Winter Preparedness
Nusrat Ghani Excerpts(1 week, 6 days ago)
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The Minister for Secondary Care (Karin Smyth)
With permission, Madam Deputy Speaker, I would like to make a statement on winter preparedness. Before I begin, I want to say a very special thank you to all the staff who will be keeping our NHS going over the Christmas holidays and into the new year. When I was a manager in the NHS, I worked on winter planning, so, if I may, I will say an additional thank you to all the people who are often unseen: the managers and admin staff who also keep the system going. I know how hard it is for people to work in the system with the challenges that winter can bring through increased demand and higher rates of infection.
There are things that we cannot predict. Storms Bert and Darragh have added pressure, and we might have a cold snap. I know that many people like a winter cold snap of snow and ice, but it is not something that the NHS ever wants to see. The NHS has excellent people who have done this before and, unlike last year, thanks to the new Government, many of them will not be on strike. While we cannot control the weather, we can plan, prepare and pull together, so today I want to update colleagues with the current picture before moving on to the things that we are doing.
NHS England and the UK Health Security Agency will publish the latest statistics tomorrow morning as usual, but we do know that levels of seasonal illness are high. The most recent figures show that last week there was a 350% increase in flu cases compared with the same week last year, but that is comparable to levels we saw two years ago. Norovirus cases are high, but covid rates are low, and although rates of RSV—respiratory syncytial virus—have been high, we expect them to start coming down over the next few weeks.
I want to make it clear that the current rates for both bed occupancy and ambulance delays are unacceptably high. I will shortly come to measures about how we are dealing with that capacity.
I will not rehearse the Darzi investigation and his findings, except on one thing. I remind the House that he found “a perpetual bed crisis”, particularly during peak periods like winter cold snaps. That means that every winter our staff have been wasting precious time solving process problems, ringing round wards to find beds and desperately trying to hold the system together. We can see that in the figures.
On an average evening in 2009, a patient would have been 39th in the queue when they arrived at a typical accident and emergency department. In 2024, they are 100th. The four-hour A&E standard has not been met for nearly a decade and ambulance response times have not been consistently achieved since their introduction in 2017. In November, the average ambulance response time stood at 42 minutes, which is more than double the NHS constitutional standard. A third of the 2.3 million people who attended A&E last month waited more than four hours, and one in 10 of those people—more than 150,000—waited for more than 12 hours.
Those life and death delays are the result of deep structural issues in the NHS that cannot be fixed overnight. But this winter, NHS staff will be on the frontline, not the picket line, because we took a different approach on how to work with staff and the unions. To resolve the resident doctors’ dispute, we spoke to them on day one, we met them in week one, and by week four we had negotiated a deal to end their strikes. That is why, for the first time in three years, the Government are fully focused on winter and not on planning for strikes.
This is what we are doing. First, the NHS is managing extra demand by strengthening same-day emergency care and offering more falls services for older people, with upgraded 24-hour live data centres. Secondly, we are continuing to support systems that are struggling with direct intervention through the NHS urgent and emergency care tiering programme.
Thirdly, the Secretary of State is chairing weekly meetings with me and senior leaders to ensure that we are managing pressures across the entire system. Last week, he specially convened with trusts and told them to prioritise patient safety by focusing on key metrics, including improving emergency ambulance response times, addressing handover delays and tackling the longest waits in A&E. We have made it crystal clear that we do not want trusts to prioritise patients who can be seen and discharged more quickly over those with the greatest clinical need, because this Government will always prioritise people, not performance. This morning, the NHS published a letter outlining how it is prioritising patient safety.
Fourthly, I am taking steps to ensure that we get a clear picture of what is happening on the ground. I recently visited Newham hospital’s A&E, Bristol Southmead hospital and the head offices of NHS England to see the aforementioned operational control centre, where it receives data in real time and responds to problems as they emerge. Fifthly, we launched a national communication campaign in the autumn to encourage people across the country to take their winter vaccines, with a particular focus on people who are less likely to come forward.
That last point is essential, because the best and easiest way to keep people out of hospital this Christmas is to encourage them to come forward and get vaccinated. Last year, people who received a covid vaccine were half as likely to be admitted to hospital than those who did not. So far, we have delivered over 17 million flu jabs and 9.5 million covid jabs, and we have introduced the first ever public vaccination campaign for RSV, with over a million and counting vaccinations delivered to protect young babies and the elderly. In total, we have delivered nearly 28 million vaccinations for this winter, and I thank every person who has come forward to protect themselves and the vulnerable.
Now, I would like to speak directly to anyone who has not yet been vaccinated. No one wants to be separated from their family and stuck in hospital this Christmas, and there is a real risk that people may inadvertently take flu home to loved ones this year. Please protect yourself, your family and the NHS, and book that appointment today, because tomorrow is the last day you can book a vaccine through the NHS app or website, although after tomorrow there will be local solutions.
While we tackle winter pressures in the short term, we are fixing the foundations of our NHS with long-term reform. Two weeks ago, the Prime Minister spoke to the nation about our plan for change, and set out our ambitions for the health service over this Parliament. We will get a grip on waiting lists and return to 92% of patients waiting no longer than 18 weeks from referral to treatment by the end of this Parliament. We are also taking action on social care, introducing the largest increase in the carer’s allowance weekly earnings limit since 1976. We will ensure that carer’s allowance meets its objectives, while reviewing unpaid carer’s leave and looking at the benefits of introducing paid carer’s leave.
We will publish an improved better care fund framework, using £9 billion of funding to provide better, more integrated health and social care for patients and people who draw on care. We are helping disabled people on low incomes adapt their homes through the disabled facilities grant. The Employment Rights Bill is already in Committee, laying the foundations for the first ever pay agreement for care workers as a first step towards building consensus on the long-term reform needed to create a national care service. By the end of our first year in government, we will deliver an extra 2 million operations, scans and appointments through innovation, investment in additional capacity and productivity gains.
We are sharing the best of the NHS with the rest of the NHS, with our Further Faster teams. These are teams of experts that are supporting 20 trusts with long waits to tackle waiting lists and increase productivity. They have been deployed to five trusts so far, and we are already seeing improvements—for example, in theatres. For this financial year, the Government have committed £12 billion more in everyday spending on health and social care than was planned by the last Government in the spring Budget.
We are giving our capital-starved NHS the funding it so badly lacked over the past decade, setting aside at least £1.5 billion next year, which will create additional capacity, including new surgical hubs and diagnostic scanners, and new beds across the estate. That will enable 30,000 additional procedures and over a million diagnostic tests as they come online. That is the difference that a Government of service make. We have also been clear that investment must come with reform. Lord Darzi has given us the diagnosis, and the cure can be found in shifting the NHS from treatment to prevention, hospital to home, and analogue to digital.
Harold Wilson once called himself an optimist who carries a raincoat. As someone who has worked in our NHS at this critical time, I am fully aware of the challenges we face and the effort required. I am making sure that we have a firm hold on problems in the short term, while we do the work of fixing the foundations of our NHS with long-term reform. Over the past 14 years, we have limped from one crisis to the next, improvising and making do with sticking plasters. It cannot go on. It is bad for patient care and it is totally demoralising for staff.
We are building a health service that is fit for the future, ready to face every winter with confidence, and we will publish our 10-year plan for health in the spring. Anyone who thinks that we cannot do it should remember: we have fixed the NHS before, and we will fix it again. The public rightly expect us to put an end to the annual winter crisis, and that is what we will deliver. I commend this statement to the House.
Karin Smyth
My hon. Friend’s comments reinforce how much pressure, we understand, is front facing. A&E is demonstrative of the overall pressure in the system, not just at discharge but, as she rightly says, in primary care. We took action in the summer to improve primary care, increasing the number of GPs available in the system. It is absolutely critical that primary care community services are integral to winter planning at a local level. That is what we expect from every single system. We will continue to monitor that over the winter period and into the spring. If those services are not involved in planning for any particular systems, enabling them to monitor the surge and flow of people, we very much want to understand how that is working.
Helen Morgan (North Shropshire) (LD)
I express my thanks and those of my Lib Dem colleagues to everyone working over the Christmas period to keep people healthy and safe. Preparedness for winter is absolutely critical for our health and care system, and a quick look at what happened last year shows us why. Ambulances across England collectively spent a total of 112 years waiting outside hospitals to hand patients over, and a quarter of a million people waited more than 12 hours to be seen. Every winter we are warned of a winter crisis. Under the Conservatives, crisis became the norm not just in winter but all year round.
