Oral Answers to Questions

Wes Streeting Excerpts

Tuesday 19th November 2024 Commons Chamber

[Sam Carling (North West Cambridgeshire) (Lab)]

21. What assessment his Department has made of the adequacy of patient access to primary care services.

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

Mr Speaker, I associate myself with your remarks about the war in Ukraine. I know the whole House stands with Ukraine as it defends its freedom and democracy. This is precisely why the Prime Minister’s leadership at the G20, and in other international fora, is vital in standing up not just for our national interests but for our values across the world.

Over the past decade, the Conservatives’ mismanagement has left the NHS with 1,400 fewer full-time equivalent GPs than in 2015, hundreds of practice closures, the loss of over 1,000 community pharmacies, and NHS dentistry a distant memory, which is why this Government took immediate action to employ 1,000 more GPs. Through the additional roles reimbursement scheme, through the Chancellor’s Budget measures and through our 10-year plan, we will shift the focus of healthcare out of hospitals and into the community.

[Josh Simons]

In my Makerfield constituency, Wigan council and my local NHS trust are working closely together to pioneer a health system focused on prevention and delivered through neighbourhood health centres, but they need help. What is the Secretary of State doing to improve access to primary care, especially data-driven preventive care, through neighbourhood health centres?

[Wes Streeting]

I agree with my hon. Friend on the importance of prevention at a local level. We are trialling neighbourhood health centres across the country to bring together a range of services, ensuring that healthcare is closer to home and that patients receive the care they deserve. This is part of our broader ambition to move towards a neighbourhood health service, with care delivered close to home. I would be delighted to meet my hon. Friend to hear more about what is going well in his community and what further action we need to take.

[Chris Vince]

Does the Secretary of State agree that access to primary care is hugely important to supporting accident and emergency departments at hospitals like the Princess Alexandra in Harlow? Does he also agree that access to primary care is about not just GPs but dentists? Finally, what are the Government’s plans to support dental surgeries such as the aptly named Harlow dental surgery, which I visited last week?

[Wes Streeting]

My hon. Friend is right that many of the pressures on our hospitals, such as the Princess Alexandra in Harlow, are a result of pressures in other parts of the health and social care system. It is outrageous that the biggest reason for five to nine-year-olds presenting to hospital is tooth decay, which is why we need to get NHS dentistry back on its feet, along with the rest of the NHS.

My hon. Friend the Minister for Care and I have regularly met the British Dental Association since the general election to consider how the dental contract can be reformed to retain dentists and rebuild NHS dental services.

[Sam Carling]

In my local area of Cambridgeshire and Peterborough, GPs are reporting feeling increasingly burnt out, with working conditions becoming more extreme. The number of patients per fully qualified GP in my area has increased by nearly 400 since December 2016, a higher increase than the national average. Can the Secretary of State tell me what his Department is doing to make the situation more sustainable while improving access to primary care?

[Wes Streeting]

General practice is a valued part of the NHS, and GPs are a vital part of our NHS family. In fact, they are delivering more appointments than ever before, and we recognise the significant pressures they face. At the same time, we know that patients are struggling to see their GP, which is why we have invested an additional £82 million into the ARRS to recruit 1,000 more newly qualified GPs this year. This will take pressure off general practice, and we will be announcing further budget allocations in the not-too-distant future to set out what further support we will provide for general practice.

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

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

Last week, I visited Summertown health centre. Staff there implored me to say to the Government that the issue is not just more money—we welcome the £100 million that has been allocated for capital investment in primary care—but the snarled-up process at integrated care board level and getting investment to the right places quickly. What will the Secretary of State’s Government do to ensure ICBs deliver that money to where it is needed, and fast?

[Wes Streeting]

The Chair of the Health and Social Care Committee is right that investment is vital, but so is reform. We tasked ICBs with leading the development of the new neighbourhood health service. We are removing their responsibility for performance management of trusts in order to free up their focus, so that primary and community services have the attention that is desperately needed. In the coming weeks, we will be talking to the British Medical Association and the Royal College of General Practitioners about how we ensure the investment announced by the Chancellor leads to improved patient care and a reformed neighbourhood health service.

[Lewis Cocking (Broxbourne) (Con)]

Goff’s Oak, in my constituency of Broxbourne, has seen a lot of development. What steps is the Secretary of State taking to ensure that GP surgeries are delivered before hundreds of new homes are built?

