reform we need to talk about fixing social care, because putting more money into the NHS today will be like pouring money into a leaky bucket. Last year, the Secretary of State for Health and Social Care stated that £1.7 billion a year is wasted because patients who are medically fit for discharge cannot leave hospital, simply because no care is available to support them at home. The hospital in Winchester that supports both your constituency, Madam Deputy Speaker, and mine has up to 160 people waiting to be discharged at any given time, and they would be better cared for with social care packages.
We need urgent action and a higher minimum wage for care workers. We need proper respite and financial support for family carers, and a clear commitment to conclude the social care review, hold cross-party talks, and deliver the real reform that the Minister has been talking about. We also need to tackle the crisis in primary care, because that is where prevention happens and where pressure on hospitals is eased. Will the Minister confirm that the funding boost will deliver the extra 8,000 GPs that are needed to guarantee everyone an appointment within seven days, or within 24 hours for urgent cases? Can she also confirm that the funding will bring dentists back into the NHS, and bring an end to dental deserts? That will not happen without urgent reform of the NHS dental contract, which is outdated, unworkable and driving dentists out of the system.
Finally, we cannot ignore the shocking state of NHS buildings, including our hospital in Winchester. It is an outrage that overcrowded hospitals must close operating theatres due to unsafe ceilings and other health and safety issues. I urge the Minister to spend the money where it matters: on primary care, on social care, and on ensuring that our existing NHS buildings are fit for purpose.
Karin Smyth
I thank the hon. Gentleman for welcoming, on behalf of his party, the commitment that the Chancellor has made and the extra funding that she has identified, but I think his party still opposes the way in which we have raised the funding to do just that. It is good to have your cake and eat it, but we are clear that the funding does come with reform. As I said in my statement, we are committed to improving the front door—primary care—as well as social care and discharge. That is why the NHS contribution, as part of the settlement to the better care fund, increases. He will be aware that we previously revised the better care fund to make it better and more targeted on discharge, which is important.
The urgent and emergency care plan that we published a couple of weeks ago also confirms our recognition that flow through the hospital system is important for patients and staff; we must ensure that we do not face that continued crisis of corridor care over many years. We are committed to the fair pay agreement, and our colleagues in the Ministry of Housing, Communities and Local Government will make more statements in the coming weeks about how that will work.
Yasmin Qureshi (Bolton South and Walkden) (Lab)
I draw the attention of the House to my entry in the Register of Members’ Financial Interests, as chair of the all-party parliamentary group for dentistry and oral health. Access to NHS dentistry is in crisis, including in my constituency. New analysis by the British Dental Association shows that the share of NHS funding spent on dentistry has more than halved since 2010, from over 3% to just 1.5%. I know how committed the Government are to reforming the dental contract, but the Public Accounts Committee made it clear that reform will work only if it is backed by proper, sustainable funding. Will the Minister ensure that NHS dentistry gets a fair share of the £29 billion announced in the spending review, so that we can end forever the crisis that is affecting millions across the country?
Karin Smyth
I thank my hon. Friend for her question and for the work she does to support NHS dentistry as part of the all-party group. As I have said, this issue is of huge importance to our constituents, and the shocking state in which the Conservatives left dentistry is there for all to see—particularly the shocking state of children’s oral health. That is why we acted rapidly to introduce the toothbrushing campaign—which, if I remember rightly, was ridiculed by Conservative Members when we discussed it in opposition—and the arrangement with Colgate to ensure that we improve children’s oral health. We are absolutely committed to reform of the contract; the Minister for Care is working hard on that and he will continue to update the House regularly. It is our confirmed commitment, as I have reiterated today, to increase access to dental services.
Sir Edward Leigh (Gainsborough) (Con)
Our spending on the NHS is now as much as the entire GDP of Portugal. We used to be a country with an NHS attached to it, but we are almost becoming an NHS with a country attached to it. Of course we would welcome this spending if we got the same outcomes that people get in civilised countries, like the Netherlands or Australia, but every time I mention fundamental reform, I am dismissed as wanting to bring in privatisation, so it is hardly worth raising that issue. Australia has an extremely successful pharmaceutical benefits scheme; I know that the Secretary of State for Health and Social Care went out there, and I have talked to Australian doctors about it. Will the Minister at least look at the successful outcomes, including some of the highest life expectancies in the world, that are being delivered in countries like Australia and the Netherlands, to see how we can deliver better outcomes? There is no point spending more money if people’s only right is to join the back of a queue.
Karin Smyth
I was expecting the right hon. Gentleman to talk about the funding model, and I am disappointed that he did not; it is something that he has talked about for many years. I do not know the details of the Australian model, but will ensure that he gets a proper answer. I am always happy, as is my right hon. Friend the Secretary the State, to look at models from across the world. We want to learn from the best, and we want to deliver the best in the NHS.
The Conservatives seem to have an obsession with input into the health service. It is true that the last Government put more money in, but it went into a leaky bucket and they got nothing out. This Government have taken a different approach. We are not just taking money from the Treasury, handing it out and then coming back for more. We are being very clear with providers and the system more generally. My right hon. Friend the Secretary of State is talking at the NHS Confederation conference this afternoon; we are working with them to ensure that we look not just at the inputs, but at what goes on in the system. We want to ensure value for taxpayers’ money in all our constituencies. There are outstanding examples of both financial and operational good practice across the country. We want to take the best to the rest, and make the best of every taxpayer pound.
Rachael Maskell (York Central) (Lab/Co-op)
The Minister has demonstrated the difference that a Labour Government make to our NHS, and to the people of our country. As she mentioned, reform is needed. May I draw her attention to the report by the independent Commission on Palliative and End of Life Care? Around 100,000 people cannot access hospice care, and too few people are able to access specialist palliative care. The report demonstrates a new system of end of life and palliative care that will transform people’s end of life experience. To go alongside the reform agenda, will she ensure that we invest in that precious time in people’s lives, and deliver a comprehensive palliative care service?
Karin Smyth
My hon. Friend is right to highlight end of life care. We know it has been neglected. I worked on it during my time in the health service, over 15 years ago, and I feel very passionately about it. It is important that we support people. We must have a system that allows people to have those conversations, and that ensures there are options for people throughout the pathway of their life. The Minister for Care is working hard to ensure that happens as part of our overall development of the health service over the next 10 years.
James Wild (North West Norfolk) (Con)
Will the Minister confirm that the funding envelope that she set out in a letter to the Queen Elizabeth hospital in King’s Lynn in April stands unchanged after this spending review?
