Oral Answers to Questions

Luke Evans Excerpts

Tuesday 6th June 2023 Commons Chamber

[Neil O’Brien]

At every stage, we are taking action to get more dentists doing NHS work. There are 6.5% more dentists doing NHS work than in 2010. The hon. Gentleman has an important idea. We are doing other things to retain NHS dentists, such as the important reforms that we made to pensions, which have helped both GPs and NHS dentists.

[Dr Luke Evans (Bosworth) (Con)]

13. What progress he has made on improving hospital facilities.

[The Secretary of State for Health and Social Care (Steve Barclay)]

The Government are providing record investment in NHS hospital facilities to improve staff and patient experiences and provide extra capacity to cut waiting lists, including the more than £20 billion that we announced just under two weeks ago.

[Dr Evans]

I thank the Secretary of State for his serious investment in Leicestershire, with £14 million for the diagnostic centre in Hinckley and now part of that £20 billion going to Leicester Royal Infirmary, Leicester General Hospital and Glenfield Hospital, including for upgrading the car park. But there is one final part. In 2018 we had £7 million allocated to Hinckley for improvements, but due to covid and the community diagnostic centre investment, the business plan has changed to a day case unit. The money is there. Will he remove the red tape and look on this kindly and swiftly?

[Steve Barclay]

My hon. Friend is right to highlight the series of investments that we have made in his local area. On the specific case he raises, he will know that the business case needs regional approval, and that is currently with NHS colleagues, but I am happy to commit to him that once that is received, we will look at it very keenly.

Recovering Access to Primary Care

Luke Evans Excerpts

Tuesday 9th May 2023 Commons Chamber

[Steve Barclay]

As I said in my statement, we have 4,000 doctors training in primary care, compared with 2,600 in 2014. We are also looking at how we can better retain the GPs we have. That is why we made the pension changes, which will affect around 9,000 GPs. It is also why we are looking at additional roles to take pressure off GPs, and at how we can reduce some of the burden of bureaucracy, too. We are training more doctors, and we are looking at retention and bureaucracy. No one is suggesting that this is solely an issue of telephony or online booking, as the hon. Lady suggests, but all of this will help to relieve pressure on extremely busy primary care.

[Dr Luke Evans (Bosworth) (Con)]

I am pleased to be talking about primary care, for obvious reasons. It is important that the Government made the pension changes, which will make a difference to retention, but I am also pleased with the next part of the plan. When I was a clinician, 15% of my workload was chasing letters and administration, which is borne out by the evidence we have heard on the Health and Social Care Committee. Will the Secretary of State comment further on the bureaucracy he is cutting? Will he ensure that this is the first step in pushing down on that bureaucracy, as that will improve the welfare of both our workforce and our patients?

[Steve Barclay]

My hon. Friend has a great deal of experience, and he is right to focus on the amount of clinical time often spent on non-clinical issues. Sending reminders through the NHS app will reduce non-attendance. We are also looking at the key interface between secondary care and primary care, as well as considering which appointments can be done elsewhere, such as through pharmacies and the additional roles. The online booking system can better triage people to the right place, and there will be some self-referral in order to take pressure off GPs—not for things that carry a clinical risk, such as internal bleeding, as the Opposition suggest; but for things like hearing aids. If a person has taken a hearing test, they will not need to clear an appointment for a hearing aid through their GP.

Oral Answers

Luke Evans Excerpts

Tuesday 25th April 2023 Commons Chamber

[Steve Barclay]

First, I very much welcome the good care that the hon. Gentleman received, and it is great to see him back in the Chamber. On the wider issue, that is why we have an elective recovery plan, in which we have applied a boost in capacity, particularly through the surgical hubs. We are looking at how we build greater resilience, especially in winter, when elective beds are often under pressure. We are also investing in areas such as eye treatment, and we are rolling out through Getting It Right First Time a programme of improvement in a range of areas, including that one.

[Dr Luke Evans (Bosworth) (Con)]

Provision for special educational needs and child and adolescent mental health services is one of the biggest issues in my inbox in Leicestershire, particularly in respect of delays in assessment and diagnosis. One of the Government’s plans was to introduce school mental health support teams. The Health and Social Care Committee heard that the aim was that 35% of pupils should be covered by 2023. May we have an update on progress and on when we are likely to reach 100%?

[Steve Barclay]

My hon. Friend makes an important point, and I am happy to update the House, as we have already achieved 35% coverage. By the end of the month, we expect to have 399 operational mental health support teams, covering 3 million children and young people. We plan to go further, with over 500 such teams by spring 2024.

NHS Workforce Expansion

Luke Evans Excerpts

Tuesday 28th February 2023 Commons Chamber

[Wes Streeting]

I wholeheartedly agree. It is why we are in the worst of all situations: the shortage of staff means not only that patients are receiving poorer care, but that we are paying over the odds as taxpayers for the Conservatives’ failure to recruit and retain the staff we need.

We are not alone in thinking that the biggest expansion of NHS staff in history and doubling the number of medical school places is the right solution. Amanda Pritchard, the chief executive of NHS England, has rightly said that we need greater investment in training to stop excellent British students being turned away. The Royal College of Physicians has called for medical school places to be doubled, and now the NHS is formally asking the Government to fund it. Why are the Government refusing to fund a doubling of medical school places, which the NHS and the Royal College of Physicians say is necessary, and which patients can see through experience is desperately necessary?

[Dr Luke Evans (Bosworth) (Con)]

rose—

[Wes Streeting]

Perhaps the hon. Member can tell us.

[Dr Evans]

I am grateful to the shadow Secretary of State for bringing me in on this point. Training is really important. As someone who has been a medical student, I know that one of the most important things to look at is how many people will be on one’s firms. We do not want 12, 15 or 20 people all coming into a cubicle to see a patient. Although I welcome the idea of expansion, can he talk me through what the ratio will be on ward rounds for medical students being trained?

[Wes Streeting]

I am glad that finally Government Members have noticed that Labour has got a plan and are asking how it will work; I wish that Government Ministers would join in. The proposal we set forward to double the number of medical school places is based on modelling put forward by the Royal College of Physicians, which understands perfectly well the points the hon. Member makes. I have had excellent meetings with university vice-chancellors, who are keen to roll up their sleeves and help. The reason we set out a plan this far from a general election was for two reasons. First, we want to give medical schools and NHS employers time to prepare for the expansion. Secondly, we hope that the Government adopt this plan to give the next Labour Government a head start. I very much hope, as this motion says, that the Chancellor will take our plan and incorporate it into his Budget, and I will cheer him if he does so.

