Cancer Strategy for England

Roger Gale Excerpts

Thursday 31st October 2024 Westminster Hall

[Sir Roger Gale (Herne Bay and Sandwich) (Con)]

I do not want to go down the road of party politics. The previous Government poured shedloads of money into the national health service, but throwing money at the problem is not the answer. I am not saying that there is not any demand for more capital expenditure—there is—but that is not the point. Unless we get the structure right, we will go on wasting more and more money. We need to be grown up about this; we must all understand that.

In the few minutes I have, I want to concentrate on an issue that the hon. Member for Wokingham (Clive Jones) touched on, but only briefly: the incidence of cancer in young people. It is many years since my eldest son used his wedding—and probably his bride too—to raise money for the Teenage Cancer Trust. In the time between then and now, sadly not a very great deal has changed. That is lamentable. The point was made that, every day, seven young people between their teenage years and their mid-20s are diagnosed with cancer. By the end of this decade, that figure is likely to have risen to 10 per day.

Most of us in the Chamber probably have family members who have had experience of cancer—or even have personal experience, as the hon. Member for Wokingham clearly has. We all know somebody who has had cancer, and sadly some of us know, only too well, people who have died of cancer. But the instances of cancer among young people are widely disregarded and neglected within the health service and beyond. It is not infrequent for a young person, subsequently diagnosed, to have to make at least three visits to a general practitioner before even being referred, because it is assumed, completely wrongly, that cancer is something that affects old people—people like me. I am expected to get cancer, but young people do not get it, do they? Well, sadly, yes they do, at a rate of seven a day, rising to 10 a day by the end of the decade.

My plea is for the Minister to take away this message: however much money is being pumped into the health service and being made available for investment in diagnostic kit, there is a real need to address one area of the population that has been neglected. That area is teenage cancer victims. It is the largest single killer of young people in this country—bar none—yet young people are overlooked when it comes to clinical trials that could be lifesaving. There is a real reason why young people as a proportion of the population should be included in clinical trials, but they are not—they are overlooked. Why? Because there is the assumption that it is not a disease that affects young people. But it does.

I make my plea on behalf of those in my family who support the Teenage Cancer Trust, and those in the Teenage Cancer Trust who have taken the trouble to brief Members of Parliament. I ram home this message to the Minister and ask him to take it away to the Secretary of State: when we set up, as I am sure we will, a national cancer strategy, the Government must make certain that the 13-to-25 age group is given the recognition it deserves, so that they get the diagnoses in time, before they die, and the treatment they need, and so they are included in clinical trials.

[Mr Clive Betts (in the Chair)]

I call Noah Law.

NHS Winter Update

Roger Gale Excerpts

Monday 8th January 2024 Commons Chamber

[The Secretary of State for Health and Social Care (Victoria Atkins)]

With permission, Mr Deputy Speaker, I would like to make a statement on the winter pressures facing the national health service and social care, as well as the impact of the ongoing junior doctors’ strikes. The NHS employs 1.3 million people and the social care system a further 1.5 million people. Together, they treat and care for tens of millions of people every day. We all know that winter is the most challenging time of the year for the NHS and social care, as our workforce have to tackle the pressures created by cold weather and seasonal viruses.

To put our health and social care system in a strong position heading into winter, this year we started preparing earlier than ever before. In January last year, we published our recovery plan for urgent and emergency care and provided £1 billion of dedicated funding to boost emergency capacity. The plan committed to delivering 5,000 new permanent staffed beds. I am pleased to update the House that more than 3,000 were already in place in December, and in the coming weeks NHS England will meet the 5,000 pledge and make sure that it has almost 100,000 core beds ready when covid and flu peak.

Our recovery plan also pledged 10,000 virtual ward beds so that more patients can be monitored safely at home, away from hospital. I am pleased to update the House that we have delivered more than 11,000 virtual ward beds, and they have been a vital service for eligible patients over the festive period.

We have boosted our ambulance service with £200 million of additional funding, putting new vehicles on the road, improving response times and getting crews out and about for more hours. In recognition of the importance of patients being discharged promptly from hospital when it is safe to do so, we have made sure that every acute hospital in England has access to a care transfer hub, bringing together teams from the NHS and social care to speed up discharge, backed by an extra £600 million for social care. To help prevent the spread of winter viruses, we brought forward flu and covid vaccinations, protecting the most vulnerable and making them less likely to require hospital treatment.

But no matter how thorough our preparations are, winter will always be the most challenging time of the year for our NHS. That is why it is extremely regrettable that the British Medical Association’s junior doctors committee has chosen to strike not once, but twice at this time of year. It has also chosen to strike for an unprecedented length of time, putting profound pressure on hospitals and GP surgeries throughout the country.

Before Christmas, the BMA’s strike caused the cancellation of almost 90,000 appointments, some of which will have to be rescheduled for a second or even third time. That is in addition to the 1.1 million appointments that have already been affected since strikes began in December 2022. This is not just another statistic; there is a person behind every one of these appointments, who may be in pain or distress and who now must wait longer for the care they deserve.

Last week, a member of the BMA leadership said

“strike action benefits absolutely nobody.”

They were absolutely right on that. The ongoing strikes are causing more appointments to be cancelled and more worry for patients, and are putting a significant strain on staff.

During December’s and this week’s strikes, the NHS’s priority has been to protect patient safety. Resources have been channelled into urgent and emergency care, including vital neonatal and maternity services. Huge efforts were made to make the most of the working days between Christmas and new year, because throughout any strike action, it is crucial that every patient who needs urgent medical care comes forward as normal. We continue to face challenges, and strikes have stretched emergency care, but thanks to the meticulous hard work in local trusts in preparing for strikes, as well as to the huge personal sacrifices that clinicians and staff are making to pick up the slack, emergency care has largely held up and the system has coped under the circumstances.

Staff across the NHS deserve our sincerest thanks for the heroic efforts they have made throughout the unprecedented strikes. I thank the doctors, nurses, paramedics and all frontline staff who have come into work to support each other, deliver care and protect patients; the consultants, including Members of this House, who are working extra hours, cancelling their holidays or even coming out of retirement to safeguard patient safety; the managers, administrators and NHS leaders who are working day and night to make sure that the right staff are in the right place to protect patient safety; and all those working in social care, from local authority staff to care workers and carers, who have rallied round to support hospitals.

