Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 14th April 2026 Commons Chamber

[Mr Speaker]

I call the shadow Secretary of State.

[Stuart Andrew (Daventry) (Con)]

The latest industrial action by the British Medical Association has now ended, yet many will be appalled by reports of individuals boasting online that

“the ability to have 10 days off will make turnout quite high.”

Does the Secretary of State agree that this behaviour is indefensible and represents a slap in the face to patients whose treatments have been cancelled, as well as to the NHS staff who have been left to pick up the pieces?

[Wes Streeting]

Yes. It reflects very poorly on the BMA and the cavalier way in which it has inflicted disruption and a £300 million bill on the country in straitened times. It was also unnecessary. Although the resident doctors committee chose to reject a generous offer, that did not mean that it needed to rush out and announce six days of strike action the very same day. With the BMA, strike action is a first resort, not a last resort. It needs to change its tune, because the country cannot afford to fund its reckless behaviour.

[Stuart Andrew]

This is a rare occasion, as I agree with the Secretary of State. The increasingly militant stance adopted by the BMA is plainly out of step with some resident doctors, who continue to report for duty. The Government’s handling of this dispute has been marked by inconsistency. First, they attempted to buy their way out of trouble, then they withdrew the training places that this House voted for. Instead of persisting with a failed strategy, is it not time for the Government to heed our calls and bring forward legislation to ban doctors from striking?

[Wes Streeting]

The Government’s approach has been consistent. We recognise that resident doctors suffered years of pay erosion and worsening conditions under the Conservatives. We came in and sought to address that substantially with a 28.9% pay rise and an offer on the table that would have gone further on pay, gone further on training places and cancelled exam fees, which is the best deal that anyone will have got in the entire public sector. Resident doctors have rejected that approach, but the shadow Secretary of State reminds the BMA that however much it might disagree with this Labour Government, the alternatives are far worse. It is far better to work with us than against us, but we will not cave.

Resident Doctors: Industrial Action

Stuart Andrew Excerpts

Thursday 26th March 2026 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

I am grateful to the Secretary of State for advance sight of his statement. Only yesterday he was boasting about progress in the NHS. Today we are back here again, facing more strikes, more disruption and more uncertainty for patients—quite the contrast. In opposition, he made resolving these strikes sound straightforward: “Just get around the table. Just negotiate. Just sort it out.” He repeatedly stated that the power to stop the strikes lay in the Government’s hands. Well, the power is now in his hands. He has had every opportunity to prove it, and yet here we are again. Not so easy after all, is it?

The Government came into office promising to end these disputes. Instead, they have conceded heavily on pay, at enormous cost, and still failed to make it work. The Secretary of State says a comprehensive deal was on the table, developed with the BMA leadership. Despite that, we still face further strikes, so what exactly has this strategy achieved? After all the concessions, all the cost and all the disruption, there is still no resolution. If, as he says, the BMA leadership helped to shape the deal, why did it not secure the support of the wider committee? This morning, the chair of the BMA’s resident doctors committee said that all the Secretary of State needs to do to avoid these strikes is come back with a better offer. That was the Secretary of State’s argument in opposition, too. He has now had every opportunity to test that theory in government, and it has not worked, just as we warned.

There is also an irony here that will not be lost on the public. The BMA says that a 3.5% pay rise for doctors is a “crushing blow”, yet it is offering its own staff just 2.75%. While it demands more from the taxpayer, it will not even meet its own standard for fairness. The inconsistency is obvious and hypocritical.

The Government’s own position on affordability no longer seems to add up. In October, Ministers were clear that anything above 2.5% would have consequences for wider NHS commitments. They said that every additional 0.5% would cost around £750 million, yet we are now beyond what they previously said was affordable, so what has changed? Were those warnings overstated, or are other parts of the health budget now going to pay the price? The Secretary of State even pointed to global events as a reason for future constraints. That is a long way from “just negotiate and sort it out”. After repealing minimum service levels, the Government cannot now be surprised that patients are once again exposed to greater disruption.

Labour promised to end the strikes. It paid a very high price, and it still did not get the result. Ultimately, it is patients who are caught in the middle of all this, but it is unfair on others in the NHS, too. Consultants are left picking up the pieces yet again. Other doctors and NHS staff are expected to carry the burden and keep services running—they do not get to walk away. That is not sustainable, and it is not fair.

The Secretary of State says he may now have to call time on the extra jobs he announced. Were those jobs ever truly secured, or were they always conditional on the BMA accepting the deal in full? When he says that strike action will consume the money set aside for this deal, is he not really admitting that his own approach has ended up burning through the very resources he said would improve pay, jobs and conditions? What is the cost of this latest round of strikes expected to be, and where will that money now come from? What assessment has he made of the impact on patient safety, consultant morale and the training progression of junior doctors? What is his plan to end this dispute, rather than simply manage the next round of disruption?

Patients need certainty. The NHS needs stability. That is why we have been clear that doctors should not be allowed to strike and that minimum service levels must be restored to protect patient safety.

[Wes Streeting]

I thank the shadow Secretary of State for his response and questions. Beneath some of the criticism of the Government was a consistent message about the unreasonable and unnecessary position of the BMA, but let me address his criticism none the less.

The shadow Secretary of State accused me of “boasting” yesterday about the progress this Government are making on the NHS. For once, I cannot say we are following the pattern of our predecessors, because of course, they did not make any progress. From the moment they entered government, we saw the NHS begin to slide in the worst direction, to the extent that we went into a modern health emergency—the pandemic—woefully underprepared, leaving our country more damaged as a result. I am proud of the progress we are making. We know that what we have seen in terms of results and patient satisfaction are grounds for optimism, not cause for complacency. What we are trying to do as a Government is absolutely essential for the country, to give it back an NHS that is there for people where they need it, when they need it. That is why the BMA’s position is both disappointing and self-defeating for all of us.

