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.

Budget Resolutions

Stuart Andrew Excerpts

Tuesday 2nd December 2025 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

This Government are trying to tell the public that this Budget was all about taking tough decisions to deliver change, about raising taxes to support the NHS and about pursuing growth and backing business. Those are commendable aims, but it is simply not the reality of what was delivered in the autumn Budget. This was a Budget for benefits paid for by hard-working people.

Last year, taxes were hiked by £40 billion, borrowing went up, inflation went up, unemployment went up and living standards fell, but at least we were promised by the Chancellor that this was a one-off. She categorically said that she would not be coming back for more. But like the promises made during the general election, that was just not true. Then, as Halloween approached, we had briefing after briefing, that infamous press conference, markets affected and consumer spending depressed, particularly in the hospitality sector, all leading to one Cabinet Minister reportedly saying that

“The handling of this budget has been a disaster from start to finish.”

I wonder who that could have been.

Now we have another £26 billion in tax rises to fund more welfare, because the Prime Minister lacks the backbone to stand up to Labour MPs and make the real hard choices. At the previous Budget and spending review, big promises were made to the public about how the Labour Government would solve the challenges in the NHS through a financial settlement that they said would improve patient care, including by bringing waiting times back to the 18-week standard within five years. We warned at the time that that money would be swallowed up, in large part by decisions of the Government’s own making. The then chief financial officer of NHS England said that it would go almost entirely on pay awards, national insurance contributions and drug price increases.

What does Labour actually have to show for that? Elective care waiting lists have fallen by less than 2% since October last year. Meanwhile, waiting lists for community health services and diagnostic scans are rising. Waits to start cancer treatment are increasing. Trauma and orthopaedic waits are up; ophthalmology—up; neurosurgery—up; gynaecology—up. Winter pressures are growing, and long waits in A&E have hit record highs. The truth is that the Labour Government do not have a plan for the NHS; they have fallen into the classic Labour trap of thinking that issuing a press release about cutting waiting lists will magically make it so, just because they are in charge. I am afraid that is not how government works.

What has the Secretary of State been focused on? A top-down reorganisation of the NHS—which not only did he not tell anyone about before the election but he explicitly said he would not do. As Conservatives, we support the principle of cutting duplication, reducing bureaucracy and saving on administration costs. The House will remember that a recent Conservative Health Secretary, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), reduced in a single year the number of civil servants in the Department for Health and Social Care by around one in six.

Let us be clear: this is yet another announcement made by the Government without any plan for delivery. For months, not one Minister has been able to answer any of our questions about how much NHS restructuring will cost or who will be expected to cover redundancy packages. For months, integrated care boards have been warning that frontline patient services were at risk because they simply do not have the money to do what is asked of them. For months, staff were left in limbo, not knowing whether their job would still exist or for how much longer. We welcome the fact that the Budget finally provided some clarity, but shifting money between years means significant risk. The NHS is already behind on its efficiency targets. If this reorganisation falls short of its goals—no small risk given the Government’s performance—there is an even more significant shortfall to make up in future years, which will hit patient care.

There are other elements of the Budget that we welcome for the health service. Focusing on improving productivity is the right thing to do, but whether the extra investment will make any difference in the grand scheme of things remains to be seen. Neighbourhood health centres can be cautiously welcomed. They build on the great success of the Conservatives’ efforts to bring care closer to where people live through the community diagnostics centre programme. However, has Labour truly learned the lessons of all the private financial initiative deals that it botched back in the 2000s, which NHS trusts are still paying for decades later? Will the Government simply move resources around or will there be genuinely innovative new ways or working, joining up services and improving the patient care experience? I hope that it is the latter, because shuffling the deck chairs into new buildings will not deliver the benefits that patients deserve.

