NHS Performance: Darzi Investigation

Wes Streeting Excerpts

Monday 7th October 2024 Commons Chamber

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

I beg to move,

That this House has considered Lord Darzi’s independent investigation into NHS performance.

I am pleased to have the opportunity to open this debate on Lord Darzi’s investigation into the national health service, not just so that we can debate the past and what went so badly wrong, but so that the House can also debate the future of our NHS, how it needs to change and the many reasons to be optimistic about what our health service can be.

We have to start with honesty. For too long, Conservative Governments swept problems under the carpet, more interested in scapegoats than solutions. [Interruption.] I know; it is terrible. That is why I asked Lord Darzi to conduct an independent investigation into our national health service. He is an eminent cancer surgeon, with 30 years’ experience in the NHS, yet what he found shocked even him: some 100,000 toddlers and babies were left waiting for six hours in A&E last year; more than one in 10 hospital beds are taken up by patients who do not need to be there; children are less healthy today than they were a decade ago; adults are living longer but getting sicker sooner; conditions such as diabetes and high blood pressure are rising relentlessly; mortality from preventable causes is far higher than in other advanced countries; almost 3 million people are off work sick; and waiting lists are at record highs while patient satisfaction is at a record low.

The fundamental promise of the NHS—that it will be there for us when we need it—has been broken for a decade. Why? Because of four knock-out blows. First, a decade of under-investment means NHS staff are forced to use pagers and fax machines, with fewer cancer scanners than Greece and buildings literally crumbling. That is not to mention the disgrace that the previous Government’s new hospitals programme was written according to fictitious timetables, with the funding running out this coming March.

Secondly, there was Andrew Lansley’s disastrous 2012 top-down reorganisation that nobody voted for, cost billions and took years. It was an enormous waste of time, talent and money that should have been spent on caring for patients.

Thirdly, there was a failure to reform. The reforms made by the last Labour Government, which delivered the shortest waiting times and highest patient satisfaction in history, were ditched—a golden inheritance squandered.

Fourthly, there was coronavirus. Lord Darzi found that the NHS was hit harder than any other comparable healthcare system because of the damage the Tories had already done. It is not just that they did not fix the roof when the sun was shining; they doused the house in petrol, left the gas on and covid just lit the match. That is why millions are stuck on waiting lists, ambulances do not arrive on time and people cannot see their GP. Never forgive, never forget and never let the Tories do it again.

[Munira Wilson (Twickenham) (LD)]

Lord Darzi’s report was utterly damning about the treatment of children in our health system. He said that too many children were being let down, and pointed out that they account for 24% of the population, but only 11% of NHS expenditure, and that over 100,000 children wait for over a year to be assessed for mental health treatment. He said we must do better, so will the Secretary of State commit to putting children front and centre of the 10-year plan, and to making them a priority, because for a decade, the Tories let our children down?

[Wes Streeting]

I strongly agree with the hon. Member. I will talk about the 10-year plan shortly, but I can guarantee that children and paediatric care will be front and centre of that plan. We can do much more to shine a spotlight on paediatric waiting lists, as well as doing much more in practice. She mentioned children and young people’s mental health, on which our parties strongly agree. We will deliver our manifesto commitment to put mental health support in every primary and secondary school in the country, as well as providing walk-in services in every community, so that young people receive the mental health and wellbeing support that they need and do not get to the crisis point reached by far too many of our children.

The hon. Member’s intervention is an example of why I am looking forward to the debate. I hope to listen to contributions and to challenge from all sides of the House. Before I take any interventions from Conservative Members, I advise them that if they want to get a hearing on the NHS ever again, then the first word that should pass their lips is, “Sorry”. Only last week, at the Conservative party conference, we did not see a single shred of remorse or contrition for their appalling record. Indeed, when it comes to the shadow Secretary of State and her party, it seems that sorry is the hardest word.