[Wes Streeting]

Of course we need to deliver both new homes and GP surgeries, but the previous Conservative Government delivered neither. We have a housing crisis and an NHS crisis in this country; I would have thought Conservative Members might have shown some humility and responsibility for those facts before challenging a Government who have been in office for only four months.

[Andrew George (St Ives) (LD)]

In Cornwall, only 25% of delayed discharges from hospital are because of lack of social care packages, with the remainder involving the significant degree of support needed from primary and community NHS services. The Royal College of Nursing has pointed out that there has been a 45% reduction in district nurses in the last decade, so what can the Government do to replace those essential roles at a primary care level?

[Wes Streeting]

The hon. Gentleman is right. Last weekend, I was up in Middlesbrough with local Members, where we saw a great example of hospital at home delivered by the community nursing team and the community health trust. We have to do a lot more in that space to ensure we provide care closer to peoples’ homes—indeed, often in the home—keeping them out of hospital and close to home, which is better for them and better value for the taxpayer.

[Mr Speaker]

I call the shadow Minister.

[Wes Streeting]

I can reassure health and care providers that we will be setting out allocations long before April next year. I recognise that people need to plan ahead of the new financial year. When deciding allocations, we take into account the range of pressures on different parts of the system. People have heard what I have said already about the need to shift out of hospital into primary and community services. The shadow Minister talks about choices; Conservative Members seem to welcome the £26 billion investment, but oppose the means of raising it. I am afraid they cannot do both. If they support the investment, they need to support the way in which we raise the money; if they do not support the way in which we raise the money, they need to spell out how they would raise it or be honest about the fact that if they were still in government, they would continue to preside over a mismanaged decline.

[Dr Evans]

One GP described the situation as “Schrödinger’s primary care”: GPs are seen as private contractors, so not exempt from the NI increases, but they are exempt from the small business relief because they are deemed to be “public”. Did the Department of Health team knowingly go along with the Treasury team’s plan to tax primary care without mitigation, leading to cuts? Or did it not understand or spot the complexity of what is going on, so mitigations have to be put in place now? Which is it?

[Wes Streeting]

I was terribly impolite; I should have welcomed the shadow Minister to his place in response to his first question.

Conservative Members seem to welcome the £26 billion investment and are happy to tell us how it should be spent, but they oppose the means of raising it. They cannot do all those things. They need to be honest with the country: either they support the investment in the NHS or they say they would cut it. Which is it?

[Tessa Munt (Wells and Mendip Hills) (LD)]

2. What recent assessment he has made of the adequacy of the condition of NHS hospital equipment.

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[Wendy Chamberlain (North East Fife) (LD)]

5. What recent assessment he has made of the potential impact of proposed changes to employer national insurance contributions on staffing costs for health and care providers.

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

The leadership shown by the Chancellor has enabled her and the Government to fix the foundations of the public finances and fill the £22 billion black hole left by the previous Government. The decisions that she took meant that she was able to provide this Department with an extra £26 billion and a real-terms increase in core local government spending power by about 3.2%. That was the right decision for the right reasons in the national interest, and I am taking into consideration pressures on all parts of health and social care before making final allocations for the year ahead.

[Wendy Chamberlain]

In North East Fife, we have a particular issue with access to dental surgeries, especially with the recent closure of a surgery in Leven. Difficulties stem from recruitment from abroad as a result of visa changes and also simply from practices going private and coming out of the system. Obviously, the NHS is devolved in Scotland, but does the Secretary of State agree that putting staffing under further strain from increasing national insurance contributions will only make things worse for dentists? What in his conversations is he doing to ensure that dentists get the support that they need?

[Wes Streeting]

It is because the Chancellor took the decisions that she did in the Budget that my Department has received £26 billion to reform and improve health and social care. As I said before the general election, all parts of the United Kingdom suffered under the previous Conservative Government, which is why I am sure that Members from across Scotland will welcome the extra £1.5 billion this year and £3.4 billion next year—the biggest funding increase since devolution. I am sure that the SNP Government will welcome the increase, and they certainly have no excuses now for not acting.

