Oral Answers to Questions
Wes Streeting Excerpts(4 days, 9 hours ago)
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Sojan Joseph (Ashford) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
This Government inherited an intolerable situation in A&E, where over a decade of Tory failures left patients waiting in pain. We are doing the hard work needed to start repairing that damage. Our new urgent and emergency care plan is backed by nearly £450 million, which will mean 800,000 fewer A&E patients waiting more than four hours this year, new urgent treatment centres, mental health crisis centres and almost 400 replacement ambulances. Those are just some of the steps that we are taking to rebuild our national health service.
Lillian Jones
I welcome the progress this UK Labour Government have made in reducing A&E waits in England. That sadly contrasts with a crisis in Scotland, where recent figures revealed 2,472 Scots waited over eight hours to be seen. Jackie Baillie rightly warned that
“Lives are being put at risk”
under the SNP, and it has been years since the Scottish Government last met any of their targets. Does the Secretary of State agree that only Labour in Westminster and in Holyrood has a serious plan to back NHS staff and cut waiting times?
Wes Streeting
I agree with my hon. Friend. There is no sign of the SNP Members this morning. They have obviously clocked off for the summer—or maybe they are just sparing their blushes, because the party has been in power for close to two decades in Scotland and has been steadily driving the NHS into the ground. The chair of BMA Scotland has said,
“the NHS is dying before our eyes”
with the SNP. It is on its fifth NHS recovery plan in less than four years. Scotland needs a new direction with a Scottish Labour Government. Working in partnership, we will fix the NHS across the United Kingdom and make it fit for the future.
Sojan Joseph
One of my first visits after being elected last year was to the A&E department at the William Harvey hospital in my constituency, where 19 patients were being treated in the corridors and others faced long waits for treatment. I therefore welcome the progress that has been made so far on reducing A&E waiting times. However, too many people end up at A&Es like the one at the William Harvey because they have no other option. What are the Government doing to increase care options in local communities, including the use of virtual wards to ensure that more people are treated closer to home and that patients in A&E are those in an emergency?
Wes Streeting
My hon. Friend is absolutely right. It is unacceptable that corridor care became the norm under the Conservatives. We will not accept it as normal; it is not acceptable. Ahead of this winter, we will require local NHS systems to develop and test plans to significantly increase the number of people receiving urgent care services outside hospital, including more paramedic-led care in the community, more patients seen by urgent community response teams, and better use of virtual wards. Together, we will improve our emergency services and make sure that people get the right care in the right place and at the right time.
David Simmonds (Ruislip, Northwood and Pinner) (Con)
The Government have spoken passionately about how minor injuries units, such as the one at Mount Vernon hospital in my constituency, help to take the pressure off A&E by diverting less urgent cases for treatment elsewhere. I am grateful to the Secretary of State for his time for a brief discussion about that last week. Will he now respond to the 25,000 local people and my constituency neighbours, including the right hon. Member for Hayes and Harlington (John McDonnell), who are joining my campaign to save the minor injuries unit? Will he intervene with the Hillingdon hospitals NHS foundation trust to prevent the unit’s closure?
Wes Streeting
Configuration of services is a matter for local commissioners. However, let me take this opportunity to reassure the hon. Gentleman that I have taken into account representations received from my right hon. Friend the Member for Hayes and Harlington (John McDonnell), as well as his letter. I apologise to him for the delay in response, but I assure him that he will get one.
Mr Will Forster (Woking) (LD)
In June, just 66% of patients admitted to Woking’s local A&E at St Peter’s hospital were seen within four hours. That is way below both the national target and the national average of 76%. Will the Secretary of State agree to investigate that to find out why my constituents of Woking are facing such lengthy and unreasonable waiting times?
Wes Streeting
As the hon. Gentleman knows, urgent and emergency care services have been struggling right across the country, but he is right to identify where there are serious and significant variations in performance. One of the focuses of this Government is to try to reduce unwarranted variation from one NHS provider to another, so that we get consistently good standards of care across the country. I commit to write to him to further explain why there are particular challenges in his area and what we can do together to help resolve them.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
Respiratory syncytial virus—RSV—is a common reason for attendance at A&E and admission to hospital among older people, and I have raised this repeatedly. Last week, the Joint Committee on Vaccination and Immunisation recommended that the RSV vaccine programme should be extended to the over-80s and those living in adult residential care homes. Can the Minister confirm that these vaccines will be available in time for this winter season?
Wes Streeting
I can certainly reassure the shadow Minister on this. The Minister for Public Health has already accepted that recommendation and is working at pace on implementation. May I wish the hon. Lady well in the Opposition reshuffle?
Laura Kyrke-Smith (Aylesbury) (Lab)
Joe Powell (Kensington and Bayswater) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
The driving force behind this Government’s approach to health is the principle that whoever a person is and whatever their background, they should receive the same world-class services as everyone else, based on need and not the ability to pay. That is why at its core, our 10-year plan for health looks to stamp out health inequalities, freeing up billions to move critical resources such as medicines and equipment to the regions and patients that need them most. Only a Labour Government will protect the NHS as a service free at the point of use, rebuild it, and make it fit for the future for everyone in our country.
Perran Moon
Meur ras, Mr Speaker. Carn to Coast runs GP surgeries across my Camborne, Redruth and Hayle constituency, including the surgery where my father practised for over 30 years. It is struggling under intense pressure, with deep-rooted health inequalities linked to the surrounding areas of deprivation. While I welcome the review of the Carr-Hill formula as part of the 10-year health plan, will the Secretary of State come to Cornwall and visit a Carn to Coast health centre with me, to see the innovative work that is already being undertaken and to discuss how the reforms will support health outcomes in the most deprived areas?
Wes Streeting
I can certainly give my hon. Friend that commitment. The damage that was wreaked by the previous Government, not just across our health service but across every other part of Government, means that the gap between the health of the poorest parts of our country and that of the wealthiest has widened enormously. We have seen real challenges in general practice, which is why there are 300 more patients per GP in the poorest communities compared with the richest, and that particularly affects rural and coastal communities with higher levels of deprivation. We are going to carry out a review of the Carr-Hill formula. That formula has to work for general practice, and I would be delighted to come and see the work that the team at Carn to Coast are doing.
Joe Powell
In Kensington and Bayswater, there is now a staggering 19-year gap in life expectancy between men living in Notting Dale and those living in Holland Park—which are just hundreds of metres apart—and that gap has grown in recent years. The Minister knows that this is a whole-of-society issue to do with housing, employment and education, but can he outline what steps the Department are taking to help inner-city areas with very high levels of health inequality, such as that experienced by my constituents in Kensington?
Wes Streeting
I am grateful to my hon. Friend for pointing out those stark differences in healthy life expectancy within a single inner London borough that contains some of the richest people on earth, as well as some of the poorest in our country. As for what we are doing as a Government, in addition to making sure that funding follows need and that we are tackling deprivation, our approach to neighbourhood health should make sure that we are working proactively in those communities that have the highest level of need, including pockets of deprivation within areas of higher affluence. Of course, as our plan recognises and as our mission-driven approach addresses, there are so many social determinants of ill health, including poverty, a lack of good work, damp housing, dirty air, and an inability to access culture and leisure opportunities that are affordable for everyone, not just the privileged few. Those are the issues that this Government are addressing, consistent with the Labour values that got us elected.
Sir Oliver Dowden (Hertsmere) (Con)
For residents of New Court Place care home in Borehamwood, wheelchairs are their lifeline. However, they are being badly let down by AJM Healthcare, their NHS wheelchair provider, with multiple unresolved assessments, bad communications and waiting times for repairs and replacements unbelievably extending to four years. Residents with physical and intellectual disabilities feel let down, overlooked and traumatised. In tackling health inequalities, can I urge the Secretary of State to look urgently at this provider and come to the aid of people who desperately need our help?
Wes Streeting
I can certainly give the right hon. Gentleman the assurance that my Department will look into the provider that he raises. One reason I was proud that this Government increased the disabled facilities grant is that it means not just more ramps, handrails and accessible kitchens and bathrooms, but dignity, independence, freedom and quality of life. That is precisely what the right hon. Gentleman’s constituents are being deprived of if they do not have wheelchairs that meet their needs. I would be delighted to look into this, and I am extremely angry that the failures he raises require me to do so.
Calum Miller (Bicester and Woodstock) (LD)
Does the Secretary of State agree that public health is at the heart of addressing the long list of inequalities he has just highlighted? I am deeply concerned that a major reorganisation of local government and the cutting of budgets to the integrated care board will undermine the co-ordination that currently exists in Oxfordshire to deliver public health. Can the Secretary of State assure me and my constituents that public health will continue to be a priority at the heart of the prevention strategy, and that funding for public health will rise in future years to make that possible?
Wes Streeting
I can certainly give the hon. Gentleman reassurance that the work we are doing to streamline and rationalise the amount of money we are spending on NHS bureaucracy means that we will free up resources that can be spent on the frontline, improving patient care and public health. Thanks to the decisions taken by my Department, the Deputy Prime Minister and, of course, my right hon. Friend the Chancellor of the Exchequer, investment in public health is rising and the spending power of local authorities is improving. That is all good news for public health.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
Tackling health inequalities requires a strong workforce. I recently met a constituent who is about to qualify as a nurse, but she has been unable to find work. She is not alone; this is a widespread problem. The reasons she has been given include recruitment freezes to save money and nurses brought in from overseas instead. We need more nurses to tackle health inequalities, so will the Secretary of State ensure that trusts are funded to support and employ new nurses, and to prioritise British nurses for British jobs?
Wes Streeting
I can certainly assure the shadow Minister that the chief nursing officer and I are working proactively to deal with nursing unemployment. We are also working with the leadership of the NHS to make sure that we are reducing our reliance on overseas workers. Grateful though I am to all the healthcare workers who come from overseas to work in our health and care services—the service would fall over tomorrow if they all left, so we should be extremely grateful—there is certainly an overreliance, and that is what we are addressing. I have to say to the shadow Minister, though, that both those issues are a result of appalling workforce planning, for which the previous Government bear a huge amount of responsibility.
Michelle Scrogham (Barrow and Furness) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
It is only with proper investment and reform that we will bring care closer to people’s homes and into the community. Our 10-year health plan will roll out a neighbourhood health service in every community, as one-stop shops for health and care services that meet the needs of local populations, including rural and coastal communities like my hon. Friend’s constituency. The previous Government failed to move care into the community. We have already hit the ground running on delivering the 10-year health plan, and launched the national neighbourhood health implementation programme on 9 July to start that work at pace.
Michelle Scrogham
My constituents in Barrow and Furness very much welcome the Government’s move towards delivering more neighbourhood health services, but my right hon. Friend will be aware of the great concern locally about the proposal from Lancashire and South Cumbria integrated care board to permanently end level 3 critical care at Furness general hospital. More than 10,000 people have signed my petition just this week to oppose that move. Will the Secretary of State please ensure that decision makers meet me and representatives locally to explore an alternative path forward that ensures patient safety, protects the integrity of our hospital and reflects the area’s growing population?
Wes Streeting
That was just one of many instances in which my hon. Friend has made the voices and views of people across Barrow and Furness heard loudly and clearly in this place and across government. In response to her question, I say yes, absolutely: on such an important matter her local commissioners should be meeting her, as the local Member of Parliament, and I think I can commit to that on their behalf. While such decisions must be made locally and clinically led, they must also be made in partnership with the local authority and the local community. We must ensure that we are engaging democratically elected representatives, and I will ensure that my hon. Friend secures that meeting.
Sir Jeremy Hunt (Godalming and Ash) (Con)
My constituents in Cranleigh have no train service and no direct bus service to the Royal Surrey County hospital in Guildford, which is a big issue for older residents who do not drive. Does the Secretary of State agree that some of the empty rooms in Cranleigh Village hospital could provide a very good opportunity for the expansion of neighbourhood health services, and if he has not been briefed on this pressing issue by his officials, may I brief him, or one of his Ministers, on it in the autumn?
Wes Streeting
That sounds like another bid for a neighbourhood health centre in the right hon. Gentleman’s constituency, but I am sure that local commissioners will be delighted to hear the case he has made, given the experience that he brings to bear.
Robin Swann (South Antrim) (UUP)
The Secretary of State for Health and Social Care (Wes Streeting)
Before this Government came to office, strikes were crippling the NHS. Costs ran to £1.7 billion in just one year, and patients saw 1.5 million appointments rescheduled. Strikes this week are not inevitable, and I sincerely hope that the British Medical Association will postpone this action in order to continue the constructive talks that my team and I have had with its representatives in recent days. Our priority is to keep patients safe regardless, and we will do everything we can to mitigate the impact on them and the disruption that will follow should these totally unnecessary and avoidable strikes go ahead.
Robin Swann
In a previous role, I found that health workers took industrial action only in extreme circumstances, so I agree with the Secretary of State that if the strikes can be prevented, they should be. During previous resident doctors’ strikes, elective or scheduled procedures were usually postponed, or planned to be postponed, to free up senior doctors to cover their work, but I note that the chief executive of NHS England has instructed hospitals to continue those procedures. Has the Secretary of State made any assessment of the impact that would have not just on patients but on the staff who would have to remain?
Wes Streeting
The approach we are taking is different from that taken during previous periods of strike action. NHS leaders have made it clear to me that those earlier strikes caused much wider harm than had previously been realised. There is no reason why planned care—appointments relating to cancer, for example, as well as other conditions—should be treated as being less important than, or playing second fiddle to, other NHS services. That is why the chief executive of NHS England has written to NHS leaders asking them to keep routine operations going to the fullest extent possible, as well as continuing priority treatments. It will be for local leaders to determine what is possible given staffing levels, which is why it is so important for resident doctors to engage with their employers about their determination—or not—to turn up at work this week, and why I must again spell out the serious consequences for patients should these avoidable and unnecessary strikes go ahead.
