Covid-19 Update
Sajid Javid Excerpts(2 years, 4 months ago)
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The Secretary of State for Health and Social Care (Sajid Javid)
As part of our continued commitment to open up travel, on 23 June, the Government extended the International NHS covid pass letter service to allow children aged five to 11 years to get an International NHS covid pass following a positive NHS PCR test or equivalent within the past 180 days—recovery status. Prior to 23 June, children aged five to 11 could only access an international NHS covid pass if they had received a full primary course of covid-19 vaccination.
Extending access to the International NHS covid pass to children aged five to 11 with recovery status will save families the cost of testing in countries where this is required for foreign travel and ensures that young children are able to provide proof of their covid-19 status on a par with the rest of the population. The UK has no covid certification requirements and this is to support outbound travel to a variety of countries that still have requirements.
A person with parental responsibility for the child—such as the parent or guardian—will be able to request the letter online via the NHS website or by calling 119. The letter will only be sent to the address on the child’s GP record.
This service is now available for children aged five to 11 resident in England and Wales. A letter based on recovery status is not available in the Isle of Man. In Northern Ireland, parents or guardians of children aged five to 11 have been able to request a digital or printed covid certificate on behalf of a dependant since January 2022. The COVIDCert NI app was updated in March 2022, to allow all those under 16 to upload the certificate—requested on their behalf—to display on the app. Anyone under 16 who tested positive for covid through an NHS PCR test prior to 1 May is able to request a recovery certificate in Scotland by phoning the covid status helpline on: 0808 196 8565.
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Draft Mental Health Bill
Sajid Javid Excerpts(2 years, 4 months ago)
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The Secretary of State for Health and Social Care (Sajid Javid)
I have published the draft Mental Health Bill today for pre-legislative scrutiny and delivered an oral statement to the house.
The draft Bill will enable the Government to deliver on two manifesto commitments:
to ensure that patients suffering from mental health conditions have greater control over their treatment and receive the dignity and respect they deserve; and,
to make it easier for people with learning disabilities and autism to be discharged from hospital
It contains provisions to increase the autonomy and dignity of people who need inpatient support for their mental health, including people subject to the criminal justice system. These reforms are intended to benefit everyone who may be subject to the Mental Health Act, and to address the racial disparities associated with its use.
The draft Bill is also intended to limit the extent to which people with learning disability and autistic people may be made subject to the Mental Health Act, while ensuring adequate community care and support is available for people with these conditions.
The draft Bill heralds a major step change in the rights available to people who may be made subject to the Act. Furthermore, they represent a significant step forward in the Government’s work to respond to the recommendations made by Sir Simon Wessely’s independent review of the Act.
The draft Bill will cover England and Wales.
We look forward to working openly with the committee to ensure that this important Bill is developed with input from stakeholders and all interested parties. This is a once in a generation chance to develop the Mental Health Act to ensure the autonomy and dignity of people who need inpatient support for their mental health.
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UK Life Sciences
Sajid Javid Excerpts(2 years, 5 months ago)
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The Secretary of State for Health and Social Care (Sajid Javid)
The life sciences have played an essential role in helping us to learn to live with covid-19. The UK’s natural strengths, and our world-beating vaccine programme, have allowed us to lead the way in this. As we learn the lessons of covid-19, it is essential that we take steps to further strengthen UK life sciences and our resilience against both future threats and a possible future resurgence in covid-19.
To date over £380 million has been invested to secure and scale up the UK’s vaccine manufacturing capabilities and we have ambitious plans to invest more alongside industry to further our domestic vaccine resilience. As announced in the spending review in October 2021, the Government have now made available £9.6 billion for key covid-19 programmes and related health spending and continues to work closely with industry to ensure our life sciences sector thrives.
Looking to the future, we are determined to take action to secure further investment into the UK’s thriving life science industry and cement our position as a science superpower. To that end, the Government have agreed a detailed heads of terms with Moderna to create a strategic partnership over the next decade. A binding contract will be negotiated with Moderna over the coming weeks and, subject to approval of a full business case, will be in place by early Autumn. The proposed partnership, led by the vaccine taskforce, will strengthen domestic mRNA capability and better equip the UK to respond to covid-19 and future health emergencies.
Moderna would establish their global research & development centre in the UK as part of an R&D strategic partnership, siting R&D capability onshore, with academic and wider vaccine ecosystem engagement, including extensive use of the clinical trials network in the UK. Their facilities would support vaccines not just against covid-19 but other diseases such as flu and RSV. The industry-leading, future-proof design of the plant will permit the addition of capability to manufacture a wide range of medicines and will be a massive boost to the UK’s R&D capability. The site will also allow the UK to be better prepared in the event of future health emergencies. The project, which will provide an important boost to the local economy and to the country’s life sciences sector, was developed with the support and collaboration of the vaccine taskforce and will be a key investment to bring novel technologies and pandemic resilience onshore in the UK.
A consistent and resilient supply of covid-19 vaccines will be critical in protecting against a possible future resurgence in covid-19, ensuring jabs are provided in time to protect those who are most vulnerable to serious covid-19. That is why one of the objectives given to the vaccine taskforce was to strengthen the UK’s onshoring capacity and capability in vaccine development, manufacturing and the supply chain to provide resilience for future pandemics.
Moderna has demonstrated expertise in mRNA development and has offered a strategic partnership with Her Majesty’s Government under which it would invest in a new state of the art manufacturing facility in the UK for the production of respiratory vaccines. This would be capable of accelerating production, with UK priority access, in the event of a future health emergency.
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Monkeypox Update
Sajid Javid Excerpts(2 years, 5 months ago)
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The Secretary of State for Health and Social Care (Sajid Javid)
The United Kingdom Health Security Agency (UKHSA) yesterday published its updated vaccination strategy in response to the current monkeypox outbreak.
Based on the currently available vaccine supply, UKHSA recommends that the available doses of the vaccine should be used for a selective vaccine strategy with the aim of interrupting transmission in the subset of individuals at increased risk. This approach is supported by the Joint Committee on Vaccination and Immunisation (JCVI).
Although anyone can contract monkeypox, data from the latest outbreak shows higher levels of transmission within, but not exclusive to, the social networks of gay, bisexual, and other men who have sex with men (GBMSM). Therefore, the updated strategy recommends that vaccination should be offered as soon as feasible to GBMSM at highest risk. Targeted pre-exposure vaccination is also recommended for others, including healthcare workers who are at high risk of exposure.
In view of the current epidemiology and vaccine supply available, wider vaccination in low-risk GBMSM individuals or the general population is not advised at this time.
NHS England is due to set out details on how eligible people can get vaccinated shortly.
To see the full updated strategy, which includes details of the recommendations for both pre and post-exposure vaccination, please visit: https://www.gov.uk/guidance/monkeypox-outbreak-vaccination-strategy.
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Access to GP Services and NHS Dentistry
Sajid Javid Excerpts(2 years, 5 months ago)
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The Secretary of State for Health and Social Care (Sajid Javid)
That is rubbish!
Wes Streeting
It is rubbish, but it is his record.
Why is it that so many people are accessing NHS services because of a failure to invest in social care, where staff can be recruited and deployed a lot faster? On the dentistry contract, the last Labour Government acknowledged that the 2006 contract was not good enough, which is why we put the reform of that contract in our 2010 manifesto. The difference is that we will not wait 12 years to deliver the promise after the election of the next Labour Government. Those are just some of the practical steps that we would take immediately and that the Government could take immediately.
Let me tell the House about some of the fundamental issues we would fix. First, mental health services in this country are in such a state that GPs are seeing more and more of their own cases present with mental ill-health. A Labour Government would recognise that there has been a surge in mental ill-health following the pandemic and we would not leave it to overwhelmed GPs to see them. That is why we have committed to recruiting 8,500 new mental health professionals, including specialist support in every school and mental health hubs in every community. We would pay for that by ending the charitable status of private schools and closing the tax loopholes enjoyed by private equity fund managers—and do not tell me the Health Secretary does not know where they are; he was using them before he became a Member of Parliament.
That policy—[Interruption.] Conservative Members are funny. They ask for our policies but they do not like it when we provide the answers, because we have them and they do not. That policy, which would put mental health hubs in every community and support in every school and speed up access to treatment for everyone in our country, would help to reduce pressure on GPs and to deliver better mental health treatment in every community and faster access to a GP for everyone else who needs to see them. It also tells you something about the choices we would make and the priorities we would have as a Labour Government: better public services enjoyed by the many, paid for by closing tax perks for the few.
I know that there is lots of cynicism about politics. We have a Prime Minister who wants people to believe that we are all the same, that things cannot change and that his shambles of a Government are the best that Britain can do. All I would say to the people of Britain is this: judge them on their record and judge Labour on ours. They have been in power now for 12 years. They delivered the highest NHS waiting lists in history, before the pandemic. They delivered record staffing shortages in the NHS with 100,000 vacancies, before the pandemic. They delivered cancer care that worsened in every year since they came to office, before the pandemic. Now they tell us that patients will be paying more and waiting longer.
The last Labour Government were in power for 13 years, and we delivered the highest patient satisfaction in the history of the NHS, the lowest waiting times on record and more doctors, nurses and new hospitals. There were no threats of strikes in the NHS when we were in government because staff could see the difference we were making and so could the patients. We did not get everything right—nobody is perfect—but Labour’s record on the NHS is one that this Government could not even begin to touch. The longer we give the Conservatives in power, the longer patients will wait. Well, people are sick, and they are tired of waiting. This Government’s time is up.
The Secretary of State for Health and Social Care (Sajid Javid)
I welcome this chance to come to the House to discuss primary care and dentistry, but I have to say that the audition by the hon. Member for Ilford North (Wes Streeting) did not go very well. I hope that he can see the irony—some might even say the hypocrisy—of his sudden interest in access to public services, today of all days. It is thanks to the strikes that he has been so vocal in supporting the fact that people right across the country cannot make their appointments, that GPs and dentists cannot get to work and that patients do not have access to the treatments they desperately need.
Several hon. Members rose—
Sajid Javid
I will take some interventions in a moment.
The hon. Gentleman has had every opportunity to do the right thing, to put patients first and to condemn these unjustified and reckless transport strikes, yet at every turn he has chosen to back his union paymasters.
Catherine West
The Secretary of State speaks about opportunities. In this House, we had a number of opportunities to get workforce reform, workforce numbers and a plan for our health service into the Health and Care Act 2022. Why did he miss those opportunities?
Sajid Javid
We are seeing record investment in the workforce, and we are seeing record increases. For the first time ever, the NHS is also coming up with a 15-year long-term workforce strategy, which I hope the hon. Lady welcomes.
The Government have always been on the side of patients and the people who care for them. I pay tribute to everyone working in primary care and dentistry for the difference they make day in, day out to their patients’ lives. I know that the pandemic has brought some unimaginable pressures, and equally I know that many of those pressures have not gone away now we are living with covid.
