NHS Mental Health Spending

Wes Streeting Excerpts

Thursday 12th March 2026 Written Statements

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

Today, I am publishing the annual statement for NHS mental health spend. The Health and Care Act 2022 introduced a statutory requirement to publish a statement setting out expectations for NHS mental health services spending before the end of each financial year.

The Government are committed to improving and supporting the nation’s mental health, focused on delivering better outcomes rather than just inputs—giving people the right support, at the right time. This priority runs consistently through our manifesto, the 10-year health plan and NHS England’s medium-term planning framework. We recognise that more must be done to reduce unacceptable waits and ensure services meet the needs of the population. That is why the medium-term planning framework sets such ambitious goals for integrated care boards over the next three years to drive improvements across mental health services, including putting mental health support in every school by 2029, expanding NHS talking therapies and individual placement support, and reducing the number of inappropriate out-of-area placements by the end of March 2027.

The Government have already taken action to improve mental health care, including through the Mental Health Act 2025, which ensures more personalised and compassionate care for people with severe mental illness. I have also launched an independent review into prevalence and support for mental health conditions, ADHD and autism, so that we can build an improved system that prevents mental ill health and delivers improved outcomes. Later this year, we will publish a new modern service framework that will set out what excellent care should look like for people with severe mental illness. Alongside this, we are confronting the root causes of mental ill health through cross-Government action, including through our suicide prevention strategy and men’s health strategy, and I fully support the efforts of the Secretary of State for Science, Innovation and Technology to make the online world safer for children.

On funding, real-terms spending on mental health continues to increase year on year, reflecting this Government’s commitment to improving mental health services. For 2026-27, mental health spending is forecast to reach a record £16.1 billion, up from £15.7 billion in 2025-26. This represents a real-terms increase of around £140 million compared with 2025-26. Real-terms growth in budgets will enable continued delivery of the ambitions set out in the 10-year health plan and the medium-term planning framework.

Spending for 2026-27 also includes ringfenced service development funding: firstly, to expand access to NHS talking therapies and individual placement and support, ensuring we reach those most in need while also supporting economic growth; and secondly, for accelerating the expansion of mental health support teams in schools and colleges to 100% coverage by 2029.

We are also making significant capital investment over the spending review period. Some £473 million of mental health capital funding has been made available over 2026-27 to 2029-30, as set out in NHS England’s capital guidance, published in November. This funding is available to systems to invest in community-based mental health centres, establish mental health emergency departments and reduce inappropriate out-of-area placements and locked inpatient rehabilitation.

Critically, financial safeguards remain in place. I am pleased to update the House that in 2025-26, all integrated care boards are forecast to meet the mental health investment standard, which sets a minimum rate of growth in annual spend on mental health services. These figures are based on data up to December, as full-year data are not yet available. To maintain this progress, the Government are requiring all integrated care boards to meet the mental health investment standard over the next three years. As this statement must be issued before the start of the new financial year, the figures for 2026-27 represent the best current estimates, based on projections that take account of the medium-term planning framework allocations published on 17 November 2025.

The proportion of overall NHS spend allocated to mental health in 2026-27 is forecast to be 8.4%, 0.28 percentage points lower than in 2025-26. This is a consequence of significant additional investment in other core areas, including those that benefit mental health services such as the substantial amounts going into NHS technology and digital transformation, general practice, community-based services, and neighbourhood health centres. These system-wide improvements are focused on fixing the fundamentals of the NHS and, although they are not counted in pure mental health service spend, will deliver significant benefits for mental health services and patients. There are also important areas of mental health-related expenditure not captured in the share of spend figure, such as prescribing mental health medication, continuing healthcare and NHS England’s investment in training the mental health workforce.

Leeds Teaching Hospitals NHS Trust: Independent Review of Maternity and Neonatal Services

Wes Streeting Excerpts

Wednesday 11th March 2026 Written Statements

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

Yesterday, alongside bereaved and harmed families from Leeds, I announced the appointment of Donna Ockenden as chair of the independent review into maternity and neonatal services at Leeds Teaching Hospitals NHS trust.

Donna Ockenden brings considerable experience as a nurse and midwife, and a strong record of exposing systemic failings in maternity care. Her leadership of the maternity reviews at Shrewsbury and Telford Hospital NHS trust and Nottingham University Hospitals NHS trust demonstrates her commitment to ensuring that families’ voices are heard and acted upon and her appointment will help us rebuild the confidence of families.

As well as the harrowing accounts that families have shared with me over the last few months, Leeds is one of the largest teaching hospitals in Europe and its perinatal mortality rates remain higher than comparable trusts.

The terms of reference for this review are now being finalised. It will examine stillbirths, neonatal deaths, serious incidents, hypoxic injuries and maternal deaths occurring between 1 January 2011 and 31 December 2025 —with the chair’s discretion to bring in more recent cases that would significantly add to the review’s findings. We will be taking an “opt-out” approach so that no voices are missed: all families whose care meets the criteria for the review will automatically be included unless they wish otherwise. As well as clinical care, the review will consider governance, accountability and how the trust handles concerns raised by women, families and staff. It will set out clear, evidence-based actions to improve safety, quality and equity of care.

The Government will work with Donna Ockenden and families to finalise the terms of reference, ensuring their experiences and priorities shape the scope of the review. Individual clinical case reviews are expected to begin in August.

I want to personally thank Leeds families for the openness and courage they have shown in sharing their accounts with me over recent months. I do not underestimate the trauma that they have experienced by revisiting their experiences in those meetings. This review must deliver for them and their babies and for all families who rightly expect safe, high-quality NHS maternity care. Donna Ockenden’s leadership will help drive the lasting change that is urgently needed.

We recognise that some of the issues being identified at Leeds may exist in other trusts across the country. While many women have expressed satisfaction with their care during pregnancy and birth, stark inequalities remain and maternal mortality has worsened. This is unacceptable and it is why I commissioned the rapid national investigation led by Baroness Amos, who has engaged with hundreds of families and staff to inform her interim findings published last month. Her final recommendations will be published in June. I will shortly launch the national maternity and neonatal taskforce that will turn these recommendations into the action needed to deliver lasting improvements.

In the meantime, we have taken immediate action to improve safety. This includes: investing over £130 million to make maternity and neonatal units safer; rolling out programmes to reduce avoidable brain injury and give early warning signals about possible issues with care; launching an anti-discrimination programme; and backing Martha’s rule which gives families the right to an urgent second opinion.

I want to reassure women who are accessing maternity care at Leeds Teaching Hospitals NHS trust that significant action is already under way to improve maternity and neonatal services, under the national oversight of NHS England. Over 500,000 women across the whole country give birth every year and the vast majority of those are safe. I encourage any woman who has concerns about her pregnancy to speak to their midwife.

While change will not happen overnight, we are determined to ensure all women receive safe, personalised, and compassionate care. This Government will not rest until women, babies and families get the care they need.

[HCWS1393]

Masculinising and Feminising Hormones: NHS England Policy

Wes Streeting Excerpts

Tuesday 10th March 2026 Written Statements

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

Today I am updating the House about NHS England’s decision to consult on a new clinical commissioning policy on the prescribing of masculinising or feminising hormones for children and adolescents with gender incongruence or dysphoria.

The safety and wellbeing of children and young people is paramount, and children’s healthcare must always be led by evidence and expert scientific and clinical advice. We are committed to ensuring that NHS children and young people’s gender services provide high-quality care for those with gender incongruence or dysphoria.

Currently, MAF hormones are only available to children and young people aged 16 and 17, and only in very limited circumstances. In line with the Cass review, which this Government and NHS England are committed to implementing, MAF hormones can only be prescribed with “extreme caution” and where there is a strong clinical rationale for not waiting until age 18.

Following an independent review of evidence, this consultation proposes that MAF hormones should no longer be available as a routine commissioning option through the NHS CYP gender service. The consultation, which will last for 90 days, sets out this proposal, and asks consultees whether all relevant evidence has been considered. NHS England will carefully consider the responses to inform next steps.