This year is very concerning so far. A&Es have overflowed through spring, summer and autumn. At my local hospital trust, Shrewsbury and Telford, one in three ambulances have had to wait more than an hour to hand over patients, while patients with devastating cancer diagnoses have had to wait months for crucial scan results. Across England, more than 7 million people are on waiting lists. Meanwhile, I am afraid, we have not heard enough from the Government on fixing one of the root causes of this crisis, which is our broken social care system.
The scale of the crisis is demonstrated by the challenges facing ambulance services across the country at the moment. October—before the winter—was the third worst month ever for handover delays at West Midlands ambulance service, which covers my constituency. The equivalent of 130 ambulance crews are out of action, waiting every single day. Now these overstretched ambulance services are formally changing their advice to reflect the pressure they are under. At times of peak demand, even category 2 patients—those suffering a heart attack or a stroke—will be asked to make their own way to a hospital. People in North Shropshire have long had to put up with some of the worst ambulance waits in the country, and they have come to harm as a result. It may no longer be the case that they can rely on an ambulance arriving.
Action is urgently needed to prevent more preventable deaths this winter. I am sure the Minister shares my alarm that ambulances may not be reaching people facing life-threatening situations. If she does, will she commit today to the Government tackling the handover delays paralysing the ambulance service by accepting Liberal Democrat proposals to make a £1.5 billion fund to provide more staffed beds, and by agreeing to urgent cross-party talks to fix the crisis in social care?
Karin Smyth
I think I have addressed the Government’s plans on social care. The hon. Lady makes an excellent point on ambulance delays, which we know to be a problem, and particularly so in the west midlands. That is one of the things I have asked the system to look at particularly, so that the Government and hon. Members can better understand the particular problems in their particular systems. We know that ambulance and handover delays are a particular problem in some systems. We are making sure that clinical and managerial leads from NHS England are visiting those systems and that they are understanding in depth the process issues in some places, where they may not be adopting the best practice that can be learned from others.
We need to roll out best practice across the country. When the Secretary of State and I visited the operational centre of the London ambulance service, we sat in on some hear-and-treat calls; in dealing with people in mental health crises, in particular, some places are doing that better than others. Those are the sorts of examples we want to learn from. I absolutely hear what the hon. Lady says about the unacceptable delays in particular parts of the country. That is very much on our priority list.
Jen Craft (Thurrock) (Lab)
Last week, I visited Basildon hospital, which is relied on by my constituents and people across Essex. Staff in the emergency department told me that they were operating under intense pressure all year round, and that it is indeed winter all year for them. That is due to a lack of beds, the terrible condition of parts of the estate and inadequate primary care services, meaning that people turn up at the ED when they should be somewhere more appropriate. What steps is the Minister taking to turn the page on 14 years of decline, and to ensure that Basildon and hospitals across the country have the resources and structures they need to better manage seasonal and year-round pressure?
Karin Smyth
My hon. Friend has already been a fantastic advocate for her local NHS services. Like the hon. Member for North Shropshire (Helen Morgan), my hon. Friend is absolutely right to highlight the acute pressures all year round. We did not always have winter crises under the last Labour Government. It was tough; I worked during some of that time, and it did happen, but getting used to such levels of bed occupancy and pressure in the system all year round is a direct legacy of the Conservatives and what they did to the NHS, particularly with the Lansley reforms, and their refusal to take a grip of it. This matter of a summer crisis going into a winter crisis is a real problem. That is why we are committed to these short-term measures to stabilise and support the system over the winter. However, as I said in my statement, we will also look at medium and longer-term reform so that we do not have to revisit this scenario year on year.
Layla Moran (Oxford West and Abingdon) (LD)
Last Friday, I visited Sherwood Pharmacy in Abingdon. Ben, who owns it, told me that local pharmacies stand ready to help. In fact, they are more than keen to help, but there are two things that he needs from the Government. First, there needs to be a real push for GPs to refer people to pharmacies, in particular for vaccinations, so that we are not collecting patients in one already overstretched part of the system and they can do what they do best. Secondly, there needs to be a general plea to the public that they can go to their pharmacies for those things. I note that in her statement the Minister did not mention pharmacies once. Let us be honest, this question is not going to do it either. How do we ensure that the message—“Go to your pharmacy and get vaccinated, you can do it faster there”—gets out there this winter?
Karin Smyth
I thank the Chair of the Select Committee for her point. She is right that I did not mention pharmacies, which was an omission on my part. We are running an advertising campaign, “Think Pharmacy First”, to ensure people use pharmacies. She is absolutely right that they stand ready. I will visit mine over the next few days to make sure I am vaccinated. Their support, working with primary care, is critical. Again, in some places relationships are working well and pharmacies support people in the community—that is apparent in the statistics. We are absolutely committed to ensuring that that works better, as part of our long-term reforms.
Karin Smyth
Again, my hon. Friend is already representing the people of his constituency so well by getting to the heart of what is happening on the ground, learning it for himself and bringing such examples to the House. He is absolutely right that there are such examples across the country, working differently in different systems, which are challenging other systems to look at that practice. That is why we say we want to bring the best of the NHS to the rest of the NHS. That is exactly what we mean. I am confident in the work happening centrally at NHS England. It is learning from such examples and wants to go around the country to ensure that we spread those sorts of ideas to other places. We are looking at them all very closely.
Andrew George (St Ives) (LD)
In the far west of Cornwall, in a medical emergency we cannot look for additional support from the north, west or south, because it is sea. The urgent treatment centre at Penzance hospital was closed two and a half years ago, under the Conservatives, adding pressure to the only emergency department for the next 100 miles, which is in Truro, and the out-of-hours doctor service has no doctors. The Minister mentioned in her statement that the NHS urgent and emergency care tiering programme is able to help. Will she use her influence to reopen the urgent treatment centre so that we can have a 24/7 emergency service in the far west of Cornwall?
Several hon. Members rose—
Madam Deputy Speaker
Order. The questions seem to be getting longer and longer, as do the responses. Let us try to keep the questions on point, and no doubt the answers will be the same.
Lizzi Collinge (Morecambe and Lunesdale) (Lab)
When I started working in public health, winter pressures were just that: seasonal flu and extra hip fractures. Under the Conservatives, winters started getting longer and longer. How will our 10-year plan ensure that seasonal pressures actually become seasonal and manageable again?
Tobacco and Vapes Bill
Nusrat Ghani ExcerptsTuesday 26th November 2024
(1 month ago)
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Mr Lee Dillon (Newbury) (LD)
I was a smoker for 15 years, I have vaped for 12 years and I have three children under 12, who I hope will follow neither habit. I support the ambition to create a smokefree society. The harm to individuals is clear, as smoking causes 80,000 deaths per year, and the cost to the country is just as clear, with smoking costing the economy nearly £22 billion a year.
However, I have concerns about the ability of retailers to enforce the age escalator proposals. Will the Minister look at increasing the age at which people can buy tobacco by a year every year, rather than linking it to when a child is born? That would mean that people of the same age would have the same right, rather than two people being 37, for example, and one not being able to purchase tobacco because of exactly when they were born during the year.
My biggest concern about the Bill is the inclusion of vapes, alongside tobacco. Vaping is the fastest growing smoking-cessation method, and evidence has found that it is twice as effective as other tools used to stop smoking. I took part in the statutory instrument debate on 13 November and I support the ban on disposable vapes that that regulation enacted. The regulation will reduce the number of children vaping, the amount of dangerous fake vapes and the impact on the environment.
However, the Bill could go too far on vaping. The all-party parliamentary group on responsible vaping has provided a useful briefing. I believe the House will pass the Bill’s Second Reading later today, so I ask hon. Members to look at the briefing before we get to Committee. Part 5, clause 92 of the Bill has the ability to undo the Government’s ambition of a smokefree country, by potentially banning flavours under a future statutory instrument. A study of more than 20,000 vapers showed that those who start with flavoured vapes or move from tobacco to flavoured vapes are more likely to quit smoking.
That was my experience too. I first purchased a refillable vape in France, which came with a tobacco flavour and a cherry flavour. I went back to the gîte with my friends where we were on holiday. I knew what tobacco tasted like—I had my cigarettes in my pocket—so I tried the cherry flavour and enjoyed it so much that I never opened the tobacco-flavoured vape pot. I took the cigarettes I had in my pocket back home to England. They were on my bedside table for six months, after which I screwed the packet up and threw it away. I have not had a cigarette since.
I honestly feel that the provisions in the Bill for Ministers to be able to ban flavours for adults goes too far. For the record, I vape something called blueberry sour raspberry. It is not aimed at children—I buy it from a specialist vape shop where customers have to be over 18. I have the bottle in my pocket and it has no bright colours or fancy graphics on it. That is my preference as an adult to vape and it stops me wanting to pick up a cigarette again. If the Bill passes its Second Reading this evening, clause 92 should require that vape flavours are regulated with a balance between the impact on adults who would otherwise be smoking and the potential for youth uptake. Hon. Members should remember that disposable vapes have already been banned by the statutory instrument passed a couple of weeks ago.