Terry Jermy (South West Norfolk) (Lab)
I warmly welcome the news that waiting lists are continuing to fall, not by chance, but because of the choices made by this Government. As the Minister will know, both the hospitals that serve my constituency have reinforced autoclaved aerated concrete, and both have received funding, but as I visit GP surgeries and dentists, it is clear that there is a link between crumbling buildings and the availability of appointments. Will the Minister reassure me that primary care in particular will continue to be supported by upgrades to buildings?
Karin Smyth
I thank my hon. Friend for the great work that he is doing to support progress on work at the RAAC hospitals in his constituency. He makes the excellent point that such issues exist not only in hospitals. As our settlement makes clear, we understand the strain in primary care, as well as in mental health services and community services, which often do not get discussed. When we publish the 10-year plan later in the summer, he will see that the move towards community and neighbourhood health services will be front and centre of what we want to achieve over the next 10 years.
Caroline Voaden (South Devon) (LD)
Like my hon. Friend the Member for Winchester (Dr Chambers), I welcome the increased investment, and the attention that the new Government are giving to the NHS. I would like to turn our attention to dentistry. My constituency of South Devon is a dental desert. I welcome the announcement of 700,000 extra dental appointments, but we have lost three dental surgeries since the election last year, and more are on the brink. The Government have been in office for a year now, and have talked about reforming the dental contract with the NHS. If that contract is not reformed, we will lose so many dentists that we will never be able to catch up. How long will it take the Government to announce a newly reformed contract with NHS dentistry, so that we can start increasing the number of appointments, and saving the dentist surgeries that we have left?
Karin Smyth
The hon. Lady is right to highlight the shocking state that dentistry was left in by the last Government. They could have reformed that contract at any time over the past 14 years. We were ready to do that in 2010, but things worked out differently; we left office, and the Liberal Democrats and the Conservatives between them did not reform the contract. The Minister for Care is working at pace to ensure that happens, and we will update the House as soon as possible.
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
I very much welcome yesterday’s statement, the funding, and the fact that the funding will go on for several years. Does the Minister agree that we depend on the people in our NHS? Will she join me in congratulating Dr Cameron and all the teams at the West Suffolk hospital, who, by adopting a whole-hospital approach, have abolished corridor care and improved the hospital’s throughput, using a model that could be widely adopted?
Karin Smyth
I am very happy to thank Dr Cameron and the whole team. As ever, with his vast experience of the health service, my hon. Friend makes an excellent point. We are reliant on clinical and managerial staff to make the system better. I know, and he knows, how low morale has been; Lord Darzi made that point very clear, and we cannot over-estimate how difficult that is for staff. That is why we have reached two record inflation-beating pay settlements for staff, and importantly, we have supported the independent process, because we want to work with staff to make things better at all levels. My hon. Friend gives an excellent example of how, by working with excellent clinical leadership and excellent managers, we can bring the best of the NHS to the rest of the NHS.
Andrew Rosindell (Romford) (Con)
The Minister will know that I too want to abolish corridor care at the Queen’s hospital in Romford. I thank her deeply for meeting me on Monday, with the chief executive of the NHS trust for Barking, Havering and Redbridge, Matthew Trainer, who is appealing for a new A&E facility at the Queen’s hospital. The situation has led to patients being cared for on trolleys in corridors. I find that unacceptable, and it is costing my local trust, which services 800,000 people in the area, an extra £100,000 a month because of additional staffing needs. Will the Minister ensure that what was said at our meeting is carried forward, and that we get a better facility for boroughs in the east London and Essex area, which the Queen’s hospital serves?
Karin Smyth
The hon. Gentleman is absolutely right that this is unacceptable. I was pleased to meet him and his local NHS leaders this week. They made, as hon. Members always do, an excellent case. Clearly, the situation was left badly under his Government. I hope that he will welcome the extra measures in this settlement. I know that my right hon. Friend the Leader of the House told him earlier that she looks forward to him joining us in the Division Lobby to support the extra funding. I hope that hon. Members know that, whatever party they come from, when I meet them, particularly in surgeries, I will follow up on the questions that are asked. They are often matters for the local integrated care board, but we will continue to work with all local systems to deliver the best care possible for all our constituents.
Sonia Kumar (Dudley) (Lab)
As an NHS physiotherapist, I welcome the statement. The Government will soon launch their 10-year plan for our NHS, in which a focus will be a move from sickness to prevention. Will the Minister set out how the spending review will support Dudley integrated care board and other ICBs in bringing healthcare on to our high streets, so that patient care is at the heart of our communities?
Karin Smyth
I thank my hon. Friend for the excellent role she plays as a clinician. Her expertise is really welcome; we want to hear from a wide variety of experts in this House—that is very valuable. She understands from her professional background, as well as from her constituency, how important it is to look at the entire pathway of care for patients, and to ensure that they have the best possible care as close to home as possible. We think that is better not just for patients, but for clinical outcomes, and it is more efficient and better use of taxpayers’ money. The move from hospitals to communities is front and centre of our 10-year plan, as is delivering neighbourhood health services.
Sir Julian Lewis (New Forest East) (Con)
The Minister will be well aware of Sir Andrew Dilnot’s ambitious plan to put a cap of £86,000 on the cost of the social care that any family would ever have to pay. It was never going to be easy to implement that. Previous Governments postponed the plan, and the Chancellor effectively scrapped it completely. May I appeal to the Minister to work across party lines, and to focus on the crippling debt that hits hard-working families when they come to the end of their working lives and need the support of the state?
Karin Smyth
I agree that this issue absolutely needs to be resolved. There was agreement previously, under the coalition, and it is so disappointing that it was so unceremoniously dumped when I came to this place in 2015; that was one of the first things that the subsequent Tory Government did. It was a great disappointment to many people across the country, particularly those who were responsible for supporting an older person or a disabled person. We have ensured that we will address this issue, and have appointed Louise Casey to lead the interim report. I know that she will continue to work with everybody, and that all hon. Members will take an active interest in that work.
Liz Twist (Blaydon and Consett) (Lab)
I welcome the additional £29 billion of day-to-day funding and additional capital announced yesterday. Our investments are already paying interest, in the reduction of waiting lists. May I remind hon. Members of the announcements made earlier this year? I was particularly pleased that the Shotley Bridge hospital replacement in Consett was announced in wave 1, and I thank the Minister for her personal interest in ensuring that wave 1 happens. The 10-year plan will soon be announced. How will the comprehensive spending review announcements help us to shift from a sickness model to a prevention model?
