Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(1 month, 1 week ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
I will leave it to others to deduce the link to Sadiq Khan’s bus. I think the hon. Lady prepared her question before the previous answer, because I just set out that we are giving £50 million of transitional labelling support. Of course, a consultation is live and we are working with businesses on it.
Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
The Food and Drink Federation has warned the UK Government that their plan to require all meat and dairy sold in the UK to have “Not for EU” labelling attacked will divert “hundreds of millions of pounds” of investment away from the UK, and that several international investors have paused their plans to invest in UK food and drink. As we continue to circle the drain of Tory-imposed recession, will the Secretary of State tell the House and the public if driving investment away from this vital sector will help or hinder attempts to avoid yet greater recessions?
Steve Barclay
My hon. Friend raises an important point. My focus, and that of the Minister for Food, Farming and Fisheries, is first and foremost on ensuring food production and food security is viable for our farmers, but diversification is also important. I am in advanced discussions with the Secretary of State for Levelling Up, Housing and Communities on extending permitted development rights.
To go back to the question raised by the hon. Member for Huddersfield (Mr Sheerman), a certain very famous farmer has raised his frustrations in Oxfordshire. I want to streamline permitted developments to make it easier for farmers to diversify, but first and foremost farmers want to produce food, which is my key focus.
Daniel Zeichner (Cambridge) (Lab)
Farmers need support against potentially devastating contagious diseases, such as African swine fever. I recently visited Dover, where the diligent Port Health Authority regularly seizes contaminated meat. Yet next month, its DEFRA funding will be cut by 70% and, incredibly, those border checks will be moved 22 miles inland. Why are the Conservatives putting the farmers of this country and our national security at risk?
The Secretary of State for Environment, Food and Rural Affairs (Steve Barclay)
Since last updating the House, we have continued to bring forward measures to place greater prioritisation on food production and food security. That includes delivering a key National Farmers Union ask for a food security index, committing to the Farm to Fork summit as an annual event, and the largest ever round of grants for farmers, worth £427 million, announced by the Prime Minister to drive greater productivity. We are also consulting on fairer food labels to ensure that our British farmers are fairly rewarded. We are announcing today a consultation on the next phase of our tuberculosis eradication strategy, which includes culling in high-risk areas, and this week I announced that my hon. Friend the Member for Colchester (Will Quince) is conducting a review into public sector food procurement.
Furthermore, we are taking action to hold water companies to account more strongly, which includes a fourfold increase in inspections and consulting on banning bonuses for companies that commit serious criminal breaches. We are working at pace with the devolved Administrations on the banning of wet wipes. As we covered earlier, we continue to address the threat from the bluetongue virus. I can confirm to the House that I have acted on the representations of my hon. Friend the Member for Penrith and The Border (Dr Hudson) on extending the neutering deadline for XL Bully dogs by some months, from 30 January 2024 until 30 June 2025. Finally, tomorrow the Minister responsible for nature will announce the successful bids for species restoration grants, building on the progress on biodiversity net gain.
Sir John Whittingdale
Is my right hon. Friend aware that the inflexibility, bureaucracy and cost of the seasonal poultry workers scheme make it prohibitive for businesses such as Kelly Turkeys in my constituency to hire labour for just a few weeks in the run-up to Christmas? Will he urge the Home Office to include it within the existing seasonal agricultural workers scheme, thus allowing producers to use labour that is already in the country?
Steve Barclay
My right hon. Friend raises an important point. Of course, there are 2,000 seasonal worker visas to meet the demand in the run-up to Christmas. He will know that from my time as the Chancellor of the Duchy of Lancaster, when I dealt with the issue of turkey supplies before Christmas, I am happy to look at that issue. He is talking about a finite period, and I will make those representations to Home Office colleagues.
Steve Reed (Croydon North) (Lab/Co-op)
Last month, I visited Newcastle-under-Lyme with local campaigner Adam Jogee to meet residents who are literally choking on toxic fumes from the Walleys Quarry landfill site. More than 10,000 residents have complained about the stench, and a five-year-old child ended up in hospital. Will the Secretary of State publish all correspondence between DEFRA, the Environment Agency and the operator, so that residents in Newcastle-under-Lyme can see why the site has not been closed down?
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(2 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Environment, Food and Rural Affairs (Steve Barclay)
We are committed to maintaining high animal welfare and food standards. Since leaving the EU, we have put in place strong controls on imports, and we are using Brexit freedoms to strengthen animal welfare standards even further by banning the export of live animals for slaughter. [Interruption.]
Mr Speaker
Order. Can I say to the hon. Member for East Londonderry (Mr Campbell) that we are in the middle of a question, and he has just walked right in front of the Member asking it?
Neale Hanvey
Yesterday, the UK Government implemented a border target operating model in which a veterinarian must provide a health certificate for meat imports from the EU. Meanwhile, the UK-Australia free trade agreement, which came into effect six months ago, is likely to lead to increased imports of low-cost products produced in Australia using pesticides that are not permitted in the UK and in the absence of veterinary checks. According to the Royal Society for the Prevention of Cruelty to Animals, Australia has lower welfare standards in many sectors, such as eggs, pigmeat production and chicken. Does the Secretary of State accept that this asymmetry on standards of animal welfare is incoherent and poses a significant risk of contaminating the food chain with banned pesticides?
Steve Barclay
It is always a pleasure to meet my hon. Friend. He mentioned the important issue of seabirds. He will have noticed yesterday’s announcement of two major positive steps. The No. 1 issue of the Royal Society for the Protection of Birds for the last 25 years has been tightening up the overfishing of sand eels. We are closing English waters to sand eel fishing, which is hugely important to seabirds, particularly the puffin. Secondly, we announced 13 marine designated areas—to put that into context, that is an area equivalent to the size of Suffolk. It is a huge step forward in protecting seabirds, on which the UK has a leading position globally.
Mr Speaker
Hopefully Emma Hardy will get us back on track. I call the shadow Minister.
Mr Speaker
Order. We only get until 10 o’clock—to take advantage is just not fair. We must have briefer questions from the Front Bench.
Steve Barclay
Not only has the water Minister, the Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Keighley (Robbie Moore), been decisive; he has met the individual farmer the hon. Lady mentions on his farm. We are taking action to look at how we can better empower the internal drainage boards—[Interruption.] The hon. Lady chunters from a sedentary position. I actually represent, in the fens, one of the areas where internal drainage boards are most important. I have worked with them for 14 years, and the ministerial team is working actively with them now.
Steve Barclay
As my hon. Friend knows, I am familiar with the Fylde and the issues there. I am always happy to meet him to discuss the issues he mentions. I am in contact with the Secretary of State for Levelling Up, Housing and Communities about new developments and some of the wider issues that my hon. Friend has been raising.
Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
The UK ended the year as the only rich nation with food price inflation of more than 10%, and families buying food still face persistent price increases. New Brexit red tape affecting European food imports poses a further risk of rising inflation in the prices of items such as bread, milk and even baby formula. May I again ask the Secretary of State to commit himself to implementing food price controls if further Brexit red tape leads to the food price hikes that are being anticipated?
Mr Speaker
When he does, can he take the licence away from the one at Cuerden, in Chorley?
Steve Barclay
I always listen closely to your steer, Mr Speaker. My hon. Friend raises an extremely important issue, which I know is very troubling to those affected. The Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Keighley (Robbie Moore) is going there in the coming days, and I can assure her that this is being discussed and actively followed up.
Steve Barclay
Such is the confusion within the Scottish National party that I hope the House forgives me for the mistake. I recognise that the hon. Gentleman has changed his party and now is an Alba Member. I am happy to correct the record.
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(6 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
It is always a pleasure to visit my hon. Friend’s constituency. He highlights a good illustration of how the national programme is working, backed with that £700 million of funding. We are closely monitoring the estate and, where RAAC mitigation is required, that work is taking place. He brings a good example of that to the House’s attention.
Karin Smyth (Bristol South) (Lab)
Not only are the hospital buildings crumbling after 13 years of neglect, creating huge capacity challenges; it seems that those still standing do not have enough beds. As we heard from The Times this morning, the number of
“hospital beds…has fallen by almost 3,000 since ministers promised 5,000 before winter”.
It feels pretty much like winter to me. Is that just another broken promise?
Steve Barclay
Through that £240 million, we have 100% adoption from GP practices that want to take part in receiving those funds and putting digital telephony in place if they have not already done so. This includes call-back, which allows people to know where they are in the queue, and links to online booking, which allows us to maximise the 31,000 additional roles that we have put into primary care so that people can see the specialist that they need. In my hon. Friend’s own integrated care board, appointments for July increased from 768,000 last July to 816,000 this July, so more patients are being seen, more appointments are taking place and more tech investment is going into the practices in his area.
Wes Streeting (Ilford North) (Lab)
To listen to the Secretary of State, you would think it was all going so well, so let me give him a reality check. In Tamworth last year, only a third of patients said it was easy to get through to their doctor on the phone, one in three GP appointments were not conducted face to face and fewer than half of patients were offered a choice of appointment. The Government are not listening to the people of Tamworth. Perhaps the Secretary of State would like to explain to the people of Tamworth why, after 13 years of Conservative Government, this is the case, and better still, adopt Labour’s plan to cut red tape, incentivise continuity of care and bring back the family doctor.
Steve Barclay
He is right that we are taking both long-term and short-term actions. A key part of the long-term workforce plan is to boost the number of dentists being trained. In the more immediate term, earlier this year we made legislative changes that give the General Dental Council the flexibility to improve the way professionals are registered, giving more flexibility in terms of the skills mix and, for example, tripling the number of people sitting part 1 this year, so that more overseas professionals can be recognised and qualified to practise in the UK.
Wes Streeting (Ilford North) (Lab)
In Mid Bedfordshire last year, 165 children—[Interruption.] I do not know why Government Members are laughing; perhaps they should listen, as it is not our party that has let down the people of Mid Bedfordshire. Last year, 165 children in Mid Bedfordshire had teeth removed due to tooth decay. Some 800 patients were forced into A&E for the same reason and 100,000 people across the region cannot get access to an NHS dentist. Instead of laughing, the Government might like to adopt Labour’s plan to provide 700,000 extra dentistry appointments every year.
Steve Barclay
Since 2010, we have had 6.5% more dentists, a quarter more appointments and, as we have just touched on, increasing flexibility in regulation and boosting overseas recruitment. It is striking that one area of the country that the shadow Secretary of State does not want to talk about is Wales, which has a record of what a Labour Government will deliver. Indeed, the Leader of the Opposition says that he wants Wales to be the “blueprint” for what the NHS would be in England. There, this week, we have seen a fiddling of the figures on health. Even without that fiddling, we know people are twice as likely to be on a waiting list in Wales as in England—
Mr Speaker
Order. One of us has got to sit down and it is not going to be me. I let you have a good crack at the beginning, Secretary of State. Your opening statement took quite a long time, which I do not mind. I do not mind your having a go about Wales, but I am certainly not going to open up a debate between the Government and Opposition Front Benches. Topical questions are for Back Benchers and about short questions with short answers. I want it to be kept that way, so please understand that. There must be too many by-elections, because Members are getting carried away.
Wes Streeting
It is not just Mid Bedfordshire. Across the country, the No.1 reason children aged six to 10 are admitted to hospital is tooth decay. Given that, will the Secretary of State at least adopt the modest measure that Labour has proposed to introduce national supervised tooth brushing for small children—low cost, high impact—to keep their teeth clean and keep children out of hospital?
Countess of Chester Hospital Inquiry
Debate between Steve Barclay and Lindsay Hoyle(7 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Steve Barclay)
With permission, Mr Speaker, I would like to make a statement on the inquiry into the circumstances surrounding the crimes of Lucy Letby.
On 18 August, as the whole House is aware, Letby was convicted of the murder of seven babies and the attempted murder of six others. She committed these crimes while working as a neonatal nurse at the Countess of Chester Hospital between June 2015 and June 2016. As Mr Justice Goss said as he sentenced her to 14 whole life orders, this was a
“cruel, calculated and cynical campaign of child murder”
and a
“gross breach of the trust all citizens place in those who work in the medical and caring professions.”
I think the whole House will agree it is right that she spends the rest of her life behind bars.
I cannot begin to imagine the hurt and suffering that these families went through, and I know from my conversations with them last week that the trial brought these emotions back to the surface. Concerningly, that was exacerbated by the fact the families discovered new information about events concerning their children during the course of the trial.
Losing a child is the greatest sorrow any parent can experience. I am sure the victims’ families have been in the thoughts and prayers of Members across the House, as they have been in mine. We have a duty to get them the answers they deserve, to hold people to account and to make sure lessons are learned. That is why, on the day of conviction, I ordered an independent inquiry into events at the Countess of Chester Hospital, making it clear that the victims’ families would shape it.
I arranged with police liaison officers to meet the families at the earliest possible opportunity to discuss with them the options for the form the inquiry should take, and it was clear that their wishes are for a statutory inquiry with the power to compel witnesses to give evidence under oath. That is why I am confirming this to the House today.
The inquiry will examine the case’s wider circumstances, including the trust’s response to clinicians who raised the alarm and the conduct of the wider NHS and its regulators. I can confirm to the House that Lady Justice Thirlwall will lead the inquiry. She is one of the country’s most senior judges. She currently sits in the Court of Appeal, and she had many years of experience as a senior judge and a senior barrister before that. Before making this statement, I informed the victims’ families of her appointment, which was made following conversations with the Lord Chief Justice, the Lord Chancellor and the Attorney General.
I have raised with Lady Justice Thirlwall the fact that the families should work with her to shape the terms of reference. We hope to finalise those in the next couple of weeks, so that the inquiry can start the consultation as soon as possible. I have also discussed with Lady Justice Thirlwall the families’ desire for the inquiry to take place in phases, so that it provides answers to vital questions as soon as possible. I will update the House when the terms of reference are agreed and will continue to engage with the families.
Today, I would also like to update the House on actions that have already been taken to improve patient safety and identify warning signs more quickly, as well as action that is already under way to strengthen that further. First, in 2018, NHS England appointed Dr Aidan Fowler as the first national director of patient safety. He worked with the NHS to publish its first patient safety strategy in 2019, creating several national programmes. Those included requiring NHS organisations to employ dedicated patient safety specialists, ensuring that all staff receive robust patient safety training and using data to quickly recognise risks to patient safety. Last summer, to enhance patient safety further, I appointed Dr Henrietta Hughes, a practising GP, as England’s first patient safety commissioner for medicines and medical devices. Dr Hughes brings leaders together to amplify patients’ concerns throughout the health system.
