NHS Maternity and Neonatal Services
Wes Streeting Excerpts(5 days, 21 hours ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Wes Streeting)
I am today announcing that I will be launching a national, independent investigation into maternity and neonatal care.
Although pregnancy and childbirth should be a time of joy, for some people this time can bring anxiety, harm or trauma and, in some cases, profound loss. I have listened to families who shared their experiences of unacceptable care, and they have shared with me the multitude of issues that exist across the system. It is clear that we are not listening as much as we should to women and their partners when they raise concerns—and for some women this is even worse, depending on their skin colour or language. We are not always identifying when things are going wrong in maternity and neonatal units quickly enough, and nor are we tackling these failings at the core. The system as a whole is then not supporting harmed or bereaved families when they rightly seek answers and accountability. Ultimately, we are not providing the care that families deserve. This is not the case across the board as many women receive excellent care. However, it is unacceptable that this is not the experience that all women have. We must urgently reset our approach to maternity and neonatal care.
That is why we are announcing this independent investigation: to understand the systemic issues behind why so many women, babies and families experience unacceptable care, and to rapidly put in place solutions to improve maternity safety and quality.
This will be a rapid investigation and will have two core roles. It will conduct urgent reviews, by the end of this year, of up to 10 trusts where there are specific issues. We will work with families and the NHS to develop criteria for selecting trusts.
Secondly, it will undertake a rapid, systemic investigation into maternity and neonatal care in England, reporting by December 2025. This will synthesise the findings and recommendations from all other reviews to recommend one set of national actions to drive the improvements needed to ensure high-quality care and that women are listened to. I will be engaging with families in determining the membership of the investigation team and its terms of reference.
I am also establishing a national maternity and neonatal taskforce, which I will chair. It will be made up of a breadth of independent clinical and international expertise, with family and charity representatives. It is imperative that this includes the voices of families who have experienced harm or loss, so I will also be continuing to meet families throughout the year. I will also ensure that membership is representative of those who can speak to the inequalities within maternal health.
The recommendations will inform the development of a new, national maternity and neonatal action plan, which we will develop with families. The action plan will lead to rapid improvement of maternity and neonatal quality and safety, and ensure that any families in the future who are harmed or bereaved will get answers about what happened, see that lessons are learnt and that there is accountability where appropriate.
In relation to calls for local reviews, I have informed families that this work will include a review into nine specific cases at University Hospitals Sussex NHS Foundation Trust. I am currently discussing with Leeds families the best way to grip the challenges brought to light in that trust by their campaigning, reports in the media, and the latest Care Quality Commission report.
We must also act now to resolve the issues we know exist. Repeated inquiries have identified significant issues across services, from a lack of compassionate care, concerns over safety, and issues in culture and leadership, and there remain stark inequalities faced by women in deprived areas or of black and Asian ethnicity.
This is why, alongside the independent investigation, I am taking immediate measures to start changes so desperately needed. We are introducing measures to hold the system to greater account and improve transparency. The worst-performing trusts will be held to account by the NHS chief executive, to ensure that the necessary improvements are made faster and deeper. This year we will introduce a new early warning system, powered by a real-time data tool, to detect safety issues earlier and allow action to be taken more swiftly to improve outcomes.
To improve safety, we will roll out new best practice standards to tackle the leading causes of maternal mortality and morbidity. We are also taking action to reduce the stark and completely unacceptable inequalities in maternity care. We will deliver an anti-discrimination programme to support trust leadership, ensuring that all families and staff will experience an environment free from discrimination and racism, and benefit ethnic minority mothers. These actions will support our manifesto commitment to set a target to close the black and Asian maternal mortality gap.
Through the investigation, and these immediate actions, I want to challenge and support maternity and neonatal services to provide compassionate, high-quality care to all families at their most vulnerable and life-changing moments.
[HCWS726]
Oral Answers to Questions
Wes Streeting Excerpts(1 week, 4 days ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Joe Powell (Kensington and Bayswater) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), sends her apologies due to a family issue. She is very much in our thoughts today.
Thanks to the decisions taken by my right hon. Friend the Chancellor at the spending review, health capital budgets will increase to £14.6 billion by the end of the spending review period. That will deliver the largest-ever health capital budget in NHS history. Across this settlement, more than £5 billion will be invested to address the most critical building repairs, reducing the most serious and critical infrastructure risks and rebuilding the broken NHS left by the Conservatives.
Helen Maguire
While I welcome the recent announcement of £12 million of extra funding for Epsom and St Helier university hospitals NHS trust, it is quite frankly a drop in the ocean in comparison with the scale of need, because the current backlog at the trust costs £150 million. Patients and staff deserve safe and modern facilities, not patchwork repairs. I therefore ask the Secretary of State to meet with me and visit Epsom and St Helier hospitals to see at first hand the scale of the challenge and how we can accelerate progress.
Wes Streeting
I absolutely appreciate the challenges that the hon. Member describes, having met with the trust myself. The Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth) and I have both met with local MPs about the challenges facing Epsom and St Helier. Lord Darzi’s investigation found that the Conservatives left a £37 billion black hole in NHS capital. We are reversing that trend, with the largest-ever capital budget for health. The £12.1 million for Epsom and St Helier trust for estate safety is in addition to the £207 million of capital that the NHS South West London integrated care board is receiving, including for maintenance backlogs. It will take time, but brick by brick Labour is rebuilding our NHS.
Joe Powell
The Imperial College healthcare NHS trust has the largest high-risk repair backlog in the country. The support from the Government estates safety fund is very welcome, but to solve this problem we ultimately need a new St Mary’s hospital. Will the Secretary of State join me in praising the work of the new three-year St Mary’s taskforce, which aims to get to full planning consent and explore different financing models so that we can finally get this hospital built?
Wes Streeting
I thank my hon. Friend for the work that he and my hon. Friend the Member for Cities of London and Westminster (Rachel Blake) are leading in partnership with the trust and Westminster city council to ensure that the people of his constituency have the hospital they deserve. As he knows, this will be the most complicated scheme in the new hospital programme, but that is no excuse for the years of delay that the scheme has faced. The trust now boasts the biggest high-risk repair backlog in the country, so my hon. Friend is right to ensure that this is not allowed to be put in the “too difficult” pile again. We look forward to engaging constructively and doing everything that we can to expedite the progress that is desperately needed for his community and our city.
Caroline Voaden (South Devon) (LD)
Luke Murphy (Basingstoke) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
The Government inherited a ludicrous situation whereby patients could not get a GP appointment and GPs could not get a job, so one of my first acts was to cut red tape to give practices flexibility to hire GPs, along with an extra £82 million investment. Thanks to that combination of investment and reform, this Government have recruited an additional 1,700 GPs to the frontline since July, exceeding our target of 1,000. We have invested an extra £889 million in general practice this year, taking action to bring back the family doctor. We do not pretend to have solved all the problems, but change has begun and the best is still to come.
Naushabah Khan
I welcome the Government’s commitment to restoring the family doctor, and the recruitment of 1,700 additional GPs nationwide, but my constituency has yet to benefit from that. Concern has been expressed to me about the expansion of the additional roles reimbursement scheme to include only newly qualified GPs, which it is feared may be too restrictive. I have met local GP partners who share that concern, so will the Secretary of State meet us to discuss how the scheme can better support areas such as mine?
Wes Streeting
We are investing an extra £900 million in general practice, and have reformed the GP contract to help bring back the family doctor and end the 8 am scramble. That contract reform included further changes to make it easier to recruit GPs through the scheme. As my hon. Friend will see shortly when we publish the 10-year plan for health, general practice is at the heart of our proposals to build a neighbourhood health service. I am keen to work with her and with GPs to make it even easier to ensure that qualified GPs can get jobs and patients can get GP appointments, and I should be delighted to meet her.
Luke Murphy
After 14 years of the Conservatives running down the frontline of the NHS, many people in Basingstoke still struggle to gain access to their GPs. One issue that patients and GPs raise time and again is the lack of capital investment in new provision to meet growing housing need. Chineham medical practice, for example, was built to serve just 8,000 patients but now serves more than 18,000, and is set to serve many thousands more in the years to come. What more are the Government doing to enable every patient in Basingstoke to see their GP when they need to?
Wes Streeting
My hon. Friend is absolutely right. Just as this Government are delivering record home building with a huge target to build the homes that Britain needs, we also need to ensure that people get the local services that they deserve. That is exactly why this Government have invested an extra £102 million this year to create additional clinical space in over 1,000 GP practices, which will create new consultation rooms and make better use of existing space to deliver more appointments. I know the Chineham medical practice was one of the practices put forward by its integrated care board for funding, so I hope we will see that practice benefiting from this investment in the near future as we rebuild our NHS.
Clive Jones (Wokingham) (LD)
The Government’s additional roles reimbursement scheme led to just three new GPs for my constituents in Wokingham, which is a drop in the ocean. More needs to be done to deliver GP practices in new developments such as Arborfield in south Wokingham. Why did Ministers not support the Liberal Democrat amendment to the Planning and Infrastructure Bill that would have made commitments to build GP surgeries in all new housing developments legally binding?
Wes Streeting
Probably because being that prescriptive about every housing development is not sensible, even if the thrust of what the hon. Member describes—that as new housing development is built, we need to ensure that local infrastructure goes alongside it—is the right approach. I take what he says about the number of GPs, and as I have said, we do not pretend to have fixed all the problems in 11 months, but with respect, those are three more GPs than were there before. I know there is more to do, but give me time, and we will rebuild general practice for his constituents and anyone else’s.
Jess Brown-Fuller (Chichester) (LD)
Access to GPs in my constituency of Chichester is being undermined by the closure of the Westbourne branch of Emsworth medical practice at the end of this month. Patients will now have to travel to Emsworth, but we are talking about a small rural village, and there is no public transport to get my elderly and vulnerable patients to that medical practice over the border. Will the Secretary of State please meet me to urgently discuss how we can protect this vital service in a rural village in Chichester?
Wes Streeting
I can well understand the hon. Member’s concern and her constituents’ concern. Practice closures are hard on communities wherever they are, but they disproportionately hit rural communities and those that suffer with poor transport connectivity. I would urge her in the first instance to raise the specific local issues with the ICB. However, I reassure her and other right hon. and hon. Members that the needs of rural, coastal and remote communities are very much in our mind—and, crucially, in the 10-year plan—and our thinking about how we build genuine neighbourhood health services in all types of neighbourhood.
Tim Farron (Westmorland and Lonsdale) (LD)
Lillian Jones (Kilmarnock and Loudoun) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
This Government are delivering record investment in our NHS, but that investment is drawn from taxpayers, and we have a responsibility to every taxpayer in the land—as well as to patients—to ensure that every single penny is well spent. That is why that investment is matched with bold reform, so that we get as much value as possible for every penny. The abolition of NHS England will slash duplication and unnecessary bureaucracy, and I am pleased to report to the House that we have slashed spending on agency staff by almost £1 billion compared with last year. All those savings are being reinvested into frontline care.
Mark Ferguson
From speaking to my local NHS trust in Gateshead, I know the value it places on driving costs down, but it still faces financial pressures. Key among those are issues related to the digital capital gap. We are really keen in Gateshead to improve that situation and to allow more people to access the NHS remotely. Will the Secretary of State meet me and Gateshead NHS trust to talk about how we can tackle that?
Wes Streeting
I would be delighted to do so. My hon. Friend is absolutely right: we have to ensure that the NHS is not only benefiting from, but at the forefront of the revolution taking place in digital services and medical technology. It is key to driving productivity and financial sustainability. That is why, at the spending review, the Chancellor announced that we would invest up to £10 billion in NHS technology and digital transformation; unlike our predecessors, we will not raid tech budgets to plug shortfalls in day-to-day spending. Just this month, we announced the modernisation of the NHS app, so that patients can receive test results and book appointments, saving £200 million in stamps, envelopes and letters.
Lillian Jones
I thank the Secretary of State for his earlier reply. In Scotland, there are more quangos than MSPs. After four years and £30 million of taxpayers’ cash down the drain, the SNP has scrapped its plans for a national care service—its flagship policy—which was seen as a significant setback for Scottish social care reform, and now we have people going to the pub in chauffeur-driven ministerial cars. Will the Secretary of State advise his Scottish counterpart on how to stop wasting Scottish taxpayers’ money?
Wes Streeting
Given the state of the NHS in Scotland, I suspect my counterpart needed to go and drown his sorrows. The truth is that the longer the SNP is in government, the longer the NHS in Scotland is on the road to nowhere. The SNP is now on its fifth health plan in four years. Thanks to the decisions taken by the Chancellor, it is not just the NHS in England that is receiving record investment, but the Scottish Government. I have used that investment to cut waiting lists by almost a quarter of a million people; the same could be true in Scotland, if the Scottish people boot out the SNP and elect Anas Sarwar and Jackie Baillie to deliver the change that Scotland’s NHS needs.
