Adult Social Care: Fair Pay Agreement and Workforce Pathway
Stephen Kinnock Excerpts(1 week, 4 days ago)
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The Minister for Care (Stephen Kinnock)
Today, I am proud to inform the House that this Government are setting out the details of the adult social care fair pay agreement, a landmark reform that will turn the page on decades of low pay, insecurity, and the exploitation of adult social care workers. In doing so, we are one step closer to delivering on our manifesto commitment.
Backed by £500 million in funding in 2028-29, the fair pay agreement will introduce annual negotiations between employer and worker representatives to agree improvements to pay and conditions for the adult social care workforce for the first time.
Led by an independent negotiating body, the fair pay agreement will strengthen the voice of workers and employers, support recruitment and retention, and help build a stable, sustainable, and growing domestic workforce.
Our response to the consultation sets out how the system will operate in practice, including how negotiations will be conducted, how agreements will be reached and implemented, and the role of the independent chair in overseeing the process. The Government will appoint a chair in the autumn and negotiations will begin in 2027.
Alongside the consultation response, we are also publishing part 3 of the care workforce pathway. The pathway is the first time the adult care sector, a workforce of 1.5 million, has seen a universal career structure with consistent standards and expectations around the knowledge, skills, values and behaviours required to deliver high-quality, personalised care and support. By adding 10 new role categories we are expanding the pathway’s coverage to nearly all adult social care workforce roles that are not health or social work, recognising and celebrating the breadth and diversity of the sector. Using the pathway, staff looking for progression can plot a route for their career and existing staff with specialist skills can be recognised for what they do, such as enhanced care workers.
Since coming into office, this Government have passed the Employment Rights Act, strengthened sick pay, supported professionalisation and raised the minimum wage. These much-needed reforms will mean that care workers have better job security, take home higher pay, and see improved professional recognition for their work.
There is more to do, but these important steps will help us lay the foundations for the national care service and demonstrate this Government’s ongoing commitment to tackling the recruitment and retention of the adult social care workforce, by ensuring that there are opportunities to develop and progress, and that people feel recognised and rewarded for the vital work they do.
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Unpaid Carers: Cross-Government Action Plan
Stephen Kinnock Excerpts(1 week, 6 days ago)
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The Minister for Care (Stephen Kinnock)
The Government are today publishing a cross-Government action plan for unpaid carers.
This action plan delivers on the Government’s commitment to strengthen support for unpaid carers across England. It sets out a co-ordinated programme of cross-Government activity to improve the visibility of unpaid carers, improve access to support, and ensure caring responsibilities are better recognised across public services and the workplace.
The plan has been developed collaboratively across Government with input from delivery partners. It responds to the need for more joined-up information and advice, improved data sharing between services, and stronger recognition of unpaid carers in workforce planning and service design. It also reflects the diversity of carers’ experiences, including the specific needs of young carers.
The action plan is structured around three core themes: recognise, refer, and reach.
Under the recognise theme, we will improve the identification and visibility of unpaid carers across health, education and employment settings. Key actions include developing “my carer” functionality within the NHS app to support self-identification and care management; improving the identification of young carers in education settings; embedding carer identification within personalised care planning; supporting NHS staff with caring responsibilities; and commissioning further research to better understand barriers to identification and improve data collection and employer support.
Under the refer theme, we will make it easier for carers to access the right support at the right time. This includes developing a cross-Government information and guidance resource bringing together support on finance, employment, health and wellbeing; exploring the use of digital notification systems such as NHS Notify and Diagnosis Connect to support targeted communications; promoting best practice on involving carers in hospital discharge planning; increasing awareness of employment rights and benefits; and improving transitions for young carers moving from children’s to adult services, including through initiatives such as the Local Government Association’s “No Wrong Door” memorandum.
Under the reach theme, we will support unpaid carers to reach their full potential alongside their caring responsibilities. This includes promoting flexible working and supportive workplace practices; reviewing the effectiveness of carer’s leave; supporting small and medium-sized enterprises to better support employees with caring responsibilities; strengthening and promoting carer passports; improving support for young carers in education; and ensuring carers’ needs are reflected across wider health, social care and employment reforms.
The action plan is underpinned by governance and oversight arrangements to ensure clear accountability, regular reporting, and ongoing review. This will support transparency on delivery and allow the plan to evolve in line with wider Government priorities and implementation milestones.
I am grateful to colleagues and officials across Government who have contributed to the development of this action plan, particularly in the Department for Work and Pensions, the Department for Business and Trade, and the Department for Education. I am also grateful to delivery partners for their valuable contributions in shaping this plan. Delivery of this agenda depends on sustained cross-Government collaboration and continued close working with our delivery partners.
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Lobular Breast Cancer: Moon Shot Project
Stephen Kinnock Excerpts(2 weeks, 4 days ago)
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The Minister for Care (Stephen Kinnock)
It is a pleasure to serve under your chairship, Mrs Hobhouse. I thank the hon. Member for Horsham (John Milne) for securing this vital debate. I also thank the hon. Member for Maidstone and Malling (Helen Grant) for campaigning on this topic, following her own diagnosis of lobular breast cancer.
I add my tribute to Dr Susan Michaelis, as today marks one year since she passed away from lobular breast cancer. As a founder of the Lobular Moon Shot Project, she campaigned tirelessly on behalf of women diagnosed with lobular breast cancer and raised awareness for the condition. I also pay tribute to members of the Lobular Moon Shot Project, including Susan’s husband, Tristan Loraine, for picking up the mantle, continuing the important work of the project and carrying Susan’s torch forward.
I recognise the number of charities that carry out important work in this area, such as Lobular Breast Cancer UK, Breast Cancer Now and Cancer Research UK, and all the right hon. and hon. Members who continue to provide support, many of whom we have heard from today.
Lobular breast cancer accounts for 15% of breast cancer cases. However, as we have heard, this form of cancer sadly goes undetected in too many women. We are determined to transform diagnosis and outcomes for patients. Earlier this year, the Minister for Public Health and Prevention, who is the lead DHSC Minister on this issue—I am standing in for her today—and Lord Vallance, the Minister for Science, Innovation, Research and Nuclear at the Department for Science, Innovation and Technology, met representatives of the Lobular Moon Shoot Project. Alongside Government research funders, they discussed the Lobular Moon Shot’s work, listened to the experiences of lobular breast cancer from those who attended, and discussed how to advance research in this vital area.
Following that meeting, last month Lord Vallance hosted a scientific roundtable that brought together a range of researchers, clinicians and industry representatives to identify opportunities to advance research and innovation. At that meeting, attendees agreed that one of the next steps should be to encourage collaborative research and funding applications across multiple existing schemes, including for basic discovery science. I would like to emphasise that Government research funders stand ready to support that work as it progresses.
We acknowledge and share the Lobular Moon Shoot Project’s ambition for researchers to take a collaborative and interdisciplinary approach to addressing the unique challenges of lobular breast cancer. Government responsibility for delivering cancer research is shared between the Department of Health and Social Care, with research delivered by the National Institute for Health and Care Research, and the Department for Science, Innovation and Technology, with research delivered via UK Research and Innovation.
The Medical Research Council primarily supports the discovery sciences and fundamental biological research, which is the focus of the Lobular Moon Shot campaign. Through MRC, UKRI has emphasised its commitment to supporting interdisciplinary team-based research across its funding schemes and highlighted support for collaborative activities to provide a platform on which to build a portfolio of research in this important area. NIHR’s research is complementary to the MRC’s focus, supporting the translation of discovery science into patient benefit.
Through the MRC and NIHR, we are already funding research into lobular breast cancer. For example, a breast cancer screening study is investigating whether a new, faster MRI scan could detect breast cancers earlier. The FAST—first post-contrast subtracted—MRI is a new type of scan that aims to detect cancers, including lobular breast cancer, that may not be routinely picked up by mammograms during a first screening visit. The £1.36 million study is jointly funded by the MRC and the NIHR. Furthermore, with a total investment of £32 million, the Institute of Cancer Research and the Royal Marsden’s NIHR Biomedical Research Centre support lobular breast cancer by combining translational research, precision diagnostics and targeted clinical trials to develop and test tailored treatments.
Promising discoveries are being made. Scientists at the Breast Cancer Now Toby Robins Research Centre at the Institute of Cancer Research have recently discovered a drug, currently being tested in clinical trials for a rare blood cancer, that could also be used to treat lobular breast cancer. Researchers now hope to progress the drug to clinical trials for lobular breast cancer. More widely, we are supporting world-leading research and development to enable the prevention of cancer and to improve diagnosis, treatment and care for people affected by the conditions. Cancer is a major area of NIHR spending. Reflecting its high priority, the institute spent £141.6 million on it in 2024-25. Alongside that, UKRI invested £198 million in cancer research in the same year.
We are investing in the best science, which explores lobular breast cancer both in isolation and in conjunction with other cancers, to maximise the opportunity to share learning and identify possible breakthroughs. Historically, the breast cancer research community has categorised the field around signalling, pathway and molecular presentation on tumours. Rather than naming a particular cancer sub-type, therefore, grants within the MRC portfolio focus on the understanding of molecular mechanisms common to both lobular breast cancer and invasive breast cancer.