Karin Smyth
I thank my hon. Friend for welcoming the Government’s investment in the health service. She has been such a strong campaigner for Shotley Bridge, and it has been a pleasure to work with her; I know she has continued to advocate strongly on behalf of her local population. The hospital is needed, but as she knows, in her community—and all our communities—patients should not always be expected to travel to hospital for care that can be delivered closer to home. We see massive improvements in virtual care and technology, which is why we have announced a £10 billion increase for technology over the spending review period. We are improving the NHS app and ensuring that people are enabled to do more digitally, but I recognise that does not suit everybody, so we will ensure that parallel processes are available for everybody. Our constituents deserve and need care closer to home, and want more of it.
Ellie Chowns (North Herefordshire) (Green)
More money for the NHS is of course welcome, although if we in the Green party had our way, it would be raised by taxing extreme wealth fairly, rather than by taxing work. The small amounts of money for social care announced in the spending review are nowhere close to the funding needed to tackle the social care crisis, and the burden is put on local authorities. In the Minister’s Department, there is a reduction in the revenue budget for social care and public health. When will her Government stop going slow on social care? When will they hold the long-promised and much-delayed cross-party talks? When will they recognise, as Lord Darzi has said, that we cannot fix the NHS without fixing social care? A truly joined-up approach to health and social care is long overdue.
Karin Smyth
The economics of the Green party are even more fantastical than the economics of the Conservatives and Reform; we all dread to think what things might be like under that party. We see that in the local council in my city of Bristol, and it is an absolute disaster. If the council could just get on with building council houses and social homes, it would help more people to live a better life, and would aid prevention. We are getting on with tackling social care. That was announced in the spending review, and that is what the Casey review will do.
Peter Swallow (Bracknell) (Lab)
I warmly welcome the largest-ever capital investment in our NHS in the spending review yesterday, building on the Chancellor’s announcement in last year’s Budget of the money to rebuild RAAC-infested hospitals such as Frimley Park hospital, which will benefit my constituents. That was committed to by the previous Conservative Government, but, shockingly, it was never paid for. With the Government standing four-square behind rebuilding Frimley Park hospital, does the Minister agree it is time for Frimley Health NHS trust to get on and announce the site for the new hospital?
Karin Smyth
I thank my hon. Friend for his support for the Chancellor’s statement and our commitment to the NHS. I know he has been working so hard on this issue on behalf of RAAC hospitals and Frimley Park hospital since he became a Member of Parliament last year, and we are four-square behind that work getting on. It is at the beginning of a very long queue in the new hospital programme. It is one of the things we inherited—we wish it was a better inheritance, but we are working with what we have. We have put the new hospital programme on a firm financial footing, and Frimley Park is at the beginning of that queue. We are very keen that people get on with it very quickly, because there are very many other people waiting behind them.
Graham Stuart (Beverley and Holderness) (Con)
The hon. Member for North Herefordshire (Ellie Chowns) is absolutely right about social care. We have a system in which healthcare is dependent on social care—Lord Darzi says so, and I think even Ministers have said so—yet all funding is going into the NHS, not into social care. We are fundamentally pouring the money into a bucket with a hole in the bottom. The Minister pretends the exact opposite of the truth. Will she share a more honest assessment with the House? What went on? Labour had 14 years to think about it, and here we are with the funding going into the NHS. As the Father of the House, my right hon. Friend the Member for Gainsborough (Sir Edward Leigh), said, the Minister is following on from the last Conservative Government and pouring more and more money into an unreformed NHS with a social care system underneath it that is broken, and she is not doing anything about it.
Karin Smyth
I have already given a history lesson about some of those 14 years. When the Conservatives and the Liberal Democrats were in the coalition together, we had a commitment, a promise and a cross-party agreement; the Conservatives then got into government by themselves and broke it, so we are where we are. We want to invest in social care, which is why we have announced the £4 billion. We are seeing a very interesting alliance going on between our Green and Conservative colleagues; they agree on something, as we saw in the Lobby last week.
Warinder Juss (Wolverhampton West) (Lab)
I thank the Minister for her statement and the excellent work that this Government are doing in bringing additional investment in the NHS and bringing waiting lists down. We have had to make really difficult decisions to clear up the mess left by the previous Government, and I am sure we all agree that we need to protect our charitable adult social care providers. Will the Minister facilitate a meeting with myself and Woodlands Quaker Home in my constituency, which provides non-profit residential social care for older people so that they are able to carry on in the best way possible?
Karin Smyth
My hon. Friend makes an excellent point about bringing down waiting lists for his constituents, and we are so pleased to see that that is continuing, as we were able to announce this morning. He also makes an excellent point about social care providers, which do an amazing job for many of us who have close family members supported by them, and it is important that they are supported and work. I am not sure whether an answer to his question about a meeting needs to be from my Department or from my colleagues in the Ministry of Housing, Communities and Local Government, but I will ensure that he has an answer.
Tom Gordon (Harrogate and Knaresborough) (LD)
I welcome the funding announced to repair hospitals with RAAC, which will hopefully include Harrogate district hospital in my constituency. It has already received some money to remove RAAC in one building, which has since been demolished, but it still has a £15 million business case waiting with the Department of Health and Social Care for the next round of RAAC repairs. Will the Minister set out a timetable for repairs to hospitals such as Harrogate’s and for when we should expect to know if we will receive some of that funding?
Karin Smyth
We are committed to ensuring that those RAAC hospitals are sorted and fit for purpose, and I was able to visit Airedale myself recently. We are asking people on the ground to do a really difficult job, keeping hospitals going and serving patients while remedying the problem of RAAC. I do not have in front of me the exact timescale for the hon. Gentleman’s hospital, but I encourage it to work very closely with the team at the Department of Health, which I think is working really well. As long as a clear timetable has been put forward, I will ensure that the hon. Gentleman gets a response to his question.
Amanda Hack (North West Leicestershire) (Lab)
I thank the Minister for her statement. The NHS is the No. 1 issue for my constituents, and I know that they will welcome the investment in the spending review. My constituency is a rural area, and one thing people often raise with me is ambulance waiting times, which I am pleased to report have improved in every category over the past year. Can the Minister explain how the spending review will ensure continued improvements in ambulance waiting times, supporting my constituents to get emergency care when they need it?
Karin Smyth
My hon. Friend is right to raise the issue of ambulances. We ensured that they were a key part of our urgent and emergency care plan, which was issued the week before last, I think—I cannot remember the exact date. We recognise how crucial that issue is, and how much more can be done by ambulances by the roadside. I was privileged to go out with the South Western ambulance service recently; it is so impressive to spend time on the frontline with people who are dealing with whatever comes at them. We know that they can do more, including remotely. We are very keen to ensure that ambulances do not spend time outside hospitals; that is why we have introduced a 45-minute turnaround time through the release to rescue scheme, which has worked very successfully in many parts of the country. We are keen to see that scheme rolled out across the country, so that we do not have ambulances queuing outside of hospitals with people, but put them back on the road where they need to be.
