NHS Capital Spending

Matt Western Excerpts

Wednesday 4th March 2026 Westminster Hall

[Several hon. Members rose—]

[Matt Western (in the Chair)]

Order. I remind Members that they must bob if they wish to be called in the debate. I first call Gareth Thomas, who will be followed by Steve Darling.

[Gareth Thomas (Harrow West) (Lab/Co-op)]

The White House in Harrow, thanks to NHS capital money, will shortly become even better than its American namesake. I pay tribute to the hon. Member for Carshalton and Wallington (Bobby Dean) for the way in which he introduced the debate. I agree very much that levels of capital investment into the NHS do not get the attention that they deserve in this place. He is certainly right about the impact on NHS capital spending of the austerity over the previous 14 years of Conservative health administrations. He rightly referenced the shameful spectacle of Conversative Health Secretary after Conservative Health Secretary handing back capital moneys to the Treasury at the end of March. My hon. Friend the Minister will be pleased to know that I have a solution to that problem if she faces it this year.

The White House, which is located at Harrow college, close to Harrow-on-the-Hill station, is set to become one of Harrow’s neighbourhood care centres thanks to NHS capital. NHS capital is allowing the local NHS to convert the White House, which is part of the college at the moment, into a new, expanded GP surgery and care centre. It will offer two opportunities for students enrolled at the college to begin a career in health and social care. Crucially, it will create a hub for care services that can keep people out of hospital and, in particular, out of accident and emergency queues.

The White House is set to be one of a number of new neighbourhood care centres, including Belmont health centre, Alexandra Avenue health and social care in Rayner’s Lane in my constituency and the Pinn medical centre in Pinner. This planned expansion of primary care over the next two years, using NHS capital moneys, builds on a recent significant increase in the number of GP surgery appointments. The nightmare of having to get an appointment to see a GP once lines open at 8 am is beginning to ease, but much more progress still needs to be made. GP appointments in Harrow have increased substantially since July 2024. Just under 120,000 appointments took place that month, but by October last year the total number of appointments each month had risen to more than 145,000—a 22% increase. For face-to-face appointments in particular, there had been a 30% increase.

I welcome the difference that NHS capital allocated to Harrow will make for primary care in the coming years. The funding for GP Direct, a surgery currently based in west Harrow, to expand and offer more and better primary care services, and for a neighbourhood healthcare centre located at the Alexandra Avenue clinic, is set to make even more of a qualitative difference to primary care services in my constituency.

However, I hope to make the case to the Minister for the allocation of further NHS capital investment at Northwick Park hospital. Waiting lists are beginning to come down at Northwick Park, but, again, there is much more to do. To help maintain that progress, Northwick Park needs a new 36-bed critical care unit, with space for further expansion. A series of NHS and independent assessments of critical care across north-west London have identified a shortage of critical care beds, particularly on the Northwick Park site. The existing intensive care unit there has a series of problems that compromise the current delivery of critical care. It is not co-located with other key NHS services on site, such as the emergency department or operating theatres. It is outdated, noisy, cramped and unfit for purpose for patients and families facing critical illness—or, worse, potential end of life.

The trust has put together a proposal for a new UK-leading exemplar intensive care unit that provides additional critical care beds and a new CT scanner, which would embed modern standards of patient experience and family support. The proposal is for a 36-bed unit and allows for a potential future expansion for a further 24 critical care beds. The new unit that is immediately proposed allows for 30 of the 36 beds to replace existing critical care beds that are located in other parts of Northwick Park hospital, which will free up extra bed space and, in turn, help to alleviate pressures on other parts of the hospital, notably in accident and emergency. It will also play a useful role in helping to prevent the cancellation of elective operations.

The recommended bed occupancy for critical care beds is set at 85%, according to the National Institute for Health and Care Excellence. Northwick Park has been consistently above that level for some time. The hospital has one of the busiest A&E departments in the country, receiving an average of 90 ambulances a day, rising to 140 on its busiest days. Critical care admissions are also up by more than 16% since 2018-19, and more than 80% of admissions to the trust are at Northwick Park hospital. It is worth reflecting on the experience of covid. Northwick Park was the first hospital during the covid pandemic to declare a critical incident, as the number of intensive care beds simply ran out.

