NHS Dentistry

Lindsay Hoyle Excerpts
Tuesday 9th January 2024

(10 months, 2 weeks ago)

Commons Chamber
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Lindsay Hoyle Portrait Mr Speaker
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I inform the House that I have selected the amendment in the name of the Prime Minister.

I call the shadow Secretary of State.

Building an NHS Fit for the Future

Lindsay Hoyle Excerpts
Monday 13th November 2023

(1 year ago)

Commons Chamber
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Helen Whately Portrait Helen Whately
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As I said a moment ago—let me remind the hon. Lady of this—we are not waiting for legislation in order to bring forward mental health reforms. That is why, for instance, we have already been rolling out mental health support teams in schools. We are already ahead of schedule on that; we are giving a quarter of England’s school and college children access to mental health support teams a year ahead of schedule. In addition, thanks to this Government, dormitory accommodation for mental health patients will soon become a thing of the past.

It has been a pleasure to work with the new Secretary of State for Environment, Food and Rural Affairs, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), and a huge honour to work with my hon. Friends the Members for Colchester (Will Quince) and for Harborough (Neil O'Brien) as part of a Government taking the long-term decisions to build a health and care system for the future, one with more doctors, nurses, pharmacists, physios and care workers, better mental healthcare for adults and children, more proactive care in the community, greater capacity, the newest technology and more choice, where conditions are diagnosed quicker or prevented altogether, thus helping people to live longer and healthier lives.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Secretary of State.

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Wes Streeting Portrait Wes Streeting
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I am very grateful to the hon. Member for his intervention. I am deeply concerned about the situation facing children with cystic fibrosis in particular, given that there is radically life-extending treatment available that offers the hope to those young people not just of longer, happier, healthier lives, but of reduced admissions to hospital. It is right that the National Institute for Health and Care Excellence makes those judgments in a rigorous way, looking at the evidence. I hope that it will be successful in bringing down the price of those drugs by negotiating with the pharmaceutical companies to make sure that we can get affordable drugs to families who desperately need them and are desperately anxious that the announcement they have read about means shorter lives for their children. No family should go through that agony, and I hope that a resolution can be found.

The Government and the previous Health Secretary got into the habit of stealing Labour’s policies—I say that not as a complaint, but as an invitation. It is clear that the Government do not have a plan to cut NHS waiting lists, but we do: £1.1 billion will be paid straight into the pockets of hard-pressed NHS staff to deliver 2 million more appointments a year at evenings and weekends, paid for by abolishing the non-dom tax status, because patients need treatment more than the wealthiest need a tax break—[Interruption.] Conservative Members groan when we mention charging non-doms their fair share, they groan when we talk about closing private equity loopholes and they groan when we talk about taxing private schools fairly. They did not groan when taxes went up on working people. They did not groan when benefits were cut for the poorest people.

We know who the Conservatives are in it for. They are in it for the few; we champion the interests of the many. That is the Labour difference. We believe strongly that people who live or work in Britain should pay their taxes here too. There is still time for the new Secretary of State to lobby the Chancellor ahead of the autumn statement. This genuinely is an oven-ready plan, unlike some of the plans we have heard from the Conservatives, and I encourage the new Secretary of State to nick it.

After 13 years, we have an NHS that gets to people too late. We have a hospital-based system geared towards late-stage diagnosis and treatment, which delivers poorer outcomes at greater cost. We have an analogue system in a digital age. We have a sickness service, not a health service, with too many lives hampered by preventable illness and too many lives lost to the biggest killers. It could not be clearer: the longer we give the Conservatives in power, the longer patients will wait. This was an empty King’s Speech from a Government who have run out of road, run out of steam and run out of ideas; a Conservative party too busy tearing itself apart to govern the country; a Prime Minister who cannot decide whether it is time for a change or to go back to year zero.

The future of the NHS after another five years of the Tories is emerging before our eyes: a two-tier health service, where those who can afford it go private, and those who cannot are left waiting behind—our NHS reduced to a poor service for poor people; our country viewed as the sick man of Europe. It does not have to be that way. The Prime Minister was right when he said,

“It’s time for a change”,

but only Labour can deliver it.

Labour has a different vision for our country in which no one fears ill health or old age; people have power, choice and control over their own health and care; the place people are born, or the wealth they are born into, does not determine how long they will live or how happy their lives will be; patients benefit from the brightest minds developing cutting-edge treatments and technology; and children born in Britain today become the healthiest generation that ever lived.

Only Labour has a plan to get the NHS back on its feet and make that vision a reality: a plan to cut waiting lists, delivering 2 million more appointments a year; a rescue plan for NHS dentistry, delivering 700,000 more appointments, recruiting dentists to the areas most in need, introducing toothbrushing for three to five-year-olds in schools and having an NHS dentist for all who need one; a plan to double the number of scanners so that patients are diagnosed earlier; a plan to recover our nation’s mental health from the damage of lockdowns; a plan to cut red tape that ties up GPs’ time, so that we can bring back the family doctor; a plan for the biggest expansion of NHS staff in history—a plan so good that the Government adopted it and gave us a head start; and a plan to reform the NHS to make it fit for the future. To those who say that that cannot be done and that things cannot be better, I say this: the last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history. We did it before and we will do it again.

It is not a change of faces we need but a change of Government. It is time to call a general election and give the British people the choice: more of the same with the Conservatives or a fresh start with Labour. Call a general election now, so that Labour can give Britain its future back.

Lindsay Hoyle Portrait Mr Speaker
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We come now to a maiden speech, so there will be no interruptions. I call Steve Tuckwell.

Steve Tuckwell Portrait Steve Tuckwell (Uxbridge and South Ruislip) (Con)
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Thank you, Mr Speaker, for calling me to deliver my maiden speech. Many words have been dedicated to this summer’s by-election campaigns and the subsequent result in Uxbridge and South Ruislip, so I hope you will allow me to add just a few more words based on my own experiences, rather than the conjecture offered by many commentators.

Let me begin with ULEZ—the ultra low emission zone—and its expansion across outer London. It will come as no surprise to anyone that this is not the first time I have mentioned those four letters in this Chamber. Even though the extended charge zone has now come into being, I stand here—no longer the local candidate, but the Member of Parliament—still determined to fight the Mayor of London’s money grab and reduce the burden placed on my residents and local businesses.

For me, however, the by-election was about much more than ULEZ and its unnecessary expansion. It was about a variety of local issues, such as securing a new hospital, keeping Uxbridge police station open, providing further support for childcare places, and protecting our green spaces for future generations. It was a by-election campaign fought on multiple local issues of substance. So, rather than dwelling on ULEZ, may I suggest that what also drove residents to the polls was the motivation to have an MP who understands the needs of the community, who appreciates the complexities of the community, and who is truly embedded in the community?

Since 2018, I have served as a local councillor for the London Borough of Hillingdon. Hillingdon Council is well respected, and in some cases even envied, for its consistent year in, year out performance in core services that residents expect, be they weekly waste collections, which are quite rare these days; refurbishing libraries, not closing them; and being one of the greenest boroughs in London, with 67 green flag awarded parks and open spaces. All of this and more is achieved through Hillingdon Council’s continual focus on sound financial management that puts residents first. I pay tribute to the leader of Hillingdon Council, Councillor Ian Edwards, and his executive cabinet, as well as Sir Ray Puddifoot—the former leader for over two decades—my fellow councillors, both past and present, and of course the officer team and frontline teams across all departments who deliver great services for their residents and my constituents.

During the by-election, Uxbridge and South Ruislip saw intense campaigning, with a media frenzy and a whopping 17 candidates, but being the centre of attention is not something new for my constituency. Uxbridge is home to the Battle of Britain Bunker—one of the most popular heritage destinations in my constituency for visitors near and far. The bunker played a key part in the allied defensive network across Britain during the second world war, and it was from that bunker that No. 11 Fighter Command was controlled. No. 11 Fighter Command, based in Uxbridge, played a crucial role in securing victory during the battle of Britain. Indeed, it was at the entrance to the bunker that Winston Churchill first uttered his famous words,

“Never in the field of human conflict was so much owed by so many to so few.”

He repeated those profound words in this very Chamber four days later, on 20 August 1940.