We know that more research is needed. That is why both the MRC and NIHR are committed to continuing to support the development of high-quality, fundable research proposals. There are a range of existing opportunities across funders that support this developing portfolio. The NIHR is actively encouraging high-quality, ambitious research proposals on lobular breast cancer, having launched a highlight notice in late 2025 to signal to researchers our interest in funding research into this area.
Stephen Kinnock
I think my hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) was first.
Daniel Francis
I thank the hon. Member for Horsham (John Milne) for securing the debate. I have supported my constituent Emma Hunwick and her campaigning on this issue. It is the third time I have attended a debate on this subject in the two years I have been an MP. I hear what the Minister says about research, but I think what supporters want is assurance that we will not be having a similar conversation again next year. They want confidence that we will have made some progress in the next 12 months.
Stephen Kinnock
In a nutshell, what I am trying to lay out is that it is not an either/or question. There is a tremendous amount of work going on to research cancer, including lobular breast cancer, which is a vital subset of that work.
The challenge for us is the idea of ringfencing £20 million, because ringfencing is not the standard process. The standard process is to have applications that are subject to peer review and judged in open competition, with awards made on the basis of the importance of the topic to the public and health and care services, value for money and scientific quality. If there is a difference of view in the Chamber today, it is whether we have an ecosystem of cutting-edge research, applications and competitive process, based on the principles I have just outlined, or a ringfenced fund.
I have to be absolutely clear and straight with my hon. Friend that currently the Government are not of the view that a ringfencing approach is the right way to go. The worry is that that approach could potentially cut across the ecosystem-based approach that we are seeking to nurture and foster, which we believe will deliver better outcomes in the end.
Helen Maguire
Thankfully, the Minister has clarified some of the issues that I was going to ask about. He says the Government are not necessarily looking to ringfence the £20 million, but are waiting for applications for research. The Lobular Moon Shot Project has already put forward some ideas on research. He has said that he stands ready to support the project, so I would just like some more specific detail. He says that we are waiting for applications for research, but does not what the Lobular Moon Shot Project has submitted or talked about fall within that?
Stephen Kinnock
As I mentioned earlier, unfortunately I am not the lead Minister on this issue, so I do not have the most up-to-date information on the proposal that has been submitted. If it is okay with the hon. Lady, I will speak with the ministerial colleague, my hon. Friend the Member for Washington and Gateshead South, and write to the hon. Lady on that subject, providing an update on exactly where the proposal is in terms of the overall process that we have. Have I understood her intervention correctly?
Dr Arthur
I appreciate that the Minister is substituting for another excellent Minister, my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson); I am sad that she is not here, because she is fantastic. We ringfence money for brain tumour research—I know that that community wants more money, so I am not saying it is the gold standard, but we have made that choice, because we recognised the public concern about brain tumours. There is also public concern about lobular breast cancer and the feeling that people who have it are being left behind. It is fantastic that we have better screening coming on board, but ultimately people need treatment if they are diagnosed during the screening process.
The Minister highlighted the fact that there is a competitive bidding process. Is it the case that the bids are not good enough? If that is the case, can we invest money to improve the quality of those bids? As I said earlier, we could bring in better staff, perhaps from overseas, or invest in PhD students to work in this area.
Stephen Kinnock
My understanding is that there are bids that are good enough and they are the ones that have attracted funding for research into lobular breast cancer. What I do not know at this moment is precisely where the live bids are and whether they are making the cut in terms of the quality that we are looking for. I will absolutely follow up with my ministerial colleague, and I will write to my hon. Friend on that point.
Sam Rushworth
I think there is a space between the two approaches. As wonderful as the Lobular Moon Shot Project is, I fully respect why the Government say that we cannot allow campaign groups to dictate which universities get x millions of pounds for particular projects, and I see the value of there being a peer-reviewed process through a competitive ecosystem. However, there is a space where we can go beyond a highlight notice, whereby the Government could specifically say, “We want research that will answer these specific sets of research questions.” I wonder whether that is something that he could take back to his colleagues for consideration.
Stephen Kinnock
I will absolutely take that suggestion back. I understand my hon. Friend’s point about having a specific call for proposals. I will discuss it with my hon. Friend the Member for Washington and Gateshead South and get back to him.
Our approach to funding research is through open and fair competition and peer review to ensure that the highest-quality proposals most likely to deliver real impact for patients are funded without imposing financial targets or limits. We also recognise that international research co-operation is fundamental to driving medical breakthroughs and saving lives. That is why the DHSC participates in and influences the EU cancer mission, which aims to improve the lives of more than 3 million people affected by cancer by 2030 through multi-country research calls and activities. For breast cancer, that includes a focus on driving screening innovation, including the MammoScreen project, supported by UKRI, which is developing safe, non-invasive, microwave-based imaging for more accurate screening.
The Government’s national cancer plan for England, published earlier this year, sets out our ambition to improve cancer outcomes and ensure that by 2035, three in four people diagnosed with cancer survive for five years or more. Research, innovation and earlier diagnosis are central to achieving that ambition. We know that too many women with lobular breast cancer face delays in diagnosis because it can be more difficult to detect. That is why the work being championed by the Lobular Moon Shot Project is so important.
The cancer plan recognises that improving outcomes depends on strengthening research, supporting innovation and bringing together researchers, clinicians, charities, industry and patients to tackle some of the biggest challenges in cancer care. That spirit of collaboration is exactly what we have seen through the Lobular Moon Shot Project. Through continued engagement with campaigners, researchers and patients, we want to support progress towards a better understanding of lobular breast cancer, and ultimately improvements in diagnosis, treatment and outcomes for the women affected by it. More broadly, the plan is about improving not only clinical outcomes, but people’s experience of cancer care. Through more personalised support and better co-ordinated services, we want to ensure that every patient receives high-quality care and support throughout their cancer journey.
The ambition of the national cancer plan is clear: to combine the strengths of our NHS, our research community and our life sciences sector so that patients benefit from the very best cancer care. That includes people living with lobular breast cancer who deserve the same progress, hope and opportunity as every other cancer patient.
The DHSC was pleased to discuss the issue of NHS breast cancer screening at the petitions debate opened by my hon. Friend the Member for North Ayrshire and Arran (Irene Campbell) last month. The NHS breast screening programme offers all women in England between the ages of 50 and their 71st birthday the opportunity to be screened every three years for breast cancer, to help detect abnormalities and intervene early to reduce the number of lives lost to invasive breast cancer. In addition, some younger women at increased risk of breast cancer because of genetics or their family history are eligible for earlier, more frequent screening, sometimes using MRI rather than mammogram.
We are also investing in research to improve the early diagnosis of breast cancer through the early detection using information technology in health, or EDITH, trial, which is backed by £11 million in Government support via the NIHR. Almost 700,000 women from across the country will take part in the trial to test whether using AI to support radiologists increases the number of cancers detected in women taking part in the national breast cancer screening programme. The trial will evaluate multiple AI technologies to assist radiologists in screening mammograms for signs of cancer. It may enable one specialist to complete the process safely, freeing up hundreds of radiologists to tackle waiting lists and rising cancer rates.
My message to the research community is clear: research funding remains available, and that funding does not have a ceiling. We know that recent advances in technology and data science create a timely opportunity to accelerate progress. Our investment in research means that the UK is well positioned to lead research on this topic. We will continue to strongly encourage research applications. We stand ready to support the research community to develop and submit high-quality, ambitious proposals in remit for review.
Our belief is that that approach will maximise the opportunity of seeing major steps forward in delivering better outcomes for those with lobular breast cancer through research. I thank all hon. Members and you, Mrs Hobhouse, for your time today.
National Lung Cancer Screening Programme
Stephen Kinnock Excerpts(1 month ago)
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The Minister for Care (Stephen Kinnock)
It is a real pleasure to serve under your chairmanship, Sir Alec. I congratulate the hon. Member for Wokingham (Clive Jones) on securing this important debate and on his continued and relentless advocacy for people affected by lung cancer. I am grateful to the hon. Member for Strangford (Jim Shannon); to the Liberal Democrat spokesman, the hon. Member for Didcot and Wantage (Olly Glover); and to the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), for their comprehensive and constructive contributions. I pay tribute to my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson), the lead Minister on this policy area.
There is a great deal of consensus across the House on this issue. We all want to see more lung cancers diagnosed earlier, more lives saved and fewer families affected by the devastating consequences of a late diagnosis. Lung cancer remains one of the greatest cancer challenges that we face. More than 42,000 people were diagnosed with lung cancer in England in 2023, and about 35,000 people lose their life to the disease across the United Kingdom each year.
Lung cancer is also one of the cancers most strongly associated with deprivation. People living in the most deprived communities experience higher rates of smoking, a higher incidence of lung cancer and poorer health outcomes. That is why tackling lung cancer is about not only improving cancer survival, but reducing some of the most persistent health inequalities in our society. For too long, outcomes for lung cancer have lagged behind those for many other cancers. The reason for that is well understood: too many people are diagnosed when their cancer is already at an advanced stage, limiting treatment options and reducing the likelihood of successful outcomes.
