NHS 10-Year Plan
Paulette Hamilton Excerpts(1 week, 3 days ago)
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Mr Deputy Speaker (Sir Roger Gale)
I call the Chair of the Health and Social Care Committee.
Paulette Hamilton (Birmingham Erdington) (Lab)
As the acting Chair of the Health and Social Care Committee, I am delighted that the 10-year plan was finally launched today. I thank the Secretary of State for Health and Social Care for presenting it to the House.
The plan represents a major opportunity for constructive reform of the health and social care system, and I am delighted that the Secretary of State will come to the Committee on 14 July to be scrutinised on it. Many organisations have waited patiently for the 10-year plan to be published. Will the Secretary of State explain how the plan will help restore the promise of a first-class service in the NHS?
Wes Streeting
I thank my hon. Friend for her question and for the leadership she is showing to the Select Committee while the substantive Chair, the hon. Member for Oxford West and Abingdon (Layla Moran), is off on mat leave. What a delight it was to see the Committee Chair on the Terrace this week with her new baby. That was really delightful and we wish her well.
One of the exciting things for me about today’s launch is just how widespread the support has been from across a range of different organisations that we will need to work with to deliver the plan. Whether it is the royal colleges and the trade unions, the organisations that represent patients, the wide range of healthcare charities or, crucially, frontline staff, everyone is up for this change and everyone is desperate for it to succeed.
We will not get everything right and we will make mistakes along the way. We will listen and always learn and reflect. We know in the Government that we cannot do this without effective leadership from Ministers, but nor can Government do this alone. It is now our responsibility to mobilise the more than 1.5 million people who work in the NHS, the more than 1.5 million people who work in social care and our whole country behind a national mission to get our NHS back on its feet, to make sure it is fit for the future and to make sure, fundamentally, that we attack the injustices that lead to ill health, so that we have a fairer Britain where everyone lives well for longer.
Department of Health and Social Care
Paulette Hamilton Excerpts(2 weeks, 5 days ago)
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Paulette Hamilton (Birmingham Erdington) (Lab)
I am delighted to open this debate on the Department of Health and Social Care’s main estimate. My remarks will focus on the recent spending review, which includes some welcome funding increases and sets out some ambitious reform objectives. However, it also raises questions about deliverability, particularly of objectives to do with capital investment, efficiency savings and the role of social care.
Let me begin with capital investment. The Government have rightly emphasised the need to shift from analogue to digital systems across the NHS. The increase of nearly 50% in technology and transformation funding will mean that it reaches up to £10 billion by 2028-29, which is a welcome and substantial commitment. However, the NHS has a poor track record on digital transformation. The National Audit Office has highlighted the risks around fragmented delivery, unclear governance and unrealistic timelines, and those lessons remain highly relevant. Its 2020 report on digital transformation in the NHS found that despite £4.7 billion in national funding, many trusts were still reliant on systems that were outdated and not integrated.
The capital budget is being asked to do a great deal more than achieve digital transformation. The Government have committed to the new hospital programme, and to addressing critical infrastructure risks, such as those posed by reinforced autoclaved aerated concrete. Over five years, £30 billion is allocated for maintenance and repair, and £5 billion is allocated for critical risk. However, by the end of the decade, there will be no real-terms uplift in the capital allocations, compared with this year. In fact, in 2027-28, the funding settlement actually falls to £13.5 billion from £14 billion the previous year, meaning that inflation in construction costs and materials will significantly erode its purchasing power. The British Medical Association has warned that current funding cannot cover both the new hospital programme and essential maintenance, and now that programme must also compete for funding with the vital digital transformation. Can the Minister explain how the Department will choose its priorities from those competing essential demands on the capital budget?
Turning to resource spending, the Department’s day-to-day budget will grow by an average of 2.7% per year in real terms. That funding will be used to deliver several welcome commitments, including investment in elective recovery and urgent and emergency care; a £4 billion increase in adult social care funding; 700,000 additional urgent dental appointments annually; 8,500 more mental health staff; and £80 million a year for tobacco cessation programmes. Those are all positive steps.
