Oral Answers to Questions

Lindsay Hoyle Excerpts

Tuesday 7th January 2025 Commons Chamber

[Stephen Kinnock]

There is a pattern here. The Conservatives welcome the additional investment in health and care but oppose the choices that we have made to raise the revenue. They need to tell us which services they would cut or which taxes they would raise instead.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Coverage Care, a not-for-profit adult social care provider in North Shropshire that operates 11 care homes and employs around 1,000 local staff, has been in touch to say that it expects the impact of the increase in national insurance contributions to be £840,000 in the first full year of implementation. Given that there are huge numbers of vacancies across adult social care in North Shropshire, will the Secretary of State consider exempting social care providers from the national insurance increase? Otherwise we are putting money into social care with one hand and taking it away with the other.

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[Nesil Caliskan]

I thank the Secretary of State for his answer on the critical issue of access to GPs in primary healthcare. My constituency of Barking is woefully under-served by primary healthcare, and especially by GPs. On average, each GP looks after 2,000 patients; the national average is 1,600. In particular, the area of Barking Riverside has no GP services. Will the Secretary of State meet me to discuss this matter, so that the thousands of homes that are being built will also have a primary healthcare facility on site?

[Mr Speaker]

Order. I remind Members to look towards the Chair, because I cannot hear what is being said. I call the Secretary of State—I hope he heard the question.

[Wes Streeting]

Thank you, Mr Speaker. I would be delighted for my hon. Friend to meet me or the relevant Minister. The NHS has a statutory duty to ensure sufficient services in each local area, including general practice, and it is vital that we also take into account population growth and demographic changes. I strongly support the Deputy Prime Minister’s commitment to delivering 1.5 million new homes, and she and I know that that must be accompanied by local healthcare facilities. We are working together to achieve just that.

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[Wes Streeting]

I am grateful to the hon. Member for that question. I am incredibly sorry about the awful conditions in which staff in that practice are having to see patients and in which the patients it serves are having to be seen—that is the epitome of the broken general practice system that we inherited. Thanks to the decisions taken by the Chancellor in the Budget, we are able to invest in the capital estate need in the NHS. That will take time, and we would be delighted to hear more about that individual case to see how the ICB and the NHS can assist.

[Mr Speaker]

I call the Chair of the Select Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

Following the theme raised by my hon. Friend and neighbour, the hon. Member for Bicester and Woodstock (Calum Miller), may I make a plea for Summertown health centre? They are my doctors, by the way, so I declare an interest. They operate in an old Victorian building and are desperate to move to new premises. That health centre was at the top of the priority list, but the ICB says that there is no money, and the doctors say that there is no pot that they can bid into in order to get this seen to. Will the Secretary of State meet me as well? Clearly, £102 million spread across 50 projects in the country is not going to be sufficient. Can we get creative about how we can get new premises built for Summertown health centre?

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[Wes Streeting]

That was a rare admission of failure in this House by the SNP. I am very sorry to hear that general practice in Scotland is in such a sorry state, because here in England we are investing £889 million in general practice, the biggest uplift in years. That is in addition to the funding I have found to employ 1,000 more GPs on the frontline before April, because we are prioritising general practice. As for the decisions the Chancellor took in the Budget, as I said before the election, all roads lead to Westminster. Thanks to the decision a Labour Chancellor has made here in Westminster, coming down that road from Westminster to Holyrood are the resources the SNP Government need to deliver the priorities of the Scottish people. If they cannot, Anas Sarwar and Jackie Baillie stand ready to deliver.

[Mr Speaker]

I call the shadow Minister.

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

To improve access, the Government have announced a planned expansion of advice and guidance, and GPs will be paid £20 per advice and guidance request they make for further expert advice from consultants. How do the Government expect this expansion to take place? Will they be mandating it given that the current position of the British Medical Association, under its collective action, is that GPs should

“Stop engaging with the e-Referral Advice & Guidance pathway”?

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[Wes Streeting]

First, as the shadow Minister has said, advice and guidance happens in general practice, and we want to see more of it. We have to give GPs the tools to do the job, and that is what we are doing. My hon. Friend the Minister for Care will be talking to the BMA shortly in the context of contract negotiations in the usual way. What the shadow Minister neglects to mention is that these reforms and improvements to general practice are made possible thanks to the £889 million we are putting in, which is investment that he and his party oppose.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Dentistry is a key part of primary care, yet an estimated 5 million people in England have been left without an NHS dentist. That is why today a petition is being handed in at Downing Street signed by more than a quarter of a million people. We have moved on from the election, but we do not yet have a timetable for when the negotiations for a new NHS dental contract will begin and when another 700,000 extra urgent appointments will be rolled out. Can the Secretary of State confirm the timetable for those improvements? What specifically are the Government’s plans for the new patient premium, and will he offer assurances to dentists that any changes to the current model will be outlined in detail to them as soon as possible?

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[Wes Streeting]

I thank the hon. Member for that question. I agree with him about the need for clarity as well as consistency. We undertook the review into the new hospital programme because the previous Government’s timetable was a work of fiction and the money was not there. I hope to report to him and to the House shortly on that, with the undertaking that the timetable we publish and the funding provided by the Chancellor in the Budget and at the spending review will mean that we will provide not just clarity but consistency, which is important for NHS leaders, important for patients and important for the construction industry partners we need to work with.

[Mr Speaker]

I call the shadow Minister.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Thank you, Mr Deputy Speaker. [Interruption.] I am sorry—that is the last time I will get called. Thank you, Mr Speaker.