Secondly, in 2019, the NHS began introducing medical examiners across England and Wales to independently scrutinise deaths not investigated by a coroner. Those senior doctors also reach out to bereaved families and find out whether they have any concerns. All acute trusts have appointed medical examiners who now scrutinise hospital deaths and raise any concerns they have with the appropriate authorities.
Thirdly, in 2016, the NHS introduced freedom to speak up guardians, to assist staff who want to speak up about their concerns. More than 900 local guardians now cover every NHS trust. Fourthly, in 2018, Tom Kark KC was commissioned to make recommendations on the fit and proper person test for NHS board members. NHS England incorporated his review findings into the fit and proper person test framework published last month. It introduced additional background checks, the consistent collection of directors’ data and a standardised reference system, thus preventing board members unfit to lead from moving between organisations.
Finally, turning to maternity care, in 2018 NHS England launched the maternity safety support programme to ensure that underperforming trusts receive assistance before serious issues arise. Also since 2018, the Government have funded the national perinatal mortality review tool, which supports trusts and parents to understand why a baby has died and whether any lessons can be learned to save lives in the future. Furthermore, the Government introduced the maternity investigations programme, through the Health Safety Investigation Branch, which investigates maternity safety incidents and provides reports to trusts and families. In 2020, NHS England’s Getting It Right First Time programme was expanded to cover neonatal services. It reviewed England’s neonatal services using detailed data and gave trusts individual improvement plans, which they are working towards. Indeed, Professor Tim Briggs, who leads that programme, has confirmed that all neonatal units have been reviewed by his programme since 2021.
Let me now turn to our forward-facing work. We have already committed to moving medical examiners to a statutory basis and will table secondary legislation on that shortly. It will ensure that deaths not reviewed by a coroner are investigated in all medical settings, in particular extending coverage in primary care, and will enter into force in April.
Secondly, on the Kark review, at the time the NHS actively considered Kark’s recommendation 5 on disbarring senior managers and took the view that introducing the wider changes he recommended in his review mitigated the need to accept that specific recommendation on disbarring. The point was considered further by the Messenger review.
In the light of evidence from Chester and ongoing variation in performance across trusts, I have asked NHS England to work with my Department to revisit this. It will do so alongside the actions recommended by General Sir Gordon Messenger’s review of leadership, on which the Government have already accepted all seven recommendations from the report dated June last year. This will ensure that the right standards, support and training are in place for the public to have confidence that NHS boards have the skills and experience needed to provide safe, quality care.
Thirdly, by January all trusts will have adopted a strengthened freedom to speak up policy. The national model policy will bring consistency to freedom to speak up across organisations providing NHS services, supporting staff to feel more confident to speak up and raise any concerns. I have asked NHS England to review the guidance that permits board members to be freedom to speak up guardians, to ensure that those roles provide independent challenge to boards.
Fourthly, the Getting it Right First Time programme team will launch a centralised and regularly updated dataset to monitor the safety and quality of national neonatal services.
Finally, we are exploring introducing Martha’s rule to the UK. Martha’s rule would be similar to Queensland’s system, called Ryan’s rule. It is a three-step process that allows patients or their families to request a clinical review of their case from a doctor or nurse if their condition is deteriorating or not improving as expected. Ryan’s rule has saved lives in Queensland, and I have asked my Department and the NHS to look into whether similar measures could improve patient safety here in the UK.
Mr Speaker, I want to take the first opportunity on the return of the House to provide an update on the Essex statutory inquiry. In June, I told the House that the inquiry into NHS mental health in-patient facilities across Essex would move forward on a statutory footing. Today, I can announce that Baroness Lampard, who led the Department of Health’s inquiry into the crimes of Jimmy Savile, has agreed to chair the statutory inquiry. I know that Baroness Kate Lampard will wish to engage with Members of the House and the families impacted, and following their input I will update the House on the terms of reference at the earliest opportunity.
The crimes of Lucy Letby were some of the very worst the United Kingdom has witnessed. I know that nothing can come close to righting the wrongs of the past, but I hope that Lady Justice Thirlwall’s inquiry will go at least some way towards giving the victims’ families the answers they deserve. My Department and I are committed to putting in place robust safeguards to protect patient safety and to making sure that the lessons from this horrendous case are fully learned. I commend this statement to the House.
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(9 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
As a former Health Minister, my hon. Friend is well aware of the risks posed by vaping. As the chief medical officer has said,
“If you smoke, vaping is much safer; if you don’t smoke, don’t vape”.
That is why we are toughening up the regime. We are also working with industry as part of our call for evidence, but we are clear on the need to go further. That is exactly what we will do.
Steve Barclay
I am always very happy for my hon. Friend and other colleagues to meet me or Lord Markham, who leads the capital programme. It is an important scheme. We are delivering it through the standardised Hospital 2.0 approach, using modern methods of construction. We are keen to progress early supported works on site, working closely with colleagues.
Wes Streeting (Ilford North) (Lab)
Last week, the Health Secretary said that he was willing to offer doctors a higher pay rise. Last night, the Chancellor slapped him down, saying that any increased offer will have to be paid for by cuts. How can the Health Secretary negotiate an end to the NHS strikes when he cannot even negotiate with his own Chancellor?
NHS Long-term Workforce Plan
Debate between Steve Barclay and Lindsay Hoyle(9 months, 3 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Steve Barclay)
The Government note the comments that you have made from the Chair, Mr Speaker.
Steve Barclay
That is also noted, Mr Speaker.
May I, on behalf of the Government, note the passing of the former head of the civil service, Lord Kerslake? He had a distinguished career in public service, including as chief executive of Sheffield Council and chair of King’s College Hospital NHS Foundation Trust, as well as being head of the civil service. We send our condolences to his family and friends both in Whitehall and across the civil service.
With permission, Mr Speaker, I wish to make a statement on our long-term workforce plan for the NHS.
This week marks the 75th birthday of the NHS. We should celebrate its achievements, its founding principles and its people. From doctors and dentists to pharmacists and physios, NHS staff devote their lives to caring for others. I am sure the whole House would agree that the NHS holds a special place in our country due to the care offered by the people who work for it.
It is said that, in 1948, the NHS had fewer than 150,000 staff and a budget of around £11 billion. Today, the NHS employs closer to 1.4 million people with a budget of more than £160 billion. The transformation of the care offered by the NHS through advances in medicine is reflected in the fact that people now live 13 years longer than on average in 1948.
Today, alongside the increase in the number of staff, the range of treatments and the improved patient outcomes, demand on the NHS has also increased. People live longer, they live with more complex medical conditions, and we are also dealing with the challenges left behind by a once-in-a-generation pandemic.
One in four adults lives with two or more health conditions. Although our population is forecast to grow by around 4% over the next 15 years, the number of those over 85 is forecast to grow by more than 50%. In addressing the challenges both of today and of the longer term, it is right that we have a recovery plan focused on the immediate steps as we rebuild from the pandemic, and longer-term plans to ensure that the NHS is sustainable for the future. This will ensure that the NHS is there for future generations in the way that it has been for us and our families over the past 75 years.
We have already set out detailed recovery plans to reduce long waits for operations, improve access to urgent and emergency care and make it easier to see GPs and specialists in primary care. On electives, we have virtually eliminated the two-year wait, which we did this summer, and cleared more than 90% of 80-week waits from their peak at the end of March—in marked contrast to the much longer waits we see in Wales, where the NHS is run by Labour.
On urgent and emergency care, we are investing £1 billion in 5,000 additional permanent beds, alongside expanding virtual wards to improve discharge from hospital and investing in community services to prevent admissions, especially for the frail and elderly. On primary care, we are investing more than £600 million, including in improving technology to address the 8 am rush. We have already exceeded our manifesto target by 3,000, with 29,000 additional roles in primary care to enable patients to access specialists more quickly, and we are reducing burdens on GP surgeries through the development of the NHS app and improving the range of services offered through Pharmacy First, enabling pharmacists to prescribe drug treatments for seven minor illnesses.
Alongside the recovery plans, we are taking action to improve prevention through early diagnosis of conditions, whether through the 108 community diagnostic centres that are already open, or the 43 new and expanded surgical hubs planned for this year. Our national roll-out of our lung cancer screening programme has helped to transform patient outcomes, turning on its head the previous position where 80% of lung cancers in our most deprived communities were detected late, with 76% now being detected early.
Alongside the immediate measures we are taking to deal with demand in the NHS, as we celebrate the 75th anniversary we are also investing in the NHS to make sure it is sustainable for the future. Last month, I announced to the House the largest-ever investment in the NHS estate, with more than £20 billion committed to our new hospitals programme.
Today I can confirm to the House that, for the first time in the NHS’s history, the Government have committed to publishing a long-term workforce plan, setting out the largest-ever workforce training expansion in the NHS’s history, backed by £2.4 billion of new funding. The plan responds to requests from NHS leaders and has been developed by NHS England. I would like to take this opportunity to thank Amanda Pritchard, the chief executive of NHS England and her team, Gavin Larner and colleagues within the Department of Health and Social Care, and the more than 60 NHS organisations that have engaged closely in the plan’s development, including many of our Royal Colleges.
The plan sets out three priorities: to train more staff, to retain and develop the staff already working for the NHS and to reform how training is delivered, taking on board the best of international practice. Let me deal with each in turn. We will double the number of medical school places, increase the availability of GPs being trained by 50%, train 24,000 more nurses and midwives and increase the number of dentists by 40%.
When it comes to improving retention, we recognise the importance of flexible working opportunities, especially for those approaching retirement. The plan will build on proposals in the NHS people plan and build on steps already taken by the Chancellor at the spring Budget on pension tax reform.
In respect of reform, the plan sets out policies to expand the number of associate roles, which provide greater career progression for existing staff and in turn reduce the workload of senior clinicians, allowing them to focus on the work that only they can do. Both measures will improve productivity by enabling more staff to operate at the top of their licence. A constant theme across the long-term workforce plan is our focus on apprenticeships and vocational training, including a commitment to increasing the number of staff coming through apprenticeships from 7% today to 22% by 2031-32. That reflects the strong commitment of the Secretary of State for Education and myself to facilitate greater career progression through apprenticeships. It will also help to recruit and retain staff in parts of the country that often find it harder to recruit
In the week in which we celebrate the 75th anniversary of the NHS, today’s announcement confirms the Government’s commitment to the first ever comprehensive NHS long-term workforce plan. The plan sets out detailed proposals to train more staff, offers greater flexibility and opportunity to existing staff, and embraces innovation by reforming how education and training are delivered across the NHS. The plan will be iterative; we will return to it every couple of years to enable progress to reflect advances in technology such as artificial intelligence so that the numbers trained can be best aligned with patient services. It also reflects a growing need for more general skills in the NHS, as patients with more than one condition require a more holistic approach.
The NHS long-term plan, backed by £2.4 billion of new funding, comes in addition to our record investment in the NHS estate. It ensures that we put in place the funding required for a sustainable future for the NHS, alongside the steps that we are taking in the immediate term to reduce waiting lists and ensure that the NHS is there for patients. As the chief executive of NHS England has said herself, the long-term workforce plan is a truly historic moment for the NHS. As such, I commend this statement to the House.
Steve Barclay
Well, that really was a confused response. The hon. Lady began with reference to Labour’s proposals and the claim that our plan followed them. I took the precaution of bringing Labour’s announcement with me to the Chamber. Members can look at it in their own time, but it does not use the word “reform” once, despite the fact that “Train, retain, reform” is a key part of our proposals. Proposals for reform include moving from five-year to four-year medical undergraduate training; the expansion of roles such as physician associate; a significant expansion in the use of apprenticeships; and flexibility for retiring consultants, so that they can return to roles in, for example, out-patient services. A wide range of reforms came about as a result of the consultation with 60 different NHS organisations and are a key feature of the plan, but in Labour’s proposals reform is not mentioned once.
In addition, Labour’s proposals are for a 10-year period. Our plan covers 15 years. Its proposal covered 23,000 additional health roles; our proposal deals with 50,000. I could go on and talk about the fact that the Labour proposal does not even mention GP trainees. Labour Members keep coming to the House and saying that primary care is important, but their proposals did not even touch on the workforce with regard to GPs. They did not even mention pharmacists, even though, as part of a primary care recovery plan, a key chunk of our proposal is Pharmacy First. It is extremely important that we can deliver services to patients in innovative ways. The ultimate irony is that the shadow Health Secretary, in one of his many interviews, including interviews to promote his book, said that the NHS “must reform or die”. He said that it must reform, yet Labour’s proposals do not mention reform at all.
Labour welcomes the plan, but it goes on to say that it will take too long to implement, while claiming that it is its plan, which, again, points to the confusion among Labour Members. Let me remind the House of what has been done. We had a manifesto commitment for 50,000 additional nurses—we are on track to deliver that, with 44,000 in place. We had a manifesto commitment to have 26,000 additional roles in primary care, and we have met that, with 29,000 roles in place. In 2018, we made a commitment to five new medical schools in parts of the country where it is hard to recruit. We have delivered that—a 25% expansion in the number of medical students, who will come on stream in hospitals next summer. However, as we celebrate the 75th anniversary of the NHS, it is right that we also look beyond that to the longer-term needs of the NHS. That is exactly what the plan does with its doubling of medical places, but alongside that, it innovates by embracing things like a medical apprenticeship so that we can look at different ways of delivering training.
The hon. Lady talked about strikes, which is a further area of confusion on the Labour Benches. Labour Members say that they do not support a 35% pay rise for junior doctors, on the grounds that the shadow Chancellor, the right hon. Member for Leeds West (Rachel Reeves), says that they should not. Either Labour Members want to support the junior doctors, or they do not—once again, their position seems confused.
I will finish with one final area of confusion on the Labour Benches. The hon. Lady talked about the elastic non-dom revenue raiser, despite the fact that the former shadow Chancellor, Ed Balls, has said that it would not raise the funds that are claimed. He has said that it would do quite the opposite: it would deter investment in the UK. In addition, Labour has already spent those funds on a range of measures, such as the breakfast clubs that Labour Members come to the House and talk about. The reality is that it would not fund Labour’s proposals, whereas we have made a commitment to back our plan with £2.4 billion of funding from the Treasury.
This is a historic moment as we celebrate the 75th anniversary of the NHS. It is a long-term commitment from a Government who are backing the NHS through the biggest investment in the NHS estate—over £20 billion —and a series of recovery programmes, expanding our diagnostic capacity and our surgical hubs. That is why the workforce plan is truly innovative. It does not just train more staff or offer opportunities to retain more staff; it reforms as well—something that is sadly lacking in Labour’s proposals.
Steve Brine (Winchester) (Con)
This is a serious piece of work, and it is very welcome. Despite calls from people like me to get on with it, it was right for the Government to take their time and get it right. The Select Committee will scrutinise it—as we do—on 12 July.