The hon. Member for Ilford North talks as though he does not know where the pressures have come from—as though he has had his head under a rock for two years. The NHS has said it believes that between 11 million and 13 million people stayed away from the NHS, including their GPs and dentists. Rightly, many of those people are now coming forward for the treatment they need—and I want them to come forward.
John Redwood
When the Secretary of State does the much-needed manpower review, will he ensure that a fast-growing area such as Wokingham with lots of new houses gets proper provision for that growth? Will the manpower plan also address how we recruit the doctors we have authority to get?
Sajid Javid
I absolutely agree with my right hon. Friend’s important point. In fact, I met my hon. Friend the Member for South West Bedfordshire (Andrew Selous) about that last week, and I agree with them both.
Hilary Benn (Leeds Central) (Lab)
Last month, a constituent contacted me who had developed severe dental pain. He phoned 40 dentists and not one of them could take him on as an NHS patient. It got so bad that he phoned 111 but was told that he was not eligible to see an emergency dentist. What advice would the Secretary of State give to someone in those circumstances? Many other hon. Members on both sides of the House will be able to tell similar stories. In the end, my constituent had to pay to go private, but that should not have happened. Why are our constituents being placed in that position?
Sajid Javid
I am sorry to hear about the right hon. Gentleman’s constituent. If he will allow me, in a moment, I will come on to the pressures that dentistry is facing and, most importantly, what we are doing about them.
Those pressures have come about for two reasons. First, there was a fear of infection, which was understandable in a context where 10 minutes in a dentist’s chair during the pandemic could have meant 10 days in self-isolation or, perhaps, worse. Dental practices were almost uniquely at risk of spreading covid, so their activity was rightly severely constrained across the world—not just here in England and across the UK—by the infection prevention rules that were necessary at the time. Despite all the innovations in dentistry over the last few years, dental surgeries do not have a Zoom option.
Secondly, the British people stayed away because of their innate sense of responsibility during the pandemic. As all hon. Members saw in their constituencies, people understood our critical national mission. Our GPs were doing their duty vaccinating people in care homes and in thousands of vaccination centres up and down the country, protecting the most vulnerable and working hard to keep us all healthy and safe.
When omicron struck—we all remember that period, which was not that long ago—I stood before this House and asked GPs to stop all non-emergency work once again. I did not take that decision lightly, but we were faced with a stark choice of having more lockdowns or accelerating our vaccine programme. We chose to accelerate, with help from all corners of the NHS and with the backing, at that time, of the hon. Member for Ilford North. I remember him standing at the Dispatch Box pledging his full support for that effort and rightly stating that the Government were acting
“in the best interests of our NHS, our public health, and our nation.”—[Official Report, 13 December 2021; Vol. 705, c. 795.]
He recognised that it was the right thing to do then; he has now conveniently changed his mind. I wonder why.
Mike Amesbury (Weaver Vale) (Lab)
But people like Mark in my constituency cannot find an NHS dentist. This is not about covid; it was happening before covid. The investment just is not there. He is in pain; he is in agony. The Secretary of State needs to step up, step in and get things right.
Sajid Javid
We are putting record amounts of investment into the NHS, including more funding into dentistry—I am about to come on to that right now—which will help with those pressures.
Clive Efford
Covid is just a pathetic excuse, because even if it was the sole reason, the Secretary of State should have been planning for when we came out of it, but nothing he has said explains why we had record numbers of patients on waiting lists even before covid started.
Sajid Javid
I think that many people working across the NHS will be listening to the hon. Gentleman and realising that he has no idea about the pressures that covid has created for everyone working there, especially those on the frontline.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
Excuse me for raising this issue, but I want to draw attention to the fact that there has been news released that the Secretary of State’s Government have declined to introduce mandatory reporting of complications resulting from mesh. In the context of problems with waiting lists, and wider issues, if we do not introduce a mandatory reporting scheme to identify problems with a medical product, more people will end up requiring medical intervention and medical treatment, so I urge the Government to look again at their declining to introduce mandatory reporting.
Sajid Javid
The hon. Lady raises an important issue. That is why the Government commissioned an independent report. We have responded to that report. We are still listening to what hon. Members such as herself and others are saying on this important issue, and then we will do a follow-up of the report within a year, so that will be later this year. I know that she will take an interest in that.
Paul Bristow (Peterborough) (Con)
Does my right hon. Friend agree that a lot of the issues with primary care services are about leadership? In my constituency, we have the brilliant Thistlemoor surgery with Dr Neil Modha and Dr Azhar Chaudhry, who serve 29,500 patients, 80% of whom do not have English as a first language. Same-day, face-to-face GP appointments are the norm in that practice. In contrast, a Thorney surgery has just temporarily closed a surgery in my constituency due to a lack of admin staff, which is not the fault of the admin staff themselves. Will he back my campaign to make sure that that GP surgery is open again serving local people as soon as possible?
Sajid Javid
My hon. Friend is campaigning passionately for primary care services in his constituency, and he points to some fantastic practices. I congratulate all the people involved in delivering that and support him in his work with his local commissioners to make sure that they are getting even better local primary care.
Dr Andrew Murrison (South West Wiltshire) (Con)
Does my right hon. Friend recognise that the crisis in NHS dentistry, which affects my constituency as it does his, well predates the pandemic, and indeed goes back to at least 2006 when the then Labour Government changed the way in which dentists are paid? Will he undertake to look at the units of dental activity system, which disincentivises dentists from providing dental work particularly in the most disadvantaged communities?
Sajid Javid
My right hon. Friend is absolutely right in his analysis, and I can give that undertaking. I will say a bit more about that in a moment.
If the hon. Member for Ilford North wants to talk about funding for the NHS, I am happy to oblige. Under the last NHS long-term plan, before the pandemic, we made a historic commitment of an extra £34 billion a year. Because of the pandemic, we then necessarily put in £92 billion of extra funding. At the last spending review, we increased funding still further so that the NHS budget will reach £162.6 billion by 2024-25, supported in part by the new health and social care levy.
We have made sure the NHS has the right level of resourcing to face the future with confidence, but we must also be alive to the consequences. The British people expect every pound spent to be spent well, and they expect us to be honest with them that every extra pound the hon. Gentleman calls for will be a pound less spent on education, infrastructure, housing and perhaps defence. I believe in a fair deal for the British people, and especially for our young people. We will be making plenty of changes alongside this funding.
Jonathan Edwards
One of the major problems we face in Wales and across the UK is the need to replace retiring GPs and dentists. There has been a welcome increase in the number of international medical graduates training in Wales, but the British Medical Association informs me that very few GP practices and dental practices in Wales are registered as skilled worker visa sponsors. Will the Secretary of State raise this with the Home Office to see what can be done to help GPs and primary care practitioners retain those international graduates to work in Wales and across the UK, if they so decide?
Sajid Javid
We are working with our colleagues in the Home Office on this and other skills and healthcare issues, so I can give the hon. Gentleman that assurance. He talks about the major problem he is facing in Wales, and that major problem is a Labour Government. I hope he agrees—[Interruption.] He is nodding.
Look at the performance of Labour in Wales, whether on health or education: the median waiting time for outpatients in Wales is almost double the median waiting time in England. People in Wales are waiting more than three years, whereas the longest wait in England is more than two years. Thanks to the covid recovery plan we set out in this House a few months ago, the number waiting more than two years has been slashed by more than two thirds in just four months, and it will be almost zero next month.
Thousands of people in Wales are waiting two or three years. In fact, one in four patients in Labour-run Wales are waiting longer than a year. In England it is one in 20, which is far too high and will be lowered, but in Wales it is one in four. It is not surprising the hon. Member for Ilford North had nothing to say about his colleagues in power in Wales.
Sajid Javid
I would like to hear what the hon. Lady thinks of the Labour Government in Wales and their abysmal performance when it comes to healthcare.
Kate Hollern
There is much better performance from the Welsh Government than from the UK Government. The Prime Minister promised 6,000 more GPs, which has not happened.
I wrote to the Secretary of State about Blackburn having only 33 GPs per 100,000 people, whereas the south-west has 73. I wrote to him about a young man whose cancer was misdiagnosed, but I have not had a response. I would say Wales is doing much better than the Secretary of State.
Sajid Javid
That is a very strange comment about the hon. Lady’s colleagues in Wales. Either she does not know or she is deliberately saying something she does not quite believe. Perhaps I can make her aware of the facts in Wales, where the number of people waiting more than two years for treatment currently stands at more than 70,000. That is more than three times the figure in England. That is more than three times the figure in England. It is at 70,000, and the hon. Lady seems to be very comfortable with that. I am surprised—it tells us all we need to know about Labour’s ambitions for government if she thinks that is acceptable.
Sajid Javid
Maybe the hon. Member for Rotherham (Sarah Champion) can tell us whether she agrees with her hon. Friend the hon. Member for Blackburn (Kate Hollern) on Wales.
Sarah Champion
The Secretary of State knows we are having a debate about the whole UK, but I am asking him specifically about England and his responsibility. Can he answer the original question from my hon. Friend the Member for Blackburn (Kate Hollern), which was about the Prime Minister’s 2019 commitment to 6,000 extra GPs? We know there are 1,000 newly qualified foreign GPs who are about to be deported by his Government, plus students who are unable to complete their studies because this Government are not providing them with the money for the final years. Under the management of the Secretary of State’s Government in the last decade, we have lost 4,500 GPs. Can he talk about what he plans to do to replace them?
Sajid Javid
I am happy to talk about that. Because of the record funding this Government have put in, both pre and post pandemic, we are seeing record increases in the workforce across the NHS. When it comes to GPs, since March 2019 we have seen an increase of some 2,389. On top of that, we have seen a further increase of more than 18,000 full-time equivalent staff working in other important primary care roles. That is in England—I am talking about England numbers.
Of course, we are working hard towards the targets we have set. We are also seeing more GPs in training in our medical schools than ever before, with more medical schools operating than ever before. I hope the hon. Lady will welcome that result and that investment.
Steve Brine (Winchester) (Con)
We are talking about GP and dentistry services today, but the wider primary care family includes community pharmacy and ophthalmology, the vast majority of which are not NHS providers but operate under contract providing NHS services. In my excellent right hon. Friend’s second year in the Health Secretary job, will there be a ruthless focus on the wider primary care landscape? When it comes to prevention, surely those people must be the front door of the NHS to ensure that the system is sustainable in the long term.
Sajid Javid
Yes, absolutely. I know my hon. Friend speaks with great experience in this area. I am just about to come on to some of the changes we will be making to primary care, which I am sure he will welcome.
Andrew Selous
When the Secretary of State goes back to the Department, will he have a quick look at how it is that, in Leeds, north-east Lincolnshire, Fylde and Wyre and Stockport in the past six-and-a-half years, we have increased the number of GPs by between 18% and 22%? I am curious to know whether there are any lessons we can draw from those areas for the rest of the country. Will he ask his officials to look into that to see whether there are useful points for us?