Greg Smith (Mid Buckinghamshire) (Con)
We have been here before with Governments of all different political persuasions. Ministers come to the Dispatch Box and trumpet what seem like very attractive amounts of money for the NHS, but the reality on the ground is that that money just about covers pay rises and inflationary pressures. On care, Buckinghamshire council and no doubt all councils are worried that the money being offered up may only just cover things such as the fair pay agreement. Can the Minister confirm from the Dispatch Box that with increasing amounts of councils’ budgets rightly being spent on care, they will get funded for things such as the fair pay agreement separately from core social care spend?
Karin Smyth
The hon. Gentleman says that we have been here before, and we really have. I was on a primary care trust board under the last Labour Government, so I saw at first hand what good government, working with local systems, can deliver: the best patient satisfaction in the NHS’s history, the lowest waiting lists, and the best access to GP and primary care. We have been here before, and that is what we will do again. From the hon. Gentleman’s questions, I do not understand whether he wants more spending or less. That is what the Conservative party is still not saying; its Members stand up and ask for more, like Liberal Democrat Members, but they will not identify the means of raising that money—in fact, they oppose them.
To respond to the specific question that the hon. Gentleman asked, over the coming weeks, my colleagues from the Ministry of Housing, Communities and Local Government will obviously be outlining in more detail how the spending review will fall out.
Alice Macdonald (Norwich North) (Lab/Co-op)
I welcome this brilliant investment in our NHS, which will also be welcomed by my constituents. I know that this Labour Government will ensure that everyone in every part of the country benefits, including women. Last year, I highlighted that women in Norfolk face the longest waits in the country for gynaecological care, with hundreds waiting more than a year for treatment for conditions such as endometriosis. Can the Minister assure me that as we advance these plans for the NHS, we will ensure that we tackle those waiting lists? Far too many women are paying the price for years of inaction under the Conservatives.
Karin Smyth
My hon. Friend has been such a strong and powerful campaigner for women’s health since becoming an MP last year, and she is absolutely right to do that. I am pleased that we have been able to make some progress on conditions such as endometriosis. Many campaigns have been fought by many women in this House—including you, Madam Deputy Speaker, if I may say so—to highlight the importance of this issue. We see women’s health as front and centre. We want to learn from the women’s health hubs in their different guises and ensure that they are an integral part of neighbourhood health services.
Clive Jones (Wokingham) (LD)
I was really saddened that there was no mention of cancer in the Minister’s statement, so I will give her the opportunity to correct that omission. Will this new money for our NHS ensure that all cancer waiting time targets are met by the end of this Parliament, and can the Minister confirm that those targets will be included in the 10-year health plan? Finally, have Ministers had a chance to read my 11-page letter and accompanying submission on what should be in the national cancer plan?
Karin Smyth
I have a slight “get out of jail free” card, because I think that letter might be with one of my colleagues, not with me. Obviously, though, I look forward to the summary.
The hon. Gentleman makes a really important point about cancer. I would have to check, but I do not think I mentioned lots of disease-specific areas, including key manifesto commitments such as dentistry. Obviously, cancer is a huge part of waiting lists overall. We will get those waiting lists down—we are determined to meet that target—and we will issue a cancer plan later in the year.
Dr Scott Arthur (Edinburgh South West) (Lab)
I thank the Minister for supporting the launch of Sarcoma UK’s report yesterday. The recommendations in that report are really important for tackling that awful rare cancer.
I welcome the ambition in what has been presented, but the comparison with what my Edinburgh South West constituents face in Scotland could not be more stark. I have just come from a meeting in which, yet again, I have been trying to defend the mental health provision at Scottish Action for Mental Health’s Redhall walled garden; in contrast, I hear from the Dispatch Box real ambition to support people with mental health problems. People in Scotland are also jealous of the falling waiting lists they see in England, and hope that one day, they will arrive in Scotland. May I ask the Minister to keep on being ambitious, in the hope—because hope is all I have—that some of it will rub off on the Scottish Government?
As Madam Deputy Speaker is feeling a little generous, may I also say that Saturday will mark the 200th Oriam parkrun in my constituency? If we are serious about preventative healthcare activities, parkrun is a great example of how we can improve both our mental health and our physical health. The Minister is welcome to attend, of course.
Karin Smyth
I always shudder a little when I am invited to do any running, jogging, boxing or whatever else people get up to—we all have our own things we like doing. Although my hon. Friend’s fabulous city is a great place to be, I will not be able to join in this weekend, but I wish good luck to everybody taking part.
We all live in hope that the SNP might learn some lessons from what we are doing to fix our NHS. We remain willing to work with the SNP, and with anybody who wants to serve patients and get a better service for their taxes. If the SNP wants to get in touch, it can do so, but the best thing to do is to elect a Labour Government in Scotland, which will hopefully happen soon.
My hon. Friend makes an important point about mental health. We are committed, as we said in our manifesto, to 8,500 more people working in mental health, and to ensure that our schools and young people have the support they deserve.
Ian Roome (North Devon) (LD)
I thank the Minister for agreeing to visit North Devon district hospital very shortly, and I look forward to welcoming her to my constituency. Despite some welcome extra repairs under the estates safety fund, that hospital now faces many years of make do and mend. What provision have the Government put aside for those years of increasing maintenance costs?
Karin Smyth
I thank the hon. Gentleman for his question. His invitation has been a long-running one, and sometimes his diary has been busier than mine, but I think we finally have a date to go to North Devon, which I am looking forward to. It is a challenged system—we had a good debate yesterday in Westminster Hall about many of the problems in Devon, and I know he will review that debate carefully. Devon is one of the systems that we are looking closely at. It has had deficit funding this year, but we want to eradicate deficit funding from the system, so we are looking very closely at how every single system uses all of its money. I know that the hon. Gentleman will continue to support the Government in ensuring that his local taxpayers get the best service for their money.
Matt Turmaine (Watford) (Lab)
I welcome the comprehensive spending review and its focus on NHS funding. It will deliver on Labour’s election promise to get the NHS back on its feet, which will be of so much benefit to my constituents. Does the Minister agree that nearly one year on, this Labour Government are really tackling the disastrous Conservative-Liberal Democrat reforms introduced under the Lansley legislation?