The shadow Secretary of State talked about the approach I took in opposition. There is a difference between the approach that this Government have taken and the approach of our Conservative predecessors. We have always been prepared to get around the table; we never close the door. As I said from the other side of the House, the power to end strikes does sit with the Government when they are willing to compromise, willing to negotiate and willing to treat the workforce with respect. That is what this Government have done, in contrast to our Conservative predecessors, which is why it is so disappointing that with a deal available—a good deal—the BMA is turning away.

The BMA should reflect not just on the contrast with the past, but on the contrast with the future. There is no more pro-NHS, pro-doctor Health Secretary or Government waiting in the wings. I am not even sure that the alternative is a Conservative Health Secretary; that person may well come from Reform UK—the party whose Members occasionally turn up and sit in the corner, when they can be bothered and when they are not flouncing out in a hissy fit. Catch them on a good day and Reform Members may even say the quiet bit out loud: they do not believe in the NHS. They do not believe in it as a public service free at the point of use, and they are certainly not going to treat the BMA or resident doctors with more respect or generosity than a Labour Government. I think the BMA needs to reflect on that.

The shadow Secretary of State asked about affordability. One of the great things about the deal that we agreed is that it is affordable because it involves productivity gains—not just the productivity gains that we have already achieved in the NHS, the target being 2% and the reality that we have achieved 2.7%, but the productivity gains built into the pay structure reform.

The shadow Secretary of State asked about the jobs. I will be honest, and I am sure NHS chief executives will want to say more about this. The fact is that I and Jim Mackey have had to do a considerable degree of persuading and arm-twisting to persuade NHS trusts to create additional specialty training places, because they have not been convinced of their necessity or utility. Part of their reservation has been about the conduct of resident doctors and the BMA. I have had a hard job to do to sell that. Those jobs will not materialise if the BMA rejects this deal, I am afraid. There is a not a “something for nothing” culture here.

I say to the crab people who still believe that they are pursuing a really effective “bank and build” strategy that they should look at what they are confronting now, and look their members and their colleagues in their eye. This is not bank and build any longer; this is a high-and-dry strategy, and it is not going to work. That is why it is important that we end this dispute and that we do it together, in the spirit of partnership. There is still time to do that—there is still a week. The door is not closed; the offer is still there, and I urge them to take it before it goes.

Meningitis Outbreak

Stuart Andrew Excerpts

Tuesday 17th March 2026 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

I am grateful to the Secretary of State for advance sight of his statement and for the clarity that he has provided to the House this afternoon. Our thoughts are also with the families of the two young people who have so tragically lost their lives—I cannot imagine the pain that they must be going through at this difficult time. This will also be an extremely distressing time for parents, students, staff and the wider community across the south-east, especially as I understand that two more cases have just been announced. Yesterday, friends of mine were very anxious about their own son, who was in the vicinity over the weekend. I pay tribute to the NHS staff, public health teams, school and university leaders, and all those working at pace to respond.

I welcome what the Secretary of State has set out on the daily publication of figures, the scale-up of antibiotic provision and the decision to introduce a targeted vaccination programme for students in halls of residence, alongside seeking further advice from the JCVI. However, a number of important questions remain. First, concerns have been raised out there on the timeline. The Secretary of State has set out the sequence of events in detail, but can he be clear about the threshold used for wider public communication? Is that threshold being reviewed in the light of this outbreak? He also set out that headteachers were contacted on Monday morning. Can he clarify when those schools were first identified, and whether there is a need to review how quickly educational settings are brought into the response, given that cases were identified several days beforehand?

Secondly, turning to the nature of the outbreak, while many cases are linked to a single venue, can the Secretary of State confirm whether all cases are believed to be part of one cluster, or whether there remains a risk of multiple sources of infection? Thirdly, on escalation, given the involvement of both a university and schools, can he set out what criteria are being used to determine when more extensive interventions are required across educational settings? This situation will undoubtedly cause concern among families, particularly with the end of term approaching.

Can the Secretary of State therefore set out what steps are being taken to manage the risk of onward spread as students return home, and what advice is being provided to families and local health services in other parts of the country? Can he also confirm that public health messaging is fully consistent across schools, GPs, local authorities and NHS services, so that families receive clear advice wherever they turn? What steps are being taken to counter misinformation online, where false claims may undermine confidence in public health advice? Can he also confirm that local laboratories, intensive care capacity and public health teams are fully resourced to manage any increase in cases, and that supply chains for antibiotics and vaccines are resilient, should further clusters emerge?

Finally, although I welcome the targeted vaccination programme and the decision to seek further advice from the JCVI, the Secretary of State has acknowledged that most students will not have been routinely vaccinated against meningitis B, and protection among older teenagers is clearly not as strong as it is in infancy. Does he accept that this creates a particular vulnerability among older teenagers and young adults, and will he ensure that any further advice on eligibility or wider catch-up measures is brought forward as quickly as possible?

This is a serious public health situation. It is right, though, that the response remains calm, evidence-led, and focused on protecting patients and supporting those families affected.

Palliative Care

Stuart Andrew Excerpts

Thursday 5th March 2026 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

May I begin by congratulating the hon. Member for York Central (Rachael Maskell) on securing this important debate, and the independent commission on palliative and end-of-life care on the amazing work that it has undertaken? Its report certainly provides an important contribution to the discussion about how we ensure that people receive compassionate and high-quality care at the end of life.