Danny Beales (Uxbridge and South Ruislip) (Lab)
I thank my hon. Friend for giving way, as well as for her excellent chairing of the Health Select Committee at the moment and for opening today’s debate. Does she agree that this Government’s record investment in our health service will be vital to turning around the health service after 14 years of under-investment and a lack of reform? As my hon. Friend has touched on, that investment also needs to be targeted to enable the three shifts that the 10-year plan talks about. In particular, we need to reverse the trend of more spending going towards secondary care while less goes to primary care. We need a big uplift in dentistry, which my hon. Friend has mentioned, but also in primary care—in GPs—and in pharmacy.
Paulette Hamilton
Hear, hear. My hon. Friend makes some valuable points, and I agree with every one of them.
Underpinning the settlement I have described, however, is the Government’s pledge to generate £17 billion in efficiency savings over three years, with a staggering £9.1 billion expected in the final year of this Parliament. Critically, those savings have already been factored into the settlement—in effect, they have been spent before they have been delivered. In the light of that, we need absolute confidence that there is a clear and robust plan to generate those savings. The Government are assuming an annual productivity improvement in the NHS of 2%, more than triple the long-term average of 0.6%. They appear to be relying on digital transformation to unlock the bulk of those savings, which is risky, given the history of digital change programmes in the NHS.
Another source of savings is the plan to cut reliance on temporary staff by reducing sickness absence and overhauling staff policies, including limits on agency spending and eliminating the use of agencies for entry-level roles. Again, this is a welcome ambition, but delivering it will be a significant challenge, one that will require meaningful, sustained improvements to staff wellbeing and working conditions. We cannot build a sustainable workforce on good will alone. Therefore, will the Minister say when we can expect an updated and fully costed workforce plan to deliver on these ambitions?
Delivering the reforming elective care for patients plan is also central to achieving those efficiencies. It proposes reforms such as optimising surgical pathways through hubs, streamlining referrals, expanding remote monitoring and reducing unnecessary procedures. The plan assumes a rapid transformation of services, with significant improvements in productivity and patient flow expected within just a few years. That is ambitious, especially given the context of ongoing workforce shortages, ageing infrastructure and rising demand. Reform is essential, but it must be realistic, properly resourced and paced to succeed. We cannot afford to set targets that look good on paper but falter in practice, damaging morale and patient care. What steps is the Minister taking to ensure that the projected £17 billion in savings will materialise and be delivered on time? What happens to those additional resources for frontline delivery if those savings are delayed or fall short?
I will also touch on adult social care, which is in desperate need of reform. The Casey commission has an important job to do, but the terms of reference for the first phase of Casey’s work state clearly:
“The commission’s recommendations must remain affordable, operating within the fiscal constraints of Spending Review settlements for the remainder of this Parliament.”
Now that those settlements have been reached, can the Minister provide clarity to the House about precisely what fiscal constraints Baroness Casey’s recommendations will have to conform to? The £4 billion for adult social care announced in the spending review includes an increase to the NHS minimum contributions to the better care fund.
Andrew George (St Ives) (LD)
I thank my fellow member of the Select Committee and stand-in Chair for giving way, and I congratulate her on how she is introducing the issues today. Does she agree that the length of time set for the Casey review to report does not give us a sense of confidence that the Government have injected sufficient urgency to address the serious problems of ensuring that we have a robust social care system that can stand up to the pressures that lie ahead?
Paulette Hamilton
I thank the hon. Member for that deep and thoughtful point. He is absolutely right. Timescales are an issue, and that is why, as a Select Committee, we are asking the Government a number of questions so that we can scrutinise what is happening and get the information.
My Committee considered the better care fund in our inquiry into adult social care. It was introduced with the aim of driving better integration between health and social care, and shifts resources upstream from NHS acute services. However, the evidence we heard was stark. These resources have been overwhelmingly focused on hospital discharge. While timely discharge is important, that does not match the fund’s original objectives. How will the Government ensure that this increase in funding leads to a greater focus on prevention? The Chancellor referred to the Government’s plan for an adult social care fair pay agreement. Reaching such an agreement is not just desirable but essential. Staff working in care homes are far more likely to live in poverty and deprivation than the average British worker.