The training piece is very strong. Doubling the number of medical school places has to be right, and I am glad that the Secretary of State thought of it. On retention, if we are saying—rightly, I would contest—that it is not all about pay, what role does he envisage the integrated care systems and, therefore, the trusts having in supporting staff as he makes the “one workforce” that is mentioned in section 5, with which I agree, come to pass?
Steve Barclay
First, this is a plan developed by colleagues in NHS England, so these are assumptions that have been agreed by those who lead within the NHS. It is about ensuring that people operate at the top of their licence. It is about having new and expanded roles, such as advanced practitioners and associate roles, that allow people to progress in their careers and, in doing so, freeing up capacity for senior clinicians, who often spend time doing things that do not need to be done by people in those roles.
Of course, there are also rapid changes in technology. We often talk about the developments in artificial intelligence, and I have touched on developments in the life sciences industry. I have also mentioned advances in screening and genomics. All those developments will in turn help us to prevent health conditions, and treating those conditions early will be not only better for the patient, but better value for money for the taxpayer.
Mr Speaker
I thank the Secretary of State for his statement, and for responding to questions for 59 minutes.
Mental Health In-patient Services: Improving Safety
Debate between Steve Barclay and Lindsay Hoyle(9 months, 3 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Steve Barclay)
With permission, Mr Speaker, I would like to make a statement on improving safety in mental health in-patient services across England. Before doing so, I want to thank all the right hon. and hon. Members from across the country who have campaigned tirelessly on behalf of their constituents to improve mental health care. Too many people have experienced care in mental health in-patient settings that has been well below the high standard that we all deserve when we are at our most vulnerable. I would also like to put on record my sincere condolences to the families and friends of those who have lost their lives.
First, I will update the House on the independent inquiry into mental health in-patient care across NHS trusts in Essex between 2000 and 2020. I thank my right hon. Friend the Member for Chelmsford (Vicky Ford) for tabling a Westminster Hall debate on the Essex mental health inquiry earlier this year. She and colleagues, including our hon. Friend the Member for Rochford and Southend East (Sir James Duddridge) and our right hon. Friends the Members for Witham (Priti Patel) and for Maldon (Sir John Whittingdale), all spoke passionately about the need to get justice for patients and their families. I know that my hon. Friend the Member for South Suffolk (James Cartlidge) also tabled an Adjournment debate on mental health in-patient care in Essex before the independent inquiry was launched in 2021.
I also pay tribute to my right hon. Friend the Member for Saffron Walden (Kemi Badenoch) and my hon. Friends the Members for Clacton (Giles Watling), for Brentwood and Ongar (Alex Burghart), for Castle Point (Rebecca Harris), and for Southend West (Anna Firth) for their determined campaigning on behalf of their constituents. Of course, we should all remember the important contribution of the former Member for Southend West, and a great friend to many across this house, the late Sir David Amess. He tabled a Westminster Hall debate on mental health services in Essex back in 2014, and he was a passionate campaigner for improving mental health care. I know he is very much in our thoughts.
In 2021 we launched the independent inquiry to investigate the deaths of mental health in-patients across NHS trusts in Essex between 2000 and 2020. The Government appointed Dr Geraldine Strathdee, a former national clinical director for mental health for NHS England, to chair the inquiry. I want to place on the record my thanks to Dr Strathdee and her team, because a lot of good work has been done. I applaud the bravery of all the victims and their families who have come forward to tell their stories.
I also recognise the work that the Essex Partnership University NHS Foundation Trust—EPUT—has done to assist with the inquiry. The trust has been in the spotlight, and progress has already been made to learn lessons and improve in-patient mental health care. EPUT’s chief executive, Paul Scott, joined in 2020, and since then the trust has invested £20 million in its mental health in-patient wards and a further £20 million in community services. Compared with 2019, patients absconding from care has decreased by more than 60%, and the use of inappropriate restraint has fallen by 88%.
However, in January Dr Strathdee raised concerns with me about a lack of engagement with the inquiry by current and former EPUT staff. I know that many right hon. and hon. Members share her concerns. Since then, the inquiry and the trust have worked together in a concerted effort to increase staff engagement. None the less, I have listened to Dr Strathdee’s concerns that the inquiry still needs further staff engagement to get victims’ families the answers they deserve. In a letter to me in March, she said that
“30 percent of named staff, those essential witnesses involved in deaths we are investigating, have agreed to attend evidence sessions. In my assessment, I cannot properly investigate matters with this level of engagement.”
She has also raised with me concerns about ongoing safety issues at the trust. To quote from her letter once again, she said:
“I am very concerned that there are serious, ongoing risks to patient safety. Due to the nature of these issues, I am confident that these cannot be properly investigated by the Inquiry without statutory powers.”
The Government take both concerns extremely seriously, and I agree with Dr Strathdee that we have now reached the point where the only appropriate course of action is to give the inquiry statutory powers.
Statutory inquiries do take longer, but this does not mean that work will start from scratch. Dr Strathdee’s existing findings will inform the next phase of the inquiry. She has informed me that, owing to personal reasons, she will not be continuing as the inquiry’s chair, so I want to thank her once again for all her commitment and hard work. I am sure the House will agree that she is a true public servant. Our work to find her successor is proceeding at pace, and I will update the House on the progress of setting up the inquiry in due course.
I recognise that Members’ concerns about mental health in-patient facilities are not confined to Essex. The Government are committed to improving mental health care across England, which is why we are boosting mental health funding by at least £2.3 billion this year compared with four years ago, why we are making urgent mental health support available through 111, and why we are delivering three new mental health hospitals to provide specialist care and cut waiting lists.
In January, we commissioned a rapid review of how data is used in in-patient mental health settings in England. More effective use of data has the potential to reduce duplication, ensuring that healthcare professionals can spend more of their valuable time with patients. The review team—well led again by Dr Strathdee—heard from more than 300 people representing every part of the in-patient mental health sector, including former patients and frontline staff. Dr Strathdee has made recommendations for how data and evidence can be used to identify risks to patient safety and failures in care more quickly and effectively. The findings and recommendations of the rapid review will be published today, and I will deposit a copy in the Libraries of both Houses. The Government will consider its findings carefully and respond in due course.
We recognise, however, that patients and families want to know how their concerns will be taken forward as soon as possible, and I also recognise that a wide-ranging statutory inquiry relating to other settings, or covering multiple patient safety issues, would not deliver those answers quickly. My Department has therefore agreed to work alongside the Healthcare Safety Investigation Branch to prepare for the launch of a national investigation of mental health in-patient services, which will commence in October, when the HSIB receives new powers under the Health and Care Act 2022.
The new Health Services Safety Investigations Body will investigate the following themes: how providers learn from deaths in their care and use that learning to improve services, including post-discharge services; how young people are cared for in mental health in-patient services and how that care can be improved; how out-of-area placements are handled; and how to develop a safe staffing model for all mental health in-patient services. Across all those areas, it will explore the way in which providers use data. I want to reassure the House that the new body will have teeth and will work at speed, that it will have the power to fine those who refuse to give evidence when they are required to do so, and that its predecessor’s investigations were typically concluded within a year.
I hope that today’s announcements will be of some comfort to the bereaved families who have done so much to raise awareness of the failings of mental health care in Essex and elsewhere. I want them to know that the Government are committed to obtaining for them the answers that they deserve, and to improving mental health across the country. I commend this statement to the House.
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(10 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
I am sure the whole House is sorry to hear that her constituent’s condition has deteriorated. The hon. Lady raises a very important point about integration, which is exactly the right approach. The 2022 reforms were about integrating health and social care and empowering commissioners to take a more integrated place-based approach. I am sure her local commissioners will take note of the valid point that she raises.
Dr Rosena Allin-Khan (Tooting) (Lab)
A 14-year old climbing out of hospital windows; a child absconding to a local railway station; a teenager with complex needs brought to A&E, requiring four police officers to spend an entire shift watching them, only for them to abscond the next day. There is a pattern here. At almost every step of the way, children needing mental health services face a perfect storm of delay and treatment in inappropriate settings, fuelled by an under-resourced service with over-stretched staff. In light of the Met’s announcement that they will stop attending emergency mental health calls, is it not time for the Government to get their act together, or simply do the right thing and step aside?
Steve Barclay
I am very happy to join my hon. Friend in paying tribute to all those who support Chemocare Bags for the fantastic work they do. That sort of support makes a real difference to patients, and the NHS benefits hugely from the work of volunteers, including those at Chemocare Bags.
Andrew Gwynne (Denton and Reddish) (Lab)
As my hon. Friend the Member for Rhondda (Sir Chris Bryant) pointed out, the brutal truth is that the Tories have consistently missed England’s cancer treatment target since 2013. Last year, 66,000 cancer patients waited more than two months for their first treatment following an urgent GP referral, and the UK now has the worst cancer survival rate in the G7. Labour will give the NHS the staff, the technology and the reform it needs, and we make no apologies for expecting cancer waiting times and diagnosis targets to be met once again. That is our mission. Why is theirs so unambitious?
Cat Smith (Lancaster and Fleetwood) (Lab)
When will the Government announce capital funding for the new hospital in Lancaster: before or after 2030?
Steve Barclay
Chorley is extremely important, Mr Speaker—I am very sighted on that.
Our commitment is that that is part of the new hospital building programme. We said that it is part of the rolling programme, so it will not be completed by 2030 but we are keen to get work started on it, and that is exactly what we will be discussing with Members of Parliament in the weeks ahead.
The Secretary of State for Health and Social Care (Steve Barclay)
As Health Secretary, I have been clear that deploying the latest technology and innovation is essential in order to deliver our priorities: to cut waiting lists, improve access to GPs and improve A&E performance. The NHS app is at the heart of this, including the enhancement of patient choice set out in our recent announcement, which is not available to patients in Wales. The Patients Association estimates that by enabling people to select a different hospital in the same region on the app, we can cut their waiting times by as much as three months.
We have been making major improvements behind the scenes, which are already paying off. Today, I can tell the House that between March 2022 and March of this year, there have been 6 million new registrations for the app; repeat prescriptions via the app have increased from 1.6 million a month to 2.5 million a month; and primary care appointments made on the app have increased from 30,000 a month to 250,000, and secondary care appointment from 30,000 a month to 360,000. We continue to work to increase the app’s functionality, including opening more records and test results and enabling more appointments, as part of our commitment to technology.
Sarah Owen
Brain tumours are the biggest killer for people under 40, but we are still waiting for the full £40 million that the Government promised to fund brain tumour research. In March, I raised in the House the heartbreaking experience of my constituents Yasmin and Khuram, whose daughter Amani died from a brain tumour just before her 23rd birthday. Once again, I ask whether the Minister for Health and Secondary Care or the Secretary of State will meet with me and my constituents to hear their calls for the full funding allocation to be given to researchers. That funding would be transformational for the treatment of brain tumours.
Steve Barclay
I am very keen to meet with my hon. Friend. I know this is an extremely important scheme for her constituency, particularly the key worker accommodation, and I look forward to having that discussion with her and the leadership of her trust.
Wes Streeting (Ilford North) (Lab)
First, I congratulate the Health Secretary on his recent write-up as the next Leader of the Opposition. According to the i newspaper, his supporters are calling him “Mr Consistent”. Is that because of the consistent rise in waiting lists since he became Health Secretary, the consistently longer waiting times that patients are facing, or the consistent delay to the NHS workforce plan?
Oral Answers
Debate between Steve Barclay and Lindsay Hoyle(12 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
The hon. Gentleman is right that we should narrow the health inequalities gap, and we are committed to doing that. That is why in the women’s health strategy, which I set out in the summer, we committed to having women’s health hubs as one-stop shops to tackle some of the gender inequality. It is also why, whether on obesity, smoking or lung cancer, we are targeting our screening and public health interventions to close the gap, which he is quite right to highlight.
Steve Barclay
I know we have clinicians in the House who do second jobs, but I did not know that the hon. Lady had expanded that definition to such an extent! She is right to highlight, through her survey, the importance of timely care. There is currently a range of initiatives, such as the development of the NHS app, the review of the 111 service, and the examination of innovations such as artificial intelligence. We are looking into how we can manage demand in the case of, in particular, frail elderly people by noting changes in behaviour patterns, which will allow us to ensure that, for example, someone who has a fall at home receives care much earlier before arriving in the accident and emergency department, because we know that once frail elderly people have been admitted they will often be in hospital for about 14 days. The hon. Lady has raised an extremely important issue through her survey, and one on which we are focusing in our urgent and emergency recovery plan.
Steve Brine (Winchester) (Con)
That urgent and emergency care plan, which was announced in January, was received with acclaim by me and, indeed, with wide acclaim. It was described as a two-year plan to stabilise services by, for instance, returning to the A&E target that the Secretary of State has mentioned. What assessment has he made of the impact of the ongoing industrial dispute among the Agenda for Change cohort, and, of course, the junior doctors, on the delivery of the plan?
Steve Barclay
To be honest, I think the position is mixed. In certain areas we have seen significant improvements in performance: the faster diagnosis standard, for example, was hit for the first time this month. Purdah prevents me from going into the details of the 78-week wait, but I expect to be able to update the House very soon on the progress that has been made. As the hon. Gentleman says, there are still challenges as a consequence of the pandemic, but we are seeing much more progress than the NHS in Wales, and it is also worth reminding the House that, through Barnett consequentials, the Welsh NHS receives more funding that the NHS in England.
Dr Rosena Allin-Khan (Tooting) (Lab)
This may surprise you, Mr Speaker, but I have found evidence that the Health Secretary has got something right. He recently hailed the power of local news outlets, and he was spot on. I have here a story from his local paper, exposing the shocking length of waits in A&E for those in a mental health crisis: 5.4 million hours across England in just one year. He is very welcome to have a look if he would like to. Given his admiration for local journalism, does he feel embarrassed for his Government’s failings and will he apologise to all the people across the country who are stuck waiting in A&E?
Steve Barclay
My hon. Friend makes a brilliant point, and that is something that we are committed to doing. There is a huge amount of expertise within the pharmacy network, which is why we are looking, through technology such as the NHS app, at how we can better enable people to get the right care from the right place at the right time. Quite often, that is not by seeing the GP, but it might be by seeing those in additional roles in primary care or going to a pharmacist who can offer the right services.
Wes Streeting (Ilford North) (Lab)
A 13-year-old girl who has already waited more than a year for spinal surgery has seen her operation cancelled twice because of the Government’s failure to negotiate an end to the junior doctors’ strike. Why on earth is the Secretary of State still refusing to sit down and negotiate with junior doctors?