This debate is important. There is a saying that nothing is certain in life other than death and taxes, but it seems that we spend an awful lot of time in this place talking about taxes, and until recently we have not really talked about death. I agree with the hon. Member for Newcastle upon Tyne East and Wallsend (Mary Glindon), who said that we have gone into assisted dying but rather missed or leapfrogged the important debate around palliative care. I pay tribute to the hon. Member for Newcastle-under-Lyme (Adam Jogee) for his tribute to Dougie Mac, and to all colleagues who have made representations and congratulated hospices on the amazing work that they do around the country. We also heard moving contributions from the hon. Members for St Helens South and Whiston (Ms Rimmer), and for Worcester (Tom Collins). These debates are even more powerful when we talk about personal experiences that we have been through, and I thank them for sharing those.

For me, palliative care is about dignity, compassion and choice at the most difficult moments in people’s lives. When it works well, it relieves suffering, supports families, and allows people to spend their final days in the place and manner that they choose. Before coming to the House I had the privilege of working for 16 years in the hospice movement in both children and adult hospices, and with organisations supporting families whose loved ones were edging towards the end of their life. Many of those were supporting the families of children who had life-limiting conditions. That experience has stayed with me and informed how seriously I take this debate, because I saw first-hand the extraordinary compassion and professionalism of the people who provide such care, and the profound difference that it makes to families facing unimaginable circumstances.

When it comes to children, no parent expects to outlive their child. Often those parents would say to me that when they realised that their child was living with a life-limiting condition, it meant that their dreams and aspirations changed. Suddenly they were not thinking about their child’s first day at school or university, or their wedding day; they were changing their whole aspect and plan for that child’s life. That is why hospices and palliative care services are so important, and they support more than 300,000 people every year.

Much has been said about the wonderful Dame Cicely Saunders, but we should also pay tribute to Sister Frances Dominica, who set up the first children’s hospice in the UK. There was a wonderful saying in children’s hospices that I always used to relay: they cannot add days to their lives, but they can add life to their days. That shows how important hospices are to so many families.

Hospices are a vital part of our health system because they are relieving pressure on hospitals and providing specialist care in communities across the country. Hospices are not an optional extra in our health system—they are a core part of how our compassionate healthcare should work. Seeing adults and children get the care that they needed at the end of their lives, as I did at Hope House children’s hospice, East Lancashire adult hospice and Martin House children’s hospice, was phenomenal. It is no wonder that our hospice movement has been world-leading.

However, the sector is under increasing strain. Hospice leaders report rising costs, workforce shortages and growing demand for services at the very moment that they are struggling. Across the country, we are seeing reductions in services, bed closures and significant financial pressures. As many hon. Members have said, Hospice UK has warned that two in five hospices are now cutting or reducing services. I know that concerns every Member of the House.

The Government will point to recent announcements about capital funding for hospices and the continuation of the children’s hospice grant, and those investments are welcome. But capital investment and capital funding cannot pay for nurses, doctors or the day-to-day delivery of care. What the sector needs is sustainable revenue funding. As a former head of fundraising, I know that capital fundraising is often the easiest, because people want to buy a new building or a piece of equipment, and paying the wages is never as, dare I say, sexy.

As many hon. Members have said, children’s palliative care also faces challenges. Children with life-limiting conditions and their families require specialist care that supports them from diagnosis through to the end of life and beyond. I remember one parent saying to me that if he got up eight times in the night to his daughter, he would consider that he had had a good night’s sleep— I cannot imagine what that must be like. I also saw siblings having a different life from those of their school friends because their brother or sister needed extra, additional care. Children’s hospices offer wonderful bereavement support to families, which is another issue that many hon. Members have mentioned.

Access to that care remains inconsistent across the country. As my right hon. Friend the Member for New Forest East (Sir Julian Lewis) said, evidence suggests that fewer than one in five integrated care boards formally commission specialist children’s palliative care services that meet national standards. There are also serious workforce shortages. England has just over 1,000 community children’s nurses, when safe staffing estimates suggest that nearly 5,000 are required. Across the UK, there are only around 24 specialist paediatric palliative care consultants, when experts estimate between 40 and 60 are needed. For many families that means they cannot access the support they need at home, even when that is their preference.

The Government have indicated that they will publish a modern service framework for palliative and end-of-life care later this year, which I absolutely welcome and I commend the Government for that. That framework presents a really important opportunity to address the challenges facing the sector.

I would like to ask the Minister a couple of questions. I will not repeat the ones that my right hon. Friend the Member for New Forest East mentioned because we all had that briefing. What steps will be taken to address the workforce shortages facing palliative services, particularly community children’s nurses and specialist consultants? What plans do the Department have to ensure that hospices have the sustainable funding required to continue delivering these vital services and protect their independence? I get the call for us not to have so much reliance on fundraising, but there is a real danger that hospices lose that independence if they take that statutory funding. The thing I always noticed was how they were more able to respond very quickly to the needs of individual families than the NHS. It is really important that we safeguard that independence.

How will the Government ensure that this opportunity with the new plan seizes the chance to stop that postcode lottery? Will it see where we should firm up some of the guidance to ICBs around the country? Will Ministers look at the innovation that charities are doing in this work around palliative care? I think particularly of Sue Ryder, which is investing in add-on wards at the Airedale general hospital in Yorkshire. It is also focusing more on home services, rather than services in the building, and on getting to more and more patients. It is important that we engage with and learn from it so that we can see it evolving into best practice.

There is also a really important issue around transition, which is important for young adults. When I worked at Martin House, we had just opened the teenage unit, which enabled us to have a setting that was a bit more grown up but not old ladyish or old mannish, if I can put it that way; it was an environment suited to the needs of those young people. Thankfully, we now see that these young people are living longer. When I was working at Martin House, young boys with Duchenne muscular dystrophy would probably come to the end of their life at the age of 18. They are now living into their late 20s, 30s and sometimes even 40s.