Joe Robertson (Isle of Wight East) (Con)
The hon. Member is making her points very well, and I congratulate her on her success in bringing this debate to the Chamber. I agree with what she has said about fair pay for social care workers—I support that as well—but does she agree that a fair pay agreement will put undue pressure on providers unless there is some money or financial incentive attached to it so that they are able to meet their fair pay requirement?
Paulette Hamilton
The hon. Gentleman has made a valuable point. The problem is that we in the Committee are waiting for the workforce plan, and we are not sure what is being planned. What the hon. Gentleman has suggested is desirable, but at this moment we do not know what the workforce plan will throw up. It is possible that what he has suggested is already in the plan; let us just wait and see.
The current position is both morally unacceptable and economically short-sighted, fuelling the workforce crisis. What concrete progress has been made in establishing the fair pay agreement? Can the Minister give the House an update? Will she also tell us whether the funding that is required to pay for this essential agreement will come out of the £4 billion that has been announced for social care?
While both the main estimate and the spending review present a vision of reform, it is clearly a vision built on some highly optimistic assumptions. We need to see robust, detailed plans to deliver the digital transformation and the unprecedented scale of efficiency savings that the Minister is counting on. Without such plans, and without realistic assessments of the challenges, the risk is not just that these reforms will fall short, but that they will do so at the expense of frontline services, patient care, and the morale of our dedicated health and social care workforce.
I urge the Minister to address the specific questions that I have raised today.
Several hon. Members rose—
Paulette Hamilton
I thank all right hon. and hon. Members who have spoken. The Health and Social Care Committee will continue to scrutinise the health and social care sectors. The Committee remains united in the view that we need a programme in place to reform social care. The spending review and the funding tells us the scale of the challenge. On 5 July, the NHS will be 77 years old. I want to pay tribute to and thank all the healthcare staff and workers in the NHS and say a big happy birthday to the NHS.
Question deferred until tomorrow at Seven o’clock (Standing Order No. 54).
Oral Answers to Questions
Paulette Hamilton Excerpts(3 weeks, 5 days ago)
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Mr Bayo Alaba (Southend East and Rochford) (Lab)
Paulette Hamilton (Birmingham Erdington) (Lab)
The Minister for Secondary Care (Karin Smyth)
Reducing waiting times for cancer diagnosis remains a key priority. Under this Government, an extra 99,000 patients have had cancer diagnosed or ruled out. This has been supported by investment, including in Cancer 360—a digital innovation that brings patient data into one central platform—and in NHS England’s cancer innovation open call to fast-track cutting-edge interventions into practice. Our forthcoming national cancer plan will set out how we will speed up cancer diagnosis even further.
Karin Smyth
I am delighted that my hon. Friend’s constituents will benefit from the £70 million investment. These machines are game changing and will reduce the number of visits for his constituents. They are also more reliable, which gives more capacity to the system. That is better for staff, as there will be less appointment cancellations. That is exactly the sort of thing we want to see more of, and we are delivering that under this Government. It is the result of our drive to reduce long waits and treat more people quicker. That was reinforced in last week’s spending review, and it is exactly what his constituents deserve.
Paulette Hamilton
Early diagnosis of less survivable cancers is vital if survival rates are to improve. What assessment has the Department made of the report by the all-party parliamentary group on less survivable cancers that looks at earlier detection and faster diagnosis, and what steps are the Department taking to deliver on this?
Karin Smyth
My hon. Friend is right to highlight that issue. I commend her great work not just on the APPG but on leading the Health and Social Care Committee on behalf of its Chair, the hon. Member for Oxford West and Abingdon (Layla Moran). She is right to highlight that it is a priority for the Government to diagnose cancers earlier and improve survival rates. That is particularly important for the group of people with rare cancers. The APPG’s report will inform the development of our national cancer plan, which will seek to include all aspects of care throughout the entirety of the cancer pathway.
Dementia Care
Paulette Hamilton Excerpts(1 month, 1 week ago)
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Caroline Voaden
I absolutely commend all those groups—the hon. Member is lucky to have so many in his constituency.
Like many other diagnoses that can be equally shocking to receive, dementia has no cure. Approved medications offer limited benefit only in the early stages and not for everyone. For those in the moderate to late stages, the most effective treatments are access to information to navigate the social care system and good-quality care. That means personalised, respectful and consistent support not only for the individual but for their family too, and that family support is critical. Across Devon and beyond, unpaid carers bear the overwhelming weight of responsibility. There is a physical, financial and emotional toll from the moment of diagnosis, yet respite support is sparse and, in many places, non-existent.