Yesterday, in relation to the elective backlog, the Secretary of State said:

“Where we can treat working people faster, we will, and we make no apology for doing so.”—[Official Report, 6 January 2025; Vol. 759, c. 597.]

Labour politicians have struggled to define what they mean by working people, but his words have caused anxiety. Will he reassure those with disabilities that prevent them from working and retired elderly people who have worked all their lives that they will not be pushed to the back of the queue and that treatment will continue to be provided in the NHS on the basis of clinical need?

[Wes Streeting]

Of course, clinical need is paramount and must always drive decision making about who to treat when and the order in which people are treated. That is why I find the question posed so deeply disingenuous. [Interruption.] We inherited NHS waiting lists at record levels and waiting times that are frankly shameful. The shadow Minister should be apologising for her party’s record, and she should also apologise for the two-tier healthcare system that sees those who can afford it paying to go private and those who cannot afford it—working-class people—being left behind. That is the two-tier system that the Government are determined to end.

[Mr Speaker]

Order. Can we be a bit careful with the language we are using?

[Dr Johnson]

The Secretary of State needs to be careful with the words he uses, as you said, Mr Speaker, because his words did cause anxiety among people. It was not a disingenuous question; it was a genuine question to make sure that people are reassured.

It will not have escaped the Secretary of State’s notice that it is cold outside. Removal of the winter fuel allowance has reduced elderly people’s ability to follow the advice that he gave last week, which was to turn the heating on. What assessment has he made of the number of additional admissions caused by his removal of the winter fuel allowance? What effect is that having on the Government’s ability to deliver their reduction in elective backlogs?

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[Wes Streeting]

I am grateful to the hon. Member for that question. With our fair pay agreements, we will be bringing together government, public and private sector employers and staff trade unions to negotiate the future for fair pay agreements that will benefit care workers across the system and give them the professional status and career progression they deserve. The Chancellor, through the Budget, also took steps to ensure that we could invest in our social care services. I am deeply saddened that the Conservative party has not supported that investment.

[Mr Speaker]

I call Dame Emily Thornberry—congratulations!

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[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

In September the Secretary of State and I met the families of people who had suffered harm following the covid-19 vaccination, including my hon. Friend’s constituent Sheila Ward, and they raised the need for reform of the vaccination damage scheme. We listened closely to their descriptions of what they had been through and agreed to look at a number of options, noting that cross-cutting Government decisions might be necessary. We are also working with the NHS Business Services Authority to improve claimants’ experiences of the scheme, and to ensure that claims are processed quickly.

[Mr Speaker]

Order. May I remind Members not to walk past when the Minister is replying to a question? Please have regard for each other; this sets a bad example.

I call the shadow Secretary of State.

[Edward Argar (Melton and Syston) (Con)]

The Prime Minister’s announcement yesterday of his elective recovery plan mirrored that of Sir Saijd Javid in 2022, but one aspect was different. Our plan explicitly recognised the importance of the workforce being in place to deliver the 9 million extra tests and interpret the results, and it set out proposals to increase that workforce further. What plans has the Secretary of State to boost the workforce in community diagnostic centres specifically, over and above the plans that he inherited from us, to ensure that his elective recovery plan is deliverable?

[Wes Streeting]

The shadow Secretary of State is right to say that we need staff in place to do the job. The additional funding announced by the Chancellor in the Budget is central to the delivery of this plan—I note that he opposes that funding, which is deeply regrettable—but we need to improve productivity as well. That is why the plan sets out steps to free up patient appointments that are unnecessary or of low clinical value, but, crucially, staff time in productivity gains is also important, so as well as making the most of the additional investment, we are making the most of delivering value for taxpayers’ money—

[Mr Speaker]

Order. Please help me a little bit. You have had a good run today—don’t spoil it.

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[Tristan Osborne (Chatham and Aylesford) (Lab)]

T5. Pharmacy First is an incredibly popular service that has allowed many residents in Chatham and Aylesford to be referred for illnesses or urgent repeat medicine supplies. Can the Minister indicate whether there warrants a further review and expansion of this offering, to include further access to medicines, including those to treat common dental conditions with bacterial infections, so that patients with these very painful emergency needs can seek immediate over-the-counter appointments?

[Mr Speaker]

Can Members please remember that these are topical questions?

[The Minister for Care (Stephen Kinnock)]

We are making a priority of resuming consultations with the sector to stabilise community pharmacy. Pharmacy First has built on existing services to increase the clinical scope. The conditions treated under Pharmacy First vary across the UK, and the NHS will keep this under review.

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[Wes Streeting]

The hon. Member is right to raise cases where there are multiple comorbidities or complex conditions requiring a range of care services. That is why we need to design services around the patient, not expect patients to contort themselves around the services. Our approach to neighbourhood health services should make a real difference in that regard, but we have to go further and faster on health and care integration, and we absolutely will.

[Mr Speaker]

Order. I call Kevin McKenna to ask the final question.

[Kevin McKenna (Sittingbourne and Sheppey) (Lab)]

I strongly welcome yesterday’s announcement about using initiatives such as community diagnostic centres to move services closer to the public. In the Isle of Sheppey, we are particularly exposed as a coastal community, but thankfully a new CDC will really help. Unfortunately, my experience in the NHS over the past few years shows that while the previous Government talked the talk about shifting care to the community, they failed to deliver. Will the Secretary of State set out what steps will be taken, so I can show my constituents that this shift will actually happen?