Lorraine Beavers (Blackpool North and Fleetwood) (Lab)
Healthcare assistants at Blackpool teaching hospitals NHS foundation trust have been underpaid on the wrong band for years, but the trust has consistently failed to put that right, and as a result staff have been left with no choice but to be balloted for strike action by Unison from today. Healthcare assistants play a vital role in our NHS, but is it any wonder that they often feel undervalued and demoralised when they are not paid the correct rate for the duties that they undertake? Does the Secretary of State agree that Blackpool’s healthcare assistants are worth just as much as those in the rest of the north-west and that the trust should pay up now?
Wes Streeting
I should declare that I am a member of Unison. The issue that my hon. Friend raises is a serious one. We obviously do not want to see strike action impacting on her local constituents, and my Department will do everything we can to help bring an end to the dispute.
I will make a more general point: these sorts of choices and trade-offs about resources are precisely why the BMA resident doctors, having received a 28.9% pay rise from this Government in the last year, ought to remember the responsibility that I and they have to some of their lower-paid colleagues. Resources are finite, and it is important that I act in the interests of all NHS staff and have particular concern for those who work extremely hard but are not properly rewarded.
Edward Argar (Melton and Syston) (Con)
The resident doctors’ strike is unnecessary, irresponsible and wrong. Recently, and again today from the Dispatch Box, the Secretary of State has been resolute in not giving in to the BMA resident doctors committee’s demands. Although I do not know the details of the current status of his discussions with the committee, may I encourage him to remain firm in his stance and, while being fair to doctors, to always ensure that he puts the interests of patients and taxpayers first?
Wes Streeting
Once again, the House is speaking with one voice, and I hope that the BMA understands the strength of feeling on both sides of the House about the unnecessary and irresponsible nature of the proposed strike action this week. Discussions in recent days have been constructive, and I hope that gives grounds for the postponement of strike action so that we can work together to avert it—not just this week, but altogether.
Lewis Atkinson (Sunderland Central) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
Under this Government, waiting lists have fallen by more than a quarter of a million in our first year, but strike action puts that hard-won progress at risk. If strikes do go ahead, we will do everything we can to minimise the disruption to patients, who will bear the brunt of cancellations. We continue to work with the BMA resident doctors committee in the hope that its members will do the right thing and call off the strikes. None the less, if they go ahead, we stand ready, responsive and resolute.
Lewis Atkinson
There were 5,448 drug-related deaths in 2023—the highest figure ever—and an 84% increase from the number that led the previous Government to publish their drugs strategy, which was supposed to save lives. Does the Secretary of State agree that the existing drugs strategy is not fit for purpose, and will he urgently start work on replacing it with a public health-led drugs strategy to tackle this public health emergency?
Wes Streeting
I am extremely grateful to my hon. Friend for his question. The number of drug-related deaths remains far too high, and we are committed to saving lives through access to high-quality treatment. For 2025-26, my Department is providing £310 million in addition to the public health grant to deliver the recommendations from Dame Carol Black’s independent review, but there is much more to do. We look forward to working with my hon. Friend to achieve success.
Edward Argar (Melton and Syston) (Con)
Dementia is one of the greatest health challenges that we as a society face today and in the future, but too many people with dementia end up in hospital, rather than being treated in more appropriate community settings. The 10-year NHS plan offers a real opportunity to shift care into the community and away from acute settings, including for dementia. Will the Secretary of State commit to working with Dementia UK, the Alzheimer’s Society and other fantastic charities as he develops the implementation of his 10-year NHS plan to ensure that it truly delivers for people with dementia and those who care for them?
Wes Streeting
I absolutely agree with what the shadow Secretary of State has said. All three shifts—from hospital to community, from analogue to digital, and from sickness to prevention—ought to benefit people with Alzheimer’s, dementias and other neurological conditions, as will the pioneering science that we need in this country, which I know he is so passionate about.
Edward Argar
Maintaining the focus on local communities, the fantastic St Mary’s birth centre in Melton Mowbray, in my constituency, has recently been temporarily closed by the local NHS trust for six months due to staff shortages. Although I appreciate that the Secretary of State does not have powers over such temporary closures and that local NHS leaders have engaged constructively, many local people fear that “temporary” could risk becoming permanent. If that risk looks like becoming a reality by the end of the summer, will the Secretary of State or one of his Ministers pre-emptively agree to meet me at that point to discuss it?
Mr Speaker, if I may briefly crave your indulgence at what is my last Dispatch Box appearance for the foreseeable future, may I take the opportunity—after seven years, almost continuously, on the Front Bench in government and in opposition—to thank you, to say that it has been a privilege, and to tell the Secretary of State that it has been a pleasure to shadow him? I think he knows it, but I genuinely wish him well.
Wes Streeting
I absolutely give the right hon. Gentleman the assurance that I would be happy to meet him about his constituency issue, or indeed anything else. For all of the exchanges that we have across these Dispatch Boxes on issues of disagreement, what is not always readily understood beyond this House is the extent to which those on both sides work extremely constructively together, on the enormous number of issues that we have in common, in pursuit of the national interest. The virtues of wisdom, kindness and selfless dedication to public service are not the preserve of one side of the House. The right hon. Gentleman has those qualities in abundance, and we wish him very well, personally and professionally.
Jas Athwal (Ilford South) (Lab)
Wes Streeting
I deplore Israel’s attacks on healthcare workers, as well as those on innocent civilians trying to access healthcare or vital aid. These actions go well beyond legitimate self-defence and undermine the prospects for peace. I will be in touch with the World Health Organisation to offer my support following the intolerable incident yesterday. I sincerely hope that the international community can come together, as my right hon. Friend the Foreign Secretary has been driving for, to ensure that we see an end to this war, but also the recognition of the state of Palestine while there is still a state of Palestine left to recognise.
Jess Brown-Fuller (Chichester) (LD)
Carers across the country have launched a protest from home today, with the Carers Trust. Their faces are projected on screens around Parliament Square because they are unable to leave their loved ones to protest in person. The Government’s pledge for the carer’s allowance review to report by early summer looks set to be broken. Can the Secretary of State today commit to ending the cliff edge for carer’s allowance and to introducing a statutory guarantee for respite care so that carers know that he is listening?
Wes Streeting
I thank the hon. Member for her question, and for making everyone aware of the powerful protest taking place today, which so visibly reminds us that lots of people’s voices may not be heard if they cannot participate in person. It is a reminder of the challenges that people face. I will undertake to raise her concerns with my right hon. Friend the Work and Pensions Secretary, and I give carers across the country the assurance that we are working as fast as we can. Having delivered the biggest expansion of carer’s allowance since the 1970s, we want to ensure we deliver for this extremely important group of people, whom we are lucky to have in our society.
Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)
Wes Streeting
I can absolutely give my hon. Friend that reassurance. It was appalling that the previous Government not only cancelled lots of the deprivation-linked funding put in place by the Labour Government but threw all that progress into reverse. That is not the approach that this Government will take. We will have funding based on need, not pork barrel politics. I can assure my hon. Friend that his constituents in Stoke-on-Trent will benefit from our sincere commitment to tackling health inequalities.
David Davis (Goole and Pocklington) (Con)
Wes Streeting
I can certainly give the right hon. Gentleman the assurance that we are looking right across NHS estates to make sure we are making best use of them, particularly in the context of neighbourhood health. I have heard the case he has made about how neighbourhood health services could be provided on that site. I hope commissioners have heard the case, but if not I will make sure that they do and that he gets the relevant meetings he needs.
Josh Dean (Hertford and Stortford) (Lab)
Wes Streeting
When this Labour Government came to office, we promised 2 million more appointments, but we have actually delivered 4.5 million. We have cut NHS waiting lists month after month, and they are now at their lowest level in two years. Of course there is more to do. I regret that we had to delay Watford general hospital; the previous Government left a plan that was not credible and had no available funding. We are cleaning up their mess, and the hon. Member has a cheek to complain about it.
Daniel Francis (Bexleyheath and Crayford) (Lab)
The report, “Barriers for adults with Cerebral Palsy on achieving full life participation”, published by the former all-party parliamentary group on cerebral palsy, highlighted the cliff-edge in support for those with cerebral palsy when they transition at the age of 18 and the need to end the separation of neuro and musculoskeletal knowledge within the NHS, given that cerebral palsy is a neuromusculoskeletal condition, and that those living with it need easy and ready access to both areas. I would therefore be grateful if I could understand—
Lee Anderson (Ashfield) (Reform)
Brierley Park medical centre applied for funding from the primary care utilisation and modernisation fund earlier this year. It has been successful, but it has not yet had the money, and the money must be spent by the end of the year. Will the Secretary of State please tell my medical centre when it will receive this vital funding?
Wes Streeting
The hon. Gentleman is absolutely right about the timeliness of decision making and the need to release funding when it is allocated. I shall make sure that my Department looks into that, and write to him with an answer.
Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
I commend my right hon. Friend for his work on reducing waiting lists, but at the Homerton in Hackney, because of a system-wide funding failure, deficit reduction money was removed three months into a 12-month agreement, which reduced the opportunity to drive down waiting lists still further. Will he or one of his colleagues meet me to discuss this issue and see what we can do to drive down those waiting lists?
Wes Streeting
We are taking action to deal with the over-running of budgets and the reckless spending across the NHS and to bring deficits under control, but I would be delighted to meet my hon. Friend.
Lincoln Jopp (Spelthorne) (Con)
Spelthorne residents Emma and John lost Holly to cancer in October last year. They set up the charity Holly’s Heroes in her name. Before she died, Holly was given a wheelchair by the NHS, and Emma and John cannot now give it back to the NHS for love nor money. I have raised this with the chief executive of the trust, but can the Secretary of State reassure me that this practice is not replicated nationwide?
Wes Streeting
We absolutely need to look at reducing waste in the NHS, so I would be delighted to pick up that case. Can I also say an enormous thank you to Holly’s family for the work they are doing in such unimaginable circumstances? I really admire people who put themselves forward to serve others in that way after such a painful experience.
Jen Craft (Thurrock) (Lab)
Last Friday I brought together GPs, housing developers, the local authority, the ICB, and anyone else you care to name, to try finally to solve the issue of our having one of the most under-doctored areas in the country for primary care. Among the many issues raised was a particularly niche one: thanks to NHS Property Services demanding a late payment from a couple of GP surgeries, which were unaware that they were due to pay this rent, those surgeries now face the possibility of having to pay a bill that equates to the cost of one GP’s salary for a year. That cannot be right.
Wes Streeting
I would be delighted to look at the issue that my hon. Friend raises. I am only sorry that I missed the party last week.
Tim Farron (Westmorland and Lonsdale) (LD)
Lancashire and South Cumbria integrated care board is having to make savings of £142 million this year, and the backdrop to that is a loss of wards at Barrow, Lancaster and Kendal. We hear a lot about additional money for the NHS. Why is none of it coming to Cumbria?
Wes Streeting
It is not the case that none of the money is going to Cumbria. We are taking action to deal with the persistent overrunning and over-spending of NHS budgets, which was an intolerable situation that we had to get a grip on. We are investing £26 billion more in the NHS, and that will rise over the course of this Parliament. We will make sure that every part of the country gets its fair share, not least through the deprivation-linked funding that I mentioned. I know that it is bumpy for ICBs as we get them back to balance, but believe me it will be worth it in the end when we have a sustainable NHS that is fit for the future.
Cat Eccles (Stourbridge) (Lab)
In 2020, a consultation was carried out to give prescribing rights to operating department practitioners, but despite positive discussions with the Department we are no further forwards and OPDs and allied health professionals are being held back. Does the Secretary of State agree that expanding their roles within scope of practice will improve efficiency, patient care and professional development?
Wes Streeting
We are keen to address these sorts of issues through our workforce planning and to ensure that staff are working to the top of their licensing capability, always within the training provided. That way we can get the best possible value for taxpayer money and, most importantly of all, the best outcomes for patients.
Damian Hinds (East Hampshire) (Con)
Does the Secretary of State agree with me about the importance of step-down provision, provided by community hospitals such as Petersfield and Alton, both for patient care and for relieving pressure on acute hospitals, such as Queen Alexandra and Basingstoke?
Wes Streeting
Yes, and that is why we are reforming the better care fund.
Josh Fenton-Glynn (Calder Valley) (Lab)
Key to the shift to prevention is making sure that people can stay in their own homes or get home from hospital. The Health and Social Care Committee found that such provision costs the NHS £1.9 billion every year. Can the Secretary of State update me on what we are doing to get the social care system working?
Wes Streeting
Thanks to the decision that the Chancellor has taken, spending power in social care is rising—not just through Department funding but in the spending power of local authorities. My hon. Friend is absolutely right: we have to get the right care in the right place at the right time. That often means better care for patients and better value for taxpayers.
Tessa Munt (Wells and Mendip Hills) (LD)
At midnight, The Times published an article on the ME final delivery plan, carrying quotes from three ME campaign groups. The charity Action for ME published a five-page briefing at the same time, and “BBC Breakfast” also featured the plan, so they had all read the plan. I checked with the relevant officers and went to the House of Commons Library about half an hour ago, and no plan has been published. More than 12 hours after the Department’s press release, no MP can access the plan. Is this how it should be?
Vaccination Coding in General Practice
Wes Streeting Excerpts(1 week, 2 days ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
I would like to update the House of an important issue affecting the NHS’s provision of vaccinations.
An issue has been identified in the use of Accurx batch messaging, a system that allows GP practices to send the same message to a group of patients, via email, NHS app or SMS. In some cases, when invitations have been sent to patients inviting them to receive a vaccination, the code for a completed vaccination was selected on the system, rather than the code for an invitation. This did not affect patients being invited to receive a vaccination, but their record on the GP practice system was updated to say, incorrectly, that they had received a vaccination.
This has affected around 57,000 records across 337 GP practices. Our investigation suggests that this has primarily affected records in relation to vaccinations for the respiratory syncytial virus vaccination—a maximum of 2% of vaccines administered—but also some other vaccinations. For anyone to miss the opportunity to be invited to receive a necessary vaccination is extremely regrettable, and we are taking steps to resolve this. There is currently no evidence that anyone has been harmed as a result. Not everyone whose record has been affected will have missed out on a vaccination, as an initial vaccination invitation will have been sent out and a direct invitation is not the only route to securing a vaccination. We would strongly encourage anyone eligible to come forward for their vaccinations when invited, to get vital protection.