The NHS is broken. NHS staff do not want to accept that, but it is. According to YouGov, that is what the vast majority of patients say. It is also what staff tell me every time I am on the frontline, but I understand why some people find the word difficult. In the past few weeks, I have met some of the NHS team who happened to be on duty on Monday 29 July. I have listened to paramedics describe the scene they walked into at the community centre in Southport. Children and adults who had been dancing to Taylor Swift were lying bleeding and, in some cases, tragically dying as a result of an unimaginable, senseless, mindless attack. Those paramedics had to make split-second decisions about who to treat and in what order to give the injured the best chance of survival. Security teams cleared busy hospital corridors to shield as many people as possible from the horror. Lab teams mobilised blood supplies. Receptionists fielded calls from panic-stricken patients. Surgical teams across multiple hospitals worked together, fighting to save those young lives. Even now, months later, mental health staff are picking up the pieces for families who are either grieving or going through the unimaginable challenge of supporting their children through what they witnessed.

On that day, those NHS responders—the whole team involved—were the best of humanity confronting the worst. That is who NHS staff are. That is what they do. Let me be clear: the NHS may be broken, but NHS staff did not break it. I want to be clear about this too: what is broken can be fixed. While the NHS may be in the midst of the worst crisis in its history, the biggest asset that we have is the people who work in it. They are up for the challenge, and up for change. The NHS is broken, but it is not beaten. Together with the 1.5 million people working in the health service, this Government will turn our NHS around, get it back on its feet, and make it fit for the future.

[Dr Jeevun Sandher (Loughborough) (Lab)]

Across my constituency, my constituents are struggling to see the GPs they need; indeed, we see that across the whole nation. On Friday, I visited the Park View surgery, where the GPs do not have the necessary resources and cannot move into the premises that they need to be in to treat their patients. Can the Secretary of State assure me that he will follow Lord Darzi’s recommendations and invest in primary care, so that my constituents get the GPs they need and the Park View surgery can move into the premises that it needs, with the capital expenditure that it requires?

[Wes Streeting]

I am grateful to my hon. Friend for his intervention. Of course it is not just in Loughborough that we have a challenge with access to general practice; it is right across the country. I want to be clear, because GPs come in for a lot of criticism: primary care may be broken, and the front door to the NHS may be broken, but GPs did not break it. In fact, there are fewer GPs now than there were in 2015, yet they are providing more appointments. They have worked hard to improve the productivity of general practice, but they are under-resourced. That is why we are committed, as I told the Royal College of GPs just last week, to delivering the shift that we need out of hospitals and into the community—to growing primary care, including general practice, as a proportion of the NHS’s budget, so that we have the GPs needed to treat patients on time.

[Alison Griffiths (Bognor Regis and Littlehampton) (Con)]

Saturday was World Meningitis Day, but in the last year we have seen an almost doubling of meningitis cases in the UK. Does the Secretary of State think that the meningitis vaccination take-up rate is where it should be?

[Wes Streeting]

I am grateful to the hon. Member for her question. No, I do not think that the take-up rate is where it should be. That is why in the short time we have been in office we have put more effort and energy into vaccine take-up, but there is more to do. I welcome her to the House, and will not have a go at her for the record of the people who sat on the Government Benches just before the general election.

[Jess Brown-Fuller (Chichester) (LD)]

At the end of September, a large GP federation serving patients across Sussex suddenly went bust, causing 130 redundancies; patient care was severely affected. The federation reported that the cause was a failure to obtain long-term contracts from any of its major clients, and the erosion of the real-terms value of contracts with both primary care networks and NHS Sussex. Does the Secretary of State agree that protecting continuity of service is key to public confidence in primary care, and will he meet me to discuss this case?

[Wes Streeting]

I am grateful to the hon. Member for her intervention. I wish that this was a challenge only in her constituency; it is a challenge right across the country. As I said to the Royal College of GPs last week, it will take time to rebuild general practice, so that it is back where we want it to be. We would be delighted to hear more from her; I will ensure that my Department makes contact, and that a Minister is in touch about the challenge in her constituency.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for today’s debate. The whole House, and indeed the whole of the United Kingdom of Great Britain and Northern Ireland, wishes him well in bringing forward the changes that we wish to see. An issue that comes to my attention regularly is research and development. We hear in the press every day about new advances in treating diabetes, heart disease, cancer, Alzheimer’s, dementia and rare diseases. When we look at the bigger picture of the NHS, we see the big problems, but sometimes there are smaller issues. Will he reassure us that research and development will be encouraged?

[Wes Streeting]

I strongly agree. Although health is devolved, I look forward to working constructively and closely with Governments right across the United Kingdom of Great Britain and Northern Ireland, because every part of the health system in every part of the UK is going through challenges. We are determined to do that. [Interruption.] I think the hon. Member wants to come in again.