[Rachael Maskell (York Central) (Lab/Co-op)]

Fourteen years of neglect have left hospices in a perilous condition. They are dealing with the rise in national insurance contributions, pay and other cost pressures, so I welcome the fact that the Secretary of State is putting in place measures to ensure that the funding recovers. Will he assure me that integrated care boards not only will pass on that recovery from the increased costs to hospices, but will help them catch up from the Tory years of neglect of the whole sector?

[Wes Streeting]

I am grateful to my hon. Friend for her question. I am looking carefully at the pressures on hospices. In fact, only last Friday I visited Saint Francis hospice, which serves my constituents and people right across east London and west and south Essex. I saw at first hand the brilliant work it is doing on end of life care, but also the pressures it is under, and I am taking those pressures into account before deciding allocations for the year ahead.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I have tried repeatedly through written parliamentary questions to get an answer to this without success, so I will try asking it face to face: will the Secretary of State tell the House how much his Chancellor’s changes to national insurance contributions will cost the NHS?

[Wes Streeting]

The hon. Member talks about the employer national insurance contributions as if they were a burden on the NHS. It is thanks to the decisions taken by the Chancellor that we can invest £26 billion in health and social care. The Conservatives welcome the investment but oppose the means of raising it. Do they support the investment or not? They cannot duck the question; they have to answer.

[Dr Johnson]

The right hon. Member speaks of ducking questions, but it is worrying that three weeks after the Budget he still does not know, or will not tell the House, how much it will cost the NHS. Of course, changes to national insurance contributions affect not just the NHS directly, but suppliers, contractors, charities and other NHS care providers. I know you are a great supporter of your local air ambulance service, Mr Speaker, as I am of the Lincs & Notts air ambulance, which now needs to raise £70,000 extra just to fund this Government’s ill-advised changes to NICs. That £70,000 is a lot of cakes to sell, cars to wash and fun runs to complete, and that is just one example of pressures placed on lifesaving services right across the country. Will the Minister confirm that he will meet the Chancellor, explain the disastrous effects of the policy and insist that she reverses it?

[Wes Streeting]

Again, we have not yet announced how we are allocating the budget for the year ahead, but I remind the Conservatives that it is thanks to the choices the Chancellor made in her Budget that she is able to invest £26 billion in health and social care. Would they cut the £26 billion this Labour Government are investing in the NHS? If not, how would they pay for it? Welcome to opposition.

[Mr Speaker]

We come to the Liberal Democrat spokesperson.

[Wes Streeting]

I am grateful to the Liberal Democrat spokesperson for her question. I pay tribute to the children’s hospice in her constituency and, indeed, to Haven House children’s hospice, which serves my constituency.

[Mr Speaker]

And Derian House children’s hospice.

[Wes Streeting]

And indeed your very own local hospice, Mr Speaker—I am sure that will appear on the record. I am particularly thankful for the advocacy we have received from Hospice UK and charities such as Together for Short Lives and others that are making their voices heard about the pressures on the system. I say to all hospices across the country that I am taking those pressures into account before deciding allocations for the year ahead, because I want to ensure that everyone, whatever their age, receives access to the timely and good-quality end of life care, palliative care and, of course, support for people with life-limiting conditions that all of them deserve.

[Antonia Bance (Tipton and Wednesbury) (Lab)]

6. What discussions he has had with Cabinet colleagues on staff salaries in the care sector.

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[Kevin Bonavia (Stevenage) (Lab)]

22. What plans he has to reform NHS health and social care services.

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

Before the election, we made it clear that investment and reform were needed in the NHS. The Chancellor announced the investment in the Budget, and since the general election we have confirmed the introduction of new league tables of NHS providers, with high-performing providers being given greater freedom over funding and flexibility. We are sending turnaround teams into struggling hospitals, giving the best performers greater freedoms over funding to modernise technology and equipment. We are creating a new college of executive and clinical leadership that will help to attract, keep and support the best NHS leaders. We are banning NHS trusts from using agencies to hire temporary entry-level workers in bands 2 and 3, such as healthcare assistants and domestic support workers. We are sending crack teams of top clinicians to areas with long waiting lists and high economic inactivity to improve the productivity of their clinics, and we are running a GP red tape challenge to slash bureaucracy. I could go on, because this is a Government who are walking the talk on NHS reform.

[Mr Speaker]

I think you already have, but there we are.