I will tell the House how ludicrous the situation is today. There are medical schools in England today that are exclusively training international students, many of whom will leave upon graduating, while at the same time we are turning away thousands of straight-A students from our own country who want to help the NHS. Brunel University is training 100 new doctors, with not a single UK student. Chester University has deferred the launch of its medical degree by a year because the Treasury will not give it a penny. Local NHS trusts and charities have chipped in to fund 20 UK medical student places at Three Counties Medical School at Worcester University, because the Government are refusing to fund a single domestic student. Despite pleas from the NHS, the Minister for Skills, Apprenticeships and Higher Education, the right hon. Member for Harlow (Robert Halfon), has threatened to fine medical schools if they increase their offers to applicants next term.

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[Wes Streeting]

I wholeheartedly agree with the hon. Member. I will talk about this later in my speech, but it is why the Government have to resolve this pay dispute with existing NHS staff. The danger is not that they walk out for another day of strike action, but that they walk out of the NHS altogether for countries that treat them better. What an absurd position to be in. It is also absurd, by the way, that we still have doctors retiring early for no other reason than that the pensions rules create an active financial disincentive to work up to normal retirement age, as many of them would like to do. It is completely absurd.

[Dr Evans]

Will the shadow Secretary of State give way?

[Wes Streeting]

I am happy to give way to the hon. Member again, but may I gently suggest that he would be better off lobbying current rather than future Ministers?

[Dr Evans]

As the hon. Gentleman sees himself as a future Minister, what is his solution for the pensions position for consultants?

[Wes Streeting]

I am delighted that the hon. Member asks. I had a good meeting with the British Medical Association pensions committee recently. There are a number of ways in which this matter could be resolved, one of which might be a tax-unregistered scheme, which we have seen used successfully in the judiciary. [Interruption.] I am perfectly fine with having a tax-unregistered scheme. I think the difference between the Opposition and the Government is that the Government have an army of civil servants to do the modelling. That is what I would like the Government to do. I say to the hon. Member again that it is no use lobbying the next Government—lobby the current Government.

Turning again to the international picture, the NHS is having to recruit from countries on the World Health Organisation’s red list—countries that desperately need the few doctors and nurses they have—because our Government cannot be bothered to train their own. I think that is unethical, immoral, a disgrace and a kick in the teeth for the UK students who desperately want to be the doctors, nurses, midwives and allied health professionals that our country needs.

The Chancellor is refusing to budge, I believe, on cost grounds, but Labour’s plan before the House today would cost £1.6 billion a year. We have shown how we would pay for it: scrapping non-doms would raise more than £3 billion. If the Chancellor needs any tips about the non-doms system, or if perhaps he is worried that non-doms might flee the country, he need only knock on his next-door neighbour’s door to see a case in point. He will find out how the system works, and that when people are asked politely to pay their taxes here, they do not flee the country.

Inaction also has costs. The NHS spent an eye-watering £3 billion on agency staff last year. One hospital was so desperate that it paid £5,200 for a doctor to work a single shift. Does that not sum up the approach of this Government: penny wise and pound foolish?

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[Wes Streeting]

The hon. Gentleman is absolutely right, and I have been following his work and that of the all-party parliamentary group on radiotherapy in this area, because he raises issues that ought to be taken very seriously. I was very grateful to my hon. Friend the Member for Easington (Grahame Morris) for coming to meet me about these challenges in particular. Of course, this has to be at the heart of a serious plan to improve cancer outcomes.

There is no doubt but that Labour’s workforce plan—supported by the NHS, supported by the professions, supported by so many members of the public—would make a difference. In fact, our inboxes have been filling with people welcoming the plan. It was a particular surprise to me to see one piece of fan mail that said:

“Despite my obvious political allegiances it would be remiss of me not mention the fact that Labour has pledged to double the number of medical school places and recruit additional health visitors and district nurses.”

It goes on to say that it

“is something I very much hope the government also adopts on the basis that smart governments always nick the best ideas of their opponents.”

Well, what luck that this particular fan of Labour’s policy joined the Government just two weeks after he sent the email. It is, of course, the Chancellor of the Exchequer, who I must say I thought was an excellent Chair of the Health Committee. It is almost as if he had learned from all his mistakes when he was the Secretary of State for Health.

This is Lent, a period for atonement and a time for forgiveness, so I make this pledge today: if the Chancellor realises the errors of his ways and comes to this House to double the number of medical school places in the Budget and adopt Labour’s NHS expansion to deliver the biggest expansion of the NHS workforce in history, I will cheer him on from the Opposition Front Bench during the Budget. I will cheer him on—

[Dr Luke Evans]

Come across!

[Wes Streeting]

Well, I need the help of the hon. Gentleman and Conservative Members, because my pleas seem to be falling on deaf ears. That is why I have taken the trouble to circulate this email to every Conservative Member, so that they can collar the Chancellor in the voting Lobby this evening—no doubt when he is voting with us, because he agrees with us—and I look forward to their assistance in helping him to see the error of his ways. In all seriousness, it is time that the Chancellor put his money where his mouth is, abolished non-doms and used the proceeds to train the doctors and nurses that the NHS needs.

We know the consequences of the current NHS crisis. Earlier this month, I met Samina and Minnie Rahman, who lost their loving husband and father on Christmas eve after calling for an ambulance three times. The family were initially told a nurse or paramedic would call them back, as it was deemed Iqbal did not require an ambulance. Forty minutes later, when his condition worsened and his family were unable to lift him into their car to drive him to hospital, they phoned 999 again. This time an ambulance was sent, but was then diverted to a higher-priority call. When Iqbal stopped breathing an hour after the first call, his family called 999 a third time, and an ambulance eventually arrived 24 minutes later. The paramedics spent 90 minutes attempting to revive Iqbal in front of his family, but they were unable to. That story is tragic and awful for the family who lost a husband, a father, and a grandfather. Perhaps most depressing is that this case is no longer surprising. The hour and a half that Iqbal waited for an ambulance was the average amount of time that patients with conditions such as heart attacks and strokes waited in December.

The West Midlands Ambulance Service has apologised to Mr Rahman’s family, but they want the Government to take action. They are calling for change to ensure that no other family must endure what they have been through, and they have three asks. First, they want an independent review to establish the number of deaths and serious harms caused by ambulance delays. The Government have rejected figures from the Royal College of Emergency Medicine that claimed that up to 500 people a week were losing their lives this winter due to long waits for emergency care. They also rejected figures from the Office for National Statistics on the number of excess deaths suffered in the past year. Well, Mr Deputy Speaker, “ignorance is bliss” is not a responsible approach to the crisis in emergency care. Sunlight is the best disinfectant, so I hope the Minister will commit to establishing the true scale of the harm caused by the crisis in the NHS.