A bunker mentality was right for that time, but now is not that time. This is a time not to hunker down and hide away, but to face the many complex challenges that face us here in the UK and across the globe. The Prime Minister, the Government and my party are quite rightly looking at the long term, and have outlined clear and decisive policies that are designed to tackle the challenges we face. They are not easy decisions, but decisions that build on the long-term horizon, rather than easy short-termism that has no foundation or substance. I was elected to stand up for the interests of my constituents. I was born and raised in the constituency that I now have the privilege of serving as an MP.

A number of years ago—probably a few more than I would care to admit—I was born at Hillingdon Hospital. The hospital holds a special place in my heart: my children were born there, and there have been plenty of visits and treatments for myself and my family over the years. I pay tribute to the entire team at Hillingdon Hospital, past and present, as they continue to demonstrate exceptional professionalism and dedication to the surrounding communities. Much has been said about the condition of our hospital, some of it rather harsh and sensationalist in the heat of by-election campaigning. With that in mind, I am incredibly proud of the work that has been completed as part of the delivery of a new hospital for Hillingdon. Thanks to the combined efforts of all involved, including the local NHS trust and Hillingdon Council, work has begun on delivering that new hospital.

I pay a specific tribute to my predecessor, Boris Johnson, for his tireless efforts in support of Hillingdon Hospital during his time as MP for Uxbridge and South Ruislip. He campaigned continuously for the funding to be secured and for the project to become a reality. That was one of many local campaigns that Boris championed across the constituency, and I thank him for his dedication in supporting many businesses, charities and community groups. While developing a new hospital is a large and complex project, I look forward to working with the Department of Health and Social Care to ensure that we can deliver long-term positive health outcomes and a state-of-the-art new hospital for my constituents.

To be stood here among these historic and world-famous green Benches is a great honour. It is incredibly humbling to follow in the footsteps of John Randall, who back in 1997 also became MP for Uxbridge as a result of a by-election. I am incredibly thankful for his advice and support on my journey to becoming an MP, and I hope to achieve as much as he did when he represented Uxbridge and South Ruislip. To be the Member of Parliament for Uxbridge and South Ruislip—the place where I was raised, where I have worked and where I live—representing friends, neighbours and strangers alike is a true honour. Immediately after the by-election, my work as an MP started: meeting some of the many faith and cultural groups that make Uxbridge and South Ruislip such a vibrant place to live, and visiting many local businesses that help keep residents in good, decent jobs and contribute to keeping our high streets bustling.

I thank the Hillingdon chamber of commerce for its engagement so early on. It is clear that we share the goal of supporting our businesses and keeping our community thriving, as well as encouraging other businesses to set their roots in our local economy. There are some fantastic businesses from small, home-based entrepreneurs and medium-sized exciting businesses such as Mills Ltd in Cowley, which is supporting gigabit infrastructure through the supply of essential tools and equipment, to a number of large national and international businesses such as Coca-Cola, Hertz and Brunel University, which all create employment opportunities for local people.

One of my priorities for Uxbridge and South Ruislip is to support business and promote our high streets. I am looking forward to taking this further through building on the work this Government have already done to protect businesses against the pressures of the cost of living. This includes a tax cut for 38,000 British pubs earlier this year through the Brexit pubs guarantee, and to ensure that our fantastic local pubs—like my local, the Middlesex Arms in South Ruislip—remain at the centre of the communities they have helped for many years. [Interruption.] A pint tonight, yes!

As I have already mentioned, much has been written about the by-election campaign. Even though local issues ultimately won over attempts to frame it with a national outlook, I want to take this opportunity to declare that I will be a Member of Parliament for all residents regardless of how or if they voted. I am incredibly proud of Uxbridge and South Ruislip and its civic pride from our active community-focused residents’ and volunteering groups to our dynamic, hard-working charities such as the Daniella Logun Foundation, which does amazing work to help children and their families with brain tumours and in raising awareness of childhood cancer.

As I have already said, we are a truly vibrant community, and through my priorities—they include a new Hillingdon hospital, securing even more police officers, protecting our green spaces, delivering improved special needs provision, supporting local businesses and improving our high streets—I stand here ready and determined to do all I can as a Member of Parliament to ensure that my community remains a great place to live, a great place to raise a family, a great place to work and a great place to grow to grow old in.

Mr Speaker, as I am sure you are aware, old habits die hard, so as a former postie, I will continue to deliver for the people of Uxbridge and South Ruislip. Thank you.

Lindsay Hoyle Portrait Mr Speaker
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We now come to the SNP spokesperson.

Osteoporosis

Lindsay Hoyle Excerpts
Thursday 26th October 2023

(1 year ago)

Commons Chamber
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Royal Assent
Lindsay Hoyle Portrait Mr Speaker
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I have to acquaint the House that the House has been to the House of Peers where a Commission under the Great Seal was read, authorising the Royal Assent to the following Acts:

Online Safety Act 2023

Worker Protection (Amendment of Equality Act 2010) Act 2023

Energy Act 2023

Non-Domestic Rating Act 2023

Procurement Act 2023

Levelling-up and Regeneration Act 2023

Economic Crime and Corporate Transparency Act 2023.

Oral Answers to Questions

Lindsay Hoyle Excerpts
Tuesday 17th October 2023

(1 year, 1 month ago)

Commons Chamber
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Maria Caulfield Portrait Maria Caulfield
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I was going to pay tribute to the hon. Lady for her work on mental health campaigning, and she will know we have done a huge amount. The suicide prevention strategy is a cross-Government piece of work, which makes sure suicide is everyone’s business, not just that of health and social care. Whether by supporting families bereaved by suicide or rolling out mental health support schemes in schools, it is this Government who are delivering on mental health services.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister.

Abena Oppong-Asare Portrait Abena Oppong-Asare (Erith and Thamesmead) (Lab)
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The House of Commons Library says there has been no statistically significant change in the rate of suicides in England since 2015. Suicide remains the biggest killer of men under 50 in the UK. Why has it taken so long for the Government to bring forward a strategy, and why do they continue to drag their feet over reform to the Mental Health Act? Can the Minister give the House a firm timetable today?

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Steve Barclay Portrait Steve Barclay
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It is always a pleasure to visit my hon. Friend’s constituency. He highlights a good illustration of how the national programme is working, backed with that £700 million of funding. We are closely monitoring the estate and, where RAAC mitigation is required, that work is taking place. He brings a good example of that to the House’s attention.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister.

Karin Smyth Portrait Karin Smyth (Bristol South) (Lab)
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Not only are the hospital buildings crumbling after 13 years of neglect, creating huge capacity challenges; it seems that those still standing do not have enough beds. As we heard from The Times this morning, the number of

“hospital beds…has fallen by almost 3,000 since ministers promised 5,000 before winter”.

It feels pretty much like winter to me. Is that just another broken promise?

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Lindsay Hoyle Portrait Mr Speaker
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You can respond sitting down if you wish.

Helen Whately Portrait Helen Whately
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It is fine; thank you, Mr Speaker.

Since Brexit, we have more than 13,000 more doctors and 48,000 more nurses working in the NHS in England, and 40,000 more full-time equivalent staff in adult social care. Our points-based immigration system means that we can recruit the talent we need from all over the world for our health and social care system, including from the European Union.

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Helen Whately Portrait Helen Whately
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We have the health and social care visa, which supports our health and social care services to recruit doctors, nurses and other professionals, as well as social care staff, helping to boost those numbers. The hon. Gentleman referred to the important NHS workforce long-term plan, which will increase the home-grown staff in our health service. That will give us 60,000 more doctors, 170,000 more nurses and 70,000 more allied health professionals in our NHS over the next 15 years.

Lindsay Hoyle Portrait Mr Speaker
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I call the SNP spokesperson.

Amy Callaghan Portrait Amy Callaghan (East Dunbartonshire) (SNP)
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It has been reported that the Home Secretary plans to tighten the rules for those arriving on a health and care worker visa, to block most from bringing dependents with them—yet another in a long list of her vendettas against children coming to these isles. What recent assessments has the Secretary of State made of how that will impact international recruitment and capacity in our already struggling health and care services?

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Stephen Hammond Portrait Stephen Hammond
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I am grateful to the Minister for that offer, because that would have been part of my question.

Lindsay Hoyle Portrait Mr Speaker
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Then you don’t need to ask it.