Despite those few bright spots, it simply is not right for the Prime Minister, the Chancellor and others to justify this latest tax grab by saying that it is to protect the NHS. As the NHS Confederation noted, this year’s Budget did not have a health focus. That means that we are left with a lot of unanswered questions. The Office for Budget Responsibility specifically raised two risks to health spending. The first was the doctors’ strikes, which the Health Secretary has failed to resolve, despite making that sound very easy to do when he was in opposition. I will give him credit, because he did briefly end them, for a few short months, but only by caving in to the demands of the British Medical Association, in return for no productivity or modernisation reforms. We warned him that giving in to the trade unions would only see them come back for more—and indeed, here we are, with patients and taxpayers paying the price, and no end in sight. The OBR confirmed that strikes have already cost £500 million, and warned about further strikes. Now it has been confirmed, just before Christmas—the worst time of year for it—that the doctors are out again.

[Noah Law (St Austell and Newquay) (Lab)]

Does the right hon. Member care to remind us how much the NHS strikes cost under his Government’s watch?

[Stuart Andrew]

Well, we did not spend tens of billions of pounds in pay rises just for the same old problem to come back. There should have been proper reform, and conditions for those pay rises, but the Government did not make that happen, and here we are again.

The NHS Confederation has also warned that local services cannot continue to absorb the costs of ongoing strikes by the BMA without consequences for patient care. I pay tribute to frontline staff, who have been trying to keep everything going. I remind the Secretary of State that we have the answer: ban doctors from striking, like the Army and the police, and introduce minimum service levels, using the legislation that our Government passed. That would protect patients and taxpayers, so why won’t he do it? Labour’s Employment Rights Bill will make things much worse, because it reduces the vote threshold for calling a strike, and there will be no minimal service levels.

In addition, the Government have shown that they cannot stand up to the unions. By pushing up inflation, the Budget will make it harder to reach pay settlements across the rest of the NHS workforce. Even an additional rise in NHS pay of just 1% of what the Secretary of State included in his pay review body evidence would create another £1.5 billion hole in his budget. Is he confident that he can head off wider industrial action with a 2.5% offer, especially given that benefits are rising much faster under this Government?

The OBR has also raised the unknown risk of increasing drug prices. My understanding is that the spending review assumed that spending on branded medicines would rise by 25%—or £3.3 billion—between 2025-26 and 2028-29. In winding up, will the Minister clarify what happens when the negotiated price costs more than what was assumed in the spending review? The rest of the money is surely intended to be used to deliver more care and to cut waiting lists, so are frontline services at risk?

[Wes Streeting]

I am grateful to the shadow Health Secretary for giving way. We should be clear that the deal struck with the United States is the first and only deal with the United States that secures 0% tariffs and mitigations against most-favoured-nation pricing. It will ensure that patients get access to good drugs. For the avoidance of doubt, although some costs are unpredictable because of the complexity of medicine pricing, of course we will not cut NHS budgets to fund the pharma deal.

[Stuart Andrew]

We will see what happens. It would be interesting to know exactly where the money will come from. [Interruption.] The Secretary of State just said that if the prices go up, there will be no cuts to the NHS budget, but where will the money come from? Which other part of the national health service and social care will the money come from? We will have to wait and see.

The Budget last week made no mention of social care. After all, Labour’s only plan is to delay coming up with a plan for a few more years, despite the urgency and the scale of the challenge. Many of us entered the cross-party talks in really good faith, and they were encouraging, but we have only met once. Surely we should be getting on with it. The message was loud and clear that we want to work together, but we want to get on with it. Please can we have another meeting, so that we can get on with tackling this really important issue?

It is not quite true to say that social care is unaffected by what was announced. The increase in the national living wage will be welcomed by those on the lowest incomes, but the Nuffield Trust estimates that it will cost the social care sector £1.2 billion. The sector is already struggling with last year’s national insurance contributions hike, so who will pay for this? Will there be funding cuts to other parts of the health budget? Will self-funders have to fork out yet more again, or will it be passed on to local authorities, inevitably leading to council tax rises? What impact will this national living wage increase have on wider pay in the sector?

[Jen Craft (Thurrock) (Lab)]

The right hon. Gentleman is talking about two completely opposite ends. He says his party wants to invest in and find a way forward on social care, but he is opposing something minimal that will raise the living standards of those who work in the industry. Which one is it: does he want to invest in social care or not?

[Stuart Andrew]

I am asking the question of who is going to pay for it. There is no detail in anything this Government do. They are full of plans and no delivery. The sectors I have been meeting are asking those questions—where is the money coming from?

