GP Contract

Debate between Luke Evans and Judith Cummins

Monday 16th March 2026 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

When we came into office, we found GP services in an appalling state—underfunded, understaffed and in crisis. Since July 2024, this Government have been fixing the front door to the NHS, investing more than £100 million to fix up GP surgeries this year, making online booking available to patients across the country and recruiting 2,000 more GPs who are now serving patients on the frontline. Following investment in advice and guidance, we have seen 1.3 million diverted referrals since April 2025. Those are people who would have otherwise been added to the electives waiting list. A lot has been done, but there is a lot more still to do. We are determined to make the system fairer for coastal communities and deprived areas, so we have launched a review into the Carr-Hill formula to close the gap on health disparities and ensure that funding is targeted on the basis of need. We will shortly update the House in the usual way on our Carr-Hill review.

Last year’s GP contract saw the biggest cash increase in more than a decade, and this year we are investing an additional £485 million, taking the total investment made through the contract to more than £13.8 billion this financial year. Investment must always be combined with reform, so the new contract will improve access for patients by requiring that all clinically urgent requests are dealt with on the same day. It will provide a mechanism to hire even more GPs via a new practice-level reimbursement scheme, and it will support the shift from treatment to prevention, as set out in our 10-year plan, through incentives to boost childhood vaccination rates, better care for patients living with obesity and requiring GPs to share data with the lung cancer screening programme.

These ideas were not cooked up by someone sat behind a desk in Whitehall. What is happening is that we are taking the best of the NHS to the rest of the NHS, working with pioneering practices that have been doing these things for a long time. Today we can see that our policies are working, and after years of decline in general practice, we are getting the front door back on its hinges. Patient satisfaction with general practice is finally moving in the right direction. According to the Office for National Statistics, almost 77% of people described contacting their GP as easy in January this year, up from just 60%, where it was languishing in July 2024. I know that when he gets up, the hon. Member for Hinckley and Bosworth (Dr Evans) will hugely welcome, as will his hon. Friends, the progress that we are making.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Minister.

[Dr Evans]

The Health Secretary and his team have perfected the sales pitch for NHS reform. The problem is that the detail never seems to arrive. We have seen a 10-year health plan with no delivery chapter, and a plan for the abolition of NHS England with no price tag; the Health Secretary has announced 10 new “straight to test” referral pathways, but could not name a single one; and now we are seeing a new GP contract with more questions than answers.

Calling something modernisation does not make it reform. If the rules and the delivery are unclear, it is simply confusion with branding. “Advice and guidance”, for example, appears in practice to create a single point of access for referrals. GPs will no longer be able to refer patients directly to a consultant, even when they believe that it is clinically appropriate. Will the Government publish the clinical evidence supporting that approach? Who will carry the legal responsibility if, in a GP’s professional judgment, a patient needs to see a consultant but must first go through “advice and guidance”? If advice and guidance becomes mandatory as an extra layer before referral, are the Government not, in essence, managing the waiting list by keeping patients in primary care rather than treating them in secondary care? Waiting lists will look shorter on paper, but patients are simply waiting elsewhere in the system. Can the Minister clarify exactly where those patients will appear in the official waiting list figures? The contract also requires patients whose cases are deemed “clinically urgent” to be dealt with on the same day, but it does not define “urgent” or explain what “dealt with” means, and that really matters.

Let me therefore ask the Minister three clear questions. First, when will the Government publish the clinical definition of “urgent”—a patient’s sick note is urgent for the patient, but not clinically urgent—and what counts as a patient’s being “dealt with” on the same day? Secondly, the Minister has talked about access, but how can practices guarantee same-day responses when demand is uncapped and definitions are not published? Finally, with advice and guidance being required as a mandate beforehand, how will we ensure that patients are protected, and where will they appear on the waiting lists?

British Indian Ocean Territory

Debate between Luke Evans and Judith Cummins

Wednesday 28th January 2026 Commons Chamber

[Dr Evans]

Absolutely. That is another perfectly sensible question to pose to the Government, and for them to answer and to set out the reasons and the rationale.

I am still concerned, when we are dealing with the detail, about the long-term nature of the deal and whether it is bomb-proof. When we come to the end of 99 years, what will happen? The only protection we have is that we have first say on taking it on. We have already heard, from Members on both sides of the House, how much China’s economy will grow. Will we even have the finances to buy that deal? Will we be outbid by the United States, by China, or by some other BRIC power? We are held over a barrel by the Mauritians, or, worse still, the Mauritians can simply say, “We don’t want it any more”, and the base is gone and we can do nothing about it.