There needs to be an appropriate environment for those people to have support, because palliative care is one of the most compassionate parts of our health system. The professionals, volunteers and charities that deliver that care do extraordinary work every day, and they deserve a system that supports them and ensures that every patient and family can access the care that they need at the end of life. I hope the Minister can tell us how the Government intend to achieve that.

Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 24th February 2026 Commons Chamber

[Mr Speaker]

I call the shadow Secretary of State.

[Stuart Andrew (Daventry) (Con)]

In the plan for change, the Government committed to meet the 18-week standard for routine operations, but the latest data suggests that the Government are not on track to meet that commitment by the end of the Parliament. In December, fewer people were treated within 18 weeks than in the previous month. Will the Secretary of State now accept the reality that patients are experiencing and, as the Institute for Fiscal Studies has warned, that the Government will not deliver their commitment on their key milestone to deliver the 18-week standard?

[Wes Streeting]

I will never surrender to the tyranny of the low expectations of the Conservative party. We have cut waiting lists by 330,000 since we came to office; they are now at their lowest level in three years. We made progress despite strikes, we made progress despite winter pressures, and we have made progress despite every bit of investment and modernisation being opposed by the Conservatives. Instead of criticising our record, the shadow Secretary of State should apologise for his.

[Stuart Andrew]

Another leadership ambition, I see.

On 29 September, I wrote to the Secretary of State regarding the late Dr Susan Michaelis’s campaign for better research into lobular breast cancer, but sadly I still have not had a reply. She established the Lobular Moon Shot Project and the last Government committed to support its aims. However, despite meeting the Secretary of State, representatives from the project say that they still have no clarity on how the project and research will be expedited. Will the Secretary of State confirm now Government approval for the funding required for this research, which is critical for so many women in this country?

[Wes Streeting]

I apologise to the shadow Secretary of State for not having replied to his letter—let me make sure that I do that. There is no disagreement across the House on the substance of the issue. I am absolutely supportive of the project and I want to fund the research, but we have to make sure that the research proposal meets the standards and has the confidence of our funders. We are working with the team to try to get the proposal over the line, but that is the only obstacle here—it is certainly not a political decision.

National Cancer Plan

Stuart Andrew Excerpts

Thursday 5th February 2026 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

I thank the Minister for advance sight of her statement. May I say right at the outset that we share the ambition to improve cancer survival and outcomes? Almost every family in Britain has been touched by cancer, and patients deserve timely diagnosis, treatment and proper support. I also recognise the Minister’s personal experience and the commitment that she has clearly brought to this agenda. We on the Opposition Benches wish her every success for the future. I also join her in thanking all those who have taken part in the shaping of this plan. It makes a big difference when we hear the voices of patients and families who have been through these experiences.

The national cancer plan sets out major commitments, including on early diagnosis, improving performance against cancer waiting time standards, the faster set-up of clinical trials, and the national roll-out of targeted lung screening. It also talks about modernising services through technology and innovation. Cancer Research UK has said there is “much to welcome” in the plan, but it is right for it to say that delivery, funding and accountability will determine whether patients see change. Too often, plans sound impressive on paper but fall short when it comes to clear published delivery milestones and accountability. In many respects, this plan mirrors the ambitions of the 10-year NHS plan: it is strong on aspiration, but light on the detail of how change will actually be delivered on the ground. My first question is simple: when will the Government publish clear, funded milestones showing how and when patients will see improvements in the next year or two?

We welcome investment in diagnostics, technology and innovation. It is also right to recognise that this plan builds on the significant expansion of diagnostic capacity delivered by the last Conservative Government, including the roll-out of more than 160 community diagnostic centres. Earlier diagnosis on this scale is only possible because of that foundation, but technology is only meaningful if it translates into real capacity and quicker treatment for patients. That is why radiotherapy matters. Radiotherapy UK is right that it is a core part of modern cancer care, but it relies on up-to-date equipment and a skilled workforce. My second question is this: will Ministers set out how the plan will expand radiotherapy capacity in practice, including equipment replacement and the workforce, so that patients can benefit in reality, rather than the plan just being something written on paper? Are we learning the lessons from the Danish example? They invested in radiotherapy and saw significant improvements over a period of years.

That point brings me on to the workforce. The success of this plan depends on cancer nurses, radiographers, pathologists and oncologists who are already under immense pressure. We have heard big promises before, but less clarity on delivery, so my third question is this: where is the fully funded long-term workforce plan to deliver the staffing needed to expand diagnostic and treatment capacity and to make sustained improvements, including in neighbourhood health centres? Will the Government explain clearly who will staff them and how they will be funded? Blood Cancer UK has highlighted the importance of ensuring that blood cancers are properly recognised in planning and that patients receive consistent support from the point of diagnosis, including access to a named healthcare professional. That underlines why delivery and accountability across the system matter so much to patients.

I also welcome the commitments in this plan to children and young people. I pay tribute to my hon. Friend the Member for Gosport (Dame Caroline Dinenage), who I know did some incredible work in this area. Having worked in children and young people’s hospices, I will never forget the journey that those children and their families go on, and I am really grateful to the Government for having a big section on that in the plan.

My fourth question is about life after—and at the end of—treatment. The plan rightly talks about improving quality of life and support after treatment, including personalised support and rehabilitation; we all want people to live longer, but for many patients and their families, hospice and palliative care are essential. Yet hospices across the country are under severe pressure, with many now in crisis, exacerbated by recent Government tax rises hitting staffing and running costs. Hospices are also notably absent from today’s statement. Will the Government urgently convene a crisis meeting with the hospice sector and set out what immediate steps they will take to stabilise services and expedite delivery of the palliative care plan?

We will support any serious, deliverable reforms that improve earlier diagnosis, speed up treatment, strengthen the workforce and improve patient experience. But we will also hold Ministers to account on turning long term ambitions into real improvements now, because we want to see patients getting the care that they need.