[Jim Shannon]

National Institute for Health and Care Excellence recommendations go from here to Northern Ireland, and then we endorse them; if we do not get them from here to start with, we cannot make people better. That is the point that I was trying to make.

[Wes Streeting]

The hon. Member’s point is taken.

The NHS stands at a fork in the road. There is a choice before us, and the parties represented in the House have different opinions on the best way forward. The first option is for the NHS to continue on its current path—to head down the road to ruin, on a mismanaged decline, with a status quo so poor that patients are forced to raid their savings to go private, and with the worst yet to come, because many Opposition Members believe that all patients should have to put their hands in their pockets when they fall ill. Reform UK has openly stated that it wants to change the funding model and replace it with an insurance-based system, and plenty in the Conservative party want to head in the same direction, chasing Reform UK down the hard-right rabbit hole.

[Victoria Atkins (Louth and Horncastle) (Con)]

That is nonsense.

[Wes Streeting]

The shadow Secretary of State says that it is nonsense. She is very upset about it, so let me point out to her that earlier this year, the Conservative former dentistry Minister, who served in her team, under her leadership, proposed a monthly £10 insurance fee to see a dentist. That is what the Conservatives were planning before the election. [Interruption.] If the hon. Member wants to intervene, I will give way.

[Victoria Atkins]

I will happily intervene. That is simply incorrect. There are a couple of points that the Secretary of State has made that are completely wrong, which I will have to correct in my speech. He is no longer in opposition. He needs to be careful what he says on the record. That is not right.

--- Later in debate ---

[Wes Streeting]

Honestly, Madam Deputy Speaker, “brass neck” springs to mind. Once again, the hon. Member gets to her feet and fails to say the word “sorry”. If she wants to correct the record, how about she stands up and corrects the abysmal record that she and her predecessors lumbered this country with? They took the NHS from being the very best—that is how it was left in 2010—to being the very worst; that is how she inherited it. If she wants to talk about humility, she might like to start demonstrating some before her time in Parliament comes to an end.

If the hon. Member wants to distance herself from her former dentistry Minister, let us turn to the candidate seeking to lead her party who is head and shoulders above the rest with its membership, the right hon. Member for North West Essex (Mrs Badenoch). She wants to go even further. On whether the NHS should be free at the point of use, she told The Times last month:

“I think we need to have a serious cross-party, national conversation.”

That is what she said about whether the NHS should be free at the point of use. I suspect that she has blamed the journalist for her own words since, but just so that Government Members are clear, that will happen over my dead body. This Labour Government will always defend our NHS as a public service that is free at the point of use, so that whenever someone falls ill, they never have to worry about the bill.

The problem is not, and has never been, the fair, equitable model of funding. It is the same model that we had in 2010, when the last Labour Government delivered the shortest waiting times and highest patient satisfaction in history. A universal, single-payer health service is the fairest, most equitable way to provide healthcare. More than that, in a way that could never have been predicted in 1948 by Attlee and Bevan, it makes the NHS the best placed healthcare system in the world for the revolution taking place in genomics, technology and life sciences. The NHS has the right funding model, but it is not taking advantage of the opportunities in front of it. That is what we need to change.

[Amanda Martin (Portsmouth North) (Lab)]

Under the previous Government, poor investment and a lack of respect for NHS workers, particularly in primary care, resulted in Portsmouth North having over 3,000 patients per GP. That has resulted in over 1,800 people waiting more than a month to see a GP. Despite that, Lord Darzi notes that many of the solutions can be found in parts of the NHS in our constituencies. Will the Secretary of State acknowledge the fantastic initiative and hard work of GPs in Portsmouth North, as they work alongside trainee GPs from King’s College London, and look to push that across the country?

[Wes Streeting]

My hon. Friend is right. In Portsmouth and right across the country, there are people who, against the backdrop of the previous Government, have none the less tried to innovate, do things differently and improve services for patients. Especially given that they sent her to represent them here in Parliament, I am sure they are relieved that they now have a Labour Government on their side.

[Robin Swann (South Antrim) (UUP)]

Chapter 5 of Lord Darzi’s report is about where and how the money should be spent. I know from previous experience that there is a lot of money that can be spent in the national health service, but does the Secretary of State agree that we have to invest to save? We cannot simply move about the money that we currently have in the health service. Investment is needed to allow us to go into the greater detail that Lord Darzi talks about in respect of moving from analogue to digital and from primary care back into the community. That needs investment; it cannot be done simply with the budget that is there.