Danny Kruger (East Wiltshire) (Con)
A good way to save money in the NHS is to invest in palliative and end-of-life care, because it averts costs that would otherwise go into the acute sector, including into ambulances. However, this Government are taking money from that sector through their national insurance rises. Given that integrated care boards are supposed to commission palliative care, will the Secretary of State commit in the 10-year health plan to a proper revenue funding model for hospices, and for a minimum service specification for palliative care?
Wes Streeting
I can reassure the hon. Member that end-of-life care is featured in the 10-year plan for health. I also recognise the pressure on our hospice sector, which is why this Government, as well as delivering £26 million through the children’s hospice grant, committed £100 million of capital investment— the biggest in a generation for our hospices. None the less, hospices do rely on the generosity of donors and I am keen to work in partnership with the sector to look at what more we can do to encourage investment. The final thing I would say is that the Opposition parties welcomed the investment in the national health service while opposing the means of raising it. They cannot have it both ways; either they support the investment and the revenue raisers or they have to be honest with the public that they would be cutting the NHS.
Seamus Logan (Aberdeenshire North and Moray East) (SNP)
One of the most egregious examples of waste in recent years was the almost £10 billion spent on useless personal protective equipment during the pandemic. When the Treasury eventually recovers some of that money, will the Secretary of State assure me that Scottish taxpayers will benefit in the usual way through the usual channels?
Wes Streeting
Fiscal decisions and spending are matters for my right hon. Friend the Chancellor, but let me reassure the hon. Gentleman of two things. First, the way in which the taxpayers of this country were ripped off during a national emergency was a total disgrace, and this Government are determined to get our money back and reinvest it in frontline services, where it should always have been. Secondly, I can reassure him that, so long as there is a Labour Government here in Westminster, Scotland will continue to benefit from the investment it needs to sort out its public services. Now it just needs a Labour Government in Scotland to spend that money wisely.
James Asser (West Ham and Beckton) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
This Government are committed to fixing the NHS and reducing A&E waiting times. Our new urgent and emergency care plan is backed by nearly £400 million of investment to deliver new urgent treatment centres, mental health assessment centres and almost 400 new ambulances. Alongside that investment, we are reforming urgent and emergency care so that more patients are treated at the scene or in their homes where appropriate, which is better for them and will help to unclog A&E departments. Lots has been done, but there is much more to do.
James Asser
The Minister for Secondary Care recently visited my constituency and saw the pressures that Newham hospital A&E was under. That is partly due to the pressures left by the previous Conservative Government, and partly due to capacity issues resulting from a massive growth in population in the borough. Further pressures will come as we regenerate the massive areas of brownfield site in the Royal Docks. Can the Secretary of State reassure my constituents that, as well as the excellent work being done on day-to-day capacity, we will be looking at infrastructure over the longer term to make sure that we are not only dealing with the growth that we have had, but future-proofing for the population growth to come?
Wes Streeting
I know that my hon. Friend the Minister for Secondary Care enjoyed her visit, and I thank the staff at Newham hospital for the work they do, which also benefits my constituents. We need to make sure that we are supporting hospitals across our country to meet need, because we are part of a wider ecosystem—I noticed that that point was also powerfully made by the hon. Member for Romford (Andrew Rosindell) in his question. My hon. Friend the Member for West Ham and Beckton (James Asser) is right to raise increasing demand and pressures, which is why we will shortly publish our 10-year plan for health. I am happy to report that Whipps Cross and Newham hospitals have also been provisionally allocated £28 million this year to improve buildings and estates.
Mr Louie French (Old Bexley and Sidcup) (Con)
The Government continue to claim that they wish to expand community diagnostic centres to speed up scanning and treatment of patients and therefore reduce demand on the likes of A&E. If that is the case, why are they cutting the revenue tariffs that were available to the community diagnostic centres under the previous Conservative Government, which has already impacted the financial viability of the CDCs and access for patients?
Wes Streeting
I think the hon. Gentleman will find that, since this Government came to power, we have reduced the size of NHS waiting lists by a quarter of a million. NHS waiting lists are coming down—latest figures show that this is the first time in 17 years that waiting lists have fallen in the month of April—so we are making progress, not least thanks to the investment that we are putting into community diagnostic centres. The hon. Gentleman has some brass neck to complain about NHS services under this Government, when we are cleaning up the mess that the previous Government left behind.
Charlie Dewhirst (Bridlington and The Wolds) (Con)
The Secretary of State for Health and Social Care (Wes Streeting)
Waiting lists are at their lowest level for two years, we have taken almost a quarter of a million patients off waiting lists and for the first time in 17 years waiting lists were cut in April. There is a long way to go, but this Government are finally putting the NHS on the road to recovery. Through our plan for change, I have announced that the NHS will also be at the forefront of the revolution in life sciences. Through the NHS app, patients will be linked up with relevant trials to boost our life sciences sector, generate investment for the NHS and develop the medicines of the future.
Charlie Dewhirst
It is nearly four years since Professor Sir Chris Whitty published his striking report on health in coastal communities. Covid inevitably delayed implementation, so will the Secretary of State look again at that report, deliver on the chief medical officer’s recommendations and ensure that my constituents in Bridlington and The Wolds can access the health services that they need?
Wes Streeting
The hon. Gentleman is right to commend Sir Chris Whitty’s report. We have taken that into consideration, as well as the wider consultation we did in preparation for our 10-year plan for health, which will commit to tackling the gross health inequalities that affect our country, particularly in rural and coastal communities.
Chris Bloore (Redditch) (Lab)
Wes Streeting
I absolutely agree with my hon. Friend. It is thanks to the fact that his constituents sent him to this House of Commons that we have a Labour Government able to deliver, with him, for his community.
Edward Argar (Melton and Syston) (Con)
May I, through the Secretary of State, pass on my best wishes to the Under-Secretary of State for Health and Social Care, the hon. Member for West Lancashire (Ashley Dalton)? In front of the Health and Social Care Committee in January, NHS England’s then chief financial officer set out that pretty much all the additional funding to the NHS last year would be absorbed by pay rises, national insurance contributions and inflation. What proportion of the latest additional funding will be absorbed in the same way?
Wes Streeting
First, I just do not buy the argument that investing in our staff is somehow not investing in the NHS. Who on earth do the Opposition think provides the treatment, delivers the care, organises the clinics and delivers the services? Even in this great new world of technology, the NHS will always be a people-based service and I am proud that this is a Government who deliver for staff. We are also waging war on waste, and that is how we can deliver fair pay for staff and improve care for patients. If only the Conservatives had done that when they had the chance.
Edward Argar
The right hon. Gentleman could not answer that question, but hopefully we will get a more positive response to this one. I recently had the privilege of meeting Dr Susan Michaelis and her husband Tristan, who have set up the Lobular Moon Shot Project, which large numbers of Members of all parties across the House have backed. They are seeking £20 million over five years—a tiny sum in the context of the overall NHS budget—to research lobular breast cancer, which Susan is currently battling, to help improve outcomes. Her immediate ask is even simpler: it is for the Secretary of State to meet her in person to discuss the campaign and its aims. He is a decent man. Will he agree to do that?
Wes Streeting
I thank the shadow Secretary of State for his question and, even more importantly, I thank the amazing campaigners for what they are doing. This is probably the easiest question he is ever going to ask me. The answer is, of course, an emphatic yes.
Katrina Murray (Cumbernauld and Kirkintilloch) (Lab)
Wes Streeting
Can I first thank my hon. Friend the Minister for Care for the considerable amount of work he has done to support the House as it makes its deliberations on this important issue? Of course, the Government are neutral; it is for the House to decide. There is not money allocated to set up the service in the Bill at present, but it is for Members of this House and the other place, should the Bill proceed, to decide whether to proceed. That is a decision that this Government will respect either way.
Katie Lam (Weald of Kent) (Con)
Wes Streeting
I should just say for the record that it is thanks to my friends at the Treasury that we are able to do so much to invest in our health service. It is important to put that on record ahead of the Budget. The hon. Lady raises a really serious issue, and we are looking carefully at what we can do to ensure that we get great people into our health service and that they can look forward to a great career. We are not in the right place as a country now; we need to be in a better place. The 10-year plan will set out our ambitions on workforce and we will publish a new workforce plan later this year.
Daniel Francis (Bexleyheath and Crayford) (Lab)
Graham Leadbitter (Moray West, Nairn and Strathspey) (SNP)
My constituency, in Scotland, has a significant shortage of health and social care workers, despite extensive efforts to advertise recruitment to get people in, as replicated in parts of England, Wales and Northern Ireland. The rug has been pulled out from under that by the changes to immigration policy and visas for that sector. Will the Secretary of State commit to pushing this harder in Cabinet to ensure that we can have more geographic and sectoral visas?
Wes Streeting
I am really proud of the contribution that overseas workers make to health and social care services across our country. If they all left tomorrow, the services would simply collapse. But I think there is an overreliance on overseas staff in health and care services, and that is contributing to levels of net migration that are simply unsustainable. I have a responsibility to help the Home Secretary bring those numbers down and to give opportunities, through better pay and career progression, to home-grown talent, and that is what we will do.
Markus Campbell-Savours (Penrith and Solway) (Lab)
Bob Blackman (Harrow East) (Con)
The Secretary of State may well be aware of the greater awareness among young people of nicotine pouches. That seems to be a gap in the Tobacco and Vapes Bill currently going through Parliament. Will he commit to look at this issue to ensure that it is covered and that we bar this alongside other forms of tobacco and nicotine?
Wes Streeting
As the hon. Gentleman knows through bitter experience, that rotten industry always finds a way, and we have to keep on top of it and tackle the scourge of nicotine addiction. He knows about this issue better than most, he having campaigned so assiduously on it, and he is right to raise it, so let us look at what we can do to strengthen the Bill, if we can, as it goes through Parliament.
Peter Lamb (Crawley) (Lab)
Sarah Bool (South Northamptonshire) (Con)
In Prime Minister’s questions last week, I raised the need for a universal national screening programme for type 1 diabetes. Will the Secretary of State agree to meet me to discuss this, so that it could form part of the 10-year plan, given that it fits so neatly into prevention of issues such as diabetic ketoacidosis over treatment?
Wes Streeting
I was in the Chamber to hear the hon. Member’s question. Obviously we are led by clinical advice when it comes to decisions on screening programmes, but I understand the case she makes. I would be delighted to ensure that she gets a meeting with the relevant Minister.
Mr Richard Quigley (Isle of Wight West) (Lab)
Mr Joshua Reynolds (Maidenhead) (LD)
I have raised with Ministers before my concerns about the closure of St Mark’s walk-in urgent care centre in Maidenhead. Frimley ICB has confirmed yet again that it will not reopen the centre, against the will of the majority of Maidenhead residents. Will the Secretary of State meet me and local campaigners to see how we can finally get St Mark’s walk-in centre back open after five years of closure?
Wes Streeting
I know that the hon. Gentleman’s constituents will have noted, through his representations as a constituency MP, that he could not have fought harder to save that service. We devolve these sorts of decisions to ICBs, in order that they make decisions closer to the communities that they serve, with the conviction that those sorts of decisions are better taken locally than centralised in Whitehall. I understand the case that he makes, but having given ICBs a challenge, resources and freedom, we Ministers must resist the temptation to meddle every time they make decisions that they believe are right for the community, even if those decisions are controversial.
Will Stone (Swindon North) (Lab)
Will the Minister look into minimising the pain of patients going through hysteroscopy and biopsy procedures by requesting that medical professionals fully brief them on anaesthetics and pain relief in advance of procedures to ensure that they can plan accordingly?
Wes Streeting
Absolutely: the NHS always does better under a Labour Government.
Nesil Caliskan (Barking) (Lab)
Barking community hospital in my constituency has been providing antenatal services to mothers in Barking for many years, and women also use its services to give birth. I was therefore really disappointed when I heard last week that the maternity birthing unit is likely to close. Many in my community are deeply concerned. They are being redirected to Newham hospital, which the Care Quality Commission has rated as “requires improvement”. Women deserve to give birth in a safe clinical environment. Will Ministers ensure that additional attention and resources are provided to Newham hospital, so that it improves its standards and my constituents who are being redirected to give birth there can do so in a safe clinical space?
Wes Streeting
Making sure that women are giving birth safely is the ultimate priority and the least that women deserve. I understand my hon. Friend’s anxiety about this reconfiguration, and she is right to raise that with the ICB in the first instance. We are happy to meet her as Ministers, too. The crucial thing is that the services are configured and delivered in a way that prioritises the safety of women and their babies.
James Wild (North West Norfolk) (Con)
In March, the Minister for Care told me that no decision could be taken on a new dental school at the University of East Anglia until the spending review settlement was known. Now that we know it, will he instruct the Office for Students to allocate new training places at the UEA from 2026?
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
Between 2001 and 2011, the 15% health inequalities weighting in NHS allocations made a positive, measurable difference to the health of deprived people. Unfortunately, it was cut to 10% in 2015. With the spending review’s increase in funding to the NHS, when will the health inequalities weighting reach 15%?