[Ashley Dalton]

I thank the right hon. Member for his statement and questions, and particularly for his personal wishes.

Overseeing delivery is absolutely crucial. It is great that we have written a plan, but what matters is delivering it. We started delivery even before we had finished writing this plan; we are not waiting. We have already put £200 million directly into cancer via cancer alliances. We have recruited 2,500 more GPs. We have already put in place 28 cutting edge radiotherapy machines and are rolling out lung cancer screening. We have opened more community diagnostic centres at evenings and weekends. We said we would deliver 2 million more appointments; we have already delivered 5 million more appointments. And we have put £25 million into the National Institute for Health and Care Research’s brain tumour research consortium.

Steps are already being taken, but it is really important, as the right hon. Member points out, that we are held to account and that people keep our feet to the fire on delivery. That is why we are setting up a brand new cancer board of charities and clinicians, which will oversee the delivery of this plan and keep our feet to the fire.

On workforce, we know how important it is to make sure that the cancer workforce is grown and developed, not only in terms of numbers but in having the resources and the support to use their skills to the utmost. The workforce plan that the Government are developing will also include cancer and will be published this spring.

I was delighted to hear the right hon. Member mention rare cancers and children and young people. This is the first ever cancer plan with a chapter on rare cancers, and the first ever cancer plan with a chapter on children and young people, and I am really proud of that.

On radiotherapy, as I said, we have invested £70 million into 28 new linear accelerator—LINAC—radiotherapy machines. We have also listened to stakeholders in the radiotherapy community. We are investing in new technology, including those radiotherapy machines, and in AI to assist the oncology workforce to reduce the time it takes to plan and then deliver treatment. By April next year, we will streamline the process to make it easier for radiotherapy centres to use cutting edge stereotactic ablative radiotherapy—SABR—which is crucial to many patients. We will also ensure that the payment system associated with this treatment incentivises rapid adoption.

The right hon. Member mentioned hospices, something that I know is very close to his heart and his experience. We are delivering the biggest investment in hospices in a generation. We have provided £100 million to upgrade buildings, facilities and digital systems, and we are giving a further £26 million to children’s and young people’s hospices, ensuring that they can continue offering specialist, compassionate support. More broadly, we are developing a palliative care and end of life modern service framework for England. That is currently being developed alongside our stakeholders, with a planned publication date of autumn 2026.

I hope that addresses most of the issues raised by the right hon. Member, but I am more than happy to speak with him further after the debate.

Medical Training (Prioritisation) Bill

Stuart Andrew Excerpts

2nd reading
Tuesday 27th January 2026 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

Let me start by saying at the outset that—

[Alex McIntyre]

You are not defecting?

[Stuart Andrew]

No, I am most definitely not defecting.

In the spirit of being constructive, I will start by saying that the Opposition support the principle behind the Bill. Doctors trained in Britain and funded by the taxpayer should have a fair, clear and consistent route to progress in our NHS. Britain trains some of the best doctors in the world, yet too many are leaving—not because they want to, but because they cannot access the training places they need. That wastes talent, damages morale, and ultimately affects patient care. However, support in principle is not a blank cheque; the Bill must work in practice, not just look good in a headline. We should also be honest about why we are here. Much of what is in the Bill has been promised by the Government since their election in plans, reviews and ministerial statements, and the fact that it is only being brought forward now suggests that this is catching up, not leading.

The first test is delivery. We cannot solve a shortage by changing the queue. Unless the Government deliver the 4,000 new specialist training places that they have promised, including the 1,000 places that are needed early, the Bill will not fix the bottlenecks; it will simply shift frustration from one group of doctors to another. That is why we are proposing constructive amendments to the Bill that we believe are workable and fair.

The next test is clarity. The real impact of this Bill will be determined by the rules that sit beneath it—who qualifies, how experience is assessed, and how decisions can be challenged. We welcome the focus on foundation training; prioritising UK and Irish graduates for foundation training is sensible, as it strengthens the pipeline and improves workforce planning. However, it will only work if there are enough placements and the system is transparent. That is why amendment 8 would clarify that a UK foundation programme must mean a programme in which the majority of training takes place in the United Kingdom. That is a necessary safeguard against loopholes.

Amendment 9 would ensure that from 2027, British citizens on UK foundation programmes are prioritised in a meaningful way. Prioritisation must apply not only at the final offer stage, but at interview, which is where selection decisions are often made. The amendment addresses many of the points that Labour Members have been raising, so I encourage them to support amendment 9 when we divide on it.

We are also concerned about doctors serving overseas with the armed forces. I was pleased to hear the Secretary of State talk about them, since they certainly should not be penalised because part of their training takes place abroad on service. As such, amendment 10 would expand the definition of a UK medical graduate to include those undertaking placements as part of an armed forces posting outside of the British Isles. I hope the Secretary of State will consider accepting that amendment to give reassurance to our armed forces, which I know is something he cares about. These are practical changes that would improve fairness and operability, and we hope the Government will adopt them.

We also support new clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), which would make clear that once priority groups are established, training places should be allocated on merit. That allocation should be based on academic achievement and clinical performance, rather than a lottery or a computer-generated ranking divorced from real performance. Again, I hope the Government will seriously consider the new clause. When the Minister for Secondary Care sums up, will she put on record that merit will remain central to selection?

Another issue that cannot be ignored is the impact on medical schools, especially those that rely on international students. New clause 3 would require an annual report to Parliament on the number of international students at UK medical schools and the financial consequences flowing from the Bill’s provisions. International students pay higher fees and help sustain our universities. If those numbers fall, what funding model would replace them? When she sums up, will the Minister for Secondary Care outline what assessment has been made of the impact on medical school finances? How many international places do the Government expect to fund in future, and on what basis?