Throughout the consultation period and until NHS England has responded to the consultation, NHS England is pausing its existing clinical policy with immediate effect to safeguard children and young people. This means that no new prescriptions for MAF hormones will be initiated through the NHS CYP gender service, at least until the point when a final policy is determined, following full consideration of consultation feedback.

The full range of clinical support interventions, described by the national service specification, remain available for patients who are in the CYP gender service, including psychological and psychosocial support. Individuals who are on the national waiting list for CYP gender services will either have had previous arrangements made for them to access local CYP mental health services, or they would have had contact with CYP mental health services or NHS paediatric services at the point of referral, with care plans in place.

Young people aged 16 and 17 years who are receiving existing NHS prescriptions of MAF hormones may continue their prescriptions under the care of the NHS CYP gender service. Each individual’s lead clinician will need to undertake a review of the circumstances of the patient’s care plan and make a shared decision with the young person—and family, as appropriate—about the future treatment approach within an enhanced informed consent process.

Evidence base

NHS England can only commission treatments based on evidence of clinical effectiveness, and with appropriate assurances around safety. This important principle applies to all treatments, not just for gender incongruence and dysphoria.

In 2021, an independent evidence review by the National Institute for Health and Care Excellence found that there is very limited evidence about the safety, risks, benefits and outcomes regarding the prescribing of MAF hormones to young people under 18 years of age.

In line with the Cass review, NHS England made changes to its existing clinical policy to place restrictions on the use of MAF hormones. This meant that MAF hormones could only be prescribed to 16 and 17-year-olds if a recommendation for their use was supported by the NHS CYP gender service and a national multi-disciplinary team.

Dr Cass also recommended that NHS England review its policy on MAF hormones. NHS England began that review in 2025, and commissioned an independent third party to undertake a further evidence review of published evidence. This included research that had been published since NICE’s review of the evidence in 2021.

The evidence reviews found very limited and weak evidence to support the continued access to MAF hormones by children and young people under the age of 18 years. After careful consideration, NHS England has concluded that there is not enough evidence to support the safety and clinical effectiveness of MAF hormones to make the treatment routinely available.

In addition to NHS England’s consultation, the Government have been examining the private prescribing of MAF hormones by the independent sector, including overseas practitioners. The Department will continue to closely monitor this position with regards to any implications and next steps. NHS England will reissue guidance from May 2025 that advises GPs not to agree shared care arrangements with unregulated providers who offer access to masculinising and feminising hormones to under 18s.

The Department is also awaiting the results of the Medicines and Healthcare products Regulatory Agency’s engagement on the Pathways trial, following concerns that it raised regarding the protocol. Any potential implications of this revised prescribing policy for the Pathways trial will be considered and discussed with the regulators during the period of consultation, and any further announcements will be made in due course.

[HCWS1391]

Gender Recognition: Data Linkage Study

Wes Streeting Excerpts

Thursday 26th February 2026 Written Statements

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

Today, I have laid the Gender Recognition (Disclosure of Information) (England) Order 2026 in Parliament. The order will come into force on 20 March 2026.

This Government have always made it clear that anyone accessing gender services deserves high-quality, evidence-based care and support. Laying this order will facilitate delivery of the data linkage study and is another step to achieving our manifesto commitment to implement recommendations of the independent Cass review.

The study was planned to take place during the lifespan of the Cass review, and a statutory instrument was brought forward in 2022 to protect those disclosing protected information for the study. However, it is well documented that some clinics did not share data to allow the study to commence and the study was therefore not completed as planned. Further to this, it is the Government’s view that the 2022 order now needs to be updated to sufficiently protect those who will now be sharing information for the purposes of the study.

This order will revoke the 2022 order and will ensure that information that may otherwise be protected under the Gender Recognition Act 2004 can be lawfully disclosed for the specific purpose of the data linkage study. This order makes technical changes to reflect that NHS England is now delivering the study, that the study is being completed as a recommendation (rather than during the lifetime) of the Cass review, and to update the list of organisations contributing to the study.

The data linkage study is a retrospective study based on an analysis of routine data collected for a cohort of adults who, as children, were referred into a former model of NHS gender care, the Gender Identity Development Service. The study requires no active patient participation and instead relies on an analysis of information already held within health records and other nationally held databases. The study aims to learn more about the needs of individuals referred to GIDS, their healthcare experience, and associations identifiable in the data which may tell us more about the intermediate outcomes for this cohort.

Since assuming responsibility for the data linkage study, NHS England has taken time to undertake due diligence work on the data sources critical to the study, and to work with organisations to refine the planned approach to data sharing. Some small but important improvements have been proposed in the study design that will better support the collaboration of organisations on whom the study team will be reliant for data, including adult gender clinics. It is my clear expectation that all relevant organisations will now provide the data required to complete this study.

Alongside the laying of this order, updated data linkage study research approvals are also in progress. As with usual research practice, the finalised data linkage study protocol will be made public once independent research and ethical approvals have been appropriately secured, at which point the study can begin.

We are determined to continue our work to improve the lives and healthcare of transgender people in this country. We will continue to implement the recommendations of the Cass review.

[HCWS1369]

Oral Answers to Questions

Wes Streeting Excerpts

Tuesday 24th February 2026 Commons Chamber

[Torcuil Crichton (Na h-Eileanan an Iar) (Lab)]

1. What steps he has taken to increase health and social care coverage in rural communities.

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

Mr Speaker, on behalf of the Government and Labour Members, may I associate myself with your remarks? Members from right across this House will share those sentiments. As the Prime Minister made clear at Cabinet this morning, and as the Foreign Secretary is making clear in Kyiv, we will stand with Ukraine, whatever is thrown at it, until it has the freedom and security that it deserves.

This Government are restoring the founding promise of the national health service: to bring quality healthcare to all, regardless of how much they earn or where they live. New funding for GPs is being prioritised for areas where the need is greatest, and we are sending more cancer specialists to rural hospitals. As we modernise the health service, the NHS app and NHS Online will bring world-class healthcare to the most remote corners of our country at the touch of a button—lots done, and lots more to do.

[Torcuil Crichton]

In places like Na h-Eileanan an Iar, going the extra mile to provide care is part of the job, and I pay tribute to the carers in my constituency who travel miles in darkness and bad weather to deliver support for the elderly. In some parts of the Western Isles, and indeed across rural Scotland, there simply is not the working-age population to provide that care, and immigration cannot solve that problem entirely. Does the Minister agree that it is only by increasing wages and paying social care staff properly—something for which Scottish Labour has been calling for some time—that we will increase the number of carers in rural areas, and provide a proper care service?

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. This Labour Government are introducing the first ever fair pay agreement for care workers. That is better pay and conditions for care workers, and more people recruited into the profession. It is backed by £500 million, and Scotland will receive extra funding through the Barnett formula. The question for the SNP is: where is the money going, and why is it not going into the pockets of Scottish care workers, as Jackie Baillie has demanded?

[Mr Speaker]

I call the Chair of the Select Committee.

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

On Friday, I visited Young Devon, an early support centre in the heart of rural North Devon, where I met young people who told me heartbreaking stories of how they felt left out and let down by the system. Young Devon was quite literally a lifeline for them. It has an open-door, person-centred approach. I am delighted that its funding has been continued for one more year, but it is only one year, and those who run the centre told me that this makes it incredibly difficult for them to plan. Can the Secretary of State clarify what the longer-term plan is for these early support hubs, how they sit alongside Young Futures hubs, and how he can help organisations like Young Devon thrive into the future?