That is why early diagnosis is absolutely critical. When lung cancer is diagnosed at stage 1, five-year survival is over 60%. By stage 4, it falls to just over 4%. Those figures alone demonstrate why finding lung cancer earlier remains one of the most effective ways of improving survival. The Government fully recognise the importance of this challenge. Improving outcomes for lung cancer and other less survivable cancers will be critical to achieving the Government’s ambitious objective that 75% of people diagnosed with cancer should survive for at least five years. That is why the national cancer plan places a strong focus on earlier diagnosis, reducing inequalities and ensuring that people with less survivable cancers receive the attention and support that they deserve.
Jim Shannon
This debate is about lung cancer, but I noticed a story in the paper today about an increase of between 5% and 10% in the number of people who now have breast cancer. Does the Minister agree that that underlines the issue that while there are many advances in cancer, and we welcome all of them, there is still a long way to go?
Stephen Kinnock
The hon. Gentleman is absolutely right. There is a lot more work to be done, and it is a priority for the Government: it is right up there in the 10-year plan and the priorities. As he said in his excellent speech, we need to mobilise every one of the shifts—from analogue to digital, from hospital to community and from sickness to prevention—in the battle against cancer, because it is a formidable enemy and we need every single weapon we can deploy to defeat it.
We are determined to break the historical pattern of slow progress and finally give people with less survivable cancers the focus, urgency and outcomes that they deserve. That commitment is already being translated into action through the NHS lung cancer screening programme. The programme is designed to identify cancers at an earlier stage among those at highest risk, particularly people aged 55 to 74 with a history of smoking. Smoking remains responsible for about 72% of lung cancers, which is why a targeted approach is both clinically effective and evidence-based.
The results so far have been extremely encouraging: more than 1.8 million people have attended a lung health check through the programme, and more than 11,000 people have been diagnosed with lung cancer. Most importantly, 77% of cancers detected through the programme have been diagnosed at stage 1 or stage 2; outside the programme, the equivalent figure is about 30%. That means that thousands of people are receiving a diagnosis earlier, accessing treatment sooner and benefiting from significantly improved prospects for survival.
The programme is already demonstrating how earlier diagnosis can transform outcomes. Recent NHS England data shows a significant improvement in early-stage diagnosis in areas participating in the programme. That means more people are being diagnosed when treatment is most effective and when there is the greatest opportunity for curative intervention.
The hon. Member for Wokingham and others have spoken about the importance of a truly national programme. I agree that every eligible person should have the opportunity to benefit from lung cancer screening. That is why the Government are committing more than £650 million to complete the roll-out of lung cancer screening across England by 2030. Through the national cancer plan, we have committed to ensuring that every eligible person in England receives their first invitation for a check by 2030, helping thousands more people to benefit from earlier diagnosis and improved outcomes.
This investment reflects the Government’s confidence in the programme and the evidence supporting it. By 2035, lung cancer screening is expected to diagnose up to 50,000 cancers and identify at least 23,000 cancers at an earlier stage, helping thousands more people to receive potentially lifesaving treatment. This represents one of the most ambitious cancer screening programmes anywhere in the world.
Dr Luke Evans
I appreciate that this is not part of the Minister’s brief. The speed of the programme’s roll-out is fantastic, but there remains a concern that if 60% of people have taken it up, 40% have not done so, despite having had an offer that could have been given to someone else who wanted to go. Can the Department take that point away and work out what is being done to close that gap of more than a third? There is clearly a greater opportunity to get more people in and get them detected sooner.
Stephen Kinnock
The shadow Minister is right that promoting and maximising uptake is a crucial indicator of success for the programme. I thank him for giving me the opportunity to take that point away; I will discuss it with my hon. Friend the Member for Washington and Gateshead South, and we will get back to him in writing as soon as possible.
Hon. Members have rightly raised the issue of inequalities. We know that lung cancer does not affect all communities equally: it remains one of the cancers most strongly associated with deprivation. People living in the most deprived communities experience significantly higher rates of smoking, a higher incidence of lung cancer and poorer health outcomes, which is why the lung cancer screening programme has prioritised roll-out in areas of greatest need.
By targeting communities at highest risk first, the programme is helping to reduce long-standing inequalities in cancer outcomes and ensuring that those who are most likely to benefit from earlier diagnosis are reached as a priority. Reducing inequalities is therefore central to our approach. The national cancer plan includes a strong focus on reducing variation in cancer outcomes and ensuring that patients benefit from earlier diagnosis, regardless of where they live, their background or their circumstances.
We are also conscious of the concerns that have been raised about access to services in rural and coastal communities. Through the continued expansion of diagnostic services, including community diagnostic centres, to which the shadow Minister rightly referred in his speech, we are bringing tests and scans closer to where people live and helping to improve access across the country.
Alongside screening, we continue to invest in diagnostic capacity, treatment services, research and innovation. We are exploring pilots for self-referral chest X-rays, which could help to streamline diagnostic pathways and make it easier for people with concerning symptoms to access investigations more quickly. We are also supporting the adoption of innovative technologies that can improve diagnosis, reduce waiting times and help clinicians to identify cancers earlier.
Alongside all our efforts to catch and treat cancer earlier, through our 10-year plan for England we have also committed to shift from sickness to prevention. We know that smoking is the leading cause of preventable death in the UK. It claims around 80,000 lives a year, puts huge pressure on our NHS and costs taxpayers billions. It causes one in four of all cancer deaths in England, including from lung cancer, and kills up to two thirds of long-term smokers. It costs health and care services £3 billion a year—resources that could be freed up to deliver millions more appointments, scans and operations. The cost of smoking to our economy is even greater, with £18.6 billion lost in productivity every year and with smokers a third more likely to be off work sick.
That is why the Tobacco and Vapes Act 2026 is the biggest public health intervention in a generation, breaking the cycle of addiction and disadvantage and putting us on track towards a smoke-free generation. Over the next 50 years, that smoke-free generation will save tens of thousands of lives and avoid up to 13,000 cases of lung cancer, stroke and heart disease.
Although survival rates for lung cancer have improved significantly over recent years, we recognise that there is still much more to do. The Government are determined to ensure that England becomes a world leader in cancer survival, and that patients benefit from earlier diagnosis and better outcomes, regardless of where they live.
I again thank the hon. Member for Wokingham for securing this vital debate, and I thank all the Members who have contributed. Through the continued roll-out of lung cancer screening, investment in diagnostic and treatment capacity, support for research and innovation, and the commitment set out in the national cancer plan, we are taking decisive action to diagnose more cancers earlier, improve survival and reduce the number of lives lost to lung cancer. Once again, I am grateful for the opportunity to set out the Government’s position today.
Clive Jones
I would just like to mention a few of the things that hon. Members have spoken about. The hon. Member for Strangford (Jim Shannon) was absolutely right to pay tribute to the Government for their work on lung cancer screening. That is an outstanding success, but screening still needs more support from the Government because, as he says, screening saves lives.
My hon. Friend the Member for Didcot and Wantage (Olly Glover) talked about lung cancer being horrific and deadly, and he spoke about his constituent John, who probably thought, when he got his diagnosis, “This is going to be horrific and deadly for me.” Because of the lung cancer screening programme, it looks like he might have a few good years ahead of him, so that is really good. My hon. Friend also talked about the speed and quality of treatment, and how important it is that we are quick with our diagnoses, that we are quick with our treatment and that our cancer patients have the support of specialist nurses.
The hon. Member for Hinckley and Bosworth (Dr Evans) is absolutely right that early detection is crucial in lung cancer treatment, as he knows from being a junior doctor once upon a time. He is also right to say that the origin of the screening programme was under the Conservatives in 2023, and he is right to join other Members in asking for lung screening to be spread out to all parts of the United Kingdom.
I thank the Minister for coming to the debate today and for answering an awful lot of the questions that we asked him. I know that he is here on behalf of the Under-Secretary of State for Health and Social Care, the hon. Member for Washington and Gateshead South (Mrs Hodgson), who is, I know, a real champion for improving cancer care in this country. I think it is great that the Government are committing £650 million for lung cancer screening in England to be spent by 2030, but what about Scotland and Northern Ireland? Is the Minister able to make a commitment that the Department will speak to the devolved Governments of Scotland and Northern Ireland to try to get them to implement what has been done so well in England, or does he need to speak to the Under-Secretary of State? We did not get a guarantee that lung cancer—
Stephen Kinnock
I just want to briefly put on the record that I will discuss that with my hon. Friend the Under-Secretary of State and we will write to the hon. Gentleman with an update on the work we are doing across the regional Governments in Wales, Scotland and Northern Ireland.
Clive Jones
Thank you for your intervention, Minister, and your clarification. But you did not need to intervene because I am sure—
Puberty Blockers
Stephen Kinnock Excerpts(1 month ago)
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The Minister for Care (Stephen Kinnock)
I would like to start by declaring an interest, because my son Milo, of whom I am extremely proud, is a trans man.
I have listened to colleagues very carefully over the course of our proceedings. There have been some truly heartfelt speeches, and this strength of feeling is certainly warranted wherever children are concerned. The Government welcome this scrutiny, and I want to thank Members from all sides of the House for the constructive tone and substance of this debate.