Accurx has amended its clinical coding to prevent this happening again. GP practices affected will review patient records, to make sure that anyone due a vaccination who has not received one is offered one as soon as possible, and that records are accurate and up to date. On average, an affected GP practice will have to review less than 200 cases and NHS England and integrated care boards will support them in this process. A detailed root cause analysis will be carried out to ensure that we learn from this and avoid similar issues in the future.
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National Security Investment
Wes Streeting Excerpts(1 week, 2 days ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
I am today confirming that the Government will proceed with the construction of a new, state-of-the-art health security campus—including new high containment laboratory facilities—in Harlow, Essex. This site will replace the UK Health Security Agency’s (UKHSA) existing facilities in Colindale and Porton Down and will form part of the Government’s network of national biosecurity centres as announced in the national security strategy. This decision reflects the hard work and extensive campaigning by the hon. Member for Harlow and is a vote of confidence in Harlow’s potential.
This facility represents the most significant investment of its kind in a generation. The programme is a multi-billion-pound investment, with £250 million to be spent over this Parliament to kickstart delivery of the new facility. It will consolidate, into a single purpose-built site, the critical high-containment laboratory functions as well as the existing research and diagnostic functions of our existing facilities in one location and will also serve as UKHSA’s corporate headquarters.
The new Harlow site will strengthen the UK’s pandemic preparedness, reinforce national security, and provide world-leading capability to detect, assess and respond to health hazards.
In addition to the public health benefits, this development will support economic growth and create an estimated 1,600 additional high-skilled jobs. It will enable closer collaboration between leading scientists and the life sciences sector. The Harlow site offers strategic opportunities for new partnerships and scientific innovation and will further enhance the Oxford–Cambridge corridor as a major engine of national prosperity.
UKHSA will finalise the design of the Harlow site before construction begins, with phased occupation of the facility starting in the mid-2030s. The site will be fully operational by 2038. A period of dual running with existing sites will ensure a safe and effective transition of operations. UKHSA will maintain operations at Colindale and Porton Down until Harlow is fully validated and operational.
This decision will affect approximately 1,650 UKHSA staff across the Colindale and Porton Down sites and staff at its headquarters in Canary Wharf. UKHSA will work closely with affected staff throughout the transition period, recognising the unique and vital expertise of its workforce.
The Defence Science and Technology Laboratory (Dstl) site at Porton Down is not affected by this decision and will remain in operation on its existing site.
[HCWS843]
Independent Review of Physician Associates and Anaesthesia Associates
Wes Streeting Excerpts(1 week, 3 days ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
In November 2024, I asked Professor Gillian Leng CBE to undertake an independent review of physician associates and anaesthesia associates in England, and to set out recommendations to ensure the safety of the roles and their contributions to multidisciplinary healthcare teams.
Today I want to update the House on next steps following the publication of the review.
Professor Leng sets out 18 recommendations that will give much-needed clarity, certainty and confidence to staff and patients. The Government are accepting these recommendations in full.
The overarching recommendations include: renaming the role of “physician associate” to “physician assistant” and “anaesthesia associate” to “physician assistant in anaesthesia” to reflect their position as a supportive, complementary member of the medical team; providing ongoing opportunities for training and career development; making it easier for others to identify these roles; establishing permanent faculties to provide professional leadership and set clear professional standards; greater clarity in the differences between the regulatory requirements of doctors and assistant roles; training in line management and leadership for doctors, with additional time allocated; redesigning models of multidisciplinary working; and improvements in safety reporting.
For physician assistants specifically, Professor Leng has recommended that their initial practice is clearly defined in line with job descriptions; they do not see undifferentiated patients (except within clear national clinical protocols); that newly qualified physician assistants should gain at least two years’ experience in secondary care, to enhance clinical skills, prior to taking a role in primary care or a mental health trust; and that they should form part of a clear team structure and have a named supervisor.
For physician assistants in anaesthesia, the review recommends full compliance with the existing Royal College of Anaesthetists scope of practice; that any further expansion of the role should be taken forward in conjunction with the Royal College of Anaesthetists; and that there should be an ongoing national audit of safety outcomes in anaesthesia, to gain assurance around the safety of the physician assistants in anaesthesia role.
Implementing the recommendations will require organisations to work together and take action. Some actions will be implemented immediately, while others will require wider input, with benefits being fully realised over time. I have asked NHS England to move with immediate effect to implement those recommendations which most directly affect patient safety, including moving to the use of physician assistants and physician assistants in anaesthesia titles and ensuring that physician assistants do not see undifferentiated patients, except within clearly defined national clinical protocols.
The NHS is its people, and physician assistants and physician assistants in anaesthesia can play a vital role in the delivery of the shifts set out in the 10-year health plan for England. The findings in this report demonstrate that, when integrated appropriately, physician assistants can improve access, enhance capacity, and provide continuity of care, while physician assistants in anaesthesia can help expand theatre capacity and flexibility in anaesthesia services.
However, the review is clear that change is needed. It sets out the fundamental issues that need to be tackled to effectively and consistently embed change into the NHS workforce. These recommendations provide a practical way forward on title, ongoing development and practice that we can all have confidence in.
I would like to express my immense gratitude to Professor Leng and her team for their effort and dedication in carrying out this considered, complex and comprehensive review. I also want to extend my thanks to all those who have engaged constructively with the review, including those resident doctors who have respectfully raised concerns, and physician assistants and physician assistants in anaesthesia who make valuable contributions across the NHS and have been subject to intense scrutiny.
We will consider Professor Leng’s findings and recommendation in detail in conjunction with the 10-year health plan. The lessons learned in the review will be embedded into the upcoming workforce plan to improve how we effect change in the NHS, and ensure the mistakes of the past are not repeated in the future. We will work with key partners, including NHS England in advance of publishing a fuller response, setting out a clear implementation plan to make the required changes in due course.
[HCWS830]
Fuller Inquiry Phase 2 Report
Wes Streeting Excerpts(1 week, 4 days ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
Today, the independent inquiry into the issues raised by the actions of David Fuller has published its phase 2 and final report. It focuses on whether procedures and practices in hospital and non-hospital settings sufficiently safeguard the security and dignity of the deceased and would prevent a recurrence of the issues identified by the inquiry, as well as considering the role of regulation.
I wish to pass my thanks on to any individual or organisation who has provided evidence to this important independent inquiry. I extend my heartfelt condolences to the families of the victims and assure them that we are committed to learning from these events.
In 2023, the independent inquiry, chaired by Sir Jonathan Michael, published its phase 1 report, which set out how Fuller was able to commit such shocking crimes, undetected for so long at Maidstone and Tunbridge Wells NHS trust. The trust set out its progress implementing all the inquiry s recommendations via an assurance statement in February 2024.
A phase 2 interim report was published in October 2024. The inquiry’s chair expedited the inquiry’s work on the funeral sector in light of reports of cases of neglect. The interim report presented preliminary findings and recommendations on the funeral sector in England. The Government committed to responding to these recommendations as part of the final phase two Government response.
The overall conclusion of today’s final report is that current arrangements for the care of people after death are partial, ineffective and in some areas completely lacking. The overarching recommendation for Government is that there should be statutory regulation to protect the security and dignity of people after death, regardless of the setting or institution.
Today’s report makes 75 detailed recommendations in total, including 19 for trusts and 25 for local authorities focusing on access, dignity, security, and wider processes and procedures to protect deceased individuals. A smaller number of recommendations—31—focus on independent hospitals, medical education, hospices, ambulance services, care homes, the funeral sector and faith organisations, making specific recommendations to improve the care of the deceased. This includes recommendations for the UK Government to establish an independent statutory regulatory regime for the funeral sector.
Every deceased individual deserves to receive the highest standard of care and dignity. The Government will work to ensure this is the case, across all settings, be that in the NHS or other settings including local authority mortuaries, hospices, ambulance services, care homes, funeral homes, and faith organisations.
The Government recognise the urgency of the concerns raised by the inquiry’s recommendations and will respond at pace. This will include an interim update on progress this year and a final response by summer 2026.
[HCWS824]
Resident Doctors: Industrial Action
Wes Streeting Excerpts(2 weeks, 2 days ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
With your permission, Madam Deputy Speaker, I will make a statement on planned industrial action by resident doctors.
Today’s waiting list figures show that after 14 years of decline, the NHS is finally moving in the right direction. Since July, we have cut waiting lists by 260,000. We promised to deliver an extra 2 million appointments in our first year, and have more than doubled that figure, delivering 4.6 million more appointments. For the first time in 17 years, waiting lists fell in the month of May, and they now stand at their lowest level in more than two years. That is what can happen when NHS staff and a Labour Government work together. We have put the NHS on the road to recovery, but we all know that it is still hanging by a thread, and that the BMA is threatening to pull that thread.
On Tuesday this week, I met the co-chairs of the BMA’s resident doctors committee to discuss the results of its ballot for industrial action. In that meeting, and in a letter I sent yesterday, I offered to meet the BMA’s full resident doctors committee and work with it to improve its members’ working lives. Since the start of this year, I have offered repeatedly to meet the entire committee, but it still has not taken up my offer. Instead of agreeing to talk, the BMA responded by announcing five days of strike action. Its planned strike action will run from 7 am on Friday 25 July to 7 am on Wednesday 30 July. These strikes are unnecessary, given this Government’s willingness and eagerness to work together to improve resident doctors’ working conditions. Following a 28.9% pay rise thanks to the actions of this Government, the BMA’s threatened industrial action is entirely unreasonable. I am asking it again today to pause, call off the strikes, and instead work with the Government to rebuild its members’ working conditions and rebuild our NHS.
Before this Government came into office, a toxic combination of Conservative mismanagement and strikes was crippling the NHS. The cost to the NHS ran to £1.7 billion in just one year; patients saw 1.5 million operations and appointments cancelled, and people’s lives were ruined. Phoebe suffers from a genetic condition: neurofibromatosis, which causes non-cancerous tumours on the outside of her body. Her first operation at Great Ormond Street hospital was cancelled twice—at first due to strikes, and then because there was not the capacity to treat her. Phoebe loves going to school, and it is an absolute tragedy that her education was set back. She was prevented from doing what she loves because the NHS was not there for her when she needed it, but this year, when Phoebe’s family contacted Great Ormond Street in March, her surgery was scheduled less than two weeks later. Compared with what she went through two years ago, the difference was night and day.
That is the difference a Labour Government make, and it is why this Government were absolutely right to end the strikes when we came to office. I am so proud of what we have achieved together with NHS staff. In the words of one NHS leader I spoke to recently, there is light at the end of the tunnel and, for the first time, it is not an oncoming train. That has only been possible because of the deal this Government negotiated.
When we agreed that deal to end the strikes last year, resident doctors did not just receive a 22% pay rise; the Government also gave a genuine commitment to build a new partnership with those we now call resident doctors, based on mutual respect. I have personally ensured that that commitment was followed through. A new exception reporting process has been agreed with resident doctors in principle, so that doctors are paid for the work they are asked to do. A review of rotational training is under way and almost complete to reduce disruption to resident doctors’ lives. We promised to tackle GP unemployment, and we have delivered with an extra 1,900 GPs on the frontline who were otherwise facing unemployment. I am determined to go further to tackle doctor unemployment.
When I say to resident doctors that I want to tackle the bottlenecks they face, and the unfair competition for specialty training places, and to create more training places, they can judge me not just by my words, but by my actions. When the pay review body recommended a 5.4% average pay rise for resident doctors this year, we accepted that and funded it in full. Those are not grounds for industrial action. Indeed, in the history of British trade unions, it is completely unprecedented for a pay rise of 28.9% to be met with strikes. The BMA itself described this pay rise as “generous”.
Thanks to this Government, the average annual earnings per first year resident doctor last year were £43,275. That is significantly more, in a resident doctor’s first year, than the average full-time worker in this country, and it is set to increase further with this year’s pay award. For resident doctors in their second year out of medical school, their average annual earnings rose to £52,300 last year. In core training years, resident doctors earned an average of £67,000. Specialty registrars earned on average almost £75,000. There is no question but that these are highly trained, highly skilled medics who work hard for their money, but to threaten strikes in these circumstances is unreasonable and unnecessary, so it is no wonder that the BMA has lost the public’s support.
At the beginning of this dispute, resident doctors faced a Conservative Government cutting their pay and refusing to talk to them. A clear majority supported action as a result. In February 2023, 56% of the public backed junior doctor strikes. Today, that support has collapsed. Just one in five people believe that the BMA is doing the right thing. Patients are begging resident doctors not to walk out on them, and I hope the BMA is listening, because many resident doctors are.
For the first time since the BMA’s campaign began, a majority of BMA resident doctors did not vote for strike action. They can see that the Government have changed and our approach has changed, yet the BMA’s tactics have not. Resident doctors have received the highest pay award in the public sector, both this year and last year, so renegotiating this year’s pay award would be deeply unfair to all other public servants. Such a deal would be paid for by their future earnings, and with the greatest respect to resident doctors, there are people working in our public services who are feeling the pinch more than they are.
Even if it would not be unfair on public sector workers, it is unaffordable. It should be apparent to anyone that the public finances this Government inherited are not awash with cash, so I will not and cannot negotiate on this year’s pay award, and I am not going to lead resident doctors up the garden path by making promises unless I know I can keep them. As I have said in person, in writing, in private and in public, I am willing and ready to get around the table and work together to improve the working conditions of resident doctors. There is so much more that we can do together. I do not just hear the complaints that resident doctors have about their placements, rotations and bottlenecks— I agree with them. I know the NHS has been a bad employer, and I am determined to change it. My offer to talk comes with no preconditions attached. I will also say this to resident doctors directly: consider very carefully the consequences of your actions.
Madam Deputy Speaker (Caroline Nokes)
Order. May I suggest to the Secretary of State that his statement has already taken 10 minutes and he has not asked for additional time? Does he wish to consider whether his statement is to the House, or to those outside the House? He might like to make a few closing remarks.