Secondly, Minnie and Samina ask the Government to instigate Cobra-style meetings to deal with the public health emergency of ambulance delays. That is already happening to deal with the fallout from industrial action, but we need the same level of action for non-strike days. Thirdly, Minnie and Samina have asked to meet the Health and Social Care Secretary, so that he can hear at first hand about their experience, and see the trauma it has caused. The Secretary of State is not able to be here this afternoon, but I hope the Minister will convey that request to him. I gently remind her that I passed on Zaheer Ahmed’s request to meet the Secretary of State after his five-year-old nephew passed away following multiple failings by the health service, but that meeting is yet to be arranged. I think the least we can do as public servants is listen to those we serve, especially those who have suffered in the most unimaginable way. I hope the Secretary of State will meet those families, and that they are able to spur the Government into taking the action we need.

One promise of the NHS is that it is there for us when we need it. That has been completely fundamental in this country for as long as many in the Chamber can remember, but that promise is now broken. People are frightened that the NHS will not be there for them in an emergency. It is not hard to understand why. Look at the news today that more than 1.5 million patients waited for more than 12 hours in A&E last year, which is estimated by the Royal College of Emergency Medicine to have seen 23,000 people lose their lives.

This is not just about emergency care. Patients in need of an operation or even a GP appointment do not know whether the NHS will be there for them when they need it. That is why so many people are voting with their feet, and with their wallets, and going private. Of course most people in this country cannot afford to pay, so they have no choice but to wait and worry. Restoring that promise of an NHS that is there for us when we need it should be a basic task for any Government, but this Government do not even have the ambition, let alone a plan to get there. Instead, the Health and Social Care Secretary said last month that a world where patients are seen within four hours at A&E is “too ambitious” and “not achievable”. But it was achieved until 2015. It was certainly achieved under the last Labour Government.

The target for ambulances reaching patients with strokes or heart attacks has almost doubled to half an hour. If someone wants to see a GP, there is an “expectation”, not a guarantee, that they will be able to do that in two weeks. Two weeks! I remember Tony Blair being attacked because people were forced to see a GP within two days—what people wouldn’t give to be in that position now. Millions wait longer than a month. The Government missed the goal so they moved the goalposts. They have accepted that the NHS will not be there for all of us when we need it. That is what managed decline looks like. That is what brings about the end of the NHS. It is not calls for a different model from the right hon. Member for Gainsborough and others; it is this: slow, irreversible decline. That is what the end of the NHS will look like, and that is why we desperately need a change in Government.

Performance-enhancing Drugs and Body Image

Luke Evans Excerpts

Tuesday 21st February 2023 Westminster Hall

[Dr Luke Evans (Bosworth) (Con)]

I beg to move,

That this House has considered the matter of steroid and image and performance enhancing drug use.

It is a pleasure to serve under your chairmanship, Ms Fovargue.

We need to talk about steroids in the UK. I am talking about not just any steroids but anabolic steroids and image and performance-enhancing drugs—or IPEDs. There are an estimated 500,000 to 1 million users in the UK, but no one is talking about it. The closest we get is the “natty or not?” discussions on social media about naturally built men and women versus people who are enhanced. There is particular discussion about Hollywood actors.

[David Mundell in the Chair]

I will not cast any aspersions about who does or does not use steroids and performance-enhancing drugs, but it is fair to say that the debate is becoming bigger and louder, not only in this country but in America and throughout the western world. The Priory Group did some research about 10 years ago and estimated that around 50,000 people were using steroids; its estimate now is that 500,000 people are using them. It says that

“we are sleepwalking into a health crisis”.

I know from my time as a GP that when it comes to—[Interruption.]

[David Mundell (in the Chair)]

Order.

--- Later in debate ---

[David Mundell (in the Chair)]

The debate can continue to 5.38 pm.

[Dr Evans]

It is a pleasure to serve under your chairmanship, Mr Mundell.

Until we were rudely interrupted by that vote, I was saying that we need to talk about steroids in the UK because, as the Priory Group has said:

“we are sleepwalking into a…crisis.”

As a GP, I know that the obesity epidemic has been a real problem, but part of the nation is actually getting fitter while part of it is getting fatter. I will concentrate on the part that is getting fitter, because of those who go the gym—mainly men—we know that one in 10 suffer from bigorexia. What am I talking about? Bigorexia is body dysmorphia—the idea that someone’s muscles are not big enough, no matter how much they eat or train. It is important to understand that this is a growing epidemic in our country; even more importantly, it is quite prolific in the gay community. I will break the issue down into three sections. I will talk a little bit about how I came to this topic, the drivers behind it, and, most importantly, what needs to be done.

Growing up, I was a fairly normal kid. At the age of 14 or 15, I was playing sport and was reasonably academic, but I was an outlier, because for my 15th birthday I had saved up £500 to buy a multigym. In my head, I wanted to improve my rugby, get girls, fight off bullies and improve my body image. Surprisingly, I was the under-16s first-team captain, but the other three aims fell to one side. Looking back, I think, “How many other young men feel like this?” That was 25 years ago. I think the points I mentioned are the driving forces behind why men want to go to the gym and improve their body image. Society says to them, “We need to be perfect”, but what is that perfect image?

[Margaret Ferrier (Rutherglen and Hamilton West) (Ind)]

Social media and reality TV have played a huge part in promoting unrealistic body ideals, which we often do not think about when it comes to men’s self-esteem. Does the hon. Member agree that there should be some greater controls around edited, unrealistic imagery?

[Dr Evans]

The hon. Member is spot on. The advent of social media over the last 20 years has really brought home that idea of body image. With the likes of Instagram, if a man is interested in using a gym, they are sent hundreds of images in 30, 40 or 50 seconds. Each individual image in itself is not the issue, but the cumulative effect of repeatedly being sent such images is a problem.

I would argue that the way to solve the problem is through the social media companies’ algorithms, to ensure that there is transparency about what people are being sent. Facebook talked about diet pills aimed at young girls being a real problem. If we do not deal with male body image and body dysmorphia, this will be the next iteration of that problem.

As a doctor, over the last 10 to 15 years I have started to see more and more young men coming into my clinics and asking to be prescribed protein powders or creatine, and asking, “How do I bulk up?” I also started to see more and more men in their 20s, 30s and 40s who were using steroids and having side effects, including bad acne, scarring acne, mood problems and depression. I have even seen some men who have had strokes, heart attacks, liver problems, kidney problems and erectile dysfunction, none of which are really talked about when it comes to steroids.

The problem with steroids is that they work, so people use them and see a drastic improvement. People who want to build muscle will see that improvement, take the cycle of whatever substance it happens to be and then plateau, which is very hard for them to deal with because they no longer see the gains they were initially getting under their regime. They say, “Oh, I’ll only use it once”, but once becomes twice, twice becomes thrice, and so on.

[Sir James Duddridge (Rochford and Southend East) (Con)]

My hon. Friend listed symptoms, but I do not think that he mentioned swelling of the brain. Matt Dear, a 17-year-old from Essex, tried to build himself up by taking bodybuilding pills, because he was committed to a career serving in the armed forces. He took pills that he had bought for £30, his brain swelled up and, tragically, he died. The memory of Matt has helped to educate children in the community. Is my hon. Friend concerned that even taking these things once can be terminal?