Karin Smyth
My hon. Friend has been such a strong advocate for Watford since he came into this Chamber, and in particular for ensuring that that hospital is in the new hospital programme. I look forward to visiting his constituency soon, because I know we lost some time.
My hon. Friend is absolutely right. I do not know if he knows this, but others will have heard me say before that one of the terrible consequences of the Lansley reforms was that they made me so angry as a manager in the system that I decided to become a Member of Parliament, and here we are today. We have learned from the lack of focus on the frontline and on patient care. That is why we are so clear—whether in the reforms we have put forward on elective care and urgent emergency care, or in the planned reforms on dentistry and primary care, in the 10-year plan and on social care—that we have to keep a relentless focus not just on taxpayers’ money, but on patients. The people’s priorities are clear. They want the NHS to do better, but they are clear in their demands that we make it work better for them and make sure that every single pound of taxpayers’ money is working to the best effect.
Mr Adnan Hussain (Blackburn) (Ind)
I welcome the Minister’s statement and this Government’s commitment to investing in the NHS, but she did not address how that funding will be allocated across the country. My constituency of Blackburn has one of the worst GP to patient ratios, with more than 3,200 patients per GP. That is placing immense strain on primary care and pushing patients to an already overstretched hospital that is frequently on red alert. Will the Minister ensure that areas with such disparities, like Blackburn, receive targeted support? Will she meet me to address these long-standing imbalances in healthcare provision?
Karin Smyth
The hon. Gentleman makes an excellent point on primary care, which sees 90% of contacts with the NHS and is where most people experience the NHS. That is why it is very much in our sights to support that work. As part of our 10-year plan, we will bring forward the neighbourhood health service to make sure that people can be seen more locally. That will be built around using primary and community care to best effect. He makes a point about funding formulas. We had a long debate about that yesterday in Westminster Hall, and it is an area of huge controversy. He will see over the coming weeks how the funding is allocated. NHS England did issue—if he has not seen it, I will make sure that he has access to it—guidance on the funding formula and where the different systems are in relation to that. We want to move everybody towards that target, and I am happy to discuss that with him once he has had a look.
Josh Fenton-Glynn (Calder Valley) (Lab)
This Government have made phenomenal progress on the elective care waiting lists left by the last Government, but the progress on mental health waiting lists has been stubbornly slow, with 1.2 million people still waiting for treatment. That includes 62,000 people covered by the West Yorkshire ICB that serves my Calder Valley constituency, which I think is the second-highest figure in the country. Can my hon. Friend please assure me that we will use this settlement to redouble the work we have done on elective waiting lists, while also putting a real focus on mental health waiting lists?
Karin Smyth
My hon. Friend makes an excellent point on mental health, which is of great concern to all Members. He is right that elective care and mental health are measured in different ways, but we are committed to supporting mental health services with 8,500 extra staff. We are making sure in particular that young people in schools are supported. We know that the situation has been terrible for young people in our country, and we will continue to provide that relentless focus.
Jim Shannon (Strangford) (DUP)
The Labour Government have committed more money to the NHS, and that has to be welcomed. For that reason, I thank the Minister for her statement today. The Chancellor yesterday announced some £50 million—this does tie in to health—for Casement Park. However, the Government were clear that that was dependent on funding from the Northern Ireland Executive. Does the Minister expect the Northern Ireland Executive to take extra moneys granted to the Northern Ireland Assembly through Barnett consequentials and divert them to a sports stadium? Are the moneys for the NHS ringfenced and protected? If not, how do I look parents in the eye in my constituency of Strangford, when their child cannot receive cutting-edge medical technology because money has to be found for a sports stadium?
Karin Smyth
The hon. Gentleman is an experienced parliamentarian, and he understands how the funding settlement for the Department of Health and Social Care is allocated through the Barnett formula to Northern Ireland.
Josh Newbury (Cannock Chase) (Lab)
This investment is so welcome, because my constituents in Cannock Chase have been struggling to access urgent care between their GP and accident and emergency since our hospital’s minor injuries unit was temporarily closed in March 2020. Despite the welcome investment in Rawnsley surgery, Chadsmoor medical practice and Red Lion surgery in my constituency, our ICB plans to kibosh any hope of our MIU reopening. Does the Minister agree that this Government’s huge investment in our NHS needs to be felt in the parts of the country, such as my towns and villages, that were so badly let down by the Conservatives? Will she meet me to discuss the worrying urgent care reform proposals for Staffordshire?
Karin Smyth
I thank my hon. Friend for welcoming the extra support for GP and primary care. I am sure he understands from our urgent and emergency care plan that we have a number of arrangements for making sure that people are seen urgently in local community settings. It is for local ICBs to decide on the best way, within that urgent emergency care plan, for people to be seen locally and treated within the available resources. I am happy to meet him, perhaps at an upcoming surgery, to discuss that further.
Chris Webb (Blackpool South) (Lab)
My constituents in Blackpool South will never forgive or forget that the previous Government left us with the worst health outcomes in the country. We have an ICB having to make £350 million of cuts. The hospital that my son and I were born in has been left inadequate and one of the worst in the country. We have dental deserts. People cannot get access to mental health counsellors or GPs. I welcome the millions of pounds allocated to Victoria hospital and to health outcomes in my constituency by this Government, and we are seeing waiting lists finally coming down. Does the Minister agree that we need to continue on this path and give deprived areas, such as Blackpool, more support to get our waiting lists down to an acceptable level?
Karin Smyth
My hon. Friend is absolutely right that his constituents and constituents across this country will not forgive the Conservatives for the state in which they left the NHS. That is clear from Lord Darzi’s diagnosis. We have still had no comment from the Conservatives on whether they acknowledge that. We are determined to be about the future, and that is what this settlement and the Chancellor’s announcement yesterday are about. It is about putting that extra funding that we raised last year into services and into a reformed system that reaches all parts of this country. We will tackle health inequalities, making sure that people who have not had that access and people who suffer worse health than others are raised up. We must take the best of the NHS to the rest of the NHS.
Madam Deputy Speaker (Caroline Nokes)
After more than an hour of diligent bobbing, I call Chris Vince.
Chris Vince (Harlow) (Lab/Co-op)
Apologies for my premature bobbing earlier, Madam Deputy Speaker.
I thank the Minister for her statement today and for her ongoing commitment to the NHS. I welcome the growth in day-to-day spending on the NHS and this Government’s commitment to bringing down NHS waiting times. However, may I gently advocate for Harlow in respect of the future of the UK Health Security Agency? It has a business case, details, designs and a site ready to go, and the estimated timeframe has consistently been assessed as the best value for money and the quickest to deliver.