I am not the Minister who is responsible for leading on this policy in the Department for Health and Social Care. Nevertheless, I feel a great deal of responsibility for the health and wellbeing of children in our country. As the Minister of State for Care, I am, for example, responsible for making sure children at end of life are receiving the right palliative and end-of-life care. And tooth decay, for example, has an appalling effect on children’s wellbeing. When it comes to gender incongruence, I cannot help but think of those children suffering in great distress, who may even be watching our proceedings this evening, and I want them to know that all of us in this Chamber want what is best for them. We might disagree about how we get there, but I do not doubt the sincerity of anyone who has spoken today.
Fundamentally, our approach on this side of the House is to be led by the evidence, and on this I pay tribute to Dr Hilary Cass, who has taken on one of the most sensitive and polarising issues of our times with such courage and professionalism.
The shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson)—I hugely respect her expertise as a paediatrician—has said that our decisions could be motivated by “fear and hostility”, but that is not a charge that anyone could level at Dr Cass, who has shown the utmost courage and professionalism from the moment that she was appointed. It was on the strength of her independence and integrity that the previous Conservative Government, of which the hon. Lady was of course a member, accepted her recommendations. One of those recommendations was for a regulated, robustly safeguarded trial. Yesterday, Dr Cass said that she is
“absolutely convinced that more children will be harmed if we don’t do the trial than if we do.”
Alex Sobel (Leeds Central and Headingley) (Lab/Co-op)
I commend the Minister on an excellent and brave speech. When the Cass report came out, I was criticised for not accepting it in full, and now the very same people who said that to me are not accepting the Cass report in full. Does he agree that that is hypocrisy, and that those people should stick to their word?
Stephen Kinnock
I know that feelings on these matters are strong and heartfelt. If the Conservative party has changed its position and is putting forward its arguments with sincerity and honour, that is a perfectly acceptable position to take, but I simply remind the House of the journey that the party has been on.
Rebecca Paul
The Cass review also suggested a clinical trial for cross-sex hormones. On that basis, will the Government launch a clinical trial on cross-sex hormones as well?
Stephen Kinnock
This is a debate about hormones for suppressing puberty, and is related to the matter that the hon. Lady raises, but it is important that we get the sequencing right. Let us look at the trial and the evidence. That is part of the process of understanding the milestones and the forks in the road faced by children who are experiencing gender incongruence. Let us do this one step at a time.
We are proceeding carefully, cautiously and under the mantra that the safety and wellbeing of children are non-negotiable, and with clarity that a robustly scrutinised trial with rigorous safeguards is the only way of establishing a robust evidence base for puberty-suppressing hormones.
Many hon. Members have asked about safeguards, so let me remind the House what they are. A child can participate only with the consent of a parent or guardian and the child’s own consent or assent, and only if they have had a diagnosis of gender incongruence for at least two years; if they are of stable physical and mental health; if they are not subject to any safeguarding concerns; if they and their parents demonstrate sufficient understanding of the nature of the treatment, including its potential advantages and disadvantages; if they have been deemed clinically appropriate by both their NHS care team and the national multidisciplinary team; and if they are already accessing NHS gender services, including participation in a tailored package of psychosocial care.
Sir John Hayes
Will the Minister at least commit to looking again at the experience of Finland and Denmark, whose evidence has led them to now emphasise counselling rather than medical intervention?
Stephen Kinnock
A little later, I will go through all the different work that is going on. This is absolutely not happening in isolation; we are taking into account a range of other studies.
Some colleagues have raised the work of the MHRA in strengthening the safeguards for young people involved in the trial. The MHRA has been engaged in a scientific dialogue with the trial sponsors, and it was the outcome of that process that led the MHRA, as an independent body, to publish the updated protocol last week. We welcome the changes, because they show that the MHRA is taking its job seriously and that the system is working as intended. We cannot cut corners when it comes to the safety and wellbeing of children, and the safeguards are now in place to guarantee greater monitoring and clinical reassessment, including objective criteria for withdrawing children and young people from the trial entirely. I remind colleagues that the bar to qualify for the trial is extremely high, with only a small number of young people expected to meet the strict criteria.
Some other colleagues—I turn now to the point made by the right hon. Member for South Holland and The Deepings (Sir John Hayes)—have queried the need to have a clinical trial when a number of children have already taken puberty blockers and information is already available. However, Dr Cass concluded that there is not enough evidence about the risks and benefits of those medications. That is why she was so clear in recommending a trial to find that clinical evidence, because that is the basis on which we can take those decisions.
The information in the data linkage study is much more limited than the detailed information that the research team will be able to collect about the relative benefits and risks of puberty-suppressing hormones. NHS England is, however, committed to delivering the data linkage study and has taken time to ensure that the data is shared by relevant organisations.
Esther McVey
I have been listening to the debate and have not yet heard what the Government will deem to be a measure of success of this puberty blocker trial before it goes ahead. What are the criteria, the measurements, the percentages and the numbers, and what are the timelines over which they will be measured? Can the Minister explain what those are? If someone is unhappy, can they sue the Government?
Stephen Kinnock
As the right hon. Lady will know, a lot of this is about the distress and the tremendous mental health pressure that young people going through gender incongruence feel. Clearly, one of the outcomes that we will look for from the trials is an alleviation and an amelioration of those significant mental health issues and distress. Those are the kind of outcomes we want to see to help some of those young people who often end up in awful situations, leading to self-harm and other terrible situations.
Some colleagues have asked about the wider support we are providing for children and young people with gender dysphoria and incongruence. I am pleased that the Pathways study is just one part of the wider work being done to ensure that the support is there. For example, Pathways Horizon is an observational study of all children and young people attending NHS children and young people’s specialist gender services. Pathways Connect is a brain imaging study, Pathways Voices will interview young people, and Horizon Intensive is about ensuring that there is a comparison group of 300 participants who are expressing gender incongruence.
Furthermore, NHS England has opened three new children and young people’s gender services in the north-west, London and Bristol, with a fourth planned for the east of England this year. I can confirm that the Government aim to have a service in every region of England in the coming years. These services use a different model with multidisciplinary teams, including mental health support and paediatrics, within specialist children’s hospitals to provide holistic care. The new services will increase clinical capacity and reduce waiting times so patients can be seen sooner and closer to home.
I can update the House that waiting lists for children and young people’s gender services have come down since this Government took office. As of April, nearly 3,000 fewer children and young people were on the waiting list compared with September 2024.
This Government stand by the principle that we will always be led by clinical advice and clinical evidence, but that does not mean we take these decisions lightly, and it does not mean that we are abdicating our responsibilities either. My right hon. Friend the Secretary of State has requested monthly updates on the progress of the trial, including any emerging risks. Throughout this process, he has immersed himself in the detail, scrutinised the issue and sought the strongest assurances from his most senior clinical advisers. We have received those assurances and are proceeding on the basis of evidence, not ideology.
I end with regret that it appears that the cross-party consensus on Dr Cass’s expert review has been lost, but also with hope that colleagues can get behind Dr Cass’s work again. We will move forward on the basis of taking decisions based on the expertise of clinical and medical professionals, and acting within clearly defined safeguards and robust oversight, including in this House, to provide the best quality of healthcare and support for all children and young people to access what they need.
On one level, this is a specific debate about a specific issue, but when we zoom out, we see that it goes to the heart of what our NHS is about, which is how best to do the greatest possible good for the greatest possible number of people. When we look at this through that basic ethical prism, there can be no doubt that this Government’s position is the right one. A small cohort of vulnerable children are struggling, and it is our job to help them—it really is as simple as that. I therefore urge colleagues to oppose the Opposition’s motion.
Question put.
Access to Dental Services: West Sussex
Stephen Kinnock Excerpts(1 month, 1 week ago)
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The Minister for Care (Stephen Kinnock)
It is a real pleasure to serve under your chairmanship, Sir Desmond. I thank the hon. Member for Chichester (Jess Brown-Fuller) for securing this important debate and I am delighted to wish her a happy Sussex Day. We may come from different political traditions, but she occupies Gillian Keegan’s former parliamentary seat, and I occupy Gillian’s former office in the Department of Health and Social Care, so we at least have that in common.
This is the second debate that I have responded to on dentistry in as many days—I was in the Chamber yesterday, and I am here in Westminster Hall today. That shows what a critical matter this is to our constituents, which is why this Government are taking clear action. On access to NHS dentistry, I point to 1.8 million extra treatments in the first seven months of the last financial year. In fact, taking the last full year into consideration, we are on track to deliver more than 2.5 million more dental treatments than in the year leading up to the general election.
Alison Griffiths
As this is a debate on dentistry in West Sussex, I invite the Minister to share the numbers that relate specifically to West Sussex rather than to the country.
Stephen Kinnock
I am so delighted that the hon. Lady intervened, as I was about to come to that. We have reduced the underspend—one of the many utterly shocking things I found across my portfolio when we came into office in July 2024 was a £392 million underspend on NHS dentistry. We had an absurd situation where demand for NHS dentistry was going through the roof, but because of utter incompetence, the previous Government were underspending by £392 million. We were hands-on on that. We have the ICBs commissioning; we have micromanaged this. I am delighted to say that we have got the underspend down to just £36 million in 2024-25. That is how we have managed to massively boost the number of treatments.