Paulette Hamilton (Birmingham Erdington) (Lab)
I share the hon. Member’s deep commitment to ensuring quality care within our communities—something I saw at first hand last year during my visit to Warren Farm Lodge care home in Kingstanding. The dedication of the staff left a lasting impression. Does she agree that we need to work with the Government to urgently develop a blueprint for transforming dementia diagnosis?
Caroline Voaden
The hon. Member has beaten me to it—I absolutely agree.
The lack of respite support is pushing carers into crisis, and when that happens the result is clear: faster entry into long-term care, increased hospital admissions, more GP appointments and distress for everyone involved.
Access to NHS Dentistry
Paulette Hamilton Excerpts(1 month, 3 weeks ago)
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Lizzi Collinge (Morecambe and Lunesdale) (Lab)
NHS dentistry has been a recurring theme for me both before the election and since, as I know is true for most colleagues, which is why this Labour Government have made it a priority. However, we are starting from a very difficult place.
Let me set out just how bad the situation is in Morecambe and Lunesdale. Last year, I knocked on the door of a man in Morecambe who had lost most of his teeth because he did not have access to dental care. Just yesterday, a constituent wrote to me asking me to speak in this debate. She and her husband travel more than 80 miles four times a year just to see their NHS dentist. They are retired and cannot afford to go private, and, like many older people, they need regular and more complex care. We do not have to look far to see the root of the problem—so to speak. Dentists have been telling us for years that the NHS dental contract is not fit for purpose. The contract creates perverse incentives. Dentists are discouraged from treating the patients who need them the most. I appreciate that this is partly because in the ’90s and early ’00s, the contract incentivised the over-treating of patients, but now the pendulum has swung back too far the other way, and we have to find a balanced approach.
Dental decay is one of the leading causes of hospital admissions in children. In 2023, over 30,000 children ended up in hospital needing their teeth removed.
Paulette Hamilton (Birmingham Erdington) (Lab)
The Government have an historic commitment to prevention. Birmingham Erdington is one of the youngest constituencies in the country. Does my hon. Friend agree that we must continue to build on supervised brushing and targeted fluoride applications in early years settings to protect the youngsters?
Lizzi Collinge
My hon. Friend is absolutely right. Prevention is always better than cure. When I sat on Lancashire county council’s health scrutiny committee, we took evidence that showed that things such as supervised brushing and help with fluoride were some of the most cost-effective interventions, and they could prevent the horror of 30,000 children going into hospital for preventable tooth removal.
Dental health has become a stark marker of inequality. Without ongoing care and access to that preventive care, children in less well-off families are more likely to suffer worsening dental problems.
The contract was a major problem. It locked in those perverse incentives, but the situation was then worsened by over a decade of neglect of all areas of public health under the previous Government. Too many families do not go to the dentist until it is too late and it is very expensive, so we need those preventive measures that my hon. Friend the Member for Birmingham Erdington spoke about and we need access to NHS dentists. We know that if people are not able to go to the dentist, it means they turn up at A&E, but they are sent away with painkillers and antibiotics, and that does not fulfil their needs.
I am pleased that our Government are taking this issue seriously. I am pleased that we recognise the scale of the problem, and I am pleased that we are taking action not only on NHS dentistry, but on preventive care. We owe it to families in Morecambe and Lunesdale and across the country to fix this broken system. We need a dental contract that actually works, fair funding for local services and access to care that is available when people need it.
NHS and Care Volunteer Responders Service
Paulette Hamilton Excerpts(1 month, 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.
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Paulette Hamilton (Birmingham Erdington) (Lab)
Does the Minister agree with me that as we rebuild our NHS, volunteers at NHS trusts will not be used to plug gaps in service and staff will be allowed to focus on clinical matters?
Karin Smyth
I am happy to give my hon. Friend an absolute assurance. Volunteers support and complement the existing workforce; they do not replace it. Including volunteers signals a recognition of the important role they play in supporting staff, services and patients. Many hon. Members are volunteers and we have all seen how those volunteers can support the wider system. However, it is important that we keep our staff and respect their important roles.