Wes Streeting
I am really grateful to my hon. Friend for her question. She is right to highlight the importance of funding following inequalities to redress that imbalance. I think she will be pleased with where we are with the 10-year plan for health, and I would be delighted to meet her to discuss it.
Richard Foord (Honiton and Sidmouth) (LD)
People in East Devon have been told that they must now travel to Exeter for audiology services that they previously received at their local community hospital. What steps are the Government taking to encourage new providers to restore accessible audiology services?
Wes Streeting
That has been a running theme this morning, which will not be lost on Ministers. We will ensure, as we deliver neighbourhood health services, that people can receive care closer to home, wherever they live. We have heard that message loud and clear today, and I think the hon. Member will see that priority reflected in our 10-year plan for health.
Peter Swallow (Bracknell) (Lab)
I declare an interest, as my brother is a GP. When my residents are able to get a GP appointment, they are frustrated when they are sent halfway across the borough to a different surgery from the one they are registered with by their primary care network. Can we address that, and is it part of our proposals in the new GP contract?
Wes Streeting
We do want to put GPs at the heart of neighbourhood health services, and we want people to have care close to home. There are benefits to primary care working at scale, so I would not want to criticise them for doing that. The important thing is different courses for different horses. Some of us are much more mobile, more active and more online and would welcome that flexibility. For others, continuity of care that is close to home, or indeed in their home, is important. It is important that people get the right care, in the right place, at the right time, wherever they live, and that is what we will deliver.
Sir Jeremy Wright (Kenilworth and Southam) (Con)
I am grateful for the consideration the Secretary of State has already given to finding a fairer and more effective way of compensating those injured by a covid vaccination, but he knows that those who are profoundly affected by such injuries are anxious for news. Can he give me, and indeed them, a progress report?
Wes Streeting
I reassure the right hon. and learned Gentleman, the constituents of his I have met and other campaigners that I am having discussions with the Cabinet Office about how we deal with that and other issues that have been raised this morning, including the sodium valproate scandal. He knows the complexities involved, and I have been grateful for his advice as a former Attorney General. I do not have specific progress to report now, but I reassure him and campaigners that this issue has not gone off the boil and we are working to find a resolution.
Claire Hazelgrove (Filton and Bradley Stoke) (Lab)
The challenge of finding and keeping an NHS dentist is raised with me time and again across the Filton and Bradley Stoke constituency, and I welcome the early action that this Labour Government have taken to introduce more than 19,000 urgent care appointments across our integrated care board area. What will be the next steps to help ensure that NHS dentistry is opened up again to everybody?
Blake Stephenson (Mid Bedfordshire) (Con)
The Secretary of State will know that my local ICB in Bedfordshire, Luton and Milton Keynes is set to merge with Hertfordshire, Cambridgeshire and Peterborough. The new ICB will cover a population of about 3 million people. Given the difficulties we have had securing a GP surgery in Wixams, will the Secretary of State set out how supersizing that quango will help rural mid-Beds to get the local healthcare it needs?
Wes Streeting
May I respectfully say that that was part of the problem with Conservative thinking? They thought that the answer to the NHS crisis was more quangos, and they measured success in the number of ICBs, not the number of appointments and the size of the waiting list. We are taking a different approach, slashing bureaucracy and reinvesting in the front line. We are not centralising but decentralising, and cutting waiting lists—a record that the Conservative party cannot begin to touch.
Perran Moon (Camborne and Redruth) (Lab)
A couple of weeks ago at my constituency surgery, though tears my constituent Amy explained how, following a hip operation in 2008, she suffered progressive nerve damage due to repeated failures in diagnosis, referral and treatment. Despite raising concerns for years, she was told that her pain was common. A nerve test in 2015 confirmed damage, and further tests last year showed a significant deterioration. After 17 years she has only now been offered surgery. All Amy wants to know is what steps are being taken to ensure that no other patient is left permanently disabled due to such prolonged and systemic failure—
Mr Speaker
Order. That is very important, but why does the hon. Member not want others to get in?
Wes Streeting
First, on behalf of the NHS I apologise to my hon. Friend’s constituent. That is an intolerable situation, but sadly not rare or exceptional. There is too much of that happening, and a culture of cover-up and covering reputations, rather than being honest with patients about failures. We are changing the culture. Safety is at the heart of the 10-year plan, and I would be delighted to talk to my hon. Friend further about his constituent’s case.
Jim Shannon (Strangford) (DUP)
This morning I attended an event about bladder cancer. Bladder cancer is the fifth highest killer in the United Kingdom, and people were anxious to meet the Minister and discuss those matters. Will he agree to meet bladder cancer organisations to take forward their four objectives to make things better for people in the United Kingdom?
Wes Streeting
I am sure my hon. Friend the Under-Secretary of State for Health and Social Care (Ashley Dalton), who is the Minister responsible for cancer, would be delighted to meet campaigners, particularly as we put together the national cancer plan. We want to ensure that we capture every type of cancer, and genuinely improve cancer care for everyone in our country.
Oliver Ryan (Burnley) (Ind)
The Minister may have seen my constituent Mollie Mulheron recently featured on “Newsnight”. Our local ICB recently refused her access to fertility treatment after recovery from an aggressive cancer with a high likelihood that her illness will return. Will the Minister meet me and Mollie to discuss that issue, and access to fertility treatment for cancer survivors and patients?
Wes Streeting
Yes, I will make sure that my hon. Friend gets that meeting.
NHS Workforce
Wes Streeting Excerpts(1 month ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Wes Streeting)
Today I am formally accepting the headline pay recommendations for NHS staff from the NHS Pay Review Body, the Review Body on Doctors and Dentists Remuneration, and the Senior Salaries Review Body. We are working closely with payroll systems to ensure staff receive their backdated pay uplifts from August.
I hugely appreciate the work of so many talented staff across the NHS. Accepting these recommendations gives them the pay rise they deserve. These awards are above forecast inflation over the 2025-26 pay year, meaning that the Government are delivering a real-terms pay rise, on top of the one provided last year, underlining the extent to which we value our nurses, doctors, and other NHS staff. These pay awards sit alongside wider work to improve the support NHS staff receive and their experience at work. This includes our recent announcements on tackling violence and aggression, improving nursing career progression and job evaluation and supporting newly qualified staff. Improving the experience of work is fundamental to improving the patient experience, from reducing the backlog in elective care to ensuring timely access to GP appointments.
I am grateful to all chairs and members of the NHSPRB, DDRB and SSRB for their thoughtful consideration of the evidence presented to them, and their reports that recognise the vital contribution that NHS staff and leadership make to our country. The pay review bodies have examined the economic picture and evidence on recruitment, retention, motivation and morale to reach their recommendations. Through their deliberations, they have made recommendations above the level we stated as affordable in our evidence. I am however accepting their headline pay recommendations as fair and well-evidenced uplifts for public servants. To maintain financial prudence, I have had to make difficult decisions on other areas of spend to afford these uplifts.
This Government have shown their willingness to make the difficult decisions needed to improve outcomes for the public from the health system. Over the past few months, we have identified how extra funds will be freed up by cutting duplication and waste, and through abolishing NHS England, and reshaping and reducing integrated care board costs by 50% to empower NHS staff and deliver better care for patients. Through NHS planning guidance, I have already outlined a significant productivity and efficiency ask for NHS systems to deliver in 2025-26 —that is, through reductions in use of temporary staffing. As a result of the savings found, none of the pay increases will be paid for by cutting frontline services.
The next steps in our plan for reform will be set out in the upcoming 10-year plan and workforce plan refresh, with its laser focus on shifting care from hospitals and into the community, as we work to get the NHS back on its feet and fit for the future. Driving these efficiencies will enable us to deliver on our objective for the NHS as set out in our plan for change—making the NHS work for patients and staff.
Pay awards
The DDRB recommended a headline 4% increase to salary scales, pay ranges and the pay elements of contracts from 1 April 2025. It also recommended that an extra £750 be added to the pay points for doctors and dentists in training. In accepting these recommendations, we have committed to:
uplifting pay points for doctors and dentists in training (circa 77,000 doctors) by 4% plus £750 on a consolidated basis;
uplifting the salaries of consultants (c.63,000 doctors) by 4% on a consolidated basis;
uplifting the pay range for salaried general medical practitioners (c.15,000 doctors) by 4%, uplifting the pay element of the GP contract by 4%, uplifting the minimum and maximum of the pay range for salaried GPs by 4%, and uplifting the GP educators pay scale by 4% all on a consolidated basis;
uplifting the pay element of the general dental practitioners contract (c.24,000 dentists) and the pay scale for salaried dentists by 4% on a consolidated basis;
uplifting the pay scales of specialist and associate specialist doctors on all contracts by 4% on a consolidated basis.
uplifting flexible pay premia by 4% on a consolidated basis.
The DDRB made a further five recommendations, which are not directly related to headline pay, targeted at specific parts of the remit group. We need further time to carefully consider these, working with our partners to determine the best way forward. To avoid delays to pay uplifts reaching NHS staff, we will advise Parliament separately on our response to these recommendations in due course.
The NHSPRB recommended a 3.6% pay increase to all Agenda for Change staff, alongside a recommendation to provide the NHS staff council with a funded mandate for pay structure reform. In accepting these recommendations, we have committed to:
uplifting all pay points of Agenda for Change staff (c.1.4 million staff) by 3.6% on a consolidated basis, taking effect from 1 April 2025.
issuing the NHS staff council with a funded mandate for 2026-27 to begin to resolve outstanding concerns within the Agenda for Change pay structure.
Given the difficult financial landscape, we will need to carefully consider as part of the SR the funding for the mandate for 2026-27, but we will work in partnership with the NHS staff council to deliver these changes from 1 April 2026.
The SSRB recommended a 3.25% cent uplift for all executive and senior managers and very senior managers in the NHS in England from 1 April 2025. In accepting this recommendation, we have committed to a 3.25% uplift for executive and senior managers and very senior managers in the NHS in England.
The SSRB also made two further recommendations. First, they recommended that an additional 0.5% of the ESM and VSM pay bill in each employing organisation be used to address specific pay anomalies, targeted at mitigating the effects of pay overlaps with the Agenda for Change pay scale. We are rejecting this recommendation on the basis that, in the current fiscal context, we believe an award of 3.25% well compensates VSMs and ESMs for the work that they do, and because previous measures of this sort have not seen widespread use by employers. Secondly, the SSRB recommended that the ESM pay framework should be withdrawn. I will be considering this in light of the abolition of NHS England and the consolidation of arm’s-length bodies, and will report back to Parliament separately on our response to this recommendation.
This pay award follow publication of the new VSM pay framework on 15 May, which envisages rewards for senior leaders who are successfully improving performance, and will ensure that the NHS continues to develop and attract the best talent to the most senior positions.
We will also bring forward legislation to uplift the member contribution tier thresholds in the NHS pension scheme in line with the Agenda for Change pay award. This will mean that these staff feel the full benefit of the award, and do not move into the next pension contribution tier solely as a result of this pay rise.
Next steps
We have listened to the workforce and know that it is not acceptable that pay awards are not delivered on time. This Government are committed to NHS staff receiving their pay uplifts at the beginning of the financial year. Last year, this Government committed to speeding up the pay review process, remitting the PRBs months earlier than previous years and submitting written evidence earlier too. This means that pay awards for 25-26 will pay in packets two months sooner than last year. But we recognise that there is more to do. That is why, this year, I am committing to remitting the health PRBs in July, with an ambition to implement awards as soon in 2026-27 as possible.
The reports of the DDRB, NHSPRB and SSRB will be presented to Parliament and published on gov.uk.
[HCWS663]
Mental Health Bill [Lords]
Wes Streeting ExcerptsMonday 19th May 2025
(1 month, 1 week ago)
Commons ChamberRead Full debate Mental Health Bill [HL] 2024-26 View all Mental Health Bill [HL] 2024-26 Debates Read Hansard Text Watch Debate Read Debate Ministerial Extracts Amendment Paper: HL Bill 93 Running list of amendments – 14 April 2025 - (14 Apr 2025)
The Secretary of State for Health and Social Care (Wes Streeting)
I beg to move, That the Bill be now read a Second time.
I want to place on record my thanks to Baroness Merron for her leadership of the Bill’s progress in the House of Lords, and to thank Members on both sides of that House for their contribution to scrutiny of it. I particularly thank Baroness May of Maidenhead for the constructive way in which she has engaged the Government, and for commissioning Sir Simon Wessely to undertake the review of mental health that underpins so much of the Bill.
At the general election, Labour stood on a manifesto commitment to modernise the Mental Health Act 1983, and I am proud to say that we are delivering on that promise in the first Session of this Parliament. In doing so, we are providing a once-in-a-generation opportunity to profoundly transform the way in which we view and support people with serious mental illnesses. The measure of a society is how it treats its most vulnerable citizens, and when it comes to the treatment of people with serious mental illnesses, we are falling well short of the humane, compassionate society that we aspire to be. Patients live 15 to 20 years less than the average, and they are often accommodated far away from their families and loved ones. The facilities in which they are housed can be completely unsuitable. During his investigation last year, Lord Darzi found nearly 20 patients in a mental health facility who were forced to share two showers and live among an infestation of rats and cockroaches.