Stephen Hammond Portrait Stephen Hammond
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But in true style, Mr Speaker, I was hoping for two bites at the cherry. [Laughter.]

In my recent discussions with the management of St George’s Hospital, one concern about the consultation is that the specialist paediatric cancer surgical unit based at St George’s may be lost if the current proposal goes through. That would potentially affect real outcomes for a number of children. Will the Minister have a look at that and explain to me whether he is concerned about the current scoring by the NHS?

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Helen Whately Portrait Helen Whately
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My hon. Friend has made a good point about the importance of transparency and accurate data. As she said, just this week we learnt that Labour-run NHS Wales had been under-reporting its A&E waiting times. According to the Royal College of Emergency Medicine, about 45,000 patients are missing from the data. While we are working hard to improve services in the NHS in England, the Labour-run NHS in Wales is merely fudging the figures.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister.

Andrew Gwynne Portrait Andrew Gwynne (Denton and Reddish) (Lab)
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The whole purpose of integrated care systems is to join up social care and NHS services in a better way. We know, for example, that fracture liaison services keep 100,000 people out of hospital, but only 50% of English NHS trusts have them, and despite the commitment given by the Under-Secretary of State for Health and Social Care—the hon. Member for Lewes (Maria Caulfield—to providing more, nothing has happened, and Lord Evans has walked back from her commitment. I realise that I am pushing at an open door in directing this question to a Minister whose leg is strapped up, but when will the Government finally deliver for the “back better bones” campaign to help older people to survive and thrive?

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Steve Barclay Portrait Steve Barclay
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Through that £240 million, we have 100% adoption from GP practices that want to take part in receiving those funds and putting digital telephony in place if they have not already done so. This includes call-back, which allows people to know where they are in the queue, and links to online booking, which allows us to maximise the 31,000 additional roles that we have put into primary care so that people can see the specialist that they need. In my hon. Friend’s own integrated care board, appointments for July increased from 768,000 last July to 816,000 this July, so more patients are being seen, more appointments are taking place and more tech investment is going into the practices in his area.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Secretary of State.

Wes Streeting Portrait Wes Streeting (Ilford North) (Lab)
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To listen to the Secretary of State, you would think it was all going so well, so let me give him a reality check. In Tamworth last year, only a third of patients said it was easy to get through to their doctor on the phone, one in three GP appointments were not conducted face to face and fewer than half of patients were offered a choice of appointment. The Government are not listening to the people of Tamworth. Perhaps the Secretary of State would like to explain to the people of Tamworth why, after 13 years of Conservative Government, this is the case, and better still, adopt Labour’s plan to cut red tape, incentivise continuity of care and bring back the family doctor.

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Steve Barclay Portrait Steve Barclay
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He is right that we are taking both long-term and short-term actions. A key part of the long-term workforce plan is to boost the number of dentists being trained. In the more immediate term, earlier this year we made legislative changes that give the General Dental Council the flexibility to improve the way professionals are registered, giving more flexibility in terms of the skills mix and, for example, tripling the number of people sitting part 1 this year, so that more overseas professionals can be recognised and qualified to practise in the UK.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Secretary of State.

Wes Streeting Portrait Wes Streeting (Ilford North) (Lab)
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In Mid Bedfordshire last year, 165 children—[Interruption.] I do not know why Government Members are laughing; perhaps they should listen, as it is not our party that has let down the people of Mid Bedfordshire. Last year, 165 children in Mid Bedfordshire had teeth removed due to tooth decay. Some 800 patients were forced into A&E for the same reason and 100,000 people across the region cannot get access to an NHS dentist. Instead of laughing, the Government might like to adopt Labour’s plan to provide 700,000 extra dentistry appointments every year.

Steve Barclay Portrait Steve Barclay
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Since 2010, we have had 6.5% more dentists, a quarter more appointments and, as we have just touched on, increasing flexibility in regulation and boosting overseas recruitment. It is striking that one area of the country that the shadow Secretary of State does not want to talk about is Wales, which has a record of what a Labour Government will deliver. Indeed, the Leader of the Opposition says that he wants Wales to be the “blueprint” for what the NHS would be in England. There, this week, we have seen a fiddling of the figures on health. Even without that fiddling, we know people are twice as likely to be on a waiting list in Wales as in England—

Lindsay Hoyle Portrait Mr Speaker
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Order. One of us has got to sit down and it is not going to be me. I let you have a good crack at the beginning, Secretary of State. Your opening statement took quite a long time, which I do not mind. I do not mind your having a go about Wales, but I am certainly not going to open up a debate between the Government and Opposition Front Benches. Topical questions are for Back Benchers and about short questions with short answers. I want it to be kept that way, so please understand that. There must be too many by-elections, because Members are getting carried away.

Wes Streeting Portrait Wes Streeting
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It is not just Mid Bedfordshire. Across the country, the No.1 reason children aged six to 10 are admitted to hospital is tooth decay. Given that, will the Secretary of State at least adopt the modest measure that Labour has proposed to introduce national supervised tooth brushing for small children—low cost, high impact—to keep their teeth clean and keep children out of hospital?

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Will Quince Portrait The Minister for Health and Secondary Care (Will Quince)
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My right hon. Friend has long championed this cause. I hope it is good news that I am able to confirm that enabling works have recently been approved for the Shrewsbury and Telford Hospital NHS Trust hospital transformation programme and are expected to commence this financial year. I can also confirm that funding has been provided for the development of the full business case and is expected to be submitted in the coming months.

Lindsay Hoyle Portrait Mr Speaker
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I call the SNP spokesperson.

Amy Callaghan Portrait Amy Callaghan (East Dunbartonshire) (SNP)
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New research by UNICEF UK has made clear how badly the cost of living crisis has hit the mental health of families with young children. Rising prices and services gutted by austerity have left 60% of parents feeling overwhelmed, anxious, unsupported and lonely all or most of the time. What representations has the Secretary of State made to his Cabinet colleagues ahead of the upcoming autumn statement to support families and to improve health outcomes?

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Neil O'Brien Portrait Neil O’Brien
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My hon. Friend is right. The amount of NHS dentistry being delivered in his ICB has gone up in the last year, but we want to go further. The NHS has recently commissioned additional children’s orthodontic capacity within his ICB, but through the actions we are going to take, we will go further.

Lindsay Hoyle Portrait Mr Speaker
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I call Judith Cummins with the final question.

Judith Cummins Portrait Judith Cummins (Bradford South) (Lab)
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Having 100% fracture liaison services coverage in England would prevent an estimated 74,000 fractures, including 31,000 hip fractures, over five years. Will the Minister finally commit to 100% FLS coverage across England?

Countess of Chester Hospital Inquiry

Lindsay Hoyle Excerpts
Monday 4th September 2023

(1 year, 2 months ago)

Commons Chamber
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Steve Barclay Portrait The Secretary of State for Health and Social Care (Steve Barclay)
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With permission, Mr Speaker, I would like to make a statement on the inquiry into the circumstances surrounding the crimes of Lucy Letby.

On 18 August, as the whole House is aware, Letby was convicted of the murder of seven babies and the attempted murder of six others. She committed these crimes while working as a neonatal nurse at the Countess of Chester Hospital between June 2015 and June 2016. As Mr Justice Goss said as he sentenced her to 14 whole life orders, this was a

“cruel, calculated and cynical campaign of child murder”

and a

“gross breach of the trust all citizens place in those who work in the medical and caring professions.”

I think the whole House will agree it is right that she spends the rest of her life behind bars.

I cannot begin to imagine the hurt and suffering that these families went through, and I know from my conversations with them last week that the trial brought these emotions back to the surface. Concerningly, that was exacerbated by the fact the families discovered new information about events concerning their children during the course of the trial.

Losing a child is the greatest sorrow any parent can experience. I am sure the victims’ families have been in the thoughts and prayers of Members across the House, as they have been in mine. We have a duty to get them the answers they deserve, to hold people to account and to make sure lessons are learned. That is why, on the day of conviction, I ordered an independent inquiry into events at the Countess of Chester Hospital, making it clear that the victims’ families would shape it.

I arranged with police liaison officers to meet the families at the earliest possible opportunity to discuss with them the options for the form the inquiry should take, and it was clear that their wishes are for a statutory inquiry with the power to compel witnesses to give evidence under oath. That is why I am confirming this to the House today.

