NHS 10-Year Plan

Roger Gale Excerpts

Thursday 3rd July 2025 Commons Chamber

[Wes Streeting]

I thank the shadow Secretary of State for his constructive approach to what does need to be a successful plan for the next decade, to get our NHS back on its feet, to make it fit for the future and to make sure we improve the health of the nation. Aside from the lines that he was no doubt given to trot out at the beginning—he almost said them with conviction—we know that we can count on him to be rather more serious and sensible than the display we saw from the Opposition yesterday.

I turn to the shadow Secretary of State’s points. He was right to say that investment needs to go alongside reform. That is why the spending review only a matter of weeks ago set out the Chancellor’s commitment to the NHS and NHS reform. The Government are providing a £29 billion real-terms increase—a £53 billion cash increase—in annual NHS day-to-day spending by 2028-29. That funding will support the first steps towards delivering the reforms, the service improvements and the new technology set out in the plan.

But investment alone is not enough. One of the reasons we are paying more and more for worse and poorer outcomes is that we have the wrong care in the wrong place at the wrong time. Contrary to what we read in some newspaper columns—on the radio this morning I heard the hon. Member for Clacton once again attacking the NHS’s equitable principles and funding model—the problem is not the model of funding; it is the model of care. That is why the shift to neighbourhood health is essential for delivering better outcomes for patients and better value for taxpayers.

The technology coming down the track, and indeed the technology we already have, will drive the big productivity gains in the system that have eluded us. In recent years, the previous Government invested in more staff, but they put all those staff in hospitals to work in an undercapitalised NHS. If there are more inputs but not the enablers to deliver the service, we do not see the responding improvements in output and impact. That drives poorer productivity, poorer value for money and poor outcomes for patients, and that is the approach that we are changing.

If, for example, we roll out, as we will, ambient AI to all GPs, and we make sure that in their interactions with patients we liberate them from being glued to the screen, filling out the forms and drafting the letters, because that is all done automatically before the GP spends a few moments checking over to make sure it is right—if we can just save 90 seconds in every GP appointment—we will save the equivalent time of 2,000 more GPs. That is how we get more bang for the buck, that is how we drive productivity improvements and that is how we deliver better care and better value.

That is why the previous Government’s workforce plan was not right. It assumed that the NHS just needed growth at the same rates and in the same way as always. In fact, so implausible were the assumptions in that plan that if we had continued with the rate of growth that they had set out, by the end of the century 100% of our entire country would be working in the NHS. I know we love the NHS and we love the people who work in it, but I do not think that everyone in our country can or should be working in the national health service. To reassure the right hon. Gentleman, we will, this autumn, set out a new workforce plan that aligns with this 10-year plan.

The shadow Secretary of State asked about neighbourhood health centres. We aim to go for 250 to 300 new neighbourhood health centres by the end of this plan and 40 to 50 over the course of this Parliament. They will be NHS providers and we will have a combination of new builds and the refurbishment and rejuvenation of underutilised existing estate, both in the NHS and in the public sector. Therefore, the cost of each neighbourhood health centre will vary, from the low millions to around £20 million, depending on whether it is an upgrade, a refurb and expansion or a new build.

Given the undercapitalisation of the NHS that we inherited, even the record investment from public sources that the Chancellor has provided will not be enough to deal with the capital backlog. That is why, as set out in the Government’s infrastructure plan, with care and caution, and keeping in mind the mistakes that were made by the private finance initiative, we are looking at alternative private sources of investment to make sure that we can go further and faster on capital improvement, particularly in the neighbourhood health service.

The right hon. Gentleman asked me to commit again to fracture liaison services. Those services have a demonstrable impact on keeping people well and providing both better outcomes for patients and better value for taxpayers. That is why we want to see them rolled out across the country.