Patients are denied the basic choice and agency that is awarded to NHS patients with physical illnesses. People from ethnic minority communities, especially black African and Caribbean men, are more than three times as likely to be sectioned. Although they are very different conditions, people with a learning disability and autistic people are often lumped in with those who have mental illness, reflecting an outdated lack of medical understanding.
Sir Jeremy Hunt (Godalming and Ash) (Con)
The Health Secretary will have been briefed by the Minister for Care about the tragic murder of Christopher Laskaris, the son of my constituent Fiona Laskaris, and the lack of a voice for parents, who know their own children extremely well, in very difficult situations like this. Have the Government considered whether they might table an amendment to make things like Christopher’s tragic murder less likely in the future?
Wes Streeting
I am extremely grateful to the right hon. Gentleman for his intervention, and I place on record my thanks to Fiona for her campaigning work in circumstances that are completely unimaginable for those who have not walked in her shoes and experienced the kind of grief that she is experiencing. I know that my hon. Friend the Member for Rother Valley (Jake Richards) has been campaigning assiduously on this issue; similarly, we have had representations from the hon. Member for Dorking and Horley (Chris Coghlan), who is in his place, and the right hon. Gentleman. We are carefully considering the arguments that have been made, and looking at what we can do in this Bill to advance things in the way that Fiona and others like her would like to see. We will continue that engagement throughout the passage of the Bill, and see if there is a workable way in which we can improve it to ensure that others do not have to go through the unimaginable heartbreak that Fiona is living with every day.
Peter Swallow (Bracknell) (Lab)
My right hon. Friend is touching on ways to strengthen this Bill even further. He will know that the Joint Committee on Human Rights has just this morning published our report on the Bill. We have praised it for all that it will do to address a number of inequalities, but we have picked out one or two areas where it could go even further. I know that he will not yet have had a chance to look at our report, but will he arrange for a meeting with members of the Committee and the relevant Minister to discuss our findings?
Wes Streeting
I wish I could correct my hon. Friend and say that I have already read in detail the feedback from the Joint Committee on Human Rights, but he is right: I have not yet had a chance to do that. However, I can assure him that I and my hon. Friend the Minister for Care will look at the Committee’s report. We would be very happy to meet members of the Committee to discuss in further detail their findings and recommendations.
We want to ensure that the Bill is as strong as it can be, given the length of time that has passed since the Mental Health Act was reformed. Indeed, the Mental Health Act is as old as I am. [Interruption.] Thank you for those interventions. I assure Members heaping compliments across the Chamber that it will not affect investment decisions in their constituencies, but I am none the less very grateful.
There is a serious point here: whereas attitudes to mental health have come on in leaps and bounds in the past four decades, the law has been frozen in time. As a result, the current legislation fails to give patients adequate dignity, voice and agency in their care, despite the fact that patients have consistently told us that being treated humanely, and making decisions about their own care, plays a vital role in their recovery.
When patients are detained and treated without any say over what is happening to them, it can have serious consequences for their ongoing health. To quote one of the many patients who bravely shared their experiences with Sir Simon Wessely’s independent review:
“Being sectioned was one of the most traumatic experiences of my life. Sadly, as a result of being sectioned I developed PTSD”—
post-traumatic stress disorder—
“as the direct result of the way I was treated”.
Sir Simon’s review was published seven years ago. It shone a light on a group of people who had been hidden, ignored and forgotten. In the time that has passed since, the case for change has only snowballed. The Bill now takes forward Sir Simon’s recommendations.
The review stressed that legislation alone would not fix the system; culture and resources matter too. This was echoed in Lord Darzi’s investigation into the NHS, which uncovered some hard truths: a dramatic rise in the use of restrictive interventions on children; and 345,000 patients waiting more than a year for their first appointment with mental health services—more than the entire population of Leicester—of whom 109,000 were under the age of 18. This Bill does not solve every problem in our mental health services, but it marks a vital step in our plans to improve the quality of care, combat long-standing inequalities, and bring about a stronger focus on prevention and early intervention in mental health.
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
Does my right hon. Friend agree that while we are seeing record levels of mental health problems in our young people, investment in community services for people with mental health problems must be a priority?
Wes Streeting
I wholeheartedly agree with my hon. Friend. As he has heard many times from this Dispatch Box, we want to see a shift in the centre of gravity in the NHS out of hospitals and into the community as one of the three key shifts that will underpin our 10-year plan for health, which we will be publishing in the not-too-distant future.
The Mental Health Act is designed to keep patients and the public safe, but it is clear to anyone who has seen how patients are treated that it does so in an outdated and blunt way that is unfit for the modern age. It is too easy for someone under the Act to lose all sense of agency, rights and respect. It is sometimes necessary to detain and treat patients, but there is no reason why patients experiencing serious mental illness should be denied the choice and agency they would rightly expect in physical care. Not only should the health service treat all its patients with dignity and respect anyway, but giving people a say over their own care means that their treatment is more likely to be successful. In the foreword to his independent review, Sir Simon Wessely said:
“I often heard from those who told me, looking back, that they realise that compulsory treatment was necessary, even life-saving, but then went on to say ‘why did it need to be given in the way it was?’”
Another patient in the 2018 review said:
“I felt a lot of things were done to me rather than with me”.
We need to get this right. We need to give these patients a voice.
Jim Shannon (Strangford) (DUP)
I commend the Secretary of State for bringing this Bill before the House. On all occasions when I have inquired of him, he has been keen to share ideas and thoughts on legislation in relation to Northern Ireland. On mental ill health, deprivation and poverty, the figures for Northern Ireland are some of the highest in the United Kingdom, which worries me as the MP with responsibility for my constituents back home in Strangford. I know he will, but will the Secretary of State share all the ideas in the Bill with Mike Nesbitt—the Health Minister back home—so that Northern Ireland can also benefit?
Wes Streeting
I am happy to reaffirm that we have a really strong working relationship with Minister Mike Nesbitt and the Northern Ireland Executive, and we are keen to share insight wherever we can.
The hon. Gentleman makes a very important point, which refers back to the remarks I made about the limitations of the legislation. Reform of the statute book is important in terms of how the law treats people. But as well as reforming the model of care, clinical pathways and looking at new treatments, innovations and technologies, we also need to focus on prevention, attacking the social determinants of ill health, including mental ill health, of which poverty is a key driver of stress, anxiety, depression and worse. That is why the Government will keep such a focus not just in our 10-year plan for health, but more broadly across public policy.
The current legislation has left many people with a learning disability and many autistic people in mental health hospitals, when they could receive much better care elsewhere. Around four in 10 people with a learning disability or autism could be cared for in the community. The Bill aims to improve the care and treatment people receive when detained, while keeping patients and the public safe. Through the Bill, we are: strengthening and clarifying the criteria for detention and community treatment orders to better support clinicians in their decision-making; introducing increased scrutiny and oversight for compulsory detention and treatment; and providing patients with a clear road to recovery by introducing statutory care and treatment plans for all patients detained under the Act, except if under a very short-term section.
Jen Craft (Thurrock) (Lab)
Does the Secretary of State agree that a proper community treatment plan for those with learning disabilities and autism is not just reliant on the actions of his Department, but a cross-Government effort and an integrated care system at a local level?
Wes Streeting
My hon. Friend is absolutely right. I am very glad that my Department is working closely with other Departments across a range of issues, in particular with my right hon. Friend the Secretary of State for Work and Pensions on the link between employment, welfare and health, and with my right hon. Friend the Secretary of State for Education on the reform of special educational needs and disabilities, and the interface between health and education services—I could go on. The point is that a wide range of factors have an impact on people’s health and wellbeing. Indeed, people’s health and wellbeing can have an impact on a wide range of aspects of their lives, which is why we have to work in a mission-driven cross-Government way.
Alison Bennett (Mid Sussex) (LD)
I thank the Secretary of State for giving way; he is very kind. I was interested, when he was talking about the impacts of mental health on society at large, whether he has given consideration to the Carers Trust proposal, which would amend the Bill so that when a parent has a mental health crisis, checks and safeguards are put in place to ensure that any young carers in that family are suitably cared for?
Wes Streeting
I am grateful to the hon. Member for that intervention and for raising the very serious issue—an issue of increasing prevalence—of the impact of parental mental ill health on children and young people. We are very happy to look at the Carers Trust proposal, and to take representations on that and other issues as the Bill progresses through its Commons stages. We want to ensure that we get not just the legal basis of mental health provision in the right place, but practical care. As we think about children and young people’s mental health and wellbeing, we also need to take into account their parents’ mental health and wellbeing through that lens, too.
Patients’ choices and needs will always be taken into account, thanks to the introduction of a new clinical checklist. It requires clinicians to involve patients and those close to them in decisions affecting their care, while retaining the power to treat individuals compulsorily where absolutely necessary.
Richard Baker (Glenrothes and Mid Fife) (Lab)
Does the Secretary of State agree that that should be a case of “only when absolutely necessary”? In my previous role, I provided advocacy for the family of a young man who has been in a state hospital in Scotland for 17 years under a compulsory treatment order. His family live several hours away in north-east Scotland. That is, in my view, a horrendous infringement of his and their human rights. Will he share any learnings from the action the Government are taking, which is so welcome, on how community treatment can be placed effectively for people who are going through such horrific restrictions on their rights to family life?
Wes Streeting
My hon. Friend’s question raises two key issues with the provision of mental health services. First, we must ensure that the bar is set in the right place for compulsory treatment. Secondly, we must ensure that both compulsory and voluntary treatment in a hospital setting is within a reasonable distance of family, friends and loved ones. My hon. Friend powerfully describes the impact of such cases, where there is not just a deprivation of liberty, but an impact on an entire family. We need to do much better on both sides of the border when it comes to the appropriate placement of people in mental health settings.
There will always be times when patients hit crisis points and lack the ability to express what they want. To ensure that their voice is not lost and that professionals are working with patients, the Bill introduces duties to encourage people to make an advance choice document while they are well. This document provides a record of their wishes for use by mental health professionals, should the patient later experience a crisis that renders them incapable of making their own decisions.
Samantha Niblett (South Derbyshire) (Lab)
I was 11 years old when my mum first tried to take her own life; she was sectioned several times over the coming years, and until I was an adult. How will this new way of treating people and making that part of the community, as well as looking after the children of those impacted, be measured over time so that we know it is successful?
Wes Streeting
I am extremely grateful to my hon. Friend for sharing such personal lived experience of the issues we are debating this afternoon. I encourage her to take every opportunity to share those experiences directly with Ministers or through the passage of this Bill, which others in a similar situation will also have had, so that we can provide the best possible support for people experiencing a mental health crisis and for their loved ones, who also experience an enormous amount of pain and anxiety in supporting someone going through acute mental illness.
We are also updating the outdated nearest relative provisions to allow patients to choose someone to be their nominated person, which gives that individual important powers to represent the patient’s interests when they cannot represent themselves. One patient explained:
“My mother used to perform this role, but she now has Alzheimer’s and she lacks capacity. Under the current system, I cannot specify who I wish to serve as my nearest relative. The responsibility would automatically go to my oldest sister—a sister I do not get on with”.
Our reforms will ensure that this statutory role is not chosen for the patient, but is rather the choice of the patient.
Advocacy services are often a lifeline for those who find themselves in the vulnerable position of being detained, giving a voice to those who may otherwise feel voiceless. Patients have reported that an advocate can ensure that
“their voice and opinion is valued and listened to. They came to my meetings, valued my opinion and put my views across to other people. People listened to my advocate.”
We are also extending advocacy services to patients who come to hospital voluntarily and making changes to improve advocacy uptake among those who are detained, as well as working to change the culture of our health and care services so that everyone is listened to and so that patients do not have to rely on an advocacy service to get their voice heard.
Calum Miller (Bicester and Woodstock) (LD)
I am grateful to the youthful Secretary of State for giving way. In the past few months, I have had a number of constituents describe the difficulties they have had in transitioning from care provided by child and adolescent mental health services to adult mental health services—a critical transition. They specifically faced difficulties in accessing the same medication when they turned 18 that they had previously been reliant on as young people. Can the Secretary of State describe to me how either the Bill or the change in culture for which he is advocating will improve the situation for people like my constituents?
Wes Streeting
I am grateful for that intervention. The hon. Gentleman raises what is, frankly, the depressingly familiar issue of the transition from youth and adolescent services to adult services, which applies across such a wide range of public services. It is so frustrating that we are still, in this decade of the 21st century, describing a problem that was prevalent in the ’90s and noughties.
None the less, we are working to improve not just the law, but the performance in this space. Many of the changes we will be looking to make under the auspices of our 10-year plan are about better joining up of data, information and patient records, better care planning for patients and designing services around patients so that everyone—whatever their age or stage of treatment—receives joined-up services, with clinicians having a full picture of that patient’s experience. Hopefully, that will also help to deal with some of the cliff edges and bumps in the road that people can often experience when transitioning from one part of the NHS to another, whether that is from youth and adolescent services to adult services or the interface between primary and secondary care.