An expansion in critical care beds at Northwick Park needs funding. It needs funding to improve services now, but also to better prepare north-west London for future health emergencies. The bid for funding is strongly supported by the trust board and, I understand, by the local integrated care board as well. I hope that the Minister, her Health colleagues and the Treasury will support it, and that the Minister will commit to doing all she can to give it a strong push.

Work on cancer care services is also taking place in the London North West University NHS trust. Northwick Park already sees more than 50,000 people with suspected cancer each year, and diagnoses more than 3,000 cases. However, too many cancer cases have to be dealt with outside of our area, and the quality of the experience for those being treated for cancer could be significantly improved with further investment. I hope that the Minister will duly make sure that Northwick Park is flagged up early for further investment as part of the national cancer plan.

[Matt Western (in the Chair)]

I expect speeches to be around five minutes so that we can get everyone in. Please be respectful to colleagues.

[Steve Darling (Torbay) (LD)]

What a pleasure it is to serve under you as chairman, Mr Western. I congratulate my hon. Friend the Member for Carshalton and Wallington (Bobby Dean) on securing this important debate. Sorting out Torbay hospital, the hospital that serves my constituency as well as the constituents of my hon. Friends the Members for South Devon (Caroline Voaden) and for Newton Abbot (Martin Wrigley), is my No. 1 priority as the Member of Parliament for Torbay.

I knew that the hospital was in a difficult place prior to my election, but as I began to immerse myself in the challenges facing it, I was shocked. I was shocked by what was effectively wanton vandalism—corporate vandalism, even—undertaken by the previous Conservative Government by making promises that they just could not keep. The vandalism—the fact that they chose not to invest—made it much harder to invest in the longer term and actually made it more costly. It is that old proverb: a stitch in time saves nine.

In Torbay we face some massive challenges. We have seen more than 700 sewage leaks at our hospital. These sewage leaks do not just happen in the corridors; they happen in clinical areas and affect wards where patients are. There have to be deep cleans, and there are delays for patients in getting on to lists and, most importantly, delays in supporting people who need medical interventions.

We heard from my colleague, my hon. Friend the Member for Carshalton and Wallington, that delays are occurring because of poor ventilation, and we have heard about the impacts—indeed, there have been very significant impacts in Torbay hospital. However, approaching the hospital, someone might think that the seventh cavalry was coming over the horizon—the tower block is wrapped in scaffolding, so it must be being sorted. However, the reality is that the £1 million scaffolding is there purely to stop bits of the building falling off and braining staff and members of the public as they go past. Having to spend so much of our NHS money just maintaining a crumbling building is not good. The Torbay and South Devon NHS foundation trust has some bids in with the Minister around the challenges in the tower block; I am sure she is considering those at the moment and I hope she will look upon them kindly.

I also want to reflect on what works well in Torbay hospital. I recently visited and saw some really exciting changes. There are millions of pounds-worth of investment in the emergency department, for example, which is really welcome. The daytime operations area, where people come in for a short period in the hospital, is calm and businesslike, which is what we want during hospital visits, but that is very different from other parts of the hospital, particularly for those people who suffer from cancer, for whom the offer is chaotic and situated all over the estate. Cancer sufferers deserve a better experience.

We have seen investment in the endoscopy unit, and 90% of patients are being seen within five weeks, which is a massive improvement. However, looking at the estate of Torbay hospital as a whole, 85% of it is not up to standard. The £350 million investment supports only half of the hospital.

We have also seen a toxic change to the spending power of this capital programme. We have seen Brexit, we have seen the pandemic, which has impacted on the spending power of capital programmes, and we have seen the war in Ukraine, which has seen building prices spiral. Some of the management in the hospital field say that, since the pandemic, the spending power of capital programmes has halved, so can the Minister tell us how the Government have taken account of the fact that money is going only half as far as it did historically?

In conclusion, Torbay is one of the most deprived communities in the country and the NHS often picks up the rough end of that. Only recently, a director told me she has patients who believe that living to their 60s is a good span of life. I am sure the Minister agrees that is not the aspiration we should have for our communities. In the south-west we have seen a lack of capital investment, whether in our railways or NHS infrastructure. I hope the Minister will tell us how the Government are planning to invest in the NHS in the south-west and, as my hon. Friend the Member for Carshalton and Wallington asked, what innovation there is to bring forward that investment. Sadly, Torbay has been kicked into the long grass until the mid-2030s. The staff are our most important asset, and they deserve that investment much sooner.