Oral Answers to Questions
Paulette Hamilton Excerpts(3 months, 2 weeks ago)
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Stephen Kinnock
I thank the hon. Gentleman for that question and I congratulate him again on his 60th birthday. [Laughter.] He raises an important point on teaching and training in dentistry. There is not enough capacity in the system. We absolutely want to ensure that we are building that capacity. As I said, a lot of that will depend on the comprehensive spending review settlement in June. I would be more than happy to discuss the issue with him in greater detail once we have a better sense of where we are on the funding.
Paulette Hamilton (Birmingham Erdington) (Lab)
The Minister for Secondary Care (Karin Smyth)
The Government are committed to improving women’s health outcomes. We have already taken urgent action to tackle the gynaecology list through the elective reform plan, and we recently announced an £11 million trial using AI tools to detect breast cancer cases earlier. The 10-year health plan will set out how we will tackle the factors that lead to poor health outcomes and the improvements we expect to see.
Paulette Hamilton
What assessment has the Minister made of the adequacy of research into and the provision of fibroid treatment for women, taking into consideration that fibroids are three times more likely to appear in black women than in white women?
Karin Smyth
The Government welcome the work my hon. Friend has undertaken and the work of the Caribbean and African Health Network in highlighting health inequalities for black women. She highlights shocking and unacceptable statistics. The National Institute for Health and Care Research has funded a significant amount of research into women’s health issues, including a £1.5 million trial comparing treatment options for fibroids. I am happy to make sure she is updated on that work and on the details of that work.
Rare Cancers Bill
Paulette Hamilton ExcerptsFriday 14th March 2025
(3 months, 4 weeks ago)
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Paulette Hamilton (Birmingham Erdington) (Lab)
I thank my hon. Friend the Member for Edinburgh South West (Dr Arthur) for bringing forward this important Bill and for his tireless work in championing the need for a greater focus on research into rarer cancers. Having worked as a district nurse for over 25 years, I have seen time and again the devastation cancer brings, not just to those diagnosed but to their families, friends and communities. The harsh reality is that one in two of us will face cancer at some point in our lives; it is an issue that touches all of us in some way.
While we have made significant strides in cancer treatment and survival rates, progress has not been equal. Some cancers, like the rarer, less survivable cancers, have been unjustly left behind. Cancers such as pancreatic, oesophageal, liver, brain and stomach still face staggeringly low survival rates. Currently, the least survivable cancers have a five-year survival rate of just 16%, compared with 55% for all other cancers. This disparity is not just a statistic; it is a failure in our services and the way these cancers are researched, which has cost lives, shattered families and left too many of us without hope.
A key driver of this has been the chronic underfunding and lack of focus on research into these cancers, which has meant that we lack tests and the tools and treatments needed to give people a fighting chance. The consequences of this neglect are devastating.
This issue is deeply personal to me. I have lost loved ones to pancreatic cancer, a disease that steals lives with ruthless efficiency. I lost my best friend, a woman full of life and love, to this cruel illness. She endured months of uncertainty before finally receiving a diagnosis in August, only to pass away shortly after. Her story is of delayed diagnosis, missed opportunities and a system that failed her. Sadly, her story is not unique. I find it truly shocking that in 2025, more than half of those diagnosed with pancreatic cancer will die within three months and only 7% will survive.
Pancreatic cancer is the fifth biggest cancer killer in the UK but receives only 3% of the UK cancer research budget. This lack of investment has meant we are not seeing the treatment breakthroughs that have transformed outcomes for other types of cancer. It does not have to be this way. We know that sustained research funding and strategic focus from the Government can dramatically improve survival rates—we have seen it work for other cancers. I particularly welcome the Bill’s proposal to nominate a named lead to focus on these rarer cancers, ensuring that they are no longer overlooked, as well as its provisions to give people a better opportunity to take part in innovative, cutting-edge trials. That is why I support the Bill.