[Wes Streeting]

I strongly agree with the former Minister. I will take that as a representation for the forthcoming Budget and spending review, and ensure that his comments are sent straight to my right hon. Friends the Chancellor and the Chief Secretary to the Treasury. Without pre-empting future fiscal events, we have been clear for some time that it is investment and reform that deliver results. That is how the last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history. If people are in any doubt about what investment minus reform does, they need only look at what Darzi says about our hospitals: after 2019, lots of resource was poured in, particularly in relation to staffing, but productivity fell. It is investment and reform that deliver results, and this Labour Government will deliver both.

[Chris Curtis (Milton Keynes North) (Lab)]

One of the moments before the last general election that I will never forget was turning up at Milton Keynes hospital with my 91-year-old grandmother, who we suspected was having a heart attack, only to be told that the average waiting time at that moment was nine and a half hours. Milton Keynes has some of the longest NHS waiting lists in the country, because of the damage done by the last Tory Government. Does my right hon. Friend agree that we all deserve an apology from the Conservatives, not just for the state they left our NHS in, but for going into the election promising a new hospital for Milton Keynes even though they clearly did not have a plan to deliver it?

[Wes Streeting]

I was delighted to visit Milton Keynes hospital with my hon. Friend before the general election. It is doing incredible work in the conditions that he describes; in particular, its innovation in the application of smart, everyday, practical technology to improve patients’ experience is to be commended.

I share my hon. Friend’s anger, his constituents’ anger and the anger of people right across the country in every community—including mine, by the way, where a hospital upgrade was promised. We were told there was a plan and a timetable, and we were told that the programme was fully funded. Then we came into government to find that the timetables were a work of fiction and that the funding runs out in March. That is something else that the shadow Secretary of State should apologise for, and I look forward to hearing her apology. People across the country are owed an apology.

Let me say to every hon. Member who is in the same position that I, my hon. Friend and people across the country are in that we will not play fast and loose with the public’s trust, and we will come forward with a plan for the upgrade of hospitals that is credible, achievable and funded. That is the difference between the way that this Labour Government will behave, in terms of both public trust and public money, and the way that the previous Conservative Government behaved, which was a total disgrace.

[Andrew George (St Ives) (LD)]

On top of coming clean to the public and making a change from the way the previous Government treated the country, will the Secretary of State also assure the House that the Government will establish a proper, effective and honest workforce plan? After the years of Johnsonian bluster, when there was no effective workforce plan, the nurses who are the backbone of the NHS are still being paid £29,000 a year at grade 5. As the Royal College of Nursing says, it is about retention of staff, not just recruitment. They are leaving in droves because they cannot stand the unsafe circumstances in which they are operating.

[Wes Streeting]

The hon. Member is right to raise the issues of recruitment and retention. My message to staff who are thinking of leaving the NHS, or who perhaps have left the NHS in recent years because of working conditions and because there was no light at the end of the tunnel, is to stay—or indeed return—and help us to be the generation that takes the NHS from the worst crisis in its history, gets it back on its feet and ensures that it is fit for the future.

On the workforce plan, let me just say that it was regrettable that it was only at 5 minutes to midnight that the previous Government published such a plan. We were highly flattered by the fact that so much that underpinned that plan was Labour party policy commitments, such as doubling the number of medical school places and increasing the number of nursing and midwifery clinical training places. We are committed to those headline commitments. We will inevitably want to update the workforce plan in the light of the 10-year plan and some of the analysis that underpins Darzi. We are clear that that kind of long-term workforce planning is essential, and we are committed—

[Shockat Adam (Leicester South) (Ind)]

rose—

[Wes Streeting]

I must make some progress; I will try to take more interventions shortly.

The public are clear that they do not want the NHS to be sacrificed. They gave Labour our marching orders at the general election to rescue the NHS and turn it around, and that is what we will do. I appreciate that the shadow Health Secretary must be embarrassed by all this, not just by the state that she and her Conservative predecessors left the NHS in, but by what Conservative Members have been saying. I was going to say, “Members who are sat behind her,” but they are actually not—I think they are hiding in shame. [Interruption.] The shadow Health Secretary says from a sedentary position that we have already had this discussion. The Conservatives would rather we just moved on and forgot their abysmal record. Well, I am afraid that we are not ready to do that just yet. At least some of her Back Benchers now say what they refused to say when they were in office: that the NHS is broken. Some of them even admit that only Labour can fix it.