I know that work does not stop when the strikes stop. NHS staff will begin turning their attention to recovering from the impact of the industrial action, restarting elective treatment and improving the flow of patients through emergency departments. The junior doctors committee’s choice to strike at this time of year means that that work must now be done under additional pressures, as staff move to catch up from industrial action as well as tackling the impacts of cold weather, covid, flu and norovirus.

I want to find fair and reasonable solutions to industrial action. One of my first acts as Health and Social Care Secretary was to bring in the British Medical Association for talks to end these long-running disputes, as well as meeting representatives for Agenda for Change unions who speak for frontline staff, including nurses. We have reached agreements with unions that represent consultants and specialty doctors on offers to be put to their members. Those offers will modernise contracts, realign pay scales and improve doctors’ career progression, while delivering value for the taxpayer and protecting the hard-won progress we have made to halve inflation. Consultants and specialty doctors are pausing strike action while members vote on the offers, with the results of both ballots expected shortly. The Government and BMA agree that they are the best deals available to us, and I very much hope that members will vote in favour so that those positive changes can be made and we can move the NHS forward.

On junior doctor negotiations, the talks that began in November had been progressing with the BMA junior doctors committee. The talks were constructive, exploring a range of proposals that would improve the working lives of doctors across the NHS. I was therefore extremely disappointed when the BMA turned its back on the negotiations before they had concluded to call the damaging strikes that we face today. The Government will not negotiate with the BMA while strike action is under way and patient safety is at risk. Every strike is hugely disruptive for our NHS. The NHS and patient safety cannot be switched on and off on a whim. I do not believe it right to negotiate with unions while they are being unreasonable and some of their members are walking out of hospitals at the busiest and most challenging time of year for patients.

I remind the House that the junior doctors committee’s headline demand of a 35% pay rise is simply unaffordable for taxpayers. Last summer, we accepted the recommendations of the independent pay review body in full. That meant that junior doctors received average pay rises of almost 9% in their September pay packets—some of the most generous increases across the entire public sector. Meeting the 35% demand would stoke inflation just as we as a country have halved it, burning a hole in the pockets of families up and down the country, and it would be totally out of step with the pay rises awarded to other dedicated public servants and employees throughout the private sector. Staff across the public sector have agreed fair and reasonable deals on pay; only the junior doctors committee has repeatedly walked away from talks.

Let me address the issue of NHS leaders asking some junior doctors to return to work when patient safety is at risk, in what are known as patient safety mitigations or derogations. As of 9.30 this morning, 40 patient safety mitigations have been submitted during the current round of strikes, and two have been accepted by the BMA. NHS leaders, many of whom are themselves members of the BMA, have decades of combined experience. They know their patients and they know their rotas, and they would ask for mitigations only if they were absolutely necessary—in, for example, a children’s emergency department. They are wholly independent of Government: it is for them to make those decisions. I trust them and I trust their judgment. That is the reality, and that is the truth about patient safety mitigations.

One of the reasons why I came into politics was the NHS and what it had done for me and my family. That is also one of the reasons why I am a Conservative. This is a Government who have delivered record NHS funding, the first ever NHS long-term workforce plan, and 50,000 more nurses for our NHS. We are providing the NHS with the doctors it needs for the future by doubling the number of medical school places, opening five new medical schools and pioneering one of the world’s first medical apprenticeships. We have also supported doctors by making changes to pensions for those at the very top of their career path—at that point, that was the BMA’s No. 1 ask, and a policy that the Opposition seemed to oppose.

Those are not the actions of a Government who are turning their back on the NHS, as some have declared. They are the actions of a Government who are building a health and social care system that is sustainable for the long term. To do that, we must put the strikes behind us and move forward together, because the NHS belongs not just to the junior doctors committee: it belongs to us all. It belongs to the millions of people who rely on its being there when they need care, as well as the millions of taxpayers who pay for it. For their benefit, it is time for the members of the junior doctors committee to show that they are serious about doing a deal. They have legitimate concerns about their working lives, and a fair and reasonable deal can be reached, but calling damaging strikes is not the way in which to achieve that. Earlier this week I said that if they called off their damaging strike action, I would get round the table with them in 20 minutes. I am, of course, extremely disappointed that they refused my offer, and continue to refuse it—the strikes are ongoing as we speak—but if they come to the negotiating table with reasonable expectations, I will sit down with them.

This Government have a clear, long-term plan for the NHS. Our recovery plans in elective, emergency and primary care can improve access to treatment, transform services, and give patients more choice in and control over their care. Our long-term workforce plan will give the NHS the staff it needs to thrive for decades to come, our social care reforms will build a better care workforce to support our growing number of older people, and by creating the first smoke-free generation we will reduce long-term pressure on our health service. We have eliminated the longest waits, but we have not yet made a significant enough reduction in waiting lists. To do that, we need the junior doctors committee to come to the table and do a deal that is in the interests of patients, in the interests of our NHS, and in the national interest. Then we can build an NHS that is not only stronger today, but stronger for our children and grandchildren.

I commend this statement to the House.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the shadow Secretary of State.

--- Later in debate ---

[Richard Graham (Gloucester) (Con)]

rose—

[Mr Deputy Speaker]

Order. The hon. Gentleman has been here long enough to know that people do not give way during a statement.

[Wes Streeting]

Patients are sick and tired of waiting—waiting for ambulances, waiting for a GP appointment, waiting for their operation and waiting for a general election that cannot come soon enough. Why do the Conservatives not get out of the way and let Labour fix the mess they have made?

[Victoria Atkins]

I welcome the hon. Gentleman back from his world tour promoting his book. It is very nice to meet him for the first time across the Dispatch Box. While he was away in sunnier climes, he may have missed what is actually happening in Wales, which interestingly has been described by the Leader of the Opposition as the “blueprint” for how Labour will run the NHS, were it ever to come into government. Interestingly, in the Labour-run Welsh NHS, people are almost twice as likely to be waiting for treatment, and they are waiting an average of five weeks longer for NHS treatment under Labour in Wales than they do in England. Indeed, the number of patients in Wales seeking treatment in England has increased by 40% in two years because of the experiences that people are having in Wales.

I will just correct the hon. Gentleman on a couple of other things, too. Just to help him understand, we are delivering the 800 new ambulances—those are new ambulances—at pace at the request of the NHS, just as we are putting in 5,000 extra beds in hospitals across England, because we understand the point about capacity and we want to help the NHS look after people in a timely and efficient manner.