Karin Smyth
I like how my hon. Friend says “gently”, because honestly no day goes past without him talking about this issue or, indeed, his new hospital. He is right, and he is a fantastic campaigner for the people of Harlow. He has made his point again, and I cannot make any further comment today, but he will be hearing from the Secretary of State soon on that issue.
Madam Deputy Speaker
I thank the Minister for her answers this afternoon. I ask anyone who is leaving before the Select Committee statement to do so quickly and quietly.
Covid: Fifth Anniversary
Karin Smyth Excerpts(3 weeks, 2 days ago)
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The Minister for Secondary Care (Karin Smyth)
I am short of time, but the Under-Secretary of State for Culture, Media and Sport, my hon. Friend the Member for Barnsley South (Stephanie Peacock), who leads on this issue, has hotfooted it from Committee and will take up any issues that I do not address. I thank my hon. Friend the Member for West Ham and Beckton (James Asser) for securing what has been a moving and popular debate. As he says, we have to remember the people and communities behind the numbers. My thoughts, and those of everyone, are with the families and communities who lost loved ones because of the pandemic. We have heard the magnitude of that grief expressed today, as well as the pain of families who were unable to be with their loved ones in the normal rituals of grief and bereavement.
My hon. Friend the Member for Middlesbrough South and East Cleveland (Luke Myer) spoke about the loss of his grandfather. The hon. Member for Honiton and Sidmouth (Richard Foord) talked about the loss of Adam, and we understand the battle to get compensation payments. My hon. Friend the Member for Ribble Valley (Maya Ellis) talked about women’s experiences of pregnancy and birth. I pay tribute to my hon. Friend the Member for Paisley and Renfrewshire South (Johanna Baxter) for the work that she is doing on the APPG, and I will make sure that she gets a response to her letter.
It has been heartening to hear of the many ways that communities have commemorated the losses and sacrifices experienced during the pandemic. The Government will bring forward a programme of covid-19 commemorative activity, and we will set out full details in response to the recommendations of the UK Commission on Covid Commemoration. I thank Baroness Morgan of Cotes and all the commission members for their consideration in recommending how to mark this period, and for their ongoing engagement with the Department for Culture, Media and Sport, which will lead on the commemorative activity.
DCMS is working with a range of partners, including my Department, and regularly engages with the covid-19 bereaved family groups. I thank those groups for their ongoing support and commend them for their strength and resilience, and for the support that they provide to other grieving families. As part of the commemoration of the pandemic, the Government supported the Covid-19 Day of Reflection in March, when more than 200 events took place. I can confirm that the Covid-19 Day of Reflection 2026 will take place on Sunday 8 March, and I hope that Members will support activities in their constituencies.
As we have heard, across the river from this House stands the covid-19 memorial wall. I certainly remember the first time we stopped at that memorial after we lost my father-in-law, Brian Davies. It is a really moving and powerful tribute to the lives lost, with almost 250,000 hearts lovingly painted on the wall. For families, it is a really important space where they can remember. I agree with the hon. Member for North East Fife (Wendy Chamberlain) that it is a poignant reminder when we pass it every day, and I know that my colleagues in DCMS are working with the Friends of the Wall on that long-standing commemoration and will update the House in due course.
Together we remember the courageous sacrifices made by frontline workers across the country, and we have heard about many of them today. There are too many people to mention, but they include NHS staff, train and bus drivers, refuse collectors, and supermarket and delivery staff. I agree with my hon. Friend the Member for Loughborough (Dr Sandher) that many on the frontline were the poorest and lowest paid, and they were disproportionately affected. We must continue to make sure that that does not happen again.
The pandemic demonstrated the remarkable work of civil society. An estimated 12.4 million people volunteered in some way, including as vaccine volunteers, befrienders and carers, as was mentioned by my hon. Friend the Member for Coatbridge and Bellshill (Frank McNally).
I will briefly turn to the steps that we are taking to ensure that the United Kingdom is better prepared for a future pandemic, which remains a top priority for this Government. My hon. Friend the Member for Glasgow North (Martin Rhodes) made a crucial point about learning lessons on PPE, as did my hon. Friend the Member for Bolton West (Phil Brickell). Later this year, we will conduct a national exercise to test our ability to respond to a pandemic, and this will involve all regions and nations of the United Kingdom, with thousands of participants. The outcome of the exercise will inform how we approach a pandemic in future.
We have heard about long covid, and I would talk more about it if I had more time. The right hon. Member for Hayes and Harlington (John McDonnell) spoke about that, as did many others. Since 2020, NHS England has invested significantly in supporting people with long covid, including through specialist post-covid services for adults, children and young people, and it has invested over £57 million in long covid research, which will remain hugely important.
I am grateful to my hon. Friend the Member for West Ham and Beckton for securing this important debate. As we mark the fifth anniversary of the pandemic, together we will ensure that lessons are learned, that our losses are honoured, and that as a nation we do not forget.
Duchenne Muscular Dystrophy
Karin Smyth Excerpts(3 weeks, 2 days ago)
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The Minister for Secondary Care (Karin Smyth)
It is a real pleasure to respond to this moving debate. I know that many people with Duchenne muscular dystrophy and their families will have wanted to tune in to hear what was said this afternoon. I thank Members who have contributed in different ways to the debate. In particular, I thank my hon. Friend the Member for Stockton North (Chris McDonald), who secured this debate and advocated so powerfully for these families. He really brought to life the experiences of Benjamin, Jack and Eli, and I commend him for doing so.
I first acknowledge the profound impact that this debilitating disease has on those living with it, and their families, and the urgent need for new and effective treatments. As has been said, my right hon. Friend the Secretary of State for Health and Social Care heard at first hand from people affected by this condition earlier this year, when he attended an event hosted by Duchenne UK. He met many young patients and listened to what they said about the challenges that they face. As we all know, meeting families and individuals from our constituencies leaves a long-lasting effect on us, and it is important that we continue to meet them.
Timely and equitable access to innovative medicines for the treatment of DMD and other rare diseases mentioned today is of the utmost importance. The National Institute for Health and Care Excellence is the independent body responsible for assessing whether new licensed medicines can be recommended for routine use in the NHS, based on a thorough assessment of their clinical effectiveness and cost-effectiveness. Through this process, many thousands of patients, including those with rare diseases, have been able to benefit from effective new treatments at prices that represent value to the NHS. NICE has been able to recommend two medicines for the treatment of DMD: ataluren, recommended in 2023, and vamorolone, which was recommended in January this year and is now available on the NHS to around 1,700 eligible patients, in line with NICE’s recommendations.