[Sir Alec Shelbrooke (Wetherby and Easingwold) (Con)]

My right hon. Friend worked in the hospice sector, and particularly the children’s hospice sector, long before he came to this place. Does he agree that the pressures on hospices, which are basically run by charitable contributions, have not been taken into account in all the Budget measures introduced since this Government came to power?

[Stuart Andrew]

My right hon. Friend is absolutely right. Let me tell the House, from 16 years of working in the hospice movement, primarily as the head of fundraising, that if you are suddenly asked to find nearly £100,000 overnight, it is almost impossible. It is therefore not surprising that hospices up and down this country are cutting the number of beds that are available. In some instances, up to 40% of beds are being cut, and those people will end up having to be in hospital beds, putting more pressure on our hospitals as we go into winter.

[Clive Lewis (Norwich South) (Lab)]

The right hon. Member asked who will pay for the national living wage increase in the adult social care sector, but something he omitted—and it is quite telling—is the number of private equity companies that are extracting vast profit from adult social care. He did not mention them. He did not mention them taking a hit to their profit. Perhaps they could pay for some of it as well.

[Stuart Andrew]

I understood from the Secretary of State’s 10-year plan that he wants more involvement from the private sector. Perhaps the hon. Member needs to have a conversation with the Secretary of State and see how that goes. In fact, if he wants, he can invite me along, because I would be quite happy to observe that conversation.

Finally, the Budget did not mention any of the issues that matter to many of our constituents, such as mental health, the hospice and palliative care sector—although I do welcome the announcement of the framework and look forward to seeing it—dentistry and general practice. What about the Government’s upcoming plans and strategies? The workforce plan is delayed. The cancer plan is delayed. The independent review of maternity and neonatal services is delayed. Nothing new was announced, suggesting that any resources to deliver those plans will have to come from existing budgets.

What are this Government actually doing for the NHS—not just press releases and reviews, but actual action? It is more money without a plan for reform and no strategy to end the strikes or help patients and staff this winter. They cannot deliver the reforms to social care the country needs because the Prime Minister came into office without a plan and does not have the backbone to make the tough decisions. They are still too distracted with working out how to abolish NHS England to cut waiting lists.

The Secretary of State claims Labour is investing in the NHS, but that suggests we get some kind of return on our money. It is clear that Labour does not have a plan to achieve its targets. This is a Budget where taxpayers are being asked to pay for benefits, not the NHS, and the Government need to own that. Of course, we wish them well. We want them to cut waiting lists, we want care to improve, and we want patients to get better quicker, but their actions do not match their rhetoric, and their plan is little more than an objective, with no method for getting there. For the sake of all our constituents, I hope the Health Secretary can put his leadership ambitions to one side and focus on the job he has, not the next one he wants, because if he fails to deliver, this will be his last.

Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 25th November 2025 Commons Chamber

[Mr Speaker]

I call the shadow Secretary of State, the birthday boy!

[Stuart Andrew (Daventry) (Con)]

Thank you, Mr Speaker. Can I ask the Secretary of State why he has not sorted out the strikes and disputes?

[Wes Streeting]

I wish the shadow Health Secretary a very happy birthday—21 again! It is good to see him here.

We continue to hold the door open to the British Medical Association. If it wants to engage constructively, we are ready and willing. What we will not do is be held to ransom. What we cannot afford to do is pay more than we already have. What we are able and willing to do is go further to improve their career progression and job prospects, and to work with them to rebuild the NHS, which the Conservative party broke.

[Mr Speaker]

Order. I have a lot of topical questions to get through.

[Stuart Andrew]

But, Mr Speaker:

“The power to stop these strikes is in the Government’s hands.”—[Official Report, 6 February 2023; Vol. 727, c. 660.]

“They need to sit down and negotiate to end the strikes, but Ministers are too busy briefing against each other.” Those are not my words, but the Secretary of State’s words when he was standing here on the Opposition side. He said it was so simple. The Secretary of State is embroiled in a leadership battle that is taking over the need to focus on averting walkouts, and the Employment Rights Bill reduces voting thresholds on strikes and scrapping minimum service levels. Does the Secretary of State accept that things are only going to get worse as a result of the Bill? And in his words, does he agree that patients have suffered enough?