Sajid Javid
I will, and I will get back to my hon. Friend on that issue with more detail. I hope he welcomes the investment we are seeing and the record numbers of doctors and GPs in training.
Richard Fuller
I know my right hon. Friend is coming on with some more ideas, but from talking to GPs across my constituency, one of the issues I have found is that, as we have diversified primary care staff beyond GPs to paramedics and others, the role of what might be called receptionists and telephonists has moved far more into triage. It is now a more complicated role. Is he attracted to the idea in the Policy Exchange document of creating an NHS gateway to provide more medically qualified staff at that first point of entry to GPs, but on a nationalised basis, available via internet, telephony and the cloud?
Sajid Javid
Yes, I am. I have seen the report my hon. Friend refers to and have discussed aspects of it with its authors, so the short answer is yes.
Sajid Javid
I will later.
In terms of the changes we are making, let me first turn to primary care. The hon. Member for Ilford North, in his motion today, is calling on me to
“urgently bring forward a plan to fix the crisis in primary care”,
as he puts it. That is his motion. He is probably too busy supporting the strikers to have read my speech to the NHS Confederation last week. Had he bothered to listen to or read what I said in that speech, or the similar words from Amanda Pritchard, the chief executive officer of NHS England, he would have heard me acknowledge that our current model of primary care simply is not working. I have made no secret of that, or of my desire for change.
We are now working on a plan for change and, based on today’s motion, I will be glad to count on the hon. Gentleman’s support when we bring those plans forward, because what he has asked for, we are already doing. Our plans, for example, include a much bigger expansion in what our fantastic pharmacists can do. In fact, on the very day that I made that speech in Liverpool, we also announced a new pilot scheme to allow people with signs of cancer to be assessed and referred by pharmacists. That is yet another example of how we are working hard to enhance the role of our brilliant pharmacists and thereby freeing GPs to spend more time with their patients.
Imran Hussain
Thus far, if I have got this right, the Secretary of State has told us that there have been record levels of investment across our NHS services, including GPs and hospitals, and that any minor concerns that have arisen are because of the covid years. Does he think that the British public have been asleep for the last 12 years? Does he think that the British public will buy this? The stark reality on our streets—the Secretary of State may want to go and have a look—is as dire as it has ever been.
Sajid Javid
As I said—I am glad that the hon. Gentleman was listening—there have been record levels of funding in the NHS, and, as we set out in our spending plans, that will continue. But that is no thanks to the hon. Member for Ilford North and his colleagues, who all voted against that record funding. They wanted to deny those resources to their constituents. He should reflect on the impact of that had their wish gone through the House.
On the changes that we are making, we are going further, from improving telephone services to letting others such as nurses and pharmacists complete fit notes. Appointment numbers are already exceeding pre-pandemic levels—for example, in April, GPs and their teams were delivering 1.26 million appointments per working day. That is a phenomenal achievement, which the hon. Gentleman should be commending, not castigating.
The hon. Gentleman raised Wakefield and primary care. He was using dodgy numbers, so he was corrected by my hon. Friend the Member for South West Bedfordshire. He also gave out further dodgy information by somehow claiming that the King Street walk-in centre was under threat. I do not know if you have seen this in the by-elections, Mr Deputy Speaker, but the Labour party has a history of just making things up and creating fake news to scare local people. That is the respect that they show for local people. The walk-in centre has never been under threat. The local clinical commissioning group has confirmed that it has never been under threat. If he had any decency, he would stand up and withdraw his remarks. I give him that chance.
Wes Streeting
I would have thought that the Secretary of State would have learned by now that it is silly to give way to me when he makes these facile points. It is absolutely the case that the walk-in centre’s future was in jeopardy. It is absolutely the case that Simon Lightwood campaigned to save it. If that is what Simon Lightwood can achieve as a candidate, imagine what he will do as Wakefield’s next Labour MP.
Sajid Javid
The hon. Gentleman is now using the past tense. A moment ago, he claimed that it was under threat. He clearly has no issues with giving false information in this House. The truth is that, if Wakefield wants a better future, as everyone in Wakefield deserves, only one by-election candidate can provide that, and that is Nadeem Ahmed.
We intend to go much further to build a truly 21st-century offer in primary care. That includes Dr Claire Fuller’s independent review, which I found to be extremely valuable, and the changes that will stem from that as well as the many others that we will bring forward shortly. We will work with the population and the profession alike. The hon. Gentleman was right to focus on the importance of the profession, but he did forget to mention, as I referred to earlier, that since March 2019 we have more than 2,380 additional GPs in primary care, record numbers of doctors in training and more than 18,000 additional primary care professionals.
Let me turn briefly to the important steps we are taking in dentistry. Urgent care has been back at pre-pandemic levels since December 2020, and the 700 centres for urgent care that we set up to provide treatment for patients during this difficult period have helped thousands of patients across the country. At the start of this year we put an additional £50 million into NHS dental services, which boosted dental capacity by creating 350,000 extra appointments. Dentists are currently required to deliver 95% of pre-covid activity, and we are planning to return to 100% shortly. I commend all the dentists who are already achieving that.
Paul Blomfield (Sheffield Central) (Lab)
The Secretary of State referred to an additional £50 million. As he knows, the way in which that was framed made it difficult for dentists to draw down the money. Will he tell the House how much of it has been drawn down and used?
Sajid Javid
I do not have the exact figures to hand, but I know that millions of pounds were drawn down and used to deliver tens of thousands of appointments across the country. That made a huge difference to a great many people.
Greg Clark (Tunbridge Wells) (Con)
The urgent care centres are an important innovation, but it is also important for them to be accessible throughout the country. There are seven in Kent, but the one nearest to my constituents is 33 miles away. Could my right hon. Friend intervene with the NHS in the south-east to bring about a more even distribution?
Sajid Javid
My right hon. Friend’s point is important and well made, and I will look at the issue closely and get back to him, if I may.
As we have already heard today—but it is such an important point—the challenge for NHS dentistry predated the pandemic. It is not just about the number of dentists in England, but about the completely outdated contracts under which they are working, which were signed under a Labour Government. [Interruption.] Labour Members do not like it, but it is true. These contracts mean that we are operating almost with one hand tied behind our backs. They do not incentivise prevention, they hold back innovation, and they mean that hard-working families cannot get the dental services that they deserve. However, we will now be changing that; our work with the sector, along with the work of Health Education England on recruitment and retention, will be vital for the future.
Sajid Javid
I will in a moment.
If there is one thing that unites all our work on primary care and dentistry, it is this. We are shifting to a new mode of operating—one that is about helping the whole population to stay healthy, not just about treating those who ask for help. We need to get to a place where we are healthier for longer, because freedom is hollow without our health.
Our new Health and Social Care Act 2022 is an important step in that ambition. Statutory integrated care systems will be responsible for the funding to support the health of their respective areas—not just treating people, but helping people to stay healthy in the first place. The Act also allows us to make safe and effective public health interventions such as water fluoridation, and we will set out further plans for that shortly.
Prevention, personalisation, people and performance: those will be our watchwords for modernising NHS services. They will sit at the heart of everything to come, from the health disparities White Paper to the update of the NHS long-term plan. While the Opposition continue to go off the rails, we remain firmly on track, laying down our plans to deliver a truly 21st-century offer for the profession and, most of all, for patients.
Several hon. Members rose—
Antimicrobials: Evaluation and Purchase
Sajid Javid Excerpts(2 years, 5 months ago)
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The Secretary of State for Health and Social Care (Sajid Javid)
The ability of bacteria—and other types of pathogen—to develop and propagate resistance to the available therapeutic drugs and medicines, such as antibiotics, used to treat them is a significant and growing threat. Alongside extensive efforts to tackle this threat, as set out in the Government’s five-year National Action Plan, we have sought to reduce the need for antibiotics. This is being achieved through both effective infection prevention and control, and through careful stewardship of the antibiotics that we have at our disposal, by reducing inappropriate prescribing. It is also essential that we incentivise the development—by pharmaceutical companies—of new antimicrobials, which has historically been challenging. To address this challenge, we committed to develop and test a new purchasing model for antimicrobials that de-links payments for antibiotics from the volumes used.
As a result, NHS England and Improvement (NHSEI), the National Institute for Health and Care Excellence (NICE) and the Department of Health and Social Care (DHSC) launched a joint project in July 2019 to test a “subscription-style” payment for two antibiotics, basing the annual payment on a NICE-led assessment of the value of the medicines, rather than on the volumes of drugs used. On 12 April 2022, NICE published guidance estimating the value of the two antibiotics to the NHS. This guidance informed negotiations between NHSEI and the two companies to agree payment levels in the “subscription-style” contracts.
I would like to inform the House that the contracts between NHSEI and the two pharmaceutical companies have now been signed. Payments to the companies for their antibiotics, Cefiderocol—manufactured by Shionogi —and Ceftazidime with Avibactum—manufactured by Pfizer—will start on 1 July 2022.
This world-leading project represents an important development in our approach to incentivising innovation in antimicrobial drugs and in our efforts to tackle antimicrobial resistance (AMR). We will continue to build on this work to develop routine arrangements for the evaluation and purchase of new antimicrobials as they are developed. I will be writing to my counterparts in Scotland, Wales and Northern Ireland to formally invite them to participate in these next steps, to ensure that the project can be adapted and scaled across the UK.
Maintaining momentum on our international advocacy and action on market incentives is crucial. We hope other countries will offer similar incentives in their own domestic markets, so that collectively we can achieve a meaningful incentive for global investment in antimicrobials. This project is representative of our leading role in this area, aligning with the Government’s vision for a Global Britain.
[HCWS116]
Oral Answers to Questions
Sajid Javid Excerpts(2 years, 5 months ago)
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Chris Clarkson (Heywood and Middleton) (Con)
The Secretary of State for Health and Social Care (Sajid Javid)
First, may I associate myself with your remarks, Mr Speaker, about the Falklands war as we remember those who lost their lives and their loved ones?
We are making good progress on tackling the covid-19 backlog, having already halved the number of patients with the longest waits and delivered more than a million tests and checks at our new community diagnostic centres. Our elective recovery plan commits an additional £8 billion to deliver approximately 30% more elective activity than before the pandemic, and we have ambitions to go further to transform services, improve patient care and ensure value for money.
Chris Clarkson
The cost of living is foremost on everybody’s minds now, so what assurances can my right hon. Friend give me that my constituents in Heywood and Middleton—a part of the world he knows very well—will get bang for their buck from the extra money they are paying into the NHS and that the money will go on testing and treatment, not management and miscellany?