Wes Streeting
Thank you, Madam Deputy Speaker. I will move to closing. I did share the statement in advance, including with Opposition parties and the Speaker’s Office. I just say to resident doctors, and it is important that the House knows what we are saying to them, that they should carefully consider the consequences of their actions. Five days of strike action mean patients and their families receiving the phone call they are currently dreading, being told that the operation or appointment they have been waiting for—often for far too long—is being cancelled and delayed. I know how I would feel if that happened to a member of my family, and I ask them to consider how they would feel if that happened to a member of theirs. While they are out on the picket line, protesting the 28.9% pay increase they have had, their friends and colleagues and other NHS staff—many of whom are paid less and receive less than them—will be inside, picking up the pieces and working in harder conditions to cover for the consequences of resident doctors’ actions.
In conclusion, the strikes are not only unnecessary and unreasonable, but unfair. They are unfair on patients, unfair on other NHS staff, and unfair to the future of the NHS, which is in jeopardy. The tragedy is that they will never have had a Secretary of State as sympathetic to their legitimate complaints as this one. If they want to know what the alternative is, its Members are not sat here. They have not even bothered to show up today, and that party does not even believe in the NHS. The grass is not greener on the other side. I ask them not to squander this opportunity. At this stage, we can still come out of this dispute with a win for the BMA’s members, a win for the NHS and a win for patients, but if the BMA continues down the path of strike action, it will lose its campaign, resident doctors will be worse off, and the heaviest price of all will be paid by patients. I commend this statement to the House.
Madam Deputy Speaker (Caroline Nokes)
I call the shadow Secretary of State.
Edward Argar (Melton and Syston) (Con)
I am grateful to the Secretary of State for his typical courtesy and advance sight of his statement. I also note that he is among the most assiduous of Ministers in volunteering himself to this House to be questioned on issues of importance. I am, however, afraid it comes as no surprise that we are here today discussing likely industrial action on this Government’s watch. Last year, we warned the Government that caving in to union demands for above-inflation pay rises without any conditions or strings attached would set a dangerous precedent. It would send a message that the Government were weak, and we warned that the unions would simply come back for more. Unfortunately, events in recent days have shown that we were right.
The public will be understandably concerned about what this industrial action will mean for them and the provision of local NHS services. For patients with an appointment scheduled or even on a waiting list, that concern will be particularly acute. Let me be clear: this BMA strike action—as the Secretary of State has said, it is supported by less than 50% of those eligible to vote—is irresponsible, wrong and unnecessary. On that, I agree with the Secretary of State.
Will the Secretary of State enlarge on the additional steps that he is taking to seek to resolve the industrial dispute and prevent the strike action from going ahead? I heard what he said about his willingness to talk. Does he anticipate further meetings before strikes start on 25 July, and does he anticipate a risk of any other parts of the NHS workforce balloting for strike action?
If this strike action does take place, what steps are being put in place to minimise disruption, what is the plan to protect patients who will need to access NHS services over this period, and can the Secretary of State guarantee that emergency cover will remain and that there will be minimum service levels in place? More broadly, and based on the previous strikes, how many appointments do the Government anticipate are at risk of being cancelled or postponed, and has he assessed what impact the decision by the BMA will have on his aim of reducing waiting lists and meeting his 18-week target?
The previous chief financial officer of NHS England said that nearly all the money allocated to the NHS at the autumn Budget will be eaten up by NHS pay settlements, the national insurance hike and increased inflationary costs, just to maintain services at their existing level. Following the recent spending review and the Chancellor’s announcement of additional funding, how much of that does the Secretary of State anticipate will be spent on staffing costs, including the already agreed pay award and the national insurance increase, and how much of it will actually make it to the frontline in the form of additional care, or to fund the reforms that he set out recently?
What does the Secretary of State anticipate will be the long-lasting impact of strike action on relations between the Government and trade unions in the health space? The 10-year plan was published just last week. As I said at the time, it is sensible and I am supportive of what he has set out in that, but concerns have been raised about its deliverability. The Secretary of State has said previously that he will need to work with the unions to deliver on the plan. Is he still confident that that will be possible? Does he believe that they will agree to the changes that are required, or is there a risk of further strike action over the coming years because doctors have sensed a weakness?
In opposition, the Secretary of State had some very strong and well-articulated views on industrial action. He said strike action was
“playing politics with our NHS”.
On that, I agree with him. He said that
“the Government ought to be pulling out all the stops”—[Official Report, 22 December 2022; Vol. 724, c. 218.]
and that
“the power to stop these strikes is in the Government’s hands.”—[Official Report, 12 December 2022; Vol. 724, c. 732.]
He is the Secretary of State now. Does he agree that the power to stop these strikes is in his hands?
Our message to the Government is clear. The Secretary of State needs to do what he has said he will do: face down union pressure and deliver an affordable settlement that is fair to staff, patients and, crucially, taxpayers. On his watch, resident doctors are set to leave the frontline to go on to the picket line—whether that happens will be down to him. Sadly, Labour’s weakness is fuelling this crisis. If the Government do not get a grip now, a summer of discontent and strikes risks turning into a summer of chaos, and it will be patients who pay the price.
Wes Streeting
I think the shadow Secretary of State’s memory is letting him down. Let me just remind him that before the general election, and after months of refusing to meet the BMA, the Conservatives finally entered negotiations, but not before strikes were left to run and run—at a cost of £1.7 billion to the taxpayer—and 1.5 million operations, appointments and procedures were cancelled. They also offered the BMA junior doctors a pay rise, which was only about 4% of the pay rise that we eventually agreed. Imagine what would have happened if the Conservatives had pulled their finger out and got the doctors around the table sooner, and had not been quite so intransigent.
The shadow Secretary of State is right to say that I criticised my predecessors for their unwillingness to negotiate. The difference between me and them is that I have acted. Resident doctors have had a 28.9% pay increase thanks to the decisions that I have taken as Secretary of State, with the support of the entire Government. They have a Secretary of State who does not slam the door in their face, but who is open to working with them to improve their conditions.
The responsibility for these strikes lies squarely with those running the BMA’s resident doctors committee. Despite failing to get a majority of their members to vote for strike action for the first time in their campaign, they are still proposing to lead their members out on a five-day strike. They even made the announcement on the day that I had already written to them to suggest that we meet to avert unnecessary strike action.
The shadow Secretary of State is right to talk about the jeopardy facing the future. Because we produced our 10-year plan in partnership with patients, the public and NHS staff, there is not only much in it that resident doctors should welcome, but much that they suggested. Our 10-year workforce plan will set out training, education and retention of the workforce, and we will work closely with resident doctors on standards. They should start to experience an improvement in their working conditions on everything from the availability of nutritious food and drink to reducing violence against staff and tackling discrimination. We have already committed to prioritise UK graduates for training, and we have started a conversation on contractual reform with trade unions across the board. We are determined to recruit more people locally and to tackle social disadvantage, access to medicine and all the issues that are at the forefront of the minds of resident doctors, such as placements, rotations and future career progression, including specialty bottlenecks. I absolutely want to work with them.
These are not conditions for strikes. These are conditions to work in partnership with the Government, just as other NHS unions and so many other trade unions across the public sector do. I say to resident doctors once more that sitting in front of me is the ghost of Christmas past. Reform—its Members are not in their place today—is the ghost of Christmas future. Perhaps BMA members might consider that they are lucky to have the ghost of Christmas present in front of them.
Alex McIntyre (Gloucester) (Lab)
I am glad the Secretary of State has reminded Conservative Members that they have rather short-term memories. When I took my place in this House last year, thousands of my residents in Gloucester were on NHS waiting lists—many of them for longer than 18 months. Since this Labour Government took power last year, the number has come down by 92%, in part thanks to the hard work of resident doctors in my constituency. Does the Secretary of State agree that strike action by the BMA will put that recovery at risk? Will he invite its members to meet my residents who are still on the waiting lists left behind by the Conservative party, so that they can explain why the 28.9% pay rise, which many of my constituents will not receive this year, is not enough?
Wes Streeting
I completely agree with my hon. Friend. I urge BMA members to consider not just the significant progress that they have already made by working with a Labour Government, but the wider context in which we are operating. It is not just resident doctors who have seen their pay eroded over more than a decade of Conservative Government; it is the entire public sector. It is not just resident doctors who are working in crumbling buildings with out-of-date equipment and technology; it is the same in our schools, our hospitals, our prisons and the entire public sector estate.
This Government are facing enormous challenges across our economy, and we cannot sort out every issue that we inherited overnight, or even in one year—it is going to take time. BMA members should be proud of the progress that we have made together, and reassured that we want to make further progress with them, but there has to be some give and take here, and there has to be some reasonableness. Given the potential consequences of their action for patients, for their fellow staff and for the future of the NHS, the strike action is unreasonable, unnecessary and deeply unfair.
Madam Deputy Speaker (Caroline Nokes)
I call the Liberal Democrat spokesperson.
Alison Bennett (Mid Sussex) (LD)
People across the country, and NHS patients in particular, will be disappointed to hear of yet more strike action by resident doctors this July, especially after the immense disruption of recent years. I and my Liberal Democrat colleagues fully recognise that this dispute does not come out of nowhere. The previous conservative Government left our NHS under unbearable strain, with doctors working under intense pressure in crumbling hospitals and often without the resources they needed. My constituents, and people across the country, need and deserve a well-functioning NHS.
Over the past three years, doctors have received a 28.9% pay rise following earlier strikes. The BMA is now calling for a further 29% increase, but we have to be honest: after years of economic mismanagement by the Conservatives, the public finances are in a dire state. That kind of increase does not feel affordable or realistic right now. That said, we cannot ignore the reality of working conditions in our NHS. Doctors are expected to save lives in collapsing wards and to deliver care in corridors, rather than in safe clinical settings. It is degrading and dangerous for both staff and patients. We need constructive dialogue, not escalation, to resolve this dispute swiftly and fairly, and most importantly, we need urgent action to rebuild our NHS and restore working conditions that our doctors and patients can be proud of.
First, will the Secretary of State improve staff morale by committing to end the dangerous and dehumanising practice of corridor care? Secondly, does he not see that by dragging out social care reform, delayed discharges and corridor care are only going to worsen doctors’ experiences of working in the NHS, weakening morale and lowering care standards?
Wes Streeting
I am grateful to the Liberal Democrat spokesperson, and I think I can reassure her on a number of fronts. First, she is absolutely right to call out the disgrace that is corridor care. Despite the best efforts of staff, who suffer the moral injury of treating patients in that situation, in too many parts of the NHS we have patients being treated on trolleys in corridors. In this decade of the 21st century, I think that is unacceptable, as is the emerging nomenclature that has started to describe these as “temporary escalation spaces”, because we are in danger of normalising what should be considered unacceptable practice. That is why this Government will shortly begin transparently publishing corridor care data showing the number of patients being treated on trolleys in corridors. I am sure there will be moments when that might cause Ministers and NHS leaders to blush, but frankly, until corridor care is consigned to history, so we should. Sunlight is the best disinfectant, and by publishing the data we will hold ourselves to account, and I am sure this House will hold us to account to ensure that we deliver the conditions that staff and patients deserve.
I also reassure the hon. Member that, while the Casey commission is under way, work on social care goes on, whether that is the £4 billion increase in investment in social care through the decisions taken by my right hon. Friend the Chancellor, or other improvements such as to carer’s allowance, the disabled facilities grant and uplifts in funding for local authorities. However, I am also committed to ensuring that, as we improve the flow of patients through our hospitals and deal with the scourge of delayed discharges, we are a lot better at thinking about how we use the taxpayer pound to best effect to deliver the right care, in the right place and at the right time. That will often mean using NHS resources to commission social care to help tackle delayed discharges, and we will be keeping a close eye on that.
Finally, I thank the hon. Member for joining the voices of reason in this Chamber. I hope it is not lost on the BMA and resident doctors watching that this is not a case of an intransigent Government unwilling to work with and support them who are trying to face down, for political and ideological purposes, a trade union speaking up for its members. This Labour Government have delivered a 28.9% pay increase and we are willing to work further to improve conditions for resident doctors. That work can start now, and I am ready to meet the BMA immediately.
There are other voices of reason in this Chamber, including among the Liberal Democrats, who recognise the pressure on the public finances. They recognise that we are trying to do many things across the NHS that will also directly benefit resident doctors, such as making sure they have the right kit and are working in decent buildings. We are improving the conditions that they are working in and that patients are treated in so that, together, we are building in, working in and being treated in an improving NHS. That is the prize, and that prize is being thrown into jeopardy by the resident doctors’ actions. If they go down this path, with all of the consequences that will follow, I am afraid—for them, let alone for the NHS and for the country—things will get worse rather than better, and I urge them not to take that course of action.
Warinder Juss (Wolverhampton West) (Lab)
Does my right hon. Friend agree that we were right to settle the strikes last year, for the sake of ensuring the future of the NHS, protecting the interests of the public and showing our doctors that they are valued, that that will always be his position, and that it is therefore somewhat surprising that resident doctors have decided to call this strike?
Wes Streeting
I strongly agree with my hon. Friend—he is absolutely right. I am happy to stand corrected, but there is genuinely no historical precedent in the history of British trade unionism for a trade union to have successfully negotiated with the Government of the day a 28.9% increase for its members and then go out on strike. I think that undermines the BMA, and the more reasonable voices in the BMA with whom we continue to work constructively. It certainly undermines our NHS.
It also reinforces the grossly unfair caricature, which is often thrown at trade unions by the Conservatives, that they are all unreasonable, do not want to work with the Government of the day and are only interested in combat and agitation. In my experience, the vast majority of trade unions and trade unionists are interested in constructive engagement, striking good deals and moving forward the interests not just of their members, but of our whole country. I urge the BMA resident doctors committee to stand in that proud tradition of British trade unionism and in the proud traditions of the wider Labour movement, but I am afraid I do not see those traditions or behaviours reflected in the current approach of the BMA RDC.