Steve Barclay
It is slightly odd that the hon. Gentleman talks about 13 years when we are actually talking about a current industrial dispute. We have shown, through our negotiation with the NHS Staff Council, our willingness to engage and to reach a settlement. Indeed, the general secretary of the RCN recommended the deal from the AfC unions to her members. Unison—the union of which the hon. Gentleman is a member—voted for the deal by a margin of 74%. We stand ready to have engagement with the junior doctors, but 35% is not reasonable. He himself has said—[Interruption.]
Mr Speaker
Order. I do not need the Minister for Social Care, the hon. Member for Faversham and Mid Kent (Helen Whately), shouting from the end of the Treasury Bench. Okay? I call Henry Smith.
NHS Strikes
Debate between Steve Barclay and Lindsay Hoyle(1 year ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Steve Barclay
The shadow Secretary of State seems to ignore the fact that we have negotiated a deal with the NHS Staff Council, and it is a deal that it has recommended to its members. Indeed, the largest health union has voted in favour of the deal—indeed it is his own health union that has voted in favour of it—and yet he seems to suggest that we should tear it up even though other trade unions are voting on the offer, and their leadership had recommended it.
Secondly, the shadow Secretary of State says that we should sit down and negotiate. We have made an offer of 10.75% for last year, compared with the Labour Government in Wales, who have offered just 7.75%, which means that, in cash terms, the offer in England is higher than that put on the table by the Welsh Government, whom, I presume, he supports. He says that he does not support the junior doctors in their ask of 35%, and neither does the leadership there. We need to see meaningful movement from the junior doctors, but I recognise that they have been under significant pay and workforce pressures, which is why we want to sit down with them.
The bottom line is that the deal on the table is reasonable and fair. It means that just over £5,000 across last year and this year will be paid for a nurse at the top of band 5. The RCN recommended the deal to its members, but the deal was rejected by just under a third of its overall membership. It is hugely disappointing that the RCN has chosen not to wait for the other trade unions to complete their ballot and not to wait for the NHS Staff Council, of which it is a member, to meet to give its view on the deal. It has chosen to pre-empt all that not only with the strikes that come before that decision of the NHS Staff Council, but by removing the derogations—the exemptions—that apply to key care, including emergency care, which is a risk to patient safety.
Trade unions are continuing to vote on the deal. The deal on the table is both fair and reasonable, including just over £5,000 across last year and this year for nurses at the top of band 5. The deal has been accepted by the largest union in the NHS, including, as I have said, the shadow Health Secretary’s own trade union. It pays more in cash to Agenda for Change members than the deal on the table from the Labour Government in Wales. It is a deal that the majority of the NHS Staff Council, including the RCN’s own leadership, recommended to its members. We have always worked in good faith to end the disruption that these strikes have caused and we will continue to do so. None the less, it is right to respect the agreement that we have reached with the NHS Staff Council and to await its decision, which is due in the coming weeks.
Steve Brine (Winchester) (Con)
Reports over the weekend suggest that the British Medical Association has asked its members not to engage with trusts if they intend to strike, as the Secretary of State has confirmed today. That is putting trust chief executives—and this is not their fault—in an impossible position. They are being asked to meet very challenging targets that we are rightly setting them, not least with respect to the covid backlog. What more can he do by his good offices to break that impasse? It is patients who are losing out.
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(1 year, 1 month ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
My right hon. Friend raises an important issue, and I am happy to look into the individual case she describes. Our wider objective in providing extra funding is to ensure that we treat more people, with 2 million more people accessing NHS-funded mental health support by 2023-24 and the number of patients in talking therapies last year up by a fifth from the year before.
Dr Rosena Allin-Khan (Tooting) (Lab)
There is a mental health staffing crisis of the Government’s own making. Figures out last week show that there are more than 28,000 mental health vacancies in our NHS, which is up on the year before and the year before that. Are we seeing a pattern here? The number of mental health nurses is down 5% since 2010, but do not worry, Mr Speaker: just so the Secretary of State is aware, Labour has a plan to recruit and retain more mental health staff and to get waiting times down. Can he put a word in with the Chancellor in case he wants to nick that too?
Steve Barclay
It is worth pointing out to the House that the vacancy rate for doctors has fallen compared with where it was before the pandemic. That is often not the narrative that is put out there, but the right hon. Lady is right to highlight the importance of retention. It is obviously better to retain a doctor, given the cost and time it takes to recruit, and that is about looking at a combination of pay issues, about which we are talking to trade union colleagues, and non-pay issues, which are often a real factor in the quality of work that doctors are doing and often shapes retention issues.
Wes Streeting (Ilford North) (Lab)
I am afraid that talk is cheap. I was at Worcester University’s medical school yesterday, where I was told directly by the vice-chancellor that that university, which has great facilities, can only recruit international students because the Government will not fund places for domestic students. The NHS has asked for medical school places to be doubled. Labour has a plan to double medical school places, paid for by abolishing the non-dom tax status. Why do the Government not swallow their pride and adopt Labour’s plan in next week’s Budget?
Steve Barclay
We are always happy to assist colleagues across the United Kingdom as part of our commitment to the Union. My hon. Friend is right to highlight current performance in Wales. As I have said, patients are waiting twice as long for hospital treatment in Wales as in England, and more than 50,000 people in Wales are waiting for more than two years for their operation.
Wes Streeting (Ilford North) (Lab)
When nurses and paramedics voted to take strike action, the Secretary of State refused to negotiate and said that the pay review body’s decision was final. He has now U-turned, but not before 144,000 operations and appointments were cancelled through his incompetence. Will he now apologise to patients for this avoidable disruption?
Steve Barclay
My hon. Friend is right to draw the House’s attention to the extremely important work of hospices and to the fact that commissioning decisions are devolved to the integrated care boards so that they can target funding in the way that best serves local communities. He is quite right to lobby on their behalf and I am sure that his relevant ICB will take note of that.
Mr Speaker
Before we come to the statement on the Illegal Migration Bill, I wish to make a brief statement.
I am aware that there are a number of cases before the courts that relate to the subject matter of the Bill. Given the national importance of the issues to be discussed, I am prepared to exercise a waiver and allow brief references to those cases. However, I would ask Members to exercise caution and not to refer in detail to issues that are being considered by the courts.
Urgent and Emergency Care Recovery Plan
Debate between Steve Barclay and Lindsay Hoyle(1 year, 2 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Steve Barclay)
Today we have published our new delivery plan for recovering urgent and emergency care services, which has been deposited in the Libraries of both Houses. Given the scale of the pandemic pressures that healthcare systems around the world and across the UK are collectively facing, we are building the NHS back to where we want it to be. That requires the widespread adoption of innovation, building on best practice already applied in specific trusts, together with significant investment in new ways of working, including a £14.1 billion funding boost for health and social care, as set out in the autumn statement.
Today’s announcement is the second of three plans to cut waiting times in the NHS. Our elective recovery plan is already in action, virtually eliminating the backlog of two-year waits in England. Our primary care recovery plan will be published in the next few weeks, to support the vital front door to the NHS through primary care. Today, together with NHS England, we are setting out our plans to reduce waiting times in urgent and emergency care through an increased focus on demand management before patients get to hospital, and greater support to enable patients to leave hospital more quickly through care at home or in the community, supported by a clinical safety net. In addition, the plan sets out how we will adopt best practice in hospitals by learning from the trusts that have displayed the greatest resilience in meeting the heightened pressures this winter.
Today’s announcement on urgent and emergency care does not sit in isolation, but is part of a longer-term improvements plan that builds on the legislative change enacted last year to better integrate health and social care through the 42 integrated care boards, which became operational in July. That was prioritised for additional funding through the £14.1 billion announced for health and social care in the autumn statement. Following the quick spike in flu cases over Christmas, with in-patient flu admissions 100 times that of the previous year and a sevenfold increase in December, we announced £250 million of immediate funding on 9 January for the pressures this winter, giving extra capacity to emergency departments to tackle the issue of patients who are fit to leave hospital but are delayed in doing so.
Today’s plan, developed in partnership with NHS England and social care partners, builds on the actions and investment that I set out to the House earlier this month as we put in place the more substantive changes required to enable the NHS to have greater resilience this time next year. To do that, this plan involves embracing technology and new ways of working to transform how patients access care before and after being in hospital. That in turn will help to break the cycle of emergency departments in particular coming under significant strain in winter.
Our plan has a number of commitments that are both ambitious and credible. First, we are committing to year-on-year improvement in A&E waiting times. By next March, we want 76% of patients to be seen within four hours. In the year after that, we will bring waiting times towards pre-pandemic levels. Our second ambition is to improve ambulance response times, with a specific commitment to bring category 2 response times—those emergency calls for heart attacks and strokes—to an average of 30 minutes by next March. Again, in the following year we will work to bring ambulance response times towards pre-pandemic levels. I am pleased that the College of Paramedics has welcomed the plan, saying that it is
“pleased to see a strong focus in the recovery of those people in the Category 2 cohort”.
Of course, this will not be the limit of our ambition, but it is vital that we get these first steps right and that we are credible as well as ambitious. To put these targets in context, achieving both would represent one of the fastest and largest sustained improvements in the history of the NHS.
Underpinning these promises is one more essential commitment: a commitment to better data and greater transparency. On data, the best-performing hospitals have benefited from the introduction of patient flow control centres to quickly identify blockages in a patient’s journey, and e-bed management systems to speed up the availability of beds when they become free. Through this plan, we will prioritise investment in improving system-wide data, both within the integrated care boards and on an individual trust and hospital site basis. This will allow quicker escalation when issues arise and a better system-wide response when individual sites face specific challenges.
On greater transparency, for some time voices across the NHS have called for the number of 12-hour waits from the time of arrival in A&E to be published. This is something I know the Royal College of Emergency Medicine has long campaigned for—I can see the hon. Member for St Albans (Daisy Cooper) nodding her head—and there has been criticism of the Government, including from Opposition Members, for refusing to provide this transparency. Instead, the data published to date has been a measure of 12 hours from the point of admission rather than from arrival in A&E. For the commitment to transparency to be meaningful, we must be prepared to publish data, even when that transparency will bring challenges, so today I can inform the House that from April we will publish the number of 12-hour waits from the time of arrival. Dr Adrian Boyle, the president of the Royal College of Emergency Medicine, has previously said:
“The full publication of this data will be an immensely positive step that could be the catalyst for transformation of the urgent and emergency care pathway that should help to improve the quality of care for patients.”
I hope this transparency will be welcomed across the House.
Our plan focuses on five areas, setting out steps to increase capacity in urgent and emergency care; grow the workforce; speed up discharge; expand and better join up new services in the community; and make it easier for people to access the right care. Action in each area is based on evidence and experience, learning lessons from the pandemic and building on what we know can work. More than that, we are backing our plan with the funds we need, and the Government are committing to additional targeted funding to boost capacity in acute services and the wider system. That is why this package includes £1 billion of dedicated funding to support hospital capacity, building on the £500 million we have provided over this winter to support local areas to increase their overall health and social care capacity.
Taken together, this plan will cut urgent and emergency care waiting times by, first, increasing capacity with 800 new ambulances on the road, of which 100 are new specialised mental health ambulances. This comes together with funding to support 5,000 new hospital beds, as part of the permanent bed base for next winter.
Secondly, we are growing and supporting the workforce. We are on track to deliver on our manifesto commitment to recruit more than 50,000 nurses, with more than 30,000 recruited since 2019. The NHS will publish its long-term workforce plan this year. We are also boosting capacity and staff in social care, supported by investment of up to £2.8 billion next year and £4.7 billion in the year after.
Thirdly, we are speeding up the discharge of patients who are ready to leave hospital, including by freeing up more beds with the full roll-out of integrated care transfer hubs, such as the successful approach I saw this morning at the University Hospital of North Tees.
Fourthly, we are expanding and better connecting new services in the community, such as joined-up care for the frail elderly. This includes a new falls service, so that more elderly people can be treated without needing admission to hospital.
Virtual wards are also showing the way forward for hospital care at home, with a growing evidence base showing that virtual wards are a safe and efficient alternative to being in hospital. We aim to have up to 50,000 people a month being supported away from hospital, in high-tech virtual wards of the sort that Watford General Hospital has been pioneering, as I saw last month.
Finally, we are improving patient experience by making it easier to access the right care, including a better experience with NHS 111 and better advice at the front door of A&E, so that patients are triaged to the right point in the hospital without always needing to go through the emergency department—this new approach can currently be seen at Maidstone Hospital, as I saw earlier this month.
These are just some of the practical improvements already being delivered in a small number of trusts that, through this plan, we will adopt more widely across the NHS and, in doing so, deliver greater resilience ahead of next winter.
I am pleased that NHS Providers has welcomed today’s plan, and that the Royal College of Emergency Medicine has called it
“a welcome and significant step on the road to recovery”.
Taken together with all the other vital work happening across health and care, including our plan to cut elective and primary care waiting times, today’s plan will enable better care in the community and at home, for that care to be more integrated with hospital services and for existing practice to be more widely adopted. I commend this statement to the House.
Steve Barclay
The hon. Gentleman started by thanking me for advance sight of the statement, and then he made a series of remarks that simply ignored what was in it. Even his last point shows how riddled with contradictions the Opposition’s approach is. He says in interviews that he supports the pay review body process—that is the official position, or at least it was—but then he says, “No, we should be negotiating individually with the trade unions and disregarding the pay review process.” There is no consistency on that at all.
The shadow Secretary of State talks about operational performance—[Interruption.] He has just had his go; he should listen to the answers. He says that it is about operational performance, but in my remarks I tried to be fair and said that these are challenges that are shared across the United Kingdom and globally. He seems to think that they are unique to England alone. We need only look at Wales to see that more than 50,000 people—notwithstanding the fact that Wales has a smaller population—are waiting more than two years for their operations, when we cleared that figure in the summer in England, leaving fewer than 2,000 in that cohort.
The shadow Secretary of State talks about the workforce. Obviously, he did not bother to read or listen to what was said in the statement. We are on track to deliver our manifesto commitment of more than 50,000 nurses. We have more than 30,000 so far. We have 10,500 more nurses in the NHS this year compared with last year. The grown-up position is to recognise—[Interruption.] Well, in the first five years we were dealing with what that letter said, which was that there was no money left. [Interruption.] Labour Members just do not like the response, but the facts speak for themselves. We have 10,500 more nurses this year than last year. The grown-up position, as I was saying, is to recognise that we have an older population with more complex needs, and that the consequences of the pandemic are severe—they are severe not only in England, but across the United Kingdom, in Wales and Scotland, and indeed in countries around the globe.