Sajid Javid
I am pleased to give that assurance to my hon. Friend. We are ensuring that every penny is spent on the elective recovery and makes the greatest possible contribution to tackling those covid-19 backlogs. We are investing £8 billion more over the next three years, and that will increase elective activity. I am also pleased to say that in his region, we have already opened some four new community diagnostic centres; just those four have done 60,000 more checks and tests for his constituents.
Vicky Foxcroft (Lewisham, Deptford) (Lab)
Following the covid-19 outbreak and the roll-out of vaccines, thousands of immunocompromised people are still shielding, so can the Secretary of State update the House on where we are on delivering Evusheld, which would allow them to have the freedom that we all enjoy?
Sajid Javid
It is an important question, and the hon. Lady will know that specific guidance is already set out for those who are immunocompromised. As she will also know, Evusheld has conditional marketing authorisation from the independent Medicines and Healthcare products Regulatory Agency. With the MHRA and others, further tests are going on via the UK Health Sciences Authority, because it is essential to ensure that Evusheld works well and satisfies clinicians when it comes to omicron.
Theresa Villiers (Chipping Barnet) (Con)
To tackle the covid backlog, it is essential that we expand the capacity of the NHS, and that means more people, so what is the Secretary of State doing to ensure that we recruit the skilled professionals we need for the NHS?
Sajid Javid
My right hon. Friend is absolutely correct, and that is why that is one of our biggest priorities. As well as asking the NHS to come up for the first time with a 15-year, long-term workforce strategy, we are also recruiting at a record rate, with more doctors and nurses working for the NHS than ever before.
Marsha De Cordova (Battersea) (Lab)
Demand for eye care services is at an all-time high, with more than 632,000 people waiting on the NHS waiting lists for ophthalmology treatments. Delays to diagnosis and treatment could lead to a loss of sight, as well as stress and anxiety for patients. Given the stark figures, it is vital that we invest in eye health, such as through the national eye care recovery and transformation programme, which, worryingly, is due to end this year. Does the Secretary of State agree that it is essential that funding for this programme is retained so that he can bring down waiting lists and ensure good-quality eye care?
Sajid Javid
The hon. Lady is right to talk about the importance of eye care services. That is why we are putting record investment into dealing with those covid backlogs. As she rightly points out, many of those are in eye care and ophthalmic facilities and surgeries. That record investment is going in, and we will keep it under review to make sure it is leading to the outcome that we all want to see.
Andrew Gwynne (Denton and Reddish) (Lab)
More than 2 million people are affected by the backlog in cancer care. Smoking is the leading cause of cancer, and we know that a key component of tackling the backlog is prevention. Given that, can the Secretary of State assure the House that no current or former tobacco lobbyist working in or with No. 10 will have any influence on the Government’s tobacco control plan, prevention strategy or planned response to the Khan review?
Sajid Javid
As the hon. Gentleman will know, all decisions are rightly made by Ministers. I agree about the importance of tackling smoking. The Government are committed to a smoke-free 2030, which is exactly why I commissioned the independent Khan review. I welcome its findings and we are carefully considering them.
John Penrose (Weston-super-Mare) (Con)
Suzanne Webb (Stourbridge) (Con)
The Secretary of State for Health and Social Care (Sajid Javid)
The Government’s commitment to deliver 50 million more general practice appointments is critical for improving access to primary care across the country. Our workforce are crucial for that, and we are well on track to deliver 26,000 more full-time primary care staff by March 2024, with more than 18,000 primary care staff already recruited since 2019.
Suzanne Webb
I thank my right hon. Friend for that answer. Does he agree that when it comes to accessing primary care services, the Government have given GPs the support and guidance that they need and that GPs must now make every effort to see our constituents face to face, which is what they expect? What more can be done to support GP practices to make their processes more efficient for patient access to test results and blood tests and for booking appointments?
Sajid Javid
I agree with my hon. Friend and am incredibly grateful, as she is, for the huge contribution of GPs during the pandemic in helping to deliver the largest vaccination programme that the NHS has ever seen. Because of the pandemic, we also provided record support to GPs that helped to cut bureaucracy, helped them to share their workload and helped clinicians to give even more support to patients.
We are starting to see the results of that, with face-to-face appointments going up—we would like to see them go up much further. We would also like to see increases in appointments, including for access to blood tests. My hon. Friend might know that yesterday we published our new data strategy, which sets out how, using the NHS app, we will give more people access to their health results.
Ms Karen Buck (Westminster North) (Lab)
The United States company Operose Health runs 70 GP surgeries across the country, including the Randolph Surgery in my constituency. Yesterday’s “Panorama” broadcast indicated serious concerns about its quality of service, staffing levels and patient safety. Since then, constituents of mine have approached me to reflect their concerns about the service. What steps is the Secretary of State taking now, urgently, to establish what has gone wrong? Will he meet MPs with those surgeries to discuss our concerns?
Sajid Javid
First, I will ensure the hon. Lady gets the meeting she requests. She will know that NHS GP services all have to meet the same requirements, the same regulations and the same standards across the country. Where patients are not getting that care and those standards are not being met, we expect local commissioners to take action.
Ms Marie Rimmer (St Helens South and Whiston) (Lab)
Lucy Allan (Telford) (Con)
The Secretary of State for Health and Social Care (Sajid Javid)
In health and care, strong leadership can make the difference between life and death. I have been clear that we can accept only the highest possible standards and that in some cases poor leadership has been tolerated for too long. That is why I have accepted in full the recommendations of General Sir Gordon Messenger’s independent review and will set out a delivery plan to begin what I think will be the biggest shake-up in health and social care leadership in a generation.
Daniel Kawczynski
Bearing in mind that the NHS will receive approximately £180 billion of taxpayers’ money this year, improving leadership and management in the NHS is extremely important, and nowhere more so than in the Shrewsbury and Telford Hospital NHS Trust. Despite the trust obtaining £312 million from the Treasury to improve accident and emergency services, a lack of coherent leadership has resulted in no decision being taken as to how the money will be spent. With rising costs in the construction industry, that is of great concern to us. Will the Secretary of State intervene with our local hospital trust to make sure that the money is spent as expeditiously and quickly as possible?
Sajid Javid
My hon. Friend is absolutely right about the importance of leadership. I am pleased to tell him that my Department has just received the strategic outline case for his local A&E’s Future Fit programme, which is currently being reviewed. As he undoubtedly knows, the business case process is led by the trust and is already supported by some early funding; I understand that the trust aims to present the full business case by 2023, with construction starting in the same year and to be completed by 2028. The Minister for Health will shortly visit Shropshire and will meet my hon. Friend and other colleagues.
Mr Speaker
This is a strange grouping, but it is a very important question, so do answer it, please.
Sajid Javid
I thank my hon. Friend for her tireless campaigning on the issue, which she brought up recently in the Health and Social Care Committee. I am pleased to tell her that elective orthopaedic surgery at the Princess Royal Hospital will resume from 20 June.
My hon. Friend is right about the importance of the Messenger review. There were many examples of excellent leadership in it, but sadly there were also examples of poor leadership, including bullying and blame cultures. That is why it is essential that we have this huge reform.
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
As hard as all hospital leaders and managers work, sometimes something goes wrong on their watch. What follows is one such example.
On Friday, I met Joanna, a lovely mum of two young children, who was diagnosed with secondary cancer three months ago. Since then, she has been passed from pillar to post and has received no treatment at all. Unfortunately, she is now receiving palliative care. What Joanna wants more than anything is to stop what happened to her happening to anyone else. Will the Secretary of State personally look into Joanna’s case to make sure that she finally gets the treatment she urgently needs, and that no one else is failed by the system as Joanna has been?
Sajid Javid
Yes, of course I can give the hon. Lady that commitment. I am very sorry to hear about Joanna; I think of her, her loved ones and her two children. I will absolutely look personally into the case. I hope that the hon. Lady agrees that where we see poor outcomes, it is important to make sure that we have the best possible leadership in place.
Valerie Vaz (Walsall South) (Lab)
I have already raised the issue of the governance at Walsall Manor Hospital. I welcome the Messenger-Pollard review—the Secretary of State will know that there is also a report called “The snowy white peaks of the NHS”, which says roughly the same thing—but I have been fobbed off because the leadership at Walsall and Wolverhampton remains the same. Could he look into why Walsall Manor should not have its own chief executive?
Sajid Javid
These are important issues, and I have discussed this with the right hon. Lady. I will take another look at the management of Walsall Manor.
Sarah Atherton (Wrexham) (Con)
Last week, a BBC Wales documentary reported on the shocking state of Wrexham Maelor Hospital and the NHS in north Wales, which is led by the Welsh Labour Government and was in special measures before covid. The average wait for referred treatment in England is 13 weeks, but in Wales it is 24 weeks. In the words of Nuffield Trust, the
“treatment…may as well not be there”.
Wrexham deserves better, so does the Minister agree that the Welsh Labour Government need to vastly improve the NHS in north Wales before more lives are lost?
Sajid Javid
I do of course agree with my hon. Friend. There are huge challenges for the NHS here in England, but as she has highlighted, the challenges are much greater in Wales because of how the Labour Government there neglected the NHS, way before the pandemic as well as during it. When it comes to leadership, although the Messenger review was commissioned for England, I think they would do well to learn some lessons from it.
Andy Slaughter (Hammersmith) (Lab)
Operose Health is one of the biggest employers in the primary care sector. When it bought up 70 surgeries across England, including in Hammersmith and Fulham, the Government were warned that this would put patient care at risk in pursuit of profit. That is what Operose’s US parent company, Centene, is notorious for. Now that the Secretary of State has evidence of Operose employing half the average number of GPs per patient, and of not reading clinical correspondence for six months, what is he going to do about it?
Sajid Javid
The hon. Gentleman might know that in 2007 the then Labour Government changed the law to allow takeovers such as that to happen. He might want to reflect on that. In terms of local management, there are consistent high standards that need to be met locally, and local commissioners should be made aware of what he has just said.
Michael Fabricant (Lichfield) (Con)
Wendy Chamberlain (North East Fife) (LD)
The Secretary of State for Health and Social Care (Sajid Javid)
Today, we remember the 72 people who lost their lives and their loved ones affected by the Grenfell Tower tragedy five years ago.
In the Department of Health and Social Care, we are getting on with the job. We are focused on tackling the covid backlogs. Our new community diagnostic centres are springing up in towns and cities across the country, with 90 of the 160 planned already open and 1 million more tests, checks and scans already delivered. Last week, I set out our plans to modernise health and social care leadership, accepting all the recommendations of the leadership review by General Sir Gordon Messenger and Dame Linda Pollard. Just yesterday, I launched our new data strategy, called “Data saves lives”, to close the digital divide between health and care.
Wendy Chamberlain
Last month, the Joint Committee on Vaccination and Immunisation published an interim statement on the autumn booster programme, in which—once again—unpaid carers have not been included. It is vital that they have equal access to vaccines to paid carers to keep their loved ones safe, as they continue to do right now. Will the Secretary of State advise me when we might receive a final statement from the JCVI on the autumn booster programme?