I will also just correct him again on the doctors in training point. I am surprised he has come on to that at this point, but had he spoken to his friends in the BMA, he would have understood that that is the phrase that the BMA is using. It has passed a motion to stop using the phrase “junior doctors”. [Interruption.] Yes, the BMA passed a motion. The hon. Gentleman referred to doctors, but he perhaps does not understand the complexities of contractual negotiations. The phrasing is used to denote those professionals who are still on formal training pathways who are not specialty doctors or consultants. That terminology has been agreed with the BMA.

In terms of the strikes themselves, I note—I know that those sat behind me on the Government Benches noted it, too—that the hon. Gentleman did not condemn the strikes. I am happy to give way, if he would like to confirm whether he condemns the strikes. Unfortunately, he has missed his chance to do so, but I suspect that everybody, including the patients at home waiting for appointments, will see the Labour shadow Minister’s failure to condemn these strikes. That is because, in line with public sector strikes more generally, the Labour movement will always prioritise union harmony over patient safety. That is not what we as Conservatives do; we will always put patient safety first.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the Chair of the Health and Social Care Committee.

[Steve Brine (Winchester) (Con)]

Happy new year. The Secretary of State will know that it is far from all doctors in training who have taken part in this strike. In my trust, Hampshire Hospitals, it was just over 60%, and the average across the south-east was little more than 50%. Many doctors were hard at work this past week caring for their patients. Does my right hon. Friend share the concern of many in the health service that the longer this dispute drags on, the more we lose the good will of the consultants who have been filling in and the more we do serious damage to the career pipeline that sees today’s doctors in training become tomorrow’s consultants?

[Victoria Atkins]

I thank my hon. Friend for asking that question and for noting the enormous efforts that clinicians across the NHS have gone to in order to cover these strikes. We are conscious of the personal impacts that has had for many, and clinicians have had a very tough few Christmases. We were all collectively hoping that this Christmas would be just a little bit easier for them, but sadly these strikes have a real impact on people who are working to pick up the slack from junior doctors not turning up. I am grateful to everyone who has gone into work, who has worked extra shifts and who has cancelled time off with their families. We must find a fair and reasonable solution to this industrial action, which is precisely why I was so very disappointed that the BMA junior doctors committee chose to walk away from these discussions.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the Scottish National party spokesperson.

[Amy Callaghan (East Dunbartonshire) (SNP)]

A very happy new year to you, Mr Deputy Speaker. Our NHS faces an unprecedented winter of pressure, with inflationary costs, increasing viral infections and staff shortages. While the SNP Scottish Government have acted with £300 million to cut waiting lists and negotiated with NHS staff, preventing even a day of strike action, NHS England is undergoing a junior doctors strike—the longest in the history of any NHS in the UK. No one wants strike action, but it works, which is exactly why the Tories want to ban it. In fact, this Tory Government appear to be working to make this winter harder by cutting NHS capital funding, undercutting attempts to recruit new staff and not getting round the table with trade unions, instead blaming the BMA and junior doctors. Is the decision to underpay NHS staff and stoke strikes the policy of this Health Secretary, or is she being forced down that path by a Chancellor who is continuing his decade-long war on junior doctors?

[Victoria Atkins]

I imagine that the hon. Lady has seen that we accepted in full the pay review body’s recommendations last year and, as of September, junior doctors and doctors in training have received on average an 8.8% increase on their basic salaries—they also earn money on top for antisocial hours, working overtime and so on. In addition, they have pension contributions of some 20%, which is a rare employment benefit across both the public and private sectors. In the future, I want to find a fair and reasonable settlement with the junior doctors, as we have been able to reach with consultants and specialty doctors, but we cannot do that if junior doctors are on strike. That is why it is so very disappointing that they walked away from the discussions.

[Mr Deputy Speaker]

I am sure that we all wish to welcome Sir David Evennett back to the House in rude health.

[Sir David Evennett (Bexleyheath and Crayford) (Con)]

Thank you, Mr Deputy Speaker. I welcome my right hon. Friend’s factual statement on the state of the NHS in her winter update. Will she confirm that she would return to the negotiating table immediately were the BMA to call off these very damaging strikes?

Building an NHS Fit for the Future

Roger Gale Excerpts

Monday 13th November 2023 Commons Chamber

[Mike Amesbury]

I certainly do not. It is a critical building safety issue, and funding should be given according to need, so that is a very well-made point.

The latest Tory gimmick—a dangerous one at that—is to introduce the so-called minimum service levels Bill. It is an attack on the fundamental right to strike, which of course is done as a last resort. It is a piece of legislation that will sack nurses and doctors, while at the moment the NHS has vacancies for 112,000 health workers. The Government have failed to meet minimum standards for patients on non-strike days for the past 13 years. The only people who the majority of my constituents—and, I am quite confident, the country—want to sack are sat on the Government Benches. They want to sack each and every one of those Tory Ministers. We do not just need the reshuffling of the deckchairs we have seen today, or the recycling of former Prime Ministers; we need the Government to go to the electorate, grow a spine, and let the people have their say. Let us rebuild our NHS and rebuild Britain with a Labour Government.

[Mr Deputy Speaker (Sir Roger Gale)]

After Steven Bonnar, I will impose a formal seven-minute time limit on speeches.

--- Later in debate ---

[Mary Glindon (North Tyneside) (Lab)]

It is a pleasure to follow my hon. Friend the Member for City of Durham (Mary Kelly Foy); I will definitely follow on her theme. Colleagues may know that I am a strong advocate for vaping as a way for adults to quit smoking. As one of the vice-chairs of the APPG for vaping, the tobacco and vapes Bill announced in the King’s Speech is of great interest to me. I have seen so many of my friends and relations in North Tyneside make the switch from being heavy smokers to using—I stress this point—safe vaping products. I again stress the message that comes from the Department: “If you smoke, change to vaping. If you don’t smoke, don’t vape.”

Someone dies from a smoking-related death every eight minutes, as my hon. Friend just said. While not risk free, vaping is 95% safer than smoking, but there are still more than 6.5 million adult smokers in the country who have not been able to quit smoking or change to vaping. Vaping is the most effective tool that the UK has to achieve the goal of a smokefree 2030, and it is crucial that the Government continue to promote these products to existing smokers so that they can transition to a less harmful alternative.