The inquiry will examine the case’s wider circumstances, including the trust’s response to clinicians who raised the alarm and the conduct of the wider NHS and its regulators. I can confirm to the House that Lady Justice Thirlwall will lead the inquiry. She is one of the country’s most senior judges. She currently sits in the Court of Appeal, and she had many years of experience as a senior judge and a senior barrister before that. Before making this statement, I informed the victims’ families of her appointment, which was made following conversations with the Lord Chief Justice, the Lord Chancellor and the Attorney General.

I have raised with Lady Justice Thirlwall the fact that the families should work with her to shape the terms of reference. We hope to finalise those in the next couple of weeks, so that the inquiry can start the consultation as soon as possible. I have also discussed with Lady Justice Thirlwall the families’ desire for the inquiry to take place in phases, so that it provides answers to vital questions as soon as possible. I will update the House when the terms of reference are agreed and will continue to engage with the families.

Today, I would also like to update the House on actions that have already been taken to improve patient safety and identify warning signs more quickly, as well as action that is already under way to strengthen that further. First, in 2018, NHS England appointed Dr Aidan Fowler as the first national director of patient safety. He worked with the NHS to publish its first patient safety strategy in 2019, creating several national programmes. Those included requiring NHS organisations to employ dedicated patient safety specialists, ensuring that all staff receive robust patient safety training and using data to quickly recognise risks to patient safety. Last summer, to enhance patient safety further, I appointed Dr Henrietta Hughes, a practising GP, as England’s first patient safety commissioner for medicines and medical devices. Dr Hughes brings leaders together to amplify patients’ concerns throughout the health system.

Secondly, in 2019, the NHS began introducing medical examiners across England and Wales to independently scrutinise deaths not investigated by a coroner. Those senior doctors also reach out to bereaved families and find out whether they have any concerns. All acute trusts have appointed medical examiners who now scrutinise hospital deaths and raise any concerns they have with the appropriate authorities.

Thirdly, in 2016, the NHS introduced freedom to speak up guardians, to assist staff who want to speak up about their concerns. More than 900 local guardians now cover every NHS trust. Fourthly, in 2018, Tom Kark KC was commissioned to make recommendations on the fit and proper person test for NHS board members. NHS England incorporated his review findings into the fit and proper person test framework published last month. It introduced additional background checks, the consistent collection of directors’ data and a standardised reference system, thus preventing board members unfit to lead from moving between organisations.

Finally, turning to maternity care, in 2018 NHS England launched the maternity safety support programme to ensure that underperforming trusts receive assistance before serious issues arise. Also since 2018, the Government have funded the national perinatal mortality review tool, which supports trusts and parents to understand why a baby has died and whether any lessons can be learned to save lives in the future. Furthermore, the Government introduced the maternity investigations programme, through the Health Safety Investigation Branch, which investigates maternity safety incidents and provides reports to trusts and families. In 2020, NHS England’s Getting It Right First Time programme was expanded to cover neonatal services. It reviewed England’s neonatal services using detailed data and gave trusts individual improvement plans, which they are working towards. Indeed, Professor Tim Briggs, who leads that programme, has confirmed that all neonatal units have been reviewed by his programme since 2021.

Let me now turn to our forward-facing work. We have already committed to moving medical examiners to a statutory basis and will table secondary legislation on that shortly. It will ensure that deaths not reviewed by a coroner are investigated in all medical settings, in particular extending coverage in primary care, and will enter into force in April.

Secondly, on the Kark review, at the time the NHS actively considered Kark’s recommendation 5 on disbarring senior managers and took the view that introducing the wider changes he recommended in his review mitigated the need to accept that specific recommendation on disbarring. The point was considered further by the Messenger review.

In the light of evidence from Chester and ongoing variation in performance across trusts, I have asked NHS England to work with my Department to revisit this. It will do so alongside the actions recommended by General Sir Gordon Messenger’s review of leadership, on which the Government have already accepted all seven recommendations from the report dated June last year. This will ensure that the right standards, support and training are in place for the public to have confidence that NHS boards have the skills and experience needed to provide safe, quality care.

Thirdly, by January all trusts will have adopted a strengthened freedom to speak up policy. The national model policy will bring consistency to freedom to speak up across organisations providing NHS services, supporting staff to feel more confident to speak up and raise any concerns. I have asked NHS England to review the guidance that permits board members to be freedom to speak up guardians, to ensure that those roles provide independent challenge to boards.

Fourthly, the Getting it Right First Time programme team will launch a centralised and regularly updated dataset to monitor the safety and quality of national neonatal services.

Finally, we are exploring introducing Martha’s rule to the UK. Martha’s rule would be similar to Queensland’s system, called Ryan’s rule. It is a three-step process that allows patients or their families to request a clinical review of their case from a doctor or nurse if their condition is deteriorating or not improving as expected. Ryan’s rule has saved lives in Queensland, and I have asked my Department and the NHS to look into whether similar measures could improve patient safety here in the UK.

Mr Speaker, I want to take the first opportunity on the return of the House to provide an update on the Essex statutory inquiry. In June, I told the House that the inquiry into NHS mental health in-patient facilities across Essex would move forward on a statutory footing. Today, I can announce that Baroness Lampard, who led the Department of Health’s inquiry into the crimes of Jimmy Savile, has agreed to chair the statutory inquiry. I know that Baroness Kate Lampard will wish to engage with Members of the House and the families impacted, and following their input I will update the House on the terms of reference at the earliest opportunity.

The crimes of Lucy Letby were some of the very worst the United Kingdom has witnessed. I know that nothing can come close to righting the wrongs of the past, but I hope that Lady Justice Thirlwall’s inquiry will go at least some way towards giving the victims’ families the answers they deserve. My Department and I are committed to putting in place robust safeguards to protect patient safety and to making sure that the lessons from this horrendous case are fully learned. I commend this statement to the House.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Secretary of State.

Oral Answers to Questions

Lindsay Hoyle Excerpts
Tuesday 11th July 2023

(1 year, 4 months ago)

Commons Chamber
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Steve Barclay Portrait Steve Barclay
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As a former Health Minister, my hon. Friend is well aware of the risks posed by vaping. As the chief medical officer has said,

“If you smoke, vaping is much safer; if you don’t smoke, don’t vape”.

That is why we are toughening up the regime. We are also working with industry as part of our call for evidence, but we are clear on the need to go further. That is exactly what we will do.

Lindsay Hoyle Portrait Mr Speaker
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I call the SNP spokesperson.

Martyn Day Portrait Martyn Day (Linlithgow and East Falkirk) (SNP)
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Youngsters who try e-cigarettes are at much greater risk of both nicotine addiction and later going on to use tobacco itself, so what consideration have this Government given to banning disposable vapes completely as a way of protecting our young people?

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Neil O'Brien Portrait Neil O’Brien
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Absolutely, and I always try to learn lessons from right across the UK. In fact, some of the ideas for reforms have come from listening to local partners. For example, our reforms to enable modern ways of working, hub-and-spoke dispensing and empowering pharmacy technicians have come from talking to those local partners.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister.

Karin Smyth Portrait Karin Smyth (Bristol South) (Lab)
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People across the country rely on local, accessible pharmacies, but whether it is high street closures or supply problems leading to the absurd situation where women are phoning or visiting multiple pharmacies for a prescribed dose of hormone replacement therapy and other drugs, the Government are again letting people down. They have repeatedly announced plans to expand the role of community pharmacies, but have failed to update legislation that could possibly help. They keep collapsing the business in this place, so we have time to sort it. Why will they not do so?

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Will Quince Portrait Will Quince
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I thank my hon. Friend for his question, and I am sorry to hear of his own personal experience. He is absolutely right that, in relation to children, I am very keen to find a way forward. The Government are committed to finding high-quality brain cancer research, and we expect to spend more as new research progresses. The £40 million of funding announced will remain available, and if we can spend more on the best-quality science, we will do so. We worked really closely with Lord O’Shaughnessy on his review, we have accepted his recommendations and we have put in £121 million to support it.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Secretary of State.