Sajid Javid
I thank the hon. Lady for raising the importance of getting vaccinations right. She will know that we rely on the independent advice of our clinicians—the committee known as the JCVI—and I think it is right that it is independent. Ultimately, it decides on its advice, and it is for Ministers whether to accept it. However, she has made an important point about unpaid carers, and I will ask the JCVI to see if that can be properly considered in the autumn booster review.
Martin Vickers (Cleethorpes) (Con)
Sajid Javid
I am happy to respond to my hon. Friend. He is right that we of course want to ensure that everyone has timely access to NHS dentistry and that the profession is an appealing career choice. Health Education England has a dental education and reform programme, which will help retain new dentists in the NHS by placing training in areas of greatest need, and offer more flexibility and more career pathways. I can also tell him that, in Lincolnshire, commissioners are already looking at ways to support NHS dentistry through support such as the golden hello incentives.
Wes Streeting (Ilford North) (Lab)
I associate myself with the Secretary of State’s remarks as we remember the anniversary of the Grenfell Tower tragedy and support the families in their ongoing quest for justice. I also associate Opposition Members with your remarks, Mr Speaker, on the 40th anniversary of the end of the Falklands war.
Last night’s shocking BBC “Panorama” investigation into Operose Health revealed the extent of the crisis in GP surgeries, with patient referrals and test results left unread for up to six months, and with patients being seen by less qualified staff standing in for GPs without supervision. This is exactly what happens when private profit is placed above patient health and safety. Why is the Secretary of State asleep at the wheel instead of launching an investigation into this scandal?
Sajid Javid
As I said earlier, the hon. Gentleman should reflect on the rule changes made by a previous Labour Government that allowed the management of many GP practices to change hands. When such serious allegations are made, it is right that local commissioners investigate them properly and independently. When it comes to GP access and capacity, I hope he will welcome that we are making a record investment, with over £0.5 billion of support during the pandemic, and recruiting GPs at a record rate.
Wes Streeting
The British people are sick and tired of hearing Conservative Ministers, after 12 years in government, passing the buck to everyone else and failing to take responsibility.
Let us look at another scandal that has happened on the Secretary of State’s watch. It has now been weeks since he was warned about the negligence, the cover-up and the bribing of whistleblowers to stay silent about the scandals at the North East Ambulance Service. Since then, he has done precisely nothing to investigate the scandal. When will he address patient safety, get a grip and stop passing the buck? Or is this another case of the Government being, in the words of the Culture Secretary, found “wanting and inadequate”?
Sajid Javid
I told Members last week that I will review whether we can have an independent review of the North East Ambulance Service, and the NHS has agreed to an independent review. The hon. Gentleman stands up week after week and tries to claim he is on the side of patients and NHS workers, but we know he is actually on the side of those who are on strike—that is where his loyalties lie. Will he reflect on how many nurses will not be able to get to work and how many appointments will be unattended because of the transport strike? I know he wants to be the second coming of Tony Blair, but he is no more than a pound shop Ed Miliband.
Holly Mumby-Croft (Scunthorpe) (Con)
Sajid Javid
My sincere condolences to the family of David Hopkins. Cancer diagnosis and treatment is an absolute priority, which is why we are putting £2.3 billion into campaigns and new initiatives to encourage people with suspected cancer to come forward. I am pleased that the referral rate is currently 120% of the pre-pandemic level. I will, of course, read the APPG’s report. I visited the largest neurology hospital in the UK last month with my hon. Friend the Member for Hexham (Guy Opperman), and I am determined to ensure that our investment in this vital area of research goes straight to the frontline.
Martyn Day (Linlithgow and East Falkirk) (SNP)
The Government have noted that Sir Robert Francis will give evidence on his work on the infected blood inquiry on 11 and 12 July, and said that they will act after hearing his evidence. What discussions has the Secretary of State had with Cabinet colleagues on the potential impact on victims’ mental health of the lengthy waiting times for compensation in relation to contaminated blood?
Sajid Javid
The hon. Gentleman raises a very important issue. The House is well aware of the Government’s work to bring justice to those who have been affected by contaminated blood, and we will continue to take that seriously.
Luke Hall (Thornbury and Yate) (Con)
A new hospital at Thornbury would provide greater primary care and outpatient services, more GP appointments and a proactive frailty hub to support the elderly to stay in their own home longer. Our bid was submitted against the sustainability and transformation plan wave 4 capital pot, and I thank the Minister for all his work and effort in speaking to me, South Gloucestershire Council and our clinical commissioning group about this bid. Will he update the House on the timescales for its outcome?
Matt Western (Warwick and Leamington) (Lab)
Sajid Javid
I am afraid that it was not clear to me which tests the hon. Gentleman was talking about; all I heard was “300,000 tests”. So if he cares to write to me, I will respond properly to his question.
Jeremy Hunt (South West Surrey) (Con)
Has the Secretary of State read the study in the British Journal of General Practice that says that people who see the same GP over many years are 30% less likely to go to hospital, 30% less likely to need out-of-hours care and 25% less likely to die? If he has, will he consider changing the GP contract to restore individual patient lists and reverse the change of two decades ago so that everyone has their own family doctor?
Sajid Javid
I have not read that review, but now that my right hon. Friend has mentioned it I will certainly take a look at it. He raises an important point about access to GPs. He is right to say that many people would want to see the same GP again and again—that would be their preference. One can see how that may lead to better clinical outcomes, but I hope he will respect the fact that others do not mind if they do not see the same GP and just want rapid access. It is important that we get the right balance.
Imran Hussain (Bradford East) (Lab)
Sajid Javid
The hon. Gentleman is right to talk about the importance of timely access to GPs, whether in Bradford or across the country. There are, of course, challenges across the country, which is one reason why we put in place an action plan, including some £500 million of extra funding, during the pandemic. On his plea for an urgent treatment centre, I will make sure that the Health Minister will meet him.
James Wild (North West Norfolk) (Con)
Before the jubilee weekend, I was pleased to welcome the Minister to the Queen Elizabeth Hospital to see the cracking RAAC—reinforced autoclaved aerated concrete—which the Department understands needs to be replaced. So will he take the opportunity to build a new QEH, fit for the future? When will the patients and staff at QEH know that they are on the list? They are impatient for a decision.
Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba)
Sajid Javid
As I have said before, no country got every decision right during the pandemic, but one thing we did get right was our response in terms of diagnostics, vaccinations and antivirals. That combination allowed us to become the first country in Europe to open up and therefore also to boost our economy. I will make sure that the hon. Gentleman gets the meeting he has asked for.
Jack Brereton (Stoke-on-Trent South) (Con)
As the Secretary of State knows from our previous discussions, we have serious concerns about West Midlands ambulance service and the significant delays we have experienced in north Staffordshire. The way to address the problems is by NHS partners working together, and Staffordshire fire service has said that it wants to do more to help the ambulance service. Will my right hon. Friend agree to do as much as he can to improve ambulance services in Stoke-on-Trent and Staffordshire?
Sajid Javid
My hon. Friend makes a very good point and some good suggestions. West Midlands ambulance service is my local ambulance service too, and I recently met its chief executive officer and chairwoman. As he knows, the NHS has published and is executing a 10-point plan for emergency service recovery, but I shall certainly take what he says into account.
Richard Burgon (Leeds East) (Lab)
Sajid Javid
I am pleased to say that we have more nurses working for the NHS than at any point in its history, and last year we recruited an additional 10,900.
Sir Christopher Chope (Christchurch) (Con)
Does my right hon. Friend the Secretary of State accept that some people have died as a direct result of having had covid-19 vaccines?
Sajid Javid
I accept that the vaccine has not worked in the intended way for every single person. I am afraid that this is a risk with any vaccine that has ever been approved in any major country. It is right, however, that when something goes wrong with a vaccination, it is looked at appropriately, and I am happy to discuss this further with my hon. Friend.
Patricia Gibson (North Ayrshire and Arran) (SNP)
Nick Fletcher (Don Valley) (Con)
I thank the Secretary of State for his recent visit to Doncaster Royal Infirmary. I apologise for the fact that the lights went out while he was there—it was not planned, but it did bolster my campaign for a new hospital. Will he meet me again during Men’s Health Week, to discuss a men’s health strategy, which many Members across the House believe would help an awful lot of men?
Sajid Javid
Yes, that is a very important issue and I will be happy to meet my hon. Friend.
Mohammad Yasin (Bedford) (Lab)
When I wrote to the Minister recently about my concerns about NHS dentistry waiting times, I was advised that my constituent was not restricted by geography, which implied that he should travel for an appointment, but the whole of the east of England has been identified by the Association of Dental Groups as a dental desert. The Minister is well aware of this problem, the severe workforce shortages and the broken dentistry contracts. When will the Government stop blaming the dental practices, get on with the job and get the workforce this country needs?
Sajid Javid
The right hon. Gentleman will know that I have visited the site and spoken to local members of the trust. It is a project that we support, and we are in the final stages of the final approvals.
Ronnie Cowan (Inverclyde) (SNP)
As was pointed out by the hon. Member for Lichfield (Michael Fabricant), this Government promised medical cannabis on the NHS 1,183 days ago. Since then, a child with epilepsy will have experienced, at a modest estimate, 35,490 seizures. We have free NHS prescriptions, which proves that the medicine exists and is approved for use in the United Kingdom. How much longer must those children suffer?
Health and Social Care Update
Sajid Javid Excerpts(2 years, 5 months ago)
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The Secretary of State for Health and Social Care (Sajid Javid)
I would like to inform the House that the final version of “Data saves lives: reshaping health and social care with data” has been published today. It builds on the groundbreaking use of data during the pandemic and sets out ambitious plans to harness the potential of data in health and care, while maintaining the highest standards of privacy and ethics.
When facing this country’s greatest public health emergency for generations, one of the most effective tools at our disposal has been the power of data. Now, as we look to live with covid, we must apply those same tools as we tackle the most pressing challenges facing the country including elective recovery and integration of health and social care.
Earlier this year, I made a speech setting out my four priorities for reform in health; prevention, personalisation, performance and people. We cannot deliver the change we need to see, and our 10 year plans for cancer, dementia and mental health, unless we embrace the opportunities from data-driven technologies. Last week, Sir Gordon Messenger and Dame Linda Pollard published their review into leadership of health and social care, and I accepted their recommendations in full. Today’s data strategy is the next step in our plans to modernise the NHS.
This strategy shows how we will use data to bring benefits to all parts of health and social care; from patients and care users, to staff on the front line, to the pioneers driving the most cutting-edge research.
It is backed by a series of concrete commitments, including investing in secure data environments to power research into new treatments, using technology to allow staff to spend more quality time with patients, and giving people better access to their own data through shared care records and the NHS app. The strategy will support NHS providers to tackle the covid backlog, providing them with the means to monitor and optimise capacity through improved data sharing and the development of advanced analytics. This is all on top of the huge investment that we have already made; for instance investing £200 million in our data for research and development programme.