Sir Edward Leigh (Gainsborough) (Con)
We can all argue about the past, but if it helps the Secretary of State, I think we should just say today that the whole House absolutely 100% supports him in his robust attitude. [Hon. Members: “Hear, hear.”] Of course we all love doctors, but the starting salary is not so very bad. They have a job—a very good job—for life, which most people do not have, and he could also mention that they have a much better career structure than most people. A far higher proportion of them get the top job—namely, as a consultant—and the consultant’s starting salary of £110,000 a year is not a bad whack.
Wes Streeting
First, I think that the right hon. Member’s opening statement and the response across the House underline to the BMA and the resident doctors committee that they do not have support across this House—from the left across to the right, with maybe one or two noises off—and that is not typical in my experience of being in this House for the last decade.
I think the career of resident doctors and the prospects they can look forward to, which the right hon. Member described, have worsened. That is one of the things that is at the heart of the dispute they have taken up with the previous Government and now with this one. Many of the things doctors used to be able to look forward to—guaranteed jobs and progression into consultant roles or general practice—have steadily eroded. We have far too much doctor unemployment and far too many specialty bottlenecks. We have what I think is a really unreasonable set of behaviours towards resident doctors in terms of placements, rotations and the ability to take time off work to attend weddings and other important life moments. The tragedy of the position we find ourselves in is that I recognise that and I want to address it. We can do that together without the need for strike action, and those are not reasons for strikes. Worse still, especially at a time when I am prioritising dealing with doctor unemployment, they are inflicting further costs on the NHS, patients and the taxpayer. That makes my freedom and flexibility and my resources to deal with those issues more limited—that is the tragedy of their tactics.
Emma Foody (Cramlington and Killingworth) (Lab/Co-op)
I thank the Secretary of State for his statement and the ongoing work to get the NHS back on its feet after it was pushed to the brink under the previous Government. Strikes inevitably have a financial and a human cost to them, and the next round of strikes will undoubtedly have that too, meaning that the NHS will take a financial hit. Can he share the impact that this will have on the system? For example, can he guarantee that the cost of these strikes will not lead to job cuts?
Wes Streeting
In all honesty, I am afraid I cannot give my hon. Friend that assurance. NHS finances are precariously balanced. We have been relative winners across the Budget and the spending review set out by my right hon. Friend the Chancellor of the Exchequer, but we are asking a lot of the system. As well as the progress and improvements we want in the NHS, we inherited a lot of mess to clean up, and that will take time and resource. Every penny spent on the price of failure through strike action is a penny that could have been spent on driving improvements in the service—improvements for patients and for staff—and on creating the jobs and opportunities that mean doctors do not graduate into unemployment and that mean resident doctors can progress into specialty training posts. That is why I say clearly and unequivocally to the BMA that if this strike action goes ahead, with all the costs, pain and misery that will follow, it will not just be patients—or, indeed, this Government—who suffer, but the BMA.
Sir John Hayes (South Holland and The Deepings) (Con)
I have known the Secretary of State a long time. I knew him before he was an important man—although he was always important to me, of course. He will know that as a Minister, I worked with the trade unions in every sector for which I was responsible, as the RMT and the University and College Union will confirm, and I was also a member of the Association of Teachers and Lecturers. I entirely endorse and amplify what he says. Responsible trade unionism requires people to be reasonable, and reasonable people in this House know that this strike against this background is entirely unacceptable, as he has described.
I ask the Secretary of State this: will he ensure that this unhappy, unwholesome and unhealthy action does not jeopardise the health of my constituents, and will he write to the local authorities—the integrated care boards—in my area and others to set out how they can minimise the impact of this action? The last thing that you want, Madam Deputy Speaker, or that I or any Member across this House wants, is for those at risk to be put at greater risk as a result of this irresponsible action by these militant people.
Wes Streeting
I thank the right hon. Gentleman for his question. He is that rare beast: a Tory trade unionist. He raises the serious point of the consequences of strike action. I will, of course, keep the House updated, but I want to reassure the House that we are taking every step possible to mitigate the disruption that these strikes will cause. That will come at a financial cost and a cost to patients because of the disruption that will follow. It will also come at a cost to other staff, many of whom are paid less than resident doctors, who will be left at work with more pressure and in harder conditions, picking up the pieces because of the actions of their colleagues who were given a higher pay rise, but who will be stood outside protesting the 28.9% pay rise that they received.
I assure the House that we will do everything we can to mitigate the impact of the strikes on patients and the disruption that will follow. What I cannot say to the House, however, is that we can offset or cancel the impact or detriment felt by patients. We will look carefully at the data on the experience and impact of the strikes that occurred during the previous round of negotiations. I will ensure that that information is published so that the House can see the impact of the previous strikes, so that we can brace ourselves for what may lie ahead.
Lewis Atkinson (Sunderland Central) (Lab)
Anyone who has ever worked in healthcare knows that it is a team sport and that delivering excellent care requires a range of staff across the allied health professions including nurses, doctors, administrative staff and estate staff. Does the Secretary of State agree that it is therefore essential that all NHS staff groups have confidence that their pay is being set fairly, and that going beyond the independent pay review body’s recommendations for one set of staff would undermine the “one NHS” team ethos that so many have worked to build?
Wes Streeting
I strongly agree with what my hon. Friend says. I have been personally invested in our relationship with resident doctors and in the deal we struck—not just because it was one of the first things we did when we came into office, and because I am very proud of what we have achieved together, but because I had and still have a huge amount of support and sympathy for resident doctors and a determination to address the issues they are raising. However, I reassure my hon. Friend and the House that resident doctors are one part of the NHS workforce—a valued part—but I have responsibility for the entire workforce. We set ourselves the task of building an NHS fit for the future, but we cannot do it on our own as a Government; it requires the whole team to pull together.
I will be honest with my hon. Friend: I feel a considerable degree of discomfort when I look back at a whole number of deals and pay awards, under this Government and our predecessors, where the “Agenda for Change” workforce have been left further behind. I will be honest with the House: at this moment, I have to resolve the immediate action that is being proposed by the BMA, but I am not going to allow the reform we have committed to with the “Agenda for Change” unions to be deprioritised —we owe that to them. We owe it to the nurses and to all the “Agenda for Change” staff to ensure that they are paid fairly, are given a fair day’s pay for a fair day’s work, and receive the terms and conditions that they deserve. My priority at this stage is the “Agenda for Change” reform. Of course, I will do everything I can to resolve the resident doctors strikes, but what I cannot do is reopen this year’s pay award.
Several hon. Members rose—
Robin Swann (South Antrim) (UUP)
I agree with the Secretary of State when he tells the BMA resident doctors that they will never have another Secretary of State as sympathetic to their legitimate complaints— I recognise that, having worked with five of his predecessors. My experience tells me that what happens here with the BMA often filters through to the devolved nations. What engagement has he had with his counterparts on the proposed industrial action so that there can be a combined resolution and message to the BMA?
Wes Streeting
I reassure the hon. Gentleman that I will obviously engage with my counterparts in the devolved Administrations. While health is a devolved matter, the decisions that we take in this place, and what is going on in the English health system, have a bearing on other health systems, and vice versa.
I am almost tempted to call back the right hon. Member for North East Cambridgeshire (Steve Barclay), who is still a Member of this House, to remind the BMA what it went up against twice before; indeed, I could call back any of my Conservative predecessors to remind the BMA that the grass is not greener on the other side of this House. It currently has a Secretary of State who has shown through actions, not just words, a willingness to work together, and I hope that it rediscovers the spirit of partnership that we had last year.
Mr Connor Rand (Altrincham and Sale West) (Lab)
We all know how vital resident doctors are to the functioning of our national health service. In the light of that, will the Secretary of State join me in once again urging the BMA resident doctors committee to get back around the table to engage in serious talks and to take up his offer to meet in the interests of all NHS staff and patients, so that we can rebuild the national health service in the way the public expect?
Wes Streeting
Quite aside from the fact that I offered to meet the entire resident doctors committee back in January, although it has never taken me up on that offer—I would definitely be outnumbered in that meeting— I can reassure the House, in all seriousness, that I met its co-chairs on Tuesday afternoon, immediately after the publication of the ballot result. I followed up in writing yesterday morning to reaffirm what I said in person, which was to express our willingness to meet immediately, without preconditions, to avert this strike action. That offer remains, and I am very happy to meet them on that basis.
Mr Andrew Snowden (Fylde) (Con)
My wife has a long-term chronic health condition; she has had to have two major lifesaving surgeries, and has had countless stays in hospitals. We have seen the fantastic work that many doctors and consultants do, but we have also seen the impact it has when there are cancellations and delays, or when no doctors are available.
Many people will have been flabbergasted by the sheer scale of the pay rise that was awarded in the first place, without anything in return to deliver the NHS reforms that the Government seek. Those people will now be absolutely outraged that the BMA is going on strike after having a near 30% pay increase. I plead with the Secretary of State to hold the line in these negotiations, and to take away the cross-party support he has in holding the line against the BMA on this issue.
Wes Streeting
We will not be reopening this year’s pay award because we simply cannot afford to, and it would not be fair on others in the NHS workforce, regardless. I honestly do not regret the deal that we struck last year, without which we would not have made the progress that we have on NHS waiting lists, which are now at their lowest level in two years. We have made that considerable progress by working together.
I do not think that the staff themselves are the drain on productivity; instead, the obstacles we face are the systems and pathways in which staff work and the conditions in the NHS—we are in real agreement on those things. I urge the BMA to keep all that under consideration before its next public intervention, which I hope will be to accept the offer to get around the table to avert the strike action that I think the whole House agrees is unnecessary, unreasonable and unfair.
Jas Athwal (Ilford South) (Lab)
I thank my right hon. Friend for his statement, which was delivered with the humility and pragmatism that is his usual professional style. After a 28.9% pay rise thanks to this Labour Government, does the Secretary of State agree that the public are not only dismayed by the actions of the BMA, but distraught and that, once again, it will be the patients who will suffer the most by this action, which is so unnecessary at this particular moment?
Wes Streeting
I entirely agree with my hon. Friend. It will be patients who suffer the most. I also urge the BMA to consider the impact on its whole membership, because it is other staff who are left picking up the pieces, and other staff who are tired—literally tired—of working in an NHS that is far from its best. To resident doctors in particular, I say that the cost of this will also be borne by them. There are choices and trade-offs in politics, especially when resources are tight. We can and we will act to deal with specialty bottlenecks. We can and we will act to tackle doctor unemployment, but our ability to do so is undermined, if not diminished, if we are instead paying the cost of this unnecessary, unreasonable and unfair strike action.
Jim Shannon (Strangford) (DUP)
I thank the Secretary of State for his statement today and fully support the line of action that he has taken. Indications that the majority of doctors in the BMA did not vote to strike makes this strike action even more difficult to understand. The Secretary of State is clearly trying to find a way forward. The way to do that is through finding solutions. Reviewing conditions of work, such as those that see junior doctors working 84 hours within the space of a week, would be helpful. Perhaps this action is not only about pay, but about the expectations of these young people who have life and death in their hands for 13 hours for six out of seven days a week.
Wes Streeting
The hon. Gentleman makes an entirely reasonable point. Pay is important—people have to be able to pay their bills and lead a good life—but so too are their working conditions. I am absolutely determined to work with resident doctors to make progress not just on pay, which we have already done, but on the conditions in which they are working. Given where we are with both of those things—the improvement on pay and the willingness to work together to improve conditions—they are not grounds for strike action.
Anna Dixon (Shipley) (Lab)
I congratulate my right hon. Friend on showing great leadership when he came into office to get those doctors back to work and end the strikes. The result of that has been falling waiting times and waiting lists, and I have seen the benefit of that for my constituents in Shipley; they are not having to wait for operations and diagnostic tests in the NHS. Does he agree that this is no time for strike action, and that, should the BMA and the resident doctors go ahead with this strike, this will adversely affect patients and waiting times?
Wes Streeting
I entirely agree with my hon. Friend. Looking back at all the contributions this morning, I have been struck by the fact that, quite extraordinarily, the entire House, on both sides of the Chamber, has spoken with one voice. There has been total unanimity across this House during these exchanges that the proposed strikes are unreasonable, unnecessary and unfair. For the avoidance of doubt, let me tell the BMA and the resident doctors committee that this House has spoken with one voice to say: abandon this rush to strike, get around the table and work with us to rebuild resident doctors’ working conditions and to continue rebuilding our national health service. I thank the House for its support.
Madam Deputy Speaker (Caroline Nokes)
I thank the Secretary of State for his statement today.
Report on Patient Safety
Wes Streeting Excerpts(2 weeks, 5 days ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
I would like to update the House on Dr Penny Dash’s report on patient safety across the health and care landscape in England.
In September, Dr Dash completed her review of the Care Quality Commission. Her work was thoughtful and thorough, and shed a huge amount of light on how the principal regulator for quality and safety had been letting people down. The CQC is now under new management, and on a clear path to recovery.
Following this important work, I asked Dr Dash to undertake a further review—this time looking at six key organisations overseen by the Department of Health and Social Care and how they work with the wider patient safety landscape. Today, we are publishing this review, and I am grateful to Dr Dash for her work.
Her review focused on the Care Quality Commission, the National Guardian’s Office, Healthwatch England, the Patient Safety Commissioner, the Health Services Safety Investigations Body and the patient safety learning aspects of NHS Resolution. I asked her to assess whether the current range and combination of organisations delivers effective leadership, listening, learning and regulation of health and care systems in relation to patient safety.
She specifically addressed whether patients would be better served by a different approach or delivery model, working closely with senior leaders and directly hearing from more than 100 people or partner organisations with an interest in patient safety.
She found that there has been a shift towards safety—in comparison with other areas of quality of care—over the last five to 10 years, with too much focus on inputs and structures, rather than outcomes for patients. She also found there has been limited strategic thinking on improving quality of care during this period.
The review sets out how many organisations are carrying out reviews and investigations, leading to an overwhelming number of recommendations. This causes confusion for patients and staff alike. At the same time, patient experience is not given the attention it deserves in the NHS, with few boards having an executive director dedicated to this purpose.
As a result of this analysis, Dr Dash has made nine recommendations, which the Government have accepted in full. These commitments form an important component of our 10-year plan for health, published last week.