[Matt Western (in the Chair)]

The next speaker will have five minutes. Thereafter, I am afraid I will have to drop to four minutes.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

It is a real pleasure to serve under your chairship, Mr Western. I thank the hon. Member for Carshalton and Wallington (Bobby Dean) for setting the scene incredibly well. Of course, I want to give a Northern Ireland perspective, but I want to put forward two areas where possible savings could be made, and I wonder whether the Minister has had a chance to look at that, collectively or individually.

The hon. Member for Carshalton and Wallington, who set the scene, had 1,000 petition signatures for this debate—well done to him for garnering that interest. Our hospitals are so important and their services are lifesaving, so in terms of our finances they are priority No. 1. It is absolutely no secret that NHS capital spending has a direct impact on patient flow, waiting times and staff morale, and also on the quality of care.

Each year, my colleagues and I listen to the Budget and assess how our block grant can benefit the people of Northern Ireland through our healthcare system. It is clear that we must invest heavily in our facilities as well as our day-to-day spending. In her spring Budget yesterday, I think the Chancellor said that an extra £380 million was coming to Northern Ireland in the block grant. That should hopefully go some way to helping balance the books.

Around two years ago in my constituency of Strangford, our minor injuries unit closed following the opening of an urgent care unit in Ulster hospital. It was one of the most modern acute hospital sites following more than £235 million in capital investment, including in the new emergency facilities, patient accommodation and surgical and research infrastructure. Rather than planning a completely new hospital, the Department of Health has focused on transforming the Ulster into the regional acute hub. That is the right strategy, aligned with wider NHS reconfiguration plans for Northern Ireland.

Furthermore, there are plans for a new maternity hospital at the Royal Victoria hospital in Belfast. That is one of Northern Ireland’s largest capital projects, with more than £100 million already invested. Further investment is also planned for the surgical hubs, elective facilities and rapid diagnostic centres. I am pleased that hospitals in Northern Ireland have witnessed increased capital investment but, in comparison to St Helier hospital, as the hon. Member for Carshalton and Wallington described, it is clear that some hospitals are still struggling drastically, and he underlined that point incredibly well. More needs to be done to ensure that they are fit for purpose.

I have two points on savings, which I put to the Health Minister back home, Mike Nesbitt. A level of middle management has been created, which is not always necessary. I am not saying that people should lose their jobs; I am just looking at how it can be done in a good way to ensure value for money. The second point is about agency staff. Back home—and I understand it is the same over here—agency staff are sometimes employed rather than full-time nurses. That is never cost-effective, because it is better to pay a nurse a good wage than it is to employ agency staff. Those are two thoughts that might be helpful.

NHS capital spending is not a luxury; it is a necessity. It is the foundation of safe buildings, modern equipment, efficient services and dignified patient care. Without sustained investment, we will continue to see rising waiting lists, staff burnout and crumbling infrastructure. The Minister is always very responsive, and we are glad to have her in her place. The hon. Member for Carshalton and Wallington is asking for the Government to commit to sustained strategic capital investment that will secure the future of our NHS and deliver the standard of care that patients and staff both deserve. Those two ideas to save money are worth looking at as well.

[Matt Western (in the Chair)]

I call Josh Taylor—sorry, I got that wrong; I call Luke Taylor.

--- Later in debate ---

[Luke Taylor]

I could not agree more with the hon. Member’s point. When the condition of an asset does not attract staff, particularly in more deprived areas, the challenges will be greater. Those compounding challenges are borne out visibly through the physical asset, and everything becomes much more difficult.

I should not have to be here making points about political faith and delivery—or the economic arguments that have been made by other Members—but I will make the important humane case, based on the experiences of my constituents. I recently did a health survey where residents wrote in and told me their stories. One of them was a woman whose husband spent 54 hours in A&E with sepsis, lying on a trolley in a room so small it could have been a broom cupboard. Another, who is in her late 80s, sat waiting on a chair for 10 hours after a suspected heart attack, while another woman, who was unable to sit on a chair because of her pain, had to lie on the floor crying and wait for several hours.

Almost half of those who responded to the survey said that they had waited for more than four hours in A&E at St Helier hospital. We have the NHS numbers, too: across the Epsom and St Helier trust, 18,600 people waited for more than 12 hours in 2025. That is sickening; it is an example of a system that is not working. “Sickening” is the right word: like thousands of people across Sutton, I am sick to the back teeth with the endless delays that have got us here.