It is vital that, as we deliver these benefits, we work in a way that maintains the high level of public trust in how the NHS uses health and care data. That means maintaining the highest standards of privacy and ethics, investing in secure data environments and cyber security, involving the public in decisions about how data is used in the future, listening and responding to their views and concerns.
We published a draft of this strategy in June 2021, and I would like to thank the hundreds of people and organisations who provided feedback which was invaluable in shaping this final version of our strategy for the future.
I would also like to thank Dr Ben Goldacre for his work on the Goldacre Report, which was published in April, and made a compelling case for how data can drive innovation and improve healthcare. I fully support his recommendations and this strategy shows how we will take them forward.
I will deposit a copy of the draft strategy in both Libraries.
[HCWS98]
Smokefree 2030: Independent Review
Sajid Javid Excerpts(2 years, 5 months ago)
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The Secretary of State for Health and Social Care (Sajid Javid)
In 2019, this Government set the bold ambition for England to be smokefree by 2030—reducing smoking rates to 5% or less.
Today, Dr Javed Khan OBE published his independent review on Smokefree 2030, providing this Government with a wide range of recommendations for how we can achieve this ambition.
Tragically, smoking remains the single biggest cause of preventable illness and death across the country. There are still almost 6 million smokers in England—and two out of three will die from smoking unless they quit.
Although smoking rates have fallen, we know that they are currently not falling fast enough.
The Government are committed to levelling up society and extending the same chances in life to all people and all parts of our country. However, smoking is one of the largest drivers of health disparities and rates vary substantially across different parts of the country. As stated by Dr Khan in his independent review, at its most extreme, smoking prevalence is 4.5 times higher in Burnley than in Exeter.
Smoking is a significant drain on the household finances of our most disadvantaged families. In Halton in Cheshire, smokers spend an estimated £3,551 a year on tobacco, nearly 15% of their income. Reducing smoking presents a huge economic opportunity in higher disposable income and higher labour productivity.
Smoking is particularly high amongst certain populations, and one third of all cigarettes smoked in England are smoked by people with a mental health condition. Nearly 10% of mothers smoke at the time of giving birth, increasing the risk of sudden infant death syndrome by over three times compared to mothers who do not smoke. Further, the risk of stillbirth is increased by at least 60% if the father smokes. Smoking is also known to increase the risk of miscarriage.
Behind all of these statistics are individuals, families and communities who are suffering from the harms of tobacco. This Government are committed to doing more to help smokers to quit and stop people from taking up this deadly addiction. We also know that most smokers want to quit.
For these reasons, we asked Dr Khan to undertake this independent review to help the Government reduce the devastation that smoking causes in our communities. There are a number of recommendations in Dr Khan’s independent review. The Government will now consider their response.
There is a call for greater investment—from local authority-led stop smoking services, through to improved data and evidence. The Government are already investing funding through the public health grant, but we will examine where we can go further.
There is a call to offer vaping as a substitute for smoking. Vaping is far less harmful than smoking and is an effective quitting device. It is recognised that there is much more Government can do to tackle the myths and misconceptions that surround vaping. We have worked with the MHRA to provide guidance to support bringing e-cigarettes to market as licensed therapies and this Government will take forward a range of work on vaping as a substitute for smoking in due course.
Dr Khan also calls for the NHS to prioritise further action to stop people from smoking. Smoking costs the NHS £2.5 billion every year. The benefits of focusing on preventing smoking-related illnesses, rather than treating them, are clear for patients and the NHS themselves.
This Government are determined to address the challenges raised in the independent review and to meet the Smokefree 2030 target. We know that more action needs to be taken to protect our people from this dangerous addiction.
The Department will now carefully consider the recommendations set out in this independent review. The independent review will help to inform our upcoming White Paper on health disparities, which we plan to publish this summer. To complement this, the Department will also be publishing a new tobacco control plan in due course.
We would like to thank Dr Khan for his far-reaching work on the independent review, and for his clear and challenging recommendations.
A copy of the independent Khan review will be deposited in the Libraries of both Houses.
[HCWS87]
Health and Social Care Leadership Review
Sajid Javid Excerpts(2 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Sajid Javid)
With permission, Mr Speaker, I will make a statement on the independent leadership review of health and social care.
This is an important report that comes at a critical time. This Government are embarking on a huge programme of reform to tackle the covid backlogs, to improve people’s experience of the NHS and social care, and to place this system on a sustainable footing for the future. But we cannot seize this opportunity and deliver the change that is so urgently needed without the best possible health and care leadership in place, because great leaders create successful teams, and successful teams get better results. So a focus on strong and consistent leadership at all levels, not just on those who have the word “leader” in their job title, will help us in our mission to transform health and care and to level up disparities and patient experiences.
This review, which I have deposited in the Libraries of both Houses, was tasked with proposing how to deliver a radical improvement in health and social care leadership across England. It sets out a once in a generation shake-up of management, leadership and training, as well as how we can make sure that health and care is a welcoming environment for people from all backgrounds, free from bullying, harassment and discrimination.
The review was led by General Sir Gordon Messenger, former Vice-Chief of the Defence Staff, and Dame Linda Pollard, the chair of Leeds Teaching Hospitals NHS Trust. I thank them both for taking on this role and providing their varied experience of leadership, along with everyone in their review team who has contributed to this important review.
Before I turn to the recommendations of the review, I shall update the House on its findings. The review found that, although there are many examples of inspirational leadership within health and social care, from ward to board, these qualities are not universal. The report states that
“there has developed over time an institutional inadequacy in the way that leadership and management is trained, developed and valued.”
As a result, careers in management are not viewed with the same respect and prestige as clinical careers. The review also found
“too many reports to ignore”
of poor behaviour, and that the acceptance of bad behaviours like discrimination, bullying and responsibility avoidance has become “almost normalised” in certain parts of the system.
We must only accept the highest standards in health and care, where failures in culture and leadership can make the difference between life and death. So we must do everything in our power to share and promote brilliant, innovative management and to act firmly where standards fall short. This means culture change from the top of the system to the frontline. The review identifies a number of areas where improvement is needed, and it makes seven transformative recommendations. I will quickly update the House on each of them in turn.
First, the review recommends new measures to promote collaborative leadership and to set a unified set of values across health and care. This includes a new national entry-level induction for new joiners to health and care, and a new national mid-career programme for managers.
Secondly, the review recommends that we should agree and set uniform standards for equal opportunities and fairness, with more training to ensure that the very best leadership approaches become ingrained. The Care Quality Commission must support this work by measuring progress through regular assessments. This does not mean more people working in diversity but fewer. In my view, there are already too many of these roles and, at a time when our constituents are facing real pressures on the cost of living, we must spend every penny with care. Instead of farming out this important work to a specific group of managers, it must be seen as everyone’s responsibility, with everyone being accountable for extending fairness and equal opportunities at work.
Thirdly, the review recommends a single set of unified leadership and management standards for NHS managers. These standards will apply to everyone, including those who work part time and flexibly, with a curriculum of training and development to help people meet them. This modernisation is well overdue, and completing the training should be a prerequisite for advancing to more senior roles.
Fourthly, the review recommends a more simplified, standardised appraisal system for the NHS, moving away from variation in how performance and career aspirations are managed towards a more consistent system that takes into account how people have behaved, not just what they have achieved.
Fifthly, the review identifies a lack of structure around careers in NHS management. It proposes a new career and talent management function for managers at a regional level, to oversee and support careers in NHS management and to provide clear routes to promotion, along with training and development.
Sixthly, the review recommends that the recruitment and development of non-executive directors needs to be given greater priority due to their vital role in providing scrutiny and assurance. It proposes an expanded specialist appointments team in the NHS, tasked with encouraging a diverse pipeline of talent.
Finally, there is currently little or no incentive for leaders and managers to move into the most challenging roles, as the barriers are often seen as simply too high. I want leaders in the NHS to seek out those roles, not shy away from them. It is essential that we address that and get great leaders into areas that feel left behind. The review proposes an improved offer, with stronger support and incentives to recruit top talent into those positions.
We will be accepting these comprehensive, common-sense recommendations in full. The recommendations have been welcomed by groups representing people who work throughout the NHS, including by the NHS Confederation and NHS Providers. By taking the review forward, we can finally bring how we do health and care leadership into the 21st century, so that we have the kind of leadership that patients and staff deserve, right across the country, and so that we make sure that some of our country’s most cherished institutions can thrive in the years ahead.
I commend this statement to the House.
Wes Streeting (Ilford North) (Lab)
The Secretary of State has picked quite the week to talk about standards in leadership.
I give a huge thanks to NHS staff and leaders for the work they are doing against the most extraordinarily difficult backdrop. I also thank General Sir Gordon Messenger and Dame Linda Pollard for carrying out the review. Its seven recommendations are sensible, and I am pleased the Secretary of State has already committed to implementing them.
As this is a rare example of decisiveness from the Health Secretary, can he tell us when he intends to publish his implementation plan? All too often, the senior leadership of the NHS still does not represent the diversity of the population it serves. Instead of throwing red meat to his Back Benchers, for reasons that will probably be obvious to everyone, I would like to hear how, in particular, he intends to ensure that equality, diversity and inclusion will be improved, so that the best leaders are incentivised into the most challenging roles and are able to provide inclusive healthcare for the breadth of diversity in our great country. Can he explain why the review has not covered leadership in primary care or social care in any detail? Surely this is a missed opportunity. Let us face it: although he is trying to dress this up as the biggest shake-up in history, I am not sure that giving staff an induction on joining the NHS is a revolutionary development, and it hardly meets the scale of the challenge.
The NHS faces the biggest crisis in its history. NHS staff are in a system under pressure like never before, and there are simply not enough of them. There are currently 106,000 vacancies across the NHS, and staff are leaving in droves. In some specialties, such as midwifery, they are leaving faster than we can recruit them. I do not know how the Health Secretary expects NHS managers to demonstrate good leadership and deliver the best outcomes for patients when there are no staff to lead. For an organisation the size of the NHS, one of the biggest employers in the world, not to have a plan for its workforce is unbelievably negligent. What is the NHS meant to do until he eventually delivers his long-term workforce strategy, which he has been promising for some time? How are managers meant to lead effectively when instead of thinking about patient care as their primary driver, they have become buildings and facilities managers, because the ceilings are falling in? The only place where more than 40 new hospitals really exist is in the Prime Minister’s imagination.