First, there should be a refreshed strategy for improving quality of care, which will be delivered by revamping and revitalising the role of the National Quality Board.
Secondly, the Care Quality Commission should continue to rebuild with a clear remit and responsibility and overhaul its registration and inspection processes to ensure they are “sector specific”.
Thirdly, the Health Services Safety Investigations Body should continue as a centre of excellence for investigations, but as a discrete branch within the Care Quality Commission.
Fourthly, the hosting of Patient Safety Commissioner should transfer to the Medicines and Healthcare products Regulatory Agency (MHRA) to strengthen links between the patient voice in medicines safety and the MHRA’s work to capture adverse events more effectively. The Patient Safety Commissioner’s work on wider patient safety should transfer into a new directorate of patient experience in DHSC.
Fifthly, local healthwatch and the engagement functions of integrated care boards (for healthcare) and local authorities (for social care) should be brought together to ensure patient and community input into the planning and design of services, and the strategic functions of Healthwatch England should also be transferred into the new patient experience directorate in DHSC.
Sixthly, staff voice functions should be strengthened, with the responsibilities of the National Guardian for Freedom to Speak Up incorporated into the new DHSC structure and providers.
Seventhly, the responsibility for and accountability of commissioners and providers to deliver and assure high quality care should be reinforced.
Eighthly, technology, data and analytics should play a much more significant role in supporting the quality of health and social care.
Finally, there should be an evidence-based national strategy for quality in social care.
Next steps
I previously announced that Dr Dash would undertake a third review on quality and its governance. However, this work has been fully incorporated as part of the 10-year health plan, and we are taking this forward with immediate effect.
Patient and staff voice should not be kept at arm’s length but be at the heart of everything the NHS does. As part of the plan, we are therefore streamlining and consolidating functions across the patient safety landscape, delivering a refreshed strategy for improving the quality of care and transforming how the NHS collects and uses patient feedback.
These changes will improve quality, including safety, by making it clear where responsibility and accountability sit at all levels of the system, and making it easier for staff, patients and users to directly feed into the system to improve quality of care.
[HCWS785]
NHS 10-Year Plan
Wes Streeting Excerpts(3 weeks, 2 days ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
With permission, Madam Deputy Speaker, I shall make a statement to the House on “Fit for the Future”, the Government’s 10-year health plan for England.
There are moments in our national story when our choices define who we are. In 1948, the Attlee Government made a choice founded on fairness: that everyone in our country deserves to receive the care they need, not just the care they can afford. It enshrined in law, and in the service itself, our collective conviction that healthcare is not a privilege to be bought and sold, but a right to be cherished and protected.
Now it falls to our generation to make the same choice: to rebuild our national health service, and to protect in this century what Attlee’s Government built for the last. That is the driving mission of our 10-year plan.
In September, Lord Darzi provided the diagnosis: the NHS was broken by 14 years of Conservative under-investment, and by their catastrophic top-down reorganisation. In the past year, Labour has put the NHS on the road to recovery. We promised 2 million extra appointments; we have delivered more than 4 million. We promised 1,000 new GPs on the frontline; we have recruited 1,900. We have taken almost a quarter of a million people off waiting lists, cutting them to their lowest level in two years. And we have launched an independent commission, chaired by Baroness Casey, to build a national consensus around a new national care service to meet the needs of older and disabled people into the 21st century.
Today, the Prime Minister has set out our prescription to get the NHS back on its feet and make it fit for the future. Our plan will deliver three big shifts. The first is from hospital to community. We will turn our national health service into a neighbourhood health service. The principle is simple: care should happen as locally as it can—digitally by default, in a patient’s home if possible, in a neighbourhood health centre when needed, and in a hospital where necessary.
We will put neighbourhood health centres in every community, so people can see a GP, nurse, physio, care worker, and therapist, and they can get a test, scan or treatment for minor injuries, all under one roof. The NHS will be organised around patients, rather than patients having to organise their lives around the NHS. It will be easier and faster to see a GP. We will train thousands more, end the 8 am scramble, provide same-day consultations, and bring back the family doctor. If you are someone with multiple conditions and complex needs, the NHS will co-create a personal care plan, so your care is done with you, not to you.
Pharmacies will play an expanded role in the neighbourhood health service. They will manage long-term conditions, treat conditions such as obesity and high blood pressure, screen for disease and vaccinate against it. We will also reform the dental contract, to get more dentists doing NHS work, rebuilding NHS dentistry.
Over the course of this plan, the majority of the 135 million out-patient appointments done each year will be moved out of hospitals. The funding will follow, so a greater share of NHS investment is spent in primary and community care.
The second shift is from analogue to digital. No longer will NHS staff have to enter seven passwords to login to their computers, or spend hours writing notes and entering data. Our plan will liberate frontline staff from the parts of the job that they hate, so they can focus on the job that they love—caring for patients. For the first time ever, patients will be given real control over a single, secure and authoritative account of their data. The single patient record will mean that NHS staff can see medical records and know a patient’s medical history, so they can provide them with the best possible care.
Wearable technology will feed in real-time health data, so patients’ health can be monitored while they stay in the comfort of their own home, with clinicians reaching out at the first signs of deterioration. The NHS app will become the front door to the health service, delivering power to the patient. You will be able to: book and rearrange appointments for you, your children or a loved one you care for; get instant advice from an AI doctor in your pocket; leave feedback on your care and see what feedback other patients have left; choose where you are treated; book appointments in urgent care so you do not wait for hours; and refer yourself to a specialist where clinically appropriate. Of course, patients can already do all that, but only if they can afford private healthcare. With Labour’s plan, every patient will receive a first-class service—whatever their background and whatever they earn.
The third shift is from sickness to prevention. Working with the food industry, we will make the healthy choice the easy choice to cut calories. We will roll out obesity jabs on the NHS. We will get Britain moving with our new NHS points scheme, and we will update school foods standards so that kids are fed healthy, nutritious meals. We will tackle the mental health crisis with support in every school to catch problems early, 24/7 support with virtual therapists for those with moderate need, and dedicated emergency departments for patients for when they reach crisis point.
The science is on our side. The revolution in artificial intelligence, machine learning and big data offers a golden opportunity to deliver better care at better value. New innovator passports and reform of the National Institute for Health and Care Excellence and the Medicines and Healthcare products Regulatory Agency will see medicines and technology rapidly adopted. Robotic surgery will become the norm in certain procedures, so patients recover from surgery at home rather than in hospital beds. The NHS will usher in a new age of medicine, leapfrogging disease so that we are predicting and preventing, rather than just diagnosing and treating. It is therefore the ambition of the plan to provide a genomic test for every newborn baby by 2035. Thanks to my right hon. Friend the Chancellor, this plan is backed by an extra £29 billion a year by the end of the spending review period, as well as the biggest capital investment in the history of the NHS.
Alongside investment comes reform. This plan slashes unnecessary bureaucracy and devolves power and resource to the frontline. It abolishes more than 200 bodies, because listening to patients, guaranteeing safety and protecting whistleblowers is core business for the NHS and should never have been outsourced. The plan commits to publishing league tables to rank providers. We will intervene to turn around failing providers, and we will reinvent the foundation trust model in a new system of earned autonomy. Pay will be tied to performance, so that excellence is recognised and failure has consequences. Tariffs will be reduced to boost productivity. Block contracts will end, with funding tied to outcomes. The plan gives power to the patient, so hospitals are financially rewarded for better service. It closes health inequalities by investing more in working-class communities, and it establishes a national investigation into maternity and neonatal services to deliver the truth, justice and improvement that bereaved families deserve.
I am sometimes told that NHS staff are resistant to change. On the contrary, they are crying out for it. They suffer the moral injury of seeing their patients treated in unfit conditions. They are ones driving innovation on the frontline, so their fingerprints are all over this plan. The public are desperate for change too. Each of us has our own story about the NHS and the difference it made to our lives. We also know the consequences of failure. To succeed, we need to defeat the cynicism that says that nothing ever changes.
We know that the change in our plan is possible because it is already happening. We have toured the length and breadth of the country and scouted the world for the best examples of reform. If Australia can effectively serve communities living in the outback, we can surely meet the needs of rural England. If community health teams can go door to door to prevent illness in Brazil, we can certainly do the same in Bradford. We know that we can build the neighbourhood health service, because teams in Cornwall, Camden, Northumbria, and Stratford—where I was with the Prime Minister and Chancellor this morning—are already showing us how to do it. We will take the best of the NHS to the rest of the NHS. We will apply to best examples of innovation from around the world to benefit people here at home. Above all else, we will give power to the patient. This plan fulfils Nye Bevan’s commitment in 1948 to put a megaphone to the mouth of every patient. It will restore the founding promise of the NHS to be there for us when we need it.
Of course, we know that there are those on the right who are willing us to fail. They will exploit the crisis in the NHS in order to dismantle it. The hon. Member for Clacton (Nigel Farage) and his cronies argue that universal healthcare could be afforded in the 20th century but not in the 21st. Labour rejects their declinist pessimism and so do the public. But that is the choice—it is change or bust, and we choose change.
We know that the British people are counting on us. It falls to us to ensure that the NHS not only survives but thrives, and we will not let our country down. Of course, if we succeed, we will be able to say with pride that will echo down the decades of the 21st century that we were the generation who built an NHS fit for the future and a fairer Britain where everyone lives well for longer. I commend this statement to the House.
Madam Deputy Speaker (Ms Nusrat Ghani)
I call the shadow Secretary of State.
Edward Argar (Melton and Syston) (Con)
I thank the Secretary of State for his typical courtesy in providing advance sight not only of his statement but of his plan. I am grateful, and others on the Government Front Bench might learn a thing or two from him. I am pleased to see the plan published. This Secretary of State is a rare thing these days: one whose announcements do tend to survive largely intact for more than a week. In the case of the plan, it is vital that it does stick.
The Secretary of State is not known to be short on ambition, and to be fair that is reflected in his plan; it is ambitious. I believe that his long-term goals are right and that the reforms he has set out build on the reforms that the Conservatives set out and carried out. The desire to shift care from hospital to community, to better use technology and to move to prevention is not new at all, but it remains vital.
The NHS undoubtedly needs reform, not just more cash—it is not fiscally sustainable in the long term to have 38% of day-to-day Government spending going on the NHS—so we need to focus on outcomes, not just inputs. But the plan, while welcome, is still sketchy on some of the details of delivery and how it will be paid for without the funds that the Secretary of State mentioned being eaten by pay rises and by inflation, as well as how that shift will be staffed. Greater use of the app is right, and builds on the amazing work done on the app by my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay) when he was Secretary of State. Greater use of technology and of genomics is right, and the Secretary of State’s big five tech bets are largely right, but, as he knows, tech alone will not deliver this; people will, so a workforce plan that is clearly aligned with his strategy is vital.
Neighbourhood health centres are one of the measures at the heart of the Secretary of State’s plan. The concept is an interesting one, but it does throw up a number of questions that I hope he can answer in the spirit in which they are asked. Will the providers of those new centres be NHS public sector organisations, private sector organisations or a mixture? How will the centres fit with GP provision and other services without duplication or fishing in the same pool for staff? What assessment has he made of the cost of new buildings and technology to go in them? How many centres does he envisage, and by when? Crucially, how will he ensure that a public-private partnership model will avoid the downsides of the Blair- Brown private finance initiative model?
I ask those questions from a desire not to see this fail but to succeed, because it is in all our interests that the Secretary of State does succeed, but that will take time. Given that, on page 71 of his plan he talks about the need for “immediate opportunities” to be seized. Although there will be others, may I take the opportunity to suggest just one? He should deliver on the pre-election commitment for fracture liaison services to be delivered in all communities, as campaigned for by the Royal Osteoporosis Society, The Mail on Sunday, the Express and many others. That policy would deliver savings within the comprehensive spending review period. Similarly, Melton Mowbray in my constituency has a fantastic community hospital—there will be many up and down the country—and I hope that such hospitals will be a part of delivering more services in the community.
On maternity care, I welcome the Secretary of State’s commitment to a national investigation into maternity scandals, but I hope that will not stop him from delivering on the work done by the hon. Member for Canterbury (Rosie Duffield) and Theo Clarke, which included measures that can be implemented now to help improve maternity safety.
On systems reform, may I offer the Secretary of State a couple of words of caution? One is on folding the Health Services Safety Investigations Body into the Care Quality Commission, even as a discrete entity within it. HSSIB is not a regulator and is not designed as such, and it is important that those distinctions are not blurred in making that change. Similarly, may I urge him to be wary of further moving integrated care boards to larger geographies—they are at risk of becoming again the old regional health authorities—as that will move them further away from the local communities they serve and the entities providing social care in those communities with whom they must interact?
That brings me finally to a significant question hanging over the plan. Unless we move faster to adjust to the challenges of social care and put it on a sustainable footing, these reforms risk failing to seize the genuine opportunity presented. In the move from cross-party talks to an independent commission, we risk losing that opportunity. Crucially, I ask the Secretary of State again to consider bringing forward the end date of that commission so that we can go further and faster on social care.
I have often said to the Secretary of State that where he is wrong we will rightly hold him to account and challenge him, but where he is right we will offer constructive support. The plan, by and large, does say the right things. We must shift to outcomes and not focus continually on inputs, and we must do that through real and genuine reform. The challenges he faces will be in the detail, much of which is still to be confirmed, and crucially for the Government, in the actual delivery. He should not underestimate those challenges. I will work with him to improve the plan where it needs it, but I will support him where he pledges and brings genuine reform to our healthcare system. His plan will have a key test: will patients see the difference, and when will they see the difference? In all that we do, it is vital, as we reform our NHS, that patients are at the heart of our deliberations and our plans.
Wes Streeting
I thank the shadow Secretary of State for his constructive approach to what does need to be a successful plan for the next decade, to get our NHS back on its feet, to make it fit for the future and to make sure we improve the health of the nation. Aside from the lines that he was no doubt given to trot out at the beginning—he almost said them with conviction—we know that we can count on him to be rather more serious and sensible than the display we saw from the Opposition yesterday.