[Wes Streeting]

I join the Chair of the Health and Social Care Committee in paying tribute to Young Devon and the work it is doing. As she will know, I have enormous sympathy for the challenge she raises about medium-term certainty on funding. As was demonstrated on the Floor of the House yesterday by the Education Secretary, my Department and the Department for Education are working closely together to make sure we are better joining up education, health provision and support for young people. There is more to do. I accept the challenge that she sets down around medium-term certainty on funding; that is why we are doing more through, for example, the medium-term planning framework. I accept, in the spirit of this exchange, that there is lots done, but lots more to do.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Last year in Shropshire, which is a fairly typical rural area, 158,000 patients waited more than a month for a GP appointment. That is not surprising, given that, like many other rural areas, we have 50 fewer qualified GPs than we did a decade ago. Meanwhile, already busy GPs are trying to develop integrated neighbourhood teams, but they report that they have not received any dedicated Government funding, and still do not have the model neighbourhood framework. Will the Secretary of State act to ensure that GPs have the resources and guidance that they need to develop those neighbourhood health teams, and ensure that everyone can access an appointment within seven days, or 24 hours if it is urgent, particularly in rural areas, where provision is poor?

[Wes Streeting]

We have 2,000 more GPs now than when Labour came into office, but the hon. Lady is right to say that we need to ensure that that provision and increased capacity are reflected throughout the country. Because general practices serving more deprived areas receive 10% less funding per needs-adjusted patient than those in wealthier parts of the country, we are reviewing and reforming the Carr-Hill formula to ensure that we can direct the right funding to the areas in greatest need, recognising that amid our rural communities, there is obviously not just plenty of affluence, but enormous pockets of disadvantage and deprivation. Whoever people are and whatever their background, the support and care that they need must be received in the right place and at the right time.

[Grahame Morris (Easington) (Lab)]

2. What steps his Department is taking to tackle inequalities in access to radiotherapy treatment services for cancer patients.

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[Douglas McAllister (West Dunbartonshire) (Lab)]

4. What steps his Department is taking to support the diagnosis of cancer patients.

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

Cancer is the canary in the coalmine for the NHS. For far too many cancer patients, under the Tories, the NHS was not there when they needed it. Under Labour, an extra 213,000 patients have been diagnosed, or have received the all-clear on time. Much has been done, but there is much more to do. I pay tribute to the leadership of the Minister for primary care and prevention, my hon. Friend the Member for West Lancashire (Ashley Dalton), and to her national cancer plan. She has poured her heart and soul into that plan, all while living with and being treated for cancer. We are investing an extra £2.3 billion in diagnostic capacity to deliver 9.5 million more tests by the end of this Parliament. Catching cancer earlier, treating it faster and preventing it is how we will save more lives.

[Douglas McAllister]

I welcome the focus of the national cancer plan on diagnosing cancer faster. That is needed across all cancers, but particularly for leukaemia. Research by Leukaemia UK has found that one in four patients face an avoidable delay in their diagnosis, and that 37% of patients are diagnosed in an emergency setting. How will the implementation of the plan address delays in leukaemia diagnosis, and what steps will the Department take to reduce the proportion of patients who are diagnosed through an emergency route?

[Wes Streeting]

My hon. Friend is right that leukaemia patients are disproportionately diagnosed too late. We are working with GPs to ensure that they are better prepared to spot symptoms or concerning blood test results, so that we can cut out avoidable delays. The real difference, however, will come with the introduction of genomic testing at birth. That will allow the NHS to leapfrog rare cancers such as leukaemia, so that they can be caught early, or even prevented. Lots done, certainly lots more to do.

[James Wild (North West Norfolk) (Con)]

When I met Big C in King’s Lynn recently, I heard about the anxiety caused; only 52% of local patients are treated within two months, whereas the national average is 71.9%. What action is the Department taking to support the Queen Elizabeth hospital trust in improving its performance for patients?

[Wes Streeting]

The hon. Gentleman is absolutely right; this is about not just diagnosis but faster access to treatment. We are meeting the faster diagnosis standard; performance was at 77.4% in December 2025, and we aim to improve that to 80% by the end of March this year. We have to go a lot further, a lot faster, on the commencement of treatment. Although I will be forthcoming about, and proud of, the progress that we are making and the targets that we are hitting, where we fall short—we are still falling far too short, when it comes to access to cancer treatment—we will acknowledge that, address it and make sure that we make more progress, more quickly.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

5. What steps he is taking to improve access to mental health services.

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[Calum Miller (Bicester and Woodstock) (LD)]

11. What assessment he has made of the adequacy of health-related funding for specialist sexual violence support services.

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

The Prime Minister has made tackling violence against women and girls a priority across the Government and every public service must play its part. In the NHS, we will be supporting GPs to identify, support and refer victims and survivors to specialist services. That will include a specialist support worker for every GP practice to draw on and training GPs to spot the signs of domestic abuse and sexual violence. As part of the Government’s VAWG strategy, the Department will provide an additional £5 million for victim support services and up to £50 million to roll out specialist services for child sexual abuse victims.

[Calum Miller]

I recently had the opportunity to visit the dedicated staff at Survivor Space, a centre for victims of sexual violence in Oxford that serves my constituents. I was shocked to learn that victims and survivors of sexual violence may wait up to two years for a counselling session. I was further appalled to learn that at least one survivor had been advised that they could not access NHS mental health services until they had first had counselling from Survivor Space. Does the Secretary of State agree that no survivor should have to wait two years for treatment, and would he or one of his Ministers meet me and representatives of Survivor Space to discuss how to get dedicated healthcare funding to the frontline in order to support such services?

[Wes Streeting]

I wholeheartedly agree with the hon. Member. The voluntary and community sector provides, and should continue to provide, support for victims. The voluntary sector does a brilliant job, in an environment that often feels safer and more inclusive, and we should welcome that. However, the existence of voluntary sector provision does not excuse the NHS from performing its duties. One change that I have led in the leadership culture of my Department is the recognition that investment in services for victims and survivors is a responsibility of the NHS and the DHSC, not of the Home Office, Ministry of Justice or others. We must take responsibility for meeting the needs of everyone. There is of course more to do on waiting times. I would be delighted to ensure that the hon. Gentleman gets the meeting that he asks for.

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

12. What assessment he has made of the potential implications for his polices of recent trends in national wellbeing indicators.

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[Harriet Cross (Gordon and Buchan) (Con)]

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

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

Today we are publishing a new GP contract. Backed by new funding, it will recruit more GPs and cut waiting times for appointments. The changes and modernisation will diagnose thousands more cases of lung cancer, protect children by boosting vaccination rates, and provide more people with weight-loss jabs on the NHS. That follows an extra £1.1 billion that we have invested in general practice this year, and builds on the 2,000 more GPs that we have recruited since the general election. After 14 years of decline, the Government are fixing the front door to the NHS, bringing back the family doctor, and ending the 8am scramble. Lots done, lots more to do.

[Harriet Cross]

Inverurie medical practice in my constituency saw its national insurance bill rise by £75,000 thanks to this Government. That has put huge pressure on the practice, which was already operating with one GP for 3,000 patients, which is three times higher than the British Medical Association recommends. When did the Secretary of State last meet the Chancellor to discuss the impact of the NICs rise on GP practices, and what are he and his Department doing about the pressure—

[Mr Speaker]

Order. We are on topicals.

[Wes Streeting]

I see the Chancellor most weeks. That is why record investment is going into our NHS, which is improving patient satisfaction with access to general practice, cutting waiting lists, and improving ambulance response times—all to fix the mess that the Conservatives left behind. And people should be in no doubt: given the chance, they would do it again. They opposed the investment, they opposed the reform, and they can never be trusted with our NHS.

[Alex Ballinger (Halesowen) (Lab)]

T3. I welcome the changes set out in the gambling White Paper about the responsibilities of the Department in relation to the treatment and prevention of gambling harms. As part of the new responsibilities, will the Secretary of State commit to undertake a review of the impact of gambling advertising, marketing and sponsorship on public health, including on the health and wellbeing of children and young people?

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[Stuart Andrew (Daventry) (Con)]

In the plan for change, the Government committed to meet the 18-week standard for routine operations, but the latest data suggests that the Government are not on track to meet that commitment by the end of the Parliament. In December, fewer people were treated within 18 weeks than in the previous month. Will the Secretary of State now accept the reality that patients are experiencing and, as the Institute for Fiscal Studies has warned, that the Government will not deliver their commitment on their key milestone to deliver the 18-week standard?