The Health Secretary said that we should accept only the highest standards in NHS management, so let me ask him not about the generalities, but about the specifics. Last month, it was reported that North East Ambulance Service bosses oversaw cover-ups of negligence, leaving about 90 families not knowing how their loved ones died. He said yesterday that he is still considering whether to launch a review. Is he seriously considering protecting managers who cover up bad practice, instead of standing up for grieving families? Staff in that service were reportedly paid to sign gagging clauses, and I understand that attempts to get them to sign such clauses are still under way. In a written question, I asked how many non-disclosure agreements had been signed in the NHS since the Government said that they would be banned in 2014. He does not know and he is refusing to investigate the use of gaging clauses in the NHS. So how can he claim to be shaking up NHS culture and dealing with bullying when he has no interest in what is going on under his nose?
Of course the NHS needs good leaders, but when it comes to examples of poor leadership in the NHS, the Health Secretary did not need the Messenger review; he just needed to look in the mirror. This is the man who described the NHS as Blockbuster Video
“in the age of Netflix”,
as if it was the greatest revelation since Moses received the 10 commandments. Who has been in government for the past 12 years? On his watch, on this Government’s watch, we have the highest waiting times in the NHS’s history; the lowest patient satisfaction since 1997; longer waiting times for cancer in every year since 2010; heart attack and stroke victims left waiting for about an hour, on average, for ambulances; and patients at risk of serious injury because the hospital is crumbling around them. He kicked off his own Health Week expecting applause for the fact that, despite his best efforts, there are still 9,000 people waiting for more than two years for treatment. He knows, I know, NHS staff know and the public know that with this Government, NHS staff are lions led by donkeys, wanting and inadequate.
Sajid Javid
I am not surprised by the typical response from the hon. Gentleman: not really engaging with the real issues and showing once again that he is more interested in theatrics than in the real issues facing our NHS. He started his comments by trying to make some kind of joke about the leadership news this week, but we all know that he is only interested in one leadership review in a political party in this House, and it is not the Conservative party’s.
Let us look at the issues that the hon. Gentleman raised. He rightly talked about the importance of the workforce overall and how we need more doctors and nurses. He should know that we have more doctors and nurses than ever before and that we are recruiting at a faster rate than ever before, with 10,000 more nurses and over 4,000 more doctors in the past year, and more in training than ever before. However, he will know that dealing with the challenges of getting more workers and building those hospitals, all of which are on track, requires proper funding, yet he and his party voted against the funding that the NHS needed to achieve that.
The hon. Gentleman is right to talk about when things go wrong in the NHS. Of course they need to be properly investigated, as they were in Telford and Shropshire, when we learned about the terrible things that had been going on under successive Governments in that trust. When there is a need for other investigations to take place, including independent ones, such as the one I have just asked for in Nottingham, that will be done. But the hon. Gentleman should understand that the best thing, which is far better than doing a review when things go wrong, is not having things go wrong in the first place. That is why he should have welcomed this report.
Mrs Theresa May (Maidenhead) (Con)
This is an important review. There have been regular radical changes in the management of the NHS throughout my 25 years in this House, so may I suggest that my right hon. Friend proceeds with care? He rightly says that good leadership of the NHS is important, for example, to ensure that we can deal with the covid backlogs, and that includes consultants. Too many experienced consultants are leaving the NHS because of problems with their pensions, so will he now commit to an urgent review of this issue, including looking at the change in the abatement scheme?
Sajid Javid
I thank my right hon. Friend for her comments. I always listen carefully to what she has to say, given her important experience. On the pension issue, she will know that in the 2020 Budget, I believe it was, significant changes were made, especially to where the taper rate kicks in—it went from £110,000 to £200,000. That benefited the top 5% of earners in this country, but it was the right thing to do to encourage and incentivise doctors, in particular, to work more. She is right to talk about what more we can do. We are looking precisely at what further flexibilities we can offer on pension arrangements.
Barbara Keeley (Worsley and Eccles South) (Lab)
The Health and Social Care Secretary talks about strong leadership and culture change. I point out to him his Government’s and his Department’s dismal record in meeting the pledge to close the in-patient units that are being used to trap more than 2,000 autistic people and people with learning disabilities rather than support them in their own homes. We have just passed the 11-year anniversary of the scandal at Winterbourne View. Not only has his Government failed in their pledge to close down these units, which was the original promise made after that scandal, but 560 people in those in-patient units do not need to be there at all, a quarter of them are more than 50 km from their own home, people are spending longer in units now than they were seven years ago, and more people have been admitted to the units year on year from 2015-16. This is one of the biggest scandals and the worst failures of his Department and Government. When is he going to act on it?
Sajid Javid
The hon. Lady is right to highlight the importance of this issue and she will know that my predecessor had asked for a review on it. It was done and we have accepted its outcome, and it is being implemented. I hope she will understand that in implementing the outcome of that review it is important that we listen to clinical advice from within the NHS and make sure that we put the interests of each patient first.
Jeremy Hunt (South West Surrey) (Con)
I thank the Health Secretary for this excellent report and commend Sir Gordon Messenger and Dame Linda Pollard for all their work in putting it together. It has some very important recommendations. People who run hospitals are doing one of the most difficult jobs in Britain today, and anything we can do to give them better support in their careers will help all of us.
Does my right hon. Friend agree that the elephant in the room is that one thing that makes their job most difficult: we have more national targets in the NHS than any other health system anywhere in the world? That means not only that there is a risk of patients turning into numbers, but that we remove the autonomy from managers to show the leadership that Sir Gordon is advocating in this report. So as my right hon. Friend implements the recommendations, will he look at the role of national targets in the NHS and whether we need to simplify and reduce them?
Sajid Javid
I thank my right hon. Friend for his support of the report. Of course he speaks with incredible experience. He is right to raise the issue of the importance of targets, and sometimes targets can have unintended consequences. The report does talk a bit about the importance of that issue. I can assure him that as we make changes and work with our colleagues in the NHS to make reforms, we will certainly be taking that into account.
Derek Twigg (Halton) (Lab)
As the Secretary of State will have seen over his years as an MP and a Minister, there are managers and leaders who are excellent and outstanding and there are others who are not so good. Is not part of the problem, as the right hon. Member for Maidenhead (Mrs May) mentioned, the continual structural changes, which add to instability, the massive recruitment and retention problems and the record numbers of people using the hospitals? No matter what he does to improve leadership, it will not solve all those problems. Part of the problem is that we do not have enough people coming forward to take up leadership roles. At what point in the next five to 10 years does he expect to have solved the leadership crisis in the NHS?
Sajid Javid
The hon. Gentleman is right to talk about the importance of recruitment in the NHS—bringing in the right people in the first place and then retaining them—but I hope that he will also recognise that good leadership plays an important part in that. This morning, I went to Chelsea and Westminster Hospital, which is an outstanding and incredibly well run hospital, and heard from the leadership team about the important role that they play in attracting and retaining talent. I hope that he recognises that point as well.
Sir Desmond Swayne (New Forest West) (Con)
Why is the Secretary of State’s departmental leadership team advertising for a deputy director, delivery, for the Covid Pass programme? What is that about?
Sajid Javid
The reason why the Department keeps that under review is that, although the pass has stopped and there is absolutely no prospect that I can see of its ever coming back into place, it is right that, as we wind things down and work on the digital resources, all things are looked at appropriately.
Florence Eshalomi (Vauxhall) (Lab/Co-op)
On Thursday 19 May, I and a group of south London MPs met south London nurses from the Royal College of Nursing. They told us that they are tired. They told us that they are fed up. They told us that they are having to use food banks. They told us that they are seeing their salaries squeezed by the cost of living. They told us that they face bullying, intimidation and abuse at work. This was coming from staff members who work in our hospitals, including at St Thomas’s Hospital, in my constituency, which I know the Secretary of State has visited on many occasions.
There is a big gap—an omission—around this leadership issue in social care. We have big retention issues. There are more than 9,000 vacancies. Does the Secretary of State have a plan to address that big omission in health and social care, including retaining the people we need on the frontline?
Sajid Javid
The short answer is that, yes, the hon. Lady is right to talk about the importance of retaining and recruiting more nurses. When it comes to nurses’ pay, she will know that we gave a 3% rise last year when there was a freeze for the public sector workforce generally. This year, we will be listening carefully to what the independent recommendation is.
John Redwood (Wokingham) (Con)
How many directors and chief executives of health bodies are there in the NHS, and what performance requirements are built into their contracts? We want them to deliver high-quality care with falling waiting times.
Sajid Javid
I cannot give my right hon. Friend the exact number that he is asking for, but I can answer the latter part of his question. I agree that we want to see a massive improvement in appraisal and performance standards; I am sure that, when he gets to see the report in detail today, he will be pleased by what he reads.
Grahame Morris (Easington) (Lab)
The Secretary of State said that we must accept only the highest standards and act where standards fall short. My constituent, Paul Calvert, bravely exposed the management failures of the North East Ambulance Service and, indeed, the criminal negligence of cover-ups of patient deaths.
Mr Calvert, who gave me his permission to raise this case—I met him in person last week—is being bullied, harassed and blackmailed, but he still refuses to sign a non-disclosure agreement. He was offered £41,000 conditional on his silence and on destroying the evidence that he has of wrongdoing. Tomorrow, we anticipate his employment being terminated. Mr Calvert and grieving families want a public inquiry into the North East Ambulance Service. Does the Health and Social Care Secretary agree, and will he outline how the Messenger review will protect NHS whistleblowers such as my constituent, Mr Calvert?
Sajid Javid
I thank the hon. Gentleman for bringing Mr Calvert’s case to my attention. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), has listened to that carefully. She is meeting some of the families affected by that case very shortly, and Mr Calvert is someone to whom she can reach out directly.
Like the hon. Gentleman and, I am sure, the whole House, I am very concerned about what I have heard about this ambulance service. I am not satisfied with the review that has already been done. We need a much broader and more powerful review. I will have more to say on the matter very shortly.
Mary Robinson (Cheadle) (Con)
I welcome this review and thank my right hon. Friend for bringing his statement to the House. Good leadership is important because it drives the culture within an organisation. It was terrible to hear what the hon. Member for Easington (Grahame Morris) had to say just now. We can see that bullying and harassment in an organisation often come down to how the leadership and the processes are operating.
Whistleblowers need to know that they can rely on the processes within organisations, but who do they go to as well? The National Guardian’s Office would be one, as would the local guardians in the hospitals. I recently introduced a whistleblowing Bill to ensure that people are able to go to another body, because they cannot be constricted within their organisation. We need to be able to benefit from whistleblowers who speak out and expose wrongdoing so that we can close down these cultures that we have seen operating in our organisations.
Sajid Javid
My hon. Friend is right: it is important that, where people who are working within the NHS or social care see wrongdoing or things that concern them, they have a safe space to report that and to make sure that their concerns are properly addressed. She will know that the Health and Social Care Act 2022 contains new provisions, including one for the Health Services Safety Investigations Body, but I have listened carefully to what she has said and I will consider what more we can do.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
The Secretary of State might recall that, as a member of the all-party group for management, I have had a long interest in management and good management. I congratulate him on having this review, because the NHS is a complex organisation.