I turn to the shadow Secretary of State’s points. He was right to say that investment needs to go alongside reform. That is why the spending review only a matter of weeks ago set out the Chancellor’s commitment to the NHS and NHS reform. The Government are providing a £29 billion real-terms increase—a £53 billion cash increase—in annual NHS day-to-day spending by 2028-29. That funding will support the first steps towards delivering the reforms, the service improvements and the new technology set out in the plan.
But investment alone is not enough. One of the reasons we are paying more and more for worse and poorer outcomes is that we have the wrong care in the wrong place at the wrong time. Contrary to what we read in some newspaper columns—on the radio this morning I heard the hon. Member for Clacton once again attacking the NHS’s equitable principles and funding model—the problem is not the model of funding; it is the model of care. That is why the shift to neighbourhood health is essential for delivering better outcomes for patients and better value for taxpayers.
The technology coming down the track, and indeed the technology we already have, will drive the big productivity gains in the system that have eluded us. In recent years, the previous Government invested in more staff, but they put all those staff in hospitals to work in an undercapitalised NHS. If there are more inputs but not the enablers to deliver the service, we do not see the responding improvements in output and impact. That drives poorer productivity, poorer value for money and poor outcomes for patients, and that is the approach that we are changing.
If, for example, we roll out, as we will, ambient AI to all GPs, and we make sure that in their interactions with patients we liberate them from being glued to the screen, filling out the forms and drafting the letters, because that is all done automatically before the GP spends a few moments checking over to make sure it is right—if we can just save 90 seconds in every GP appointment—we will save the equivalent time of 2,000 more GPs. That is how we get more bang for the buck, that is how we drive productivity improvements and that is how we deliver better care and better value.
That is why the previous Government’s workforce plan was not right. It assumed that the NHS just needed growth at the same rates and in the same way as always. In fact, so implausible were the assumptions in that plan that if we had continued with the rate of growth that they had set out, by the end of the century 100% of our entire country would be working in the NHS. I know we love the NHS and we love the people who work in it, but I do not think that everyone in our country can or should be working in the national health service. To reassure the right hon. Gentleman, we will, this autumn, set out a new workforce plan that aligns with this 10-year plan.
The shadow Secretary of State asked about neighbourhood health centres. We aim to go for 250 to 300 new neighbourhood health centres by the end of this plan and 40 to 50 over the course of this Parliament. They will be NHS providers and we will have a combination of new builds and the refurbishment and rejuvenation of underutilised existing estate, both in the NHS and in the public sector. Therefore, the cost of each neighbourhood health centre will vary, from the low millions to around £20 million, depending on whether it is an upgrade, a refurb and expansion or a new build.
Given the undercapitalisation of the NHS that we inherited, even the record investment from public sources that the Chancellor has provided will not be enough to deal with the capital backlog. That is why, as set out in the Government’s infrastructure plan, with care and caution, and keeping in mind the mistakes that were made by the private finance initiative, we are looking at alternative private sources of investment to make sure that we can go further and faster on capital improvement, particularly in the neighbourhood health service.
The right hon. Gentleman asked me to commit again to fracture liaison services. Those services have a demonstrable impact on keeping people well and providing both better outcomes for patients and better value for taxpayers. That is why we want to see them rolled out across the country.
On maternity, I welcome his support for the investigation. NHS England is in the third year of the three-year plan put in place by the previous Government and we have sought to support that progress and not to interfere. Yet as we have seen, even with the most recent CQC report into the trust in Nottingham, we have so much more to do and an entire change in approach and culture is needed, let alone a change in practice and behaviour. I am committed to working with all parliamentary party groups across this House and to making sure that the expertise and insight that we have right across these Benches, on both sides of the Chamber, help us to drive maternity improvements.
He asked about us rolling HSSIB into the CQC. Let me provide him with this reassurance. HSSIB has been a really effective body, but we cannot justify the duplication of back-office functions and the inefficiency that comes with that. However, the CQC, when we came into office, was in such a dire state that we had to replace the leadership and we have in place an improvement plan. The House therefore has my assurance that we will not roll HSSIB into the Care Quality Commission until we are assured that the CQC is back to the standards that we expect for it to perform its core duties today, let alone the work it will do with HSSIB housed within the CQC.
On ICBs, I will not measure success through the number of bodies in the NHS; I think that has led us to where we are. However, I am committed to making sure that as we devolve more power, more responsibility and more resource closer to the frontline, to system leaders and to provider leaders, we also make sure that we have in place democratic accountability, so that Members of Parliament, local councils and metro mayors can influence and shape healthcare where they live.
The right hon. Gentleman also asked about social care. We are not waiting for Casey. The spending review gave an additional £4 billion to social care. We are delivering the biggest expansion of carer’s allowance since the 1970s and a significant increase in the disabled facilities grant. The Deputy Prime Minister and I will also shortly set out how we will deliver the first every fair pay agreements for the care workforce, building real social care progression.
On neighbourhood health, social care has to be part of it. In the context of this plan, social care features because it has a role to play on admission avoidance and speeding up delayed discharges. However, we know that social care is important in its own right and that is why it is important that it has its own commission.
Finally, the shadow Secretary of State asked about whether people will see and feel these improvements. We know on the Government Benches that we will be judged by results and by whether people can feel the change that we are delivering. All I would say to people watching our proceedings today is this: in our first year, we promised 2 million more appointments to cut waiting lists—we doubled that; we promised to deliver 1,000 more GPs—we have almost doubled that; and we promised that people would see the NHS moving in the right direction—waiting lists are at the lowest point for two years. We know that there is more to do, but I hope that the progress people have seen under this Labour Government reassures them that, when it comes to our national health service, if anything, we under-promise and over-deliver. We know that people will see and feel the change. I say respectfully, given the shadow Secretary of State’s constructive tone, that that will be the difference between a Labour Government and a Conservative one.
Mr Deputy Speaker (Sir Roger Gale)
I call the Chair of the Health and Social Care Committee.
Paulette Hamilton (Birmingham Erdington) (Lab)
As the acting Chair of the Health and Social Care Committee, I am delighted that the 10-year plan was finally launched today. I thank the Secretary of State for Health and Social Care for presenting it to the House.
The plan represents a major opportunity for constructive reform of the health and social care system, and I am delighted that the Secretary of State will come to the Committee on 14 July to be scrutinised on it. Many organisations have waited patiently for the 10-year plan to be published. Will the Secretary of State explain how the plan will help restore the promise of a first-class service in the NHS?
Wes Streeting
I thank my hon. Friend for her question and for the leadership she is showing to the Select Committee while the substantive Chair, the hon. Member for Oxford West and Abingdon (Layla Moran), is off on mat leave. What a delight it was to see the Committee Chair on the Terrace this week with her new baby. That was really delightful and we wish her well.
One of the exciting things for me about today’s launch is just how widespread the support has been from across a range of different organisations that we will need to work with to deliver the plan. Whether it is the royal colleges and the trade unions, the organisations that represent patients, the wide range of healthcare charities or, crucially, frontline staff, everyone is up for this change and everyone is desperate for it to succeed.
We will not get everything right and we will make mistakes along the way. We will listen and always learn and reflect. We know in the Government that we cannot do this without effective leadership from Ministers, but nor can Government do this alone. It is now our responsibility to mobilise the more than 1.5 million people who work in the NHS, the more than 1.5 million people who work in social care and our whole country behind a national mission to get our NHS back on its feet, to make sure it is fit for the future and to make sure, fundamentally, that we attack the injustices that lead to ill health, so that we have a fairer Britain where everyone lives well for longer.
Helen Morgan (North Shropshire) (LD)
I thank the Secretary of State for early sight of the plan this morning. After years of Conservative failure, a plan for the future of the NHS is welcome and Liberal Democrats support the Secretary of State in his vision to shift the NHS to a community-focused, preventive service. However, I seek his reassurance on some questions.
In the 143 pages of the 10-year plan, there is only a passing reference to social care. Everyone knows that we cannot fix the NHS without fixing social care. With so many people unable to return home from hospital to get the care they need, solving the crisis in social care is a huge part of moving care out of hospital and into the community. Will the Secretary of State bring forward the Casey review, so that it reports in full this year, and reinstate the cross-party talks, so that consensus can be reached on the future of care?
I welcome the idea of a neighbourhood health centre, but how does that interact with the plan for GPs? The 10-year plan implies that GP contracts will encourage them to cover a huge geographic area of 50,000 people. In North Shropshire, that would be two or three market towns combined and would span dozens of miles. Can the Secretary of State reassure me that there will still be a physical health centre, accessible to all, and that in areas with little public transport in particular, people will be able to access care when they need it?
Finally, the plan hinges on the shift to digital solutions, and that is not without risk. The use of the NHS app is critical to what happens. How will the Secretary of State ensure that those without a smartphone—because they cannot afford one, do not feel confident using one or simply do not have adequate broadband or internet—can access the NHS? Many elderly and disabled people in particular who are digitally excluded will feel worried by today’s announcement.
Wes Streeting
I welcome the Liberal Democrat support for the plan, and the constructive way in which Liberal Democrats have sought to work with us since the general election in pursuit of better health and social care services. I understand the point the hon. Member makes on social care. I will not repeat at length the points I made to the shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar), but I hope the House is reassured by the action we are already taking on social care, whether through greater funding, the expansion of the carer’s allowance, increasing the disabled facilities grant, the fair pay agreements, and ensuring a partnership with social care to deliver better neighbourhood health services.
Given what we have said about the importance of data, digital connections and better systems, I should say that in some parts of the country, the social care system is ahead of the NHS; it makes better use of data, and joins up systems in a more effective and efficient way. The NHS can learn lots from social care, as well as the other way round. I will take on board the representations of the Liberal Democrat and Conservative Front Benchers on speeding up the Casey commission—that is duly noted.
I absolutely reassure the hon. Member for North Shropshire (Helen Morgan) on the point that she raises about neighbourhood health centres. One of the reasons we want to devolve so much power in the NHS is that I genuinely think that the closer decisions are made to the communities they serve, the better the outcomes and the provision. A one-size-fits-all approach to neighbourhood care simply will not work. My constituency is on the London-Essex border, and there are three hospitals within a 15-to-20 minute drive of where I live. In many rural towns, coastal communities and villages across the country, there is not even one hospital within that distance. In fact, people are driving huge distances across the country to get to a hospital. On our priority of rolling out neighbourhood health centres, I want to reassure Members on both sides of the House that we will start with the areas of greatest inequality and need, and communities where people have to travel far to their nearest hospital, so that people can genuinely receive care closer to home and, indeed, at home. Technology can play a big role in that.
I understand the cynicism about digital roll-out. Government IT projects do not have a great reputation historically; let us be clear about that. We are learning from past mistakes and ensuring that we have the right experts in the room to help us. So much of that is about the digital clinical leadership helping to marry the best scientific and technological minds in our country to the best clinical and scientific experience to ensure that we get this absolutely right. We cannot afford to fail or be left behind. The tragedy in the country today is that there are so many brilliant innovators in life sciences and med tech who are designing and making things here in Britain, but when it comes to scaling up, they are shipping out, because the NHS has been a poor partner and a poor customer. We will change that; we will create more in Britain, and ensure that it is rolled out right across the country. Staff will be liberated from the drudgery and toil of unnecessary bureaucracy and admin that can be automated, and patients will have more ease, convenience, choice and control at their fingertips. This revolution is happening, and it is crucial that no one is left behind.
I take seriously the point the hon. Member made about the digitally disconnected, and there are two responses to that. First, people like me who book via the touch of a button free up telephone lines, get out of the way of reception desks, and free up more capacity for face-to-face and telephone appointments. I believe strongly in horses for courses, and in patient choice. Those patients who want to pick up the phone or who want to be seen face to face must be given that choice and control, and we will give it to them.
Secondly, working with the Science, Innovation and Technology Secretary, we will deal with the fundamental problem of digital disconnection in our country. I knocked on the door of one of my party members when I was canvassing down her street because I had heard she was ill. She opened the door, and I asked if she was okay and if she needed anything from the shops. She looked me up and down as if I had just said the most ridiculous thing and said, “Oh no, dear. Thank you very much, but I do my shopping online with my iPad.” We should not assume that because people are older, they are naturally digitally disconnected. They are some of the most tech-savvy people, and we have to ensure that those skills are enjoyed by all, in keeping with the NHS’s principle of ensuring that healthcare is available universally to everyone, regardless of their ability to pay.
Several hon. Members rose—
Jen Craft (Thurrock) (Lab)
Thank you, Mr Deputy Speaker. The heart, soul and lifeblood of our NHS are the people who work in it. I doubt there is anyone in this House who does not owe a personal debt of gratitude to a health care worker. Can the Secretary of State reassure me that the fingerprints of NHS workers are all over this 10-year plan, and that it has been designed and produced with all their valuable inputs?
Wes Streeting
I certainly can give my hon. Friend that reassurance. We launched the biggest consultation since the NHS began. We had over 270,000 contributions, 250,000 thousand responses and almost 2 million visits to the change.nhs.uk website, so I can absolutely give people the assurance that staff and patients’ fingerprints are all over the plan. That is why we have such a rich plan, in which people can have confidence.
Sir Jeremy Hunt (Godalming and Ash) (Con)
There is much to welcome in today’s plan, particularly the proposal to bring back family doctors, which I tried to do but frankly did not succeed in doing when I was Secretary of State, so we all wish him well with that, but does he agree that as we seek to transform out-of-hospital care, it is vital that we do not take our eye off the ball and allow another Mid Staffs inside hospitals? Does he also agree that it is essential that the CQC gives overall ratings and calls a spade a spade when it comes to the quality of care in hospitals, so that we know whether the care delivered by hospitals in our constituencies is outstanding or good, and if not—if it requires improvement or is inadequate—that action can be taken, and lives can be saved?
Wes Streeting
I strongly agree with my predecessor on that. It is important that the CQC’s reports and judgments can be understood by the public and the people responsible for carrying out the improvements that it recommends. Via the NHS app, we will have much more transparency for patients about the range of providers, the quality of services and the views of other patients. That will give patients the freedom to choose, in a more data-driven way, where and when they are treated. There is also the importance of data-driven face-to-face inspections by experts. We can also have early warning systems that would alert people who hold his office and mine that something is going seriously wrong, so that we can intervene before more lives are lost unnecessarily.