In 2022, King’s College London restated that vapes are 95% safer than smoking, and switching to vaping was a critical recommendation of last year’s Khan report, “Making smoking obsolete”. It is unequivocal that under-18s should not use or have any access to vaping products, but despite the Government’s announcement to tackle youth vaping, it remains a major concern, and far more needs to be done to address the issue. Had the Government accepted the amendment proposed to the Health and Social Care Act 2022 by my hon. Friend the Member for City of Durham in 2021, there would have been strict regulations to stop vapes appealing to children and we would not have seen the trebling in the number of children vaping in the past two years. Measures are specifically needed to target rogue manufacturers and retailers. Ultimately, Trading Standards needs to have the resources and powers to enforce the law.

Since entering the UK in 2021, disposable vapes dominate the vaping market, with 70% of disposable vape sales generated by new vape users, but we are now seeing a whole new raft of consumers—schoolchildren attracted by low pricing, bright colours, sweet flavours and packaging replicating the branding of well-known confectionery, soft drinks and much more.

According to the latest figures highlighted by the Chartered Trading Standards Institute, more than 138 million disposable vapes are sold every year, and with one in three products being potentially non-compliant, that is more than 45 million non-compliant products being sold here every year. Figures also revealed that 1.4 tonnes of illegal vapes were seized in the last six months of 2022 in the north-east of England alone, with Trading Standards officers across the country working tirelessly to try to combat the tidal wave of non-compliant vapes.

In 2022, JTI UK commissioned tests on a variety of popular disposable vapes in the UK. The results discovered that 25 out of 28 products were not legally compliant, as they all exceeded the e-liquid volume and nicotine strength limits mandated by law. The Government must ensure that regulations are effective in targeting rogue vape producers and retailers, not the manufacturers who are making and selling them responsibly.

While the sale of vapes to children is the major concern, it is vital that the Government do not introduce restrictions that result in fewer smokers turning to vaping products. According to Action on Smoking and Health, 40% of smokers incorrectly believe that vaping is as or more harmful than smoking. It is critical that all e-cigarettes and e-liquids, including product, packaging and marketing communications, do not appeal to minors by prohibiting imagery, flavour names and descriptors, and environment or objects that are typical of the world of children and youth, such as comic or cartoon characters, toys or sweets.

It is also important that the Government ensure vapes appeal to adult smokers, maintaining a low price point and flavours that are specifically aimed at adults. Part of the reason that vaping has been so successful in helping smokers to quit is that it is significantly cheaper than cigarettes. Should a tax be imposed on these products, they will move out of the price range of lower-income households and become relatively less attractive to smokers. That must not be overlooked as the areas with the highest smoking rates are often some of the UK’s poorest.

The UK Vaping Industry Association does not believe that an increase in price will stop youth vaping. It is already predicted that as many illegal vapes are sold as legal ones, and if the price of legal products is increased, more and more children will revert to buying illicit products. Flavours also play an important role in helping smokers to quit. According to a survey published by OnePoll, 80% of vapers seeking to quit smoking considered the availability of flavours. Additionally, 74% of respondents noted that flavoured vapes had been helpful in their efforts to quit smoking.

A balance has to be struck. Banning disposable vapes is not and should never be the answer. Disposable vapes are pivotal in providing an accessible way for smokers to try vaping before investing in vapes.

To conclude, I hope the Government’s response to the consultation is successful and that the next Labour Government and the NHS, under the reins of the shadow Secretary of State for Health and Social Care, my hon. Friend the Member for Leicester West (Liz Kendall), will go in the right direction and implement all the necessary regulations.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the shadow Secretary of State for Work and Pensions.

Osteoporosis

Roger Gale Excerpts

Thursday 26th October 2023 Commons Chamber

[Anna Firth (Southend West) (Con)]

The hon. Lady is making a critical speech on osteoporosis treatment and support, and on absolutely the right day as well, when her campaign goes national. Is she aware that one in three people over the age of 50 who break a hip die of that injury or related complications within a year? That is a terrifying statistic. A large proportion of those fractures are osteoporotic, so does she agree that prevention and screening are key? There is groundbreaking work going on in Southend. The fracture clinic at Southend Hospital, which I had the pleasure of visiting a couple of weeks ago, is to launch a new fracture liaison service next spring, with the support of Mid and South Essex Integrated Care Board. It will be the first FLS screening service in the UK to offer consistent screening support across a whole region.

[Mr Deputy Speaker (Sir Roger Gale)]

Order. If the hon. Lady wishes to make a speech, I think there may be time, but she is making an intervention.

[Judith Cummins]

The hon. Lady raises some important points. I agree that screening and prevention are key to tackling osteoporosis, and I congratulate her and Southend on getting their FLS up and running. It will make a real difference to the lives of people in Southend.

Fibrodysplasia Ossificans Progressiva

Roger Gale Excerpts

Thursday 7th September 2023 Commons Chamber

[Mr Deputy Speaker (Sir Roger Gale)]

We now come to the debate on funding for the prevention of fibrodysplasia ossificans progressiva, or FOP for short. I call Sir Mike Penning to move the motion.

--- Later in debate ---

[Ronnie Cowan (Inverclyde) (SNP)]

I congratulate the right hon. Member for Hemel Hempstead (Sir Mike Penning) on securing the debate. I apologise if I stumble between illnesses, diseases and genomics; this is not my specialist subject.

Rare illnesses are collectively widespread. There are thousands of different rare diseases and illnesses, and each one can require highly specialised treatment. That means that people living with them can face the prospect of a long “diagnostic odyssey” before they are accurately diagnosed and able to access treatment. The various aspects of their treatment and care also often lack co-ordination. It is vital that we continue to strive for improvement and ensure that all those living with a rare disease get the right diagnosis faster, and can access co-ordinated care and specialist treatment.

The “UK Rare Diseases Framework” was co-produced by the UK Government and the devolved nations. It sets out the key priorities for the next five years for improving the lives of people living with rare diseases. Each nation committed to producing their own action plan based on how those key priorities will be implemented. The Scottish Government understand the importance of the framework and are committed to implementing the 51 commitments outlined within it. They also welcome the progress that has been made in Scotland in delivering genomic medicine and empowering patients through the UK’s rare diseases forum.