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[Dr Evans]

My hon. Friend makes an incredibly important point—these are dangerous prescription drugs, if they are not used properly. There is a plethora of side effects that are not talked about, from the short-term acute stuff that could mean someone has swelling of the brain or a clot, or is having a heart attack, or the long-term effects, such as depression, scarring acne or erectile dysfunction, which, particularly for young men, can have a huge psychological effect when they are trying to find partners. My hon. Friend is spot on. My heart goes out to Matt’s family; I am pleased there is a memorial for him.

Our role as responsible elected Members is to think about what we can do. The obvious area I get directed to is sport. It is actually quite hard to dope in sport, especially for an elite athlete. It does happen, but the culture is quite strong not to do so. Many athletes who want to be elite have come to me, as their GP, and have refused to take prescriptions because they are not sure whether it will be an exemption or clean, or whether it might get them in trouble with UK Anti-Doping.

Sport is an interesting area. I have met UN Anti-Doping a couple of times, and it is seeing people using these drugs to improve their image, but then finding out that they are quite good at sport and then getting into trouble with the authorities. The classic example is the young Welsh rugby player, who wants to look big on the streets when he is out and about, and wants to look good in Ibiza—and he finds out that having that size and strength is good on the rugby field. He starts playing semi-professionally and then gets picked up by UK Anti-Doping.

At the other end of the spectrum, we see cyclists, particularly affluent middle-aged men, who have the money and wherewithal to train, dedicate their time, buy the equipment they need, and start to see progression through the ranks of cycling. Then they meet the edge and ask, “What’s next? Let’s lose weight. Let’s have a fat burner. Let’s think about steroids or something else, like EPO.” That sees people caught out.

Those are the people going into elite or semi-elite athlete status; we have not even touched on society and the health aspects. We have heard a lot over the past 10 years about women’s health and body image, but less so about men’s. “Love Island” is back on TV at the moment, and we often hear a debate about how the females look: “Is there diversity? What about their shapes?” Very rarely do we hear that about the men. Nine out of 10 of them will have a six-pack, large shoulders and big biceps, and we seem to think that is okay.

Spencer Matthews from “Made in Chelsea” talked about the pressure and the need to use steroids he felt, because of his concern about what he looked like. We only have to look at what is currently in cinemas—the Marvel comic films—to see the aspiration set for young men.

[Nick Fletcher (Don Valley) (Con)]

I congratulate my hon. Friend on securing this debate. Does he agree that boys and men are in a unique position in the 21st century? There are all kinds of pressures on boys and men that are often not seen, and which they often do not talk about. Does he agree that one way the Government could help is by putting in place a men’s health strategy? We could look at subjects such as this, and other issues that men are facing, as a whole to help men today.

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[Dr Evans]

I am grateful to my hon. Friend for his intervention. I commend his work on the men’s health strategy, and on securing the men’s world health debate. He is right that these tend to be pertinent male issues. There is a difference: from my clinical approach, I see men’s health-seeking behaviours. It is apt to say that we should target some of these issues in these ways, particularly steroid abuse and performance-enhancing drugs used for imaging, because men tend to be most affected—not exclusively but mainly. My hon. Friend is absolutely right.

That leads to the fitness industry itself, which purports to put out images of the six-pack and shoulders bigger than a fridge. The problem is that those are stationary images of a point in time. Aspiring to live in that point in time is very difficult. Young people may not understand that many people in bodybuilding go through cycles of bulking up and then dropping weight to fit a certain image for their competitions. That is fine for a bodybuilder, but it is not good for a 19 or 20-year-old university student to aspire to that, because they are at a time of meeting other people and creating relationships.

There is a ratchet effect. We see images of very large, muscular men, which people aspire to, and there is a cheap and effective way to get there; that is a real concern. That leads to a wider issue currently faced by societies across the western world: what is masculinity?

We have heard a lot about toxic masculinity, which allows space for the likes of Andrew Tate to step in. Lots of people listen to what he has to say, in part because he is saying, “Be strong, stand up, look after yourself.” On the other hand, he has been found to be completely wanting and is now under investigation. Is that the kind of role model we want in front of our young men? Young men who do not understand what masculinity is because they are not told within society will look for other options—be they the Marvel comics or the likes of Andrew Tate—to tell them what is acceptable to be masculine. That is a dangerous place to settle in.

But we are waking up to the issue; the online culture is starting to move towards calling it out. The likes of James Smith and Ben Carpenter talk openly about the pros and cons of the fitness industry, and how it has been marketed. The Women and Equalities Committee did a report on body image, as did the Health and Social Care Committee. The Advertising Standards Authority produced an interim report that identified the key issue of depictions of muscularity in advertising, and it hopes to have further information about that in quarter four of 2023. Awareness is there and the culture is starting to think about it, but we are still at least 10 years off in comparison to the female idea of body image.

We are not doing enough, which comes out when we speak to the likes of UKAD. I thank Trevor Pearce and Jane Rumble from UKAD for providing me with information when I met them. In 2019, a UKAD survey found that 34% of gym goers are aware of IPEDs being used in their gym. That is certainly my experience as a gym goer. Wherever I have been in the country, I have been aware of such drugs being taken, because I have found syringes and packets in the changing rooms. That is quite a scary thought, from my own anecdotal experience—yet one in three men who use gyms is finding the same.

The Medichecks survey of people who go to the gym found that 61% of men want to be bigger, and that 80% of men are aware of some of the side effects of steroids, yet three out of four of those men would consider using steroids or IPEDs. As I mentioned, one in 10 gym goers has bigorexia—a number that is thought to be increasing. Thinking back to being that young boy with my multigym at the age of 15, if I had had the online ability to get hold of such substances, and an ever-growing social media pressure to conform and have muscles, maybe I would have been tempted? That is a scary thought for the generations coming through.

In 2020, The Times reported that users could easily buy steroids through Instagram, even though they are class C drugs. The law says that class C drugs are lawful for personal use with a prescription, but it is illegal to distribute or supply them. In 2021, Border Force seized 1.225 million doses of anabolic steroids, which was down on the number seized a few years before—that does not cover other drugs that are available, such as the fat-stripping drug Clenbuterol—yet there were only 37 convictions for possession or supply last year. The trend has been for between 30 and 40 people to be convicted each year, over the last five years.

The Government have produced an updated drug strategy, called “From harm to hope: A 10-year drugs plan to cut crime and save lives”. The House of Commons Library confirmed to me that there is no mention of the words “steroid” or “IPED” in that report. The start of the report says:

“Over 300,000 people are addicted to heroin and crack cocaine in England. This is the biggest section of the illegal drugs market”.

Is it? Given that we expect 500,000 to 1 million people to have taken steroids, we simply do not know. That is the point I am driving at. The report talks about the principle of

“putting evidence at the heart of this approach”.