Finally, before Ministers use the affirmative resolution procedure on any of the Bill’s parts or clauses, I urge them to undertake a comprehensive, evidence-based approach to vaping regulations. I will not vote against the Bill at this stage, but I hope the Government are open to practical amendments in Committee that support the ambition to have a smokefree generation without penalising those who already rely on vapes to lead a healthier lifestyle.
Madam Deputy Speaker
We have three remaining contributions from Back-Bench Members. This is fair notice for colleagues who have contributed to the debate to make their way to the Chamber for wind ups. I call Kirith Entwistle.
Phil Brickell
I thank the right hon. Member for his contribution. I will take assurance from the Minister on that when he winds up.
I place on record my enthusiasm for the separate ban on single-use vapes from June 2025, which the hon. Member for Newbury (Mr Dillon) mentioned. As other Members have noted, not only are they particularly cheap and therefore accessible to young adults, but they are an inefficient use of critical resources, difficult to recycle and frequently littered around the countryside.
By introducing these world-leading reforms, we can create a smokefree generation and break the cycle of addiction and disadvantage. I am proud that it is a Labour Government who are delivering this legislation.
National Insurance Contributions: Healthcare
Nusrat Ghani Excerpts(1 month, 2 weeks ago)
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Karin Smyth
The hon. Gentleman may or may not think that this is political knockabout, but I was very clear in my opening statement that we understand the pressures that the sector is under. We understand the mess that we inherited, and we are fixing it. We are working with social care, GPs, providers and hospices that are affected by any changes in the Budget, and we will continue to talk to them in the usual way. We are committed to doing this faster than the last Government did it. Under the last Government, planning guidance and commitments to the NHS were always running late—they were always playing catch-up. We are committed to making sure that the sector is much more sustainable, so that it can do the important job we are asking it to do.
Jim Shannon (Strangford) (DUP)
Thank you, Madam Deputy Speaker. As Members know, I am the last person —when I am called, the debate is almost over.
Will the Minister confirm whether consideration has been given to the fact that the rise in national insurance contributions will not affect the NHS as a whole, as the block grant for us in Northern Ireland will cover it? However, GP practices in my constituency of Strangford will suffer, and unlike high street businesses or manufacturing, they cannot increase prices to cover that impending rise, leaving practices with no option other than to reduce hours in order to stay solvent. Does the Minister agree that this is the last thing already overstretched GP practices need, and will she commit to take this issue back to the Treasury for reconsideration as it relates to healthcare businesses such as GPs, dentists and pharmacies?
Income Tax (Charge)
Nusrat Ghani Excerpts(1 month, 3 weeks ago)
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Warinder Juss (Wolverhampton West) (Lab)
The Chancellor’s Budget last week finally ended the Conservative party’s austerity. It is a Budget that fixes the foundations to deliver real change, by fixing the NHS, cutting hospital waiting lists, reforming public services and rebuilding our country.
As the Chancellor said, this Budget is about “investment, investment, investment”. This Labour Government are investing over £25.5 billion over two years in the NHS. That will cut waiting times, so that patients do not have to wait longer than 18 weeks from referral to consultant-led treatment; provide 40,000 extra appointments; put in place new surgical hubs and diagnostic scanners, building capacity for more than 30,000 additional procedures and over 1.25 million diagnostic tests; and provide new radiotherapy machines to improve cancer treatment.
We are investing in NHS technology and digital, to run essential services and to drive NHS productivity improvements, freeing up staff time. We are providing a dedicated capital fund to deliver upgrades to GP surgeries, boosting productivity and enabling the delivery of more appointments.
We are investing £26 million to open new mental health crisis centres. At last, we have a Government who are committed to tackling the root causes of mental health problems and to supporting people to remain in work and to return to work.
We are supporting social care through at least £600 million of new grant funding to be able to increase local Government spending, alongside an £86 million increase to the disabled facilities grant to support more adaptations to homes for those with social care needs, thereby reducing hospitalisations and prolonging independence.
This Government are cutting down barriers to opportunity for all by increasing the core schools budget by £2.3 billion, supporting the recruitment of 6,500 teachers in key subjects and tackling retention issues, to prepare our children for life, work and the future.
We are providing a £1 billion increase to improve SEND provision and to improve outcomes and an additional £300 million for further education to ensure that young people are learning and developing the skills they need to succeed in the modern labour market, which will help the City of Wolverhampton college in my constituency. We are increasing investment in children’s social care reform, and it is great to see a real-terms funding increase for local government spending.
We are taking all of these decisions, while also taking tough decisions on spending and welfare, eliminating fraud and error in the welfare system—
Peter Swallow (Bracknell) (Lab)
I start by declaring that my brother and his wife are both NHS doctors, and I am incredibly proud of them.
The Budget begins the work to undo a decade of recklessness and neglect by the Conservatives, who left our NHS uncared for, our schools crumbling and carers unsupported. It will fix the foundations of our economy, build the growth we need to invest in public services and end 14 years of Tory austerity. With this Budget, my right hon. Friend the Chancellor has put forward a bold, tough vision to deliver on our manifesto promise of change—£25.7 billion over two years for the NHS to slash waiting times, with an extra 40,000 elective appointments a week, and £2 billion committed to technology to begin a serious transformation towards digital healthcare.
Labour Members understand the need to fund our NHS properly, but we also understand that after 14 years of neglect, the NHS is badly in need of reform. We cannot cure 14 years of sickness in one Budget, but with this investment, we are finally taking the medicine we need.
I warmly welcome the £1 billion investment the Chancellor is making to address the crisis in special educational needs—a first step in fixing a broken system. During the Conservative leadership contest, the new Leader of the Opposition endorsed the view that getting an autism diagnosis brings
“economic advantages and protections”
and
“better treatment or equipment”.
That is a far cry from the experience of parents and children with SEND in my constituency. The Leader of the Opposition would do well to listen to the former Conservative Education Secretary, who described the SEND system under her party as “lose, lose, lose”. The Government’s commitment to increase SEND funding by £1 billion is a step towards addressing the crisis. It must be only the beginning of tackling this huge long-term problem. Ultimately, the system needs root and branch reform, but the money will start to make real, concrete differences and to break down the barriers to opportunity for many young people in Bracknell and across the country.
I will briefly mention the fantastic commitment to set up a £44 million investment to trial a new kinship carer’s allowance—again, that is a real contribution to solving a problem that has long been neglected.
This is a Budget that invests in our NHS, in education, and in families and working people. If the Opposition choose to oppose it, they need to be honest with their constituents and the British people about what that means. Opposing the Budget means less money for our NHS, less money for our struggling SEND system, and no additional support for the kinship carers who have felt invisible for too long. The Government have chosen to fix the foundations—
Clive Jones
On a point of order, Madam Deputy Speaker. I must apologise to the House for not making a declaration at the beginning of my speech. I am a governor of the Royal Berkshire hospital, and I have a family member who has shares in a health company. I apologise for not mentioning it at the beginning of my speech.
Madam Deputy Speaker (Ms Nusrat Ghani)
I thank the hon. Member for advance notice of his point of order. It is most definitely relevant to the debate, and his transparency is noted.
Ms Polly Billington (East Thanet) (Lab)
Even those of us who are new to this place know to expect more communication from our constituents about what is wrong than what is right, so it is notable that I received emails of thanks and congratulations from constituents last week, after the Chancellor delivered her historic Budget. Stability is highly prized by people after so much chaos, and investment, especially in our NHS, is something that people have been crying out for.
However, we must be honest with ourselves about the state of our NHS in east Kent and in coastal communities like mine. East Thanet has been overlooked for far too long. The service has had to endure the chaos and incompetence of the past 14 years, and has not been as resilient as other places to the onslaught. The director of public health in north-east Lincolnshire, Stephen Pintus, has described people living in coastal communities as “old before their time”. We need to reform the way we deliver NHS services in coastal communities. Investment on its own will not be enough. We need to redesign our health service to answer the questions: what care do people need, where do they need it and how do they need it delivered?
My constituents have been suffering with poor NHS services for far too long. East Kent hospitals university NHS foundation trust, which runs the Queen Elizabeth the Queen Mother hospital in Margate, is ranked the third worst in England for its 12-hour waits for emergency services. Its maternity services have been deemed inadequate. When staff were asked, “If a friend or relative needed treatment, would I be happy with their care?”, only 45% of staff said yes. I have people emailing me about their urgent care and essential appointments being delayed by waiting lists. People in dire need of mental healthcare are being told to wait for months to get the help they desperately need. There is denial of continuous care due to costs and a lack of staffing—and, shockingly, poor communication and record keeping resulted in a cancer patient being misdiagnosed.