There is another important angle. In almost every one of the stories I was told, there was nothing but deep appreciation for the dedicated staff on the estate, many of whom the respondents credit with saving their lives in spite of—not because of—the conditions that they find themselves in. How can we keep recruiting into the NHS or uphold its public image if these are the conditions that we are expecting staff to work in? This is normally the part of the speech where I talk about the Government’s awful inheritance from the Conservatives, but I do not feel like making that point any more, because the people of Sutton have had enough context-setting and this Government is almost two years old now.

I thank the Minister for her discussions of this topic with me and other colleagues. I feel that we are engaging openly and positively, and I want to make that very clear for the record, but I ask the Government to listen to the pleas of our constituents, and to please provide the money to expand our emergency department. At risk of returning to my point about trust, if we do not fix this, we risk a catastrophe in Sutton that might undermine the faith of my residents and the broader public in the entire model of the NHS.

My speech has been about expanding, refurbishing and fixing St Helier hospital, but there is the separate issue of the real and urgent need for the specialist emergency care hospital that our NHS and residents were promised by the previous Government. We need that too, and we need it quickly. The expansion of our A&E would complement the provision in Sutton, and it needs to be brought forward.

[Matt Western (in the Chair)]

I now call Josh Babarinde.

Advanced Brain Cancer: Tissue Freezing

Matt Western Excerpts

Wednesday 7th January 2026 Westminster Hall

[Several hon. Members rose—]

[Matt Western (in the Chair)]

I remind Members that if they wish to be called in the debate, they should bob.

--- Later in debate ---

[Dame Siobhain McDonagh]

On a point of order, Mr Western. I want to make a clarification. In my response to the intervention by the hon. Member for Esher and Walton (Monica Harding), I mixed up quangos. I suggested that it was the fault of the MHRA that the Oncotherm machine was not in an NHS hospital. It is, of course, the fault of the National Institute for Health and Care Excellence. I would not want anybody to think that that machine has not been approved and registered by the MHRA.

[Matt Western (in the Chair)]

Thank you. Your point of order is noted.

Auditory Verbal Therapy

Matt Western Excerpts

Tuesday 21st January 2025 Westminster Hall

[Several hon. Members rose—]

[Matt Western (in the Chair)]

Order. I remind Members that they should bob if they wish to be called in the debate. I never thought I would be saying these words, but it is my pleasure to invite Mr Jim Shannon to speak.

--- Later in debate ---

[Mrs Hodgson]

I thank everyone who has taken the time to come along and made such excellent contributions on this vital issue. I thank the Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), who spoke for the Opposition, and the hon. Member for North Shropshire (Helen Morgan), who spoke for the Lib Dems, for listening.

I was happy to hear that the Minister will meet AVUK and explore the potential of a pilot. That is great news. I hope that he might also get a chance to speak to Sam today—that would be wonderful. I also hope that, if NICE deems—as we all have—that this therapy is both clinically and economically valuable, he will update the guidance to ICBs. The Minister also mentioned the NHS 10-year plan. I hope he recognises that it has already been nine years since the guidance was updated and that the issue needs urgent attention, perhaps towards the start of the 10-year plan rather than the end of it; otherwise, we will be getting on for 20 years.

Today, we have the opportunity—the Minister especially—to change the fate of deaf children in this country. They deserve the same opportunities and outcomes as their hearing peers. That surely cannot be a controversial position. These children are the future. We must invest in them, not only because it is the right thing to do morally, but because any financial investment will produce economic returns in abundance. Mainly, we should invest in them because our children deserve it.

[Matt Western (in the Chair)]

I also thank Sam and his family for attending this morning.

Question put and agreed to.

Resolved,

That this House has considered the provision of auditory verbal therapy.

Oral Answers to Questions

Matt Western Excerpts

Tuesday 15th October 2024 Commons Chamber

[Matt Western (Warwick and Leamington) (Lab)]

A really important part of improving health outcomes in the east midlands, and across the country, is the use of diagnostics. The Rosalind Franklin laboratory, which was set up in my constituency, was closed down just a few months ago at a cost of £0.6 billion. Does my hon. Friend agree that one of the most important things we could do is to restore good quality diagnostics to our NHS?

[Karin Smyth]

My hon. Friend is absolutely right. We are committed to improving diagnostics as part of our reform of the health sector. Analysis of waiting lists shows that 20% of people will end up with a hospital admission, most as a day case. To improve waiting times, the focus must be on early prevention, diagnostics and consultant review at an early stage.

