NHS: Winter Preparedness

Debate between Stuart Andrew and Wes Streeting

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

Debate between Stuart Andrew and Wes Streeting

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

Debate between Stuart Andrew and Wes Streeting

Tuesday 2nd December 2025 Commons Chamber

[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?

Oral Answers to Questions

Debate between Stuart Andrew and Wes Streeting

Tuesday 25th November 2025 Commons Chamber

[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?

Oral Answers to Questions

Debate between Stuart Andrew and Wes Streeting

Tuesday 21st October 2025 Commons Chamber

[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”.