Helen Morgan (North Shropshire) (LD)
I welcome this piece of legislation, which I think is generally in a very good place. I have had a tragic situation in my constituency, where somebody who had been admitted to hospital in a suicidal state discharged themselves, after which, unfortunately, no follow-up care was provided, and they took their own life. It has been devastating for their family. Would the Secretary of State consider looking at how the community supports people experiencing a mental health crisis who might have discharged themselves, and how we can keep them safe in future?
Wes Streeting
I am very grateful to the hon. Lady for that intervention. The Bill deals to an extent with cases that would fall under the category she describes, in particular through reforms to community treatment orders. However, it would not necessarily cover the full extent of the sorts of people who might find themselves in that position, which is where I think we can use technology—which is not the answer to every problem in the health service, by the way. However, through better use of data, patient records and analytics, we will be better able in the future to predict risk and prevent tragedies as in the case the hon. Lady describes, which are a tragedy not just for those whose lives are cut needlessly short, but for those who live their lives with that intolerable grief and loss for the many years that follow.
It is a shameful truth about our society that people with a learning disability or autism are detained, sometimes for years, with little or no therapeutic benefit. The Bill will put an end to that injustice, limiting detentions so that people with a learning disability and autistic people are no longer detained beyond 28 days unless they have a co-occurring mental health condition that would benefit from treatment in hospital. This will require the necessary community provision in place to support people with a learning disability or autism, and we are working to set out what strong community services look like and on the resources required to implement them, so that there are robust alternatives to hospital care.
To help to plug the flow of inappropriate admissions to hospital, the Bill places a duty on integrated care boards to improve monitoring and support for people with a learning disability or autism who may be at risk of future detention. The Bill will introduce statutory care, education and treatment reviews to ensure that patients are safe and receiving the right care and treatment when detained, and that a plan to discharge them to the community is being worked up. We will also remove prison and police cells from the definition of “places of safety”. Police cells are for criminals, not patients in desperate need of medical help.
Throughout the development of these reforms, we have maintained the central purpose of the Mental Health Act—to keep individuals and the wider public safe. The vast majority of people with mental illness, including severe mental illness, present no risk to themselves or others, and, for the majority of people, treatment can be provided without compulsion. However, there are some people whose illness, when acute, can make them a risk to themselves, and sometimes to others.
No one knows this better than the families of Ian Coates, Barnaby Webber and Grace O’Malley-Kumar, the victims of Valdo Calocane’s violent rampage in Nottingham, whose campaign for justice and accountability has been truly awe-inspiring, or indeed the family of Valdo Calocane, with whom I have also spent time, listening to their experience of feeling badly let down by health services. As the independent investigation into the murders found, both he and his victims were failed by the health service, and their families have been left to live with the consequences with a level of pain the rest of us can scarcely imagine. I would like to place on the record my thanks to all four families for meeting me as my team and I worked on the Bill.
Thanks to the amendments that we are making to the Mental Health Act, decision makers will have to consider the risk of serious harm when making decisions to detain. That will ensure that any risks to the public and patients are considered as part of the assessment process. We will also introduce a new requirement for the responsible clinician to consult another person when deciding whether to discharge a patient, putting in place robust safeguards against the release of potentially dangerous people.
Finally, as I have said, legislation alone will not fix the wider issues of increasing mental health needs and long waiting times. To do that, the Government are investing in earlier intervention to meet patients’ needs and prevent them from reaching crisis point.
Iqbal Mohamed (Dewsbury and Batley) (Ind)
Will the Secretary of State give way?
Wes Streeting
I am just coming to my conclusion, I am afraid.
In the past 10 months, we have met the mental health investment standard for 2025-26; invested an extra £680 million in mental health services this year, which is a real-terms increase; funded mental health support teams in schools for almost an extra 1 million pupils; invested an extra £26 million to build new mental health crisis centres; funded NHS talking therapies for an additional 380,000 patients; and begun recruiting the 8,500 mental health professionals we promised in our manifesto. That is all part of the additional £26 billion this Labour Government are investing in health and care services—investment that was opposed by every party on the Opposition Benches; investment that is happening only because we have a Labour Government.
Mental health reform is not just about changing laws; it is about changing lives. The action we are taking will provide support and care to people at their most vulnerable, modernise our mental health services to keep us all safe, and create a safety net that any of us might need one day. I commend the Bill to the House.
Madam Deputy Speaker (Judith Cummins)
I call the shadow Secretary of State.
Edward Argar (Melton and Syston) (Con)
I thank the Secretary of State for bringing the Bill before Parliament. The last update to the Mental Health Act, in 2007, took eight years following the Richardson review, and this Bill has been a similarly long time in the making, so I welcome the speed with which he has moved on it since taking office. Although we may tussle on occasion, as I have said since the election, we on the Conservative Benches will not oppose for the sake of opposition. We will be constructive, working to improve legislation and supporting the Government where we believe they are doing the right thing, and I recognise the Secretary of State’s constructive approach to the Bill.
At the outset, let me join the Secretary of State in paying tribute to the families of Calocane’s victims in Nottingham for what they have done subsequently—their campaigning, their dedication and their work, including on this legislation—and for the incredible dignity with which they have conducted themselves in unthinkable circumstances.
As the Secretary of State mentioned, the Mental Health Act 1983—I will not miss the opportunity to allude to his youthfulness—governs the compulsory detention and medical treatment of people with severe mental illness for the safety and protection of themselves and those around them. He also set out that sadly, all too often, those with learning disabilities or autism have been conflated with that group. We must take this opportunity to address that, and the Bill rightly seeks to do so. In the more than 40 years that have followed the 1983 Act, healthcare, treatments and, crucially, our understanding of mental health illnesses have come on in enormous strides. It is not only important but right that our laws are updated to reflect the modern world and the knowledge that we have today.
We are debating measures that impact those with the most severe mental health issues and their families, but as was highlighted in interventions on the Secretary of State, we should not forget the broader context, the challenges posed by mental health issues more broadly, or the importance of continued investment in this space. We should also recognise the many organisations that do amazing work both to educate society about mental ill health and to support people with mental health illnesses.
Let me take this opportunity to pay tribute to my right hon. Friend the Member for Godalming and Ash (Sir Jeremy Hunt), who has just left the Chamber, for the work that he did on mental health as Secretary of State. I think it is fair to say that, away from the to and fro of party politics, the current Secretary of State shares my right hon. Friend’s passion and determination to address these issues. As he said, we have done much, but I believe we can and must continue to strive to do better.
Keeping legislation up to date is particularly important for a measure such as the Mental Health Act, which gives the state the power to deprive people of their liberties in order to protect the safety of the individual and those around them and to carry out treatment. Those powers should only ever be used when absolutely necessary, and it is therefore right that they are reviewed and updated to ensure that they remain relevant, proportionate and appropriate.
The most recent update to the Mental Health Act, in 2007 under the last Labour Government, introduced community treatment orders and independent mental health advocates and changed the detention criteria. Since then, as the Secretary of State alluded to, trends have emerged that have raised concerns. The overall number of detentions under the Act has been rising steadily. There were around 52,500 recorded detentions in England in 2023-24, including 963 of children aged 17 and under. That is a 2.5% increase on the previous year and around 14% higher than in 2016-17. In the same year, 2023-24, black people were 3.5 times more likely than white people to be detained under the Act, and seven times more likely to be placed on a community treatment order. The reasons for that are likely to be complex, and I will return to them later.
That is why in 2017, just 10 years after the previous update, the then Prime Minister, Theresa May—now Baroness May—commissioned an independent review of how the Mental Health Act was used and how it could be improved. The review considered not only the trends in detentions, but wider concerns about whether some processes were out of step with what should exist in a modern mental health system, including the balance of safeguards, patient choice and patients’ agency in their own care, and the effectiveness of community treatment orders. Sir Simon Wessely published the report of his review in 2018, and I take this opportunity to put on the record again our thanks for his important work.
Edward Argar
The previous Government published a draft Mental Health Bill based on the recommendations in the report, giving others the opportunity to have their say. The draft Bill was subject to pre-legislative scrutiny by a Joint Committee of Parliament, allowing Members of both Houses to thoroughly review it and make recommendations before the final version was introduced.
Given the importance of this area of policy, which can have such a profound impact on people’s lives, I believe it is right that we took the time to get this right. The work to update the Mental Health Act started under the previous Government and we had a commitment in our election manifesto to update the law in this area, and that has been carried on by the new Government. We continue to believe that this is the right thing to do, so I put on the record our in-principle support for the Government on the Bill.
I pay tribute to my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) for his work in this space as a shadow Minister. Not only does he have professional expertise, but he has brought it to the House’s deliberations on this legislation. I suspect that we may hear from him a little later.
There are many areas of the Bill that we welcome, including the strengthening of the patient’s right to express a treatment preference, the expansion of access to independent mental health advocates, and the removal of police and prison cells as places of safety so that patients can be treated in an appropriate setting. That said, of course we will not stand back without scrutinising and seeking constructively to improve the Bill as it passes through the House. Part of our role as the Opposition is to engage constructively in the scrutiny of legislation—to ask questions, to probe further, to seek to prevent unintended consequences, and to identify potential problems and ensure that they are aired in Committee—in order to improve it for everyone’s benefit, and that is what we shall do. I know that my hon. Friend the Member for Hinckley and Bosworth (Dr Evans) will approach the Public Bill Committee in that vein.
We very much welcome efforts to improve patients’ voice and involvement in their own care, including through greater use of advance choice documents. In its current form, the Bill places a duty on NHS England and integrated care boards to make patients aware of their option to have such a document, but this could be as simple as having a poster on a noticeboard, for instance. It does not necessarily require a conversation. Introducing it as a legal right for patients who are being treated or for someone who is at risk of detention would mean that they have to be specifically told about the option, allowing them to make a deliberate decision. I suspect that in Committee we may gently press the Minister to go further in strengthening the patient’s right to have their voice heard. I have been on a number of Bill Committees, and gently hinting to the Minister areas where we might press further may make his and his officials’ lives a little easier when amendments are tabled in Committee.
We were pleased that peers passed an amendment to better protect children who require a nominated person, removing the discretion where a court order regarding parental responsibility is in place. However, we believe there is more we can do to support and protect children, particularly regarding age-appropriate settings for treatment. I hope that when the Minister for Care winds up, or in Committee, he will explore in greater detail the steps the Government are taking to reduce the number of children being treated on adult mental health wards and to ensure that lessons are learned at both national and local service provider level.
Thirdly, we are conscious that a number of elements of the Bill will require additional resources to be put in place. The removal of police and prison cells—sensibly—as places of safety will require sufficient alternative capacity for people to be treated when they are detained. What approach do the Government intend to take in addressing this?
Increasing the frequency with which patients can apply to the mental health tribunal to have their detention reviewed and widening automatic referrals will potentially increase demand and pressure on the system. We know that the legal system is already under pressure, and the impact assessment acknowledges that there will be impacts and costs, so is the Minister confident that the system has the capacity to handle the additional demands? If not, what steps are being taken with the Ministry of Justice to address that?
Edward Argar
The hon. Gentleman is right to highlight both the costs and the investment that is needed, but the cost does not detract from the importance of and need for the measures set out in the legislation. He points out that as a proportion of overall health spending, mental health spending has fallen slightly in the latest figures. I hope that the Minister in his wind-up will address how the Government will ensure that this legislation, which enjoys broad support across the House, has the resources behind it to deliver the outcomes we all wish to see in practice?
Edward Argar
I will regret doing so, but of course I give way to the Secretary of State.
Wes Streeting
I should point out for the record that mental health spending has increased in real terms this year, thanks to the decisions the Government have taken. As a proportion of spend on health services overall, it is true to say that it has decreased by 0.07%, but that does not take into account the fact that as well as investing heavily in our elective backlog and in clearing waiting lists, we are investing in general practice, which will benefit enormously people with mental ill health.
Edward Argar
The Secretary of State was kinder than he normally is, and I am grateful to him for acknowledging the reduction in the proportion of mental health spending—it is slight, but it is none the less a reduction. I hear what he says more broadly, but I hope that he and the Minister will reiterate their commitment to ensuring that the legislation succeeds, which we all wish for, and that the pressures it may place on parts of the system will be addressed and not simply be absorbed within the system. I suspect that the Minister will come to that in his concluding remarks.
While it is the right principle to direct more mental health patients away from in-patient hospital settings and to community treatment settings where clinically appropriate—this is key, and goes to the Secretary of State’s point—we must ensure that the NHS has the capacity to provide community treatments when the Bill is on the statute book. The Government accepted that the reforms will take a number of years to implement, given the need to recruit and train more clinical and judicial staff, but what is the plan and how much will it cost? Will it be phased in over a number of years?