[Wes Streeting]

I was very clear in opposition about the Government’s responsibility to sit down and negotiate, and that is exactly what I have been doing. It takes two to tango. As for the other trivial nonsense the right hon. Gentleman mentions, I have been very clear that I am a faithful. Of course, if he were a gameshow, he would be “Pointless”.

--- Later in debate ---

[Wes Streeting]

If I were the hon. Gentleman, I would be more worried about the situation close to home and the SNP’s abysmal record of failure: while waiting lists are falling in Labour-led England and Labour-led Wales, in SNP-led Scotland they are rising, despite the biggest funding settlement since devolution began. It is a record that should make him and his party blush.

[Stuart Andrew]

On a point of order, Mr Speaker. I know that you have been incensed by the unprecedented briefings we have seen by the Government in the run-up to the Budget. It beggars belief that, despite your clear statements on this issue, they have done it again today by announcing that the Chancellor will announce £300 million for NHS tech in her Budget tomorrow—not through a briefing to journalists but with an article on the gov.uk website. This happened just today, after a Minister stood at the Dispatch Box yesterday and said:

“I can assure the hon. Member, given the respect that the Government pay to this House and to their obligations in it, that if there is an important policy announcement to be made, it will be made to this House.”—[Official Report, 24 November 2025; Vol. 776, c. 32.]

Given that that was clearly not the case in this instance, despite your statements, can you advise us as to what we as Members of this House can do?

[Mr Speaker]

It is frustrating for me and all Back Benchers, because everything should be heard here in the Chamber first. The Budget should be sacrosanct; it should be heard only on Budget day. What I would say is that it makes a change for Budget speculation to at least come to the Chamber, as that is quite out of the ordinary at the moment.

I thank the right hon. Member for giving notice of his point of order. As I have said on a number of occasions in recent weeks, the Government’s own ministerial code states that major announcements should be made in the House in the first instance, not in the media. We had an urgent question yesterday on this issue. The Public Administration and Constitutional Affairs Committee has been conducting an inquiry into ministerial statements and the ministerial code. I look forward to seeing its report earlier rather than later. I would also point out that the country expects the Budget to come out on Budget day. It does nothing for the City and it does nothing for how people view this Chamber if it does not. We will leave it there.

Unpaid Carers: Inequalities

Stuart Andrew Excerpts

Thursday 20th November 2025 Westminster Hall

[Stuart Andrew (Daventry) (Con)]

It is a pleasure to serve under your chairmanship this afternoon, Ms Vaz. I am pleased to respond to this important debate on behalf of the Opposition, and I thank the hon. Member for Shipley (Anna Dixon) for securing it and for her long-standing leadership on carers’ rights.

I acknowledge the contributions made by hon. Members across the House this afternoon. They have spoken very openly about their personal experiences, which helps to bring alive this debate and these issues. I am conscious that the hon. Member for Bexleyheath and Crayford (Daniel Francis) talked about how much work he has to do before he even gets to work, which reflects what so many people across the country feel. As has just been said, unpaid carers are the backbone of our care system. They provide vital support to loved ones, often around the clock and with little recognition, and at great personal cost. This debate is therefore not just timely, but probably overdue.

Before entering Parliament, I spent over 15 years working mainly in palliative care, and much of that in children’s hospices—lastly at Martin House children’s hospice up in Yorkshire. I saw the extraordinary compassion, amazing resilience and sacrifice from unpaid carers every single day, whether from parents caring for their terminally ill children, many of whom had very complex needs, or relatives supporting someone at the end of their life—people managing both care and grief at the same time. I will always remember one parent saying they would consider it a good night’s sleep if they got up only eight times in the night to help their daughter, which gives an indication of how much work they do. As the hon. Member for Shipley said, so many carers end up giving up work because they have to provide that care. Sadly, so many relationships break down because of the pressures.

I now find myself having to care for my elderly father. I had to move him into my home, and I am now seeing at first hand the things people have to do. When I am here, I always worry, “Is he okay? Is there enough food and milk in the fridge?” I also watch every single move he makes. I once turned my back, for literally a minute, and he fell flat on his face. I realise that it was not my fault, but I cannot help but have those feelings of guilt.