According to the most recent data available, the Sussex integrated care board, which serves the constituency of the hon. Member for Chichester, has delivered over 67,200 more NHS dental treatments. That is 11% more treatments between April and October last year compared with the same period before the general election. I hope that answered the question from the hon. Member for Bognor Regis and Littlehampton (Alison Griffiths).
While we have made significant progress, I do not downplay for a second the issues faced by the constituents of the hon. Member for Chichester. Whenever I reel off these statistics in a debate or on the morning media round, I can hear people saying, “Okay, you say that, but where is my dentist appointment?” I understand that there are pockets of progress and areas where we are not at all where we need to be. But it is important to be realistic: 14 years of neglect cannot be put right overnight. The result of that neglect has been people doing DIY dentistry, and the No. 1 reason why children aged five to nine are going to hospital is tooth decay. It is a shocking and Dickensian state of affairs, frankly, and the Government take it very seriously.
As I said in the main Chamber yesterday, the solution is not to bring out sticking plasters and press releases, and to tinker around the edges. The sector needs long-term reform, and the Government have laid the groundwork for a recovery that is based on solid foundations, not the sort of gimmicks that we saw under the previous Government. For example, the patient premium cost £126 million and we did not see any increase in new patients. We had to scrap that because it was a waste of time and money.
The most important thing we can do to end dental deserts is train the next generation of dentists in the relevant areas. We are taking steps to increase the supply of dentists across the country. Earlier this month, I announced the first sustained expansion of dental school places since 2007. Let that sink in for a minute. It is 20 years since we had any increase at all in dental school places, apart from a one-off increase after covid. Backed by £11 million, a total of 50 dental school places per year have been allocated equally to the University of Portsmouth and the University of East Anglia.
Alison Griffiths
In Bognor Regis and Littlehampton, and in significant parts of Chichester, we have coastal areas. In our manifesto, the Conservative party pledged golden handshakes to attract dentists to coastal constituencies, because we know that is one of the issues. Could you tell please me what specific proposals you have to attract dentists to coastal constituencies?
Stephen Kinnock
We will be publishing the data on the golden hellos in August, along with all the other data. There is a time lag from the end of the financial year to when we have collated all the data—it takes a few months—so there will be data in August on a number of issues we have discussed today. The challenge of golden hellos is that we run into problems around the contract, incentivising people to do NHS dentistry, and getting people to live and work in certain parts of the country when they might be more attracted to a big city. We are aware of the challenges for coastal areas.
On the Portsmouth announcement, I have never driven from Portsmouth to Chichester, but I understand it is about a 20-minute drive, depending on the traffic—
Stephen Kinnock
Yes, but before the hon. Lady intervenes, I will say that I am fully aware that Portsmouth is in Hampshire, so I ask her not to give me a deluge of letters from her constituents.
Jess Brown-Fuller
I promise that I will not give the Minister a lesson in geography, although what he said suggests that he may not have frequented the A27. If somebody can get to a dentist in Portsmouth in 20 minutes, they are setting off at 3 am to do so, because that is the only time it can be done in about 20 minutes.
Stephen Kinnock
We clearly need to check our GPS on that one. I understand that there are challenges, but the point is that, for the first time in decades, Chichester has a school in its vicinity that is training dentists who will be within striking distance. Who knows where all the dentists will end up living when they have done the training? But our data suggests a strong correlation and causation between where somebody goes to dental school and where they end up putting down roots and working, living and settling. That is very much our hope for the 25 places that are, for the first time in 20 years, going to the University of Portsmouth, which I was pleased to visit just a few weeks ago.
Jess Brown-Fuller
I am sure the Minister will join me in congratulating Chichester college, which is creating a programme to train up the next generation of dental assistants and nurses. Staff there are excited to be able to contribute to addressing the recruitment issues in the Chichester area.
Stephen Kinnock
I strongly echo the hon. Lady’s congratulations to Chichester college. Of course, technicians, nurses and therapists play a crucial role; dentists’ practices function not just because of the dentist but because of the whole team.
It was, frankly, a travesty that the hon. Lady’s local area did not have a dental school, and it was a problem that Governments ignored for far too long. I am delighted that we have put that right, and hope she will recognise what a game changer it is. Whereas before, people had to train elsewhere and make an active decision to move to Chichester to practice dentistry, we hope that local people can now train up in the area and stay there if they wish to. That is a real incentive for people in Chichester to choose a career in dentistry, and to stay and serve in Sussex among the people they grew up with. It will also attract young people from across the country, who may choose to continue their careers, make their homes and put down roots in the area.
Similarly, the most important thing we can do for the long-term dental health of the hon. Lady’s constituents is to make the shift from treatment to prevention. In 2024, more than one in 10 children aged five years old in Sussex ICB had experience of tooth decay, despite it being largely preventable. We are backing supervised toothbrushing through a national programme that will reach up to 600,000 children in the most deprived areas of England, backed by £21.5 million. Over £290,000 has been invested across West Sussex, East Sussex and Brighton and Hove, and over 45,000 free toothbrushes and toothpastes have been delivered through our innovative partnership with Colgate-Palmolive. We are beefing up the soft drinks industry levy to remove more sugar from children’s diets and updating standards so that there is healthier food and drink in schools.
This year, we are undertaking vital reforms in dentistry. Two months ago, we embedded urgent dental care into NHS practices, making it easier for patients to get support where they need it most. The problem we heard time and again from the sector was that dentists were not incentivised to undertake NHS work, so we brought forward a package of reforms, from which I will highlight two measures. First, dentists are set to receive higher payments for treating patients who need urgent care, taking the payment for a unit of dental activity from approximately £42 to approximately £75. Dentists now have the extra incentive to provide urgent care for issues such as severe pain, infections or dental trauma on the NHS.
Secondly, from this month, those receiving complex care, such as treatments for severe gum disease or decay in multiple teeth, will be able to schedule a single planned package of treatment and pay one patient charge for it, rather than having several courses of treatment and paying a patient charge for each. That could save people more than £200 per year—money going straight back into the pockets of working people. We are also paying dentists more fairly for this work, to incentivise them. The appointments also mean that we are easing some of the pressures on St Richard’s hospital in the hon. Lady’s constituency, because we are preventing more painful conditions from spiralling into avoidable hospital admissions.
In a nutshell, our 2026 reforms are putting patients first and supporting those with the greatest need while backing our NHS dentists, making the contract more attractive and effective, and giving them the resources to deliver more.
The Government remain committed to rebuilding NHS dentistry after years of neglect. We have made a start with reforms to the dental contract that prioritise patients with the greatest need, support better access to urgent care and deliver a better deal for dentists. Alongside that, we are taking targeted steps to support areas where access is most challenging, including through workforce incentives, new school places and reforms to the exams process for overseas-qualified dentists, which will deliver an additional 2,000 dentists per year by 2028. And we are just getting started: as I have said previously at the Dispatch Box, I remain firmly committed to delivering fundamental reform of the dental contract before the end of this Parliament.
However, meaningful reform requires careful consideration. The challenges facing NHS dentistry are complex, and there is no single universally agreed solution or perfect payment model. That is why it is important that we take the time necessary to develop reforms that are effective and sustainable, and that work for patients and the profession. I will continue to engage closely with dentists, representative bodies and patients to ensure that the reforms we bring forward address long-standing concerns and support the long-term future of NHS dentistry.
Oral Answers to Questions
Stephen Kinnock Excerpts(1 month, 2 weeks ago)
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Dr Kieran Mullan (Bexhill and Battle) (Con)
The Minister for Care (Stephen Kinnock)
We know that some patients prefer not to use online services. Online tools complement rather than replace existing routes, such as telephone or walk-in access. The GP contract requires online access to be available during core hours, which eases pressure on phone lines and reception staff as non-digital routes to access care. Under this Government, patient satisfaction with GP access has risen from 61% to 75%.
Dr Mullan
I understand why making use of the NHS app and online appointments is sensible and works well for many patients, but I cannot be the only MP to have heard from constituents—you may even have heard from your constituents, Mr Speaker—who struggle with that. They may not have a smartphone. I have met many elderly patients who simply cannot make use of online forms and too often GP practices do not make it easy for them to make appointments by telephone or by walking in. It is important that the Government make it crystal clear to all our GP providers, who I know are doing their best, that no matter how far we go with digital innovation, our patients must always be able to access primary care through traditional routes, such as making an appointment by telephone or by walking in.
Stephen Kinnock
I am in violent agreement with the hon. Gentleman, which is quite unusual. We are clear that patients should not be digitally excluded. The contract is clear that patients should always have the option of telephoning or visiting their practice in person. All online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing a GP. In the past year, since April 2025, some 11.5 million more GP appointments have been delivered.
Chris Vince (Harlow) (Lab/Co-op)
I thank the staff at Princess Alexandra hospital in Harlow, particularly in the older persons assessment and liaison ward, where elderly patients are transferred from A&E and supported to either return home or transfer to different wards, another example of where Harlow is leading the way. How can we work together to support patients, like those on the OPAL ward, to access primary care if they are not confident in using some of the online tools that have been mentioned?