Why does all this matter? Those are all technical questions that I want the Government to answer, but overall we must see the wider context, which has been explained here numerous times before. The United States is changing its foreign policy, China is changing its foreign policy, yet the UK does not appear to have an approach in either direction. It appears that we are looking towards a sphere of influence, with America having one side and China and Russia having another. So the question for the House is, “Why rush this through?” Why not think about it? Why not answer these simple questions, to get this side of the House on board, so that we could then say, “We think this is the right thing for the country?

The saddest aspect of this whole debate is the way in which the Government have turned it into a scapegoating of the Opposition as if we were playing political games, rather than seeing that the simple technical questions that need to be answered are the key to unlocking our understanding. If we as parliamentarians cannot get answers to these questions and do not understand the rationale, how can we explain it to our constituents, how can we explain it to the nation, and how can we explain it to the world? If the Government want us to stop—supposedly—playing politics, I ask them to give simple answers to simple questions, back them up and give evidence for them. Otherwise, we are left fighting the Black Knight, who is brave, who is forthright, who is keen to stand in the way of any progress, but who simply will not answer a question and is cut down, limb by limb, in a pool of blood.

[Madam Deputy Speaker (Judith Cummins)]

I will now announce the result of today’s deferred Division on the Draft Medical Devices (Fees Amendment) Regulations 2026. The Ayes were 294 and the Noes were 108, so the Ayes have it.

Budget Resolutions

Debate between Luke Evans and Judith Cummins

Monday 1st December 2025 Commons Chamber

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

I congratulate the Government on keeping one of their manifesto commitments, because their manifesto said, “Change”—it is just that no one realised that would be all that was left in the British public’s pocket when it came to it. I would like to give a second congratulations to the Chancellor, because I gather that she has won an award: best Dubai estate agent for 2025. We know that 250,000 people have now emigrated from Britain because of the impacts of her Budget. I expect she is now going for the next award in 2026.

More importantly, this seems to be a Labour Government who are caught between trying to do things on purpose or by mistake. At the last Budget, they were up front that they were going to tax education for the first time. They did not realise that what they were actually going to do was put up taxes on hospices, pharmacies and GPs—that was all missed. Now a new Budget has come forward, and I call it the “ball of wool Budget”. Why? Because for the first time in history we have had this ball of wool unravel time and again, for weeks upon weeks, until it was finally spun into a yarn that we were supposed to believe, but the British public have seen right through it. It is unparliamentary to use the term “liars”, but I think I can use “Pinocchio”, and I think the Prime Minister and the Chancellor may well fall into that category.

Rest assured, people in Leicestershire and up and down the country see right through this Labour Government. They see what this Budget was all about: trying to placate the Back Benches, and how? It is through £40 billion of tax rises in the first Budget and £26 billion of tax rises in this one. Don’t just take my word for it, because even if, before the last Budget, we believed in the fictional black hole, which was then disproved by the OBR, the Chancellor went on Sky News after that Budget and said:

“We’ve now wiped the slate clean… It’s now on us…we’ve set the spending envelope on the course for this Parliament, we don’t need to come back for more. We’ve done that now”.

She went on:

“there’s no need to come back with another Budget like this, we will never need to do that again.”

Yet here we are with £26 billion more tax on the British public, yet we still have weak growth, high inflation and no living within our means.

The Chancellor has even broken her own manifesto commitment, which she has admitted, because in the 2024 Budget she said from the Dispatch Box:

“I have come to the conclusion that extending the threshold freeze would hurt working people. It would take more money out of their payslips. I am keeping every single promise on tax that I made in our manifesto, so there will be no extension of the freeze in income tax and national insurance thresholds beyond the decisions made by the previous Government.”—[Official Report, 30 October 2024; Vol. 755, c. 821.]

Yet, one year on, she said from the Dispatch Box last week:

“I am asking everyone to make a contribution.”—[Official Report, 26 November 2025; Vol. 776, c. 393.]

I need to tell the Chancellor that being asked for a contribution is not the same as being told, which is what this Government are doing. What would happen if someone tried to refuse, saying, “No, I’ve paid my fair share”? My constituents say, “I’ve done enough,” but they cannot just say no. They will get a fine or, worse, a criminal record and go to jail. So let us deal with the semantics and say what it is: a naked choice to increase tax on the British public.