I also pay tribute to the hon. Member for North East Fife (Wendy Chamberlain) for her amazing work on the Carer’s Leave Act. That really is important, and the cross-party support for it showed Parliament at its best. It is great that carer’s leave is now a day one right and that it can be taken flexibly, because that is what unpaid carers need. They need to be able to take that half-day, or full day, if they need it because, as we have heard, one in seven are juggling work and caring responsibilities. I thank the hon. Lady and my hon. Friend the Member for Gosport (Dame Caroline Dinenage), who I know would like to have been here today—she gave quite a bit of support during the Act’s passage—for encouraging the previous Government.

[Wendy Chamberlain]

I thank the right hon. Gentleman for his kind comments. Passing a private Member’s Bill is obviously more straightforward with Government support, which I had, so I am grateful to him and his colleagues.

[Stuart Andrew]

It just shows how, when Parliament works well, it works exceptionally well.

I want to repeat some of the comments that have been made. The Government have launched a review of the potential benefits of paid carer’s leave, with the conclusions coming at the end of the year, I believe. As others have said, that is welcome, but I am sure that carers would hope that there will be clarity and no delays.

I look forward to hearing the Minister’s response to some of the issues that have been raised in this debate, and to hearing whether the Government are genuinely open to acting on the review’s findings. A fair point has been made about the length of time that people have to contribute to that consultation, given the responsibilities that they have. We must ensure that the consultation is accessible. I was a critic of this when we were in government, but doing just online consultations means that those who are not digitally savvy can be excluded. It is important we make sure that is not happening.

As other hon. Members have said, the financial pressures on carers remain severe, with one in four unpaid carers living in poverty. The employment rate among carers is just 50%, compared with 75% across the general population, but with the right support an estimated half a million carers could return to work. That would not only strengthen their security but contribute to the economy, which is what we all want to see.

In fairness, it is not just the Government who have to act; there is a responsibility on employers, too. I saw in the hospices that some businesses took on our young adults despite their life-limiting conditions. The employers told us that what they got from those individuals was utterly amazing, and that they were really dedicated to their work.

The recent increase to the carer’s allowance earnings limit is a step in the right direction, for which I thank the Government. However, the Carers Trust has rightly called for a full review of carer’s allowance and the wider support system. I am keen to hear whether that is something the Government are considering.

I am also concerned that the level of respite support has been falling, and has dropped by 6% in local authorities in the last year alone. I am concerned about, and pay tribute to, the charities that offer so much respite support. I know, from my consultations with charities, that the rise in national insurance contributions has had an impact, and that they have had to reduce and scale back their staffing. That is a concern, and I hope we recognise the size of their contribution.

At the hospices at which I worked, it was not just about end-of-life care. Some of the most important care they provided was respite stays. Either the child came on their own so that the family might go on holiday, or the whole family came together, which gave them the opportunity to be a family again. The child who needed care was being looked after by the care team, which meant the parents could be parents again to the siblings, who often miss out in such situations.

[Jonathan Davies]

The shadow Minister is making a very powerful speech. He raises the issue of national insurance, and I know that change was very difficult in the last Budget, but it was to get over £20 billion into the NHS, which I hope will improve respite care. We saw huge cuts to local authorities under the last Government, and we are paying for that in different ways, including in Derbyshire. I hope we will be able to move beyond the national insurance thing and get better public services. Hopefully, we will even be able to reduce national insurance in the future, but it is right to contextualise that in the circumstances in which we find ourselves.

[Stuart Andrew]

This has been a really good debate so far, and I do not want to get into party politics, but the rise in national insurance contributions is having an impact on charities—it really is. The cost is about £1.4 billion. Charities have been a cornerstone of respite provision, and without them we would not have as many respite places as we need.

The other point I want to make is about the social care review. I went to those cross-party talks, and I was encouraged by the first meeting—it felt like all of us, representing our political parties, wanted the talks to succeed—but it is disappointing that we have not had another meeting since. I am concerned. Baroness Casey is an exceptional person. She has a huge amount to contribute, and she certainly left me with the impression that she is absolutely determined to find solutions to some of the issues in social care, but I am anxious that she has responsibilities for other issues, all of great enormity.