When the shadow Secretary of State stands up, I wonder whether she can tell us whether she agrees with the hon. Member for Mid Norfolk (George Freeman), who said:

“I applaud Wes Streeting for having the political courage. I think only Labour can really say this. The NHS is sort of their thing…I really hope that we can get behind him”.

It is not just Back Benchers. What about the shadow Foreign Secretary, the right hon. Member for Sutton Coldfield (Mr Mitchell)? He said:

“I’m very supportive of what Wes Streeting is saying… The Conservative government put a lot of money into the NHS, the record is there for all to see… I’m not one of those who is seeking to attack…the Labour Party on the NHS.”

He is going for my vote, but sadly—or gladly—I am not qualified to vote in that particular election. Perhaps the shadow Health Secretary can tell us what the shadow Foreign Secretary meant when he said we were not—[Interruption.] She is clearly enjoying this. Was the shadow Foreign Secretary speaking for the shadow Cabinet? [Interruption.] No, he was not.

Let me move to my favourite comments on the NHS from a Tory MP. This right hon. Member said:

“We were not obsessed with how we can ensure that it actually delivers the experience that patients actually deserve…Out of fear of our opponents mischaracterising our efforts, we shirked the difficult decisions…If Wes Streeting comes forward with genuine reforms I think we should back him.”

Those are the words of the candidate that the shadow Health Secretary is backing to lead her party, so does she agree with the right hon. Member for Newark (Robert Jenrick)? Will she finally apologise for her part in the Tories’ abysmal record and have the humility to admit that when it came to NHS reform their cupboard was bare, and that actually they quite agree with our efforts to clean up the mess that they left behind?

For all the agreement with our diagnosis and praise of our plans, the problem is that there is no apology. Of the four leadership candidates and eight former Health Secretaries, not a single one has apologised for the state they left the NHS in. Would the shadow Health Secretary like to correct that record today and finally say sorry? I expect that we might have to wait a long time. While the Conservatives continue the longest leadership election in history, we are getting on with the job of cleaning up their mess.

[Josh Fenton-Glynn (Calder Valley) (Lab)]

The reform that we desperately need includes the so-called “left shift” out of hospitals and into primary care. Yet under the previous Government, the amount of money spent on hospitals went from 47% to 58% of the NHS budget. According to Age UK, every day 2,000 people are admitted to hospital who could be treated elsewhere and earlier. Does my right hon. Friend agree that the only way to fix the NHS is to get more and better care in the community?

[Wes Streeting]

My hon. Friend is absolutely right, and that brings me to our reform agenda.

To deliver the Government’s reform agenda, we will have to take on both left and right-wing orthodoxies—for simplicity’s sake, we will call them The Guardian and the Daily Mail. The Daily Mail agrees on the need for health service reform, but attacks proposals for public health reform as “nanny state”. The Guardian loves prevention, but all this talk about health service reform makes it very nervous. The truth is that the Daily Mail and The Guardian are half right and half wrong. We all need to face up to the challenges of today. Our society is getting older and living longer but becoming sicker sooner. Those rising tides of demands and costs are combining to form a perfect storm that threatens to shipwreck the NHS.

[Shockat Adam]

Will the Secretary of State give way?

[Wes Streeting]

I must make progress.

The right must accept that without reform on public health, we will pay a heavy price, with higher taxes and poorer quality of life—exactly the sort of dependency culture that the right rails against. The left must accept that investment without reform of the health service would be killing the NHS with kindness, with more cash and poor results until the public give up altogether.

[Several hon. Members rose—]

[Wes Streeting]

I must make more progress.

That is the choice: public health reform or higher taxes; NHS reform or no NHS. The Tories did neither; Labour will do both. It really is reform or die, and we choose reform. That is why this month we will begin formal engagement with NHS staff and patients, who will help to write the 10-year plan for our NHS—a plan that will deliver the change and modernisation that our health service is crying out for—with three big shifts in its focus.