The Rare Cancers Bill offers a road map to bring real-life, lifesaving changes to those diagnosed with life-threatening diseases. It is not just about policy, but about people; it is about giving hope to those who have been left behind. As chair of the all-party parliamentary group on the less survivable cancers and vice-chair of the Health and Social Care Committee, I firmly believe that through the provisions of this Bill, we can start—I say start—to bring forward access to innovative treatments that could turn the tide. I say to Members of this House, “Let us be bold. Let us make a difference. Let us ensure that future generations have a better chance of survival than those who came before them. Let us send a clear message to patients and their families that they are not forgotten. This is our moment to make a lasting impact—let us make it count. Let us support this Bill.”
Hospice and Palliative Care
Paulette Hamilton Excerpts(6 months ago)
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Paulette Hamilton (Birmingham Erdington) (Lab)
I thank the hon. Member for Wimbledon (Mr Kohler) for securing this important debate. As a nurse for 25 years and as co-chair of the all-party parliamentary group on hospice and end of life care, hospice and palliative care has always been at the heart of my work, both in this Chamber and in my community.
I start by acknowledging the fantastic decision by the Government to boost investment in hospices by £100 million—the largest funding uplift in a generation. That is a clear sign that the Government are listening to the hospice sector and responding with actions, not just words. However, this uplift must be the beginning and not the end. This new money will not last forever. We must now take concrete steps to ensure that the awful conditions in the hospice sector that we inherited are never repeated. It is worth noting that while the independent commission on palliative and end of life care recently created by my hon. Friend the Member for York Central (Rachael Maskell) is welcome, it will mainly be about delivery and not funding. We simply cannot wait for a palliative care taskforce to complete its report; that could take months, which this sector cannot spare.
In my role, I hear time and again about postcode lotteries and the chronic lack of funding that plagues this vital sector. Through no fault of its own, John Taylor hospice, which does fantastic work in my constituency, is facing a crisis in funding; it has had to announce redundancies and a reduction in in-patient beds due to the funding shortfall. That story is being repeated all over the country—I am sure many Members in this Chamber have a similar situation that they could share. Hospice care still relies heavily on charity, bake sales and donations to fund much of the work that supports families during their most vulnerable moments. That must change. This postcode lottery not only is unfair, but undermines the principles of universal healthcare. We cannot allow end of life care to depend on where someone lives and how much money they have.
Hospices across the UK provide care and support to 300,000 people every year. They are an absolutely essential part of our healthcare system, although they are in the charity sector. Every single day, hospices face rising costs of energy, food and medicine; every single day, they deliver exceptional care, even as pressures mount; and every single day, they battle deficits that threaten their ability to continue. Despite all those challenges, our hospices save the NHS millions each year by alleviating pressures on hospitals and providing community-based care. However, their ability to continue this vital work is at risk, and they need long-term sustainable support. We need to face the future head on and fix their funding model permanently.
While I absolutely understand that hospices are under pressure, the integrated care boards that fund them are similarly under a great deal of pressure due to year-on-year budget reductions from NHS England. Asking ICBs to find extra money without it being allocated centrally as revenue is impossible.
Death is a part of life, as the hon. Member for Wimbledon said, and as we all know. Nobody would say we should neglect healthcare, so why are we neglecting the hospice sector by not securing a sustainable funding formula? To truly address the gaps in our system, we need a sustainable funding model that ensures hospices can meet growing demands without being forced to cut services. The people of this country deserve a future where every family, no matter their circumstances, can access the highest quality of end of life care without worry, one where hospice care is not a postcode lottery but a promise.
Let us turn this moment into an opportunity. We must act urgently to implement and improve a sustainable funding package for hospices and palliative care. With constructive action, we can build a system that uplifts the most vulnerable among us, strengthens the NHS and shows the best of what we can achieve as a nation. Let us ensure that the legacy of this debate is not one of uncertainty, but one of determination and passion, and that when we see the 10-year plan, hospice and palliative care will be fully funded going forward.
Oral Answers to Questions
Paulette Hamilton Excerpts(7 months, 3 weeks ago)
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Paulette Hamilton (Birmingham Erdington) (Lab)
Wes Streeting
We all know that general practice is under enormous pressure, and that will be a big part of this Government’s agenda. I reassure my hon. Friend that our view is that there should be patient choice, patient control and different courses for different horses. I value online and over-the-phone appointments, but they will not be right for everyone on every occasion. Patients should have a voice and a say.