[Wes Streeting]

I will never surrender to the tyranny of the low expectations of the Conservative party. We have cut waiting lists by 330,000 since we came to office; they are now at their lowest level in three years. We made progress despite strikes, we made progress despite winter pressures, and we have made progress despite every bit of investment and modernisation being opposed by the Conservatives. Instead of criticising our record, the shadow Secretary of State should apologise for his.

[Stuart Andrew]

Another leadership ambition, I see.

On 29 September, I wrote to the Secretary of State regarding the late Dr Susan Michaelis’s campaign for better research into lobular breast cancer, but sadly I still have not had a reply. She established the Lobular Moon Shot Project and the last Government committed to support its aims. However, despite meeting the Secretary of State, representatives from the project say that they still have no clarity on how the project and research will be expedited. Will the Secretary of State confirm now Government approval for the funding required for this research, which is critical for so many women in this country?

[Wes Streeting]

I apologise to the shadow Secretary of State for not having replied to his letter—let me make sure that I do that. There is no disagreement across the House on the substance of the issue. I am absolutely supportive of the project and I want to fund the research, but we have to make sure that the research proposal meets the standards and has the confidence of our funders. We are working with the team to try to get the proposal over the line, but that is the only obstacle here—it is certainly not a political decision.

[Euan Stainbank (Falkirk) (Lab)]

T4.   Many people in Falkirk face barriers to accessing treatment because they are juggling often contradictory bits of paper regarding appointments across different health boards. What assessment has the Minister made of this Government’s NHS digital transformation strategy for improving treatment, compared with the strategy being pursued by the Scottish Government for the healthcare that is available to my constituents?

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[Wes Streeting]

The hon. Member highlights a real challenge that we have inherited: the disconnection between undergraduate education and training, and the jobs that are available. We are addressing that through our workforce plan. I want to place on the record my thanks to South Western Ambulance Service, which in December improved ambulance response times by just under 30 minutes for category 2 calls. There are still big challenges in the south-west, but the team deserve real credit for the improvement they have led.

[Sarah Edwards (Tamworth) (Lab)]

T5.   My constituents are forced to travel to Burton, Derby and Sutton Coldfield for their NHS treatment, which cannot be provided at the local community diagnostic centre. Some travel up to 30 miles for chemotherapy, with little or no public transport. What is the Minister doing to deliver healthcare investment locally and to improve the transport links between NHS sites so that those who need to use them can get to their treatment?

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[Bradley Thomas (Bromsgrove) (Con)]

Several weeks ago, I received a jaw-dropping email from a local Bromsgrove GP, who told me that a 10-month-old child nearly died after ambulance delays. Worse, the same day, another patient—a 66-year-old driving instructor—suffered a cardiac arrest during a driving lesson and died while being driven to the hospital by his wife. My constituents demand a better service and better response times. What are the Government going to do about this, and will the Secretary of State meet me and the concerned GP who wrote to me to address this issue?

[Wes Streeting]

Nothing is more sobering than hearing experiences of the life-and-death difference between the NHS being there for people when they need it and it not being there when they need it. People will be aware of a tragic case over the weekend involving a woman in her 90s in the Isle of Wight, which we are looking into. Ambulance response times are improving, but I do not pretend that they are good enough; we have done a lot, but there is a lot more to do, and the hon. Gentleman has painfully and powerfully underscored what happens when the NHS is not there for people when they need it. That is the NHS we inherited, and it is the NHS I am determined to change.

[Peter Lamb (Crawley) (Lab)]

Crawley A&E’s closure was accompanied by a commitment to a 24-hour urgent treatment centre, a commitment that the trust is now breaking. Can the Minister meet me to discuss how local services can be preserved and improved?

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[Paul Waugh (Rochdale) (Lab/Co-op)]

In Rochdale, we need more midwives to provide the safe staffing levels that our mums-to-be rightly expect, but newly qualified student midwives often find it difficult to find jobs when they qualify. Can the Minister explain exactly when the NHS workforce plan is due so that they can give reassurance to those newly qualified midwives that they will have a career in the NHS?

[Wes Streeting]

I am grateful to my hon. Friend for raising this issue. The NHS workforce plan will be published in the spring. I recognise the challenge he has set out, and we are determined to address it—we desperately need more midwives, and we certainly need good clinical leadership in this area. That is what the Government are working towards.

[Andrew George (St Ives) (LD)]

Minor injuries units are being phased out in urgent treatment centres such as the brilliant one at West Cornwall hospital in my constituency—its hours were cut under the Conservatives, and have not been restored. Those units clearly help to take the pressure off ambulance and emergency services, so what will Ministers do to ensure that those services are reinforced rather than reduced?

[Wes Streeting]

One rationale for both the 10-year plan and the medium-term planning we are doing across the NHS is to ensure better integration, with the principle of people receiving the right care in the right place at the right time. Decisions about local configurations are matters for local leaders, but we keep these things under review, and if the hon. Gentleman has concerns, he should certainly write to us.

[Lola McEvoy (Darlington) (Lab)]

As the Secretary of State knows, Darlington Memorial hospital is part of the County Durham and Darlington NHS foundation trust, which has recently been marred by the scandal of over-operation in breast services. We know that many women came to harm as a result of those failures, but we are yet to find out how many and the full extent of the harm because the trust has not completed the comprehensive look-back. Will the Minister meet me to ensure that our trust has all the resources it needs to learn the lessons necessary to ensure that no women—whether in my area or across the country—have invasive and painful clinical procedures that they do not need?

Puberty Blockers Clinical Trial

Wes Streeting Excerpts

Monday 23rd February 2026 Written Statements

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

Today, I am updating the House that the preliminary work to establish the pathways clinical trial into the prescription of puberty suppressants for children and young people with gender incongruence has been paused.

The MHRA, the agency authorising the clinical trial, has written to the trial sponsors, King’s College London, to raise concerns regarding the trial which will now be discussed with clinicians. On Friday, DHSC published a copy of the MHRA letter, which is available here: https://assets.publishing.service.gov.uk/media/6998b06d047739fe61889efb/Sponsor-letter110226.pdf

Discussions between the MHRA and King’s College London will begin this week to address these new concerns. I will review the outcome of those discussions, taking clinical advice.

I have always been clear about the red lines regarding this trial and the prescription of puberty blockers, the safety and wellbeing of the children and young people and always being led by the expert clinical evidence. Those have been—and will remain—the driving considerations in every decision being made.

The clinical trial will not start to recruit until the issues the MHRA raised have been resolved. It will only be allowed to go ahead if the expert scientific and clinical evidence and advice conclude that it is safe to do so.

[HCWS1347]

NHS Agenda for Change Workforce

Wes Streeting Excerpts

Thursday 12th February 2026 Written Statements

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

Today, I am announcing that from April 2026, over 1.4 million NHS staff on Agenda for Change terms and conditions will receive a 3.3% pay rise.

The uplift is above the Office for Budget Responsibility’s forecast inflation of 2.2% for 2026-27, delivering a real terms pay rise for NHS staff.

It will be in pay packets from April for the first time in six years. We have listened to the workforce and understand the difficulties they face when pay awards are not delivered on time. That’s why this Government committed to speeding up the pay review process, remitting the pay review bodies months earlier than previous years, and submitting written evidence earlier too.

In making this award, I am accepting in full the recommendation from the NHS Pay Review Body for 2026-27. Their report recognises the vital contribution that NHS staff make to our country.

This award is above the Government’s affordability position set out in their evidence to the NHSPRB. As we are delivering the pay round much earlier this year, announcing now in February, the business planning process for the Department of Health and Social Care and its arm’s length bodies is under way. The existing challenging productivity and efficiency commitments required by ICBs and providers to deliver breakeven positions are the foundations of the Government’s ability to fund this within the existing settlement. This additional pressure above affordability will be managed by DHSC and ALBs (including NHSE central budgets) but none of the pay increases will be paid for by cutting frontline services.