First, a shift from hospital to community will turn the NHS into a neighbourhood health service as much as a national health service, so that patients get more of their tests, scans and healthcare on high streets and in town centres in their own community, and from the comfort of their own home. It will ensure that patients can easily book appointments to see the GP they want to see in the manner that they choose, and it will bring back the family doctor, rebuild NHS dentistry and build a national care service.

[Shockat Adam]

Will the Secretary of State give way?

[Wes Streeting]

I must make progress. There are lots of speakers and little time.

Secondly, there will be a shift from sickness to prevention. It will mean that we take action to give our children a healthier and happier life, flattening the curve of rising pressures that threaten to overwhelm the NHS by building a healthier society, which will help to build a healthier economy.

Thirdly, there will be a shift from analogue to digital. Upgrading the NHS app will give patients real choice and control over their own healthcare, creating a single patient record owned by the patient and shared across the system so that every part of the NHS has a full picture of the patient that they are treating. Getting the NHS working hand in glove with our country’s leading scientists will put modern technology and equipment in the hands of NHS staff, and patients at the front of the queue for the latest treatments.

[Layla Moran (Oxford West and Abingdon) (LD)]

rose—

--- Later in debate ---

[Wes Streeting]

I must begin to conclude my remarks, Madam Deputy Speaker, but I see that the Chair of the Select Committee on Health and Social Care is seeking my eye. Given that I will be before her Committee soon and know where my bread is buttered, I give way.

[Layla Moran]

The Secretary of State is very kind indeed. I can take no credit for what I am about to say, which comes from reports on prevention and digital transformation published by the previous Select Committee, which he would do very well to look at. What those reports say is very much echoed in Lord Darzi’s report—particularly that the place-based narratives about embedding the NHS into our communities are key, as is reform of Government as a whole, and embedding health in every Department. Will he say a bit more about reform in Government, and not just reform in the NHS?

[Wes Streeting]

I strongly agree with the Chair of the Select Committee and commend the work of the previous Committee, to which she refers. She has certainly given me some revision for the first meeting that I will attend. To answer her question, she is absolutely right that digital transformation and place-based healthcare planning are key. This Government will have a much sharper focus on health inequalities than the previous Government did. In fact, if we consider the NHS over the past 30 or 40 years, even when it has performed well overall, and patients in every part of the country have received access to timely care, some health systems have still been more challenged than others. We need to be honest about the structural challenges in those areas. Secondly, she is absolutely right that, if we are serious about health and prevention, we need a serious cross-Government approach. That is why I am delighted that the Prime Minister’s mission-driven approach has already seen Departments coming together with a focus on prevention. That will deliver fruit.

This is the major surgery that our national health service needs over the next decade to make it fit for the future. There is no time to waste, so we have hit the ground running. We inherited a Care Quality Commission that is not fit for purpose. I was genuinely stunned to learn that one in five health and care providers has never been inspected; some hospitals have been left uninspected for a decade; and inspectors were sent to care homes when they had never met someone with dementia. The Conservatives did not think that patients would like the answers, so they stopped asking the questions. This Labour Government are different: we will be honest about the problems facing the health service, and serious about solving them. Our policy is radical candour.

Today I am delighted to announce that Sir Julian Hartley has been appointed the new chief executive of the CQC. He is a proven reformer with a track record of turning around large organisations, and I am confident that he will provide the leadership that staff in the CQC need to address this crisis, improve patient safety and restore confidence in the regulator. Sunlight is the best disinfectant, so this Government are taking action to turn the regulator around. That is the difference a Labour Government make.

We inherited the farce of newly qualified GPs facing unemployment. Patients could not get a GP appointment, while GPs could not get a job, so we cut red tape, found the funding and are recruiting an extra 1,000 GPs. That is the difference a Labour Government make. We have tabled a motion to ban junk food ads targeted at children —our first step towards making our country’s children the healthiest generation that has ever lived. That is the difference a Labour Government make. Just this week, the Secretary of State for Science and Technology and I announced funding to produce new cutting-edge cancer treatments: a new blood test that can detect 12 different cancers. We are backing Britain’s scientists to save lives. That is the difference a Labour Government make.

Of course, strikes in the NHS have cost taxpayers billions. Patients saw 1.5 million operations and appointments cancelled. The Conservatives saw strikes as an opportunity to scapegoat NHS staff, so they let the strikes rage on. In fact, the shadow Health Secretary had not even bothered to meet the junior doctors since March. This Government do not exploit problems; we solve them. I called the junior doctors on day one and met them in week one, and in just three weeks, we had negotiated a deal to end the strikes. That is the difference a Labour Government make.