The shadow Secretary of State says that the statement did not cover the plan for GPs. Well, again, I was clear that this was one of three plans. We had the elective plan in the summer, which hit its first milestone. We have the second component today on urgent and emergency care, and we will set out in the coming weeks our approach to primary care. That is the approach that we are taking. [Interruption.] The shadow Secretary of State keeps chuntering. We did not have the pandemic 13 years ago. [Interruption.] I can only surmise that he did not get his remarks quite right the first time, which is why he feels the need to keep chuntering now and having a second, third and fourth go—perhaps next time.
On ambition, the shadow Secretary of State ignores the fact that we need to balance being ambitious with being realistic. These metrics, in the view of NHS England, show the fastest sustained improvement in NHS history. Clearly, his remarks are at odds with NHS England.
On funding, we are putting an extra £14.1 billion of funding into health and social care over the next two years, which reflects the fact that the Chancellor, notwithstanding the many competing pressures he faced at the autumn statement, put health and social care, alongside education, as the key areas to be prioritised.
On virtual wards, I had not quite realised that the shadow Secretary of State was the clinician who had invented virtual wards. I think that the credit for virtual wards actually goes to the staff, such as those I met at Watford, who are driving forward that innovation. It is slightly strange that he sometimes wants to claim ownership of something that has been clinically led by those working on the frontline. We have recognised the value of virtual wards, which is why, at North Tees this morning, at Watford last month, or on various other visits, I have been discussing how to scale up those plans.
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(1 year, 2 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
I welcome my hon. Friend’s drawing attention to the investment that has been made, which is in no small part due to his campaigning and championing his constituents, as he does so assiduously. I think the Minister of State, Department of Health and Social Care, my hon. Friend the Member for Colchester (Will Quince) has plans to join him to mark the opening of that important facility, which shows our investment in the estate within the NHS.
Gareth Thomas (Harrow West) (Lab/Co-op)
One way to improve retention and recruitment of NHS staff at Northwick Park Hospital, which serves my constituency and which I believe the Secretary of State visited last Thursday, would be to invest in doubling its intensive care beds. Did the Secretary of State discuss that issue with the chief executive of Northwick Park when he visited last week? Will he tell us when he might be able to announce funding for the new 60-bed unit that Northwick Park needs?
Steve Barclay
The hon. Gentleman is right to highlight the importance of bed capacity at Northwick Park, but my discussions with the chief executive were more in the context of how step-down capacity will relieve pressure on A&E. The hon. Gentleman will know that Northwick Park has one of the busiest, if not the busiest, A&Es in London on many days, and the chief executive spoke to me about the value of adding extra bed capacity from a step-down perspective, much more so than from an intensive-care perspective. If there are specific issues for intensive care, I am happy to follow them up with the hon. Gentleman.
Dr Rosena Allin-Khan (Tooting) (Lab)
In mental health we rely on staff, not shiny machinery, so why is the Secretary of State rehashing old announcements and scrapping plans? It is because the Government have run out of ideas. Labour has a plan. We will recruit 8,500 more mental health professionals, ensuring a million more patients get treated every year. We will double the number of medical school places. We will train 10,000 extra nurses and midwives every year, and we will focus on retaining the fantastic staff we already have. Where is the Government’s plan? We have had our plan for two years, but they are binning theirs.
Steve Barclay
My hon. Friend makes an extremely powerful point. I hope the Labour-run NHS in Wales takes heed of her comments. She brings professional experience to this issue and is absolutely right that there needs to be investment in the NHS estate in Wales.
Steve Barclay
The hon. Gentleman is just factually wrong. We have increased medical undergraduate places by a quarter—I was in the Department at the time the decision was taken—so he is wrong on the facts. We also need to look at new ways of getting medics in and having more diverse recruitment in relation to social profile. That is why the apprenticeship route is an extremely important one that I am keen to expand.
NHS Winter Pressures
Debate between Steve Barclay and Lindsay Hoyle(1 year, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Steve Barclay)
Mr Speaker, I wish to take this first opportunity to update the House on the severe pressures faced by the NHS since the House last met. I and the Government regret that the experience for some patients and staff in emergency care has not been acceptable in recent weeks. I am sure that the whole House will join me in thanking staff in the NHS and social care who have worked tirelessly throughout this intense period, including clinicians in this House who have worked on wards over Christmas. They include my hon. Friend the Member for Lewes (Maria Caulfield), the Minister for mental health, and the hon. Member for Tooting (Dr Allin-Khan), the shadow Minister for mental health.
There is no question but that it has been an extraordinarily difficult time for everyone in health and care. Flu has made this winter particularly tough: first, because we are facing the worst flu season for 10 years—the number of people in hospital with flu this time last year was 50; this year, it is over 5,100. Secondly, it came early and quickly, increasing sevenfold between November and December. It also came when GPs and primary and community care were at their most constrained. When flu affects the population, it affects the workforce too, leading to staff sickness absence that constrains supply just as it also increases demand.
These flu pressures came on top of covid. Over 9,000 people are in hospitals with covid, while exceptional levels of scarlet fever activity and an increase in strep A have created further pressure on A&E. All that comes on top of a historically high starting point. We did not have a quiet summer, with significant levels of covid, and delayed discharges were more than double what they were during the pandemic. I put that in context for the House: in June 2020, there were just 6,000 cases per day of delayed discharge—patients medically fit and ready to leave hospital—whereas throughout last year the figure was between 12,000 and 13,000 per day. The scale, speed and timing of our flu season have combined with ongoing high levels of covid admissions in hospital and the pandemic legacy of high delayed discharge to put real strain on frontline services.
Since the NHS began preparing for this winter, there was a recognition that this year had the potential to be the hardest ever. That is why there was a specific focus on vaccination. There were 9 million flu shots and 17 million autumn covid boosters. We extended eligibility more widely than in the past, to cover the over-50s, and became the first place in the world to have the bivalent covid vaccine, which tackles both the omicron and the original covid strain.
NHS England also put in place plans for the equivalent of 7,000 additional beds, including the introduction of virtual wards of a sort that one can see at Watford General Hospital. That innovation is still at an early stage of development, but has the potential to be significant in reducing pressure on bed occupancy in hospitals; in Watford alone, it has saved the equivalent of an extra hospital ward of patients. In addition, our plan for patients put £500 million specifically into delayed discharge, with a further £600 million next year and £1 billion the year after. Although the funds are already starting to make a difference, efforts have taken time to ramp up operationally with local authorities and the local NHS.
In addition, our 42 integrated care boards, recognising how bed occupancy in hospitals and social care are connected, will fully integrate health and care in the years to come. But likewise, they are at an early stage of maturity, with ICBs having become fully operationalised only in July 2022, less than six months ago.
Our plans involving the integration of hospital care and social care, additional funding for discharge, increased step-down capacity, the equivalent of 7,000 additional hospital beds and a vaccination programme at scale have provided the groundwork for the Government response, but it is clear we need to do more right now in light of the level of flu and covid rates and given that hospital occupancy remains far too high and emergency departments are too congested. Recognising that, we launched the elective recovery taskforce on 7 December, and in the coming weeks, we will publish our urgent and emergency care recovery plans. NHS England and the Department of Health and Social Care have been working intensively over Christmas on these plans, which were reviewed with health and care leaders at an NHS recovery forum in Downing Street on Saturday.
The recovery falls into three main areas of work: first, steps to support the system now, given the immediate pressures we face this winter; secondly, steps to support a whole-of-system response this year to give better resilience during the summer and autumn—as we have seen with the heatwave this summer and with the levels of covid, pressure is now sustained throughout the year, not just, as in the past, during autumn and winter; and, thirdly, our work alongside those two areas on prevention, on maximising the step change potential of proven technologies, such as virtual wards, and on the wider adoption of innovations such as operational control centres and machine reading software to treat more conditions in the community, away from someone reaching an emergency department in the first place.
Let me first set out the measures I can announce today to provide support to the NHS and local authorities now. First, we will block-book beds in residential homes to enable some 2,500 people to be released from hospitals when they are medically fit to be discharged. When that is combined with the ramping up of the £500 million discharge funding, which will unblock an estimated 1,000 to 2,000 delayed discharge cases, capacity on wards will be freed up, which will in turn enable patients admitted by emergency departments to move to wards, which in turn unblocks ambulance delays. It is important, however, that we learn from the deployment of a similar approach during the pandemic by ensuring that the right wraparound care is provided for patients released to residential care. I have asked NHS England to particularly focus on that, so that it is the shortest possible stay on patients’ journey home and into domiciliary care, and indeed it is in the NHS’s own interests for those stays to be as short as possible. Taken together, this is a £200 million investment over the next three months.
Next, our A&Es are also under particular strain. From my visits across the country I have seen and heard how they often need more space to enable same-day emergency care and short stays post emergency care. Our second investment is in more physical capacity in and around emergency departments. By using modular units, this capacity will be available in weeks, not months, and our £50 million investment will focus on modular support this year. We will apply funding from next year’s allocation to significantly expand the programme ahead of the summer. We are giving trusts discretion on how best to use these units to decompress their emergency departments. It might be for spaces for short stays post A&E care, where there is no need for a patient to go to a ward for further observation, or for discharge lounges that previously have not been able to take a patients in a bed—many of those are often simply chairs—or for additional capacity alongside the emergency department at the front end of the hospital.
The third action we are taking to support the system right now is to free up frontline staff from being diverted by Care Quality Commission inspections over the coming weeks, and the CQC has agreed to reduce inspections and to focus on high-risk providers in other settings, such as mental health. Those are the actions we are taking that will have an immediate effect.
I turn to the measures we are taking now that will give greater resilience into the summer and next winter. We now have 42 NHS system control centres in operation across England, staffed 24 hours a day, seven days a week, tracking patients on their journey through hospitals, helping us to identify blockages earlier and getting flow through the system. Where we have implemented these systems, such as the one I saw in operation in Maidstone, they have had a clear impact. We will therefore allocate funding in next year’s settlement to apply these systems more widely.
Similarly, we have also seen how the use of artificial intelligence and data can demonstrably reduce demand and release patients sooner. NHS England has been tasked with clarifying and simplifying the procurement landscape, taking on board best international practice, so that a small number of scalable interventions are taken forward where international experience shows they can deliver meaningful benefits to patients.
Next, we will capitalise on the incredible potential of virtual wards. Last week at Watford General Hospital, I saw how patients who would have been in hospital beds were treated at home through a combination of technology and wraparound care. Patients released sooner are often much happier, knowing that they are receiving clinical supervision and always have the safety net of being able to quickly return to hospital should their condition deteriorate. There is scope to expand these measures to many more conditions and many more hospitals in the months ahead.
We are also opening up more routes for NHS patients to get free treatment in the independent sector and offering even greater patient choice. The elective recovery taskforce is helping us to find spare operating theatres, hospital beds and out-patient capacity.
We must also take steps in primary care. We are clear that our community pharmacists can support many more things to ease pressure on general practice. From the end of March, community pharmacists will take referrals from urgent and emergency care settings; later this year, they will also start offering oral contraception services. But I want to do even more, as they do in Scotland, and work with community pharmacists to tackle barriers to offering more services, including how to better use digital services. The primary care recovery plan will set out a range of additional services that pharmacists can deliver.
Finally, notwithstanding very severe pressures, we know that to break the cycle of the NHS repeatedly coming under severe pressure, the best way to reduce the numbers coming through our front doors is to address problems away from the emergency department. On Friday, we signed a memorandum of understanding with BioNTech —a global leader in mRNA technology—to bring vaccine research to this country, which will give as many as 10,000 UK patients early access to trials for personalised cancer therapies by 2030. This builds on the 10-year partnership we struck with Moderna in December to also invest in mRNA research and development in the UK and build state-of-the-art vaccine manufacturing here.
We are also reviewing our wider care for frail, elderly patients in care homes long before they ever get to A&E or our hospitals. Take the brilliant work being done in Tees valley, where community teams are being used to help with falls to prevent unnecessary ambulance trips to hospitals. We have looked at what more support we can offer elderly patients further upstream. With an ageing population, and many more people with more than one condition, it is clear that we have to treat patients earlier in the community and go beyond individual specialties to better reflect patients with multiple conditions to give the right support to people where they are, which is often at home or in residential homes.
Today’s announcement provides a further £250 million of funding, which recognises the spike in flu on top of covid admissions and high delayed discharge numbers from the pandemic. The funding will provide immediate support to reduce hospital bed occupancy and decompress A&E pressures, and, in turn, unlock much-needed ambulance handovers. This funding builds on the £500 million announced in the autumn statement specifically for discharge, which is ramping up, and the additional funding for next year.
All this work ultimately builds on the much-needed greater integration of health and social care through the 42 integrated care boards, which we will strengthen through the Hewitt review, and through a step change in capability, including operational control centres.
This immediate and near-term action sits in parallel with our wider life science investment, such as the deals with BioNTech and Moderna, and underscores our commitment to recognising the immediate pressures on the NHS and investing in the science that will shift the dial on earlier, upstream treatment at scale, particularly for the frail elderly, long before a patient reaches an emergency department. This is a comprehensive package of measures, and I commend this statement to the House.
Steve Barclay
The hon. Member talks about a fresh start, but even his own shadow Cabinet colleagues do not seem to agree with his plans. His own deputy leader seemed to distance herself from his plans to use the private sector, and his own shadow Chancellor seems to have distanced herself from his plans for GPs. Perhaps he can share with the House exactly how much his unfunded plans for GPs will cost, because the chief executive of the Nuffield Trust has said:
“It will cost a fortune”,
and is
“based on an out of date view”.
The point is that he has no plans that his deputy and his own colleagues support, and he has not set out how he would fund those plans in a way that does not divert resource from other parts of the NHS.
The hon. Member talked about pressure, yet there was no mention of the fact that the NHS in Wales, the NHS in Scotland and, indeed, health systems across the globe have faced significant pressure as a result of the combination of covid spikes and flu spikes, particularly in recent weeks. This is not a phenomenon limited to England and the NHS; this is a pressure that has been reflected internationally, including for the NHS in Wales.
The hon. Member refers to talks with the trade unions, and it is right that we are engaging with the trade unions. I was pleased to meet the staff council of the NHS today. Indeed, the chair of the NHS staff council, Sara Gorton, said the discussions had made “progress”, notwithstanding one trade union leader who was not in the talks giving an interview outside the Department to comment on what had and had not been said in those talks. We want to work constructively with the trade unions on that.
The hon. Member says that we are only announcing measures today, but again, he seems to have written those comments before he got a copy of the statement. The integrated care boards took operational effect in July last year—[Interruption.] Because they are scaling up, we are putting control centres in place and we are integrating health and social care. In the autumn statement, we announced £500 million for discharge, a further £600 million next year and £1 billion the year after, recognising that there is significant pressure, and that is ramping up. NHS England set out its operational plans in the summer, including the 100-day discharge sprint. That, for example, set out the greater use of virtual wards, which is new technology being rolled out at scale. It also announced the extra 7,000 community beds. Indeed, we also set out the additional measures in our plan for patients.