Stephen Kinnock
Once again, my hon. Friend has done a great job promoting Harlow, as we are all familiar with him doing in the House. We are improving GP access across the board. We have over 2,000 more GPs since July 2024 and we are launching a £102 million fund to build more clinical space in over 1,000 GP practices across England. A lot has been achieved, but a lot more needs to be done.
Perran Moon (Camborne and Redruth) (Lab)
Lloyd Hatton (South Dorset) (Lab)
The Minister for Care (Stephen Kinnock)
For 2026-27, NHS mental health spending is forecast to reach a record £16.1 billion, representing a real-terms increase compared with the previous year. That is supported by £473 million in capital funding over the next four years, including investment in new mental health emergency departments and community-based mental health centres. Dorset is one of the places across England to benefit from an expanded urgent and emergency mental health offer, with new mental health emergency departments planned.
Lloyd Hatton
This summer, two new state-of-the-art mental health facilities are opening in Dorset: Chaddesley House in Poole and Seastone in Bournemouth. That is thanks to continued investment from this Labour Government. However, the Forston clinic in the west of the county requires fresh investment to upgrade worn-out hospital buildings. Will the Minister meet local NHS bosses, the hon. Member for West Dorset (Edward Morello) and me to discuss securing the investment needed to finally upgrade the Forston clinic?
Stephen Kinnock
My hon. Friend is right that his constituents will be able to access care at the new facilities in Poole and Bournemouth thanks to the Government’s investment in the new hospitals programme, but there is more to do. We are committed to addressing poor-quality NHS infrastructure and ensuring that facilities such as Forston clinic are safe, comfortable and capable of high-quality care. That is why we are investing £30 billion over five years for the maintenance and repair of the NHS estate. We would be delighted to meet the hon. Members and local NHS leaders to discuss the issue further.
Vikki Slade (Mid Dorset and North Poole) (LD)
I thank the Minister for his comments about Forston, which some of my residents use. Evidence suggests that half of mental health conditions are established by age 14, and three quarters by age 24. In Dorset, our rates of hospitalisation for self-harm are almost twice the national average for 15 to 19-year-olds. I recently met Anya, a student at Lytchett school and deputy Member of Youth Parliament for Dorset. She has launched her “Health in Mind” campaign to ease young people back into school following periods of mental or physical health issues. It is so inspiring to see the work that she is doing, but will the Minister meet me and Anya to hear more about her campaign and to see how we can reintegrate children more successfully back into school after ill health, particularly mental ill health?
Stephen Kinnock
I pay tribute to Anya for the outstanding work she is doing. We are providing early intervention for children’s mental health and wellbeing by rolling out mental health support teams to every school by 2029. We are also investing £13 million to pilot enhanced training for staff so that they can offer more support to young people with complex needs such as trauma, neurodivergence and disordered eating. If the hon. Lady writes to me with further details of Anya’s work, I am sure that we can continue that conversation.
Robbie Moore (Keighley and Ilkley) (Con)
Lisa Smart (Hazel Grove) (LD)
The Minister for Care (Stephen Kinnock)
This Government are rebuilding England’s broken NHS dentistry system. The dental recruitment incentive scheme encourages dentists to work in underserved areas. Data on the scheme’s effectiveness will be published later this year. We are taking steps to increase the supply of dentists. For example, last week I was very proud to announce the first sustained expansion of dental school places since 2007, backed by £11 million a year. A total of 50 dental school places a year have been allocated.
Lisa Smart
My constituent John, who is from Bredbury, has been in touch because like so many others his local dentist is going private and for many families in my constituency, private dentistry simply is not an affordable option. Research by the British Dental Association found that 96% of practices are not accepting new NHS patients and the golden hello, worth £20,000 over three years, is not adequately compensating for a contract that loses them money every day. The scheme just is not working. It has recruited two dentists—two!—in the whole of Greater Manchester, neither of whom is in my constituency. What more can the Minister do to ensure that my constituents get the dentists they need, where they need them?
Stephen Kinnock
I thank the hon. Lady for that question, and she is absolutely right to raise the issue of the contract. The fundamental problem is that the units of dental activity system is a contractual system that does not work for NHS dentistry. That is why we had the absurd situation when we came into office in July 2024 of a £392 million underspend on NHS dentistry, because dentists were not incentivised. We are changing that. I have got the underspend down to £36 million. There is still a very long way to go and we need to reform the long-term contract to incentivise dentists to do NHS dentistry.
Anna Gelderd (South East Cornwall) (Lab)
Access to NHS dentistry remains too difficult in rural and coastal communities such as South East Cornwall, where residents face long travel times and limited provision. Will the Minister meet me to discuss what next steps we can take to improve local access?
Stephen Kinnock
My hon. Friend is absolutely right that, as we know, there are areas in the country that are known as dental deserts. We have to fix that. It comes back to the fundamental issue of how we incentivise dentists to do NHS dentistry regardless of where they are in the country. There are particularly acute pressures in constituencies such as the one she so brilliantly represents, and I would be happy to meet her to discuss them further.
Mrs Elsie Blundell (Heywood and Middleton North) (Lab)
Nadia Whittome (Nottingham East) (Lab)
The Minister for Care (Stephen Kinnock)
I pay tribute to my hon. Friend for the work she did formerly as a care worker. The Government inherited a social care system in desperate need of reform. We are taking action, including by providing over £4.6 billion of extra funding for adult social care by 2028-29 and developing the first ever fair pay agreement for care workers. Baroness Casey will submit her first report this year with recommendations on the further action we should take to move towards a national care service.
Claire Young (Thornbury and Yate) (LD)
Stephen Kinnock
As I said earlier to the hon. Member for Hazel Grove (Lisa Smart), the fundamental long-term reform of the dental contract is vital to incentivising dentists to do NHS dentistry. I am pleased by how we have really put downward pressure on the underspend. As a result of that, we are on track to deliver more than 2.5 million extra dental treatments than in the same period before the general election.
Lloyd Hatton (South Dorset) (Lab)
Mr Will Forster (Woking) (LD)
Stephen Kinnock
Importantly, we have the £102 million utilisation and modernisation fund to enable more GP primary care estate. We have also committed to delivering 120 more neighbourhood health centres by the end of this Parliament, so I hope that the hon. Gentleman’s integrated care board has put in an expression of interest for that scheme. I am, of course, prepared to discuss that with him further.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
Alison Griffiths (Bognor Regis and Littlehampton) (Con)
Stephen Kinnock
As I have said to hon. Members across the House today, there is a fundamental challenge around the dental contract. Units of dental activity do not work as a way of incentivising dentists to do NHS dentistry, so that, fundamentally, has to be fixed. I am proud that, thanks to the measures that we have put in place, 2.5 million additional courses of treatment have been delivered, compared with the same period before the general election.
Gill Furniss (Sheffield Brightside and Hillsborough) (Lab)
Last year I had the opportunity to witness a transcatheter aortic valve implantation procedure, which is a groundbreaking procedure for people who require valve changes. What I saw was quite incredible, and I recommend that all hon. Members go and see the procedure in St Thomas’ hospital. The patient, who was 82, had been bedbound for weeks, but after that 20-minute surgery they were fit enough to be discharged later that day and to look after themselves. That has a massive impact, not just on the patient’s life but for our NHS and the wider economy, as illustrated by Heart Valve Voice’s optimal pathway report. What steps is the Department taking to ensure that NHS systems identify patients and treat them?
Joe Robertson (Isle of Wight East) (Con)
The crisis in social care is particularly bad in my constituency on the Isle of Wight, partly because of our unique geography but also because the Government have reduced funding to our local authority. Our council is now looking at discharging patients to the mainland, away from family and friends, which is completely unacceptable. Will the Government recognise our unique challenges as an English island and help provide a social care solution that recognises the challenges that we face?
Stephen Kinnock
The hon. Member and I have discussed this issue, and I absolutely recognise the need to ensure that social care is provided in the most convenient way possible to his constituents and as close as possible to home. Obviously we are fixing a broken system, but we have delivered £4.6 billion more in funding, we are delivering the fair pay agreement, and we are working hard to ensure that we get adult social care back on its feet and fit for the future.
Justin Madders (Ellesmere Port and Bromborough) (Lab)
My constituents were delighted to see the opening of the Great Sutton medical centre, but it has brought into sharp focus the need for an urgent upgrade of GP practices in Ellesmere Port town centre. I have submitted an expression of interest to the neighbourhood centre programme, and I wonder whether the Minister would agree to meet me to discuss that further.
Stephen Kinnock
I am delighted that my hon. Friend has submitted that expression of interest. We are now assessing proposals against criteria that include: a fit with our national neighbourhood health strategy; sound estate planning; deliverability; sustainability; and, critically, local need. We will be prioritising areas where there is low life expectancy and higher deprivation. I would be delighted to meet him to talk about his expression of interest and about our programme for revolutionising care in our country through the shift from hospital to community.
Dr Ellie Chowns (North Herefordshire) (Green)
Unpaid carers play a crucial role in supporting so many people who need to draw on social care, thereby supporting our health service and our formal social care system, but they tell me that they are under immense strain and need more support. They are, of course, more likely to be women and to be older. Does the Minister recognise the urgent need for more respite care for unpaid carers, and will he take action to provide it now, rather than waiting a few years for the Casey commission?