In December 2022, the Scottish Government published their “Rare Disease Action Plan”, which was developed through significant engagement with the rare disease community. Through their combined efforts, the Scottish Government will ensure that they are putting those living with a rare disease at the heart of policymaking, ensuring this meets the needs of the rare disease community in Scotland while reaping the benefits of a four-nation approach. The Scottish Government’s action plan sets out four key themes to implement the UK rare disease framework: ensuring patients get the right diagnosis faster; increasing awareness of rare diseases among healthcare professionals; better co-ordination of care; and improving access to specialist care, treatment and drugs. The Scottish Government remain fully committed to ensuring that there is continual improvement in supplying patient-centric care that is safe and effective for those living with a rare disease.

The genomic medicine landscape is developing rapidly. In the last five years we have seen the implementation of impactful genetic testing for a variety of conditions, which has helped to inform patient treatment, allowing patients to receive the right treatment at the right time. Pathogen genomics is also helping to deliver “precision public health” by guiding investigations of infection outbreaks, antimicrobial stewardship, better-targeted disease control, and infection surveillance.

The Scottish Government published “Genomics in Scotland: Building our Future” in March this year. The Scottish Government’s strategic intent is to deliver an equitable, person-centred, population-based genomics service and infrastructure for Scotland. This publication is the first in a series, setting out the Scottish Government’s strategic vision for Scotland’s genomics future. They will publish a series of documents in the future, explaining how they will deliver genetic services that will allow Scotland not only to treat disease but to prevent ill health before the prevalence of symptoms. Scottish physicians and scientists have been actively participating in the advancement of genomic medicine over the past three decades. Scotland has a great foundation to build on within the NHS laboratory network, but it is important that these laboratories are fit for the future, as we know that genomic medicine is on a steep trajectory.

Achieving the Scottish Government’s ambition of having a genomics ecosystem with the infrastructure to support it will require investment in rapidly evolving technologies, skills and facilities. The Scottish Government will be innovative and adaptive to change, working collaboratively through the triple helix approach with academia, industry and the public sector to harness the opportunities at their disposal and deliver an integrated approach to genomics across Scotland. Their genomics strategy aligns with their rare disease action plan, and they will engage with the Rare Disease Implementation Board, as well as key rare disease organisations such as Genetic Alliance UK, to ensure that the strategy is informed by those who will benefit most.

While I see the intent and acknowledge the money being spent, it is clear that far more money is required to fund the research that is needed. The UK Government have overspent tens of billions of pounds on the Ministry of Defence, Crossrail and HS2—and, ironically, PPE during a health crisis—which shows that the money is there, but it must be spent wisely. In Scotland, following the 2022-23 emergency budget review, genomics was allocated a revised budget of £5 million. Through the funding allocated so far in 2022-23, the Scottish Government have established the Scottish Strategic Network for Genomic Medicine and funded a genomics transformation team within the NHS National Services Division, led by a consultant clinical scientist and supported by clinical leads for rare disease and cancer.

Genomic medicine is an integral part of precision medicine and precision health. It can lead to earlier and more precise diagnoses, as well as more targeted prevention and management of diseases. Over the next five years, the genomics landscape in Scotland will be transformed as we work to ensure that patients have equitable access to timely, personalised and high-quality genomic medicine for a range of conditions, including FOP.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the shadow Minister.

Reforms to NHS Dentistry

Roger Gale Excerpts

Thursday 27th April 2023 Commons Chamber

[Judith Cummins]

I absolutely agree with the hon. Member’s important remarks. Collection of data is paramount for solving the issue.

The dodging of responsibility for more than 12 years is nothing short of a disgrace. Now, we all bear witness to the human consequences of this crisis. The victims of Government negligence are—as they almost always have been—the most vulnerable people in our society. In Bradford, 98% of dentists are now closed to NHS patients. As I informed the Prime Minister just last month, 80% of practices are now refusing to accept children as new NHS patients.

The lack of access is having crushing consequences. In the financial year of 2021-22, 42,000 NHS hospital tooth extractions were carried out for 0 to 19-year-olds—an 83% rise on the previous financial year. A dental nurse has recently spoken of routinely extracting up to 10 teeth from a single child, so children are routinely losing half their teeth. This dental crisis is now ultimately a crisis of inequality. The rate of tooth extraction is more than three times higher in Yorkshire and the Humber than in the south-east of England. Children living in our country’s most deprived communities face an extraction rate three and a half times greater than those living in the most affluent areas.

In care homes for the elderly, the access crisis has been just as devastating. In 2019, 6% of care homes reported that they were unable to access NHS dental care services, but by 2022, that figure had risen more than four times to 25%—a quarter of all care homes.

As this Conservative Government continue to mull over minor reforms, they fail entire generations of people, who deserve a reasonable standard of care. No more are the cradle-to-grave principles of the NHS.

A 21st-century Britain requires a 21st-century approach. We need more than mere revision of the contract. My right hon. and learned Friend the Leader of the Opposition has spoken of the need for a new healthcare system that is just as much about prevention as about cure. It is a concrete fact that no dental treatment is stronger than protecting a healthy and original tooth, but in 2021-22 tooth decay was again the most common reason for hospital admission of children between six and 10 years old. For zero to 19-year-olds, hospital tooth extractions cost our NHS a shocking £81 million a year. In 2022, instead of children visiting the dentist on a regular basis, it cost our NHS an average of more than £700 for a single minor extraction of a child’s tooth in hospital.

We are paying for the cost of catch-up with our failure to prevent tooth decay, so prevention should be at the heart of our Government’s agenda for dental reform. We owe that to the generations of people currently being let down by the system. This country once had a strong school dental service. With the current shocking rates of tooth decay among children, now is the time to resurrect that policy as an interim prevention measure. It is not only the right thing to do but a sensible option for the country’s finances. Care homes would benefit from a dental contract that commissions stronger community dental services, as used to happen.

By using integrated care systems, upskilling care workers, and further involving local authorities, access can be increased and the pressure on dental services reduced. Prevention really is better than cure. We have a duty to ensure that taxpayers’ money is spent effectively in areas right across the country. A decade of savage cuts by the Tory Government has left long-term damage. An estimated £880 million a year is now required just to restore to 2010 levels of resources. There will be no escaping the need for more investment, but it must be thoughtful investment. One answer could be the introduction of a prevention-focused capitation-type system, where lump sums are provided to NHS dental teams to treat sections of the population.

Successful targeted investment is possible, and in 2017 I developed a project in Bradford with the former Health Minister, the hon. Member for Winchester (Steve Brine). I thank the hon. Member, who is now the Chair of the Health and Social Care Committee and who is present in the Chamber. He worked with me on the pilot scheme, which invested over £250,000 of unused clawback over three years into my constituency of Bradford South. That went straight back into local services and ensured that patients were able to access roughly 3,000 new NHS dental appointments in an area with high dental deprivation—targeting extra resources straight into an area where they were needed.