When it comes to IPEDs and steroids, we need data and evidence.

That leads me to my asks of the Government. Given that a Health Minister is responding, I think it is fair to concentrate on simply the health aspect of the issue. I ask for three things. First, will he commission the research into steroids and IPEDs suggested in the Health and Social Care Committee report on body image? Secondly, will he pull together the different Departments that the issue crosses over? The issue is not a single departmental issue. It is not covered simply by the Department of Health and Social Care, the Department for Digital, Culture, Media and Sport, the Home Office or the Government Equalities Office; it is all of them—there is a crossover. We need to pull together in roundtables and a taskforce to think about how we deal with this.

My third ask is for education and awareness. We need to think about schools, outside agencies and the NHS—a bit like the Government have done with eating disorders. The number of people suffering eating disorders has skyrocketed, and the Government have responded well by getting the information and support out, and looking at ways to strategise. We are a long way off dealing with eating disorders, but this is the next big, similar crisis. I urge the Government to take that kind of strategy forward.

It would be remiss of me to come to the debate without offering wider solutions and there are some ideas that need to be talked about. They have pros and cons; I raise them because we need to have the conversation. We could look at compulsory mandatory education for personal trainers, who are the most likely people to come into contact with gym goers. We could change the IPED laws, and make sentencing more severe; or do the opposite, and take them out, and say, “No, this is a health issue that we need to deal with.” The debate needs to happen.

We can look at examples from across the world. Norway has licensing of gyms. If new drugs were being found in a nightclub—with new drugs being found and one in three people being aware of the situation—the authorities would be knocking on the door saying, “Should we be licensing? Should we revoke that licence? What should we do about it?” We are a long way off putting such a scheme in place, but it is not beyond our remit to have a discussion about whether that is something we should do to increase the responsibility of the gym owners. There are pros and cons. Fundamentally, we do not have the data and none of the details has been explored enough. That leads us full circle; we really need to start a conversation—we need to talk about steroids in the UK.

--- Later in debate ---

[Dr Evans]

Thank you for your chairmanship, Mr Mundell. Indeed, I thank both the Chairs we have had during this debate, as well as the Clerks for staying late and the officials for being here.

I thank the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) for talking about algorithms and body image. My hon. Friend the Member for Rochford and Southend East (Sir James Duddridge), who is no longer in his place, raised the sad case of Matt. The constant campaigning of my hon. Friend the Member for Don Valley (Nick Fletcher) for men’s health has been fantastic. My hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) hit the nail on the head: this issue is about how we record data.

I am grateful to the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald) for his point about bold ideas. The whole point of this discussion is that no stone should be left unturned. The bold ideas might not be right, but they need to be explored, because that is the key thing to do when trying to deal with this issue.

I am glad to hear about the twins of the hon. Member for Croydon Central (Sarah Jones). These are exactly the conversations that people should be having up and down the country. Mothers, fathers, grandfathers and grandmothers should be asking questions about what young people are aware of and what they are seeing.

It is lovely to come into a debate after three years and hear that there is unanimous support across the House on this issue and a desire to fill the void, because there is a worry that the likes of Andrew Tate will step into it. I would love to take the Minister up on his “keen pursuit”—to quote him—of this issue. We are at the start of a road, and this is all about having a conversation about steroids in the UK.

Question put and agreed to.

Resolved,

That this House has considered the matter of steroid and image and performance enhancing drug use.

NHS Strikes

Luke Evans Excerpts

Monday 6th February 2023 Commons Chamber

[Will Quince]

Once? The shadow Home Secretary, the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper), has spent it twice over already. And that is if indeed it would raise any money; I know I look very young, Mr Speaker, but I am old enough to remember a former Chancellor, one Ed Balls, say he did not believe taxing non-doms would raise any money whatsoever.

[Dr Luke Evans (Bosworth) (Con)]

I declare my interest, Mr Speaker.

We have spent a lot of time talking about pay, but making working conditions for frontline staff much better is key, so what are the Government doing to focus on improving the simple things in a clinician’s life such as joining up testing, improving prescribing, and making sure that 10% to 15% of a GP’s workload is not spent chasing admin? These are simple things that would make a huge difference and improve outcomes for both patients and staff.

[Will Quince]

I completely agree with my hon. Friend. Ensuring that we support the mental health and wellbeing of NHS staff and that working conditions and working environments are the best they can possibly be is how we can attract and retain the best. Measures such as wellbeing champions, training for line managers, occupational health services and flexible working are very important, but the key to this is having conversations with the unions, because they are the representatives, ambassadors and advocates. That is why I very much hope they will engage in the pay review body process and continue to have those conversations with me, not just about pay, but about how we can improve working conditions and working environments and reduce the bureaucracy that makes the job so difficult.

Oral Answers to Questions

Luke Evans Excerpts

Tuesday 24th January 2023 Commons Chamber

[Steve Barclay]

Those discussions are ongoing with my right hon. Friend the Chancellor. The hon. Gentleman will know that we made progress in the summer on a couple of areas in relation to pensions, and my right hon. Friend is having further discussions with us in that context.

[Dr Luke Evans (Bosworth) (Con)]

I declare an interest as a GP and the immediate family of a GP and doctors. GPs are working incredibly hard in tough times. It is true that supply has gone up, but so too has demand. Change needs to happen in primary care, but one of the bedrocks is the GP partnership model. Does this Government agree?

[Neil O’Brien]

Unlike the Opposition, we do not regard GPs’ finances as murky and we do not want to go back to Labour’s policy of 1934 by trying to finish off the business that even Nye Bevan thought was too left-wing. We do not believe in nationalising GPs; we believe in the current model. [Interruption.] We do not believe that people with a problem should immediately go to hospital, driving up costs and undoing the good work of cross-party consensus in the last 30 years. A plan that was supposed to cause a splash has belly-flopped.

NHS: Long-term Strategy

Luke Evans Excerpts

Wednesday 11th January 2023 Commons Chamber

[Wes Streeting]

I am grateful for the right hon. Gentleman’s intervention, because it brings me directly to the Government’s amendment to the motion, which is not a plan but a litany of excuses for the situation across the United Kingdom, including in Wales. I will run through them. By way of excuse, they say that the situation is challenging across the United Kingdom, and they are right: in Wales, the NHS is struggling; in Scotland, the NHS is struggling; and in Northern Ireland, the NHS is struggling. What do all parts of the United Kingdom have in common? Thirteen years of Conservative underfunding.

I will tell the right hon. Gentleman that, as he knows perfectly well as a Welsh Member, the reason why the Welsh NHS struggles more than England overall is the age profile of the population, the number of disabled people in Wales and the level of deprivation. The same disparities between Wales and England overall also explain the enormous health inequalities within England, which is why health outcomes in my city—in London—are so much better than in so many parts of the north or south-west of England. And you know the way to deal with that? It is genuine levelling up. But if people want a Government who tackle health inequalities so that every person in every part of the United Kingdom gets good-quality healthcare, they need to elect a Labour Government here in Westminster. That is the truth that the right hon. Gentleman does not want to admit.