As part of the overall AfC pay package for 2026-27, we will progress talks with trade unions and employers at pace, through the NHS Staff Council, to agree and implement funded improvements to the AfC pay structure. These talks will build upon discussions held to date exploring the feasibility of multi-year arrangements, and separate funding will be made available for these reforms as committed to in response to the 2025-26 PRB recommendation on pay structure reform. Once agreed, the reforms will deliver additional pay increases for some staff that will be effective from, and backdated to, 1 April 2026. Our priorities will be to improve pay for those on the lowest pay bands in support of the Government’s commitment to “make work pay” and to improve pay for graduates across all professions. This will recognise and build on the work of the staff council to identify its priorities.

We will continue to implement commitments to improve the support NHS staff receive and their experience at work, as well as improving nursing career progression, investing in job evaluation to ensure that all staff are paid fairly for the work they are asked to do, and supporting newly qualified staff. Improving the experience of work for all staff, ensuring the NHS is a great place to work, is fundamental to improving the patient experience: from reducing the backlog in elective care, to ensuring timely access to GP appointments.

The NHSPRB report will be presented to Parliament and published on gov.uk

[HCWS1340]

Early Support Hubs

Wes Streeting Excerpts

Wednesday 11th February 2026 Written Statements

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

This year, the theme of Children and Young People’s Mental Health Week is “This is My Place”, drawing important attention to children and young people’s sense of belonging and the important role that communities and community organisations play in supporting their mental health and wellbeing. As a Government, we rightly celebrate the vital role of community organisations in providing support, compassion, connection, and hope to children and young people where and when they need it.

That is why I am pleased to announce that the Government are investing an additional £7 million so that the 24 early support hubs we are currently funding can continue to operate an expanded service offer for 2026-27. This means that in total we have provided more than £20 million since April 2024 to ensure that thousands more children and young people will continue to receive quicker mental health support, and to enable further continuity in the provision of these services. These hubs help to prevent mental ill health while also bringing care closer to home, both important objectives in our 10-year health plan.

Crucially, this continued investment means that thousands of children and young people will receive earlier, open-access mental health and wellbeing support, where any child can self-refer without an intermediary or prior formal contact. The hubs will continue to offer mental health support and advice to young people aged 11 to 25, and provide continued access to a range of services that are tailored to local need. This could include group work, counselling, psychological therapies, specialist advice, as well as signposting to information and other services. In addition to the mental health offer of hubs, young people may also be able to access advice on wider issues, including sexual health, jobs, drugs, alcohol, and financial worries.

Alongside continuing to support the services offered by these 24 hubs, the funding will ensure continued evaluation of the impact of these services, with early indications suggesting that young people value the holistic approach of the hubs. The evaluation has also highlighted the benefits of easily accessible support for young people, based on interviews with service managers. The evidence and insights collected through the early support hubs evaluation, which aims to publish in the summer, will support the delivery of young futures hubs, alongside best practice and learning from other initiatives. This learning will inform our ambitions for community mental health and wellbeing support for children and young people, ensuring that they have access to what they need, as soon as they need it.

[HCWS1328]

Nursing Workforce

Wes Streeting Excerpts

Wednesday 11th February 2026 Written Statements

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

Today I am announcing a comprehensive package to recognise the value of the nursing profession. Nurses are essential to leading and delivering the Government’s 10-year health plan, and critical for patient safety and outcomes, but the profession has been undervalued in the NHS for far too long.

Too many nurses are not being compensated appropriately for the work they do, and there is currently no universal preceptorship programme in place for new graduate nurses.

This Government are clear that a constructive relationship with unions is in everyone’s interests. Following engagement with all nursing unions, including UNISON, Unite, and GMB, and a dedicated period of intensive engagement with the Royal College of Nursing, they have agreed a series of measures that will transform the nursing profession and make sure that nurses get the pay and support they deserve.

Today I am committing to invest in the NHS nursing workforce in four ways:

Prioritising increasing graduate pay. It is important that graduate salaries are competitive within the wider labour market to attract graduates into the NHS. I am therefore asking the NHS staff council to prioritise graduate pay in the upcoming discussions on pay structure reform. This will impact all graduates under the Agenda for Change contract, including nurses.

Reviewing the work of every band 5 nurse. Every band 5 nursing role will be reviewed by employers over a set timeframe to ensure that job descriptions and pay bands reflect the work that nurses are being asked to do. Additional national funding will be made available to support the band 5 review process and any resulting salary uplifts. This will be separate and additional to the funding that will be made available for annual headline pay rises and for pay structure reform.

Establish a single national nursing preceptorship standard. I have asked the chief nursing officer for England to lead work as part of the upcoming professional strategy for nursing to improve the quality and consistency of preceptorships for all newly qualified nurses. This work will be delivered in partnership with trade unions, employers and other key stakeholders.

A review of the evidence. We will review the evidence that is gathered as part of the review of band 5 nursing roles to determine whether any further action is required.

We will continue to work together with unions to ensure this work is delivered at pace, and that nurses get consistent support in their early careers and are paid for the work they are asked to do.

[HCWS1329]

Medical Training (Prioritisation) Bill

Wes Streeting Excerpts

2nd reading
Tuesday 27th January 2026 Commons Chamber

[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 begin by thanking the Leader of the House, the Chief Whip, their counterparts in the other place, colleagues in my Department and in the NHS, the Bill team and parliamentary counsel, who have moved mountains to prepare this Bill in double-quick time. I once again place on the record my sincere thanks to my counterparts in the Governments of Wales, Scotland and Northern Ireland—as well as the respective Secretaries of State for those nations—for the spirit in which, regardless of party, they have helped us to bring the Bill forward. Last but by no means least, I am enormously grateful to Jackie Baillie, Labour’s deputy leader in Holyrood, for her wise counsel.

The NHS is on the road to recovery, not least because of the herculean efforts and dedication of NHS leaders and frontline staff who, even in the depths of winter, are delivering outstanding episodes of care, hour after hour and day after day. Among the encouraging signs of year-on-year improvement are waiting lists falling at their fastest rate in three years—down more than 300,000 under Labour—and quicker ambulance response times, shorter waits in A&E and speedier cancer diagnoses for more people. December was the busiest month in NHS history for 999 calls, but despite that, and regardless of industrial action and winter pressures, ambulances arrived at heart attack and stroke patients nearly 15 minutes faster compared with last year.

The progress we are seeing is a reminder that nothing positive for the people who use the NHS ever happens without the people who work in our NHS. Our investment and modernisation are starting to restore confidence and renew belief among frontline staff; with that, hope, optimism and ambition are returning too. That is why, outside of the pandemic, staff retention is at its highest in a decade and vacancies are at their lowest since records began in 2017. There is lots done, but, as we know, there is so much more to do.

I will always be honest about the state of our national health service—what is going well and where we need to improve. There is no sugar coating the fact that staff morale is still too low, and the way that some of our NHS workforce is still treated and the conditions in which too many of them still work are nothing short of a national disgrace. Not only is it a stain on our NHS, but it shames us as a country when those who care for us in our hour of need suffer bullying, harassment and racist abuse; have nowhere to rest, go to the toilet or get changed; cannot get a hot meal on a night shift; have limited flexible working options; must book holiday a year in advance; need to log in seven times just to use a PC; spend time form-filling rather than looking after patients; and face basic errors with pay and contracts. Before Christmas, I had a doctor in my constituency advice surgery in tears as she described the way she had been treated by a previous employer. This is no way to treat the people who kept us going when everything else stopped, so we are taking action.

Trusts are now implementing the 10-point plan for resident doctors and my Department, together with NHS England, is developing new staff standards to create better working practices and better conditions.

We have awarded above-inflation pay rises to everyone working in the NHS for this year and last year, which is beginning to recover the pay erosions seen under the last Government. We have begun 2026 with constructive talks with the British Medical Association’s resident doctors committee, as we seek to broker industrial peace. I have also told NHS leaders that they need to step up when it comes to the conditions that their staff face. They cannot expect the Secretary of State to micromanage availability of hot food in their canteen, for example.