In the run-up to the election, my right hon. Friend the Member for Richmond and Northallerton (Rishi Sunak) was prophetic in what he said. We were not listened to, and I understand all the reasons why. He said, “A Labour Government will tax your holiday, your house, your GP, your pharmacy, your flights, your car, your pension, your savings”—have I missed anything? They have taxed charities, and even milkshakes—tax, tax, tax. The public have seen what a Labour Government have done. They were told about it, and they have seen it twice in a Budget. When it comes to the next one, I hope they will remember that.

[Madam Deputy Speaker (Judith Cummins)]

The hon. Gentleman may have meant to evade the rules with his reference to the Prime Minister and the Chancellor, but he did not. I advise him to withdraw those comments.

[Dr Evans]

Forgive me, Madam Deputy Speaker. Whether it was the reference to either being a liar or Pinocchio, I withdraw them both.

Mental Health Bill [Lords]

Debate between Luke Evans and Judith Cummins

Report stage
Tuesday 14th October 2025 Commons Chamber

[Madam Deputy Speaker (Judith Cummins)]

Members will have noticed that many people are standing to speak and there is not a significant amount of time for the debate, so with the exception of Front-Bench contributions, there will be an immediate four-minute time limit. I call the shadow Minister.

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

When we last debated the Bill on Second Reading, I said that protecting someone’s freedom for their own safety is not a licence to own their life, but a duty to help them find it again. That principle still guides us today, because good intentions alone do not mend a troubled system. Compassion without competence is not care; it is sentiment without substance.

On Second Reading, I spoke of bridges and rough roads, and of how resilience and recovery depend on the strength of the structures that carry people through their hardest times. Tonight, we return to that bridge. The question before us is not whether we believe in reform—after all, there is cross-party agreement on that—but whether the Government have built the foundations to make it stand. Warm words are plentiful, but the reality is that too many people are still falling through the gaps: detentions are still present, community services are stretched, and families are left navigating a maze of bureaucracy while waiting for help that may never come.

We all know that reform cannot be delivered on aspiration alone. It requires a delivery plan, a workforce and a system capable of learning from its own mistakes. We know the chapter on delivery is missing from the 10-year NHS plan and there is further risk tonight that we miss another opportunity. After all, the principles in the Bill are the right ones. They are even on the face of the Bill—choice and autonomy, least restriction, therapeutic benefit, and treating the person as an individual—but those principles need power behind them and that power lies in delivery.

This Report stage is our chance to turn those words into commitments. New clause 31 requires the Government to publish a fully costed delivery plan within 18 months of the Act passing into law, setting out how integrated care boards and local authorities will deliver adequate community services. Crucially, the plan must be developed through consultation with those who know best. That is vital, because although we support the many aims of the Bill, the Government already have a pretty dismal record of announcing reforms without any credible plan to deliver them.

Let us take the ongoing NHS reorganisation. In March, Ministers made a surprise announcement of the abolition of NHS England and its absorption into the Department of Health and Social Care, yet six months on they cannot say what it will cost, how many staff will be lost or how it will be paid for. The Health Service Journal reports growing confusion inside the system and warnings from NHS leaders that the lack of clarity risks paralysing decision making. Written questions to the Government simply receive the answer

“some upfront cost in the millions”

yet independent estimates say the cost is over £1 billion. Even the chief executive, Sir Jim Mackey, points out that the Treasury must agree funding for integrated care board redundancies within weeks or the NHS will have to turn to a plan B.

The same chaos is playing out across integrated care boards, with local leaders warning that there is already destabilisation due to the 50% reductions. If Ministers cannot manage their own top-down reorganisation, why should anyone believe they can deliver a more ambitious overhaul of mental health services without a clear costed plan, especially when waiting lists have risen in the last three consecutive months?

This Labour Government have already cut the proportion of spending on mental health. As Dr Lade Smith CBE, the president of the Royal College of Psychiatrists, said at the time:

“It is illogical that the share of NHS funding for mental health services is being reduced at a time of soaring need and significant staff shortages.”

Going on, she said that:

“The proportion of NHS funding allocated to mental health services will decrease”,

which will

“equate to these vital services missing out on an estimated £300 million or more that they would have received if their share…had been maintained.”