In a 2021 report by Chris Whitty entitled “Health in Coastal Communities”, he highlighted the problems faced by constituencies such as mine, and found that they had some of the worst health outcomes in England, with low life expectancy and high rates of major diseases. One of the major reasons for that is simply lack of access to healthcare services—both a lack of NHS services in coastal communities and a lack of transport options.
Whatever the reasons for the challenges in coastal communities, we need to see reform. The extra funding the Chancellor announced last week is crucial to bringing down waiting lists and stopping the chaos of 14 years of Tory mismanagement. The British people delivered us a mandate to fix the NHS. If done well, this reform will be transformative for the country, especially in coastal communities like East Thanet.
Madam Deputy Speaker (Ms Nusrat Ghani)
I am about to call the final Back-Bench Member. No doubt a lot of colleagues who have contributed will be making their way back to the Chamber for the Front-Bench speeches. I call Matt Turmaine.
Matt Turmaine (Watford) (Lab)
Thank you very much, Madam Deputy Speaker.
Prior to being elected to this place I worked in health and social care, so it has been interesting to hear some of the pronouncements from the mouths of Opposition Members, which in many instances are, frankly, farcical.
In my constituency, the legacy of 14 years of failed Conservative government is plain to see: people unable to get GP appointments; a lack of NHS dentists for residents to sign up with; poor mental health support for young people and adults; and, of course, the undelivered promise of a new hospital in Watford, cancelled under the coalition and not delivered by the Conservatives over subsequent years. The previous Government’s track record is one of decline. In 2010, average waiting times were 18 weeks and satisfaction levels in the NHS were at their absolute highest. What a contrast to 2024, with the NHS on its knees.
The Chancellor of the Exchequer announced in the Budget an additional £22.6 billion to support the NHS. That will help to deliver more appointments for my constituents in Watford, and it will bring progress towards once again having to wait no more than 18 weeks from referral to treatment. As has been said, we have done it before and we will do it again.
I also welcome the Chancellor’s £1.4 billion to help rebuild schools. She mentioned Watford in her Budget speech, noting that schools in my constituency will benefit from RAAC being dealt with. Mentioning RAAC also brings us to the new hospital programme. I know my right hon. Friend the Chief Secretary to the Treasury will be listening when I say loud and clear that Watford is desperate for a new hospital. That has been the case for many years. The trust’s plan is ready to go, go, go, but I recognise that the Chancellor has achieved the seemingly impossible by managing to start the new hospital programme and moving forward with addressing the hospitals affected by RAAC. We hope the rest will follow soon.
I campaigned in good faith in the general election for a new hospital and to honour the commitment made by the previous Government, but as we heard from the Chancellor in the summer, there was no money there. The Chancellor has worked wonders with this Budget. She has dealt with the financial black hole, she has got the country back on its feet and she has put it on the road to recovery. It is an excellent Budget for the people of Watford; it is an excellent Budget for the country. I wholeheartedly support it.
Madam Deputy Speaker (Ms Nusrat Ghani)
We have been able to get in over 80 contributions, so thank you very much to everybody for abiding by the time limit. I now call the shadow Minister.
Alex Burghart (Brentwood and Ongar) (Con)
Thank you very much, Madam Deputy Speaker. It is a great pleasure to play a part in bringing today’s interesting debate to a close.
I take this opportunity to welcome the Chief Secretary to the Treasury to his post—I know he has been in post for a few months, but we have not had the chance to get to know each other. I must say I have been very impressed him. He is a fluent speaker. He is good on detail. That is not sarcasm—I was once warned by Hansard that sarcasm did not come across well in the written record—but I know what it is to be sent out to defend the indefensible. I can see that he is developing a fine skill and that he is some way on his way to mastering it. I just gently say to your man starting out in his Front Bench career in government not to get too good at it, because you will find your party will give you ample opportunities to defend the indefensible in the years ahead.
Madam Deputy Speaker
Order. Shadow Minister, I do not think you are speaking to me when you say “you”. You are obviously speaking to the Minister.
Alex Burghart
It has been a long day, Madam Deputy Speaker. I hope you will forgive me.
But enough of such pleasantries. This is a bad Budget. It is as bad as bad can be. At its heart is a decision to tax businesses hard—very hard—and through them to tax workers until the pips scream. It is a Budget that sees the total effective tax rate on low-earning roles increase to its highest level since 2010, hitting working people hard, as the Chief Secretary to the Treasury admitted on Sky television on Friday. We know that taxing business is a bad idea. As my right hon. Friend the Member for Tatton (Esther McVey) said earlier, businesses and working people are the dynamo of the economy. If we denude and degrade them, there is nothing for public services to feed on.
But we discover, as this Budget unravels, that it is not just businesses that are being taxed. It is GPs, it is care homes, it is hospices—as the hon. Member for Poole (Neil Duncan-Jordan) pointed out—and it is dentists, charities, childcare, higher education and school support staff. I understand that Labour Members will want to support big tax rises in the Budget, but before they vote on them, I ask them to consider whether they want to vote for tax rises on those services. In response to an intervention from my hon. Friend the Member for Hinckley and Bosworth (Dr Evans), who is sitting behind me, the Health Secretary said that he would listen to GPs, but either the money from the national insurance contributions is in the Budget, or it is not. Either it is in the envelope, or it is not. Has the thinking been done on this? At present, it would seem that all those services are in limbo. Yesterday, during Education questions, the Education Secretary was asked by both the shadow Secretary of State, my right hon. Friend the Member for Sevenoaks (Laura Trott), and the shadow Minister, my hon. Friend the Member for Harborough, Oadby and Wigston (Neil O’Brien), whether school support staff would be affected. She could not answer.
These are serious questions, and the Government must know the answers. His Majesty’s Treasury must have the data, and it must publish that data. So let me first ask the Chief Secretary if he will publish figures showing who will be hit by his national insurance contribution tax rises, what the costs will be to the services concerned, and whether they will receive compensation. As I said, the Treasury must have the data, and if the Chief Secretary does not have it at his fingertips, I ask him to put it in the Library of the House of Commons as soon as possible. We all want better public services; the question is, do we think we can get them if the services that I have mentioned are being taxed? As the Chief Secretary said on television the other day, without reform more generally, money will just follow money out of the door.
We are told that Labour has a plan for improving the NHS. We know that, because the Prime Minister told us in a speech on 11 September that in the spring he would have a plan. That plan, he said, would contain a transition to a digital NHS, moving more care from hospitals to communities, and focusing efforts on prevention over sickness. Who could argue with those sensible measures? It was good to read in the Red Book at a time of the Budget that His Majesty’s Government intend to:
“Invest more than £2 billion in NHS technology and digital to run essential services and drive NHS productivity improvements”,
which
“will deliver 2% productivity next year.”
That is very sensible, but it gives rise to a strange sense of déjà vu—and then one remembers that in the spring Budget this year the then Chancellor, my right hon. Friend the Member for Godalming and Ash (Jeremy Hunt), announced £3.4 billion in additional funding for the NHS to deliver 2% annual increases in productivity through new technology and digital across the health service in England.
So part 1 of Labour’s three-point plan is not new at all. It is a Conservative initiative, already accounted for by a Conservative Chancellor. Let us proceed to part 2, moving more care to communities. On that, the Red Book says absolutely nothing. As for part 3, prevention, there is a small increase in tobacco duty and a vaping products duty. Not content with taxing us into growth, the Chancellor intends to tax us into health—but it is all right, because apparently the Prime Minister has a plan to have a plan in the spring.
I will tell you a funny story about the spring, Madam Deputy Speaker. When I was first working as a parliamentary researcher, there was some long-forgotten report that the Department for Children, Schools and Families was producing. We asked when it would be published, and we were told, “In the spring.” We asked, “When does spring end?” The Department told us, “When summer begins.” In that tale is an insight into the way in which Labour Governments think. It is tomorrow and tomorrow and tomorrow, and never does reform come.
That is the plan for the NHS. It is relatively well developed, next to the non-existent plan for welfare reform. My right hon. Friend the Member for Central Devon (Mel Stride), who is now the shadow Chancellor, started that work, but silence has now descended. More workers are needed to grow the economy—the OBR was quite clear on that. The Chancellor has chosen tax over employment, which will not deliver growth.