However, there are workforce problems that only Government can solve. We have known for years that the treatment of resident doctors is often totally unacceptable and that the very real fears about their futures are wholly justified. Every time I have met a resident doctor, either formally or informally, they have told me without fail how their careers are blocked because there are far too many applicants for training places. Not only do I think that they have a legitimate grievance, but I agree with them.

[Dr Kieran Mullan (Bexhill and Battle) (Con)]

The Secretary of State is essentially talking about postgraduate training. I wonder what thought he has given to new clause 2 in the name of my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer). I have spoken to students who worked really hard all the way through medical school to get the best exam results and perform highly but then ended up in an allocation system that pays no attention whatsoever to that. Merit has been entirely removed from the system. I think it was wrong for us to make that change. Does he have any sympathy for returning to a merit-based system?

[Wes Streeting]

I certainly do have sympathy with that argument. We have begun to move the system in the right direction in terms of giving applicants greater preference in placements, but it is not lost on me that the system of rotations, placements and jobs means doctors are moved around the country and families are uprooted. The frictional cost of relocating from one place to another is a challenge that resident doctors in particular face. I do not think that an amendment to the Bill is the right vehicle in which to address that issue, but I am sympathetic to the arguments that the hon. Member makes, and I am sure he will make them again during this afternoon’s proceedings. We will take his arguments seriously and look to work together with the BMA and others to act to improve the experience of training, rotations and jobs.

UK graduates used to compete among themselves for foundation and specialty roles. Now they are competing against the world, because of the visa and immigration changes made by the Conservative Government post Brexit. The situation is compounded by the previous Administration’s total lack of workforce planning, which saw more students going to medical school without the number of specialty training places being increased. That is why we see the training bottlenecks that resident doctors face today.

[Several hon. Members rose—]

--- Later in debate ---

[Wes Streeting]

I will give way to the hon. Member for Henley and Thame (Freddie van Mierlo) and then to my hon. Friend the Member for Hitchin (Alistair Strathern).

[Freddie van Mierlo (Henley and Thame) (LD)]

A constituent of mine is studying medicine at Queen Mary University of London but at a campus in Malta. Students at the Malta campus complete the same General Medical Council-approved curriculum, assessments and licensed exams as London-based students, and graduates hold a UK primary qualification. He was given a formal guarantee that he would be at no disadvantage if he chose to study at the Malta campus. Can the Secretary of State reassure me that graduates like my constituent will be prioritised on the NHS foundation medical training programme?

[Wes Streeting]

Students studying in Malta will not be prioritised in the Bill, but they will still be able to make applications. Queen Mary University’s Malta website is clear that Queen Mary does not administer the UK foundation programme and cannot control whether or on what basis applicants are accepted into the programme, and no one is guaranteed a post on qualification.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

Will the Secretary of State give way?

[Wes Streeting]

I will make some progress because, with respect, I have not yet set out the measures that we are to debate today. Let me take the intervention from my hon. Friend the Member for Hitchin, then I will set out the Government’s rationale and take further interventions.

[Alistair Strathern (Hitchin) (Lab)]

I wonder if the Secretary of State shares my residents’ utter disbelief that the last Government created a system where thousands of UK medical graduates, educated at the cost of billions to the UK taxpayer, were suddenly forced to compete with overseas students, pushing many abroad for their careers and losing a big talent pool that should be powering our NHS and getting it back on its feet.

[Wes Streeting]

That is right. I have to say, many of my counterparts around the world cannot fathom how we ended up in this situation in the first place. They certainly do not do as we have been doing, investing so much in their home-grown talent only to then see that talent compete on equal terms with anyone from anywhere else in the world.

Let me set out why we need this Bill. There are workforce problems that only Government can solve. We know that the treatment of resident doctors has been totally unacceptable for years and we see the training bottlenecks that resident doctors face today. In 2019, there were around 12,000 applicants for 9,000 specialty training places. This year, that has soared to nearly 40,000 applicants for 10,000 places, with nearly twice as many overseas-trained applicants as UK-trained ones. As a result, we now have the ridiculous state of affairs where UK medical graduates, whose training British taxpayers fund to the tune of £4 billion a year and who want to carve out a career in their NHS, are either being lost abroad or to the private sector. If we do not deal with that, the scale of the issue and the resentment it causes will just get worse. More taxpayers’ money will be wasted, more British medics will turn their backs on the NHS, and patients and our NHS will ultimately suffer.

[Seamus Logan (Aberdeenshire North and Moray East) (SNP)]

The Secretary of State knows that the SNP believes that this is a pragmatic Bill that will have a net-positive outcome for the health service in Scotland. We welcome the Bill and are glad to support it. However, there are specialty fields, such as general practice, which have a high number of international graduates. Because of Government policy, there are significant challenges in supporting the retention of some individuals. For example, the new requirement for settled status is 10 years with some exceptions, whereas training programmes are often only three years long. I am sure that the Secretary of State does not want the UK to be a hostile environment for our vital overseas medical staff. Will he therefore make representations to the Home Office so that it is aware of the anomaly?

[Wes Streeting]

I will say two things to the hon. Gentleman. This Bill does not in any way detract from the fundamental point that the NHS has always been an overseas recruiter and we have always been fortunate to draw on global talent from around the world who come and give through their service, their taxes and their wider contribution to the national health service and our country. We will continue to welcome that and people will continue to be free to apply. In future, they will apply on terms that are fairer to our own, home-grown talent.

There is nothing in what the Home Secretary proposes that will stop people who come through our universities and have the skills that we need to contribute to our health and care system applying for jobs and settling and making the UK their home. The Bill supports the Home Secretary to reduce an over-reliance on overseas talent and labour, which contributes to levels of net migration that even bleeding-heart liberals like me can see are too high. That is the issue that the Home Secretary seeks to deal with.

[Kevin Bonavia (Stevenage) (Lab)]

My right hon. Friend is right that we need to deal with this pressing problem and I support the aims of the Bill. However, as he can imagine, as the only current Member of this House with Maltese heritage, I have had representations from all quarters, both in the UK and in Malta, about the impact on Malta of this. Our two countries have a special health relationship, including the affiliation of the UK foundation programme with the Maltese equivalent. I understand that now may not be the time to have Malta in the priority group, but I note that there is a power in clause 4(6) that allows the Secretary of State to amend that in future. Is that something that my right hon. Friend will think about reviewing in future?

[Wes Streeting]

My hon. Friend is right about the measures in the Bill. He is also right about the importance of our relationship with Malta, which is long-standing and deep, and this Government place enormous value on that. We will, of course, keep the workings of the measures in the Bill under review. He is also right to say that the Bill provides flexibility to the Secretary of State to adjust, as our needs may demand.

[Dr Murrison]

The Bill is basically a good one, and we all share the intent to encourage home-grown talent to remain in our national health service, so could the Health Secretary explain why he appears to have set his face against British students who for various reasons train at, for example, St George’s in Cyprus or St George’s in Grenada and who then want to come back and practise in our national health service? They want to come back and practise at home. Amendment 9 would deal with that conundrum. Why will he not support it?

[Wes Streeting]

We set UK medical school places based on future health system needs. We cannot control how many places the overseas campus universities create, whether they are UK-based universities or not. Prioritising those graduates in the way that the right hon. Gentleman suggests would undermine sustainable workforce planning. It would also undermine social mobility and fair access. Those campuses are commercial ventures; they receive no public funding and students are generally self-funded. The nature of prioritisation is that we set priorities, and these are the priorities that this Government are setting out. We must break our over-reliance on international recruitment.