The Bill cannot stand in isolation. Workforce planning depends on more than allocating training posts; it requires enough trainers and clinical supervisors, viable rotas that support learning and facilities that make training possible. The revised NHS workforce plan must set out how those needs will be met, and how the extra training places will be staffed and supported. With NHS England set to be abolished in April 2027, we need to hear from the Government who will lead workforce planning and accountability thereafter.

Our approach is straightforward. We will support measures that are fair and practical, that strengthen patient care and that respect staff. We will press the Government where we feel that proposals are rushed, underfunded or left vague. Backing doctors means giving them a route to progress and ensuring that the system is properly planned and properly resourced. I repeat that, in principle, we support the Bill. We want doctors trained in Britain to build their careers in the national health service.

That brings me to enactment. As we have heard, the Government propose that the Bill should take effect when the Secretary of State decides, rather than on the date of Royal Assent. When he said that he wanted to introduce this Bill, and that it would be urgent, I said that we encourage that and support it. However, if this Bill is truly urgent, and if Ministers want it to affect this recruitment round, why would they not commence it immediately? The Secretary of State should not be playing politics with people’s jobs. It is not right for doctors, including those not involved in industrial action, to be treated as bargaining chips, and it is not right for Parliament to be treated in this way to give him the tools that he needs because he did the first set of negotiations so badly. Will the Government support amendment 1, so that the Bill takes effect on Royal Assent? Will they commit to enacting the Bill as quickly as possible?

When does the Secretary of State intend to commence the Bill? If the Minister for Secondary Care cannot give the House a date today, what makes the Bill so urgent that it needs to be pushed through Parliament in a single day? Will the Government proceed with this legislation, even if no agreement is reached with the BMA? If industrial action is paused, will the Government still honour their commitment to prioritise UK medical graduates?

Many doctors took industrial action because they felt that their career progression was blocked. This Bill could play a part in rebuilding that trust, but that will only happen if Ministers deliver, publish the detail and follow through. They must be straight with the House. If this Bill is urgent, it should commence on Royal Assent. If implementation takes time, the Government should publish a timetable and the steps required to deliver it. To do anything else, frankly, would be discourteous to Parliament.

[Dr Murrison]

I think the Secretary of State has perhaps misunderstood how traumatic the process is for the young medical graduates going through this performance. Does the shadow Secretary of State agree that the sooner this legislation comes into force, the better it is for those young people, some of whom are finding the current situation incredibly difficult? They do not know what the successor scheme will look like, and the delay is adding to that unhappiness.

[Stuart Andrew]

I absolutely agree with my right hon. Friend. I said right at the outset that we would be constructive, but we have heard from many who are anxious about their future and do not know what will happen. The sooner that we can give them that certainty, the better. That was the premise on which we offered to support the Bill. I am grateful to him for making that point.

I am conscious that others want to speak, so I will end by saying this. Prioritisation without capacity will not fix the workforce crisis. Promises without delivery and headlines without planning will not retain the doctors whom our NHS needs. The Government must fund the extra places, set out the operational detail, and begin this reform without delay, because that was the premise that the Secretary of State identified. When he came to Parliament just a few weeks ago, he said that we needed to get on with this urgently, and that he would encourage business managers to provide the time. Well, if that is the case, let us get on with the job.

Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 13th January 2026 Commons Chamber

[Mr Speaker]

I call the shadow Secretary of State.

[Stuart Andrew (Daventry) (Con)]

With one in five hospice beds no longer available because of increased costs such as national insurance contributions, it is hardly surprising that doctors are raising concerns about the increase in the number of end-of-life patients in our hospitals. It is therefore concerning to hear that the palliative care modern service framework will not now be available until the autumn. Given that the situation is increasingly urgent, will the Secretary of State commit to accelerating that timescale?

[Wes Streeting]

We are moving at pace on the modern service framework, but we have recognised those financial pressures, whether through the continuation of the children’s hospice grant over multiple years so that hospices can plan or through the capital investment we have put into hospices, providing the biggest funding uplift for hospices in a generation. I recognise that there is more to do, and I enjoy a close working relationship with the hospice movement to look at what more we as a Government can do to support the vital work that it does.

[Stuart Andrew]

Capital funding is welcome, but we cannot pay doctors and nurses with bricks and mortar. Hospice UK has said that without additional support, there will be

“more unnecessary hospital admissions, more unneeded A&E attendances and more patients not getting the care”

they need, so I push the Secretary of State again to accelerate the timescale. Their lordships are considering the assisted dying Bill and they need to see the palliative care MSF before making such an important decision. We must also make sure that we relieve hospices of this Government’s NIC hikes.

[Wes Streeting]

I understand the point the shadow Health Secretary makes about capital funding, but I would also say that, through that capital funding, lots of hospices are able to free up their own resources, which would previously have been committed to rebuilding works, to spend on services. I recognise that there is more to do, and we are working closely with the hospice movement. I hope that the right hon. Gentleman is reassured to learn that we will be reporting on the modern service framework initially in spring, so that we can then take on board feedback and reiterate. Then we will get to the autumn, but people will not have to wait until then to hear the direction of travel.

NHS: Winter Preparedness

Stuart Andrew Excerpts

Monday 15th December 2025 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on winter preparedness in the NHS.

[The Secretary of State for Health and Social Care (Wes Streeting)]

The NHS’s national medical director says:

“This unprecedented wave of super flu is leaving the NHS facing a worst-case scenario”.

This is backed up by the data. On any given day last week, an average of 2,500 patients were in hospital beds—a 55% increase on the week before, and almost double the number from 2023. One hundred and six flu patients are in intensive care, compared with 69 the previous week. There are 1,300 more staff off than in the week before, and the number of calls received by NHS 111 last week was 446,000—8% higher than at this time last year.