The Government’s plan has been to tax, to spend, to think a bit, to set up a website, to get told to serve waffles for every meal, and to think a bit more. Then they will see whether any money is left, they will discover that there is not, and they will need to increase taxes again. What is becoming painfully apparent is that Labour wasted its time in opposition. It had 14 years to come up with a plan for the NHS, but it did not, and now it is scrabbling to find one. By the time we see the Prime Minister’s fabled plan, more than 10% of this Parliament will have passed, and very little will have been done that was not already being done before.
The Prime Minister said there would be no extra money without reform, but that is precisely what he has given the country. That is the price of political complacency. It is the price of thinking that governing is easy. It is the price of believing your own hype, and of failing to be honest with yourselves.
Some people said that the Labour party was trying to pull the wool over people’s eyes, and I was one of them. I thought that behind the great ambiguities of the Labour manifesto there would be a game plan, but game plan has come there none. We have £140 billion of extra borrowing, and £10 billion more in higher debt repayments. Mortgage payments are up, and there is austerity for employers and workers. A loveless landslide has become a loveless tax rise for the British people, and they will not wear it.
NHS Dentistry: Rural Areas
Nusrat Ghani Excerpts(1 month, 3 weeks ago)
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Madam Deputy Speaker (Ms Nusrat Ghani)
Let me give the hon. Lady a moment to gather her thoughts before she resumes her speech. It is best not to refer to a Member by their first name. She has a solid 30 minutes—although the Minister has to respond within those 30 minutes—so she can take her time.
Sarah Gibson
Thank you, Madam Deputy Speaker.
I remind the House that the Conservative Government had the last decade to reform the dental contract but failed to do so. I therefore implore the new Government to act now with two simple actions. First, they should introduce a timeline for reforming the NHS dental contracts system. The Secretary of State for Health and Social Care said that that was their intention, but I feel that there is an element of urgency about this—especially for rural areas—that has not been addressed. Secondly, I would like it to be a mandatory requirement for ICBs to appoint dentists to their boards. There is a strong feeling among dentists that ICB boards of directors do not understand the issues they face.
Tim Roca (Macclesfield) (Lab)
I share the astonishment of other Members that not a single Conservative Member is here, in a debate on NHS dentistry in rural areas. I am a bit old-fashioned and I want a functioning Opposition. It is sad that they are not here to take part in this debate. When I contacted surgeries in Macclesfield to find out the state of play, 15 said that they do not accept NHS patients at all. That is the legacy that the Conservatives have left us. Can the Minister confirm that the Government will move urgently and quickly on NHS dentistry reform?
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. Interventions should be short, and the Minister must respond to the Member whose debate it is.
Stephen Kinnock
We are working at pace, and I will say more about that shortly. I share my hon. Friend’s reflections on the complete absence of the Conservatives. They made a complete mess of our public services, called an election and ran for the hills.
On 4 July, we inherited a broken NHS dentistry system. It is a national scandal that tooth decay is the leading cause of hospital admission for five to nine-year-olds in our country. It is truly shameful and nothing short of Dickensian. In the area served by the NHS Bath and North East Somerset, Swindon and Wiltshire integrated care board, which includes the constituency of the hon. Member for Chippenham, 33% of adults were seen by an NHS dentist in the 24 months up to March 2024. That compares to a 40% average across England. In 2023-24, there were 44 dentists per 100,000 of the population there, whereas the national average was 50.
When we look at the problem in the round, it is not so much that we do not have enough dentists, but that not enough of them are doing NHS work, and they are not in the parts of the country that need them most. That challenge is compounded by the fact that some areas of the country are experiencing recruitment and retention issues, including many rural areas, where the challenges in accessing NHS dentistry are exacerbated. That of course includes Chippenham, where Hathaway dental practice has recently had a request granted to reduce its NHS activity, as the hon. Lady pointed out. I understand, thanks to a freedom of information request by the British Dental Association, that the practice had a £4.2 million underspend on its NHS contract. That is precisely the problem that hon. Members have pointed out. There is a quantum of funding, but the way in which it is structured makes private sector dentistry far more attractive than NHS dentistry. That is the root cause of the problem; we are alive to that issue.
Overall, it is clear that we have a mountain to climb. It is a daunting challenge, but we are not daunted, and we are working at pace. The golden hello scheme, for example, will see up to 240 dentists receive payment of £20,000 to work for three years in one of the areas that needs them the most. Integrated care boards have already begun to advertise posts, as we have accelerated that process. In the ICB area of the hon. Member for Chippenham, there have been seven expressions of interest, five of which have been approved. Providers can now include incentive payments when they advertise vacant positions.
Alongside that, we will deliver a rescue plan that gets NHS dentistry back on its feet. That will start with providing 700,000 additional urgent appointments as rapidly as possible, as set out in our manifesto. Strengthening the workforce is key to our ambitions, but for years the NHS has faced chronic workforce shortages, so we have to be honest about the fact that bringing in the staff we need will take time.
Access to Primary Healthcare
Nusrat Ghani Excerpts(2 months, 2 weeks ago)
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Madam Deputy Speaker (Ms Nusrat Ghani)
I inform the House that I have selected amendment (a), tabled in the name of the Prime Minister.
I call Helen Morgan.
NHS Performance: Darzi Investigation
Nusrat Ghani Excerpts(2 months, 3 weeks ago)
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Helen Morgan
I thank the right hon. Gentleman for his intervention. There is a general problem with care in the community of all types not being there for people. We have people in places where they will not get better as quickly—in some cases, their situation may be deteriorating—because that care is not available. Mental health provision in my constituency is absolutely appalling. People register with a doctor over the border just to access better mental health care. I could not agree with him more.
In conclusion, the Darzi report is shocking, but it is not surprising based on the experience of my constituents. Poor access to primary care—whether that is GPs, dentists or early mental health intervention—is leaving people in pain and distress. Long waiting lists and crumbling hospitals are leaving people unable to get back to work, with their situation deteriorating, and the crisis in social care—the elephant in the room—is depriving people of their independence and leaving them in hospital when they could be at home. The new Government must make fixing the NHS and care their No. 1 priority. Liberal Democrats will be here to provide constructive opposition to ensure that they do.
Madam Deputy Speaker (Ms Nusrat Ghani)
I call Ben Goldsborough to make his maiden speech.
Several hon. Members rose—
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. As the Front-Bench contributions went on for so long, Back Benchers will now be limited to three minutes, and I ask that maiden speeches be limited to five minutes to squeeze in as many people as I can. I call a tieless Dr Luke Evans.
Valerie Vaz (Walsall and Bloxwich) (Lab)
It is a pleasure to follow the hon. Member for Hinckley and Bosworth (Dr Evans).
The report is a tour de force from Lord Darzi, and I thank him for his work. The Secretary of State rightly commissioned the report as a benchmark for future improvement. I was a member of the Health Committee from 2010 to 2015. Given the evidence we heard, there was no alternative but to pause the Bill—the Committee played an important role in that. Chapter 10 of the report sets out the structure. Lord Darzi points out that the 2012 Act was three times the size of the original Act setting up the NHS. The 2022 Act moved into integrated care, and in paragraph 15 on page 121, he raises some concerns about how the ICBs—integrated care boards—operate, and their accountability. Could there be a review into how they operate? Paragraph 37 highlights that trust chief executives’ pay is based on the turnover of the organisation, which encourages trusts to
“grow their revenue rather than to improve operational performance.”
Some are even paid more than the Prime Minister.
The flow of patients is important, which is where working with local authorities is so important. We can move planes around the world, but it seems we cannot move people out of hospital. The Select Committee visited Torbay, which was set up in 2009. We followed Mrs Smith from a single point of contact all the way through. As Lord Darzi said on page 77, collaboration is not the same as integration. On page 5, paragraph 13, he points out that too great a share of the money is spent in hospitals rather than in the community. On page 81, he said that “GP…contracts are complex” and doing the right thing for patients is the wrong thing for GP income. He said, “That cannot be right.”
Our mantra should be “prevention, prevention, prevention”. In our report, we said that public health should be moved into local authorities. As Lord Darzi said, health visitors are dropping. He also said that the NHS is missing an opportunity to intervene early. We had Sure Start, which is where health visitors were focused. He talked about clinical negligence. Some £2.9 billion— 1.7%—of the budget is spent on settling claims. Can the Secretary of State pursue the duty of candour and ask each trust to look at whether they can move cases into arbitration?
Sadly, disparities by ethnicity make very grim and sad reading. Paragraph 24 refers to the median age at death as 62 for white people, 40 for black people, 33 for Asian people and 30 for those from a mixed background. There was supposed to be a chart in the report, but it is not there. Will the Secretary of State look at producing it?