The NHS workforce plan will nearly double the number of mental health nurses by 2031-32, but the Secretary of State has said that he intends to update the plan. It would be helpful if, during the Bill’s passage, he or the Minister could tell either the Bill Committee or this Chamber what the changes that he envisages making through this legislation will mean for the workforce.
We recognise the significance of the provisions limiting the detention of patients with a learning disability or autism. Under the Bill, they can be detained for treatment only if they have a co-occurring mental health condition that requires hospital treatment and meet the criteria in the Mental Health Act 1983. Autism alone would no longer justify continued detention under the 1983 Act; in theory, this will ensure that those with autism receive the appropriate support in the right setting, as we would all wish. What steps are being taken to ensure that there are sufficient services, with sufficient capacity, to properly support people with autism and learning disabilities? Can he confirm that under this legislation, there will always be a central role for professional clinical judgments on these matters?
This debate in part follows on from concerns being raised about racial disparities in the application of the Mental Health Act. Can the Secretary of State or the Minister provide more evidence to help the House better understand this issue? What research has been undertaken, or is being planned, to enable us to understand what is behind the statistics?
We welcome this important opportunity to look again at how we treat and protect people with the most severe mental illnesses, and to ensure that our laws remain relevant and proportionate in the modern world, empowering people and treating them humanely. Updating the Mental Health Act is the right thing to do, and we will work constructively with the Government to improve the safety, treatment, agency and, crucially, dignity of mental health patients who are detained, and of the wider public.
Better Care for Veterans: National Training and Education Plan
Wes Streeting Excerpts(1 month, 2 weeks ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Wes Streeting)
As the nation marks the 80th anniversary of VE Day, we are announcing a new national training and education plan to transform healthcare for the armed forces community across England.
The Government are proud of the courage and dedication of our armed forces. It is our duty to ensure that those who have been injured or are unwell, whether physically or mentally, receive the very best possible care. However, the NHS is not currently set up to provide the best possible services to the armed forces community. Too many veterans still struggle to navigate civilian healthcare systems and may not self-identify as veterans to NHS staff, putting them at risk of missing out on the additional support and bespoke services that are already available. That is why we are rolling out the national training and education plan—to help guarantee that armed forces veterans and their families benefit from the improved and targeted healthcare that they deserve. The plan will train and educate NHS staff across the country to meet the unique health needs of veterans, serving personnel and their families.
NHS staff across England will receive dedicated training to help them identify and support patients with military backgrounds. GPs, NHS doctors, nurses and managers will work with regional trainers to make sure they embed this support into their services. The three-year training programme, backed by £1.8 million, will be rolled out across England from October 2025.
This announcement sits within wider Government commitments to veterans, including putting the armed forces covenant fully into law, and the newly announced Operation Valour, a £50 million boost in funding to ensure that veterans across the UK have easier access to essential care and support. The national training and education plan will ensure that the NHS is set up to fulfil the armed forces covenant, with the appropriate training and education required to develop a skilled, educated and inclusive NHS primary, community and secondary care workforce, to meet the evolving needs of the armed forces community within the NHS in England. This new training is part of our plan for change to fix the NHS and make sure it works for everyone, including those who have risked everything to serve our country.
[HCWS624]
Oral Answers to Questions
Wes Streeting Excerpts(1 month, 3 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Jo Platt (Leigh and Atherton) (Lab/Co-op)
The Secretary of State for Health and Social Care (Wes Streeting)
Despite my best efforts, may I welcome the hon. Member for Runcorn and Helsby (Sarah Pochin) to her place? Being a Member of Parliament is a privilege, and I know how special it is to sit on these Benches having been sent here by constituents. Regardless of our political differences, I wish her well personally.
As part of our 10-year plan for health, we want to deliver a real shift in the centre of gravity in the NHS, so that people get more care closer to home and, indeed, in their home, too. The NHS is as much a neighbourhood health service as a national health service. We have already made progress in shifting care to the community: providing more than £889 million in funding for GPs; agreeing the GP contract for the first time since the pandemic; and recruiting more than 1,500 GPs on to the frontline. Our 10-year plan will set out how we will continue to transform the NHS into a neighbourhood health service.
Jessica Toale
I am deeply concerned about the quality of healthcare for people experiencing homelessness in my constituency of Bournemouth West. HealthBus, a local charity, is doing great work in getting out into the community to treat people where they are and to prevent them from having to go into hospital, but it is not getting the funding that it needs and has discovered serious discrepancies in the way that the local integrated care board commissions services, particularly in relation to health inequalities. Can the Secretary of State tell me how this Government are prioritising health outcomes for people experiencing homelessness, and will he meet me and HealthBus to discuss how we can support its important work?
Wes Streeting
The founding mission of the NHS was to be there for people whenever they fall ill, so that they never have to worry about the bill. Unfortunately, thanks to the disaster and the failures of 14 years of Conservative Government, too many people in our country today experience the fear that Nye Bevan sought to eradicate. As my hon. Friend would expect, tackling health inequalities for homeless people and other vulnerable groups is central to the values of this Labour Government. Those values will be reflected in our 10-year plan for health. I would be delighted to hear from her further on what we can do to improve services in her area.
Jo Platt
I thank the Secretary of State for his announcement this morning regarding GP services. One way that pressure is eased in our GP services is through charities such as Compassion in Action, which provides non-clinical, whole-person care in my constituency. It receives GP referrals from across Leigh and aligns with the Government’s aim to shift care from hospitals to communities. Will the Minister join me in thanking the staff and the founder, Pam Gilligan, and agree to come for a tour of the facilities and to see at first hand the impact that they have?
Wes Streeting
I wholeheartedly join my hon. Friend in thanking Pam and everyone at Compassion in Action for the work that they do. At the heart of our approach to health is a recognition that Government action is essential for improving health outcomes in the country, and that Government acting alone will not be sufficient. That is why working with the voluntary sector, employers, trade unions, community groups and all of us as individual citizens is vital for tackling health inequalities and improving care in our country. I would be delighted to ensure that one of the team pays a visit to the charity as soon as possible.
Stuart Anderson (South Shropshire) (Con)
Community hospitals can reduce pressure on major hospitals, especially in rural communities such as mine. Will the Secretary of State lay out his plans to support community hospitals in South Shropshire?
Wes Streeting
At the heart of this Government’s approach is investment in, and reform of, the NHS to ensure that we deliver better outcomes for patients. That means the biggest devolution of power in the history of the NHS with more decisions taken closer to patients and to their communities, and more power in the hands of patients, too. Community hospitals have a vital role to play, and thanks to this Government’s decision to deliver £26 billion more into our NHS—opposed by the Conservative party—we will no doubt be able to make further and faster progress.
Susan Murray (Mid Dunbartonshire) (LD)
In my constituency there is an ageing population in need of local healthcare services. Will the Secretary of State meet his Scottish counterpart to discuss the need for increased access to community healthcare, and specifically the need for a new health and care centre within my constituency?
Wes Streeting
The hon. Member will be delighted to know that only last week I met with my counterparts in Scotland, Wales and Northern Ireland to talk about how we can work together to improve health and care throughout the United Kingdom of Great Britain and Northern Ireland. She will know that health is devolved, but thanks to the decisions taken by this Labour Government, the Scottish Government have just been delivered the biggest financial settlement since devolution began. That might mean that they finally make some progress on their waiting lists in Scotland, where one in six Scots are on a waiting list and the SNP is on its fifth NHS reform plan in four years.
Alex Ballinger (Halesowen) (Lab)
Natasha Irons (Croydon East) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
People deserve the very best health and care. Our plan for change is already bringing waiting lists down. Our 10-year plan for health will set out how we improve access and make the three shifts that I described earlier, so that the NHS is fit for the future. At the same time, we are rebuilding adult social care now and for the future. Baroness Casey’s independent commission has launched, and it will set out through its work how we will create a national care service. All that is made possible thanks to the investment decisions taken by the Chancellor in her Budget. That investment was opposed by the Conservative party, which shows that only Labour can be trusted to invest in and modernise our NHS.
Natasha Irons
Last week, the Centre for Young Lives published a report on the state of mental health support for children and young people across England. It outlines that despite an ongoing crisis in mental health among young people,
“There remains a 55% treatment gap”
between adult and children’s mental health, and that
“fewer than 10%...of ICBs have a dedicated strategy”
for supporting children’s mental health. Will the Secretary of State consider strengthening statutory guidance for ICBs to ensure they assess the local need of children and young people, publish treatment gap data on an ongoing basis, and create joined-up, community-based mental health support for our young people?
Wes Streeting
Young people’s mental health is a priority for this Government. That is why we set out in our manifesto our commitment to making sure that mental health support is available in every primary and secondary school in the country. We have walk-in mental health services in every community, and we invest in the mental health workforce, so that we can cut waiting times. I am also working closely with the Secretary of State for Education to make sure that our education and health services work together, so that children get the very best start in life, and so that we look after mind, body, soul, aspiration and futures.
Joe Robertson (Isle of Wight East) (Con)
The Chancellor increased the cost of employing people in social care by raising national insurance contributions for social care employers, and then exempted NHS employers from those increased costs. When will this Government properly support social care and relieve the sector from pressures caused by the Chancellor under this Government?
Wes Streeting
Thanks to the decisions taken by this Chancellor, we are putting £26 billion more into health and social care. Thanks to the decisions taken by this Chancellor, the spending power of local authorities has risen. Thanks to the decisions taken by this Chancellor, we have delivered the biggest expansion of carer’s allowance since the 1970s. Thanks to the decisions taken by this Chancellor, we have significantly increased the disabled facilities grant, not just last year but this year. That is the investment delivered by a Labour Government, and opposed by the Conservatives and Reform, and it shows that only Labour can be trusted with our NHS.
Mr Speaker
You will have another chance in a minute! I call the shadow Minister.
Dr Luke Evans (Hinckley and Bosworth) (Con)
This Government have been in power for 10 months. Two months ago, Labour postponed the cross-party talks on social care. When will they be rescheduled?
Wes Streeting
As I have announced to the House, Baroness Casey’s independent commission is up and running. She is making contact with parties across the House as part of the work of her commission, and it is for her to decide the basis on which she engages with parties. I look forward to working with parties at the conclusion of the process.
Dr Evans
I thank the Secretary of State for that change, making the process no longer cross-party. The Government have said that the changes will not be implemented fully until 2036. Only this week, the Health and Social Care Committee released its new report on social care and the huge cost of inaction. The report called for new actions that could be taken now, such as the publishing of annual assessments of unmet care needs for adults, and annual estimates of how much delayed discharges cost the NHS. Will the Secretary of State commit to those two today?
Wes Streeting
I take the Select Committee seriously, and I will look carefully at its report, but the shadow Minister has some brass neck. He mentions this Government having been in office for 10 months, but the Conservatives had more than 10 years in office, and we are picking up the pieces from the mess they left behind. That is why they were kicked out of government, and why they are being kicked out of opposition. Looking at this lot, I think: this must be how the islanders felt, looking at the dodo.
Manuela Perteghella (Stratford-on-Avon) (LD)
Gregory Stafford (Farnham and Bordon) (Con)
The Secretary of State for Health and Social Care (Wes Streeting)
As the Prime Minister and I announced, NHS England will be brought back into the Department to put an end to the duplication, waste and inefficiency resulting from two organisations doing the same job. That is the final nail in the coffin of the disastrous 2012 reorganisation, which led to the longest waiting times, lowest patient satisfaction and most expensive NHS reorganisation in history. Since the announcement, we have set up a joint board, assessed resources and responsibilities across existing organisations, developed proposals about the role, functions and structure of the new centre, and started detailed operational and legislative planning.
Gregory Stafford
The Secretary of State claims to support change, yet delays to NHS reorganisation, including to the promised abolition of NHS England, suggest otherwise. Is it not the truth, as he outlined in his Guardian article, that he is bogging the system down in a slow, top-heavy restructuring, while resorting to tax rises, instead of delivering the decentralised, locally delivered, value-for-money healthcare that our constituents deserve?
Wes Streeting
A lot of words and not a lot of sense. We are reforming the NHS and, as a result of these changes, redirecting hundreds of millions of pounds to the frontline. What was the Conservative party’s response to the abolition? The shadow Chancellor of the Duchy of Lancaster, the hon. Member for Brentwood and Ongar (Alex Burghart), said it could be a “great thing”, but it
“could be a total disaster”.
Will they let us know when they have made their mind up?
Anna Dixon (Shipley) (Lab)
The Lansley reforms were implemented top down by the Conservatives. The idea that the NHS could ever be truly independent, when it is there to serve us—the taxpayer and the general public! Does the Secretary of State agree that it is absolutely the right decision to move funding away from the centre to the frontline to prioritise patients in the NHS’s work?
Wes Streeting
My hon. Friend has huge experience in this area, and she is absolutely right. What we saw under the Conservatives was bloated bureaucracy—layer upon layer of checkers, when we need more doers. That is why frontline staff, patients and provider leaders all welcome the changes that we are making, so that we can invest more into our frontline.