I know that SNP Members will not be here today, because we are talking about England, but here is another truth that Nicola Sturgeon does not want to admit either: people in Scotland will be better off under a Labour Government too. She knows that just as well as anyone else.

When Conservative Members are not talking about other parts of the United Kingdom, they say that health pressures exist right across the world, but international pressures do not explain why the average wait for an ambulance is 14 minutes in France, while heart attack victims and stroke victims routinely wait an hour for an ambulance here in England. International pressures do not explain why it is that, over the past year, one in six UK adults had a pressing need for medical examination or treatment but could not get access. They do not explain why this is the highest figure out of 36 European countries and almost triple the EU average. Their excuses about international pressures do not explain why cancer outcomes in England are behind other comparable countries. None of that explains why the state of the NHS is as bad as it is today, but perhaps the hon. Member for Bosworth (Dr Evans), who was trying to intervene, wants to stand up and justify why it is that, after 13 years of Conservative Government, his constituents are waiting an average of an hour for a heart attack or stroke case.

[Dr Luke Evans (Bosworth) (Con)]

I am grateful to the hon. Member for giving way, and there are two points that I would like to pick up, seeing as he has come back to me on the second one. The first one, about comparable data, is really important. Does Labour have a position on sharing data between Wales, for example, and England, because the data is not comparable, which makes it very difficult to work out what is going on? Secondly, a plan was brought forward by the Government. It is called the NHS White Paper, which was brought forward by the NHS to transform the NHS with the integrated care boards, which are now in place. The people on those boards—42 of them—are the best people to make that change.

[Wes Streeting]

I find it astonishing. The hon. Gentleman’s position seems to be this: the Government have a plan, after 13 years, and apparently that plan is in progress. So why is it that so many Conservative Members just this week have stood up to talk about the fact that their constituents cannot see a GP, they cannot get an ambulance when they dial 999, and they are waiting hours on end in A&E departments? I know they like three-word slogans, but is the latest Conservative slogan on the NHS really “Crisis, what crisis?”?

--- Later in debate ---

[Wes Streeting]

My hon. Friend is absolutely right. We are spending £3 billion on agency costs that would surely be better spent on ensuring that we have a serious workforce plan, and on hospital departments that are staffed by regulars who get to know their shift, get to know their colleagues, and get to know their patients and communities.

Let me turn to what the Secretary of State for Department for Business, Energy and Industrial Strategy said about ambulance staff, because I think he irresponsibly suggested that ambulance staff have not committed to minimum service levels for category 2 calls today, which is just not true. I think he ought to apologise to ambulance workers.

[Dr Luke Evans]

rose—

[Dame Angela Eagle (Wallasey) (Lab)]

rose—

--- Later in debate ---

[Dr Luke Evans (Bosworth) (Con)]

As a parliamentary candidate, I was once asked by a journalist, “We have 30 seconds left on the panel. How would you solve the NHS?” I said, “If I had that answer, I would not be sitting here with you.” Mr Deputy Speaker, you have given me four minutes to do it, and I will do my best.

My hon. Friend the Member for Erewash (Maggie Throup) made an important point about context, and it goes back to when the NHS was formed in the 1940s and 1950s. We have an ageing population. In the last two decades we have seen a 50% increase in the number of 100-year-olds. Many people over 70 have four, five or six medical conditions and are on multiple medications. Technology has moved far forward, too.

When I started training, a cholecystectomy to remove the gallbladder was open surgery that required a person to be in hospital for a week. It can now be done within 24 hours. When we started people on routine blood pressure medications such as ACE inhibitors—many Members will know ramipril—they had to stay in hospital to have their kidneys checked. We now start it routinely for millions of people across the country.

That is the pace at which we are moving in the west and the developed world, and we have to try to keep up. Throw in a pandemic and workforce shortages, and we can see why every western country with a developed care system is struggling. That is the backdrop of what we are dealing with.

On top of that, demand and supply have gone up, but they have not gone up equally. Services are working hard to provide more tests and more appointments than ever before, yet demand is growing partly because the pandemic led to later and more complex presentations. In the Health and Social Care Committee we have heard that there are 27.5 million GP appointments a month, which is up by 2 million on 2019, yet it is still not enough.

In my area of Leicestershire and Rutland, we have enough GP appointments for everyone to be seen seven times a year, but the problem is that appointment rates are disproportionate. Some young people never need to go, and many older people need routine follow-ups. This is the backdrop we are dealing with. Members on both sides of the House talk a lot about long-term plans, but I would like to focus on day-to-day stuff.

[Aaron Bell]

I am grateful to my hon. Friend for bringing us his experience from before he came into this place, and he is right to look at the long-term demographic challenges. Does he agree that they will require the NHS to become even more efficient and productive? That is not just something we are asking for; it is what the staff in the NHS want, because they are aware that they are still delivering analogue services in a digital age.

[Dr Evans]

My hon. Friend has hit the nail on the head, and that is where I want to focus my remarks, because simple day-to-day changes to make the working clinician’s life better in turn improve productivity, patient care and patient satisfaction.

As with the Sky cycling team, looking for percentage gains brings big outcomes. So let us go through a quick list of some things we could do. We could have a root-and-branch review of prescribing. How much time is spent with patients waiting for prescriptions in hospitals to be dispensed? How much time is wasted by GPs signing prescriptions on paper? We have electronic prescribing but the prescriptions still get printed out to be signed. A root-and-branch review of prescribing all the way through would solve that problem, making this system more streamlined and fit for the 21st century. It would also save wastage, because there is an estimated £1 billion-worth of medication in Mr and Mrs Jones’s back cupboard just in case.

What about the IT? I am talking not about singing and dancing robots, but simply about making the IT for the day-to-day clinician work like their mobile phone does. That is not too much to ask. We could address the interface between primary and secondary care, allowing secondary care to be able to book blood tests into primary care and vice versa. This stuff does not happen. We no longer send faxes but we still send letters instead, and we pay someone to scan them so that a doctor can have a look at them and sign them off. We could cap list sizes, on a graded time for GPs. We are recruiting more GPs and it is going to take time, but that is a way of ensuring demand and at the same time continuity of care.

What about all the other stuff associated with the administrative time of looking after doctors to make sure they are fit for purpose? There is so much red tape when someone tries to join a performers list or come off one, or start an induction in a hospital. This is simple stuff we can change now, today. We can further do that by enabling the new ICBs, because my biggest worry with them is that they are going to ask for permission not for forgiveness. These 42 regional areas will be able to design the difference that can stick for the future.

I was hoping we might be able to spend these few hours today talking about the wider picture, because this all comes from context. The biggest question this House has to answer is what is the purpose of the NHS and what should it do? We all agree with the principles of clinical need and not to have to pay, but how do we deliver that for the 21st century?