As I have said, I am proud of the fact that the NHS is an international employer, and it is no coincidence that the Empire Windrush landed on these shores in 1948, the very year our NHS was founded. We are lucky that we have people from around the world who come and work in our health and care service. Since Brexit, however, under the last Government, we have begun to see something much more corrosive, with the NHS poaching staff from countries on the World Health Organisation’s red list because their own shortages of medical practitioners are so severe. The continued plundering of doctors from countries that desperately need them while we have an army of talented and willing recruits who cannot get jobs is morally unacceptable. If some Opposition Members want to defend that record and dismiss the morality argument, I would point out that that position is naive on economic grounds. Competition for medical staff has never been fiercer. The World Health Organisation estimates a shortfall of 11 million health workers by 2030. Shoring up our own workforce will limit our exposure to such global pressures without depriving other countries of their own home-grown talent.

[Ben Coleman (Chelsea and Fulham) (Lab)]

I congratulate my right hon. Friend on his excellent speech and the strong points that he is delivering. I associate myself with the remarks of my hon. Friend the Member for Stevenage (Kevin Bonavia) about Malta. As a member of the Health and Social Care Committee, I have also been approached by Queen Mary University. It seems to me that we should be approaching this with a sense of fairness, and if students have entered into a GMC-recognised course with the expectation of having priority access for foundation status, we should accept that those who are currently in training still enjoy that, even if we change the rules for people who enter those courses in the future. Is that something that my right hon. Friend will consider?

[Wes Streeting]

As I have said, the position we have set out is founded on fairness. The basis on which people have applied to these universities has made it clear that the universities cannot guarantee places and that overseas applicants studying at UK universities’ overseas campuses can still apply. There is nothing to prevent those people from applying, but when it comes to prioritisation, we are prioritising UK-trained medical graduates from UK-based universities who have undertaken their training here in the UK. I think that is the right priority to draw.

[Anneliese Dodds (Oxford East) (Lab/Co-op)]

rose—

[Gregory Stafford (Farnham and Bordon) (Con)]

rose—

[Wes Streeting]

I will take an intervention from the hon. Gentleman. I will come to my right hon. Friend in a moment.

[Gregory Stafford]

The Secretary of State mentioned the need for more medical staff across the world and, of course, in this country as well. At the general election, he pledged to double the number of medical school places by 2030. Is that still a commitment, and how far has he got with it?

[Wes Streeting]

With respect, I think the hon. Gentleman has got his chronology slightly wrong. As shadow Health Secretary, I proposed that we should double the number of undergraduate medical school places. That policy was poached by the then Conservative Government, who made modest progress with it. We then came into government, looked at their long-term workforce plan and concluded that it was not a particularly long-term workforce plan, and we are revising it as we speak. The number of medical school places will be determined by future need. We will publish our long-term workforce plan in the not-too-distant future.

[Alison Bennett (Mid Sussex) (LD)]

rose—

[Wes Streeting]

I will give way to the hon. Lady and then to my right hon. Friend the Member for Oxford East (Anneliese Dodds).

[Alison Bennett]

The Secretary of State rightly notes that there is international competition for healthcare talent. On Friday, I met Dr Osoba, a GP who trains future GPs. She told me how disheartening it is to train future GPs whose intention is to leave the UK. What is the Secretary of State doing to ensure that British-trained medics stay working in the NHS?

[Wes Streeting]

The hon. Member puts her finger right on the issue at the heart of the Bill. That is exactly the challenge we want it to address. The Bill is not a panacea—it does not solve all the problems—but reducing competition for specialty places from around four to one to less than two to one, as the Bill will do, will make it far more likely that people who have undertaken their training here in the UK will stay here and contribute to our national health service. Of course, there is much more to do on career structure, pay and conditions, but we will go as fast as we can and as far as the country can afford. We recognise that we need to keep the great people we have invested in, because doing so is in their interest and in our national interest.

[Anneliese Dodds]

My question relates to exactly that issue. The Secretary of State will be aware, because I have written to his Department about it a number of times, that many disabled medics face a particular challenge. They may have had to take time out of their training because of a medical condition. They are told that they can obtain a certificate of readiness to enter specialty training and go into a training specialism, but the computer says no and NHS England is not sorting this out. Will he please get a personal grip on this and fix it for my constituents?

[Wes Streeting]

I am certainly aware of my right hon. Friend’s concerns. I can give her that assurance and will report back to her on progress.

Without action to prioritise UK medics, we will also make it tougher than it already is for those from working-class backgrounds like mine to become doctors—or, for that matter, to even consider a career in medicine. The odds are already stacked against them: they are less likely to know doctors, their teachers may be less familiar with how to help students into medical school, they will have fewer opportunities to do work experience, and fewer people in their lives will tell them that they should aim high and reach for the stars. The result is that only 5% of medical school entrants are from lower-income working-class backgrounds. Someone’s background should not be a barrier to becoming a doctor, so our job—especially as a Labour Government committed to social justice—is not just to ensure that a few kids like me beat the odds, but to change the odds for every child in this country so that they can go as far as their talents will take them.

[Aphra Brandreth (Chester South and Eddisbury) (Con)]

It is vital that we address this issue to ensure that UK-trained doctors are prioritised for vacancies over international applicants—the Secretary of State is making important points about that. We need those places to be opened up for UK medics immediately, so will he explain why the Bill will not come into force immediately after Royal Assent but instead includes provision for it to come into force

“on such day or days as the Secretary of State may by regulations appoint”?

[Wes Streeting]

It is important that the Bill is workable. A number of factors may well interrupt our ability to move at the pace at which I want to open up those places. One of those factors is the ongoing risk of industrial action. We know that the BMA is balloting for further industrial action at the moment. We respect the process that it is undertaking, and we are not closing the door to discussions while it does so. However, we are clear that that is a further disruption risk. I hope that we will be in a position to open up a new application round very shortly for current applicants, but that will depend on our ability to expedite the passage of the Bill through both Houses, and to ensure that the system is ready to implement it. That is why bringing forward the Bill on this timescale has been particularly important.

[Dr Murrison]

I am grateful to the Health Secretary; he is being generous with his time. Is he saying that he intends to use this as some sort of lever or bargaining chip in his discussion with the BMA?

[Wes Streeting]

I am clear that this is about whether the system will be ready to implement the measures in the Bill. I must say that I view the Conservatives’ amendment on this issue with a degree of cynicism. Not so long ago, they were accusing me of being too kind to resident doctors when it came to making changes to pay or conditions without something in return. They seem to have completely changed their position. I am sure that that is not remotely cynical and is for entirely noble reasons, but I will wait for the shadow Health Secretary, the right hon. Member for Daventry (Stuart Andrew), to make his case. Let’s just say that I am not entirely convinced.

The Bill implements the commitment in our 10-year plan for health to put home-grown talent at the front of the queue for medical training posts. Starting this year, it prioritises graduates from UK medical schools and other priority groups over applicants from overseas during the current application round and in all subsequent years. For the UK foundation programme, the Bill requires that places are allocated to UK medical graduates and those in a priority group before they are allocated to other eligible applicants.

For specialty training, the Bill effectively reduces the competition for places from around four to one, where it is today, to less than two to one. That is a really important point for resident doctors to hear, not least because in the debate we had on the Government’s previous offer to the BMA, that point was lost amid some of the broader and, frankly, more contested arguments between the Government and the BMA around pay. It is not just the provision of additional training posts that reduces the competition ratio; it is also the measures in this Bill. I hope that that message is heard clearly by resident doctors as they think about their own futures immediately or in the coming years. For posts starting this year, there must be prioritisation at the offer stage, and for training posts starting from 2027, prioritisation will apply at both the shortlisting and offer stages.

In the 10-year plan, we committed to prioritising international applicants with significant NHS experience for specialty places in recognition of the contribution they have made to our nation’s health. This year, we will use immigration status as a proxy for determining those who are eligible, so that we can introduce prioritisation as soon as possible. From next year, under the terms of the Bill, we will set out in regulations how we are defining significant NHS experience.

[Dr Simon Opher (Stroud) (Lab)]

Will the Secretary of State give way?

[Wes Streeting]

I give way to my hon. Friend with significant NHS experience.

[Dr Opher]

I commend the speed with which my right hon. Friend has brought this legislation to Parliament. I have been a GP trainer for 25 years. Fifty per cent of GP trainees are international medical graduates, and there has been some disquiet from them. Will he reassure our international medical graduates that they are welcome and treasured in the health service?