Those are just our first steps. Rebuilding the NHS will not be easy and it will take time, but we have done it before and we will do it again. Along with the millions of dedicated staff in health and social care across our country, this can be the generation that takes the NHS from the worst crisis in its history to build an NHS fit for the future—an NHS that is there for us when we need it, with world-class care for the many, not just the few. That is the change that Britain voted for; that is the change we will deliver together; and that change has already begun.

[Madam Deputy Speaker (Judith Cummins)]

Before I bring in the Opposition Front Benchers, the House should be aware that over 50 Members wish to speak in the debate, so I ask you to help each other. On this occasion, I will impose a three-minute limit on Back-Bench speeches, with the exception of maiden speeches and that of the Chair of the Health and Social Care Committee. I call the shadow Secretary of State.

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[Victoria Atkins]

I will help the hon. Gentleman, because I appreciate that he is new to this place. If he had been listening carefully to me, he would have heard that I am and have always been—in fairness, I hope the Health Secretary would acknowledge this as well—very open about the fact that the NHS needs reform. In fact, I said as Secretary of State that I wanted to reform our NHS to make it faster, simpler and fairer.

By the way, I speak with personal experience. I know there are some Members on the Back Benches who are new to this place and perhaps have not quite moved on from the natural competitiveness of a general election campaign, but I was diagnosed with type 1 diabetes at the age of three. I have seen the very best of the NHS, but I have also seen some of its darkest corners. The NHS is genuinely one of the reasons why I came into politics, and one of the most damaging things about political discourse and the healthcare system in this country is when people seek to attribute to others a lack of care or commitment to our healthcare system, just because we have different ways of tackling these challenges and different solutions.

This is why—I will say this again, because I am not sure that the right hon. Gentleman is listening—I will work constructively with him to improve the health service, but we have to do this on the facts. Some of the suggestions he made in the debate today and in his discourse during the general election campaign and so on are not accurate, and this is where I will pull him up. For example, he has not mentioned the introduction of Pharmacy First or the 160 community diagnostic centres. Just to help him, those were backed by the largest central cash investment in MRI and CT scanning capacity in the history of the NHS. Those, as well as the new surgical hubs that we introduced, are not only putting healthcare into the community but, critically, helping to improve the numbers of chest checks and scans going through the system, which means speedier diagnosis.

[Wes Streeting]

The right hon. Lady mentions Pharmacy First. How many pharmacies went bust on her watch?

[Victoria Atkins]

As the right hon. Gentleman knows, because I imagine he will have got exactly the same briefing I used to get when I was in his shoes and being advised by exactly the same civil servants—and I am having to let this flow back into my memory here—the average person in England is within walking distance of their pharmacy. He will know that in many high streets in our market towns, as well as in London and other urban areas, there is a density of pharmacies. We want to support those pharmacies to ensure they are able to provide the services that they can provide, and in fairness, to enable pharmacists to work at the top of their licences. He supported Pharmacy First when I introduced it, so I am a little surprised that he appears to be casting doubt on it, but I am grateful for his intervention.

The next point is that our women’s health strategy—it does not have the attention from his ministerial team that it should have at the moment, and I hope that will improve over the coming months—is seeing the roll-out of women’s health hubs across England into every integrated care board area by the end of this year, ensuring that women’s health issues receive the attention they deserve.

Of course, there are parts of the NHS that need to change and do much better. The NHS needs to reform for the future of healthcare, and our focus must be on improving outcomes for patients, not protecting structures, bureaucracy and vested interests in the NHS. As I have said repeatedly, we will scrutinise constructively and support any meaningful efforts to reform the NHS to improve outcomes and experiences for patients, because we all want the NHS to thrive.

However, after nearly 100 days, there has not been anything yet for us to scrutinise or indeed support from this Government. [Interruption.] The Secretary of State says he has just given me a list. Interestingly, I am pretty sure that three out of those four were started under my Government. [Interruption.] I am pretty sure that I was the Secretary of State who ordered the review of the Care Quality Commission, precisely because I was so concerned. He will be able to build on that report, and quite rightly so, but he should please be careful of his facts. Disappointingly, it is the right hon. Gentleman’s fondness for parties and concerts that has made the news recently, rather than his health policies. This Government need to sober up and start taking responsibility for their choices.