I hope the Minister can update us on when we might have another meeting. As the hon. Member for North Herefordshire (Dr Chowns) said, we do not have to be invited by Baroness Casey; we can be invited by the Secretary of State. I know that Baroness Casey is doing an enormous amount of work on this issue, but it is important that, politically, we try to find where we can agree. If we can introduce things earlier, that would be to the benefit of everybody in the country who needs care.

I say that because I want to be constructive in opposition. I recognise that some of these things are not easy to deliver. They are difficult issues, but they demand more than our sympathy—they demand action. I do not claim that we got everything right in government, but I am clear that carers need to know that we are all listening and are keen to respond and deliver when we can. Unpaid carers do not seek praise; they just want systems that they can rely on, policies that reflect their worth and services that offer real support.

Finally, this is not about just one Department—it is not just the Department of Health and Social Care. There are many other Departments. Having been a Minister, I know the structure of Government means that working cross-departmentally can sometimes be a challenge. Can the Minister update us on how that is going? I know it is a challenge, and I wish him well in any cross-departmental work that is happening.

Unpaid carers deserve fairness, support and action. I finish by saying to every single one of them: thank you for the amazing contribution you make every day, looking after others and being the backbone I mentioned at the beginning.

Draft Health and Care Act 2022 (Consequential Amendments) Regulations 2025

Stuart Andrew Excerpts

Wednesday 19th November 2025 General Committees

[Stuart Andrew (Daventry) (Con)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I am sure it will delight the Committee to know that I do not intend to detain us for too long. [Interruption.] I always get a cheer when I say that. I would like to begin by saying that I do not see anything particularly contentious in this. The Minister rightly points out that these are technical changes that bring the Down Syndrome Act into line with the reforms introduced by the Health and Care Act 2022, in particular the replacement of CCGs with ICBs and the renaming of the NHS Commissioning Board as NHS England.

However, it is worth questioning the Government on the longer-term stability of these changes. As hon. Members will know, the Government have stated their intention to abolish NHS England by April 2027. That process has already been delayed, reportedly due to uncertainty over who will meet the redundancy costs for staff within those organisations. If that abolishment proceeds, a new health Bill will be required. At present, we do not know when that Bill will be brought forward or what it will contain. It is therefore entirely possible that the statutory references being updated today will need to be amended again in the near future.

I also note that there is no statutory review clause in this instrument. While that may be understandable given the technical nature of the changes, it adds to concerns that further legislative changes may not be properly anticipated or subject to adequate scrutiny in good time.

While I support these draft regulations, I urge the Minister to clarify what transitional arrangements are being considered for the functions currently held by NHS England and the integrated care boards. That is especially important, as he rightly pointed out, for the consistency of support that we all want to see in the context of the Down Syndrome Act. We must ensure that people with Down’s syndrome are not adversely affected by any ongoing organisational changes within the health system. The Minister mentioned some of the updates to the Down Syndrome Act. Perhaps he could update us further on any other actions that are ongoing. How many still need to be done?

In addition, I note that the Act seems to require the Secretary of State to publish guidance, on which the Government have just launched a consultation. One of the criticisms of the Act at the time was that it is specific to Down’s syndrome. Although I obviously welcome that focus, others face similar disabilities and challenges. How might the Government support them?

Finally, it looks like people can respond to the guidance only online. Can the Minister assure the Committee that he is confident that those who are digitally excluded will not be prevented from taking part in this important consultation?

Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 21st October 2025 Commons Chamber

[Mr Speaker]

I call the shadow Secretary of State.

[Stuart Andrew (Daventry) (Con)]

First, it is great to be in this new role. I genuinely want to be part of a constructive Opposition, but equally I want to do my role in holding this Government to account. I note the lack of detail in the Secretary of State’s answers on reorganisation, so can I ask the basics again? How many people will be made redundant, what will it cost and who is paying?