What is clear when we have a sevenfold increase in flu in a month—50 cases admitted last year compared with 5,100 this year—is that there is a combination of a surge in demand on top of the existing high-level position, and the surge in demand corresponds with a constraint on supply as staff absences also increase because of flu, so during the Christmas period community services are more constrained. Those two things together have created significant pressure on our emergency departments. That is why in the engagement I have had with health leaders the two key messages they gave to me were the importance of getting flow into hospitals, which is constrained by the high bed occupancy—that is why getting people out of hospital is so central to relieving pressure—and, within the emergency departments specifically, the need to decompress those services with same-day emergency treatment and having short stay post-emergency departments. That is a better way to decompress those emergency departments—through the triaging and bringing other clinical specialties closer to the front door. We have listened to the NHS frontline and those were the two key requests made to me, alongside other issues such as care quality inspections and how to make them more flexible. However, alongside those immediate pressures, we need to recognise that we had pressures last summer during the heatwave and we had pressures in the autumn, which is why we have announced a wider set of measures today.
So we have listened and we have acted; we have taken measures to deal with the immediate pressure, but we have also set out how we will build further capacity that will go through into the autumn. Alongside that, we have signed deals, for example with Moderna and BioNTech, and we are bringing forward the life science investment so that that has a better impact on pressures on the frontline.
Steve Brine (Winchester) (Con)
There is no doubt that, in some places more than others, patient flow in acute hospitals is the issue gumming up the system, and the Secretary of State is right to say that demand far outstrips supply, in part because of the very high flu numbers. Today’s injection of funding is very welcome as is the additional surge capacity the Secretary of State spoke about in his statement. His mention of prevention is especially welcomed by me; let us do so much more on this. Another £250 million is a lot of the public’s money. What real-time oversight does he have to ensure that NHS England spends it wisely, and may I make a plea that domiciliary care is not overlooked, because the lack of care in people’s homes is every bit as much the enemy of patient flow as the lack of care home places that he has identified today?
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(1 year, 4 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
I can do much better than that. We have commissioned a full investigation and inquiry into the Government’s handling of covid and, as part of that, I am sure that the inquiry will look at PPE. But it is important to put it into context. We secured 23.2 billion items of PPE, which was a huge step, done at pace, to help protect our frontline.
Steve Barclay
I do agree with my hon. Friend, and I think it would help the House to assess the performance of the Welsh Government if there were more transparency. For instance, the Opposition motion on today’s Order Paper refers to vacancies in England. I am sure it will surprise the House to learn that the Welsh Government stopped collecting statistics for workforce vacancies in 2011. I look forward to Opposition Members’ encouraging their Welsh colleagues to be more transparent.
Feryal Clark (Enfield North) (Lab)
Members on both sides of the House will have been shocked and appalled by the recent deaths of children from streptococcus A, and our thoughts are with all the families affected. Cases are on the rise, and as we head into winter it is vital for parents to be able to secure for their children the care that they so desperately need. The shortage of GPs means that too many are struggling to see a doctor, and now there are reports of shortages of antibiotics as well. What advice can the Secretary of State give parents whose children are exhibiting symptoms but who cannot obtain a GP appointment, and what assurances can he give on the supply and availability of antibiotics?
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(1 year, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
My hon. Friend raises an important point, particularly for category 3 and 4 ambulance journeys. As she highlights, there are numerous aspects to the challenge of ambulance delays: the blockage in the flow from social care and delayed discharge, which we have debated many times in the House; issues in accident and emergency with pre-cohorting, post-cohorting and triaging nurses; conveyance rates, which often vary significantly between ambulance trusts; call handling, which we have put additional money into; and the work of the auxiliary service. My hon. Friend is quite right that within the portfolio of options, minor injuries units are an area that can help to relieve pressure on busy A&Es.
Wes Streeting (Ilford North) (Lab)
I welcome the Secretary of State back and welcome his team, but I have had boxes of cereal with a longer shelf-life than Conservative Secretaries of State. As a consequence of the turnover and chaos, the truth is that the NHS is not prepared for this winter—it cannot even get allocated funds out of the door.
Let us turn to the future. Over the summer, the Prime Minister promised to establish a “vaccines-style taskforce” to tackle the Conservatives’ NHS backlog on “day one” and to have overall waiting list numbers falling by next year. May I ask the Secretary of State who is on that taskforce, how many times it has met and what its programme of work is?
Steve Barclay
My right hon. Friend raises an important point about face-to-face care, which matters to many constituents, but I gently remind him that in the Lincolnshire integrated care system, 71.9% of appointments were face to face in September 2022. It is not the case that every patient wants a face-to-face appointment; there can be instances in which an online service is better. For patients facing domestic violence, for example, it can often provide a much more convenient service.
Mr Speaker
Order. I know we are bedding back in, but Front Benchers have to think about Back Benchers. These are their questions as well, so please let us make sure that I can call as many of them as possible.
Martyn Day (Linlithgow and East Falkirk) (SNP)
The Scottish Government introduced new national guidelines to make it easier for retiring NHS staff to return to support the NHS, while drawing their pensions. However, there is a substantive issue of pension tax rules pushing senior clinicians to reduce their commitments or retire early. As we know, pension taxation is a wholly reserved matter, so will the Minister address this issue with Cabinet colleagues in order to find a permanent solution that will allow us to help the NHS retain senior staff?
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(1 year, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
My hon. Friend will be aware that the matter is devolved to the Welsh NHS, but I can say that in the last financial year, the Government allocated £70 million to NHS England to specifically address dementia waiting lists and increase the number of diagnoses. To further support recovery of the dementia diagnosis rate and access to post-diagnostic support, NHS England is funding two trusts in each region to pilot the diagnosing advanced dementia mandate tool, which will improve access to diagnosis.
Wes Streeting (Ilford North) (Lab)
I welcome the Secretary of State to his first oral questions and, as this is likely to be his last oral questions, also wish him the best for the future. I associate myself with his remarks about his predecessor, who of course resigned from the Government on a point of principle as others chose to remain loyal; on that note, I also pay tribute to the former Minister, the hon. Member for Charnwood (Edward Argar), for the diligent approach he took to his work and the spirit in which he engaged with the Opposition. One of the contenders for the Conservative leadership says that public services are in a state of disrepair. Another describes the NHS backlog as frightening. A third called ambulance waiting times appalling, and of course the Secretary of State for Culture, Media and Sport said that the former Health Secretary’s preparation for a pandemic was “found wanting and inadequate”. They are right, aren’t they?
Steve Barclay
We will respond shortly to the independent pay review body, which, as part of its recommendations, weighs up the pressures on the cost of living and the other factors within its remit. The Government are delivering more doctors, more nurses, more appointments and more treatments, investing in our estate and planning for the future. That includes investment in research and development, and in future technology through our life sciences. That not only delivered the vaccine that allowed us to lift the covid restrictions that the Opposition wanted to retain, but will unlock the technologies of the future.
Mr Speaker
I call the Chairman of the Health and Social Care Committee, Jeremy Hunt.
Jeremy Hunt (South West Surrey) (Con)
May I recommend some scintillating summer reading to the Secretary of State: the study of 4.5 million patients that showed that people who see the same GP over a long period are 30% less likely to go to hospital and 25% less likely to die? Will he, after reading that, consider changing the GP contract to get rid of the micromanagement, and replace it with what doctors and patients want, which is the ability to have a long-term relationship?
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(1 year, 10 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
The hon. Lady raises an extremely important point. In the work of the equalities unit in the Cabinet Office, a key focus is on variations in the data across social groups, place and economic background, so that we can learn the right lessons. I am sure that, as part of the inquiry review, Judge Hallett will be looking closely at the data, particularly where there are variations within it.
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(2 years ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
My hon. Friend raises an important point. Before the Russian invasion, the rationale for the national cyber strategy that we launched in December was to make the UK more resilient. As we have just discussed, that requires a whole of society approach, but it also requires specific action within Government, which is why I launched the further Government cyber strategy, working closely with the National Cyber Security Centre, which is a world leader in its field.
Rachel Hopkins (Luton South) (Lab)
The Prime Minister says that he is serious about eradicating Russian influence from our country, yet his Government have sat on their hands for two years, with the majority of recommendations of the Russia report still yet to be implemented. On cyber security, the Russia report exposed the complete lack of accountability within and across Government Departments when it comes to cyber matters. New legislation has only made lines of responsibility more confusing. We are vulnerable. The National Cyber Security Centre has managed an unprecedented 777 cyber incidents over the last 12 months, up from 723 the previous year, with 40% aimed at the public sector. Either the Government are not taking the Russian cyber threat seriously, or the Minister does not have control of his own Department. Which is it?
Steve Barclay
I concur with my hon. Friend that the Commonwealth is of huge importance. He is right to highlight that, but it fits within the wider strategy of the integrated review as part of global Britain, including building on defence ties such as with the Australian and US Governments through AUKUS. This brings significant defence opportunities, as well as opportunities for Treasury policy such as freeports and for our wider work through the Department for International Trade on free trade agreements. This is all part of global Britain, of which the Commonwealth is a key stakeholder.
Jim Shannon (Strangford) (DUP)
My mother calls me James or Jim, so you can choose, Mr Speaker.
I thank the Chancellor of the Duchy of Lancaster for all his answers. On the recent fears of Russian cyber-attack, what contact and security support is there for our banking sector? What financial help or assistance can be offered to keep our institutions free from Russian cyber attack?
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(2 years, 1 month ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
I take my hon. Friend’s point, but having the 12 regional clusters will help businesses that want to do the right thing and know how best to protect against the risks of cyber. Our aim is to help businesses improve their cyber-security. Given events in Europe today, it is particularly pressing that businesses take this seriously.
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(2 years, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Geraint Davies
A year ago, Phil Grant of the DVLA tragically died of coronavirus. He was a man in his 60s with a heart condition who had previously been allowed to work from home during the first lockdown and was forced to go to work. A year on, just pre last Christmas, unions and management agreed that, after 700 cases of coronavirus at the DVLA, there should be new arrangements for people to work from home and a rota system to allow safety. The Government intervened and stopped that from being instated on the grounds that omicron was not as dangerous. Since then, we now have a cumulative figure of 1,700 coronavirus cases at the DVLA. Will the Minister intervene to enable the scheme agreed by both unions and management to be implemented for at least a couple of months and meet me urgently so that the safety of workers and their families can be protected?
Steve Barclay
I recognise the seriousness of the case. On behalf of all colleagues in the House, I am sure, I express our sympathy for the family concerned. As he will know, it is difficult to comment on individual cases. He will also be aware that under plan B, employees are encouraged to work from home where possible. I am happy to flag the case to my right hon. Friend the Secretary of State for Transport, who oversees the body concerned. My right hon. Friend is balancing the need to address those employment issues with the importance of getting testing boosted when it comes to HGVs, cars and others. But he will pick up the case and I will raise it with him.
Steve Barclay
I do agree with my hon. Friend. These civic honours are a rare acknowledgment, awarded by Her Majesty herself, to celebrate a place’s individual heritage, its sense of community and the fact that residents have worked so hard to create a special environment. That is being recognised. The platinum jubilee will be a historic moment in time that brings people together and helps us to renew our nation as we emerge. I am delighted that Dudley, among a number of places, has put itself forward for Her Majesty’s consideration.
Brendan O'Hara (Argyll and Bute) (SNP)
Repeatedly throughout the pandemic, the devolved Administrations have asked their people to do the right but often difficult thing, which, to their enormous credit, they have. Does the Minister think that the Prime Minister’s remarkable admission that he attended an illegal Downing Street party during a period of strict national lockdown will strengthen or undermine the relationship between the Government in London and those in Cardiff, Belfast and Edinburgh?
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(2 years, 4 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
I very much do agree that Bury would be a great location, as indeed would a number of locations across the north-west. It is important that the Places for Growth programme does not solely look at inner-city locations but also looks at the opportunities that places like Bury offer to relocate jobs.
Mr Speaker
I call Richard Holden. He is not here—in which case, let us go to Barry Sheerman, who is here.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
It is on Thursday mornings, Mr Speaker, that those of us who are regulars miss David Amess—those Thursday mornings when he was so lively and showed that he was a true parliamentarian.
When the Minister talks about putting jobs in places around the country, will he lead, with all of us in our constituencies, a campaign for sustainable development in every town, city and community in this country?
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
I do not want the Secretary of State to get away with it this morning. What is he doing about the “blob”? If he reads the Tory-supporting Daily Telegraph, it says that the blob is stopping the Government, and the Prime Minister in particular, getting their policies delivered in every Department. Can the Chancellor of the Duchy of Lancaster tell us a little more about what this blob is? If it is stopping the Government delivering their policies, could he do something about blobism?
Steve Barclay
Thank you for that, Mr Speaker.
On the substantive point raised by the hon. Gentleman, as was recognised in the declaration on Government reform signed by the Prime Minister, by my predecessor as CDL and by the Cabinet Secretary—and indeed by Ministers and permanent secretaries across Whitehall—we are committed to reform and modernisation. Covid has shown the opportunity to do things differently, but we should not lose sight of the fact that we have huge talent and capability within our civil service. I can point to numerous examples, but the furlough scheme was put in place at great pace by officials in Her Majesty’s Revenue and Customs. There is already innovation within our civil service, but it is clear, as covid has shown, that there is opportunity to go further and faster. There is now a commitment from the Prime Minister and the Cabinet Secretary to do exactly that.
Committee on Standards: Decision of the House
Debate between Steve Barclay and Lindsay Hoyle(2 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Hon. Members
Mr Speaker
Order. To those who are shouting, “Where is the Prime Minister?” I say that the Prime Minister phoned me this morning, as did the leader of the Scottish National party, the right hon. Member for Ross, Skye and Lochaber (Ian Blackford), and they told me that neither of them could be with us. They have given their reasons and whether they are right, wrong or indifferent, I do not make judgments. I can only say on the behalf of the two people concerned—both leaders—that one is at COP26 and the other is visiting hospitals in the north-east. That is where the Prime Minister is, so I do not need to hear “Where is he?” all the way through the debate. I have explained it and Members can make their own decisions.
Steve Barclay
Thank you, Mr Speaker.
I am grateful to the hon. Member for North East Fife (Wendy Chamberlain) for securing and opening this debate. The Government have been listening carefully to the legitimate concerns raised by right hon. and hon. Members from all parts of the House, both during and since last Wednesday’s debate. These matters are vitally important to you, Mr Speaker, and to the whole House.
Before I set out the Government’s position, I would like, first, to express my regret and that of my ministerial colleagues over the mistake made last week. We recognise that there are concerns throughout the House about the standards system and the process by which possible breaches of the code of conduct are investigated.