Lord Darzi’s report gives the Secretary of State and the health team an important opportunity to re-set the NHS. It is the envy of the world and free at the point of use. As Lord Darzi said, we cannot afford not to have an NHS.
Alex McIntyre (Gloucester) (Lab)
I congratulate my hon. Friends the Members for South Norfolk (Ben Goldsborough), and for South West Norfolk (Terry Jermy), and the hon. Member for Esher and Walton (Monica Harding), on their wonderful maiden speeches.
I first wish to pay tribute to my predecessor, Richard Graham. Richard represented Gloucester and its residents for 14 years, and I thank him for his service. In the last Parliament, he worked to make spiking a specific criminal offence—something I am proud that this Government will deliver.
It is the most incredible privilege to stand here on behalf of Gloucester residents and to make my maiden speech in this debate, and it is particularly appropriate for three reasons. First, my local NHS hospital, Gloucestershire Royal, has played an important part in my family’s life. It was where my wife and I spent our first night with our little boy, who turns one later this month. I have also spent much of my professional career representing NHS trusts up and down the country, and I have heard at first hand some of the challenges they face, particularly in the recruitment and retention of frontline key workers, to whom I am sure we all owe a personal debt of gratitude. It is also appropriate because I know how many families in my constituency are struggling to get the NHS care they need and will recognise many of the findings in Lord Darzi’s report. Seeing a GP, going to the dentist for a check-up or arriving at A&E in an ambulance and going straight through the doors—those might seem like the basic requirements of a functioning health service, but for my constituents they have become a luxury.
Gloucester is a city rich with potential. We are a city small in size but giant in stature. We have a proud history stretching back to the Roman colonia of Glevum, one of the administrative capitals of Roman Britain. We are one of only three cities in the UK to have hosted a coronation, and our mighty cathedral soars above the city skyline. Younger Members of the House will recognise the cathedral’s cloisters as part of the magical world of Hogwarts, while older Members may recognise our city and our tailor as part of the magical world of another famous Potter—Beatrix.
Last month, we celebrated Gloucester Day, which marks the end of the siege of Gloucester, in which our city stood tall when all hope appeared lost. You can still find brilliant examples of our wonderful heritage across the city, perhaps on a visit to the Folk of Gloucester or on a tour with the Gloucester Civic Trust. We also have a proud military history, from the Glorious Glosters to RAF Quedgeley, which is now Kingsway; and our historic docks, recently designated a heritage harbour by the Maritime Heritage Trust, are home to the brilliant Soldiers of Gloucestershire Museum.
Gloucester also stands out as a place of great innovations: the vacuum cleaner, the ferris wheel, the first jet aircraft and, of course, Viennetta were all pioneered in our great city. But our potential to be great is not confined to the history books—and no, I am not just talking about the country’s finest rugby team, Gloucester-Hartpury, who have won the premiership women’s rugby title two years in a row. The seeds of change were sown in recent years—first under Parmjit Dhanda, Richard’s Labour predecessor, and then under Richard—with the regeneration of the Quays, the Forum and the exciting new university campus, which is due to open next year. But we can and we must go further; plans for the redevelopment of Podsmead and Matson must be brought to life, and brownfield sites across the city turned into the social housing of the future. This Government’s mission to get Britain building can and should unlock our city’s potential.
However, it is not in development that our city’s greatest potential lies; that potential is, of course, in our people—the brilliant people of Gloucester, who are community-minded, fiercely proud and quite happy to tell me exactly what they are thinking. As the new MP for Gloucester, I know that although potential is found in all residents in our city, opportunity is not. I entered politics because I see the potential of every child in Gloucester, and I want to fight to ensure that opportunities like the ones I had growing up in a working-class family under the last Labour Government are open to every single family like mine in our city. When I visit schools in my constituency, I see the next generation of solar and wind engineers, the next cohort of developers and cyber-security experts, and the carers, nurses and doctors who will look after me when I am old.
Gloucester is a diverse city, with over 70 different languages spoken on Barton Street alone—a city that stood united during the uprising of racism and Islamophobia we saw elsewhere in the country this summer—but more needs to be done. At a recent meeting of the Gloucestershire Race Collective, I promised to use my position in this House to give voice to the concerns of our diverse communities in Gloucester, and to work with this Government to tackle rising levels of racism and Islamophobia in our country.
As I work with this Government to deliver on their mission to provide opportunities for everyone in my constituency, regardless of their background, I hope that those opportunities will strengthen the already incredible bonds that bring our city together. Those bonds are best demonstrated by some of the amazing community organisations and charities working in our city, like Gloucestershire Gateway Trust, whose Bridging the Gap programme helps break down barriers to work and gets local people into sustainable employment; like Gloucester Feed the Hungry, whose warm welcome, hot coffee and delicious samosas put a smile on the faces of so many in our city; and like the Holly Gazzard Trust, which is tackling domestic abuse and stalking, turning that family’s personal tragedy into a safer future for all. There are many more such organisations—I could go on all day, but I am conscious of time—that demonstrate the very best of our city: a community that is driven to help others to achieve their potential.
In closing, I make a simple promise to the constituents of Gloucester and the community that I am so proud to serve: I will work tirelessly to deliver a better future for our city. It will be a future in which everyone can access the NHS care they need and every child has the opportunity to thrive; a future that celebrates our heritage, our potential, our diversity and our community—our Gloucester.
Rachael Maskell (York Central) (Lab/Co-op)
Is a real pleasure to follow the new hon. Member for St Neots and Mid Cambridgeshire (Ian Sollom). I am sure that he will be a rising star on the Liberal Democrat Benches. It is a pleasure to follow all hon. Members who have made their maiden speech today.
I am really grateful for the analysis that Lord Darzi has set out for us. The NHS has never been under such duress, nor have its staff, but following a diagnosis, we need a prescription. That is what I want to talk about today. We live in an ageing society, and while we celebrate the medical advances since Labour was last in power—in diagnostics, treatments, digital and technology—we know the urgency with which we need to apply them. Transformation has to be central to the agenda. I congratulate the Secretary of State on his focus on the NHS bringing about the transformation that is needed.
However, before we can look at that, we need to look at the financial flows in the NHS, which are not working, and the governance structures. I am not talking about reorganisation; I am talking about having one controlling mind in the right place in the service, overseeing the system. At the moment, there is too much focus on secondary care. That is sucking resources and work into that part, and driving inefficiency. Moving services into primary care is the key to unlocking the productivity and savings that are needed. It will improve health as well.
In the short time that I have, let me point to two examples in my community. First, in mental health, 30 Clarence Street is set up to be open access, so that there are no more long queues to see mental health practitioners, and multidisciplinary, with the public sector and the voluntary sector working hand in hand to meet people’s needs. I invite the Secretary of State to come and see that service, because it is what we should be doing across our NHS. Two more hubs are to be set up in my constituency, leading the way on mental health. Then there is the work of Nimbuscare in primary care settings; it is pulling out from the NHS all the services that do not need to be in the secondary part. It is unplugging the backlog at the front door of the health service, while ensuring that we are looking after people at the back door. That is the transformation that our health service truly needs. I wanted to share those examples, and set out how they can be extended to build the NHS of the future.
Susan Murray (Mid Dunbartonshire) (LD)
Thank you, Madam Deputy Speaker, for calling me to make my maiden speech. It is a pleasure to speak after the many excellent maiden speeches we have heard, including from the hon. Members for South Norfolk (Ben Goldsborough) and for South West Norfolk (Terry Jermy), my hon. Friend the Member for Esher and Walton (Monica Harding), the hon. Member for Gloucester (Alex McIntyre) and my hon. Friend the Member for St Neots and Mid Cambridgeshire (Ian Sollom). That took a bit of time, but it is important that those excellent speeches are acknowledged. I enjoyed listening to them all.
It is a great privilege for me to stand here today representing Mid Dunbartonshire, and the communities that are close to my heart. I have lived there for 30 years, and it is where both my sons went to school. Mid Dunbartonshire is in Scotland, in case Members had not noticed. It is a new constituency, following boundary changes this year. It sits 100% inside the East Dunbartonshire council area, as did the old constituency of East Dunbartonshire, but it now includes Lennoxtown and Milton of Campsie to the north and some of Lenzie to the east. I am delighted that these towns are now in the constituency I represent, but my sorrow is that it does not include Kirkintilloch East and Twechar, which are also dear to my heart and where I have been a councillor since 2017. I am sure that the hon. Member for Cumbernauld and Kirkintilloch (Katrina Murray) will look after the community there, and it was good to hear her highlight the problems with local bus services in her maiden speech.