[Wes Streeting]

I welcome the shadow Secretary of State to his place. It is good to hear from the Conservative Front Benchers; I had almost forgotten they existed. The Conservatives created a complex web of bureaucracy. It is a bit rich to complain we are not abolishing their creation quickly enough. We have had a number of expressions of interest in voluntary redundancy across my Department, NHS England and the integrated care boards, and we are working through that as we speak.

[Stuart Andrew]

Again, the Secretary of State cannot answer. His answers are too vague. He is very good at making promises, but the facts are that he is presiding over a reorganisation that has stalled, creating uncertainty for staff. Waiting lists are up 50,000 in the past three months, hospices are in crisis because of national insurance contribution rises, and we have had strikes again—despite big pay rises—with the threat of more. If the Secretary of State wants the leadership in the future, perhaps he should show leadership in the NHS now, and tell us not just the plans, but when he will give the details and how he will deliver on his promises to patients.

[Wes Streeting]

Waiting lists are lower now than when Labour took office, and that is in stark contrast with the record of the Government in which the shadow Secretary of State served; waiting lists increased every single year they were in charge. This is the first year in 15 that waiting lists have fallen. That is the difference that a Labour Government make. We are only just getting started. As for leadership changes, we all know why they are calling the Leader of the Opposition “Kemi-Kaze”.

Points of Order

Stuart Andrew Excerpts

Tuesday 21st October 2025 Commons Chamber

[Mr Speaker]

First of all, you cannot continue the debate, but you have certainly put that on the record.

[Stuart Andrew (Daventry) (Con)]

On a point of order, Mr Speaker. Before beginning my questions, I meant to pay tribute to our former colleague Oliver Colvile, who sadly passed away last night. He served as the Member for Plymouth Sutton and Devonport between 2010 and 2017 and was named by Conservative Home as one of a minority of Conservative MPs not to have voted against the Government, which, as a previous Whip, I thought was exceptional. He was a true gentleman whose eccentricities endeared him to many. I am sure the thoughts of the whole House are with his family.

[Mr Speaker]

We all remember Oliver Colvile very fondly. He really was a good MP and a nice kind of guy to meet. I knew Oliver way before he came to this House. We are all saddened to hear the news.

Mental Health Bill [Lords]

Stuart Andrew Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

I want first to recognise and thank everyone for the constructive debates we have heard here and in the other place throughout the Bill’s passage. In particular, I thank the shadow Minister, my hon. Friend the Member for Hinckley and Bosworth (Dr Evans), for everything he has done on the Bill, especially in Committee. I pay tribute to my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) for his expertise, whose involvement with the Bill began before he was elected to this place. I also pay tribute to my right hon. Friend the Member for Salisbury (John Glen) and my hon. Friend the Member for Farnham and Bordon (Gregory Stafford) for their thoughtful contributions.

This is clearly an important and emotive issue, and the respect and sensitivity that have been shown by all sides is a testament to this House. Since the election, we have said that we would not oppose for the sake of opposition. While we have rightly asked tough questions of the Government, we have done so with the best interests of patients at heart, because everybody here wants to help and support vulnerable people better—those patients with the most severe and complex mental health needs. This Bill, which started under the previous Government—I pay tribute to former Prime Minister Baroness May for that—and continued under this Government, will achieve that. We welcome efforts to improve the patient’s voice and involvement in their own care, to ensure that patients receive effective and appropriate treatments, to minimise restrictions on liberty so far as is consistent with patient and public safety, and to treat patients with dignity and respect.

Although we are disappointed that opportunities to strengthen the Bill further have been missed, especially in public safety and the protection of vulnerable children, we listened closely to what the Minister said and to his assurances on action, for which we thank him. We will of course continue to push on these matters, not on party political grounds, but because doing so is the right thing for patients.

We are very disappointed that the proportion of health spending on mental health has been reduced. We welcome the Government’s continuation of our work looking again at how we treat and protect people with the most severe mental health illnesses, so that we can improve the safety, treatment and dignity of patients and the wider public, and ensure that our laws remain relevant and proportionate in the modern world. The Government must now turn their words into action and deliver on the commitments that they have made.

I thank everybody again for the constructive way in which they have dealt with the Bill. We are pleased to support its Third Reading. We hope that it will bring improvements for those we all care about: the patients.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.