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(2 years, 7 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
My hon. Friend brings a welcome clinical focus, and he is absolutely right on the importance of data and interoperability. He will know that the data strategy for health and social care—Data Saves Lives—along with the Health and Care Bill, which he mentioned, seeks to improve data sharing across the health system for the reasons that he rightly highlights.
David Linden (Glasgow East) (SNP)
We know that one policy decision that the UK Government have taken, albeit an unsustainable and undemocratic one, is that Scotland should not have a say in its constitutional future. We also know that, for example, the UK Government are spending huge amounts of taxpayers’ money on research into public attitudes towards the Union. If the UK Government have taken the decision not to have a referendum, we know that it is because the polling suggests that support for independence is up. Why will the Minister not publish that polling information and be honest with the public?
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(2 years, 7 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
My hon. Friend is right to highlight this issue, which he and I have discussed on many occasions. In July I chaired a roundtable on it across Government, and it is prioritised across Departments. We have a manifesto commitment that the Chancellor and I are committed to delivering on. As my hon. Friend knows, we have a £200 million cost to this that we need to tackle. But at the same time we also need to be true to the manifesto, which was not about tackling those on low incomes who had high pay-offs because of the way their pension benefits were structured and those proprietary claims. We need to differentiate between that and the real ill that he is concerned about, which is those on six-figure salaries who are receiving pay-offs. That is something we are prioritising.
Mr Speaker
I am not quite sure if that related to the original question, so we are going to have to watch out for that in future.
Alison Thewliss (Glasgow Central) (SNP)
Scottish hospitality and generosity is world-renowned, but could the Minister explain to us why he thinks that Scottish taxpayers should pay for England’s social care crisis?
Steve Barclay
It is a slightly odd question, because through the broad shoulders of the United Kingdom, it is Scottish jobs that have been protected through the furlough, it is Scottish businesses that have been supported through the self-employment income support scheme and it is the block grant that has provided additional funding to the Scottish Government. The oddity is that they are choosing not to use those uplifts in the Scottish grant to prioritise the things that they come down to Westminster and say they care about.
Mr Speaker
Can I just suggest to the Minister that it might be easier if he speaks through the Chair?
Alison Thewliss
It would be good if the Minister answered the question, as well. The Prime Minister’s hike in national insurance has been roundly panned, not least by his own Back Benchers and the Chair of the Treasury Committee, the right hon. Member for Central Devon (Mel Stride). People in Scotland are already feeling the pain of a decade of Tory austerity cuts and the harms caused by Brexit, with the devastation of the £20 a week cut to universal credit still to come, none of which they voted for. Why should my constituents pay for the Prime Minister to break his manifesto pledge with a new poll tax on the poorest who can least afford it?
Government's Management of the Economy
Debate between Steve Barclay and Lindsay Hoyle(3 years, 1 month ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Chief Secretary to the Treasury (Steve Barclay)
I thank the hon. Member for Oxford East (Anneliese Dodds) for securing this debate, which is an important opportunity to take stock ahead of next week’s Budget. With the leave of the House, Mr Speaker, I shall also close the debate for the Government later.
The hon. Lady, and Members from all parties, will appreciate that I cannot discuss any of the specifics of next week’s Budget, but I can say that although we may not always agree on the way ahead, I believe that we in this House all want the same outcome: a vibrant and prosperous economy that gives people everywhere the opportunities that they deserve.
In responding to the motion, I intend to do three things. First, I shall briefly remind the House of the economic and fiscal situation that we inherited in 2010. [Hon. Members: “Good idea!”] It is a welcome motion for enabling that. Secondly, I shall examine the state of the economy a decade later, noting the difference, for which the credit goes to previous Treasury Ministers—not current Conservative Treasury Ministers—who took difficult decisions in the national interest. Finally, I shall say a little about the Government’s ambitions now, with the obvious caveat that a Budget is imminent.
As Members will recall, the outlook in 2010 was not good. The financial crisis had torn a hole in our country’s future, the economy was shrinking and the deficit was ballooning. As George Osborne said at the time of his speech in the Queen’s Speech: Economy debate in 2010 :
“Getting over the worst economic inheritance any modern government has been bequeathed by its predecessor is not so easy.”
He also noted that the British economy had become
“deeply unbalanced…Unbalanced between different parts of the country…Unbalanced between different sections of society… Unbalanced between different parts of our economy”.
As set out by the most recent Labour Chief Secretary, the right hon. Member for Birmingham, Hodge Hill (Liam Byrne)—I accept that it was a light-hearted note and that much of the criticism he has received has probably been unfair, but the substance remained—there was no money left.
The coalition Government took power in 2010, at a moment when one thing mattered more than anything else: strong leadership prepared to make the right decision in the national interest. As hon. and right hon. Members will recall, in the years that followed the Government took steps to put this country back on a stable financial footing, because we need a strong economy to fund strong public services. The economy expanded in every year of the decade that followed. In fact, between 2010 and 2019, it grew by a total of 19.2%, which was faster than France, faster than Italy and faster than Japan—a reality not reflected at all in today’s motion. Achieving that success was about many things, not just fiscal discipline. In 2010, for instance, the Government created the Office for Budget Responsibility, which introduced independence, greater transparency and credibility to the economic and fiscal forecasts on which fiscal policy is based. Indeed, 10 years on, the OBR is considered by many of its peers to be the gold standard of independent fiscal institutions.
Just as now, a key focus for the Government throughout that period was protecting, supporting and creating jobs; here, too, the numbers are impressive. Participation in the labour market reached a record high of 79.8% in the three months to February 2020—three percentage points higher than in 2010. In the same year, the UK had a higher employment rate and a lower unemployment rate than both the OECD and G7 averages. Between the 2010 election and the end of 2019, we saw over 3.8 million more people in employment—equivalent to an average of nearly 1,000 extra people in work every single day—and 85% of that growth was in high-skilled occupations. Importantly, that growth was across the board. The employment rate increased for all regions in the country, as well as for women, for young people and for poorer households. Indeed, prior to the pandemic, the employment rate among women was at a record high of 72.7%, and youth unemployment was down almost half on 2010.
If hon. Members remember just one key statistic, perhaps it should be this: real household disposable income per head—the Treasury’s preferred measure of living standards—was 11.4% higher in 2019 than at the start of 2010, and incomes grew most strongly for households on lower and middle incomes. Remember that this was also the decade when we made significant personal tax cuts and introduced the national living wage, which we have increased every year. Taken together, changes to the national living wage, personal allowance and national insurance contributions mean that an employee working full-time on the national living wage is more than £5,200 better off than in April 2010. This is a track record of which any Government of any political persuasion should be proud.
It was not just households across the country that understood the benefits; the world recognised them too. In 2018, the UK topped the Forbes list of best countries for business for the second year running. A year later, the World Economic Forum acknowledged our strengths in innovation capability, business dynamism, institutions and market size. Businesspeople everywhere felt the same. The UK has the third highest foreign direct investment stock in the world after the US and Hong Kong, and more foreign investment than Germany and France combined. None of this reflects today’s motion; indeed, it reflects strong leadership, fiscal responsibility and a Government prepared to act in the national interest.
Coronavirus has been a great challenge that we, as a country, have had to face together. Every country has had to reckon with the virus’s economic impact, but because of the decisions made by successive Chancellors over the past 10 years, our economy and public services were strong when the pandemic hit. The markets understood that we were a Government who could plan for the future and make decisions when they mattered. As a result, we have been able to respond in the way in which we have. This House has heard about that response numerous times. It is one of the largest and most comprehensive responses in the world, totalling more than £280 billion since March 2020. Millions of jobs and livelihoods have been supported through the furlough scheme and the self-employment income support scheme. We have allocated billions of pounds in loans and grants to businesses across the UK. It is a response that the IMF singled out as
“one of the best examples of coordinated action globally”.
It called the response “aggressive” and “unprecedented”—that is a frequently used word, but I do not apologise for using it again. Indeed, the Resolution Foundation has said that the response
“prevented an unprecedented collapse in GDP from turning into a living standards disaster.”
The fact that we had rebuilt the public finances in recent years, combined with the UK’s strong institutional framework, gave us the wherewithal to borrow to provide the significant economic support that was required. Our decade of economic success made all of that possible.
I know that the Opposition wish to keep talking about the past, which is surprising given that many of those years were spent supporting the economic policies of the previous Leader of the Opposition. I am always more than happy to speak about our record over the past 10 years—I welcome today’s motion as providing an opportunity to do so—but I, like this Government, want to look forward to the future.
Last year’s spending review tells us everything we need to know about this Government and this Chancellor’s direction of travel. There was significant additional funding to help our public services in their continuing fight against the pandemic—we are making record investments in public services, including an historic settlement for the NHS, which provides a cash increase of £33.9 billion a year by 2023-24; we are providing better lifelong learning, such as through the £375 million to deliver the Prime Minister’s lifetime skills guarantee; we are recruiting more police officers to make our streets safer, with more than 6,600 already recruited towards our 20,000 target; we are implementing our 10-point plan to tackle climate change, mobilising £12 billion of Government investment, which will in turn create hundreds of thousands of green jobs across the country, including in carbon capture and storage, electric vehicles and renewable energy; we are investing in technology, innovation and the digital economy, as part of our goal to make the UK a science superpower—this Government are increasing investment in research and development at the fastest speed and greatest scale since records began; and we are investing in the UK’s economic recovery, with more than £100 billion of capital investment next year to spread opportunity, create jobs and drive economic growth.
The motion states that the last decade “weakened the foundations” of the economy, yet we saw nine years of continuous growth, while we reduced the deficit from 10% to below 2%, The motion says that the UK was “particularly vulnerable”, yet we have consistently protected our NHS, with the 2018 NHS settlement being the biggest cash increase in public services since the second world war. The motion says that our actions during the pandemic have “exacerbated the problems”, yet we have vaccinated more than one in three adults, which is far more than any other European country. The motion says that the UK has suffered
“the worst economic crisis of any major economy”,
yet independent bodies such as the IMF have praised the UK’s response, which in turn was possible only because of the economic decisions of the last decade. The motion talks of “inequalities”, yet distributional analysis of the Government’s interventions shows that we protected the poorest working households the most, through schemes such as the furlough. It is because of our economic record that we have been able to place the protection of jobs at the heart of our covid response, with the furlough and the other business support measures.
As the Chancellor said last month:
“Sadly, we have not been and will not be able to save every job and every business, but I am confident that our economic plan is supporting the finances of millions of people and businesses.”—[Official Report, 11 January 2021; Vol. 687, c. 23.]
He was right, and jobs will remain at the heart of his economic plan, as we work together to build back better and level up the whole of the UK.
Mr Speaker
Before we head up to Scotland, I remind Members that there will be a three-minute limit after the SNP spokesperson, Alison Thewliss.
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(3 years, 2 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
As my right hon. Friend the Chancellor set out a moment ago, the Office for Investment, led by Lord Grimstone, is focused on exactly that issue, working in tandem with the Build Back Better Business Council, which the Prime Minister and the Chancellor chair.
Mr Speaker
Order. I now suspend the House for three minutes to enable the necessary arrangements to be made for the next business.
Lockdown: Economic Support
Debate between Steve Barclay and Lindsay Hoyle(3 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mr Speaker
Order. Toby, I do not need this all the way through. Please, I want to get on with this statement. I have granted the UQ, and I do not need Back Benchers chirping.
Steve Barclay
Thank you, Mr Speaker.
Yesterday, the Prime Minister set out why we are introducing new measures to tackle coronavirus. This decision is not one we would wish to take, but it responds to the soaring infection rate.
Just as we have a responsibility to protect lives, we must also safeguard livelihoods. That is why the Government have provided unprecedented levels of financial support throughout this crisis, in a package described by the International Monetary Fund as
“one of the best examples of co-ordinated action globally”.
This package includes an extension to the coronavirus job retention scheme, where employees will receive 80% of their usual salary up to a maximum of £2,500, while employers need only pay national insurance and pension contributions. We will provide more support to the self-employed. We are increasing the self-employed income support scheme grant from 40% to 80% in November. This boosts the total grant from 40% to 55% of trading profits from November to January, up to a total of £5,160, aligning it with the furlough scheme. In addition, homeowners hit by the pandemic can continue to claim a six-month mortgage holiday, and businesses that are required to close can receive non-repayable grants worth up to £3,000 a month. In total, these grants are worth over £1 billion a month.
We are also planning to extend the existing business loan schemes and the future fund to the end of January, as well as making it possible to top up bounce back loans. Local authorities will also receive £1.1 billion to support businesses more broadly, and up to £500 million to support the local public health message through the contain outbreak management fund. We will also uplift the Barnett guarantee this week to give Scotland, Wales and Northern Ireland further certainty over their up-front funding.
These measures build on the Government’s economic package that now totals over £200 billion. They will provide security to millions of people while giving businesses the flexibility to adapt and plan, and they underline our unrelenting focus on listening and responding to the damaging path of this virus.
Steve Barclay
The hon. Lady started by saying that the circuit breaker would have been shorter, but those on her Front Bench have repeatedly said, when interviewed, that a circuit breaker would have to be repeated.
The deputy chief medical officer was clear that an earlier national lockdown would not have been appropriate, because at the time, the path of the virus was very slow in certain areas, such as the south-west, so the economic damage would have been disproportionate. I might have expected to hear the hon. Lady’s argument from some Members of the House, but it is surprising that the economic spokesperson for the Opposition was willing to see that economic damage. [Interruption.] She chunters, but I am simply quoting the deputy chief medical officer, whose advice was that a lockdown would have been the wrong action to take at that time. I am pointing to economic damage, which she seems to see as trivial and something to be disregarded.
The hon. Lady then claimed that the Government had in some way dismissed certain parts of the United Kingdom. I gently point out that furlough was not ended; it continued to the end of October, and has now been extended. Furlough has continued in all parts of the United Kingdom without any gap in its provision.
The hon. Lady asks whether the Government have a plan in place. My right hon. Friend the Chancellor came to the House on 24 September to set out our winter plan for jobs. It included the kickstart scheme, which is up and running, and provides much-needed training to our constituents across the country. While setting out his winter plan, he said candidly that if the pathway of the virus changed, the Government would listen and adapt, and that is exactly the action that we have taken.
Finally, somewhat strangely, the hon. Lady said that she needs to “drag” Ministers to the Chamber to set out their approach. [Interruption.] She is repeating the point. Mr Speaker, I thought the Prime Minister was here yesterday to give a statement to the House. It is somewhat strange to say, the day after he did that, that Ministers have to be dragged to the Chamber to give updates on the position.