[Wes Streeting]

My hon. Friend is absolutely right about the contribution that international medical graduates make, and I have no doubt that that will continue to be the case for many years to come. I hope it is clear to those going through medical school or aspiring to a career in medicine that, in terms of the future of healthcare in this country, general practice is where it’s at. We are looking to shift the centre of gravity in the NHS out of hospital and into the community, with care closer to people’s homes and, indeed, in people’s homes, with GPs as leaders of a neighbourhood health service. I hope that gives encouragement to GPs serving today about the future of their profession, about which they care enormously. I also hope that that message resonates with people who are thinking about a career in medicine, when they think about what kind of career that might be.

[Sarah Pochin (Runcorn and Helsby) (Reform)]

I recently spoke to a doctor in my constituency who was concerned about resident doctors going abroad to get a training place in their chosen specialty. We in Reform welcome this Bill. Can the Secretary of State make a commitment that we will prioritise our own UK-trained resident doctors ahead of those trained abroad, and will he assure me that the Bill will help UK-trained resident doctors to secure a training post in their chosen specialty?

[Wes Streeting]

I can give the hon. Member that assurance—that is exactly what the Bill does. Madam Deputy Speaker, I cannot, however, resist the enormous temptation to say that while I welcome the support of the hon. Member and her party, I hope that her party’s position will not change now that it has adopted so many of the formerly Conservative culprits who landed us with this system in the first place. Whether it is the former Home Secretary, the right hon. and learned Member for Fareham and Waterlooville (Suella Braverman), or the former Immigration Minister, the right hon. Member for Newark (Robert Jenrick), I am afraid that Reform looks rather more like the Conservative party that the country rejected at the last election, which I am sure will not be lost on people when they go to the ballot box in May—[Interruption.] As my hon. Friend the Minister for Care says from a sedentary position, Reform UK are increasingly the teal Tories—it is certainly the most successful recycling project currently taking place in the House of Commons. Anyway, that was totally self-indulgent, and very churlish given that the hon. Member for Runcorn and Helsby (Sarah Pochin) is supporting the Bill, so I will slap myself on the wrist and get back to the serious matters at hand.

As we set out these changes, it is important to note that they will have no impact on doctors working in the armed forces, who will continue to be a priority, and neither does the Bill exclude international talent, as people will still be able to apply for roles and continue to bring new and vital skills to our NHS. The principle here is home-grown talent. It is not about where students are born; it is about where they are trained. What the Bill does is return us to the fair terms on which those home-grown medics competed before Brexit.

[Robin Swann (South Antrim) (UUP)]

I welcome the Secretary of State’s approach to the Bill, and how he has worked across all devolved Administrations. May I seek his assurance that medical students who reside in Northern Ireland, who identify as Irish and who study in an Irish institution in the Republic of Ireland will not be excluded from coming back to work in the national health service in Northern Ireland, where we very much need all the talent we can get?

[Wes Streeting]

I absolutely give the hon. Member that assurance—the Bill covers medical graduates from the UK and Ireland, for very obvious reasons. I welcome the broad support that the Bill appears to have across the House, because for the changes to benefit applicants in the current round—for posts starting this August—it must achieve Royal Assent by 5 March. Any delay will risk vacancies in August and disrupt planning in NHS trusts, which rely on their new trainees to deliver frontline care. Doctors also need sufficient time to find somewhere to live, sort childcare and arrange other aspects of their lives before their posts start. I am grateful that Parliament has agreed to expedite the Bill’s progress, and confident that we will be able to work at pace with our majority in this House, and with cross-party support in the other place.

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

I sense that the Secretary of State is about to reach the end of his remarks. We are keen to start the debate, but it would be helpful to get clarity on one thing before we begin. When will we see the workforce plan? It has been delayed a couple of times. We wrote to the Department in November asking for an explanation as to why it has been delayed and when we can expect it. Can the Secretary of State give us some clarity, because that is the context in which the narrow technical measure that we are discussing needs to happen?

[Wes Streeting]

That is a fair question from the Chair of the Health and Social Care Committee. We are taking longer than I would have liked with the workforce plan. I hope it reassures the hon. Member and the House that we have taken more time because that is what the royal colleges, trade unions, and clinical and NHS leaders asked us to do. Their strong urging was to get it right, rather than rush according to a political timetable, which I thought was a fair challenge. It will be published this spring.

[Alex McIntyre (Gloucester) (Lab)]

I welcome this legislation. Does the Secretary of State agree with me that the fact that the Government have listened to the concerns of resident doctors about training places, and have acted at pace to bring forward the legislation, shows that we as a Government are committed to fixing the problems left behind by the Conservative Government? Does he agree that the BMA should consider that when thinking about going forward with any potential further action?

[Wes Streeting]

I agree with my hon. Friend. For context, I say to members of the BMA and resident doctors that to bring forward legislation in this way and at this pace is not easy. We have a packed legislative programme. The clock is ticking on getting everything through that we want to get through in the time that we have available, and I am grateful to the business managers in both Houses for facilitating the Bill. Cross-party support is going to be important, particularly in the other place, where we have lots of expertise to draw on, including from Cross-Bench peers.

We have introduced the legislation because fundamentally we agree with the case that the BMA and resident doctors have been making. In our discussions with BMA representatives, immediately prior to the last round of industrial action and since, it has been very clear that when it comes to jobs, we are not that far apart. We recognise the problems and we are working together to address the solution. On pay, there remains a gap between the expectations of the BMA and what the Government can afford. All I ask of resident doctors and their BMA representatives is some understanding and a bit of give and take about the range of pressures on the Government and the national health service, many of which require funding, which is why there are choices and trade-offs.

I hope that the BMA representatives know and have noticed that, regardless of the fact that we remain in dispute on these issues and have had a number of rounds of industrial action, I have not slammed the door in their faces and stopped talking—we have continued with good-natured and constructive talks—and I have not thrown my toys out of the pram either, and said “Right, we will not proceed with this Bill.” We have continued to work to enact solutions that we think are good for resident doctors, and therefore good for patients and good for the NHS. I hope that this will be the spirit in which we can work together.

The goal is to be in a place, particularly with the BMA and resident doctors although this applies to other groups in the workforce too, where we can work together and make progress outside disputes, so that we can gather around tables as partners, rather than as opponents. That will take some gear shifting from where we have been to where we want to be, but I know that both the Government and the BMA have entered the new year in that spirit, so we will continue to make progress.

Having stressed the urgency of the legislation, I want to address the commencement clause included in the Bill, which has already been raised. First and foremost, it is there as a failsafe. We are running to an extremely tight deadline. I do not want to be in a position where a law is enacted and we are unable to implement it in a timely and orderly fashion. Secondly, there is a material consideration about whether it is even possible to proceed if strikes are ongoing, because of the pressure that they put on resources and the disruption that is caused operationally, particularly among the people I require to help me deliver the measures in the Bill. Of course, I am keeping my options open. We are in a good place with the BMA, and we have entered the latest round of talks in good spirit, but we do not yet have an agreement on their disputes and we are waiting for the outcome of their ballot, so I am not going to do anything now that unnecessarily makes it harder to end the strikes.

The Opposition amendment to remove the commencement clause is designed to make industrial action more likely, not less likely. It tries to bind my hands and make this job even more difficult. It looks like political gameplaying, at a time when we are trying to save the NHS, and it looks like party interest before national interest. I hope that the Conservatives will consider whether their amendment is really necessary.

British taxpayers spend £4 billion training medics every year. We treat them poorly, place obstacles in their way and make them fearful for their futures. We are forcing young people, who should be the future of our NHS, to work abroad, in the private sector or to quit the profession entirely. It is time that we protect our investment and our home-grown talent. This Bill will ensure a sustainable workforce, cut our reliance on foreign labour, halve competition for places and give home-grown talent a path to become the next generation of NHS doctors. I commend this Bill to the House.