It goes without saying that Mid Dunbartonshire is the best constituency in the UK. Local towns are regularly promoted as the best place to live in the UK—Bearsden in 2021 and Kirkintilloch in 2024—and in 2017 “Woman’s Hour” revealed East Dunbartonshire as the best place in Britain for women to live. Incidentally, that was when Jo Swinson began her third term as the Liberal Democrat MP for East Dunbartonshire, so I thank Jo for all her work in the constituency. I also want to recognise her successor, Amy Callaghan, and particularly the personal challenges that Amy overcame during her time as an MP. She has shown such courage in her service to the community, and I wish her well in the future. I also thank Stuart McDonald, who was the MP for the newer part of the constituency. I know that he is held in very high regard and with much affection in that area.
I am pleased to speak in the debate on Lord Darzi’s report, because I know only too well the challenges that individuals and families have to face when our health lets us down. In 2006 my husband had a brain haemorrhage, which changed our lives in an instant. I became his full-time carer and could not continue in my profession, and he was never able to return to his career. From being comfortably off, life changed to watching every penny. Without the support of our family, we could have lost our home, and we were very fortunate. Friends and our community helped me to survive and get on with life. I cannot praise NHS Greater Glasgow and Clyde enough. My husband spent months getting well enough to come home from hospital. Perhaps we were lucky with the timing, because at that time the excellent, talented and caring staff had the resources, which I have seen decline ever since.
I worked in the NHS before a career in medical marketing. I know the NHS from working in it and with it, and from my experience of visiting my husband. Latterly, I have been aware of the integration of health and social care through my role on the council. I know the pressures that good, kind, caring professionals are under to become as efficient as possible, and they are absolutely doing their best.
Looking back, that was the beginning of my involvement in politics. I was thrown into the space that our society refers to as “community”. I know why it is important for Government to fund local authorities and communities and to give them real power. They prevent costs to the NHS every day by stopping the revolving door of treatment, discharge home and relapse back into treatment, and they support self-care and wellbeing. They are our CPS—not the Crown Prosecution Service, but our community prevention service, which pays back investment in spades by preventing costs.
What makes Mid Dunbartonshire special is its people and communities. Like in other places, during covid the community stepped up to support each other, and groups are still helping with shopping and patient transport. There are groups of volunteers fighting climate change, reducing social isolation, providing mental health support and peer support, supporting carers, providing financial advice, helping with housing problems, looking after community buildings, preserving our heritage, knitting for peace, and promoting fair trade, performance art and more—tackling problems at home and internationally. Mid Dunbartonshire people care and take action. From listening to other maiden speeches, I know that that is happening all over the UK. Liberal Democrats want to harness that power for good.
One message that came across loud and clear on the doorsteps was that residents in Mid Dunbartonshire are tired of voting against things; they want to vote positively for things. Thomas Muir of Huntershill in Bishopbriggs was a famous son of Mid Dunbartonshire. At the end of the 18th century, he was a strenuous advocate of equal representation of the people in the House of the people, where I stand today. He said:
“I have devoted myself to the cause of the people. It is a good cause. It shall ultimately prevail. It shall finally triumph.”
The fight for fair votes prompted revolution at the end of the 18th century, and Thomas Muir was found guilty of sedition and transported to Australia for his efforts. In the 19th century, it took three reform Acts of this House to slowly extend voting rights for men. In the 20th century, the Representation of the People Act 1918 gave voting rights to some women and to men aged over 21. But it was not until 1928 that all adults had the right to vote. Today, in the 21st century, the call for better democracy continues.
The turnout in Mid Dunbartonshire at the last election was almost 72%, but many constituencies had a turnout in the low 40 per cents. The result shows a clear failure to engage a huge number of voters. I call on the Government to consider carefully the mandate that the result gave them, to treat every potential voter with dignity and respect, and to make the change to give every vote an equal weight, no matter where it is cast. This is an opportunity to end self-serving and self-obsessed politics, and to truly introduce the politics of service.
I will join my colleagues in this place in scrutinising Government proposals and working constructively with them to improve the quality of life for my constituents and all residents of the UK who make up the rich diversity of our communities.
Several hon. Members rose—
Madam Deputy Speaker
I call Adrian Ramsay, who has two minutes, and I can then squeeze in one more speaker.
Adrian Ramsay (Waveney Valley) (Green)
Thank you, Madam Deputy Speaker. It is a pleasure to follow the new hon. Member for Basingstoke (Luke Murphy) and hear about his pride in his constituency.
Our NHS provides amazing life-saving, dedicated care every day, but we also know that people are too often let down. Too many patients languish, often in pain, on long waiting lists. In rural constituencies such as mine, people often have to travel lengthy distances to access treatment. Lord Darzi points to systemic and chronic under-investment caused by austerity in funding and capital starvation. Resilience was stripped from the NHS before covid, and we owe it to those whose lives were lost or changed forever by the pandemic never to repeat these same mistakes and to do things differently. However, the Chancellor’s arguments about tough decisions and a black hole of £22 billion are alarmingly similar to those made by the previous Government. It is good to see the Chancellor signalling some movement on fiscal rules, and I hope this logic will apply to supporting our public services, which are a crucial investment in our future.
Putting wellbeing at the heart of what we do should help us navigate how we support the NHS. Bad planning, poor housing, weak transport and divisive social policies have a huge impact on health outcomes, for example. So I welcome the Secretary of State’s comments and he has been bullish about reform, but he has not been specific about exactly what he means by private sector involvement in the delivery of NHS services. There are real reasons to keep delivery of the NHS public, and not to outsource it to private providers. The Secretary of State has made statements about using the private sector to reduce waiting lists, but he has not explained whether he considers this to be a short-term plan while the NHS is being rebuilt, or a permanent policy. Lord Darzi’s diagnosis was helpful and the emphasis on prevention is hugely welcome, but to deliver it we require bold action and investment.
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
Fixing the NHS is our great task and our solemn promise, for there is much to fix after 14 years of managed chaos and decline under the neglectful eyes of our mostly absent predecessors. The candid assessment of the state of the NHS from Lord Darzi is truly alarming, and as my right hon. Friend the Secretary of State has said, it presents an accurate diagnosis of our difficulties. The report makes clear many of the problems of resources, management and structure, but today I would like to speak up for medical research, of which this country has such a proud record.
We all know of the catastrophic potential of infection, witnessed so very recently during the covid pandemic. Indeed, like many of us new Members, I too caught covid right here in this House in the crush to hear the King’s Speech. I do hope that hon. Members of a certain age, such as myself, will remember to get vaccinated. However, let us remember Jenner, who devised vaccination, Lister, who pioneered antisepsis, and Fleming, who discovered penicillin. These British scientists leading the fight against infection were probably responsible for saving more lives than any other people in the long history of medicine.
Last week, we learned of the first successful trials from Oxford of vaccines for ovarian cancer, and we will see many amazing advances in the year to come. Today, we can be excited about molecular genetics, artificial intelligence and the huge power of our people’s NHS data to unravel so many of the mysteries of modern medicine. I know that our Government will develop bold plans to repair the embattled NHS, but on this day I urge our brilliant new Government to pledge to do their utmost to support vital NHS medical research, which carries such promise.
Madam Deputy Speaker
Order. Thank you so much, but you must not continue speaking when I am standing. I call the shadow Minister.
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. We did manage to get in 16 speakers even though we had a short amount of time due to Front-Bench contributions.
Government Policy on Health
Nusrat Ghani Excerpts(3 months, 3 weeks ago)
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Victoria Atkins (Louth and Horncastle) (Con)
It is always nice to see the right hon. Gentleman, but I was expecting to see the actual Secretary of State respond to this question. Perhaps he is at a business meeting with health firms—
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. May I ask the shadow Secretary of State just to pose the question? The Minister will respond, and then the shadow Secretary of State will get her two minutes after that.
Victoria Atkins
(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the involvement of people with no formal appointment in the development of Government policy on health.
I apologise to the House, Madam Deputy Speaker. I am more used to answering, but believe you me, I am looking forward to the questions.
Kit Malthouse (North West Hampshire) (Con)
On a point of order, Madam Deputy Speaker. The Secretary of State has obviously decided that attack is the best form of defence, but the operation of the House will collapse if he declines to answer any questions about a very serious matter of public concern. Can we seek your guidance, Madam Deputy Speaker, on whether he is conducting himself appropriately in the House? We are seeking transparency on a matter of probity, and he has a duty to answer the House, not least under the ministerial code.
Madam Deputy Speaker (Ms Nusrat Ghani)
The urgent question has just started, so there will be ample opportunity to continue to hold to account the Secretary of State, who no doubt believes that his answers are responding to the UQ. We have some time to go, so if Members bob, I will endeavour to ensure that they are called to do so.