Although that was never meant to be a long-term solution, it proved that targeted investment is possible. Where there is a will, there is a way. With a staggering 10% of this year’s £3 billion national budget for NHS dentistry set to be returned, the system is clearly broken. Taxpayers’ money is returned not because people are not desperate for NHS dentists, but because the Government continue to push an underfunded and unworkable system. They lack the will to act and to find a way forward to protect dental health in this country. Now is the time to put “national” back into NHS dentistry.

The Government may once again list the challenges that stand in the way of re-establishing a truly universal dental care system. We are in a time of extraordinary change, with unprecedented cost of living crises, war on the European continent, and a society impacted by a deadly virus. Our health system is undoubtedly challenged, but 80 years ago the Conservative-Labour coalition Government published a guiding principle of NHS dental reform, just as this country fought for its very freedom and independence. In Sir William Beveridge’s own words:

“A revolutionary moment in the world’s history is a time for revolutions, not for patching.”

It is time for real change, not empty promises. This is the time for a Government dedicated to acting in the public good, to revitalise and resurrect NHS dentistry once again, ending the shoddy record of this Government’s patching of our NHS dental services.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the Chairman of the Select Committee.

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[Several hon. Members rose—]

[Mr Deputy Speaker (Sir Roger Gale)]

Order. I do not intend to put a time limit on the debate at this stage. Colleagues will have noticed that the Chairman of the Select Committee was commendably brief; if everyone emulates that, it should be possible for everybody to have their say without putting a time limit on. However, there is another debate that it is intended should follow this, and I hope that that will have a hearing as well.

Brain Tumour Research Funding

Roger Gale Excerpts

Thursday 9th March 2023 Commons Chamber

[Sir Iain Duncan Smith (Chingford and Woodford Green) (Con)]

On a point of order, Mr Deputy Speaker. I apologise to my hon. Friend the Member for St Ives (Derek Thomas) and to the House for intervening on this very important debate—like others, I am fascinated by what is being said—but may I ask whether the Government have notified the Speaker’s Office that they intend to make a statement about the semi-briefings being made to the media that they have decided to pause or stop whole elements of HS2? Surely that would be best done through a statement to the House, rather than through elements of the media. I would be grateful for your guidance as to whether a statement should be made, and whether the Speaker’s Office has received any notification that the Government are inclined to do so.

[Mr Deputy Speaker (Sir Roger Gale)]

I am grateful to the right hon. Gentleman for raising this issue and for giving me advance notice of his intention to do so. So far as I am aware, as we stand no such request has been made to the Speaker’s Office. Mr Speaker has made it abundantly plain on very many occasions that he expects information of this kind to be given from the Dispatch Box to this House, as a courtesy, before it is made available to anybody else. The right hon. Gentleman has made his point. Mr Speaker will have heard it, and I do not doubt that those on the Government Front Bench will have heard it as well.

NHS Workforce Expansion

Roger Gale Excerpts

Tuesday 28th February 2023 Commons Chamber

[Mr Deputy Speaker (Sir Roger Gale)]

We now come to the first Opposition day motion, on the subject of expanding the NHS workforce. I have to inform the House that Mr Speaker has not selected the amendment.

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[Several hon. Members rose—]

[Mr Deputy Speaker (Sir Roger Gale)]

The Front Benchers have taken an hour and a quarter out of the time available for this debate. The Opposition have indicated that they would like to wind up at 4.30, meaning that the wind-up speeches should start at around 4.05. I think there are 11 Members standing. I am not going to set a time limit, but doing the maths, if all colleagues wish to get in, we are down to five minutes. It is up to you. If you choose not to allow your colleagues to speak, you can take longer.

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[Ashley Dalton (West Lancashire) (Lab)]

I am really glad that you have consistently raised the issue of covid. Could you suggest why it is that services such as the overnight children’s A&E at Southport and Ormskirk Hospital in my constituency, which was closed, allegedly due to covid restrictions, still remains closed to this day?

[Mr Deputy Speaker (Sir Roger Gale)]

Order. I gently say to the hon. Lady that expression is through the Chair. This is a mistake that even those who have been here quite a while make. It is “the hon. Member”, not “you”.

[Ashley Dalton]

Thank you, Mr Deputy Speaker.

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[Several hon. Members rose—]

[Mr Deputy Speaker (Sir Roger Gale)]

Order. We are now down to about three minutes a head if all colleagues are going to speak; it is entirely up to you.

Draft Mental Health Bill 2022

Roger Gale Excerpts

Thursday 26th January 2023 Commons Chamber

Select Committee statement

[Mr Deputy Speaker (Sir Roger Gale)]

We now come to the Select Committee statement. Dr Dan Poulter, representing the Joint Committee on the Draft Mental Health Bill, will speak for up to 10 minutes, during which no interventions may be taken. At the conclusion of his statement, I will call Members to put questions on the subject of the statement and call Dr Poulter to respond to those in turn. I emphasise that questions should be directed to him and not to the relevant Government Minister. Interventions should be questions and should be brief. Those on the Front Bench may take part in questioning.

NHS: Long-term Strategy

Roger Gale Excerpts

Wednesday 11th January 2023 Commons Chamber

[Several hon. Members rose—]

[Mr Deputy Speaker (Sir Roger Gale)]

Order. I am afraid I have to drop the limit to four minutes, and it may be necessary to drop it down further to three minutes later. That depends entirely on colleagues, and how generous or otherwise they are to their friends.

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[Anna Firth (Southend West) (Con)]

Time is short, so I want to put on the record straightaway my thanks to all the hard-working hospital and ambulance staff at Southend Hospital and everyone working in the NHS across the city of Southend and picturesque Leigh-on-Sea, because none of them is on strike and all of them are treating patients with huge care and dedication. They are also innovating at high speed to tackle the unprecedented demand on their services. Two modular ambulance units have already been installed at Southend Hospital, providing 12 extra beds; an enhanced discharge service pilot was started last year; an active discharge ward has been opened with 12 beds and 12 comfy chairs; and yesterday 12 major treatment spaces were added, with more to come. I know this because I am in regular contact with my hospital and the local NHS and I have been visiting the hospital and seeing and supporting what it is doing on a regular basis. It is very impressive and it deserves all of our praise and recognition.