Wes Streeting Portrait Wes Streeting (Ilford North) (Lab)
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The Minister is aware, I know, of the outstanding campaigning work that my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) is doing, not least because of the experience of her sister—our late great friend Margaret McDonagh—with glioblastomas. Over decades now, we have seen no improvements in outcomes, no drug trials of any seriousness and no mandatory training of oncologists. I have learned through experience that, when the McDonaghs come knocking, it is best to say yes, and if anyone says no, they will be hit by this unstoppable steamroller. With that cautionary note in mind, might the Minister be prepared to meet me, my hon. Friend and relevant stakeholders across the Department, NHS England and the National Institute for Health and Care Excellence to see what more can be done? There are challenges, I know, but what more can be done to make sure that, for families such as my hon. Friend’s and Margaret’s, and for thousands of others each year, glioblastomas are not simply a death sentence?

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Maria Caulfield Portrait Maria Caulfield
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I thank my hon. Friend for raising that issue. There were many recommendations during pre-legislative scrutiny. We are working through those and we hope to be able to respond fully shortly after the summer recess.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister.

Rosena Allin-Khan Portrait Dr Rosena Allin-Khan (Tooting) (Lab)
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As my hon. Friend the Member for Leeds North East (Fabian Hamilton) highlighted, all too often, children are stuck on long waiting lists for treatment. In West Yorkshire, 30,000 children are currently stuck waiting for mental health treatment, and more than 9,000 people have had their mental health referral closed without accessing treatment. Does the Minister find that acceptable? If the answer is no, what will her Government do about it? This picture is not unique to West Yorkshire, but replicated across England. This Government are letting patients down. When is the Minister going to act to tackle the crisis in mental health services?

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Neil O'Brien Portrait Neil O’Brien
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My hon. Friend is assiduous in making the case for his constituency. Ministers of course will meet him to discuss this matter. I know he is closely following the progress of the CDC bid, which we have been talking about. Those diagnostic centres are doing fantastic work to get earlier diagnosis and save more lives, particularly in areas of deprivation.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister.

Andrew Gwynne Portrait Andrew Gwynne (Denton and Reddish) (Lab)
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From this complacent Minister’s replies already, one would think that health inequalities in England were improving, not widening. Last year, 11,000 people, including 312 children, were hospitalised for malnutrition in the United Kingdom. That is the highest number since comparable records began. Why are so many people in Britain going hungry under the Tories?

Neil O'Brien Portrait Neil O’Brien
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We need to have care in discussing these subjects. Eating disorders are a sensitive subject and the statistics the hon. Gentleman is quoting are a mix of different things. I have already talked about the £3,300 of cost of living support that this Government are providing to the average UK household, with more targeted help for more vulnerable households. It is something we are seized of and are working on.

Lindsay Hoyle Portrait Mr Speaker
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I call the SNP spokesperson.

Martyn Day Portrait Martyn Day (Linlithgow and East Falkirk) (SNP)
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Millions of people with disabilities or serious medical conditions rely on specialist equipment, such as ventilators or home dialysis, which personally costs them more money to run, while giving considerable savings to NHS hospitals. Will the Minister urge Cabinet colleagues in the Department for Work and Pensions to help to tackle health inequalities by ensuring that those people receive a fair and timely reimbursement for those additional costs, which are essential to run the equipment to help keep them alive?

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Steve Barclay Portrait Steve Barclay
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I am always very happy for my hon. Friend and other colleagues to meet me or Lord Markham, who leads the capital programme. It is an important scheme. We are delivering it through the standardised Hospital 2.0 approach, using modern methods of construction. We are keen to progress early supported works on site, working closely with colleagues.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Secretary of State.

Wes Streeting Portrait Wes Streeting (Ilford North) (Lab)
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Last week, the Health Secretary said that he was willing to offer doctors a higher pay rise. Last night, the Chancellor slapped him down, saying that any increased offer will have to be paid for by cuts. How can the Health Secretary negotiate an end to the NHS strikes when he cannot even negotiate with his own Chancellor?

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Lindsay Hoyle Portrait Mr Speaker
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I call the Chairman of the Health and Social Care Committee.

Steve Brine Portrait Steve Brine (Winchester) (Con)
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Back to NHS dentistry, I am afraid. Later this week, the Select Committee will publish its report on NHS dentistry services. Spoiler alert: it will be uncomfortable reading for some. Will the Secretary of State tell us when and how he plans to bring forward plans for the tie-in of newly qualified dentists? Could that go hand in hand with a “return to the NHS” campaign for dentists who have already left that part of the service?

NHS Long-term Workforce Plan

Lindsay Hoyle Excerpts
Monday 3rd July 2023

(1 year, 4 months ago)

Commons Chamber
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Lindsay Hoyle Portrait Mr Speaker
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I wish to thank the Secretary of State for Health and Social Care for coming to the Chamber to make his statement. It is a pity that the Prime Minister did not do so on Friday when the world heard what he had to say before we did. The Prime Minister is a Member of Parliament. He is answerable to the Members of Parliament from all political parties. I have to say that his behaviour was not acceptable. He may be the Prime Minister, but the Members of Parliament should hear first. I am very pleased that the Secretary of State is doing it the right way.

Steve Barclay Portrait The Secretary of State for Health and Social Care (Steve Barclay)
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The Government note the comments that you have made from the Chair, Mr Speaker.

Lindsay Hoyle Portrait Mr Speaker
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I would love them to take what I have said on board.

Steve Barclay Portrait Steve Barclay
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That is also noted, Mr Speaker.

May I, on behalf of the Government, note the passing of the former head of the civil service, Lord Kerslake? He had a distinguished career in public service, including as chief executive of Sheffield Council and chair of King’s College Hospital NHS Foundation Trust, as well as being head of the civil service. We send our condolences to his family and friends both in Whitehall and across the civil service.

With permission, Mr Speaker, I wish to make a statement on our long-term workforce plan for the NHS.

This week marks the 75th birthday of the NHS. We should celebrate its achievements, its founding principles and its people. From doctors and dentists to pharmacists and physios, NHS staff devote their lives to caring for others. I am sure the whole House would agree that the NHS holds a special place in our country due to the care offered by the people who work for it.

It is said that, in 1948, the NHS had fewer than 150,000 staff and a budget of around £11 billion. Today, the NHS employs closer to 1.4 million people with a budget of more than £160 billion. The transformation of the care offered by the NHS through advances in medicine is reflected in the fact that people now live 13 years longer than on average in 1948.

Today, alongside the increase in the number of staff, the range of treatments and the improved patient outcomes, demand on the NHS has also increased. People live longer, they live with more complex medical conditions, and we are also dealing with the challenges left behind by a once-in-a-generation pandemic.

One in four adults lives with two or more health conditions. Although our population is forecast to grow by around 4% over the next 15 years, the number of those over 85 is forecast to grow by more than 50%. In addressing the challenges both of today and of the longer term, it is right that we have a recovery plan focused on the immediate steps as we rebuild from the pandemic, and longer-term plans to ensure that the NHS is sustainable for the future. This will ensure that the NHS is there for future generations in the way that it has been for us and our families over the past 75 years.

We have already set out detailed recovery plans to reduce long waits for operations, improve access to urgent and emergency care and make it easier to see GPs and specialists in primary care. On electives, we have virtually eliminated the two-year wait, which we did this summer, and cleared more than 90% of 80-week waits from their peak at the end of March—in marked contrast to the much longer waits we see in Wales, where the NHS is run by Labour.

On urgent and emergency care, we are investing £1 billion in 5,000 additional permanent beds, alongside expanding virtual wards to improve discharge from hospital and investing in community services to prevent admissions, especially for the frail and elderly. On primary care, we are investing more than £600 million, including in improving technology to address the 8 am rush. We have already exceeded our manifesto target by 3,000, with 29,000 additional roles in primary care to enable patients to access specialists more quickly, and we are reducing burdens on GP surgeries through the development of the NHS app and improving the range of services offered through Pharmacy First, enabling pharmacists to prescribe drug treatments for seven minor illnesses.

Alongside the recovery plans, we are taking action to improve prevention through early diagnosis of conditions, whether through the 108 community diagnostic centres that are already open, or the 43 new and expanded surgical hubs planned for this year. Our national roll-out of our lung cancer screening programme has helped to transform patient outcomes, turning on its head the previous position where 80% of lung cancers in our most deprived communities were detected late, with 76% now being detected early.