It is clear from both the NHS and UK Health Security Agency data that there is a real risk for the NHS and for patients, and it is at this moment of maximum danger that the British Medical Association has chosen to go ahead with Christmas strikes, when they will inflict the greatest level of damage on the NHS.

The BMA said this dispute was about pay, but we gave doctors a 28.9% pay rise. Then it said it was also about jobs, so I offered a deal to halve the competition for jobs to less than two applicants per post. It is now clear what these strikes are really about—the BMA’s fantasy demand for another 26% pay rise on top of the 28.9% doctors have already received. I also offered to extend the BMA strike mandate, so it could postpone this action and go ahead once flu has subsided. The fact that it also rejected that offer shows a shocking disregard for patient safety. Since this strike represents a different magnitude of risk from previous industrial action, I am appealing to ordinary resident doctors to ignore the BMA strike and go to work this week. Abandoning patients in their hour of greatest need goes against everything that a career in medicine is meant to be about.

The entire focus of my Department and the NHS team is now on getting the health service through the double whammy of flu and strikes. We have already vaccinated 17 million people, which is 170,000 more than last year, and 60,000 more NHS staff. We have invested in 500 new ambulances, 40 new same-day emergency care and urgent treatment centres, and 15 mental health crisis assessment centres. The NHS will also be recalling resident doctors to work in emergency situations, and we will not tolerate the dangerous attempts to block such requests that we have seen from the BMA in the past.

I am proud of the way that the NHS team has pulled together through strike action in the past, and I know they will move heaven and earth to keep patients as safe as they can this winter. I am just appalled that they are having to do so without the support of their colleagues in the BMA.

[Stuart Andrew]

This winter, a serious flu wave and rising respiratory syncytial virus infections are pushing the NHS to its limits. Flu admissions, as we have heard, are up 55% in a week, and RSV cases are rising, especially in older people. However, the Government have failed to prepare, as we pointed out earlier in the year.

In July, the Health Secretary accepted Joint Committee on Vaccination and Immunisation advice to expand the RSV vaccine to over-80s, but that expansion seems to have been quietly dropped. Flu vaccine uptake remains dangerously low, with fewer than 30% of some key groups vaccinated. Most worryingly, that includes NHS staff, who are going off sick because of flu, adding to staffing pressures. Delayed discharges are worsening: 19,000 more bed days have been lost this year. Still there is no winter discharge plan, no new funding and no clarity—and today, yes, resident doctors confirmed further strike action this week, which will add pressure to a system already under significant strain. That is why we would ban strike action, but at the same time this Government are literally making it easier for unions through their Employment Rights Bill.

When the NHS is under this level of pressure, families deserve the reassurance that care will be there when they need it, so I ask the Secretary of State: will he now publish the Government’s plan for managing winter pressures, including on delayed discharges and emergency care? Given that he is worried about a double whammy of rising flu cases and a strike, what extra resources is he providing, and if he is not, where is the money coming from? What action will he take to ensure RSV vaccine access for older people, and what will he do to raise flu vaccine uptake in vulnerable groups, particularly in NHS staff? Families are frightened, and some are already grieving. This crisis was not inevitable, but the Government’s failure to prepare has made it much worse.

[Wes Streeting]

I will ignore the political nonsense about banning strikes and clamping down on trade unions. I will, however, take on directly the charge that we have not prepared for this winter.

We have delivered over 17 million flu vaccinations this season—hundreds of thousands more than this time last year—and 60,000 more NHS staff than last year are also getting their jab. We are on track to deliver the 5 percentage points increase in flu vaccine uptake in healthcare workers, as set out in our urgent and emergency care plan. On children and young people, half a million two to three-year-olds have been vaccinated, which is the same as last year, and 3.6 million school-age children have been vaccinated, which is up 100,000 on last year. We will be going back to schools to do repeat visits in areas where uptake in schools has not been as high as we would like. For care home residents, flu vaccination uptake is 71%. We are on track to meet the RSV vaccination uptake target for 2025-26 in the published urgent and emergency care plan, so we are doing a lot on the vaccination front to prepare.

In fact, on winter planning more generally, we started earlier and did more than ever to prepare for this winter. We had stress-tested winter plans trust by trust. Local NHS leaders ran scenario-based exercises, including managing surges in demand and responding to virus outbreaks to test and strengthen their winter readiness plans, which are now being put into action. We have strengthened access by boosting GP access to keep people well and out of hospital. Through advertising campaigns, new online access routes and more GP practices open for longer hours over the Christmas period, we are making sure more people can be seen closer to home. That matters, because when people can get help early from their GP, they are less likely to end up in A&E.

We are also going further to improve our urgent and emergency care performance this winter. That is set out in our urgent and emergency care plan. We are investing almost £450 million into UEC this winter, meaning: 500 new ambulances on the roads; expanding same-day and urgent treatment centres; providing targeted support to the most challenged trusts; creating capacity and keeping flow moving by sharing weekly data with trusts; encouraging the use of alternative community services; and streamlining in-hospital discharge processes to get patients discharged more quickly from hospital when it is safe to do so, including joining up the NHS and social care, where relationships between health and social care have been improving year on year. If I think about where we are this year compared to last year, there has been sustained improvement. A lot done; more to do.

Of course our job is made harder by strike action. That is why the Government are doing everything we possibly can to get the NHS through this winter. I just wish we were doing it with the BMA, rather than against the BMA.

Resident Doctors: Industrial Action

Stuart Andrew Excerpts

Wednesday 10th December 2025 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

I thank the Secretary of State for advance sight of his statement, and sincerely thank him for making me aware last night of his intention to come to the House today and make a statement. Given that the next set of planned industrial action is due just a few days before Christmas, and at a worrying time when winter pressures are increasing early, with more flu patients needing hospital beds, we all want to see an end to these strikes. We on the Opposition Benches offer our thanks and gratitude to all those in the workforce who have worked so hard to try to minimise the impact of the strikes so far.