Edward Argar (Melton and Syston) (Con)
The Health Service Journal reports that officials have acknowledged that the first draft of a high-level plan for merging NHS England and DHSC has been delayed. When we ask any written question about the merger, the standard answer seems to be:
“Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to determine the structure and requirements needed to support the creation of a new centre for health and care.”
Even when we ask a question specifically about the size of the transformation team, the answer is virtually identical. The Government either wilfully decide not to answer, or simply do not know. As with so many things, the Government go for the headline-grabbing announcement and talk the talk on reform, without having done the actual work to deliver it. My question to the Secretary of State is simple: when will that first high-level plan for the merger, with a full assessment of costs and savings, be published?
Wes Streeting
Honestly, the right hon. Member had his chance—he was the Minister who took forward the last reform Act, under the Conservative Government. He failed in that task, and now he turns up without a shred of remorse or a shred of humility, attacking this Government for cleaning up the mess that the Conservatives left behind. They are not a party of government—they are not even a party of opposition any more. They are a total irrelevance.
Josh MacAlister (Whitehaven and Workington) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
Reducing hospital backlogs is a key priority in this Government’s plan for change, as the 18-week standard for elective care has not been met for almost a decade. Our elective reform plan sets out how we will return to that standard by the end of this Parliament, through a combination of investment and reform. Since July, the waiting list has reduced by over 219,000 and we have delivered an extra 3 million appointments, exceeding our manifesto pledge and doing it earlier than planned.
Adam Jogee
I am grateful to the Secretary of State for his answer and for the progress made, but there is still more to do. My constituent in Newcastle-under-Lyme has recently been recovering from brain surgery at the Royal Stoke university hospital. However, she has faced multiple setbacks due to failures in the duty of care, including scalding injuries and a severely mishandled admission process. She is now receiving the correct care, but she had to wait many months to be admitted to the correct ward, and has been given limited time for rehabilitative treatment. Does the Secretary of State agree that to tackle backlogs, our hospitals must have the resources they need to provide the right care the first time round, so that patients are given the time and support to fully and effectively recover?
Wes Streeting
I am grateful to my hon. Friend for his question, and horrified to hear about his constituent’s experience. This Government will never brush problems under the carpet or pretend that things are better than they are, and I know that for all the progress we have made in the past 10 months, there is still so much more to do. When we publish our 10-year plan for health, we must ensure that quality and safety are at the heart of every patient interaction. My hon. Friend is right about the need for investment. That is why we are investing £26 billion in the NHS and social care, and why it is so disappointing that the Opposition parties voted against it.
Wera Hobhouse (Bath) (LD)
On a recent visit to the breast unit of the Royal United hospital in Bath, specialists told me about a red flag system that could help to speed up care. If someone has a red flag symptom, such as a lump or a bleeding nipple, the triage team can book them straight into the breast clinic, rather than waiting to see a GP. Does the Secretary of State support such an approach?
Wes Streeting
I thank the hon. Member for her extremely constructive contribution. That is exactly why at the heart of our plans for reform and modernisation, we are placing such an emphasis on digital and technological transformation. We have such rich data about the experiences of our patients, but we are not using it effectively enough. If we use the information more effectively and efficiently, we can spot and identify risk much more proactively, and ensure that people get timely access to urgent care and treatment when they need it.
Dr Marie Tidball (Penistone and Stocksbridge) (Lab)
I am grateful to the Secretary of State for the work that he and his team have done to reduce NHS waiting times month on month for the last six months. However, the backlog that grew under the last Conservative Government is still impacting on my constituents. I have listened to countless constituents who have told me about the upsetting impact of long waiting times for an ADHD diagnosis for children. That is having a detrimental knock-on impact on access to support, including child and adolescent mental health services and shared care agreements, and there is a lack of support for adopted children. I welcome the news that waiting lists have gone down, but will the Secretary of State set out how his work will be targeted at bringing down waiting lists for ADHD diagnoses in my constituency, to ensure consistency in diagnosis rates across trusts?
Wes Streeting
I am so grateful to my hon. Friend for her question, and I pay tribute to my right hon. Friend the Secretary of State for Education, who is leading cross-Government work in that area. We have a taskforce that is specifically looking at the issues that my hon. Friend raises, and together we are looking to ensure that our education and health services are better joined up to meet the needs of young people. I am working with my hon. Friend the Member for Whitehaven and Workington (Josh MacAlister) and drawing on his experience to look at how we can improve the health and care of care-experienced young people and young adults. I hope we will have lots of progress to report on those issues.
Lee Anderson (Ashfield) (Reform)
One way to reduce the backlogs is to reduce or put an end to health tourism in this country, whereby people come to this country, get their treatment, and then nip back to where they come from. Does the Secretary of State think it is a good idea that people entering this country should provide evidence of health insurance or be refused entry?
Wes Streeting
When any of us travel abroad, we expect to take out travel insurance and pay for our healthcare needs overseas, and that is the standard that we expect for visitors to our country. We have lots more to do to improve on that front. I deplore the comments made by the hon. Gentleman’s party leader, who said that he does not support a taxpayer-funded NHS for the British people. He might want that debate, and the Leader of the so-called Opposition says that she wants that debate, but as far as Labour is concerned, we are clear about where we stand. Under Labour, the NHS will always be a national health service, publicly funded and free at the point of use.
Seamus Logan (Aberdeenshire North and Moray East) (SNP)
The Secretary of State for Health and Social Care (Wes Streeting)
This Government are taking a hard-headed approach to cutting waiting times. We are investing an extra £26 billion in our NHS, and where the independent sector has spare capacity, we will pay to get NHS patients treated faster and free at the point of use. So far, our approach to investment and reform has cut waiting lists by more than 200,000. Perhaps the hon. Member will tell us how it is going in Scotland.
Seamus Logan
The Secretary of State claimed this morning on BBC Radio 4’s “Today” programme—a most excellent programme—that Labour is the only party that can be trusted with the national health service. Can he confirm that no aspect of the NHS whatsoever, whether it is ownership of the estate, the provision of specialist services or any other form of privatisation, will be included in the much-promised trade deal between the UK and the United States? No more excuses, Secretary of State: just give a direct answer to a direct question.
Wes Streeting
I have said it before, and I will say it again: the NHS will be privatised over my dead body. This party founded the NHS as a publicly funded public service, free at the point of use. We use the independent sector to cut waiting lists, and guess what? The SNP-led Government in Scotland do the same thing. We have made it clear that the NHS is not up for sale in any trade deal. That is clear and unequivocal. The hon. Gentleman can sling mud as much as he likes, but he cannot run from the SNP’s abysmal record on the NHS over 18 long, poor years.
Yuan Yang (Earley and Woodley) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
GPs are at the front door to our NHS. Today, I can announce that we are supporting more than 1,000 surgeries across the country to modernise their buildings, backed by more than £102 million—the biggest public investment in GP facilities for five years. Following years of neglect, this vital funding will create additional space to see more patients, boost productivity, improve patient care and enable 8 million more family doctor appointments each year.
Yuan Yang
I very much welcome today’s announcement on refurbishing 1,000 GP surgeries across the country, because I have made it my priority to meet with as many GPs as possible in my constituency. Our local GPs have told me that our health centres need more physical space in order to accommodate growing local needs and facilitate the expansion of healthcare into the community. Is the Secretary of State willing to meet me and my local GPs to discuss how we can better improve the physical space needed for care to be brought closer to people’s homes?
Wes Streeting
I would be delighted to do so. Since we came into government, we have made this announcement today, put £889 million into general practice and agreed a contract with GPs, including reform for patient access and services. We are fixing the front door to the NHS, but of course that will take time. We recruited 1,500 more GPs by the end of March, but day by day, week by week, month by month and year by year, people should see improvements in their GP services thanks to Labour.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
Taking medicines on time is important, especially for those with conditions such as diabetes and epilepsy. Dr Acheson, an A&E consultant who has time-critical medicines for his own Parkinson’s disease, understands that well. He has been running a quality improvement programme to ensure that time-critical medicines are given on time in A&E. Will the Secretary of State lend that project his support and commit to reviewing how time-critical medicines are delivered on wards?
Wes Streeting
I thank the shadow Minister for her constructive question. I would be delighted to hear more about that initiative. She is absolutely right about timely access to medicines, and through a combination of service reform and the modernisation of technology, we can assist clinicians and patients to help them to manage their medication and ensure that people get timely access to medicines.
Dr Johnson
I thank the Secretary of State for that answer, and I would be delighted to meet him to discuss it further.
Unfortunately, when Labour negotiates, Britain loses. The Government capitulated to union demands with nothing in return. It is therefore of no surprise to anyone that within months, they are back in dispute with resident doctors and the British Medical Association has announced a ballot for strike action. What will the Secretary of State do to protect patients and taxpayers?
Wes Streeting
I will tell the hon. Lady what we are not going to do: we are not going to see £1.7 billion wasted on strikes by resident doctors or 1.5 million cancelled operations and appointments, which is exactly what happened on the Conservatives’ watch. Within three weeks, we ended the strike by resident doctors and we have cut waiting lists by 200,000 as a result. As I have said to resident doctors, their pay offer will be fair and neither staff nor patients want to go back to the bad old days of strikes under the Tories. They had an unwilling and incalcitrant Government under the Conservatives, who were unwilling to work with resident doctors, but we want to work with them to deliver better care for patients.
Mr Richard Quigley (Isle of Wight West) (Lab)
Helen Morgan (North Shropshire) (LD)
In his statement to the House just after Christmas, the Secretary of State acknowledged that cross-party consensus is essential to delivering meaningful social care reform. The Liberal Democrats support him in that endeavour, but we still do not have a date for those cross-party meetings, so will he give us one now?
Wes Streeting
Dates for meetings with the commission are now a matter for the independent commission.
Josh MacAlister (Whitehaven and Workington) (Lab)
Sir Jeremy Hunt (Godalming and Ash) (Con)
Wes Streeting
The funding is still there, but as many people have urged me, including the right hon. Gentleman, we are taking the decision to give more freedom and flexibility to independent care boards, systems and providers to determine how they can best spend NHS resources on services to improve patient care, safety and outcomes. Everyone will know that maternity safety is understandably a priority for this Government. We expect the NHS to deliver on maternity safety standards and will hold it to account on that.
Olivia Bailey (Reading West and Mid Berkshire) (Lab)
Bob Blackman (Harrow East) (Con)
Wes Streeting
We are absolutely convinced that better use of digital tools will enable us to reduce the number of missed appointments significantly and factor in the likelihood of no-shows, so that we can reduce waste and eliminate inefficiency. I understand the case for penalties that the hon. Gentleman is making, but that is not a route we want to go down until we have made those improvements and judged how effective they have been.
Jim Dickson (Dartford) (Lab)
Blake Stephenson (Mid Bedfordshire) (Con)
Wes Streeting
Thanks to the investment that the Chancellor committed to, we are investing in the NHS estate, which is in a sorry state. I am afraid that that is an investment that the hon. Gentleman did not vote for, and his constituents will be fuming when they find out who was responsible.
Mr Bayo Alaba (Southend East and Rochford) (Lab)
I recently heard from Chelsea, a constituent of mine, who raised concerns about her grandmother Anna’s care. After a delayed discharge, she was released with the wrong equipment, which sadly resulted in her falling out of bed and sustaining a further injury. Ensuring that patients are discharged in a safe and timely manner is key to continuing the Department’s significant progress in cutting waiting lists for treatment, so what steps is the Secretary of State taking to promote integrated working between services to support discharge into the community for patients?
Wes Streeting
I am extremely sorry to hear about that particular case. It is really important that we support and facilitate better discharge, which is why we are reforming the better care fund and looking to better integrate health and social care services through our 10-year plan. I would be delighted to hear further from my hon. Friend about what we can do to improve in his area.
Tessa Munt (Wells and Mendip Hills) (LD)
Ellie Chowns (North Herefordshire) (Green)
Yesterday’s report from the Health and Social Care Committee is explicit that we cannot build an NHS fit for the future without effectively reforming social care. Back in January, the Secretary of State promised cross-party talks as well as Baroness Casey’s commission. He cannot outsource political leadership to Baroness Casey. Political will is the sticking point with the reform of social care. Will he show that leadership and bring the parties together to find the solutions to unblock this crisis?
Wes Streeting
Since we came into government, we have already taken action on social care with the investment we have put in—the biggest expansion of carer’s allowance and the funding for home adaptations through the disabled facilities grant. Now that the commission is up and running, there will be cross-party engagement, but it is an independent commission and for Baroness Casey to decide how to engage.
Catherine Atkinson (Derby North) (Lab)
Last week, this Labour Government announced the freezing of prescription charges, putting pounds back in the pockets of people in Derby. I have visited pharmacies, including the Littleover pharmacy, which provide essential care and support for their communities. The Conservatives underfunded pharmacies and more than 750 closed across England between 2021 and 2024. What is the Minister doing to support community pharmacies so that we do not lose these vital local services?