The Topol review that was carried out only two or three years ago showed a world of technology and change that is almost beyond belief for such a massive human organisation. I have not had the time to read the report yet, but is the Secretary of State sure that we have high-quality training for our managers? Many of the business schools and many of the people providing the training in our universities are not training for that kind of environment. We do need first-rate, high-quality management schools with a health bias.
Sajid Javid
I agree with the hon. Gentleman. I know that he has a long-standing, valuable interest in this issue. I appreciate that he has not had time to look at the report, but I think he will be pleased when he reads our recommendations around a modern training plan.
Mr Peter Bone (Wellingborough) (Con)
The most important thing that happened in Westminster this week was yesterday’s reception for Harry’s Pledge. Harry is a young boy who needs a lot of care. Harry’s Pledge campaigns for the needs of carers and those who are cared for. I am introducing a private Member’s Bill to give guidance for that. Will the Secretary of State look at that Bill to see whether the Government could support it? Leaders in care need to have the guidance to judge whether they are succeeding.
Sajid Javid
This is a very important issue for my hon. Friend. I would be happy to meet him to discuss it further.
Clive Efford (Eltham) (Lab)
NHS staff are exhausted and demoralised, and now we are asking them to deal with the growing waiting lists. We still have a huge vacancy problem within our NHS. Where is the plan to deal with that issue? If we are to improve our NHS going forward and have anything there for these managers to manage, we need to deal with that problem within the workforce.
Sajid Javid
That is exactly why I have commissioned a 15-year workforce strategy from the NHS.
Lucy Allan (Telford) (Con)
I thank the Secretary of State for his statement and congratulate him on the work he has been doing in this important area. Does he agree that for too long there has been a culture of a lack of accountability among NHS senior management, and too often a blame culture, where things go wrong but are not transparently acknowledged? Does he agree how awful that is for the patients concerned? Will he do everything possible to ensure that we tackle the blame culture and the lack of accountability to the public, who the NHS is there to serve?
Sajid Javid
I agree very much with my hon. Friend. She will know from her own NHS trust, particularly the maternity problems there and the terrible cases set out in the Donna Ockenden report, just where that kind of culture can lead. Of course there are fantastic examples day in, day out of great culture and great leadership in the NHS, but there are also poor outcomes. She is absolutely right that we need to tackle those. That is exactly what is in this report.
Alex Cunningham (Stockton North) (Lab)
I cannot really understand why yet another restructure of the NHS is the answer to the crisis we face. The last one diverted billions of pounds from patient care, and millions of people are suffering as a result. Instead of yet another costly restructure, why does the Secretary of State not just get on with building the new hospitals we need, such as the one at North Tees in Stockton, and tackling the health inequalities that blight our communities?
Sir David Evennett (Bexleyheath and Crayford) (Con)
I warmly welcome my right hon. Friend’s statement on the review and his strong support for inspirational leadership, which is key for our NHS. Does he agree that relevant training and career development are vital for all staff working in the NHS, to allow them to gain career advancement?
Mr Clive Betts (Sheffield South East) (Lab)
I hope the Secretary of State will agree that it is key that managers in the NHS and local authorities can work together effectively. I give great credit to the leaders in the clinical commissioning group, the hospital trust, the director of public health, the social care directors and the city council, who worked really well together in Sheffield during the pandemic to deliver a joined-up service and have kept us as MPs thoroughly involved.
As we move on to the slightly wider integrated care system and integrated care board, will he give a commitment that the place-based working that has been so effective in the past will be allowed to continue at local authority level?
Sajid Javid
The place-based working that the hon. Gentleman talks about is also at the heart of the integration White Paper that the Government presented recently.
Dr Andrew Murrison (South West Wiltshire) (Con)
I welcome Gordon Messenger’s review, but does the Secretary of State not agree that in the history of the national health service, reorganising senior management has often been a distraction? Will he prioritise the area that would make a real change to health and care—the interface between the two—and focus on career progression and development for care workers in particular, who hold the key to unblocking the awful problems that we have in both sectors?
Sajid Javid
I know my right hon. Friend speaks with experience, and I appreciate that he will not have had time to look at the report in detail yet, but I think when he does read it he will find that it is precisely what he has just asked for. This is not a reorganisation; it is all about strengthening management, and the report sets out in quite some detail how that can work.
Nick Smith (Blaenau Gwent) (Lab)
I agree with the right hon. Member for Maidenhead (Mrs May) on NHS reorganisations. I once met a very senior and very able NHS manager who said they had been through 14 restructures of the NHS and they quite liked number five. How will this review better integrate ambulance services with their local hospitals to improve performance standards for local patients?
Sajid Javid
When it comes to ambulance services, an important part of the NHS, this review is just as important. We all want to see good leadership in ambulance services, but if we get better leadership across the board we will see better collaboration and co-ordination—something heavily referred to in the report.
John Stevenson (Carlisle) (Con)
I welcome this statement; leadership is vital and it is something we do not talk enough about in this country, whether in the private or public sector. My right hon. Friend referred to recommendation 6 on non-executive directors. Does he agree that we need to attract a more diverse set of non-executive directors, with regard to their skillset as much as anything else?
Jim Shannon (Strangford) (DUP)
I thank the Secretary of State for his statement and for the commitment to quality leadership within the NHS. As he said himself, that is so important. The review findings and recommendations are a method to deliver that improvement. Retention of staff—the consultants, the GPs, the doctors and the nurses—is core to any improvement, so what is being done to retain staff and not lose them? Is it the Secretary of State’s intention to share the findings with regional Administrations, particularly the Northern Ireland Assembly, to provide betterment across all the United Kingdom of Great Britain and Northern Ireland?
Sajid Javid
The hon. Gentleman will know that the review specifically looked at the NHS and care in England, but there are important lessons here that can be drawn on by, for example, the health service in Northern Ireland. On the issue of retaining staff, the NHS is undertaking many initiatives to improve that, but I hope he will agree with me that one key way to retain staff is to ensure we have good leadership and good managers.
James Wild (North West Norfolk) (Con)
The review underlines how vital leadership is to driving change and improvements in care. I put on record my thanks to the chief executive and board of the Queen Elizabeth Hospital Kings Lynn NHS Foundation Trust, who have taken that hospital out of special measures, thanks to the hard work of the staff. As my right hon. Friend knows, to continue to improve care and to retain and recruit staff there is a pressing need for a new hospital for the QEH. I urge him to make an announcement on the new hospitals programme and to back QEH’s bid.
Sajid Javid
My hon. Friend rightly never misses an opportunity to make the case for his local hospital. I have heard him carefully and I am happy to meet him to discuss it.
Stephen Hammond (Wimbledon) (Con)
I thank my right hon. Friend for his statement and for the report. Recommendation 4 talks about a standardisation of appraisal. Does he agree that cutting out variation in performance is key, and will he therefore confirm that the recommendations from Tim Briggs’s “Getting It Right First Time” report will be embedded in that standardisation procedure?
Sajid Javid
I agree with my hon. Friend: that recommendation for a standard appraisal system, which, remarkably, does not exist at the moment, is of particular importance, like all of the recommendations. I agree with the emphasis he puts on that.
Richard Graham (Gloucester) (Con)
The focus that the Health Secretary is giving to leadership management training must be right. We all know that in a Care Quality Commission report on a hospital or an Ofsted report on a school, one of the key differences between adequate and outstanding is the quality of leadership. All credit to the report for focusing on that; I think we would all benefit from understanding that it is one of the key characteristics of hospitals whose internal staff surveys show strongly positive morale—often a key leading indicator.
Will the Secretary of State say a word or two about the point raised by the hon. Member for Easington (Grahame Morris)? The report and what has come out of the North East Ambulance Service are truly shocking and highlight what I think Sir Gordon Messenger called a need for a change of culture. How can we encourage all our NHS trusts to be open and transparent about what has gone wrong, so that we do not have future scandals like that?
Sajid Javid
My hon. Friend will see when he has had the opportunity to read the report in full that it does rightly talk about the importance of that particular issue: ensuring that people within the NHS and care feel comfortable coming forward when they see wrongdoing, so that we can act much more quickly. That is why we will be implementing all the recommendations. Regarding the North East Ambulance Service, I hope he heard what I said earlier about the need to look at that again very carefully.
Mr John Baron (Basildon and Billericay) (Con)
As a former chair of the all-party parliamentary group on cancer for 10 years, I welcome this review. However, I put it to my right hon. Friend that at least part of the problem with waiting times and lists is the fact that only around half of all NHS staff are clinically trained. There is an imbalance there. Following my amendment during the passage of the Health and Care Act 2022, which he accepted, I suggest that one thing that could really help would be to get the NHS to focus more on outcomes such as one-year cancer survival rates, as a means of encouraging earlier diagnosis, and less on processes, which are very management-heavy.
Anna Firth (Southend West) (Con)
I thank the Health Secretary for this vitally important report at this critical time. Is he aware of reports circulating in the media that some NHS health information pages appear to have been de-sexed in their language about conditions affecting women? Is he, like me, very concerned about this, and will he look into it?
Sajid Javid
My hon. Friend will not be surprised to learn, I hope, that as Health Secretary I think an individual’s biological sex is incredibly important when trying to meet their health needs. I have seen the reports. In fact, I do not think they are just reports. With regard to the NHS website on ovarian cancer, I think it is actually has been, as she puts it, de-sexed. That is not something that I agree with. Of course, issues of gender, rather than sex—I distinguish the two—should be approached with compassion and sensitivity, but it is right that when it comes to healthcare, where there are health issues that impact only people of a particular biological sex, such as ovarian cancer and prostate cancer, the health service recognises that.
Jerome Mayhew (Broadland) (Con)
I am very concerned that the review found evidence of a blame culture and responsibility avoidance. We have to be clear that this culture is not just damaging but actually kills patients, because lessons are not learned from mistakes that are actively hidden. What can we learn from the airline industry, which adopted a no-blame culture and, through that, dramatically reduced airline-related deaths?
Sajid Javid
It was precisely because of that important point raised by my hon. Friend that when we had the recent Bill before Parliament—now the Health and Care Act 2022, thanks to the will of this House—we accepted the safe space amendment.
Duncan Baker (North Norfolk) (Con)
I recognise the importance of leadership and reform of the NHS. Can we now show some leadership and reform in the area of NHS dentistry? The Labour Government wrecked NHS dentistry when they brought in the contracts that have led to dentists leaving the profession in droves. When people up and down the country, including my constituents in North Norfolk, cannot see an NHS dentist, is it not about time that we reformed the rotten contracts that Labour brought in?
Sajid Javid
My hon. Friend is right. It is well known how the Labour Government came up with contracts with the British Dental Association that are leading to poor outcomes for millions of people across the country. We have already made some short-term changes, and we are in the process, right now, of making some longer- term strategic changes that will create all the right incentives.