Oral Answers to Questions

Matt Western Excerpts

Tuesday 23rd July 2024 Commons Chamber

[Wes Streeting]

I would not rely on anything the former Prime Minister said—[Interruption.] Oh, our Prime Minister? I thought the right hon. Gentleman was talking about the former Prime Minister. In that case, I can reassure him that we are absolutely committed to the new hospitals programme. On the budgets and the timescales, as I have said, we will come forward with an honest appraisal of what we have inherited from the last Government and what we will be able to deliver within reasonable timescales.

[Matt Western (Warwick and Leamington) (Lab)]

T5. I congratulate the Secretary of State on his position. Yesterday’s NHS data showed that we have among the highest incidences of dementia in the world, with something like 500,000 cases just in England. I appreciate that this is early days, 16 days in, but does the Minister have any idea why that may be, and what can be done about it?

[The Minister for Care (Stephen Kinnock)]

I thank my hon. Friend for that question and welcome him to his place. This issue is personal for me, and I am sure it is for many others across this House. A number of potential new disease-modifying drugs for Alzheimer’s are in the pipeline, including lecanemab and donanemab. We are committed to ensuring that clinically effective and cost-effective medicines reach patients in a timely and safe way. The National Institute for Health and Care Excellence is appraising lecanemab and donanemab to determine whether they will be made available in the NHS.

World Stroke Day

Matt Western Excerpts

Thursday 23rd November 2023 Westminster Hall

[Sir Robert Neill (Bromley and Chislehurst) (Con)]

I beg to move,

That this House has considered World Stroke Day.

As ever, it is a pleasure to serve under your chairmanship, Mr Hollobone. I am grateful for the opportunity to raise this important topic. This year, World Stroke Day fell on 29 October. We had hoped to have this debate a little nearer to then, but the date we were originally given had to be vacated because of the Prorogation of Parliament. I am grateful to the Chairman of Ways and Means for so swiftly rescheduling it.

I refer Members to my interest as co-chair of the all-party parliamentary group on stroke. I am delighted to see one of the vice-chairs, the hon. Member for York Central (Rachael Maskell), in her place. I also declare a personal interest. My wife Anne-Louise suffered a stroke four years ago, as many in this House know. She made a courageous fight to recover, and I think we have discovered a number of areas where much more work needs to be done because stroke is very often, to a degree, a hidden condition. It does not receive as much publicity as heart attack or cancer, for example. Although we have made improvements and advances in recognising early stroke symptoms so that swift treatment can be given, the thrust of the debate is to say that much more needs to be done.

[Matt Western (Warwick and Leamington) (Lab)]

The hon. Member is making a powerful speech, and I appreciate his passion. He spoke of awareness, understanding and education about strokes. We need much more work on that; many people are unaware of stroke symptoms. They should be aware of what might be happening to a family member or friend before their very eyes.

[Sir Robert Neill]

That is right and that is why I commend the Stroke Association for raising awareness and recognition of symptoms. It promotes the Act FAST campaign, which details the symptoms that should be looked out for: if someone shows facial weakness, arm weakness or speech problems, then it is time to call 999. That has been important in raising awareness. I thank the Stroke Association for the briefing it has provided, as well as others who have assisted in the preparation of my comments, including the Royal College of Radiologists and, from the private sector, Ipsen UK, a biopharmaceutical company that works in this field. I will refer to its research.

The essence of the matter is this: stroke is not often recognised, but even when it is, the quantity is not talked about enough. In the UK, stroke strikes every five minutes and more than 100,000 people have strokes every year. It is a leading cause of adult disability; two thirds of stroke survivors leave hospital with a disability. Sadly, it is also a leading cause of death in the UK. Leaving aside the human cost, there is also an economic cost. Too many survivors are unable to return to work. A conservative estimate of the cost to the economy is some £26 billion a year. Some would suggest that it is even more. Never mind the care costs and the burdens on unpaid carers, which some of us know all too well.

Stroke is preventable. In about 80% of cases, it can be treated by changing risk factors, checking for high blood pressure and atrial fibrillation, but we still lag behind other countries on stroke outcomes. The Stroke Association told me that, for every minute a stroke is left untreated, nearly 2 million brain cells die. The brain is both extraordinary and fragile, which is why fast treatment and swift responses are so important. That means getting somebody to a specialist stroke unit as soon as possible. In Anne-Louise’s case, we were lucky that that was not far away, but sadly there will always be disability thereafter. However, that can be reduced through investment in treatments, such as mechanical thrombectomy. If a patient gets mechanical thrombectomy swiftly, their level of impairment is greatly reduced.