Clive Efford (Eltham and Chislehurst) (Lab)
The sheer brass neck of the Conservatives to turn up on the very day that Transparency International UK published its report showing that £15 billion of contracts were red-flagged during the covid epidemic—[Interruption.] I am not reading. Those contracts have been red-flagged and are worthy of further investigation, and £500 million of them were given to companies that had not even lasted 100 days. Should the Conservatives not have taken that into consideration before coming here with this urgent question?
Wes Streeting
I wholeheartedly agree with my hon. Friend. Frankly, every single contribution from the Opposition Dispatch Box should begin with a grovelling apology for the way they conducted themselves in government, but they will not apologise: they have learnt nothing and they show no humility. To my hon. Friend’s point, when it comes to covid corruption and crony contracts, the message from the Chancellor is clear. We want our money back and the covid commissioner is coming to get it.
Madam Deputy Speaker (Ms Nusrat Ghani)
I call the Liberal Democrat Front-Bench spokesperson, Sarah Olney.
Sarah Olney (Richmond Park) (LD)
The Liberal Democrats find it deeply ironic that the shadow Health Secretary has raised this question on the involvement of people with no formal appointment in the development of Government policy. Are they forgetting their record in government? Perhaps we should remind everyone that, under the Conservatives, it was their friends that benefited from large contracts to supply the Government during the covid pandemic. The result is that, just today, as the hon. Member for Eltham and Chislehurst (Clive Efford) has already highlighted, Transparency International UK has revealed multiple red flags in more than 130 covid contracts totalling over £15.3 billion. With the Conservatives out of power, we have the opportunity to clean up our politics, so will the Secretary of State update the House on whether the Prime Minister plans to appoint his own ethics adviser or whether Sir Laurie Magnus will remain in the post? Will the ethics adviser be empowered to initiate their own investigations and publish their own reports?
Wes Streeting
I strongly agree with the hon. Member. In the short time that I have been in post, I have been delighted to have had virtual meetings with the current Northern Ireland Minister of Health, as well as with his predecessor, the hon. Member for South Antrim (Robin Swann), who now sits over there on the Opposition Benches—I am delighted to see him in his place.
Ministerial meetings attended by third parties are declared in our quarterly transparency publication. People will want to lobby and influence Government, and Members of Parliament, all the time. Members of Parliament regularly receive correspondence—let alone the deluge of advice that we receive in government. The important thing is that Ministers take decisions on the basis of the best possible advice available, that they weigh up carefully the evidence and arguments in a fair and proper way, and that advisers may advise but Ministers ultimately decide.
This Government are aware of the deep crisis in trust in our politics. That is why, on his very first day, the Prime Minister talked outside Downing Street about restoring Government to service. It is why it should be no surprise whatsoever that many people who have given outstanding public service to this country, such as my right honourable friend Alan Milburn—and the same is true of Patricia Hewitt, Alan Johnson, my noble Friend Lord Reed, the Mayor of Greater Manchester and many more—want to roll up their sleeves and help the Government. They can see the state that the Conservative party left our country in, and are willing once again to roll their sleeves up to get our country back on its feet, turn the situation around and ensure that everyone in our country can look forward to the future with optimism and hope after 14 years of abysmal failure.
Madam Deputy Speaker (Ms Nusrat Ghani)
That is the end of the urgent question. I thank all Members who participated. In reference to the Secretary of State earlier, the privilege of choosing UQs is down to the Chair and is based on merit and the urgency of the point being raised.
Unpaid Carers
Nusrat Ghani Excerpts(3 months, 4 weeks ago)
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Tom Gordon (Harrogate and Knaresborough) (LD)
I thank my hon. Friend for bringing forward this Adjournment debate, and of course for the work she did before this parliamentary Session on what is now the Carer’s Leave Act 2023. One of the reasons why I became involved in politics is that the day before I started my master’s degree, my mum was diagnosed with breast cancer. I studied my degree part-time over two years to look after her and my little sister, who was just five. Looking back, it is clear that I was filling the role of a carer, but I did not identify as one. That is a key point to note if we are to have a carers strategy. A recent Carers Trust survey found that 73% of those who provide or have provided unpaid care do not identify as unpaid carers. Does my hon. Friend agree that a national carers strategy should prioritise the identification of carers across all sectors?
Madam Deputy Speaker (Ms Ghani)
Order. This is an Adjournment debate and interventions must be super-short.
Wendy Chamberlain
I am grateful to my hon. Friend. It demonstrates how prevalent caring is in our society when we have Members who have direct experience of it. Identification of carers, or people identifying themselves as carers, is a key issue that any strategy should address.
The then shadow Minister was right that we need a cross-Government strategy. This is not a new idea, because we have had such strategies before; the last one was drawn up all the way back in 2008, but the problems that unpaid carers face have not gone away. Unpaid carers are significantly more likely to be in poverty than the rest of the population. The most recent data available from the Department for Work and Pensions—the 2023 family resources survey—shows that just under a third of households in receipt of carer’s allowance are food insecure, compared with 10% of households as a whole. That is a huge difference.
To assess food insecurity, the survey asks the respondent whether in the past 30 days: they have has eaten less than they felt they should because of lack of funds; they have been hungry, but not eaten due to lack of funds; or they have lost weight due to not enough money for food. It also asks whether they or someone in their household has gone without eating for an entire day because they lack money for food. Further, the survey found that 13.3% of households in receipt of carer’s allowance—that is just more than one in every eight—had used a food bank in the previous 12 months, compared with just 3% of households overall.
Childhood Cancer Outcomes
Nusrat Ghani Excerpts(2 years, 8 months ago)
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Siobhan Baillie (Stroud) (Con)
I congratulate my hon. Friend the Member for Gosport (Dame Caroline Dinenage) on securing this important debate. I thank my constituents who have written to me about the debate to bring it to my attention. It is important that we bring local and personal experiences into this place when we are thinking about policy and legislation. I am grateful to Sophie’s mum, Charlotte, for sending me notes about Sophie and her beautiful picture. It is impossible not to be brought to tears—I am a crier anyway and I am pregnant at the moment, so I hope that hon. Members will forgive me if I go.
The theme running through many of the examples that we have heard today, and the correspondence that I have received, is a plea for the Government, MPs and policy makers not to misunderstand childhood cancer and not to write it off as rare, because so much flows from that label in terms of funding, attention and even time in this place. I understand that with 80-odd types of childhood cancer, it is complicated, but that is absolutely no excuse. We have already heard that it is the biggest killer of children under 14. I have not done the maths, but I know that that is many, many devastated families, even in the Stroud district, whom we cannot overlook.
One constituent wrote to tell me that the death of a friend when they were in their teens still plays on their mind. The GPs and out-of-hours services that he accessed did not have the training to identify that his symptoms were due to bone cancer and, as a result, after 13 gruelling months—we have heard time and again the horror of the treatment that the children go through—he died from the disease. Had his diagnosis been made sooner, my constituent is absolutely clear that his chances of survival would have been greatly increased.
We hear comments about mystery viruses and mystery symptoms. One of my greatest concerns is listening to the reality of pushed GPs, who are busy people and who are not equipped or trained enough to be able to spot some of the signs soon enough.
Ms Nusrat Ghani (Wealden) (Con)
Is that because there is not enough research? I was surprised to learn that only 4% of funds raised for cancer research and treatment are directed towards childhood cancer and that children, unfortunately, are receiving treatment for adult bodies. It all requires greater investment, which is obviously something that the Minister can respond to. As my hon. Friend has, I have had many cases in my constituency, particularly in Crowborough, Mayfield and Forest Row.
Siobhan Baillie
I thank my hon. Friend for that intervention. What I will say is that that is certainly not due to lack of care and love, because GPs absolutely want to do the best for their patients. Whether it is research, whether it is training, whatever it is, we have to fix this, so I support the calls for a children’s cancer mission, and urgently so. I want to bring everybody together for research and awareness raising.
I am very lucky that Meningitis Now—that fantastic charity, which has been mentioned—has absolutely turned around understanding and knowledge about meningitis in my constituency. It is a small charity, but it packs a punch. Why can we not do that for childhood cancer research and sufferers?
Post-pandemic parents, as I have just said about GPs, will look to call 111 for advice. We told parents and we told the whole country, “Don’t go to the A&E. Don’t go out to your NHS. Call 111.” So this is also about training that is really focused on that service.
Listen, the Minister is a fantastic Minister. I am bothering her all the time about lots of things, so I know her intellect and her care for people up and down the country. The Government have already committed to improving cancer outcomes, and the 10-year plan is absolutely an opportunity to make changes for the hundreds of families who are affected and desperately need our help.