Calum Miller (Bicester and Woodstock) (LD)
I welcome today’s announcement of new money for GPs’ surgeries, but GPs in my constituency tell me that they cannot get capital out of the integrated care board and that the Valuation Office Agency consistently undervalues the cost of rents, making future building impossible. Will the Secretary of State agree to meet me, and GPs from my constituency, in order to understand the problem better?
Wes Streeting
Thanks to the investment that we have announced, those practices will be upgraded. I advise the hon. Gentleman to engage with his local ICB. We are happy to receive representations if we can help, but let me gently point out that the investment is only possible thanks to the decisions made by the Chancellor, which he opposed.
Sonia Kumar (Dudley) (Lab)
Ladies Walk NHS health centre in Sedgley is a vital hub for my constituents, providing essential services such as phlebotomy and diabetic foot care, but owing to the inaction of the Conservative council this much-needed community asset faces closure in 2026, leaving residents without access to critical care. Will my hon. Friend agree to meet me to discuss urgent steps to safeguard the future of the centre and ensure that Sedgley residents continue to receive the NHS services on which they rely?
Vikki Slade (Mid Dorset and North Poole) (LD)
Last month I began to receive concerning emails from employees of the NHS trusts in my constituency, saying that the trusts were seeking to create a subsidiary company and move staff into it. They are really worried about their future rights. I know how important it is to the Secretary of State that people have good employment rights. What steps is he taking to ensure that there is full consultation with staff before the creation of subsidiaries, and to prevent the creation of two-tier employment practices in the NHS with no continuity of service?
Wes Streeting
While I understand the desirability of such arrangements for NHS trusts, this Government are absolutely clear that staff must be in receipt of good NHS terms and conditions, and must feel part of the NHS workforce and the NHS family. I would be happy to receive further representations from the hon. Lady.
Independent Commission on Adult Social Care: Terms of Reference
Wes Streeting Excerpts(1 month, 3 weeks ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Wes Streeting)
The Independent Commission on Adult Social Care, chaired by Baroness Louise Casey of Blackstock DBE CB, formally launched on 29 April with a meeting with people with first-hand experience of the social care system. Today, I am updating the House that we have published the terms of reference. A copy has been placed in the Libraries of both Houses and on gov.uk at https://www.gov.uk/government/publications/independent-commission-into-adult-social-care-terms-of-reference/independent-commission-into-adult-social-care-terms-of-reference A copy can also be found on the commission’s website at https://caseycommission.co.uk/about/terms-of-reference/
The commission, reporting to the Prime Minister, will work with people drawing on care and support, their families, staff, parliamentarians, local government and the public, private and third sectors to make clear recommendations to define and build the adult social care system that will meet the current and future needs of our population. The commission will consider older people’s care and support for working-age disabled adults separately, recognising that these services meet different needs.
Split over two phases, the commission will set out a vision for adult social care, with recommended measures and a road map for delivery:
The first phase, reporting in 2026, will identify the critical issues facing adult social care and set out recommendations for effective reform and improvement in the medium term. It will recommend tangible, pragmatic solutions that can be implemented in a phased way to lay the foundations for a national care service. The recommendations of this phase will be made within the Government’s spending plans which will be set out at the spending review.
The second phase, reporting by 2028, will make longer-term recommendations for the transformation of adult social care. It will build on the commission’s first phase to deliver a more preventative model of care needed to support our ageing population, and how to best create a fair and affordable adult social care system for all.
The challenges facing adult social care—from inconsistent standards of care to an undervalued and overstretched workforce, and a lack of support for unpaid carers—are complex and deeply rooted. There have been plenty of good ideas in the past 15 years, but we have been missing the broad consensus we need to find a solution around what our country wants from social care so that it stands the test of time.
That is why Baroness Casey has been tasked with starting a national conversation on what people expect from adult social care as well as building cross-party consensus. Given the independent nature of the commission, Baroness Casey and her team will take any future discussions with political parties forward.
While an independent commission is necessary to address the challenges facing the sector, the Government are taking immediate action to improve it. We are making available up to £3.7 billion of additional funding for social care authorities in 2025-26, we have increased the carer’s allowance earnings limit and introduced legislation that is paving the way for the first ever fair pay agreement in adult social care. The Government are also taking forward a range of initiatives for 2025-26 including announcing new measures to professionalise the workforce, uplifting the disabled facilities grant, promoting better use of care technologies, enabling frontline care and health staff to digitally share up-to-date information, and changes to the better care fund.
I am confident that, with Baroness Casey’s leadership and experience chairing this momentous commission, and with help and support from across the House, she will set us on the road to fundamental reform that will build an adult social care system fit for the future.
[HCWS615]
NHS Prescription Charges
Wes Streeting Excerpts(1 month, 4 weeks ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Wes Streeting)
The Prime Minister, my right hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer), has announced that NHS prescription charges in England will be frozen for the first time in three years. This builds on wider Government action as part of the plan for change to tackle the cost of living crisis, and will save patients around £18 million in 2025-26.
The single charge for prescriptions in England will remain at £9.90. The cost of prescription prepayment certificates will also remain the same, with three-month PPCs staying at £32.05,12-month PPCs at £114.50, and the hormone replacement therapy PPC staying at £19.80.
The charges freeze will also apply to NHS wigs and fabric supports; these prices will remain at current levels:
Surgical brassiere £32.50
Abdominal or spinal support £49.05
Stock modacrylic wig £80.15
Partial human hair wig £212.35
Full bespoke human hair wig £310.55
Around 89% of prescription items in England are already dispensed free of charge to children, over-60s, pregnant women, and those with certain medical conditions. This freeze will not impact current exemptions. All working-age adults who would normally pay for their prescriptions, which is estimated to be around 40% of the population, could benefit from the freeze.
In addition to the freeze on charges, the NHS low income scheme offers help with prescription payments; there are free prescriptions for eligible people in certain groups, such as pensioners, students, and those who receive state benefits or live in care homes.
The prescription charge freeze builds on wider government action to tackle the cost of living, including the roll-out of free breakfast clubs, expanded childcare through 300 new school-based nurseries, lowering the cost of school uniforms, and extending the fuel duty freeze—all aimed at easing financial pressures on families across the country.
This announcement also follows news last month of the Government agreeing funding with Community Pharmacy England worth an extra £617 million over two years. The investment comes alongside reforms to deliver a raft of patient benefits, as part of the Government’s agenda to shift the focus of care from hospitals into the community, so that people can more easily access care and support on their high streets.
Alongside action to rebuild the NHS, the Government’s plan for change is focused on growing the economy to improve living standards across the country. The charges freeze will help contribute to this.
[HCWS611]
2023 Agenda for Change Deal: Non-pay Workstreams
Wes Streeting Excerpts(2 months ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Wes Streeting)
Today I am updating the House on work under way to improve the working lives of NHS staff.
The 2023 Agenda for Change (AfC) pay deal, agreed between the previous Government and the NHS Staff Council, included 10 commitments to look at issues that impact NHS staff. Some of these commitments have already been fulfilled; however, five of the commitments involved representatives from the Department, the NHS Staff Council, NHS Employers and NHS England working collaboratively to produce recommendations for Government to consider.
These five commitments included: identifying ways to support the fair and consistent application of the NHS job evaluation scheme (JES), ways to improve nurse career progression, options to tackle violence and aggression against NHS staff, ways to reduce agency spend through the NHS terms and conditions, and options to improve support for newly qualified healthcare registrants.
I have now carefully considered each of the 37 recommend- ations that have been made, in the context of the extremely challenging fiscal situation and other departmental priorities.
I am delighted to inform Members that I will be taking forward 36 out of the 37 recommendations at this time, which will have a considerable and positive impact on the NHS workforce. The full list of recommendations has been published at https://www.nhsemployers.org/articles/nhs-staff-council-joint-statement-2023-non-pay-commitments I will continue to update my colleagues as we work in partnership with NHS Employers to improve the working lives of colleagues across the NHS.
The NHS should always be a great place to work, regardless of job role or location. Staff should be free from fear of violence, aggression or discrimination and I know that the Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth), looks forward to working closely with colleagues in the Social Partnership Forum to implement all the recommendations to better protect staff from the risk of violent behaviour. This includes encouraging a reporting culture where all incidents of violence and aggression are reported, the consistent collection of data, and developing a standard approach to post-incident support for all staff that are impacted.
Supporting career progression for our nurses is another important aspect of this work. As a result of these recommendations, our ethnic minority and internationally educated nurses should receive better and more consistent support for their career progression through six-monthly career reviews and more consistent recognition of their overseas experience. In combination, all the recommendations will have a positive impact on the experience of our highly valued nursing staff.
I wanted to take this opportunity to particularly highlight the importance of accurate and consistent application of the NHS job evaluation scheme (JES). Staff should expect to be paid correctly for the work that they are asked to deliver by their employer, as is their contractual right. That is why I am particularly pleased to be accepting the package of recommendations relating to improving local job evaluation practice.
The NHS JES underpins the AfC contract as the mechanism for determining the pay bands for all posts under the NHS terms and conditions (Agenda for Change). It is the responsibility of each NHS employer to comply with the Equality Act 2010 which mandates equal pay for work of equal value.
All NHS organisations should have the necessary resources and skills in place to be confident that they are correctly and robustly applying the NHS JES; however, we know this is not the case. While I know there are some areas where this is working well, this is not consistent across all organisations. I want to be clear that my expectation is that the NHS JES is applied correctly and robustly throughout the whole of the NHS, underpinned by partnership working between employers and trade unions at a local level, to ensure that all staff are paid correctly for the work they are asked to deliver.
Further information and guidance will be developed with the NHS Staff Council to support local partnerships to apply the NHS JES correctly.
These recommendations will restore confidence in the NHS JES and build essential capacity to enable proper application of the scheme. With the roll-out of a new national job evaluation software solution, we are seeking to monitor banding outcomes and improve efficiency by making the current administrative functions easier and more consistent, which will in turn reduce administrative costs locally.
Next steps
I have now instructed officials to work with NHS England, the NHS Staff Council, the Social Partnership Forum and NHS Employers to agree an implementation plan to phase the delivery of the non-pay measures over the next two years. This will minimise the potential impact on resource across the system.
This Government have ambitious plans for the NHS, and we are getting the health service back on its feet through our plan for change, delivering over 2 million extra appointments and cutting hospital waiting lists. A vital part of these plans is to improve the working lives of our NHS staff, and that is why we are announcing this support package to tackle violence and improve career progression opportunities for staff. We recognise that NHS productivity can be impacted by poor workplace experience for staff, which we are addressing through these measures. We are in the process of developing a 10-year health plan and a refreshed long-term workforce plan to set this out comprehensively. This work will ensure that we not only have the right people in the right places to deliver the care patients need, but also that the NHS is a great place to work for our staff.
I am incredibly grateful to all those involved who worked so hard to produce these recommendations.
I will continue to keep Parliament updated on the progress of this work.
[HCWS597]
Clinical Trials and Health Data Research Service
Wes Streeting Excerpts(2 months, 2 weeks ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Wes Streeting)
Today I am updating the House on plans to create a new Health Data Research Service and fast track the set-up of clinical trials to accelerate the development of the medicines and therapies of the future. These changes will improve patient care and help to make Britain the best place in the world for medical research.
We will invest up to £500 million to establish a new Health Data Research Service. This will improve access to data for medical research by providing a secure single access point, meaning a researcher does not have to navigate different systems or make multiple applications for information for the same project. This will unlock the power of NHS data to transform research and lead to breakthroughs that improve care for patients.
The Wellcome Trust will be the first charitable funder supporting this groundbreaking initiative, committing an additional £100 million towards its development. The service will be hosted for at least the first five years at the Wellcome Genome Campus near Cambridge, leveraging the campus’s world-class facilities and expertise.
We will involve the public as we design the service, building trust and understanding through transparent communication and discussion about how patient data is used to deliver health benefits to patients across the UK.
We will work closely with Wellcome and other stakeholders to ensure the successful implementation of a service that will drive faster research that benefits patients sooner.
This Government’s work to make the UK a world-leading destination for commercial interventional clinical trials also supports our clear focus on driving economic growth, alongside improving health outcomes for patients and the public.
We will also accelerate clinical trials and deliver radical improvement in regulatory, set-up and recruitment processes over the next year. This will help to bring down the time it takes to move from the trial being submitted for regulatory approval from over 250 days to 150 days.
We will do this by streamlining approval processes for clinical trials by moving to standardised contracts, with contracting undertaken by a single lead research site. We will reduce the unnecessary duplication of checks that can be best conducted centrally. We will publish NHS trust level set-up performance data for the first time, and continue to work with industry and the Association of the British Pharmaceutical Industry to improve data on our metrics to compare our performance with international competitors.
We will also implement the new clinical trials regulatory framework announced in December 2024 by the Medicines and Healthcare products Regulatory Agency, to speed up trial approvals and encourage innovation in trial design without compromising patient safety.
I will continue to keep Parliament updated on the progress of this work.
[HCWS587]