As my hon. Friend has said, NICE is appraising givinostat, and the first NICE committee meeting is scheduled for July this year. If the medicine is recommended, the NHS in England will be legally required to fund it. I am aware that a small number of patients in the UK have been receiving treatment with this drug through a company-led early access programme, established by the pharmaceutical company Italfarmaco, as we have heard. It is important to note that participation in these programmes is decided at NHS trust level, and although the drug is free to patients taking part in it and to the NHS, NHS trusts must still cover administration costs and provide clinical resources to deliver the EAP.
NHS England has published guidance on free-of-charge medicine schemes, such as the givinostat EAP, providing advice on financial, administrative and clinical risks. NHS England cannot, however, centrally direct NHS trusts to participate in company sponsored EAPs like this one, or in any other private activity. To issue any form of national direction around participation in EAPs would both pre-empt and undermine the role of NICE, whose purpose is to advise the NHS on whether particular treatments should be made routinely available on the NHS.
Even when there is an agreement that a company will continue to provide a drug free of charge in the event of a negative decision by NICE, participating trusts remain liable to cover the significant costs of delivering that service, including the cost of the clinical resources and staff time needed. That would be outside their funding allocation and in addition to paying for any subsequent NICE-recommended treatments that they would be mandated to fund.
Chris McDonald
I thank the Minister for her response, to which I am listening very carefully. I appreciate her point that it would be inappropriate for the Department of Health and Social Care to direct what trusts should do, but what we have heard from the trusts is that they would like to issue this drug, but have certain issues and problems. Perhaps it might simply be a matter of the Department giving help and support, and facilitating information-sharing between trusts that have made this work and those that have not. Perhaps it could be more encouragement than direction.
Karin Smyth
I thank my hon. Friend for that constructive suggestion. We need to wait to see how the NICE recommendation goes in July. With this disease and so many others, it is important to share learning and information, and trusts should be encouraged and supported in doing so. We will work with him on that constructive recommendation.
I understand my hon. Friend’s concerns about the fact that non-ambulant patients are not yet able to access givinostat, but it is important to note that the eligibility criteria for participation in the early access programmes have been determined by the pharmaceutical company. NHS trusts that decide to participate in the EAP must only provide treatment in line with the criteria, which state that patients must be ambulant. A clinical trial is being carried out by the pharmaceutical company to evaluate the safety and tolerability of the drug in non-ambulant patients, and to further explore the efficacy of the drug in this population. I know that for the patients and families affected, it will be disappointing to hear that there is no access to the drug for ambulant patients before a NICE decision, or for non-ambulant patients prior to clinical trials being concluded. I want to assure my hon. Friend that we have arrangements in place to support rapid access to new medicines.
Karin Smyth
I will not; I want to finish in the time available, and I think Members want to hear the full response.
Outside of company-led EAPs, there are established routes for patients to get access to new, innovative medicines prior to them being licensed. The early access to medicines scheme, or EAMS, helps give people in the UK with life-threatening or seriously debilitating conditions early access to new medicines that are not yet licensed where there is a clear unmet medical need. EAMS is supported by key partners, including the MHRA, NICE and NHS England, and is a key part of this Government’s commitment to accelerating patient access to innovative, life-changing treatments, in support of the UK’s position as a global leader in life sciences. In fact, since the scheme launched in 2014, over 50 medicines, including for this disease, have benefited from being accessed early through EAMS.
The innovative medicines fund has also made available £340 million of ringfenced funding for the NHS to fund early access to medicines that NICE has recommended with managed access. Through this process, licensed treatments that demonstrate substantial clinical promise but still have significant uncertainty around their clinical and cost-effectiveness can be funded. Further evidence is then collected on the drug for a defined period of time. That is considered by NICE in determining whether the drug can be recommended for routine NHS funding.
The Secretary of State has been clear that if givinostat is recommended by NICE in draft guidance, NHS England should aim to work with the pharmaceutical company to provide early funding through the innovative medicines fund. This could potentially speed up access by up to five months, and the treatment could be funded as soon as this summer, if recommended.
This scope of this debate is wider than just access to new medicines. It is important to note that while rare diseases are individually rare, they are collectively common. One in 17 people will be affected by a rare condition over their lifetime. The UK rare diseases framework outlines four priorities, based on engagement with the rare disease community. They are: helping patients to get a final diagnosis faster, increasing awareness of rare diseases among healthcare professionals, better co-ordination of care, and improving access to specialist care, treatments and drugs. In England, we publish a rare diseases action plan annually. These detail the specific steps we are taking to meet the shared priorities of the framework. I am pleased to highlight the 2025 England action plan, which was published in February this year on Rare Disease Day. One such action is reviewing the effectiveness of early access schemes, such as the early access to medicines scheme, the innovative licensing and access pathway, and the innovative medicines fund. They are all designed to help make innovative treatments available earlier to patients who need them. We are specifically considering how well they support access to treatment for people living with rare diseases like Duchenne.
NHS England, NICE and MHRA will meet annually to continue to discuss progress on these schemes. These meetings will include representatives from patient advocacy groups and from industry, and clinical researchers, and the next one will happen in the summer.
Managing a complex rare condition can be challenging, and it often means interacting with many different specialists and providers of health and social care. It can mean travelling across the country to access highly specialist care from experts. All of that can add up to a significant emotional and physical burden, and it can deepen inequalities. Co-ordination of care can minimise this burden on patients and their carers, and it can ensure that healthcare professionals work together to provide the best possible care, as we have discussed this evening.
In the 2025 action plan, we have introduced a new action to incentivise providers to run clinics for multi-system disorders, in order to reduce the number of appointments and improve co-ordination of care for families. The NHS is also working to include the definition of “co-ordination of care” that is set out in the CONCORD—co-ordinated care of rare diseases—study in all new and revised NHS service specifications for patients with rare diseases.
I recognise how hard it is when patients want access to these new treatments. I also recognise the distress and worry it causes, not only to patients, but their families and friends. Hon. Members have articulated that well on behalf of their constituents this evening. The Government are committed to providing access to the most innovative medicines, but it has to be at a price that provides value for the NHS, and it has to be clinically safe and effective. That is why we are working hard with industry, NICE and MHRA to make that happen. I know that my hon. Friend the Member for Stockton North will continue to work with the Government and providers to make that happen. I am grateful for the opportunity to respond to this debate on such an important issue.
Question put and agreed to.