Stephen Kinnock
The hon. Lady is absolutely right that unpaid carers are the lifeblood of our care system, and we pay tribute to them for the compassion that they show. I was very pleased yesterday to accompany the Under-Secretary of State for Business and Trade, my hon. Friend the Member for Halifax (Kate Dearden), to the launch of the new paid carer’s leave consultation document. I am also pleased to chair the cross-ministerial group that will produce an action plan for unpaid carers, addressing exactly the issues that the hon. Lady mentioned about respite care.
Jen Craft (Thurrock) (Lab)
Last week the Supreme Court overturned the previous Cheshire West judgment on the Mental Capacity Act 2005, throwing the sector that cares for people with learning disabilities and/or autism into what it has called “chaos”. There is significant concern that, without further clarification as to whether someone who does not have mental capacity can consent to deprivation of liberty, vulnerable people will be put at significant risk. Will the Secretary of State listen to calls for—
Paul Holmes (Hamble Valley) (Con)
Waiting times for cataract operations in my constituency are rising hugely because the local ICB and its AI system have stopped offering services through all the advertised providers, and the ICB has scrapped its contract with Specsavers, meaning that only GPs can diagnose the problem. Will the Minister have a look at the local problem and intervene so that we have the widest and best range of providers to reduce those waiting lists?
Stephen Kinnock
The hon. Gentleman is absolutely right that getting the link between high street optometrists and secondary care working more effectively is vital. That is why I was pleased to announce the £20 million e-referral investment earlier this week. We are also working on a single point of access, to get the digital interface working far more effectively. He is right that we should be focusing on that more; there is a lot more to do.
Adam Thompson (Erewash) (Lab)
Particularly for people with a very low body mass index or an eating disorder, the use of app-based fitness classes for hours of ultra-high-intensity exercise every day can lead to addiction. When I wrote to one brand to ask about implementing access limitation tools in its app, it was dismissive. Will the Secretary of State consider reviewing whether such tools could be mandated to support those with eating disorders?
Palliative and End-of-Life Care Modern Service Framework: Interim Update
Stephen Kinnock Excerpts(1 month, 3 weeks ago)
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The Minister for Care (Stephen Kinnock)
In November 2025, I announced that the Government would develop a modern service framework for palliative care and end-of-life care in England. This MSF is one of the only six MSFs announced, which clearly demonstrates that palliative care and end-of-life care is a top priority for this Government. The MSF will help address rising demand; late identification of need; inequitable variation in access, experience and outcomes; and the wider pressures facing the health and care system. Today I am providing an update on progress ahead of publication in autumn 2026.
The MSF is a clinically led, evidence-based framework to support sustained improvement in outcomes for patients and carers, including by systematically identifying, measuring and reducing health inequalities, and reducing unwarranted variation in access, experience and outcomes. This Government’s goal, being developed with partners, is that every person who needs palliative care or care at the end of life will have equitable access to high-quality support, shaped by what matters to them, their families and carers. There will be a notable shift towards outcome measurement to understand improvement, including a specific focus on identifying and reducing inequalities in outcomes across different population groups. Systems are already beginning to implement these reforms, so that by March 2029 we will have delivered impact against the aim, set out in the neighbourhood health framework, of increasing by 10% the number of people identified as approaching end of life, and reducing non-elective admissions and hospital bed days for this cohort by 10%. Furthermore, as part of the 10-year health plan commitment to at least double the number of people offered a personal health budget by 2028-29, so that they can have more control over their care, we will start trialling PHBs for those with palliative care and end-of-life care needs by the end of 2026-27.
We are undertaking extensive engagement with more than 70 organisations across the health and care sector, including clinical experts, the voluntary sector, people with lived experience, and those representing babies, children and young people, adults and older people, and their carers.
A review of the evidence, and our engagement to gather real-world examples, has identified five working sub-goals for the system to drive change. With our stakeholders, we will build on these insights to develop areas for action for those commissioning and delivering services:
Support our staff and our population to better understand palliative care, death and dying.
Provide a person-centred approach and ensure equitable access to earlier and more effective identification of needs, in all settings of care.
Prevent distress through proactive and equitable assessment and management of need closer to home.
Ensure equitable access to personalised palliative care.
Deliver a palliative care response that is timely, effective and equitable, including access to out-of-hours telephone support, within this Parliament.
Performance and outcome metrics will support system accountability and will measure what matters most to people receiving care, and to their families and carers. There will be separate measures for adults, and for babies, children and young people, with a focus on unwarranted variation and health inequalities, and a commitment to developing person-centred outcome and experience measures.
The strategic commissioning framework sets out how integrated care boards, in partnership with local authorities, will focus on long-term population health strategy and planning, and care redesign. The MSF will support this by setting standards and the clinical evidence base, and by highlighting areas for innovation to inform integrated models of palliative care, guide population health improvement plans and align with neighbourhood health. This will support the shift to strategic commissioning, including the requirement—in line with ICBs’ statutory duties—for clear and transparent contractual arrangements for commissioned palliative care activity across all providers, including hospices, to meet population health needs, with explicit regard to reducing inequalities and improving outcomes for underserved and disadvantaged groups.
The national director for primary care and community services will be informing the systems, setting out two actions to ensure progress is made towards strategic commissioning of palliative care and end-of-life care services:
Action 1: Produce an integrated needs assessment and understand service provision and utilisation.
Action 2: Move to sustainable contracting of hospice services.
The Government are also committed to publishing a 10-year workforce plan to ensure the NHS has the right people, in the right places, with the right skills to deliver for patients, including those approaching the end of life.
We will continue to co-design the MSF with people with lived experience, their families and carers, and sector partners, to refine the themes and areas for action, and finalise the metrics and accountability framework. We remain on track to publish the final MSF in autumn 2026, supported by system delivery and commissioning approaches.
Attachments can be viewed online at: http://www.parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2026-06-04/HCWS88/
[HCWS88]
Community Pharmacies
Stephen Kinnock Excerpts(1 month, 3 weeks ago)
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The Minister for Care (Stephen Kinnock)
It is a pleasure to serve under your chairship, Ms Jardine, and I congratulate the hon. Member for Tiverton and Minehead (Rachel Gilmour) on raising this important issue. The number of hon. Members present shows how vital community pharmacy is right across our country.
Since coming into office, this Government have continued to reverse the decades of cuts to community pharmacy, and have frozen prescription charges for the second year in a row to help our constituents with the cost of living. Wherever they live in the country, women can now get emergency contraception from their local pharmacy free of charge on the NHS. That work has only been possible thanks to the tireless efforts and dedication of pharmacy teams in supporting patients in their communities, delivering a wide range of NHS services, not least in the west country. In fact, just last week, I was in Bristol visiting the fantastic Concord pharmacy, which is at the forefront of our efforts to shift care from hospital to community. I thank Saeed and his team for the warm welcome they gave me. I saw how they are delivering blood pressure checks, vaccinations and Pharmacy First services to the people of north Bristol.
For too long, community pharmacies such as Concord have been held back from realising their true potential. It is why the Government have given them a central role in our 10-year plan to shift the focus of the NHS from sickness to prevention, from hospital to community and from analogue to digital.
Gordon McKee (Glasgow South) (Lab)
An excellent example of community pharmacies in England embracing innovation is their interaction with the NHS app. My constituents in Scotland do not have access to a similar app because the Scottish Government have not got on with fixing it. Will the Minister join me in calling on the Scottish Government to produce a proper equivalent NHS app, so that constituents in Scotland can benefit in the same way?
Stephen Kinnock
My hon. Friend makes a vital point. It appears that the Scottish Government are stuck in the analogue age, and we need digital solutions. I join him in encouraging the Scottish Government to get with the programme, get with the NHS app and get moving on some of these important initiatives.
We all know that we simply cannot make the shift from hospital to community without our community pharmacies. I am not the only one to see that—I am sure that all of us have made use of community pharmacies in our constituencies, and that colleagues will know the importance of the accessibility of pharmacies in towns and villages across the country. There are over 10,000 pharmacies in England. They are busy dispensing medicines, offering advice, and delivering care and services to support our communities. Patients across the country can also choose to access over 400 distance-selling pharmacies, which deliver medicines to patients’ homes free of charge, playing a vital role in reaching the most isolated members of our society. However, I acknowledge that access is not the same in all areas of the country. Rural areas often have fewer community pharmacies, so people have to travel further to access a pharmacy as well as other services.
Colleagues have also been right to raise concerns about pharmacy closures in the past. Local authority health and wellbeing boards are responsible for assessing whether local needs are adequately met by the existing providers, and what improvements are needed to ensure that people can access services. Those assessments inform integrated care boards’ commissioning decisions. In areas where there are fewer pharmacies, our pharmacy access scheme provides additional financial support to eligible pharmacies. The scheme helps pharmacies that are critical for patient access to stay open and provide local communities with continued access to medicines and excellent healthcare advice. In certain rural areas where there are no pharmacies, dispensing doctors can supply medicines to patients directly without the need for a pharmacy.
The hon. Member for Tiverton and Minehead will be aware that there are currently 14 pharmacies in her constituency. I am aware of the closure of two pharmacies in her constituency since 2017, and that the local population instead get their medicines from the neighbouring dispensing GP or from one of the over 400 distance-selling pharmacies available nationally. I also note that the latest data shows that there are 199 pharmacies in Devon, with 914 across the south-west. The Government are committed to supporting the critical role that they play in serving their communities.