That is not to say that my inbox is not also full of people’s problems with accessing the NHS, and of course there is more to do. However, we have to look at this in context. We have to look at the international context, because these challenges are not unique to the UK. Countries around the world are facing an unprecedented double whammy from the combined upswings of covid and flu leading to hospitalisations. France currently has 22,500 people in hospital with covid, and Italy has more than 8,000. When it comes to flu, cases in Italy have hit their highest level in 15 years. Even Sweden, always held up as a great exemplar for the NHS, has a huge burden on its healthcare systems due to respiratory viruses.

Obviously the UK is not immune to these twin pressures, and obviously we are facing much higher rates of hospital bed occupancy than is normal at this time of year. We have 8.6% of our beds occupied by covid patients. Four years ago, there were none. Last year there were only 50 people in hospital with flu. This year there are more than 5,000—a hundredfold increase. As I have said, in Southend we are seeing identical figures on a local level. However, to suggest that we are not committed to our NHS is frankly outrageous.

In addition to the billions of pounds—I will come on to funding in just a minute—we delivered 9 million flu shots and 7 million autumn boosters into people’s arms last year. This was to prepare for what we knew was coming. We are putting in an additional 7,000 beds, and £500 million into delayed discharge before Christmas and another £250 million now. Over the last 12 months we have recruited 4,700 new doctors and more than 10,500 new nurses. Of course there is more to do, but to suggest that nothing has been done—which is what one might think, sitting here and listening to Opposition Members—is plainly not true. We have heard the PM’s plan to tackle the backlogs and waiting lists. If they think that is not much of a plan, they should consider what the Nuffield Trust said last week about Labour’s plans. It said that they would

“cost a fortune and stem from a failure of understanding and an out-of-date view”.

Last week—[Interruption.]

[Mr Deputy Speaker (Sir Roger Gale)]

Order. The hon. Lady is out of time.

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[Several hon. Members rose—]

[Mr Deputy Speaker (Sir Roger Gale)]

Order. I regret to say that I must now take the time limit down to three minutes. I am desperately trying to get everybody in, but we are trying to get a pint into a half-pint pot. I call Claudia Webbe.

[Claudia Webbe (Leicester East) (Ind)]

The first thing that needs to be said in this debate is that its title gives a false impression: “mismanagement” creates an impression that the Government have been doing their best to manage the NHS well but have failed to do so, whereas in fact the emergency in our NHS is the result of 13 years of deliberate policy decisions by the Conservatives. A staff shortage of 133,000 that has only grown in recent years is not “mismanagement”. A shortage of almost 40,000 NHS nurses is not “mismanagement”, especially not when the Government knew there was a huge shortfall and decided anyway to end the nurses’ bursary and make already-underpaid nurses pay a fortune to train while inflicting annual real-terms pay cuts on staff across the NHS.

Consistently allowing staffing numbers to remain far below safe levels is a decision, not something that was just badly managed, as was the intentional fragmentation of the NHS and the Health Secretary’s decision, along with the Government in 2012, to end statutory responsibility to provide a safe and fit health service. Cutting thousands of beds and millions of annual bed days in the NHS is a wrecking strategy—even more clearly so when it continued during the pandemic. It is part of an ideological push towards a rationed system that is more profitable for private providers and in which the NHS is in perpetual crisis not because of demand, but because beds, staff, hospitals and services have been intentionally slashed below the demand that was there. Even the current push to a so-called “integrated care system” is acknowledged by the King’s Fund and others to be, in reality, based on a US accountable care system that is designed to withhold treatment in order to cut costs and share the profits with private providers.

It is vital to be clear that the NHS is not merely collapsing; it is in a state of induced coma. There is not enough time in this debate to properly list all the damage that Conservative Governments have done to our health service in the past 13 years—and all in the full knowledge of what the consequences would be for those who need the NHS and who work in it and the deaths that it would cause.

The scale of this intentional damage is so great that playing around the edges with a little more cash that will end up in private company accounts—let alone talk of one-off payments to NHS staff who now rely on food banks—is just PR. The solution to all this is not better management; the only solution to 13 years of fragmentation and hollowing out is a return to the NHS’s original principles: a publicly owned, properly funded national healthcare service free to all.

[Mr Deputy Speaker (Sir Roger Gale)]

Order. I must ask hon. Members to keep one eye on the clock. I know that it is difficult when you are reading notes, but you really must watch the clock.

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[Several hon. Members rose—]

[Mr Deputy Speaker (Sir Roger Gale)]

Order. This is a test of your ingenuity—whether you can sell a bar of soap in 30 seconds—because you are going to have to go down to two minutes if I am going to get everybody in. Do your best. I call Robin Millar.

[Robin Millar (Aberconwy) (Con)]

I acknowledge the hard-working staff of Betsi Cadwaladr University Health Board, who serve us to the best of their ability and make terrific efforts to give us the care that we need and deserve in north Wales.

I want to mention Welsh colleagues from across the House, many of whom share my concern over the state of the health service in Wales. I know that some who are not present today will share that concern, even on the Opposition Benches, although it does raise the question of why they are not present. My right hon. Friend the Member for Vale of Glamorgan (Alun Cairns) and my hon. Friend the Member for Clwyd South (Simon Baynes) make the case for Wales as a case study of healthcare under Labour. I add to their observations that healthcare spending now accounts for some 55% of the Welsh Government budget.

I want to look briefly at the effects of the Labour prescription for healthcare in Wales. Our treatable mortality rate is 20% higher than in England. Last year, five out of seven of our health boards were in some form of special measures. My health board, the Betsi Cadwaladr University Health Board, was in special measures for six years. It got so bad that the BBC reported on a patient from Swansea who was forced to go to Lithuania for a hip operation when she discovered that she was on year four of a seven-year waiting list for treatment. The hon. Member for Batley and Spen (Kim Leadbeater), who is not in her place, was absolutely correct when she said that the Government have to take responsibility—the Welsh Government must take responsibility for their 25 years of stewardship of healthcare in Wales.

On the defence of the hon. Member for Ilford North (Wes Streeting) for the inequalities in Wales, I would say this: in 2015, the Nuffield Trust reported that the Welsh Government had used their powers to set different priorities and a different tone from their London counterpart. It has emphasised prevention—

[Mr Deputy Speaker]

Order. I call Paulette Hamilton.