Sadly, access to mechanical thrombectomy greatly varies across the country. In Greater London, where my constituency is, the percentage of patients given a thrombectomy in 2021—there may be updated figures, but this is the latest one the Stroke Association had—was 7.8%. In the east of England, it was 0.3%. In most other parts of the country, it hovers around 2%. Even if that has grown somewhat, it is still far less than we would wish to see. I welcome the Minister and am grateful to see him in his place, and I am sure that he is aware that investment across the piece would greatly improve people’s outcomes. That needs to be mainstreamed into investment plans, and we certainly seek to do that. I hope the Minister will commit to removing that postcode lottery in survival according to where a person is when they have the misfortune of having a stroke. If we do not do anything about this, the cost I referred to is predicted to increase to about £75 billion by 2035. We cannot afford for that to happen, either economically or in human terms.

We have talked about prevention and thrombectomies, which can be a game changer, but we do not have anything like the numbers accessing them that other countries do and the figures are not in line with the Government’s own targets. Perhaps the Minister could tell us what is being done to catch up and spread availability across the piece, because at the moment only about a third of the people who need that treatment receive it. That is simply not good enough for the two thirds that were unlucky enough to be in the wrong place at the wrong time. That is important, but there is also the issue of the workforce. I am indebted to the Royal College of Radiologists on this point. Early diagnosis, of course, can help through either thrombectomy or other interventions, but we have a shortfall in the number of clinical radiology consultants of some 30%. They are needed to do the imaging—the MRIs and all the other things—that could enable those other treatments to take place swiftly. Without further action, that shortfall of consultants in radiology is forecast to increase to 41% by 2027—2,890-odd posts. What is being done to address the shortfall in that specialism and, indeed, others?

Only 48% of hospital trusts can provide adequate 24/7 interventional radiology services, largely because of that workforce shortage. I am sure the Minister will once again agree that that is not satisfactory. The use of interventional radiology—image-guided surgical treatments, effectively—is critical in the modern treatment of strokes. When we look at the national health service’s workforce plan, what are the plans specifically to recruit the workforce—the skilled specialists we need to support those new procedures, which will save lives and improve lives for survivors?

As well as the key issues of intervention and treatment, the other issue I want to touch on is what happens thereafter, because the outcomes can vary greatly. Some people, as we all know, are fortunate enough to be out of hospital quite quickly, whereas others—my wife included—spend much longer there. What troubled me was when Anne-Louise eventually left the rehabilitation unit in Orpington, where she had excellent care, we were lucky enough to be able to continue care at a proper level, through our own resources as a family. There was a young woman in there, probably in her mid-40s, who was a single parent. She lived on her own and had no one to take care of her. She was there before Anne-Louise arrived in the unit; she was still there when Anne-Louise left. What happens to someone in that condition is a real worry to us.

I am sure the Minister will rightly observe that the percentage of patients discharged into community stroke services has risen from 53% to 61% in 2022-23, but the quality and consistency of the community service provision is very variable. There are real shortfalls in the number of specialists—again—so we have a workforce problem in the community as well when it comes to physiotherapists, speech and language therapists and neuropsychiatrists.

We sometimes forget that, as well as the very real physical impacts of stroke—which can be a lack of mobility or balance, a level of paralysis, speech impairment and post-stroke spasticity, as it is called, which I will come back to in a moment—there is very frequently a degree of mental ill health associated with such a life-changing event. Many stroke survivors suffer from varying degrees of depression, and the lack of neuropsychiatrists and psychologists to assist them is very stark.

We know that nearly half of stroke survivors experience some degree of post-stroke spasticity within six months of having a stroke, and some will be classed as severely disabled. We then find that some 80% of survivors may develop it at some point unless they get that proper and consistent treatment. At the moment, we do not deliver the recommended levels of community care in the therapies, of all kinds, that are recommended by the nationally accepted guidelines. What is being done to improve that?

At the moment, in the community setting, post-stroke patients experiencing post-stroke spasticity may have to wait four to seven months to be seen for a multi- disciplinary-team assessment. That is far too long. I have a constituent who has been waiting for nearly a year to be assessed to receive the multidisciplinary treatment that she needs. Accessing that support surely should not be done on such a fragile basis.