Mr Speaker
Order. I decide whether we have an urgent question, and I am sure that the Minister is not questioning my judgment on that.
Steve Barclay
Mr Speaker, I hope that you know me well enough to feel that I would never do that; I clarify that for the record in case any other impression was given. My point was that the diligence of Ministers in updating the House was demonstrated by the Prime Minister yesterday in his statement.
Mr Speaker
Order. We will leave it at this, but it is no good to have something played out through the press on Saturday and Sunday, so that on Monday everybody already knows about it, and it is no shock. That is why the right hon. Gentleman could not judge whether to have a UQ. We will leave it there.
Steve Barclay
We have a plan set out—the winter plan. We have always demonstrated that we will listen and adapt; that is what the Government are doing. They are setting out a comprehensive package of support to protect as many jobs and livelihoods as possible.
Mr Speaker
Let us enter Central Devon with the Chair of the Select Committee on the Treasury, Mel Stride.
Mel Stride (Central Devon) (Con) [V]
I broadly welcome the new measures that the Government have brought forward to support jobs and, in particular, the increase in support for the self-employed from 40% to 80% under the self-employment income support scheme arrangements. However, as my right hon. Friend will know, the Treasury Committee produced a report earlier this year in which we identified more than a million individuals—the self-employed in particular—who were missing out on support. Will he update the House on whether, under the new measures, any of those identified in the report will receive support where they were not before? If the answer is no, why is that the case?
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(3 years, 6 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Speaker
Order. Dr Julian Lewis, you know better than to take advantage of me; it is not fair to others. Who wants to answer the question?
Steve Barclay
It is in order to address such pressures that we have set out such a comprehensive package of support that applies universally, including to the businesses to which my right hon. Friend refers. Through his question, he points to another substantive point, which is that suppliers supply to different sectors. One of the challenges with the Opposition’s proposals to extend the furlough was that they were never clear which sector they wanted to extend it to. The fact that suppliers supply multiple sectors, including the public sector, is a good illustration of why that proposal is flawed.
Public Health Restrictions: Government Economic Support
Debate between Steve Barclay and Lindsay Hoyle(3 years, 6 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Steve Barclay
It is slightly odd that Opposition Front Benchers talk about deviation when their position has deviated as much as it has, not least on the curfew, which they said they would support yet refused to.
On the hon. Lady’s points of substance, the package of support announced by the Chancellor and Prime Minister did support local authorities with an additional £1 billion, as I said in my opening remarks, plus a further £500 million to address trace and trace locally, reflecting the fact that the Government are listening to local leaders and bringing forward responses. We saw that with the additional funding allocated to Merseyside and to Scotland, Wales and Northern Ireland—again reflecting our listening in conversations with the First Ministers of Scotland, Wales and Northern Ireland.
The hon. Lady makes a fair point about underspends that has been made by a number of colleagues. She is right to point to the sheer extent of support that we have offered, including the grants of £10,000 and £25,000. To deliver them at pace, they were allocated on the estimations that we had. As a result, the actual spend that has been required has led to some local authorities having very big underspends and others not. If we were to say that the authorities where the estimates were incorrect should benefit disproportionately, we would be accused of treating some unfairly compared with others. We met the need that was addressed at that time through the awards.
It is right from a fiscal point of view that the underspends are returned because they are surplus to the requirement on which they were allocated. In last week’s urgent question issues were raised by Merseyside Members, and ministerial colleagues engaged, listened and the funding for Merseyside more than doubled per head.
It is a slightly odd line of attack for the Opposition to say that we should not bring back underspends where they met their need but the estimations were inaccurate, yet not use the money to respond to the legitimate needs of areas such as Merseyside and elsewhere that are being moved into tier 3.
Mr Speaker
Order. Can I help the Minister? He is meant to be speaking through the Chair and not to the other end of the Chamber, and I hope that we can work together on this. Has he finished the answer to that question?
Steve Barclay
On the wider point, my right hon Friend, as a former Government Chief Whip, knows full well that in government one balances these Budget submissions alongside the wider fiscal position that the Government face. On his first point, he is absolutely right. If we combine the 67% of support through the job support scheme with the dynamic element of universal credit, that takes us much more towards 88%. I can give specific examples, but I have been asked to be briefer—by you, Mr Speaker—in my replies. The point is that my right hon. Friend is absolutely right on that, and I am very happy to share some examples with him.
Mr Speaker
Especially when the Member does not want an answer, Minister! [Laughter.]
Dan Jarvis (Barnsley Central) (Lab) [V]
Without additional financial support, the restrictions to which South Yorkshire will be subject will deal a hammer blow to businesses and high streets across our region. Can I ask the Chief Secretary what assessment the Treasury has done on the economic effect of the tier 2 measures, and whether he is personally satisfied that the current support available will be enough to save jobs and businesses here in South Yorkshire?
Steve Barclay
One of the strongest benefits to businesses in Wales, and indeed across the United Kingdom, is the broad shoulders and ability of the UK Treasury to act on behalf of the entire United Kingdom. That is a huge strength and it has helped to enable schemes such as furlough and others to be of benefit to businesses in Wales. On the measures put in place by national Governments, the more that is done through the Joint Biosecurity Centre with consistency, the better. But obviously, that is a decision for the Welsh Government.
Tim Farron (Westmorland and Lonsdale) (LD)
I will do my best, Mr Speaker.
Outdoor education centres are a crucial part of our visitor economy. There are 60-plus of them in Cumbria, employing hundreds of talented people whose jobs are, I am afraid, now seriously at risk. Outdoor education centres provide huge benefits in personal development, education, and physical and mental health, which are particularly valuable, even essential, at this time. They are as safe to reopen as schools, yet they face imminent closure and ruin. Will the Minister meet with me and the heads of outdoor education centres so we can take urgent action to save them?
Steve Barclay
My hon. Friend is quite right: this is about not only working together to retain as many jobs as possible, but looking to the jobs of the future. He has constructive views on how we use levelling up in terms of the future jobs that can be offered in Stoke. We need to combine that with our commitments on infrastructure, broadband, research and development investment, and net zero, then look at those future jobs and the skills training that is offered to his constituents in Stoke, so that those who move from their current jobs can quickly get into those jobs of the future.
Mr Speaker
In order to allow the safe exit of hon. Members participating in this item of business and the safe arrival of those participating in the next, I am suspending the House for three minutes.
Areas with Additional Public Health Restrictions: Economic Support
Debate between Steve Barclay and Lindsay Hoyle(3 years, 6 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Steve Barclay
As we covered earlier, there are specific measures for areas with local lockdowns, such as the £1,500 support for businesses that are closed for three weeks or more. The Chancellor announced a package of measures in the winter plan, including tax deferrals, loans and other cash-flow support, alongside the self-employed income support and job support that he announced in the same statement.
Mr Speaker
Let us head up to Harrow so that Bob Blackman can glide his question in.
Bob Blackman (Harrow East) (Con) [V]
Thank you, ground control.
I thank my right hon. Friend for explaining the current position. He will know that we are currently experiencing an increase in the infection rate in virtually every borough in London. What we do not know is whether lockdowns or further restrictions will take place covering the whole of London or on a borough-by-borough basis. In either case, there will be a huge impact on business, so will my right hon. Friend set out what measures will be in place to support London and each London borough in the event of local lockdowns or a London-wide lockdown?
Self-employed Persons: Financial Support
Debate between Steve Barclay and Lindsay Hoyle(4 years ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
The Chief Secretary to the Treasury (Steve Barclay)
We know that many self-employed people are in real distress, but we are working urgently to address this problem, and I say to the self-employed: we have not forgotten you—help is coming. But the policy and delivery are complex, and we cannot and should not rush to announce a scheme that gives rise to more questions than it answers. The Chancellor has held meetings this morning with representatives of the self-employed and will continue to meet them this afternoon.
It is important to remember that covid-19 is an urgent challenge to our entire economy, affecting workers of all types. It is essential that we respond swiftly, so that people can keep their jobs and businesses can carry on. That is the basis of our coherent, co-ordinated and comprehensive plan. It is a plan that gives those on the frontline the tools they need to tackle the virus, with all the support the NHS needs, backed up by an initial £5 billion fund for public services. It is a plan that puts a shoulder behind business with a statutory sick pay relief package for small and medium-sized enterprises, business rates holidays for all retail hospitality, leisure and nursery businesses in England, and grant funding for small enterprises, as well as support through Her Majesty’s Revenue and Customs’ time to pay scheme. As of yesterday, businesses with cash-flow concerns are also able to access the coronavirus business interruption loan scheme, offering up to £5 million for SMEs through the British Business Bank. For larger firms—[Interruption.]
Mr Speaker
Order. It might be easier if Members pass notes down the line, rather than going round and speaking to everybody.
Steve Barclay
The coronavirus business interruption loan scheme, on which Members across the House have raised questions, is now available, offering up to £5 million for SMEs through the British Business Bank. For larger firms, the Bank of England is providing a new facility to help support liquidity.
I urge all Members of the House to continue speaking—as I know many are doing—to the business leaders in their constituencies and ensure they are aware that they are not alone and that help is coming. In this House, we are all standing behind business and everyone who works in it. To encourage businesses to retain staff, we are deferring VAT, and my right hon. Friend the Chancellor has announced the job retention scheme to facilitate that.
Taken together, this is a huge programme of support, and we will keep thousands of workers in jobs, but we know that there are thousands of self-employed people who have been wondering what the future holds for them. My right hon. Friend the Chancellor has already set out a range of measures in support. Sole traders and freelancers will be able to access the business interruption loan scheme as long as activity is channelled through a business account. We are also removing the minimum income floor for the self-employed workers affected by coronavirus so that they too can access universal credit in full. That is not only the standard allowance, but a wider package of support for those with children, disabilities or, indeed, housing needs. At the same time, the next self-assessment income tax payments will be deferred until January 2021, helping those who have set money aside for those payments with immediate cash flow. That means there is a package on tax, on loans and, more widely, through universal credit, to support those with that safety net.
Let me reassure everyone in this House and the self-employed people they represent that further help is indeed coming, but we have to make sure we get this right and that we target the right support to those who are most in need. The Chancellor will provide a further update on support for the self-employed in the coming days.
Steve Barclay
May I first welcome the constructive tone that the right hon. Gentleman has struck? His offer to come to the Treasury might contravene some of the recent social distancing requirements, but I appreciate the spirit in which it was made. He is right that we need to move at pace and to work together. That is why my right hon. Friend the Chancellor was involved in further meetings this morning, as he will be later today, as we work through how to take this forward.
The Chancellor was drawing attention to the complexity of the target population. I think that a number of Members would have concerns, not least as we look to the future, if we were subsidising some very wealthy self-employed people. I take the point that they are not the ones getting in touch with the right hon. Gentleman, but it is important that our approach is mindful of the target population.
The right hon. Gentleman raised the issue of reassurance, which is a legitimate concern, and one shared across the House. I draw the attention of his constituents, and those of colleagues across the House, to the Chancellor’s comments this morning. We are working at pace on this and we recognise the issue being raised. I hope that provides reassurance, certainly in terms of an announcement, although the operation of any solution may take further time, as the Chancellor set out.
Considerable work is being done, but the population is complex. We are looking at the burdens of different delivery mechanisms, whether on the Department for Work and Pensions or local authorities, which have their own staffing pressures because of the number who are ill. That is why we are exercising flexibility in lots of other areas in order to reprioritise resources, but it is important that the scheme is deliverable and mindful of the other challenges we are dealing with.
European Union (Withdrawal Agreement) Bill
Debate between Steve Barclay and Lindsay HoyleWednesday 22nd January 2020
(4 years, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Commons Consideration of Lords Amendments as at 22 January 2020 - (22 Jan 2020)
The Secretary of State for Exiting the European Union (Steve Barclay)
I beg to move, That this House disagrees with Lords amendment 1.
Mr Speaker
With this we may take Lords amendments 2 to 5, and Government motions to disagree.
Steve Barclay
Less than a fortnight has passed since we last debated the Bill in this House. Since then the House of Lords has sat for nearly 40 hours to debate more than 100 amendments. The noble Lords in the other place have asked this House to think again on five matters and I will address each in turn.
Turning first to Lords amendment 1 on citizens’ rights tabled by the noble Lord Oates, I know that noble Lords share the Government’s commitment to putting the rights and welfare of citizens at the heart of our withdrawal negotiations. The first part of the amendment establishes a declaratory system and the second part requires Ministers to bring forward regulations making provisions for those with declaratory rights to apply for a document evidencing their rights. This amendment would mean the successful EU settlement scheme in its current form would need to be abandoned, because there would be no need to register if people could later rely on a declaration that they were already in the UK. This would make null and void the 2.8 million applications and the 2.5 million grants of status that have already been completed. The Government would, under this amendment, also be unable to issue digital status to EU citizens without also issuing physical documents, including to those already holding a digital status under the current scheme. That would increase the risk of fraud and raises costs to Government and citizens.
Wayne David
Given the Secretary of State’s reference to the letter to the Welsh Government and the Welsh Minister, how does he square the circle of wanting, on the one hand, to reinforce the principles of Sewel and so on, but on the other, wanting to amend the legislation to withdraw the commitment?
Mr Speaker
Order. I am bit bothered about time. We have quite a few Members who want to make speeches. I remind Members that they cannot just walk in and put a question to the Minister—let us all work together for one another.
Steve Barclay
I was trying to be generous in taking interventions, but I will take your direction, Mr Speaker.
We very much respect the devolved Governments’ opposition to Brexit as a whole, but the legislative consent process should not be the place to show such disagreements; rather, it is for voicing concerns with parts of legislation that relate to devolved competences. The refusal of legislative consent in no way affects the Sewel convention or the Government’s dedication to it. However, as recognised by both Mike Russell and Lord Sewel, these are not normal times. Given those circumstances, I urge Members to reject this amendment.
We have covered significant ground in debating this Bill. Once passed, it will stand as an historic piece of legislation. I therefore hope that the House will respectfully disagree with their lordships’ amendments.
Oral Answers to Questions
Debate between Steve Barclay and Lindsay Hoyle(4 years, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Steve Barclay
The whole point of the deal—I hope the hon. Gentleman supports it on Third Reading—is that it ensures that we will leave in a smooth and orderly way. The specific issues of hill farmers are matters for both the negotiation and the Agriculture Bill. I am sure he, among others, will contribute to that debate.
The Secretary of State for Exiting the European Union (Steve Barclay)
I welcome my hon. Friend back to his place as a great champion of the constituency of Lincoln. We continue to have regular conversations with ministerial colleagues on all aspects of exiting the European Union, including fisheries and marine policy.
Mr Speaker
Topical questions. Nigel Mills. [Interruption.] Sorry—supplementary question, Karl MᶜCartney.