Alongside the immediate measures we are taking to deal with demand in the NHS, as we celebrate the 75th anniversary we are also investing in the NHS to make sure it is sustainable for the future. Last month, I announced to the House the largest-ever investment in the NHS estate, with more than £20 billion committed to our new hospitals programme.

Today I can confirm to the House that, for the first time in the NHS’s history, the Government have committed to publishing a long-term workforce plan, setting out the largest-ever workforce training expansion in the NHS’s history, backed by £2.4 billion of new funding. The plan responds to requests from NHS leaders and has been developed by NHS England. I would like to take this opportunity to thank Amanda Pritchard, the chief executive of NHS England and her team, Gavin Larner and colleagues within the Department of Health and Social Care, and the more than 60 NHS organisations that have engaged closely in the plan’s development, including many of our Royal Colleges.

The plan sets out three priorities: to train more staff, to retain and develop the staff already working for the NHS and to reform how training is delivered, taking on board the best of international practice. Let me deal with each in turn. We will double the number of medical school places, increase the availability of GPs being trained by 50%, train 24,000 more nurses and midwives and increase the number of dentists by 40%.

When it comes to improving retention, we recognise the importance of flexible working opportunities, especially for those approaching retirement. The plan will build on proposals in the NHS people plan and build on steps already taken by the Chancellor at the spring Budget on pension tax reform.

In respect of reform, the plan sets out policies to expand the number of associate roles, which provide greater career progression for existing staff and in turn reduce the workload of senior clinicians, allowing them to focus on the work that only they can do. Both measures will improve productivity by enabling more staff to operate at the top of their licence. A constant theme across the long-term workforce plan is our focus on apprenticeships and vocational training, including a commitment to increasing the number of staff coming through apprenticeships from 7% today to 22% by 2031-32. That reflects the strong commitment of the Secretary of State for Education and myself to facilitate greater career progression through apprenticeships. It will also help to recruit and retain staff in parts of the country that often find it harder to recruit

In the week in which we celebrate the 75th anniversary of the NHS, today’s announcement confirms the Government’s commitment to the first ever comprehensive NHS long-term workforce plan. The plan sets out detailed proposals to train more staff, offers greater flexibility and opportunity to existing staff, and embraces innovation by reforming how education and training are delivered across the NHS. The plan will be iterative; we will return to it every couple of years to enable progress to reflect advances in technology such as artificial intelligence so that the numbers trained can be best aligned with patient services. It also reflects a growing need for more general skills in the NHS, as patients with more than one condition require a more holistic approach.

The NHS long-term plan, backed by £2.4 billion of new funding, comes in addition to our record investment in the NHS estate. It ensures that we put in place the funding required for a sustainable future for the NHS, alongside the steps that we are taking in the immediate term to reduce waiting lists and ensure that the NHS is there for patients. As the chief executive of NHS England has said herself, the long-term workforce plan is a truly historic moment for the NHS. As such, I commend this statement to the House.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister.

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Steve Barclay Portrait Steve Barclay
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Well, that really was a confused response. The hon. Lady began with reference to Labour’s proposals and the claim that our plan followed them. I took the precaution of bringing Labour’s announcement with me to the Chamber. Members can look at it in their own time, but it does not use the word “reform” once, despite the fact that “Train, retain, reform” is a key part of our proposals. Proposals for reform include moving from five-year to four-year medical undergraduate training; the expansion of roles such as physician associate; a significant expansion in the use of apprenticeships; and flexibility for retiring consultants, so that they can return to roles in, for example, out-patient services. A wide range of reforms came about as a result of the consultation with 60 different NHS organisations and are a key feature of the plan, but in Labour’s proposals reform is not mentioned once.

In addition, Labour’s proposals are for a 10-year period. Our plan covers 15 years. Its proposal covered 23,000 additional health roles; our proposal deals with 50,000. I could go on and talk about the fact that the Labour proposal does not even mention GP trainees. Labour Members keep coming to the House and saying that primary care is important, but their proposals did not even touch on the workforce with regard to GPs. They did not even mention pharmacists, even though, as part of a primary care recovery plan, a key chunk of our proposal is Pharmacy First. It is extremely important that we can deliver services to patients in innovative ways. The ultimate irony is that the shadow Health Secretary, in one of his many interviews, including interviews to promote his book, said that the NHS “must reform or die”. He said that it must reform, yet Labour’s proposals do not mention reform at all.

Labour welcomes the plan, but it goes on to say that it will take too long to implement, while claiming that it is its plan, which, again, points to the confusion among Labour Members. Let me remind the House of what has been done. We had a manifesto commitment for 50,000 additional nurses—we are on track to deliver that, with 44,000 in place. We had a manifesto commitment to have 26,000 additional roles in primary care, and we have met that, with 29,000 roles in place. In 2018, we made a commitment to five new medical schools in parts of the country where it is hard to recruit. We have delivered that—a 25% expansion in the number of medical students, who will come on stream in hospitals next summer. However, as we celebrate the 75th anniversary of the NHS, it is right that we also look beyond that to the longer-term needs of the NHS. That is exactly what the plan does with its doubling of medical places, but alongside that, it innovates by embracing things like a medical apprenticeship so that we can look at different ways of delivering training.

The hon. Lady talked about strikes, which is a further area of confusion on the Labour Benches. Labour Members say that they do not support a 35% pay rise for junior doctors, on the grounds that the shadow Chancellor, the right hon. Member for Leeds West (Rachel Reeves), says that they should not. Either Labour Members want to support the junior doctors, or they do not—once again, their position seems confused.

I will finish with one final area of confusion on the Labour Benches. The hon. Lady talked about the elastic non-dom revenue raiser, despite the fact that the former shadow Chancellor, Ed Balls, has said that it would not raise the funds that are claimed. He has said that it would do quite the opposite: it would deter investment in the UK. In addition, Labour has already spent those funds on a range of measures, such as the breakfast clubs that Labour Members come to the House and talk about. The reality is that it would not fund Labour’s proposals, whereas we have made a commitment to back our plan with £2.4 billion of funding from the Treasury.

This is a historic moment as we celebrate the 75th anniversary of the NHS. It is a long-term commitment from a Government who are backing the NHS through the biggest investment in the NHS estate—over £20 billion —and a series of recovery programmes, expanding our diagnostic capacity and our surgical hubs. That is why the workforce plan is truly innovative. It does not just train more staff or offer opportunities to retain more staff; it reforms as well—something that is sadly lacking in Labour’s proposals.

Lindsay Hoyle Portrait Mr Speaker
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I call the Chair of the Select Committee.

Steve Brine Portrait Steve Brine (Winchester) (Con)
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This is a serious piece of work, and it is very welcome. Despite calls from people like me to get on with it, it was right for the Government to take their time and get it right. The Select Committee will scrutinise it—as we do—on 12 July.

The training piece is very strong. Doubling the number of medical school places has to be right, and I am glad that the Secretary of State thought of it. On retention, if we are saying—rightly, I would contest—that it is not all about pay, what role does he envisage the integrated care systems and, therefore, the trusts having in supporting staff as he makes the “one workforce” that is mentioned in section 5, with which I agree, come to pass?

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Steve Barclay Portrait Steve Barclay
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First, this is a plan developed by colleagues in NHS England, so these are assumptions that have been agreed by those who lead within the NHS. It is about ensuring that people operate at the top of their licence. It is about having new and expanded roles, such as advanced practitioners and associate roles, that allow people to progress in their careers and, in doing so, freeing up capacity for senior clinicians, who often spend time doing things that do not need to be done by people in those roles.

Of course, there are also rapid changes in technology. We often talk about the developments in artificial intelligence, and I have touched on developments in the life sciences industry. I have also mentioned advances in screening and genomics. All those developments will in turn help us to prevent health conditions, and treating those conditions early will be not only better for the patient, but better value for money for the taxpayer.

Lindsay Hoyle Portrait Mr Speaker
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I thank the Secretary of State for his statement, and for responding to questions for 59 minutes.