On maternity, I welcome his support for the investigation. NHS England is in the third year of the three-year plan put in place by the previous Government and we have sought to support that progress and not to interfere. Yet as we have seen, even with the most recent CQC report into the trust in Nottingham, we have so much more to do and an entire change in approach and culture is needed, let alone a change in practice and behaviour. I am committed to working with all parliamentary party groups across this House and to making sure that the expertise and insight that we have right across these Benches, on both sides of the Chamber, help us to drive maternity improvements.

He asked about us rolling HSSIB into the CQC. Let me provide him with this reassurance. HSSIB has been a really effective body, but we cannot justify the duplication of back-office functions and the inefficiency that comes with that. However, the CQC, when we came into office, was in such a dire state that we had to replace the leadership and we have in place an improvement plan. The House therefore has my assurance that we will not roll HSSIB into the Care Quality Commission until we are assured that the CQC is back to the standards that we expect for it to perform its core duties today, let alone the work it will do with HSSIB housed within the CQC.

On ICBs, I will not measure success through the number of bodies in the NHS; I think that has led us to where we are. However, I am committed to making sure that as we devolve more power, more responsibility and more resource closer to the frontline, to system leaders and to provider leaders, we also make sure that we have in place democratic accountability, so that Members of Parliament, local councils and metro mayors can influence and shape healthcare where they live.

The right hon. Gentleman also asked about social care. We are not waiting for Casey. The spending review gave an additional £4 billion to social care. We are delivering the biggest expansion of carer’s allowance since the 1970s and a significant increase in the disabled facilities grant. The Deputy Prime Minister and I will also shortly set out how we will deliver the first every fair pay agreements for the care workforce, building real social care progression.

On neighbourhood health, social care has to be part of it. In the context of this plan, social care features because it has a role to play on admission avoidance and speeding up delayed discharges. However, we know that social care is important in its own right and that is why it is important that it has its own commission.

Finally, the shadow Secretary of State asked about whether people will see and feel these improvements. We know on the Government Benches that we will be judged by results and by whether people can feel the change that we are delivering. All I would say to people watching our proceedings today is this: in our first year, we promised 2 million more appointments to cut waiting lists—we doubled that; we promised to deliver 1,000 more GPs—we have almost doubled that; and we promised that people would see the NHS moving in the right direction—waiting lists are at the lowest point for two years. We know that there is more to do, but I hope that the progress people have seen under this Labour Government reassures them that, when it comes to our national health service, if anything, we under-promise and over-deliver. We know that people will see and feel the change. I say respectfully, given the shadow Secretary of State’s constructive tone, that that will be the difference between a Labour Government and a Conservative one.

[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.

[Mr Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

I thank the Secretary of State for early sight of the plan this morning. After years of Conservative failure, a plan for the future of the NHS is welcome and Liberal Democrats support the Secretary of State in his vision to shift the NHS to a community-focused, preventive service. However, I seek his reassurance on some questions.

In the 143 pages of the 10-year plan, there is only a passing reference to social care. Everyone knows that we cannot fix the NHS without fixing social care. With so many people unable to return home from hospital to get the care they need, solving the crisis in social care is a huge part of moving care out of hospital and into the community. Will the Secretary of State bring forward the Casey review, so that it reports in full this year, and reinstate the cross-party talks, so that consensus can be reached on the future of care?

I welcome the idea of a neighbourhood health centre, but how does that interact with the plan for GPs? The 10-year plan implies that GP contracts will encourage them to cover a huge geographic area of 50,000 people. In North Shropshire, that would be two or three market towns combined and would span dozens of miles. Can the Secretary of State reassure me that there will still be a physical health centre, accessible to all, and that in areas with little public transport in particular, people will be able to access care when they need it?

Finally, the plan hinges on the shift to digital solutions, and that is not without risk. The use of the NHS app is critical to what happens. How will the Secretary of State ensure that those without a smartphone—because they cannot afford one, do not feel confident using one or simply do not have adequate broadband or internet—can access the NHS? Many elderly and disabled people in particular who are digitally excluded will feel worried by today’s announcement.