--- Later in debate ---

[Victoria Atkins]

I am going to make some progress.

One of the choices facing the Health Secretary is whether he will fight for the investment required from the Treasury to implement the productivity plan. At spring Budget, the Conservatives announced more than £3.4 billion of investment to upgrade IT systems, expand services on the NHS app and make better use of artificial intelligence, in order to reduce bureaucracy for staff and free up clinical time for doctors and nurses. Alongside the long-term workforce plan—the first ever in the history of the NHS—this plan will see productivity grow by 2% a year by the end of the decade and unlock £35 billion of savings, yet the productivity plan is not mentioned anywhere in this 163-page report.

This plan was made in partnership with NHS England and funded by the Conservative Government. While the right hon. Gentleman has talked a good game on productivity, we are still waiting for him to confirm his commitment to deliver the plan that was drawn up with NHS England to help improve productivity. I asked him three weeks ago whether he was cancelling this plan, and he failed to answer. I am very happy to give way now if he wants to commit to it. The whole NHS would like to know.

[Wes Streeting]

I am delighted that the shadow Secretary of State has so generously given way. I am not going to pre-empt the Chancellor’s announcements at the Budget and the spending review, but I say to her that the reason why so many of the things she said at this Dispatch Box as Secretary of State were a pile of nonsense is that they were plans built on a pillar of sand—a £22 billion black hole for which she and her party are yet to apologise. Will she do that now?

[Victoria Atkins]

As the right hon. Gentleman knows, calculations were made in the Treasury for this economic inheritance, but the Treasury cannot even explain how it has arrived at those calculations. If I were him, I would be a little bit careful of relying on that figure, because I fear it may trip up his Chancellor in due course. Perhaps the reason why he cannot answer the question about whether he is in fact committed to the productivity plan is that his friend the former Health Secretary, who has been walking in and out of the Department for Health with all of his private healthcare businesses, has not told him whether he plans to accept it, but we will find that out in due course.

The Secretary of State’s silence continues with new medicines, technology and trials. These will be at the forefront of the reforms needed in health services across the world, let alone the NHS, yet the Darzi report mentioned NICE only once in 163 pages. Even worse, I am hearing from the life sciences sector that he and his team are refusing to meet these businesses, putting at risk the hundreds of millions of pounds of investment that the Conservative Government secured, as well as the highly skilled jobs they provide and the life-enhancing treatments they promise our constituents. It is his responsibility to persuade the Chancellor to continue supporting and investing in this innovation for the future, because patients will not thank Labour if it refuses to engage in the medical revolution with these businesses.

Another choice that the right hon. Gentleman must make—we perhaps have a precursor of what he is going to say—concerns the workforce. We know that NHS staff are at the heart of our healthcare services, and that training, retaining and developing our workforce is critical to the future of the NHS. The Conservative Government created the first ever long-term workforce plan for the NHS—again, a plan that was asked for and welcomed by the whole NHS, and developed hand in hand with NHS England to train the doctors, nurses, midwives and other healthcare staff that we need now and in the future. The plan was described by NHS England’s chief executive as

“one of the most seminal moments in our 75-year history.”

Crikey, even the right hon. Gentleman supported it. Yet this supposedly independent investigation failed to mention the plan once. Will the right hon. Gentleman confirm that this Government stand by this plan and will fund it as the Conservatives would do? [Interruption.] He says that he talked about it, but he did not give an answer, because his job is to ask the Chancellor for this funding—has he done so?

[Wes Streeting]

I did.

[Victoria Atkins]

Right, okay. We have that on the record now and we will wait to see what happens at the Budget.

It is also striking that the report mentions pay and wages only twice in 163 pages, despite the fact that staff costs account for 65% of provider operating costs a year. If the report and the Secretary of State do not acknowledge the single biggest cost pressure for providers, how can they claim to have the answers on reform? He claims to have sorted out industrial action in the NHS, and I must again correct him on something. He keeps referencing when I last had a conversation with the junior doctors committee, as it then was. What he neglects to tell us is that we entered mediation with junior doctors in May—he never thinks to mention that when he is holding forth at the Dispatch Box.

[Wes Streeting]

How did it go?