[Wes Streeting]

I would be delighted to meet my hon. Friend and other Members from across Medway to discuss the challenges that their part of the south-east faces, and to explain why our predecessors made promises they could not keep, with timetables that were completely fictitious and funding that runs out in March. I am really sorry for the way that communities were let down by the previous Government. This Government will not make the same mistakes.

[Kevin Bonavia]

I am grateful to my right hon. Friend for his earlier answer. Last week, I spoke to one of my constituents, Norman Phillips, who has been an unpaid carer for his wife Ros for the past 18 years. Like many unpaid carers across Stevenage, Norman has been put through absolute hell by the previous Tory Government’s complete inaction on social care for over 14 years. Does the Secretary of State agree that unpaid carers such as Norman play a vital role in providing care, and that unpaid carers need to be at the heart of any reforms to the social care system—reforms that are much needed?

[Wes Streeting]

I, too, pay tribute to Norman and to family carers like him, who play such a vital role supporting loved ones. Through the carer’s allowance uplift in the Budget, the Chancellor announced the largest increase to the weekly earnings limit since the introduction of carer’s allowance in 1976. As well as that investment, we will have a 10-year plan for social care, and I see the care workforce, care providers and family carers as all being important partners in building that plan.

[Jeremy Hunt (Godalming and Ash) (Con)]

I welcome the Secretary of State’s plans to reform the NHS, but may I caution against the idea that the answer is to fire more incompetent managers? The problem is not bad management: it is micromanagement from the centre that sees hospitals managed with more than 100 targets by NHS England, making ours one of the most micromanaged healthcare systems in the world. Will the Secretary of State’s plans allow managers more autonomy, helping them to innovate, save money and improve care for patients?

[Wes Streeting]

I am happy to confirm that it is my view that, when there are too many targets and everything is being measured, nothing ends up being measured. We need to give more freedom and autonomy to good leaders, including clinical leaders and managers in the NHS who are coming up with some of the best productivity gains in the system. That is why we have announced new support for, and investment in, the college of leadership for both clinical and executive leaders in the NHS. I would be delighted to meet the right hon. Gentleman to discuss those issues. He was a great Chair of the Health and Social Care Select Committee, but back in July, we saw a great example of how we can improve things by sacking bad managers.

[Bob Blackman (Harrow East) (Con)]

One of the lessons from the pandemic is the importance of NHS communications. Last week, I joined victims of the sodium valproate scandal to hand in a petition. They tried to download from the website the Medicines and Healthcare products Regulatory Agency’s yellow card adverse drug reactions literature, but were unable to do so. Will the Secretary of State look at this as a matter of urgency? People need to be warned about the risks of taking certain drugs.

[Wes Streeting]

As the hon. Gentleman knows, I am a great champion of patient power, and a key part of giving patients more power and control over their healthcare is better access to information. That is why, as well as improvements to the NHS app—which will provide far easier interaction with the NHS for patients—I am working with my right hon. Friend the Secretary of State for Science, Innovation and Technology to make sure all the information held by Government is more accessible for our citizens, particularly where that includes vital safety information and guidance, as the hon. Gentleman has mentioned.

[Pamela Nash (Motherwell, Wishaw and Carluke) (Lab)]

10. What assessment his Department has made of the potential impact of the autumn Budget 2024 on health and care services.

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

Thanks to the decisions that the Chancellor took in the Budget, we are able to provide an additional £26 billion to give the NHS the funding it needs. This will support the NHS in England, enabling it to deliver an extra 40,000 appointments a week to cut waiting lists. Of course, for my hon. Friend and her constituents, the Budget has given Scotland the biggest real-terms increase in funding through the Barnett formula since devolution began. I hope the Scottish Government will use that investment to deliver improved services for the Scottish people.

[Pamela Nash]

The Labour party is the party of the NHS, and the significant additional investment announced in the recent Budget has reaffirmed that. The Secretary of State has made it very clear in this question session that the benefits of that additional funding must be felt across the UK. Will he join me in urging the Scottish Government to ensure that that funding reaches the frontline and creates the badly needed additional appointments in GP, dental and hospital services that my constituents and people across Scotland badly need?