Mental Health In-patient Services: Improving Safety

Lindsay Hoyle Excerpts
Wednesday 28th June 2023

(1 year, 4 months ago)

Commons Chamber
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Steve Barclay Portrait The Secretary of State for Health and Social Care (Steve Barclay)
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With permission, Mr Speaker, I would like to make a statement on improving safety in mental health in-patient services across England. Before doing so, I want to thank all the right hon. and hon. Members from across the country who have campaigned tirelessly on behalf of their constituents to improve mental health care. Too many people have experienced care in mental health in-patient settings that has been well below the high standard that we all deserve when we are at our most vulnerable. I would also like to put on record my sincere condolences to the families and friends of those who have lost their lives.

First, I will update the House on the independent inquiry into mental health in-patient care across NHS trusts in Essex between 2000 and 2020. I thank my right hon. Friend the Member for Chelmsford (Vicky Ford) for tabling a Westminster Hall debate on the Essex mental health inquiry earlier this year. She and colleagues, including our hon. Friend the Member for Rochford and Southend East (Sir James Duddridge) and our right hon. Friends the Members for Witham (Priti Patel) and for Maldon (Sir John Whittingdale), all spoke passionately about the need to get justice for patients and their families. I know that my hon. Friend the Member for South Suffolk (James Cartlidge) also tabled an Adjournment debate on mental health in-patient care in Essex before the independent inquiry was launched in 2021.

I also pay tribute to my right hon. Friend the Member for Saffron Walden (Kemi Badenoch) and my hon. Friends the Members for Clacton (Giles Watling), for Brentwood and Ongar (Alex Burghart), for Castle Point (Rebecca Harris), and for Southend West (Anna Firth) for their determined campaigning on behalf of their constituents. Of course, we should all remember the important contribution of the former Member for Southend West, and a great friend to many across this house, the late Sir David Amess. He tabled a Westminster Hall debate on mental health services in Essex back in 2014, and he was a passionate campaigner for improving mental health care. I know he is very much in our thoughts.

In 2021 we launched the independent inquiry to investigate the deaths of mental health in-patients across NHS trusts in Essex between 2000 and 2020. The Government appointed Dr Geraldine Strathdee, a former national clinical director for mental health for NHS England, to chair the inquiry. I want to place on the record my thanks to Dr Strathdee and her team, because a lot of good work has been done. I applaud the bravery of all the victims and their families who have come forward to tell their stories.

I also recognise the work that the Essex Partnership University NHS Foundation Trust—EPUT—has done to assist with the inquiry. The trust has been in the spotlight, and progress has already been made to learn lessons and improve in-patient mental health care. EPUT’s chief executive, Paul Scott, joined in 2020, and since then the trust has invested £20 million in its mental health in-patient wards and a further £20 million in community services. Compared with 2019, patients absconding from care has decreased by more than 60%, and the use of inappropriate restraint has fallen by 88%.

However, in January Dr Strathdee raised concerns with me about a lack of engagement with the inquiry by current and former EPUT staff. I know that many right hon. and hon. Members share her concerns. Since then, the inquiry and the trust have worked together in a concerted effort to increase staff engagement. None the less, I have listened to Dr Strathdee’s concerns that the inquiry still needs further staff engagement to get victims’ families the answers they deserve. In a letter to me in March, she said that

“30 percent of named staff, those essential witnesses involved in deaths we are investigating, have agreed to attend evidence sessions. In my assessment, I cannot properly investigate matters with this level of engagement.”

She has also raised with me concerns about ongoing safety issues at the trust. To quote from her letter once again, she said:

“I am very concerned that there are serious, ongoing risks to patient safety. Due to the nature of these issues, I am confident that these cannot be properly investigated by the Inquiry without statutory powers.”

The Government take both concerns extremely seriously, and I agree with Dr Strathdee that we have now reached the point where the only appropriate course of action is to give the inquiry statutory powers.

Statutory inquiries do take longer, but this does not mean that work will start from scratch. Dr Strathdee’s existing findings will inform the next phase of the inquiry. She has informed me that, owing to personal reasons, she will not be continuing as the inquiry’s chair, so I want to thank her once again for all her commitment and hard work. I am sure the House will agree that she is a true public servant. Our work to find her successor is proceeding at pace, and I will update the House on the progress of setting up the inquiry in due course.

I recognise that Members’ concerns about mental health in-patient facilities are not confined to Essex. The Government are committed to improving mental health care across England, which is why we are boosting mental health funding by at least £2.3 billion this year compared with four years ago, why we are making urgent mental health support available through 111, and why we are delivering three new mental health hospitals to provide specialist care and cut waiting lists.

In January, we commissioned a rapid review of how data is used in in-patient mental health settings in England. More effective use of data has the potential to reduce duplication, ensuring that healthcare professionals can spend more of their valuable time with patients. The review team—well led again by Dr Strathdee—heard from more than 300 people representing every part of the in-patient mental health sector, including former patients and frontline staff. Dr Strathdee has made recommendations for how data and evidence can be used to identify risks to patient safety and failures in care more quickly and effectively. The findings and recommendations of the rapid review will be published today, and I will deposit a copy in the Libraries of both Houses. The Government will consider its findings carefully and respond in due course.

We recognise, however, that patients and families want to know how their concerns will be taken forward as soon as possible, and I also recognise that a wide-ranging statutory inquiry relating to other settings, or covering multiple patient safety issues, would not deliver those answers quickly. My Department has therefore agreed to work alongside the Healthcare Safety Investigation Branch to prepare for the launch of a national investigation of mental health in-patient services, which will commence in October, when the HSIB receives new powers under the Health and Care Act 2022.

The new Health Services Safety Investigations Body will investigate the following themes: how providers learn from deaths in their care and use that learning to improve services, including post-discharge services; how young people are cared for in mental health in-patient services and how that care can be improved; how out-of-area placements are handled; and how to develop a safe staffing model for all mental health in-patient services. Across all those areas, it will explore the way in which providers use data. I want to reassure the House that the new body will have teeth and will work at speed, that it will have the power to fine those who refuse to give evidence when they are required to do so, and that its predecessor’s investigations were typically concluded within a year.

I hope that today’s announcements will be of some comfort to the bereaved families who have done so much to raise awareness of the failings of mental health care in Essex and elsewhere. I want them to know that the Government are committed to obtaining for them the answers that they deserve, and to improving mental health across the country. I commend this statement to the House.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister.

Mental Health Treatment and Support

Lindsay Hoyle Excerpts
Wednesday 7th June 2023

(1 year, 5 months ago)

Commons Chamber
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Lindsay Hoyle Portrait Mr Speaker
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I inform the House that I have selected the amendment in the name of the Prime Minister.

Oral Answers to Questions

Lindsay Hoyle Excerpts
Tuesday 6th June 2023

(1 year, 5 months ago)

Commons Chamber
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Will Quince Portrait Will Quince
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By 2030, Mr Speaker.

Lindsay Hoyle Portrait Mr Speaker
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And obviously we want 24-hour provision in Chorley, which has the fastest-growing population, but let us move on.

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Steve Barclay Portrait Steve Barclay
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I am sure the whole House is sorry to hear that her constituent’s condition has deteriorated. The hon. Lady raises a very important point about integration, which is exactly the right approach. The 2022 reforms were about integrating health and social care and empowering commissioners to take a more integrated place-based approach. I am sure her local commissioners will take note of the valid point that she raises.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister for mental health.

Rosena Allin-Khan Portrait Dr Rosena Allin-Khan (Tooting) (Lab)
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A 14-year old climbing out of hospital windows; a child absconding to a local railway station; a teenager with complex needs brought to A&E, requiring four police officers to spend an entire shift watching them, only for them to abscond the next day. There is a pattern here. At almost every step of the way, children needing mental health services face a perfect storm of delay and treatment in inappropriate settings, fuelled by an under-resourced service with over-stretched staff. In light of the Met’s announcement that they will stop attending emergency mental health calls, is it not time for the Government to get their act together, or simply do the right thing and step aside?

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Neil O'Brien Portrait Neil O’Brien
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As the hon. Gentleman knows, tax matters are for the Treasury, but we are absolutely committed to providing cost of living support. By the end of June the Government will have covered nearly half a typical household’s energy bill since October, so we are providing one of the most generous packages in Europe.

Lindsay Hoyle Portrait Mr Speaker
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I call the Scottish National party spokesperson.