In his statement, the Secretary of State talks about the competition for places. This is not new information. He said himself that the figures have soared in the last two years. Why is it only now that he is addressing it, so close to a damaging strike? He could have dealt with this issue back in the previous talks with the unions, but he did not. I have said, though, that I want us to be constructive in opposition, so I welcome the work that he has done to offer more places to UK doctors. Depending on the detail of the legislation, we will help to secure that aim. I make this offer to work with him to ensure that we get there.

On the 4,000 places that the Secretary of State has announced, and the 1,000 specifically announced for this year, can he tell the House in which specialisms those places will be? Can he break it down into GPs, surgery, obstetrics, anaesthetics and so on? Is he confident that there are enough trainers and that there is enough capacity in the training settings he has chosen? GPs are trained in general practice and in hospitals, and there is community training for some specialists, such as paediatrics. When will these places be available for applications? Will he also look at replicating the Australian model of placing any international doctors in areas of the country with the greatest need? We know we need to address those issues.

All of this is dependent on the BMA accepting the offer, but what if it does not? After all, its track record speaks for itself. We warned that giving pay awards with no conditions would encourage the BMA to come back for more, and it has. If its members rejects this offer, what are his plans to manage and deal with the situation? As the Secretary of State has said himself, the NHS is under pressure from combined flu and RSV, so what is he doing to ensure that those who are eligible for the vaccines actually have them? What additional resources has he made available to manage the strikes if they happen, and for winter pressures if they do not?

Does the Secretary of State recognise that if the BMA membership reject this offer and carry on with the strikes, his Government’s own Employment Rights Bill will make things much worse next year? Will he think again about the reductions in the minimum thresholds for strikes and reintroduce the minimum service levels? Does he expect that this new legislation and the announcements he has made today will have any implications for the Equality Act 2010? If so, what are they, and how will he address them? Will he have to disapply the Act?

These strikes must end. The BMA is behaving appallingly, but if the Secretary of State does not deal with those issues around thresholds and minimum service levels, it will only get much worse, with unions like the BMA causing more issues. It is patients—our constituents—and their families and loved ones who will suffer.

[Wes Streeting]

First, I thank the shadow Health Secretary for the constructive terms on which he has agreed to work with the Government. That should give resident doctors across the country who receive their survey the confidence of knowing that, should they vote for this deal, emergency legislation will be introduced in the new year. We will be able to work at pace, because with the majority that the Labour party has in this House, and with cross-party support in the other place, we can make sure that we expedite the legislation and achieve our goal of making the changes for international medical graduates that we have always intended to make, and that we committed to well in advance of today. By expediting those changes, there will be a direct impact on people applying for speciality places now and those who, even in recent weeks, have experienced the disappointment of not receiving the training place they had hoped for. We can keep that hope alive. We can improve the number of specialty places available if resident doctors vote for this deal, so I urge them to do so.

The shadow Health Secretary asked why we had not dealt with this before. I am tempted once again to revert to my usual analogy of the arsonist heckling the fire brigade, but given the constructive terms on which he has offered to work with us on this, I will pull my punches a little. I will say, however, that putting together the 1,000 extra places now, and bringing together the legislation urgently, requires significant operational detail. He is right: we have to ensure that we have enough trainers. Jim Mackey and his team have literally been working trust by trust to ensure that we can give the shadow Health Secretary, the House and resident doctors an assurance that we can facilitate those extra places.

When it comes to the legislation, the shadow Health Secretary will know, and people will appreciate, that this is fiendishly complicated. I have had to secure agreement from business managers, as we have a packed legislative programme. We have had to make sure that the Bill would be legally watertight and consistent with both domestic law and our international treaty obligations, and I have needed support from my counterparts in Wales, Scotland and Northern Ireland. I must thank them sincerely for the spirit in which, regardless of party, they have worked with this Government; we can give resident doctors that assurance.

As for what will happen if the strike goes ahead, let me say first that the shadow Health Secretary was right to say that frontline staff and NHS leaders did a superb job of managing previous rounds of strike action. In fact, during the last round we did indeed maintain 95% of planned care, and I believe—we will see when the waiting list figures are published in January—that the impact on waiting list progress will therefore not have been as severe as it might have been. However, I must be upfront with the shadow Health Secretary and the House and point out that there is a very different degree of risk this time. While we are aiming to maintain 95% of elective activity, I cannot guarantee that. I cannot give that assurance in all good conscience, given the level of pressure that we are under.

I offered to extend the mandate, so that the BMA could reschedule the same amount of strike action for January, if its members reject this offer, and I do not understand why the BMA would not do that. I find it inexplicable. As a Labour MP, I have spent a lot of time in rooms with trade unions and negotiating, and I honestly cannot think of a single other trade union in this country that would behave in this way. I am shocked by it. I am shocked because of the risk that it poses to patients and the pressure that it places on other NHS staff, and shocked because it threatens the recovery of the NHS that we all care about.

I would say this to resident doctors who are following these exchanges: listen to what the Conservative party has said about trade union laws, and about their rejection of the deal that we struck within weeks of coming into office. There is not a more pro-NHS, pro-doctor Government waiting in the wings. There is a Labour Government who are committed to the NHS, and committed to the NHS workforce, who have gone further than any other Government before on pay, on terms and conditions, and on the pace at which we are improving them. These were never grounds for strike action before, and they are certainly not grounds for strike action now. I appeal to resident doctors, over the BMA, to do the right thing, to vote for this deal, and to work with a Government who want to work with them.