[Wes Streeting]

I am grateful to my hon. Friend for her question. It is thanks to the people of Scotland sending 37 Labour Members of Parliament here at the last election—not only have they shown that they value the NHS and are demanding change, but they voted for change—that we are now delivering that change through the Budget. I say to Scottish Government Ministers that, as they know, I said before the election that all roads lead to Westminster and that we all suffered under the Conservative Government, but this year that road is carrying an extra £1.5 billion to the Scottish Government and next year it will carry an extra £3.4 billion to the Scottish Government, so they have no excuse not to act.

[Saqib Bhatti (Meriden and Solihull East) (Con)]

Approximately 220,000 people currently reside in the Solihull borough, and if Government planning reforms go through, the number will increase significantly. My hon. Friend the Member for Solihull West and Shirley (Dr Shastri-Hurst) and I have written to the Health Secretary about the need for infrastructure and A&E services at Solihull hospital. Will he agree to meet us to see how we can make this Budget work for the people of Solihull?

[Wes Streeting]

I know, not least because of the mismanagement of the NHS during the last 14 years, that communities right across the country, including the hon. Gentleman’s constituents in Solihull, are struggling with poor services and crumbling estates. We would be happy to receive representations from him, but he has to level with his constituents. If he wants money to be spent in his community, he must support the investment and be honest about the fact that he supports the means of raising it. If he does not support the means of raising it, he should tell us where that investment would come from.

[Mr Speaker]

We have been very slow to get to topicals, so let us see if we can speed it up. Dan Tomlinson will set a good example.

[Dan Tomlinson (Chipping Barnet) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

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

This weekend, we launched the first in-person consultation as part of change.nhs.uk, the biggest national conversation about the future of the NHS we have ever seen. We know that the Leader of the Opposition wants a conversation about whether the NHS is free at the point of use, and I can tell her, from that first conversation, that no one agreed with her.

[Dan Tomlinson]

Earlier this month, I visited Barnet hospital to see the way in which it is changing the emergency care department so that more patients can be seen more quickly, freeing up capacity in accident and emergency. What steps are the Government taking to ensure that trusts such as the Royal Free and others across the country get the support they need, through investment and reform, to improve patient care?

[Wes Streeting]

I am grateful to my hon. Friend for his question. The Royal Free hospital saved my life when I went through kidney cancer, so it holds a special place in my heart. Thanks to the Chancellor’s decision and the investment she put into the NHS at the Budget, and the reform my Department is delivering, we will deliver the change and improvement that his constituents and mine, and the rest of the country, deserve.

[Mr Speaker]

I call the shadow Secretary of State.

[Wes Streeting]

It is thanks to this Government and the action we have taken that, for the first time in three years, we go into winter without the spectre of national strikes looming over the NHS, and with NHS staff on the frontline not the picket line. It is thanks to the priority this Government have given to prevention that we have already delivered almost 15 million covid-19 and flu vaccinations, alongside the new RSV—respiratory syncytial virus—vaccination to help vulnerable groups for the first time. The shadow Secretary of State mentions the winter fuel allowance. This Government are protecting support for the poorest pensioners to protect them not just this winter, but every winter, and over the coming years the value of the pension will of course rise with the cost of living.

[Edward Argar]

I am grateful for that response but, just as my hon. Friends have highlighted in respect of the damaging impact of increases in employer national insurance contributions on GPs, hospices and care providers, I fear it was another example of the Government simply not answering the question and not having a plan yet. Either the Government have not done their homework and, as with the impact of NICs increases, they have not thought this through and do not know, or worse, they do not care—which is it?

[Wes Streeting]

This Government are prepared for winter and we are already standing up the operational response to winter pressures. On funding, the right hon. Gentleman was in government just before the general election. Is he saying that his Government did not provide enough funding for the NHS this winter? If not, why not? If he does accept that it is enough money, he will surely welcome the extra investment that the Chancellor is putting into the NHS from next year.

[Dr Lauren Sullivan (Gravesham) (Lab)]

T2. What steps are Ministers taking to address the ongoing shortages of medications for attention deficit hyperactivity disorder, which have been going on for 18 months?

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[Paulette Hamilton (Birmingham Erdington) (Lab)]

T3. Many of my constituents are worried that online GP appointments are too often used as a substitute for face-to-face consultation, which risks adding pressures to NHS waiting lists further down the line. Will the Secretary of State reassure my constituents that they will receive timely, in-person GP access and the quality of care that they deserve?