NHS Funding: South-west
Karin Smyth Excerpts(3 weeks, 3 days ago)
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The Minister for Secondary Care (Karin Smyth)
It is a pleasure to serve under your chairmanship, Dr Huq. I thank the hon. Member for Torbay (Steve Darling) for securing the debate. We could have had more time, as this is an important issue for us all across the whole south-west. I thank colleagues for taking part.
The hon. Gentleman is right that the system has real challenges receiving deficit funding in our part of the NHS recovery support programme. He will rightly be following that closely. In the autumn Budget, which I think virtually everyone in this room disagreed with, the Chancellor took the necessary decisions to put our NHS on the road to recovery, with a more than £22.5 billion increase in day-to-day health spending and over £3 billion more in the capital budget over this year and the last. Today, the Chancellor has announced the conclusion of the spending review, with £29 billion more day-to-day funding in real terms than in 2023-24. There is a £2.3 billion real-terms increase in capital spending over the spending review period—something I hope everyone welcomes.
The SR puts the NHS on a sustainable footing by cutting waiting lists so that by the end of this Parliament 92% of patients will start consultant-led treatment for non-urgent health conditions at 18 weeks, delivering on the Prime Minister’s plan for change commitment and prioritising people’s health. To respond to the hon. Member for Bath (Wera Hobhouse), we do encourage use of the independent sector for capacity, and that is a decision for ICBs to make sure they achieve those standards. The settlement also supports the shift from analogue to digital, with a total investment of up to £10 billion in NHS technology and transformation between ’26-27 and ’28-29, and an almost 50% increase from ’25-26. I agree with the right hon. Member for Salisbury (John Glen) that technology offers huge opportunities in geographies like ours.
Thanks to the Chancellor, we are taking the necessary steps towards fixing the foundations of our NHS and making it fit for the future. Since coming into office, the Government have published our urgent and emergency care plan, which will support the NHS across England to improve the timeliness and delivery of care to patients requiring urgent and emergency care over the next year, including for next winter. We are delivering on our plan for change through the accelerated roll-out of the NHS app. We will create an NHS fit for the future and continue to invest in the latest technology, shifting healthcare from analogue to digital.
Our investment and reform in general practice, to fix the front door to the NHS and bring back the family doctor, includes an additional investment of £889 million. We have published our elective reform plan, which will cut waiting times from 18 months to 18 weeks. We have exceeded our pledge to deliver an additional 2 million appointments, tests and operations—we have delivered over 3 million more. Waiting lists have fallen for the sixth month in a row and have now been cut by over 219,000 since we came to office. The Government have committed to a10-year health plan that will lead the NHS to meet the challenges set out in the plan for change to build the NHS for the future, and it will be coming very soon.
I know that hon. Members across the House share the concerns of the hon. Member for Torbay about the crumbling NHS estate after years of neglect. I wish to assure Members that my right hon. Friend the Chancellor has given us the funding to begin reversing the trend of decline in the south-west and nationwide, with health capital spending rising to £13.6 billion this year.
In the south-west region, allocations have been made totalling £448 million in operational capital, empowering systems to allocate funding to local priorities; over £238 million from our constitutional standards recovery fund to support NHS performance across secondary and emergency care; and £83 million from the £750 million estates safety fund to deliver vital safety improvements, enhance patient and staff environments and support NHS productivity. This includes £7.3 million for Torbay hospital in the constituency of the hon. Member for Torbay; £10 million from our primary care utilisation fund for improvements in the primary care estate; and almost £5 million to help to reduce inappropriate out-of-area placements for mental health patients in the south-west.
ICB allocations have been talked about a lot today. For the south-west, they have been confirmed as totalling £11.5 billion out of a total of £116.7 billion allocated for England. The regional allocation per capita for the south-west is above the national average. We heard from my hon. Friends the Members for South Dorset (Lloyd Hatton) and for Bournemouth East (Tom Hayes) that the signs are being seen in their constituencies.
Karin Smyth
I am going to just complete these points, so that I can try to address as many points as possible.
In the constituency of the hon. Member for Torbay, the local ICB, NHS Devon, receives £2.5 billion of the £11.5 billion for the south-west. The allocation per capita for Devon is higher still, and above the south-west regional average. Likewise, NHS Cornwall and the Isles of Scilly ICB received just over £1.2 billion of that £11.5 billion total. The allocation per capita for Cornwall and the Isles of Scilly is above the south-west regional average and national average.
To respond to the hon. Member for St Ives (Andrew George), I understand from NHS England that the ICB has had the debt written off, so that might be something he wants to follow up. My hon. Friend the Member for Truro and Falmouth (Jayne Kirkham) and others talked about funding allocations—we could talk about this for a very long time. They are difficult things to get right, and are controversial, but the funding formulation does account for older people and for rural populations.
The latest financial performance position publicly available is for quarter three of last year. It showed an overall deficit position of £51.7 million against the year-to-date plans, of which Dorset ICS had the largest variance of £27.7 million. Final end-of-year positions are still being finalised and will be made publicly available in due course. For ’25-26, NHS systems overall have received £2.2 billion of deficit support funding in their allocations. All systems in the south-west have now agreed a balanced plan for ’25-26. The position on deficit support for ’26-27 will follow the spending review settlement for individual organisations agreed as part of the planning guidance process.
NHS England will continue to support all organisations to deliver financially sustainable healthcare through a range of improvement measures, some of which we have heard about today. Devon integrated care board, and three trusts within the ICB, are currently part of the recovery support programme, which provides intensive support to challenged organisations. Where organisations are struggling significantly, the Department of Health and Social Care provides cash support to support the continuity of patient services—obviously, that is critically important. So that colleagues are aware, I am personally meeting with finance colleagues from NHS England and the Department of Health every week to support that work. We are clear as a Government that we need to be certain that every pound of taxpayers’ money is used to best effect, and that best practice is followed in this region and across the entire NHS.
The hon. Member for Torbay asked about coronary services, and that is a local decision. NHS Devon and Torbay Foundation Trust have proposed undertaking a test-and-learn process for out-of-hours primary percutaneous coronary intervention. That service will be provided in Torbay and Exeter, which would involve a temporary change to provide out-of-hours services at Exeter only. Members will be aware that the ICB was due to make a decision on the pilot at its board meeting in May. However, following significant local feedback, the ICB has decided to reflect on those issues raised, and I am sure the hon. Member for Torbay will be following up on that. The ICB will be providing an update at its board meeting in July.
In conclusion, the Government are taking the necessary steps to fix the NHS, and the Chancellor’s spending review settlement puts the NHS further on the road to recovery. I assure Members that we will write back to them on any other individual points raised.