Martyn Day Portrait Martyn Day (Linlithgow and East Falkirk) (SNP)
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The last time I asked Ministers whether they would support that Bill I was told that the issue of VAT and skin cancer was a matter for the Treasury, and we have just heard a similar answer. Surely this is a matter for joined-up government. What are Ministers doing—instead of imposing more pressure and costs on the NHS—to persuade their Treasury colleagues to consider more cost-effective cost preventive measures such as making skin protection products more affordable?

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Steve Barclay Portrait Steve Barclay
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I am very happy to join my hon. Friend in paying tribute to all those who support Chemocare Bags for the fantastic work they do. That sort of support makes a real difference to patients, and the NHS benefits hugely from the work of volunteers, including those at Chemocare Bags.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister.

Andrew Gwynne Portrait Andrew Gwynne (Denton and Reddish) (Lab)
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As my hon. Friend the Member for Rhondda (Sir Chris Bryant) pointed out, the brutal truth is that the Tories have consistently missed England’s cancer treatment target since 2013. Last year, 66,000 cancer patients waited more than two months for their first treatment following an urgent GP referral, and the UK now has the worst cancer survival rate in the G7. Labour will give the NHS the staff, the technology and the reform it needs, and we make no apologies for expecting cancer waiting times and diagnosis targets to be met once again. That is our mission. Why is theirs so unambitious?

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Maria Caulfield Portrait Maria Caulfield
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I thank the hon. Lady for her question, and let me also pay tribute to the hon. Member for West Ham (Ms Brown), who has campaigned hard in this space. I met a group of women to discuss painful hysteroscopies just a few weeks ago. This is a priority in the women’s health strategy, as the hon. Member for Luton North (Sarah Owen) said. We are working with the royal college to update its guidelines, because a lot of these issues are associated with women’s consent, the provision of information before these procedures, and women knowing that they can have them under a local or general anaesthetic and can also ask for pain control. This is not working in practice, which is why it is a priority in the women’s health strategy.

Lindsay Hoyle Portrait Mr Speaker
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I call the Chair of the Select Committee.

Steve Brine Portrait Steve Brine (Winchester) (Con)
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Women living with HIV of course have the right to healthcare on the same terms as anyone else, except that now they do not when it comes to starting a family. Many people living with HIV are currently excluded from accessing fertility treatment, both by law and by the Government’s microbiological safety guidelines. So will the Government now follow the scientific evidence, particularly on undetectable viral load, and remove what are surely discriminatory restrictions on the basis of HIV status?

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Maria Caulfield Portrait Maria Caulfield
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I thank my hon. Friend, who does a huge amount of work supporting her local midwives in Stroud. I can give her encouraging news: not only have we spent £190 million on midwifery services, but we are seeing an increased number of midwives coming through midwifery training. Excitingly, we have a nurse conversion course, which takes 18 months, with NHS England paying the tuition fees for nurses to convert to being midwives. We have had 300 in training this year and we are expanding that to 500 in the next academic year. We have encouraging retention rates too, which show that midwives are not only joining the profession, but staying in it.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister.

Liz Kendall Portrait Liz Kendall (Leicester West) (Lab)
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There is a particular group of women whose health needs should be highlighted during Carers Week: women who look after an older or disabled relative. The majority of unpaid carers in their 50s and 60s are women. Eight million unpaid carers have seen their own health suffer, with those providing high levels of care twice as likely to have poor health as people without caring responsibilities. So will the Minister finally commit to a cross-Government national carers strategy, including health issues in it, as the last Labour Government did? That is a key demand during this year’s Carers Week.

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Neil O'Brien Portrait Neil O’Brien
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International recruitment is up. In fact, we have 38,000 more doctors and 54,000 more nurses in the NHS than in 2010. In England at least, we are taking every step we can to draw on that international talent and we are using it to grow staffing in the NHS.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Minister.

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Cat Smith Portrait Cat Smith (Lancaster and Fleetwood) (Lab)
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When will the Government announce capital funding for the new hospital in Lancaster: before or after 2030?

Lindsay Hoyle Portrait Mr Speaker
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And Chorley, of course.

Steve Barclay Portrait Steve Barclay
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Chorley is extremely important, Mr Speaker—I am very sighted on that.

Our commitment is that that is part of the new hospital building programme. We said that it is part of the rolling programme, so it will not be completed by 2030 but we are keen to get work started on it, and that is exactly what we will be discussing with Members of Parliament in the weeks ahead.

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Steve Barclay Portrait The Secretary of State for Health and Social Care (Steve Barclay)
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As Health Secretary, I have been clear that deploying the latest technology and innovation is essential in order to deliver our priorities: to cut waiting lists, improve access to GPs and improve A&E performance. The NHS app is at the heart of this, including the enhancement of patient choice set out in our recent announcement, which is not available to patients in Wales. The Patients Association estimates that by enabling people to select a different hospital in the same region on the app, we can cut their waiting times by as much as three months.

We have been making major improvements behind the scenes, which are already paying off. Today, I can tell the House that between March 2022 and March of this year, there have been 6 million new registrations for the app; repeat prescriptions via the app have increased from 1.6 million a month to 2.5 million a month; and primary care appointments made on the app have increased from 30,000 a month to 250,000, and secondary care appointment from 30,000 a month to 360,000. We continue to work to increase the app’s functionality, including opening more records and test results and enabling more appointments, as part of our commitment to technology.

Lindsay Hoyle Portrait Mr Speaker
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I think a statement would be better next time.

Sarah Owen Portrait Sarah Owen
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Brain tumours are the biggest killer for people under 40, but we are still waiting for the full £40 million that the Government promised to fund brain tumour research. In March, I raised in the House the heartbreaking experience of my constituents Yasmin and Khuram, whose daughter Amani died from a brain tumour just before her 23rd birthday. Once again, I ask whether the Minister for Health and Secondary Care or the Secretary of State will meet with me and my constituents to hear their calls for the full funding allocation to be given to researchers. That funding would be transformational for the treatment of brain tumours.

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Steve Barclay Portrait Steve Barclay
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I am very keen to meet with my hon. Friend. I know this is an extremely important scheme for her constituency, particularly the key worker accommodation, and I look forward to having that discussion with her and the leadership of her trust.

Lindsay Hoyle Portrait Mr Speaker
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I call the shadow Secretary of State.

Wes Streeting Portrait Wes Streeting (Ilford North) (Lab)
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First, I congratulate the Health Secretary on his recent write-up as the next Leader of the Opposition. According to the i newspaper, his supporters are calling him “Mr Consistent”. Is that because of the consistent rise in waiting lists since he became Health Secretary, the consistently longer waiting times that patients are facing, or the consistent delay to the NHS workforce plan?

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Neil O'Brien Portrait The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
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We are still committed to reducing the advertising of unhealthy food, including the junk food watershed that will be implemented in 2025. Ahead of that, we are taking action on obesity across the board, including the sugar tax, which has cut the average sugar content of affected drinks by 46%, the calorie labelling that we have on out-of-home food in cafés and restaurants, and the location restrictions on less healthy food that are coming in from October.

Lindsay Hoyle Portrait Mr Speaker
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I call the SNP spokesperson.

Martyn Day Portrait Martyn Day (Linlithgow and East Falkirk) (SNP)
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Kidney Research UK has published a report on the health economics of kidney disease, predicting a terrifying rise over the next 10 years. As we know, uncontrolled diabetes is the biggest cause, with Diabetes UK noting that those disproportionately most at risk are those from poverty and from south Asian and black ethnic backgrounds. Reducing health inequalities is therefore key, and it is a key ambition for the Scottish Government. It means tackling poverty in our society. What steps is the Minister’s Department—

Lindsay Hoyle Portrait Mr Speaker
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Order. This is topicals.

Martyn Day Portrait Martyn Day
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It is topical because the research was just published yesterday.

Lindsay Hoyle Portrait Mr Speaker
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The question cannot go on forever; let us get an answer.

Neil O'Brien Portrait Neil O’Brien
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I had a useful conversation with the Scottish public health Minister where we discussed many of these issues. We are providing huge cost of living support—some of the most generous in Europe, worth £3,300 a household—and taking action across the piece. Whether it is smoking or obesity, we are tackling the underlying causes of the health inequalities that the hon. Gentleman mentions.