[Several hon. Members rose—]

[Mr Deputy Speaker (Sir Roger Gale)]

Order. Some 60 Members wish to participate. Clearly, the statement will likely impact every constituency in the country, so I understand why so many hon. Members wish to question the Secretary of State. It is our intention to try to call everybody, but there is important business later that has to be reached. May I urge brevity on all Members, and short answers on the Secretary of State? Health Committee member Jen Craft will now set an example.

[Jen Craft (Thurrock) (Lab)]

Thank you, Mr Deputy Speaker. The heart, soul and lifeblood of our NHS are the people who work in it. I doubt there is anyone in this House who does not owe a personal debt of gratitude to a health care worker. Can the Secretary of State reassure me that the fingerprints of NHS workers are all over this 10-year plan, and that it has been designed and produced with all their valuable inputs?

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[Wes Streeting]

I strongly agree with my predecessor on that. It is important that the CQC’s reports and judgments can be understood by the public and the people responsible for carrying out the improvements that it recommends. Via the NHS app, we will have much more transparency for patients about the range of providers, the quality of services and the views of other patients. That will give patients the freedom to choose, in a more data-driven way, where and when they are treated. There is also the importance of data-driven face-to-face inspections by experts. We can also have early warning systems that would alert people who hold his office and mine that something is going seriously wrong, so that we can intervene before more lives are lost unnecessarily.

[Mr Deputy Speaker]

I call Select Committee member Josh Fenton-Glynn.

[Josh Fenton-Glynn (Calder Valley) (Lab)]

The shifts announced today, from analogue to digital, and from hospital to community, are exactly the shifts that will make the NHS stable for the future. Will the Secretary of State elaborate on the “analogue to digital” point? A practice manager in Calder Valley recently said to me, “It’s all very well looking at artificial intelligence, but it takes us half an hour to turn on a computer.” What more will he do to ensure that we improve the NHS digital offer for everyone working in the health service?

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[Wes Streeting]

First, I thank the hon. Member for the Green party’s support for so much of the 10-year plan. She is right to highlight the importance of social care to resolving the NHS crisis. Let me reassure her that we are acting urgently as we await the first report of the Casey commission. The Chancellor did that with the Budget and the spending review, providing £4 billion more of investment. We have done that with the biggest increase in carer’s allowance since the 1970s, and with the disabled facilities grant, which does not just mean more ramps and home adaptations but more freedom, more dignity and more independence for disabled people. The Deputy Prime Minister and I will shortly set out how we will deliver fair pay agreements, and social care will absolutely be part of the neighbourhood health team. I hope that that reassures the hon. Member.

Let me also reassure parties across the House that we will wait for the Casey commission to launch. I would like to be able to proceed with the actions we will be taking in this Parliament and, crucially, with the long-term plan for social care in a cross-party way, to build that genuine national consensus—I would be delighted to achieve that.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the Chair of the Housing, Communities and Local Government Committee.

[Florence Eshalomi (Vauxhall and Camberwell Green) (Lab/Co-op)]

I thank the Secretary of State for this really ambitious and bold plan to make sure our NHS is fit for the future. He will be aware that Professor Ian Abbs, the chief executive of St Thomas’ hospital in my constituency, will step down later this year. I want to thank him for his dedication and compassion in leading St Thomas’, especially during the covid crisis, when the hospital cared for so many patients, including the then Prime Minister in his crucial hour.

The Secretary of State may be aware that Royal College of Nursing analysis shows that by 2029, 11,000 nurses may have left the profession after working less than 10 years in the service. Nurses cite exhaustion, mental health and stress as their reasons for leaving the profession. Can he give us an update on how we will ensure we have a workforce that is fit, so that we can achieve our ambitious 10-year plan for the NHS?

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[Mr Deputy Speaker (Sir Roger Gale)]

I call Warinder Juss—not here.