Dr Luke Evans
The Minister points to the important partnership between community pharmacies and dispensing GPs. There are concerns about the change in the EMIS module and the future for dispensing practices. If the Minister does not have the answers here, will he write to me about what is happening with EMIS and where he is looking to take dispensing practices in the future?
Stephen Kinnock
I absolutely commit to writing to the hon. Gentleman with more detail. He raises some important points, and I will get back to him.
The Government have always been clear that investment must come with modernisation, and our 10-year health plan and our three shifts set out a clear pathway to getting there. In her 2024 Budget, the Chancellor took important decisions that enabled us to give the sector a record 19% uplift across 2024-25 and 2025-26. It was the largest uplift of any sector across the NHS in that spending review period. I am proud that just a few days ago, we announced another significant uplift in funding for community pharmacies. That means a further £340 million uplift for the sector this financial year, to support the supply of medicines and delivery of vital services across our country. That will include supporting the introduction of pharmacist prescribing as part of NHS services in autumn 2026, to expand access to NHS care and strengthen support in communities across England, delivering upon the commitment made in our manifesto. That 10% uplift is almost three times the growth of the overall NHS budget, and it shows that when we talk about making the left shift, we are putting our money where our mouth is.
I will start with the shift from sickness to prevention, because community pharmacies will be vital in making sure that vaccine coverage reaches every part of our country. The NHS vaccination strategy in our 10-year health plan commits us to increasing vaccine uptake through primary care. One way that we are getting that done is through the national vaccinations programme. Alongside a core offer of vaccination in GP practices, we are making sure that vaccines are offered through sexual health services, maternity services, schools, health visitors and community pharmacies. Selected community pharmacies across the country have already been commissioned to provide MMR and RSV vaccines.
The expanded vaccination programmes make use of pharmacy teams’ expertise in delivering vaccines, releasing pressure on GPs and helping to protect the most vulnerable members of our society. We have also seen a significant increase in the provision of flu jabs within community pharmacies, with approximately 4.7 million people being vaccinated by pharmacists in the 2025-26 seasonal flu vaccination programme up to February 2026. That is up by around 600,000 vaccinations the previous year, showing the progress that has been made.
When we talk about prevention, we are not just talking about vaccines, because community pharmacies are also delivering the hypertension case-finding service, which spots people at risk and helps to prevent cardiovascular disease. Nearly 3.6 million free consultations were delivered in the 12 months to February this year. That is a great example of the sickness to prevention shift in action.
Turning to our shift from analogue to digital, so many pharmacists and pharmacy technicians are not working with technology that is equal to their skill, talent or ambition. I am afraid to say that it is a similar story across other parts of the NHS, where the outdated technology is holding staff back from realising their full potential. We are supporting pharmacies through digital transformation. Last year, a new Amazon-style prescription tracker went live on the NHS app across nearly 1,500 community pharmacies in England, enabling patients to check on their prescriptions through real-time updates.
This year, we want to make digital access even easier, with stronger links between pharmacies and general practice as we build stronger neighbourhood health teams across every community. That will make them match-ready for the introduction of pharmacy prescribing as part of NHS services from this autumn. Digital also has a huge role to play in our supply chains and improving the public’s access to the medication they need. That has included our secondary legislation to enable the expansion of hub-and-spoke dispensing between different pharmacies, to make it possible for more pharmacies to use automated dispensing, realise economies of scale and increase efficiency and productivity.
Additionally, GPs cannot currently see live national shortages when prescribing, but this year we will make it possible for GPs to be aware of these shortages in real time. That will mean that patients no longer have to go from pillar to post looking for medicines that are not available, because GPs will be able to prescribe an antibiotic unaffected by supply issues.
In the NHS that is fit for the future, pharmacies will play a key role in the shift from hospital to community. We have already begun making huge progress in rebuilding primary care and fixing the front door to the NHS by ending the 8 am scramble, whether through extra funding for general practice, hiring more GPs or the introduction of online services. We will go even further to ease the pressure on GPs by making sure that pharmacists are making the most of their clinical abilities.
That is why the Government have been promoting the Pharmacy First campaign, although I take on board some of the very interesting suggestions about the rebranding. I will have a think about that; I am not going to make any rash decisions today. The most recent data shows that the number of people polled who knew that their pharmacy would treat Pharmacy First conditions rose from 71% to 79%. Trust in the advice given by the pharmacy team increased from 61% to 70%, and intention to use the pharmacy if people had conditions covered by Pharmacy First went up from 32% to 37%.
Jim Shannon
I very much welcome what the Minister has said. There is lots of good stuff being rolled out across the United Kingdom, but I asked him to share some of the things that have been done with the Northern Ireland Assembly Minister, Mike Nesbitt. I know the Minister has regular contact with him, so perhaps he could say, “This is what we are doing here. Maybe you should do the same.”
Stephen Kinnock
We do indeed have an excellent relationship. If the hon. Gentleman does not mind, I will go back into some of the discussions that we have been having and write to him with an update on the latest thinking.
A second public advertising campaign ran from October 2025 to this January, and I look forward to updating the House when data about its impact becomes available. Another thing to watch is the independent prescribing pathfinder programme, through which 200 sites have delivered 34,000 consultations. About 60% resulted in a prescribing decision, and 90% of those prescriptions were completed without the need to refer to a GP. When it comes to relieving pressure on other parts of the system, the pathfinder programme shows immense promise.
As announced last week, the new community pharmacy contractual framework for 2026-27 will focus on implementing what we have learned from the pathfinder programme as we roll out NHS pharmacists prescribing nationally from autumn this year. That will deliver the 10-year plan’s ambition for pharmacies to go beyond dispensing and to offer more clinical services as part of an integrated neighbourhood health team.
We have also introduced legislation to enable pharmacy technicians to manage dispensing processes that would otherwise be undertaken by pharmacists, and to allow checked and bagged medicines to be handed out in the absence of the pharmacist. That saves time for patients, who will not have to queue for as long to get their medicine. It is good for busy pharmacists, who will have more time for clinical services, and for pharmacy technicians, who will be able to use their skillset as qualified professionals.
Pharmacies are a massive untapped resource. The NHS that we are building puts them front and centre of care in every community, whether on the local high street or as one of the more than 400 distance-selling pharmacies that can reach across the country, including rural areas. This year, I plan to spend a lot more time with our partners in the sector to seize every opportunity to go further, and I am always keen to work with colleagues across the House on this.
As the hon. Member for Hinckley and Bosworth (Dr Evans) said, there is a clear commitment to long-term reform. Some of the issues that are holding the sector back require fundamental thinking. We are in discussions, and I am looking forward to a meeting very soon with Community Pharmacy England. I want to put on the record my thanks to it and, in particular, to Janet Morrison, for the incredibly constructive way in which it has engaged with me and my team on the contract negotiations and the strategic thinking that needs to go into long-term reform. Our latest deal with the sector shows that this Government are in it for the long haul and are fully committed to putting pharmacies right at the heart of getting our NHS back on its feet and fit for the future.
Community Pharmacy Contractual Framework Consultation
Stephen Kinnock Excerpts(1 month, 3 weeks ago)
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The Minister for Care (Stephen Kinnock)
I am pleased to announce that we have now concluded our consultation on the community pharmacy contractual framework for 2026-27. We have agreed with Community Pharmacy England that in 2026-27 the CPCF will increase to £3,636 million, an increase of £340 million—or 10% —compared with 2025-26 budgets.
This investment will enable us to roll out independent prescribing—a Government manifesto commitment—which will allow us to improve access to primary care and better use the skills of pharmacy teams to keep people well in their communities.
This funding will include an increase in the retained medicine margin to further support the supply of medication. The medicine margin allowance will be £1.1 billion in 2026-27, an increase of £200 million from 2025-26. In addition, we have agreed to write off up to £239 million of historical net contract overspend—driven by over-delivery of medicines margin. This will bring more certainty of funding for contractors and support pharmacies in purchasing the medication prescribed for patients.
This agreement with CPE will provide much-needed investment, further building on last year’s uplift in stabilising the community pharmacy sector. We are also committing to work with the sector on reforms that improve sector sustainability, ensuring that community pharmacies are able to continue to deliver for patients.
I would like to thank CPE’s committee and am grateful to them for working constructively and at pace with officials to agree how best to use this significant new investment to support the sector, so that community pharmacies can continue to provide services to patients across the country.
This announcement follows record investment over the last two years and a range of measures to deliver more services to patients, including:
making emergency contraception available free of charge at pharmacies on the NHS;
offering patients suffering from depression convenient support at pharmacies when they are prescribed antidepressants, to boost mental health support in the community;
cutting red tape and bureaucracy to give patients easier access to consultations, with more of the pharmacy team able to deliver a wider number of services; and
boosting funding for medicine supply so that patients have better access to the medicines prescribed for them.
I am therefore very pleased to share this announcement and look forward to continued collaborative working with Community Pharmacy England and the wider sector as we build on what we have announced today and deliver what we all want for community pharmacy: a service fit for the future.
[HCWS73]