Ipsen has recently published a report, “Neuro- rehabilitation: State of the Nation”, which discusses this issue. It found that there is a lack of foundational awareness about spasticity and that it is not picked up often or soon enough. In fact, there are issues with the sporadic nature of treatment and a five to six months average waiting time for spasticity services. One in four NHS sites in England do not have access to specialist services for spasticity—there are only 0.26 consultants per 1,000 in prescribed specialist services in England and Wales compared with two to three in most European countries. Something like two in three stroke survivors do not receive a six-month review of their care, and that is one of the fundamental targets set out in the national guidelines. If two thirds are not receiving it, then clearly something is failing us badly.

We would like the Government to designate stroke as a major condition, and they also ought to consider post-stroke spasticity management as an integral part of the major conditions strategy. Perhaps the Minister will take that away and consider it. What can be done to level up the commissioning and provision of those rehabilitation services? What can be done to look at the high-level priority areas for stroke research that have been identified? These are important matters and we would hope that that could be done. There are other things that I hope the Minister will take a look at. Can we continue to improve availability at community level? Can we ensure that everybody receives the treatment set out in the National Institute for Health and Care Excellence guidelines? As I say, at the moment we are falling significantly short.

In conclusion, having set out those points—I could go on for much longer if we wanted—I hope that my speech highlights some of the real areas of concern. I also want to say a word about the voluntary groups; most of us in the field have become aware of the work of the very well-established Stroke Association, but we have a number of other groups, and in some cases entirely survivor-led groups give each other mutual self-support without any support from public funding.

I want to pay tribute to one group—frankly, the one that helps my wife and that she has received a great deal of assistance from being a member of. It is called Sidcup Speakability Group, and, as the name implies, it operates in our part of south-east London. It is the group’s 10th anniversary, so I just wanted to put on the record what it has done. It works entirely off its own back, and the level of conditions that people have varies greatly. But it proves that there is willingness. It is also worth remembering, as any senior consultant in the field will say, that there is sometimes a myth that a patient gets to a stage where they can never improve any more. Obviously, a patient has the best improvement earlier on. That is why early treatment and interventions are so important, and why the waiting times are so unacceptable. But even if the rate might be less, if people work continually, gains can still always be made incrementally. That is what the people at Speakability have found. To do that, we cannot expect the burden to fall simply upon friends and families. We need specialist treatment to be consistently available. That can turn people’s lives around. In our case, it may not be enough to turn it around in time, but it will be for others. That will be worth our while. The more people we can get back into work, as they wish, the more people can lead enriching lives, to a greater or lesser extent, as many stroke survivors do. There is light at the end of the tunnel, but we have to give them those fundamental services to start with.

I am very grateful to the Minister for paying great attention to the issue, and I hope he will take away those specific asks. Perhaps he could keep in touch with us, as a group, on how we could roll out services much more consistently and give people the level of treatment they deserve. I know a number of us in this room have been affected by stroke within our families, and I think we all want to work together—there is no party political issue in this—to have a proper strategy to sort it out.

Junior Doctors’ Strikes

Matt Western Excerpts

Thursday 30th March 2023 Commons Chamber

[Matt Western (Warwick and Leamington) (Lab)]

Junior doctors are the backbone of the NHS. I would never describe those whom I have met as “militant”; they are hard-working and of all ages. Somehow, this is the second strike that junior doctors have staged in the last 13 years—there was none in the previous 13 years, under a Labour Government. Will the Secretary of State confirm: has he not set out his own precondition, and that is that he will not meet them until they call off the strikes?

[Steve Barclay]

There are two different things there—one on which the hon. Gentleman is correct and one on which he is not. He is correct that we have said that a precondition for meaningful and constructive talks is that the trade union suspends strikes. That is a precondition that the other trade unions were more than willing to accept, and it is applied in other sectors such as education. We have been clear on that.

The hon. Gentleman is not correct on my point about militancy, which referred to the junior doctors committee specifically. We stand ready and recognise the real pressure that many within the junior doctors community have faced. The NHS has been under significant pressure coming out of the pandemic. We recognise that there are issues on which we want to work and have constructive engagement with them. It is just regrettable that some in the junior doctors committee of the BMA want, as they have said in media interviews, to take a more overt political agenda, rather than work with us to focus on the real issues that many junior doctors are concerned about.