[Wes Streeting]

We all know that general practice is under enormous pressure, and that will be a big part of this Government’s agenda. I reassure my hon. Friend that our view is that there should be patient choice, patient control and different courses for different horses. I value online and over-the-phone appointments, but they will not be right for everyone on every occasion. Patients should have a voice and a say.

[Lincoln Jopp (Spelthorne) (Con)]

T4. I recently met a GP who was in the market to hire a new seven to eight session GP to meet demand. Following the Budget and the increase in national insurance contributions for employers, he can now only afford a three to four session GP. What advice does the Secretary of State have for my friend the GP?

[Wes Streeting]

I would say to GPs who are thinking about staffing for the next financial year that they should hold tight and wait for funding allocations shortly, so that they can make informed decisions about staffing and care for patients.

[Damien Egan (Bristol North East) (Lab)]

T6. On the doorstep in Bristol North East, people regularly talk to me about the difficulties they have getting a GP appointment. Will the Minister assure primary care services in my constituency, such as Kingswood health centre, that the Budget will help them and marks the first steps in transforming our NHS?

[Charlie Maynard (Witney) (LD)]

T5. Will the Secretary of State give a clear date by which QR codes will be incorporated into the NHS app at the point of care, thereby making the process faster and safer, as was highlighted to me by Dr Steve Bright at the Windrush health centre in Witney?

[Wes Streeting]

I might resist the invitation to give a specific date today, but the hon. Gentleman makes a valuable point about the ease of use of the NHS app, and I will write to him further on that point.

[Mark Ferguson (Gateshead Central and Whickham) (Lab)]

T7.   Usher syndrome is a rare inherited disease that can lead to both deafness and blindness. As chair of the Usher syndrome all-party parliamentary group, I have met many of those who suffer from Usher syndrome. What assessment has the Department made of the adequacy of support for those suffering from Usher syndrome and their family members?

[Sarah Olney (Richmond Park) (LD)]

T8. Last Friday, I met GPs at the Fairhill medical practice in north Kingston in my constituency. They have told me that the increase in national insurance contributions will add £50,000 a year to their costs. Can the Secretary of State tell me whether GPs can expect to see an across-the-board cut in the NICs payable by GPs to help them manage to continue delivering services for families in the area?

[Wes Streeting]

We have not yet announced allocations for general practice for the year ahead, and we are taking into account all the pressures that general practice is under.

[Dr Beccy Cooper (Worthing West) (Lab)]

T10. The renewed focus on prevention in our health system is welcome, but under the previous Government, the public health grant that facilitates much of that work was cut by 28%. Has the Minister, in partnership with the Treasury, considered when we might be able to address that public health funding issue, which is essential to enabling progress in prevention?

[Martin Wrigley (Newton Abbot) (LD)]

T9. I have been shocked this week by all the major GP groups in my constituency detailing their financial situations. They are all close to the edge and are considering the options of bankruptcy, redundancies or handing in their contracts. What urgent respite can the Secretary of State give them?

[Wes Streeting]

I am in no doubt about the state that general practice was left in by our Conservative predecessors. That is why, in making decisions about funding allocations for the year ahead, we are taking into account all the pressures that general practice is under, as we clean up the mess left by the Conservatives.

[Alice Macdonald (Norwich North) (Lab/Co-op)]

In summer 2023, I spoke to Rachel, who suffers from endometriosis. She was told that she might have to wait 18 months for urgent surgery. She is still waiting. In fact, she has had the menopause induced to help tackle her symptoms. Can the Minister tell me what the Government are doing to improve the diagnosis and treatment of women, including Rachel, who have had to wait far too long?

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[Stuart Anderson (South Shropshire) (Con)]

Ludlow community hospital in my constituency provides a great service for the local community, but it is restricted by its location and its building. There is a business model that would be more cost-effective in the long term that involves moving the facility to the eco park. Will the Secretary of State meet me, healthcare stakeholders and the league of friends in Ludlow to take that forward?

[Wes Streeting]

The hon. Member is welcome to make representations to the Department for the capital investment that he is calling for, but he should welcome the means of providing it, which was the Chancellor’s decision in the Budget.