[Several hon. Members rose—]

NHS Workforce

Luke Evans Excerpts

Tuesday 6th December 2022 Commons Chamber

[Wes Streeting]

I strongly agree with my hon. Friend. As the Leader of the Opposition has said, the NHS is not on its knees; it is on the floor. How many times were we told during the pandemic that restrictions were needed to stop the NHS falling over? It has now fallen over, and for the first time in its history people no longer feel certain that, when they phone 999 or arrive at A&E, they will be seen in time. It is the first time in our country’s history that people have not felt confident that emergency medicine will be there for them when they need it.

The Conservatives blame the crisis in the NHS on everything from the weather to the pandemic, and even NHS staff. Of course there is no doubt that the pandemic has made things worse, but the Government—the Conservative party—sent the NHS into the pandemic with 100,000 staff shortages. They spent a decade disarming the NHS, before sending it into the biggest fight it has ever faced. They cannot pretend that the NHS was well prepared. The problem for the Conservative party is that people are not stupid. Their memories are not that short. They know that the NHS was struggling to treat them on time before the pandemic, and they know who is to blame.

[Dr Luke Evans (Bosworth) (Con)]

Is not the point that health is devolved across four different nations, which are each led by a different party? Does this mean that the pandemic has hit all health services, including across the western world? This is a rising tide of the problem of the pandemic and dealing with an ageing population. This is not party political at all, and it is remiss of the hon. Gentleman to try to make it that. What does he say to that?

[Wes Streeting]

I would say two things. As I have already said, I accept that the pandemic made the challenge right across the United Kingdom worse. I also accept that, in every part of the United Kingdom, the NHS is under severe pressure. I would say two things in response. First, even if some of our friends on the SNP Benches do not want to acknowledge it, there is no doubt that every part of the United Kingdom would be better off with a Labour Government and every part of the NHS in every part of the United Kingdom would be better off if there were a Labour Government, because the investment that we are proposing in NHS staff today would benefit countries right across the United Kingdom. [Interruption.] In response to the outgoing hon. Member for Peterborough (Paul Bristow), do not say that politics does not make a difference. Do not expect the people to believe that somehow there was an inevitable sense of decline in the NHS. I am sure people remember that, when Labour was last in government, we delivered the shortest waiting times and the highest patient satisfaction in history.

--- Later in debate ---

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. As we see so often with this Government, they make promises but break them. They try to fool the public into thinking they are delivering more GPs—or indeed more police officers—when it was the Conservative party that cut them. They try to give with one hand, but they take with the other, and after 12 years people have had enough.

Of course, it is not only the promise to recruit more GPs that the Conservatives are breaking. We had the promise of 40 new hospitals, which the Secretary of State repeated today, yet in response to the question posed by the right hon. Member for Uxbridge and South Ruislip (Boris Johnson), the Secretary of State said that of those 40 new hospital schemes

“five hospital schemes are in construction, two are now completed and we aim to announce the next eight by the end of this year.”

So, where are the other 25? Where are these 40 new hospitals? As far as I can tell, they exist only in the imagination of the former Prime Minister. Yet the script has not changed—Ministers are still here claiming 40 new hospitals.

When I visited Leeds with the shadow Chancellor, my right hon. Friend the Member for Leeds West (Rachel Reeves), I saw a vast pile of dirt where a new building was due to go up. We heard today that the Government cannot even negotiate an agreement with the hospital to get the site working and get the new facilities built. With every minute, every month and every year of delay construction costs are going up, so taxpayers are left in the worst of all worlds: broken promises, no 40 new hospitals, and paying through the nose for the ones that are being built because of Government incompetence.

We see the tragic consequences of the shortages and broken promises in the NHS. My hon. Friend the Member for Rotherham (Sarah Champion) raised the tragic case today at Health questions of a five-year-old boy who had what his doctor described as the worst case of tonsilitis he had ever seen. He was turned away from hospital, with his parents told there were no beds and not enough doctors. His infection worsened and five-year-old Yusuf later passed away. His death certificate recorded the primary cause of his death as pneumonia and the secondary cause as tonsilitis. What kind of country are we living in when a five-year-old boy can die of tonsilitis? This is criminal.

I met Yusuf’s uncle, Zaheer Ahmed, last week, and I did not know what to say to that poor man and his grieving family, who lost that little boy in the most unimaginable circumstances. I invite the Secretary of State to meet Yusuf’s family to hear how that little boy was failed and to hear at first hand about some of their interactions with the NHS, which I thought were completely unacceptable and intolerable. On that note, I welcome the independent inquiry that has been committed to. That is really important for the family who have been failed in this heartbreaking case. We do not want to see more cases like that.

At the heart of the crisis in the NHS—as with so many of the problems facing our country—is a failure to plan. The NHS has not had a workforce plan since 2003. That would be unacceptable in a multinational company one one-hundredth the size of the NHS. The failure to plan means that short-term fixes are always favoured over what is in patients’ long-term interests. That is why the Government cut the nursing bursary and why, this summer, in the middle of the biggest crisis in the history of the NHS, they took the infuriating decision to cut a third of medical school places.

[Dr Luke Evans]

Will the hon. Gentleman give way?

[Wes Streeting]

The hon. Gentleman has been to medical school; does he think that it was a good idea to cut the number of places this summer?

[Dr Evans]

When we talk about Labour’s record on training, the hon. Gentleman may forget that, in 2007, the medical training application service ended up in judicial review. Many of my colleagues moved out of disciplines that they loved dearly because of Labour’s mess in making those plans. He has been speaking for almost half an hour, setting out his exposé of what is going on in the health service, but I am yet to hear a plan. I hope that he will spend the next half an hour telling us about the detailed plan of how we get to 10,000 new medical places, because when it comes to firms in hospitals, there is not enough space for medical students to get that experience, so I am looking for him to solve that problem.

--- Later in debate ---

[Steve Barclay]

The hon. Lady mentioned the summer, and I think she knows that I visited the Jean Bishop integrated care centre and looked at the great innovations and brilliant work that her constituents, among others, are doing there. I looked at how it is bringing social care and the NHS together through an integrated model and how there has been new investment, supported by the amazing fundraising within the local community and by NHS funding. It would be great to get a bit of balance about the amazing feedback I heard from both staff and patients at the Jean Bishop integrated care centre who are working innovatively. I hope the hon. Lady would agree that the innovation of a centre such as the Jean Bishop is what we need to see in more places across the NHS. To her wider point, there are challenges in social care; she raises a fair point. That is why, despite the many competing pressures that the Chancellor faces, he has allocated £500 million for this year. It is also why he then committed the £2.8 billion for next year and the £4.7 billion for the year after—the biggest ever increase in that funding. But it is not simply about the funding increase; it is also about using new models such as that integrated care model to deliver far better care.