Oral Answers to Questions

Matt Western Excerpts

Tuesday 24th January 2023 Commons Chamber

[Neil O’Brien]

We are working to increase the amount of funding going into pharmacies so that they can do more clinical services. I will look closely at the issue that my hon. Friend raises.

[Matt Western (Warwick and Leamington) (Lab)]

T7. Last week, the Government decided to mothball the covid-19 testing facility in Leamington, which will leave up to 670 people without a job. The lab reputedly cost more than £1 billion—perhaps the Minister could confirm—and when the investment was made, I was promised that it would be used for other purposes, such as pathological testing and other diagnostics. Why is that not happening?

[Maria Caulfield]

As the hon. Gentleman knows—we discussed the issue over the telephone last week—the decision was taken to wind down the Rosalind Franklin Laboratory because the number of PCR tests has reduced significantly and NHS laboratories can take that capacity. There is a residual service and additional use of the laboratory is being considered.

Oral Answers to Questions

Matt Western Excerpts

Tuesday 19th July 2022 Commons Chamber

[Steve Barclay]

I have had quite a few meeting requests this morning, and I am always keen to meet colleagues. My hon. Friend will be well aware that part of the reason for having integrated care boards within the place-based approach is that commissioners can determine the best mix of services in the locality, including in Burton.

[Matt Western (Warwick and Leamington) (Lab)]

7. What recent estimate he has made of the average waiting time for emergency care.

[The Minister of State, Department for Health and Social Care (Maria Caulfield)]

NHS Digital publishes information on average waiting times, and the data for May shows that the median average total time spent in A&E for all patients was three hours and six minutes.

[Matt Western]

Across the west midlands, 38 people died waiting for ambulances between March and May 2022. In the same period in 2021, two people died; before 2019, in the corresponding period, there were no deaths. A week ago Sunday, 80 people were waiting in accident and emergency in my constituency. What are the causes of these problems?

[Maria Caulfield]

The west midlands is more affected than many regions of the ambulance service. There are a number of causes, the first of which is that we are living with covid, which has not disappeared. If we look at the in-patient rates, we see that they have increased significantly; last month, they were 17.9 per 100,000 and they are now up to 24.4 per 100,000 in the west midlands, which is experiencing significantly higher rates than other parts of the country. [Interruption.] If the shadow Secretary of State wants to hear this, I can tell him that we also have a significant number of staff sicknesses from covid; this time last year, it was about 4% of staff but when I spoke to some trusts this weekend I heard that it was up to 6%. That has a knock-on effect on acute and emergency services and ambulance services being able to respond.

Ambulance Pressures

Matt Western Excerpts

Monday 18th July 2022 Commons Chamber

[Steve Barclay]

First, I am happy to join my hon. Friend in paying tribute to the work of the local staff in her ambulance trust. She raises an important point about the fleet, and I was very interested in this issue four years ago when I was ambulance trust Minister and discovered that there were, I think, 32 different types of ambulance. When I was out with crews over the past fortnight, one of the issues we discussed was the merits of tailgates so that people are not suffering work absence and musculoskeletal injuries because they are trying to push heavy loads on to an ambulance. I am interested in exploring with her and colleagues how we get the right standardisation and the right fleet in place. Indeed, we have been targeting additional money to support that work.

[Matt Western (Warwick and Leamington) (Lab)]

Since March, West Midlands ambulance service has been on the highest level of alert, and I understand that it was joined by the other ambulance services across England last week. In May, Mark Docherty, the director of nursing for West Midlands ambulance service, predicted that the service would collapse by 17 August—that is a month away from now—if hours lost by crews delayed outside hospitals kept increasing, which of course they have. Can the Secretary of State give some specific answer on what he is doing to address the issues in the west midlands, and also in our care homes, which are a root problem of trying to get people out of hospitals?

[Steve Barclay]

The hon. Gentleman is right that the west midlands in particular has been under significant pressure, and 111 ambulance service response times are significantly challenged, which is driven by wider system pressure and delayed handing over of patients. The measures taken through the national support that is going in include handover delay improvements, on which works is taking place across all integrated care boards. NHS England has allocated an additional £150 million to support the system, and an extra £20 million of capital is going into fleet. Given that I am new in post, I am happy to meet the hon. Gentleman to discuss any specific issues about the West Midlands ambulance service’s performance.