[Mrs Paulette Hamilton (Birmingham, Erdington) (Lab)]

I was a nurse for 25 years and I returned to the frontline during the pandemic. I know at first hand that after 13 years of Tory mismanagement, our NHS is in crisis. Many health workers who have dedicated their lives to caring for others day in, day out are still living with the after effects of having worked flat out during and before the pandemic, all while trying to do the work of three or four people due to staff shortages. It is soul destroying for people to go on duty knowing that there will be inadequate staffing levels for nine or 12-hour shifts. Tory cuts have reduced A&E departments to shells of what they were under the last Labour Government—they are now so busy that staff feel that they can seem, at times, like a zoo.

Social care needs fundamental reform that truly brings together health and social care. People in Erdington, Kingstanding, Castle Vale and across the UK are finding it almost impossible to get a GP appointment, an ambulance or an operation when they need one, but the implications of stress on the health of staff can be tragic. The ongoing failure of the Government to address staffing levels can be a matter of life or death for patients. It breaks my heart to say that I just could not face the prospect of working in nursing right now.

In November, 140,000 people had to wait more than four hours to be admitted to A&E, and unfortunately my husband was one of them. If we add all that time together, collectively, the British public waited almost 65 years for emergency treatment, but the real question is: how much longer will they have to wait for a competent Government—

[Mr Deputy Speaker (Sir Roger Gale)]

Order. I know this is difficult, but we have to keep to the time. We will now not get everybody in.

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[Liz Kendall (Leicester West) (Lab)]

Today’s debate has laid bare the dire state of our health and care system after 13 long years of this Conservative Government: more than 7 million people waiting for hospital treatment, 400,000 for more than a year; the worst ever waits for A&E, with 50,000 patients a week now waiting more than 12 hours in A&E; excess deaths this winter at their worst level since 1951, except for the pandemic years; ambulance response times plummeting; cancer targets missed; and waits for mental health care so bad that thousands of patients end up forced to go to A&E or even attempting to take their own lives. In social care, the situation is even worse: 165,000 staff vacancies, 30,000 more than in the NHS; more than half a million older and disabled people waiting to have their needs assessed in the first place, not even on a waiting list; and millions—millions—of families pushed to breaking point because they cannot get the help they need to look after their loved ones.

The question I want to focus on today is why we have ended up here. Labour Members have never claimed that everything was perfect in the NHS when Labour last left government, but Conservative Members squandered a golden inheritance of the lowest ever waiting lists and the highest ever patient satisfaction, with access to services we can only dream of now. Ministers want to blame all of the current crisis on covid and this year’s winter flu, but the truth is that waiting times were at record levels and staff shortages were soaring long before the pandemic struck.

The most glaring reason for the problems we face is the sheer incompetence of this Government. To take just one example, effective winter planning in the NHS is a non-negotiable and a key test for any Secretary of State. When Labour was in Government, winter plans were done and dusted well in advance. I know that from my time working in the Department of Health. So, it beggars belief that not a single penny of the original winter hospital discharge funding was out of the door by the end of November. Some £300 million of it still has not reached the frontline. Their latest flawed plan to buy up care home beds, when what most people need is care in the community or their own homes, was not even announced until 9 January. That is not effective planning; it is scrabbling to shut the stable door after the horse has bolted.

There are even more fundamental reasons for the current crisis than the Government’s sheer incompetence. The root cause is a decade of Conservative economic failure trapping Britain in a vicious cycle of low growth, low pay and high taxes, which in turn has failed to provide sufficient or sustainable funding for our public services, including decent pay for frontline staff. Einstein’s definition of madness was to keep doing the same thing over and over again but expecting a different result. Yet that is precisely what we saw in the Chancellor’s autumn statement, so Britain is once again set for, at best, anaemic growth by the end of the Parliament. Britain deserves so much better than this. Labour’s green prosperity plan, our industrial strategy and our plan to fix business rates set out a different path for the future. No wonder the chairman of Tesco says that in terms of a growth plan Labour is the

“only team on the field”.

Economic growth that delivers proper investment in the NHS and social care is vital, as Labour’s record in Government shows, but on its own it will not secure a care system fit for the modern world. It also requires reform. On that, Ministers have again utterly failed to deliver. Mr Deputy Speaker, you will forgive me if I take the House on a brief trip down memory lane. Remember the Lansley reforms? I am sure Conservative Members would rather forget. That legislation so large it could be seen from outer space, but no one understood what it was for. Years of time and effort were squandered on a disastrous internal NHS reorganisation that failed either to integrate care or to deliver the improvements in patient care that the Conservatives claimed. There was the Conservatives’ cap on care costs—[Interruption]—and their solemn promise that no one would have to sell their home to pay for their care. Remember that? [Interruption.] It was first promised in 2012, postponed in 2015 and 2017, and re-promised by the right hon. Member for Uxbridge and South Ruislip (Boris Johnson) on the steps of Downing Street. [Interruption.]

[Mr Deputy Speaker (Sir Roger Gale)]

Order. It is perfectly plain that the hon. Lady does not want to give way.

[Liz Kendall]

Thank you, Mr Deputy Speaker.

The promise was buried once and for all by the Chancellor in his autumn statement last year—a Chancellor, I remind the House, who said that his biggest regret as Health Secretary was failing to put in place a long-term plan for social care.

In contrast—[Interruption.] I am sure the right hon. Member for Vale of Glamorgan (Alun Cairns) will be interested to hear this. In contrast, Labour has a 10-year plan for investment and reform in our NHS and social care. It includes the biggest ever expansion of the NHS workforce, funded by scrapping non-dom tax status; ensuring that patients can see the doctor they want in the manner they want, whether that is face to face, over the phone or online; a new deal for care workers—[Interruption.] Maybe the hon. Member for Ashfield (Lee Anderson) would like to listen to our plan and suggest it to his Ministers. We will have a new deal for care workers to tackle staff shortages and give older and disabled people the support they need. Above all, we will have a relentless focus on prevention and early intervention. There will be a new principle of home first, shifting the focus of care out of hospitals and into the community, with more people being cared for in their own home, which is where they want to be.

Using new technology, providing genuinely joined-up care and support, putting people first, giving staff the support they deserve, providing investment with fundamental reform: that is Labour’s plan, not the failed sticking-plaster approach that we have seen from the Conservatives over the past decade. Britain deserves a fresh start. We deserve a better future. That is what Labour will deliver. I commend the motion to the House.