[Anna Dixon (Shipley) (Lab)]

I congratulate my right hon. Friend, his team and the amazing NHS staff on over-delivering on Labour’s promises, and for this amazing, ambitious 10-year plan that will ensure the NHS is fit for the future. I particularly welcome the “My Carer” feature on the NHS app that will allow family and unpaid carers to communicate with the care team for a loved one. Will my right hon. Friend explain how this plan will deliver benefits for disabled people and their carers?

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[Mr Deputy Speaker (Sir Roger Gale)]

Order. Some 20 Members are still seeking to ask questions, and we have an important debate to follow. The questions are getting longer, and so, I fear, Minister, are the answers. Can I urge brevity again, please?

[Jas Athwal (Ilford South) (Lab)]

I also thank my right hon. Friend the Secretary of State for a bold and ambitious plan. Over the past few months, I have had the privilege of connecting with some really inspiring people across my constituency, such as Jagdeep Aujla. His Dopamine Warriors boxing club, which the Secretary of State visited some weeks ago, sets a powerful example. Jagdeep’s boxing club offers a safe, empowering space for people living with Parkinson’s to connect with each other, maintain their fitness, and slow the progression of the condition. Will my right hon. Friend outline how the Government’s 10-year health plan will support the shift from hospital to community, so that more support is available on people’s doorsteps, particularly organisations such as the Dopamine Warriors?

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[Wes Streeting]

My hon. Friend is right that we need to not just treat sickness, but prevent illness. That was a strong message that we got from the public. He will see lots of good stuff on prevention in the plan, and I know that he will welcome it. On the location of the UK Health Security Agency, he may have inadvertently misled the House: he said he did not want to lobby me too much, but that is absolutely not true; he will not leave me alone on this issue. He lobbies me every single day. I can assure him we will make a decision on that issue shortly.

[Mr Deputy Speaker (Sir Roger Gale)]

I am sure that the hon. Member for Harlow will wish to correct the record.

[Matt Turmaine (Watford) (Lab)]

I welcome the 10-year plan, and I thank the Secretary of State for giving my constituents in Watford the opportunity to feed into it through the consultation. Does he agree that the Tories accepted decline in the NHS as inevitable, but it takes a Labour Government to get the NHS back on its feet?

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[Wes Streeting]

I knew exactly where that question was going, because my hon. Friend has been such a strong champion of his constituency since he arrived in this place. I am committed to rolling out neighbourhood health across the country, and to making sure that we particularly benefit the communities with the greatest need that are the most poorly served. This is in no small part possible thanks to the leadership of the Chancellor of the Exchequer and the wise decisions that she has taken. Not only have we delivered investment in the NHS, but interest rates have fallen four times, wages are finally rising at a higher rate than the cost of living, and we have the fastest-growing economy in the G7. That is the leadership that we need from the Chancellor, and it is here to stay.

[Mr Deputy Speaker (Sir Roger Gale)]

Finally, and with thanks for his patience, I call Richard Baker.

[Richard Baker (Glenrothes and Mid Fife) (Lab)]

Thank you very much, Mr Deputy Speaker—persistence pays off.

Will my right hon. Friend assure me that he will report regularly to this House on progress against this excellent plan? I hope that will help us to evidence the case for investment in community health facilities in Scotland, which have long been promised but not been delivered by the SNP, including the much-needed new health centre in Lochgelly in my constituency.

[Wes Streeting]

I can absolutely give my hon. Friend that assurance. I just feel so sorry for him, because he comes here to stand up for his constituents, knowing full well that while they have a Labour Government who are delivering the biggest increase in investment to the devolved Administrations since devolution began, the SNP, which has been in government for almost two decades, is squandering the money and the opportunity. People will not get change in his constituency, or across the rest of Scotland, if they face more of the same from the SNP. Scotland needs an alternative, and Scotland’s NHS needs an alternative. That alternative is Scottish Labour and the leadership of Anas Sarwar and Jackie Baillie, and it cannot come soon enough.

[Mr Deputy Speaker (Sir Roger Gale)]

May I thank the Secretary of State for answering in excess of 65 questions, and the shadow Secretary of State for being in attendance throughout the entire proceedings?