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

I welcome Ministers’ leadership in attacking the record waiting times inherited from the Tories. Will they in turn recognise Guy’s and St Thomas’ efforts to reduce delays, especially in the ear, nose and throat and paediatric spinal surgery teams? Will the Secretary of State outline measures to protect our NHS from cyber-attacks, which was another issue neglected by the last Government but is affecting patients in Southwark?

[Wes Streeting]

I am grateful to my hon. Friend for the question and pay tribute to the work being done by Guy’s and St Thomas’. He is right to raise cyber-security. That is why the capital investment announced by the Chancellor is welcome and necessary, and joint working across Government, including with security colleagues and my right hon. Friend the Secretary of State for Science, Innovation and Technology, is vital to keep patients’ data and information safe and to keep critical systems running.

[Mr Lee Dillon (Newbury) (LD)]

When the Secretary of State reviews GP funding, will he also consider the burden that sits on GP practices when they have to hold the lease for their surgeries and what role integrated care boards could have in holding that risk, which is stopping the recruitment of GPs to join practices as partners?

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[David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)]

Opt-out testing for HIV at A&E has been a great success since it was announced last year, particularly in identifying those who were not aware they had the disease and among difficult-to-reach communities. Can the Health Secretary confirm whether the programme will continue?

[Wes Streeting]

Opt-out HIV testing has been a great success so far. Of course, we will make further announcements on its future in due course. I would like to say, as a former member of the HIV commission that made the representations to the previous Government, that he has me at a real advantage—or disadvantage, depending on the side of the spending fence. I very much welcomed the approach taken by the previous Government, which this Government plan to continue.

[Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)]

Will the Secretary of State explain what plans he has—if any—to limit the scope of practice of anaesthetic associates and physician associates, about whom there has been such publicity lately?

[Wes Streeting]

Indeed there has. Medical associate roles can and do play a valuable role in freeing up other clinicians’ time to do the things that only they can do, but there are legitimate concerns within the professions about scope of practice, doctor substitution and transparency for patients. We need to grip that and address it. We will have a further announcement to make about that shortly.

[Mr Richard Holden (Basildon and Billericay) (Con)]

South Green surgery in my constituency has been given notice by its landlord that it has to move by the end of March next year. Will the Secretary of State meet me to see what we can do to ensure that other facilities can be provided if available, or to do the best for those local patients?

[Wes Streeting]

That would be a matter for the right hon. Gentleman’s ICB. I know that he is new to the area, so I am happy to make some introductions.

[Karl Turner (Kingston upon Hull East) (Lab)]

My constituent Craig Eskrett was diagnosed with motor neurone disease 12 months ago. He says that the services are there in the local NHS trust, but there is a distinct lack of co-ordination. Will the Minister meet me to discuss what improvements can be made to co-ordinate those services for sufferers of MND?

[Richard Foord (Honiton and Sidmouth) (LD)]

At the weekend in Devon, I met a psychiatric nurse who previously worked in London and has been recruited to the south-west. She does not have a start date, and is still subject to routine checks after waiting months. Can the Secretary of State expedite these routine checks, given waiting lists for mental health?

[Wes Streeting]

Absolutely. That is a good example of why investment needs to be matched with reform to speed things up, improve productivity and get staff to the frontline, where they want to be.

[Harpreet Uppal (Huddersfield) (Lab)]

Last week, the chief executive of Forget Me Not children’s hospice visited Parliament with local dad Steve, whose son is supported by the hospice. The hospice provides vital services to families such as Steve’s, but its services are at risk in the longer term without sustainable funding, including the NHS England children’s hospice grant. Can the Health Secretary take urgent steps to improve funding for hospices?

[Wes Streeting]

I am grateful for the steps that my hon. Friend is taking to make representations on behalf of her local children’s hospice, both on the Floor of the House and outside the Chamber. I recognise the pressure she describes. We are determined to help hospices to overcome them.

[Jim Shannon (Strangford) (DUP)]

Can the Secretary of State confirm what assessment has been made of the number of women waiting for endometriosis surgery across the United Kingdom? What has been done to reduce waiting lists?

[Wes Streeting]

As my hon. Friend the Minister for Secondary Care said, the wait for women with common conditions such as endometriosis is far too long. That is why we are taking steps to cut waiting times and stop the merry-go-round of repeat visits to the same clinician to get the same answer, until someone finally listens to what a woman has to say.