[Dr Luke Evans]

Is that not precisely the point? The NHS will gobble up the money, so it is about how we use the system. The integrated care systems and integrated care boards—established through the White Paper that the NHS asked for—are doing exactly that. They are trying to join up primary care, secondary care, social care, preventive health, county councils and borough councils all in one place to make a better stand on how we can produce healthcare that is better for our constituents and better for the taxpayer. Will my right hon. Friend make sure that, when he goes to the integrated care board chairs, he gives them the chance to solve the problems and unleashes the power to do exactly that, because they know best?

[Steve Barclay]

My hon. Friend raises an extremely important point. It is not just about the significant funding increase that the Chancellor has allocated; it is also about how that funding is deployed, in particular through using population level data for the integrated care system to bring health and care together. One area that the hon. Member for Ilford North and I agree on is the impact of delayed discharges across health and our hospital trusts as a whole. We often see that manifested in ambulance handover times, which are so impacted by that.

On the investment that is going in, my hon. Friend the Member for Bosworth (Dr Evans) is right to say that it is also about how it is deployed. Again, missing from the Opposition motion was any reference to the commissioning of the former Labour Secretary of State, Patricia Hewitt, to look at how to take on board how that funding is spent in an integrated way. It would also be remiss of me not to draw the House’s attention to the £5.9 billion of capital funding that we are using to transform diagnostic services by making the most of new technologies and improving the equipment for our frontline staff, making it easier for them to deliver the patient outcomes that we need. That is investment, along with the investment in care, that this Government can be proud of.

In the motion, the shadow Secretary of State refers to a shortage of workforce, but he ignores the locum doctors and bank nurses that make up a significant proportion of the NHS workforce. He ignores the record numbers of doctors and nurses that we now have working in the NHS, with a 3% increase on last year in both doctors and nurses.

I am sure you will be surprised, Mr Deputy Speaker, given your background in Wales, to discover that we cannot see what the vacancy rate is in Wales because the Welsh Government stopped collecting workforce vacancy statistics in 2011. You would have thought that the motion would be an opportunity for the Opposition to encourage their Welsh colleagues, given the importance that they say applies to vacancy statistics. You would have thought they would be keen to see that information from across the Union of the United Kingdom. I thought that Labour was a party of the Union. Why would it not want to have that transparency across Wales on the vacancy figures? But the motion was silent on that point. Perhaps in closing, the relevant shadow Minister will make a commitment to encourage the Welsh Government to have that same level of transparency.

[Dr Evans]

The Secretary of State hits the nail on the head when it comes to comparing the different countries across the Union, because different countries choose to use different statistics on waiting times to manage their staffing. Does this not confirm the argument we should have a unified way of using those statistics across the four nations?

[Steve Barclay]

I very much agree. In fact, in the spirit of co-operation, I would be happy to write to Sir Ian Diamond at the Office for National Statistics to encourage that, if the Welsh Government were willing to make that commitment. I do not know whether the Opposition would be willing to sign up to encouraging the Welsh Government to have that level of transparency. They seem reticent about having that transparency.

--- Later in debate ---

[Munira Wilson]

rose—

[Dr Luke Evans]

rose—

[Steve Barclay]

I will give way to the hon. Lady first and then to my hon. Friend.

--- Later in debate ---

[Steve Barclay]

I have said that I am going to give way to my hon. Friend the Member for Bosworth (Dr Evans), and then I am going to wrap up. As I was saying, sometimes there are areas where it is more difficult to recruit and we need to look at the data on that.

[Dr Evans]

When it comes to retention, pensions are a big issue, and the Opposition Front-Bench team have picked up on that. One recommendation from the Select Committee was to mandate for recycling to try to help with that. What other work is being done to try to ensure that senior colleagues with the most experience are incentivised to take on the extra lists and try to deal with the backlog, in all four corners of the country?

[Steve Barclay]

We are uniquely placed in having a Chancellor who has not only a deep understanding of health issues, but an understanding of recent Health and Social Care Committee reports. Obviously, that is an issue that we, with Treasury colleagues, will keep under review.

The motion ignores the vital work that the Government are doing to back health and care, the £6.6 billion of investment in our NHS that was announced in the autumn statement, and the social care investment of £2.8 billion and £4.7 billion next year. This Government are investing in our health and social care. We have always put the NHS workforce first and we always will.

--- Later in debate ---

[Chris Stephens]

The hon. Gentleman knows of my affection for his constituency—many members of my family live there. He raises an important point about rural communities, and in relation not just to the NHS but to the other challenges he outlines. He makes a pertinent point about what all the health services need to consider when applying their services to the areas that he has the privilege of representing, and I thank him for that.

The Secretary of State talked about the autumn statement, but it will not deal with the increasing cost of food and energy, and all the other pressures facing staff. There must be a serious discussion about the NHS workforce, about retention, about giving staff career opportunities and also about wellbeing. I thank NHS staff for what they have done not just during the pandemic, but when I and family members have had health challenges. The work they do and the miracles they perform on a daily basis should be recognised in this place.

[Dr Evans]

It is worth stressing that point. For all the Daily Mail headlines about the NHS, we must not lose sight of all the good work that goes on unrecognised for the countless thousands of people who go to hospitals, GP surgeries or mental health services and get excellent care. If two patients are on similar pathways but one receives excellent care and the other receives poor care, should not the emphasis be on moving more towards excellent care and less—if not an outright stop—towards poor care?

Oral Answers to Questions

Luke Evans Excerpts

Tuesday 1st November 2022 Commons Chamber

[Maria Caulfield]

I thank the hon. Lady for her question. The Government introduced the first women’s health strategy to make issues such as endometriosis a high priority. Of course it will take time—we published the strategy only in the summer—but work is happening already. The women’s health ambassador is working to better inform young women about the signs and symptoms of endometriosis, so that they cannot be fobbed off with advice such as, “This is just a normal period.” Better and mandatory training for healthcare professionals in women’s health is being introduced and we are working with the royal colleges to streamline the referral process.

[Dr Luke Evans (Bosworth) (Con)]

Early diagnosis in endometriosis and many other conditions is important, so I welcome the news that a community diagnostic centre was approved in Hinckley last week. That will bring MRI, ultrasound and CT scans to the heart of my community, but we are looking for more. For the likes of endometriosis, people sometimes need to have a day case procedure. Will the Minister meet me to discuss having a day case unit in Hinckley? A bid is going through that I am keen to see ensured, so that we can get the diagnosis of things such as endometriosis in the heart of my community.

[Maria Caulfield]

My hon. Friend campaigned hard for the CDC in Hinckley and I am glad that he has been successful. Community diagnostic centres will provide a range of tests to speed up the diagnosis process. I am happy to meet him, because they are just the start of a huge opportunity, particularly for conditions such as endometriosis, to get diagnoses as soon as possible.