Wes Streeting
I thank my hon. Friend for that question. On whether people feel cautious optimism or quiet scepticism based on the experience that he describes, I have heard the same thing so many times. “I love AI, genomics and machine learning—yep, great. But can you just give me the basic technology that works?” Well, I can confirm that in 2026-27 we will make sure that we create a single log-on for staff. I am not holding my breath for that to be the front-page splash tomorrow, but that one thing, as well as saving loads of staff time, will give them confidence that genuine change is coming.
Sir Edward Leigh (Gainsborough) (Con)
As always, the Secretary of State makes a good fist of an impossible job, but I think we all know in our heart of hearts that this model, which takes 38% of public funding, is unsustainable in the long term. He mentions the Australian outback; I have been a voice in the wilderness, urging him to replicate the excellent Australian system, which is a mix of public and private. I will not do that again now, but may I ask him to at least look at Australia’s pharmaceutical benefits scheme, which ensures national procurement of medicines, so that people who have a medical card there get their medicines cheaper than people here?
Wes Streeting
I am always willing to search the world for ways to spend taxpayers’ money more effectively, and the right hon. Gentleman makes some good arguments on making sure that we get a good deal on medicines pricing, and on using the real procurement power of the single payer model—but therein lies the answer to the other part of his challenge. It is the single payer model, created in 1948, that makes the NHS ideally placed to get much better value in procurement, and to harness and lead the revolution in AI, machine learning, genomics and big data, in a way that many insurance-based systems struggle with. I assure him that if there were a better way of funding the NHS, I would have the political courage to make the argument, but we looked at other systems of funding and concluded that that is really not the problem. It is not the model of funding; it is the model of care, and that is what we are going to sort out.
Alex McIntyre (Gloucester) (Lab)
When I knock on doors in my Gloucester constituency, I hear time and again about the importance of tackling the 8 am scramble for a GP appointment, and the difficulty many of my constituents faced under the Conservative Government getting the care they needed. Will my right hon. Friend explain how Labour’s 10-year plan for health will deliver on the Government’s mission to get treatment out of hospitals and into the community, so that every one of my constituents can get the care they need in the community in which they live?
Wes Streeting
I am grateful to my hon. Friend for his question; he is such a strong voice for the people of Gloucester. We are already delivering improvements in general practice, with 1,900 more GPs employed on the frontline, £900 million more for general practice, and the first contract agreed with GPs for quite some years. We are working in genuine partnership with GPs, who will be at the centre of the neighbourhood health service and of neighbourhood health centres. I am determined to ensure that we do things with our friends in general practice, not to them. Where things are working, I have no interest in going in like a bull in a china shop and imposing top-down change unnecessarily; we learned that lesson from Lord Lansley. I am confident that we have a plan that GPs will relish and embrace, and that they will feel reassured that the future of general practice is bright. After years of campaigning for a Government to rebuild general practice, they finally have a Government who are on their side.
Seamus Logan (Aberdeenshire North and Moray East) (SNP)
I thank the Secretary of State for his statement on his plan. I note the comments on the National Institute for Health and Care Excellence and the Medicines and Healthcare products Regulatory Agency, but the Scottish Medicines Consortium is the envy of the other three nations. I would like to offer him an early win. There is a drug, Enhertu, for the treatment of women with secondary breast cancer; it prolongs life. It is available in Scotland and in 20 other nations. Will he review the situation in England under this plan?
Wes Streeting
We work closely with NICE to make sure that we consider, in an evidence-based way, the case for prescribing new medicines. We want patients to have access to the latest treatments and technology, and we work with the pharmaceutical industry to get as many medicines as possible to patients. We definitely need growth in this area.
I have a counter-offer for the hon. Gentleman. I notice that the Scottish Government are now on their fifth health plan; none of the others has worked. We are always willing to help, and I will put a copy of the plan in the post to my Scottish counterpart, but I will not hold out much hope. In England and Wales, where a Labour Government are in place, waiting lists are falling; in Scotland, waiting lists are rising, and we have heard astonishing admissions of failure from Ministers whose party has been in power for almost 20 years. It is very clear: Scotland needs an alternative. Scotland’s NHS needs an alternative: Scottish Labour.
Clive Efford (Eltham and Chislehurst) (Lab)
I welcome my right hon. Friend’s statement. Yesterday was one year to the day since I completed my radiotherapy treatment for prostate cancer. I was very lucky—my cancer was caught at stage 3 and was treatable—but I had to ask my GP for the prostate-specific antigen test that got me my treatment. I know my right hon. Friend has that said he wants to see a national screening programme aimed particularly at black men over 45, one in four of whom will get prostate cancer, people like me who have a family history of prostate cancer, and men over the age of 50. Will he ensure that we have a national screening programme as part of the 10-year plan?
Wes Streeting
My hon. Friend is absolutely right about the importance of screening, and it is brilliant to see him fighting fit. That is exactly the sort of outcome that we want from effective diagnosis and treatment. He is also right to highlight the racial inequalities in this area. It cannot be right in this decade of the 21st century that black men are twice as likely as white men to die of prostate cancer. The national cancer plan will come out later this year, and the screening committee is looking at the case he makes. He will find at the centre of the 10-year plan a commitment not just to diagnose earlier and treat faster, but to tackle the gross health inequalities that blight our society in a way that is simply not tolerable in the 21st century.
Sir Julian Lewis (New Forest East) (Con)
Does the NHS 10-year plan include an assisted dying scheme? If the present private Member’s Bill runs out of time at the end of this parliamentary Session, and thus falls, will the Secretary of State reintroduce the legislation as a Government Bill in the next parliamentary Session?
Wes Streeting
I am grateful to the right hon. Gentleman for that question—[Laughter.] Given that the Bill is still passing through Parliament, assisted dying is not referred to in this 10-year-plan, but I assure both this House and the other place that regardless of different views among Ministers and across the House, we will abide by the law of the land. We will abide by the will of this House and the other place. If the Bill times out in the other place, I have no doubt that someone else will bring it back. I suspect it will not be a Government Bill.
It is important that we have the debate and that we scrutinise the legislation well. I am proud of the way the House has conducted the debate. My hon. Friend the Minister for Care, who is not in his place now, along with the Minister of State, Ministry of Justice, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), have done an exemplary job in supporting people on both sides of the debate to give the Bill the detailed scrutiny that it had here and that it will no doubt have in the other place. That is a credit to this House.
Mr Clive Betts (Sheffield South East) (Lab)
Let me say to the Secretary of State: well done. This is a really ambitious and excellent programme.
On the subject of cancer care, in the past few years we have both had good experiences of the NHS at its best, but it is important to improve services by getting the NHS to work with universities and the voluntary sector in local cancer alliances. Will he look at what I think is an unintended consequence of that? If a local cancer alliance is funded by an NHS trust, its funding continues; if it is funded by an ICB, as the South Yorkshire cancer alliance is, its funding will be cut in line with the rest of the ICB’s budget. That is not fair. Whether an alliance suffers cuts depends on which organisation funds it. Will he see if he can rectify that?
Wes Streeting
I am grateful for my hon. Friend’s support. Given his expertise, it means a lot. I am especially grateful to the GPs in his constituency with whom he and I spent time; that experience really had an impact on my thinking about neighbourhood health.
On cancer, I am happy to look at the issue he raises with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton). We want to get this right. Cancer alliances have played a valuable role, and we want to see that approach to joined-up working between research, diagnostics and treatment go from strength to strength, so I will happily pick that up.
Ellie Chowns (North Herefordshire) (Green)
In the constructive spirit that has characterised much of this discussion, I welcome much of what the Secretary of State has announced today: bringing care closer to people in their homes, investing more in prevention—it is all good stuff. But there seems to be a missed opportunity here. In the 143 pages of this document, there is virtually no mention of social care. Lord Darzi told us last year that we cannot fix the NHS without fixing social care. Six months ago today, the Secretary of State promised cross-party talks and urgent work on the Casey commission, but the commission is delayed and the cross-party talks have never materialised. Will the Secretary of State please treat the care crisis with the urgency it deserves and bring forward that work, so that we can build the necessary cross-party consensus to fix the care crisis?
Wes Streeting
First, I thank the hon. Member for the Green party’s support for so much of the 10-year plan. She is right to highlight the importance of social care to resolving the NHS crisis. Let me reassure her that we are acting urgently as we await the first report of the Casey commission. The Chancellor did that with the Budget and the spending review, providing £4 billion more of investment. We have done that with the biggest increase in carer’s allowance since the 1970s, and with the disabled facilities grant, which does not just mean more ramps and home adaptations but more freedom, more dignity and more independence for disabled people. The Deputy Prime Minister and I will shortly set out how we will deliver fair pay agreements, and social care will absolutely be part of the neighbourhood health team. I hope that that reassures the hon. Member.
Let me also reassure parties across the House that we will wait for the Casey commission to launch. I would like to be able to proceed with the actions we will be taking in this Parliament and, crucially, with the long-term plan for social care in a cross-party way, to build that genuine national consensus—I would be delighted to achieve that.
Mr Deputy Speaker (Sir Roger Gale)
I call the Chair of the Housing, Communities and Local Government Committee.
Florence Eshalomi (Vauxhall and Camberwell Green) (Lab/Co-op)
I thank the Secretary of State for this really ambitious and bold plan to make sure our NHS is fit for the future. He will be aware that Professor Ian Abbs, the chief executive of St Thomas’ hospital in my constituency, will step down later this year. I want to thank him for his dedication and compassion in leading St Thomas’, especially during the covid crisis, when the hospital cared for so many patients, including the then Prime Minister in his crucial hour.
The Secretary of State may be aware that Royal College of Nursing analysis shows that by 2029, 11,000 nurses may have left the profession after working less than 10 years in the service. Nurses cite exhaustion, mental health and stress as their reasons for leaving the profession. Can he give us an update on how we will ensure we have a workforce that is fit, so that we can achieve our ambitious 10-year plan for the NHS?
Wes Streeting
I am so grateful to my hon. Friend for her question. I pay tribute to Professor Ian Abbs. He is an outstanding NHS leader, and we have loved working with him. As with many people of his calibre moving on from their positions of leadership in the NHS, it is a bit like the Hotel California—you can check out any time you like, but you can never leave. We will not let him drift off into a quiet retirement; we are determined to make use of his expertise.
My hon. Friend is absolutely right to raise the importance of nursing. Nurses and midwives will play an increasingly important role in neighbourhood health. They are central to our shift to a modern, digital NHS. They are clinical leaders in their own right. Following the 10-year health plan, the chief nursing officer for England will work with the professions to develop a strategy that will make nursing and midwifery modern careers of choice, to address the decline in applications. As I have set out this week, we are looking forward to working closely with the Royal College of Nursing and Unison—of which, I should say, I am a member—to make sure that the status, the conditions and the impact of nursing on our NHS go from strength to strength, because nurses are the backbone of the NHS. We would not have a national health service without them.
Sir Bernard Jenkin (Harwich and North Essex) (Con)
I join others in welcoming much of the Secretary of State’s plan, but I want to return to the question of the Health Services Safety Investigations Body, to which my right hon. Friend the Member for Melton and Syston (Edward Argar) referred. I welcome the tone of the Secretary of State’s response to that part of my right hon. Friend’s questions, but will he agree to meet those of us from the Select Committee—a cross-party group of people—who campaigned over many years to bring this body, which is still in its infancy, into existence before making any further decisions on it?
As my right hon. Friend says, HSSIB is not a regulator, and to put it in with a regulator will create confusion about what it is. If he were Secretary of State for Transport, he would never dream of putting the air accidents investigation branch into the Civil Aviation Authority, because they have completely different and separate functions. That needs to be understood across the health service, and it is obviously not well understood at the moment.
Wes Streeting
I welcome the hon. Member’s constructive approach. Of course, we are happy to receive representations on HSSIB. I would just like to outline the problem we are trying to solve, which is that the patient safety landscape is increasingly cluttered. We have far too many bodies trying to do the same thing, cutting across each other, and for frontline staff and leaders on the receiving end of those many and often competing instructions, it can actually make things less safe rather than more safe. I really value the expertise in the Health Services Safety Investigations Body. We do not want to see that expertise lost, nor do we want to move it into the CQC prematurely, before the CQC is ready to receive it. I hope that that reassures him, but we are happy to have that conversation.
Rachael Maskell (York Central) (Lab/Co-op)
I congratulate my right hon. Friend, his Ministers and officials on putting together a vision for the NHS for the next 10 years. It will optimise how we live, but it is also really important that we can palliate how we die. Could he set out how he will ensure that we do not have a postcode lottery for specialist palliative care services, so that we can palliate well for everybody across our country? Will he meet with the leaders of the independent commission on palliative and end-of-life care to ensure that we get this right really quickly and for the future?
Wes Streeting
I am grateful to my hon. Friend for her question. We want a society where everyone receives high-quality, compassionate care from diagnosis through to end of life. Palliative and end-of-life care services will have a big role to play in our shift out of hospitals and into the community, the emphasis on personalisation for patients and their families, and the joining up between primary and community care services. I would be delighted to hear more from the commission. It is really important that we get this right. Regardless of where people stood on the debate about assisted dying, the one thing that united everyone across the House was a belief that palliative care needs to be so much better than it is today, and that is what we will work on together.
Richard Tice (Boston and Skegness) (Reform)
There is much that unites us in this House about the excellence in this 10-year plan—in particular the fact that the NHS needs reform and that, of course, healthcare should always be free at the point of delivery. But brilliant frontline staff, doctors and nurses say to me that the issue is the bureaucracy and the unnecessary processes and procedures, including in social care. Can the Secretary of State reassure the House that the senior management of the NHS are absolutely determined to reduce the bureaucracy, in particular around technology and the delays caused by GDPR?
Wes Streeting
The NHS leadership are absolutely determined to work with us to reduce waste, inefficiency and bureaucracy. We have in Sir Jim Mackey an outstanding chief executive of the NHS, and he and his team are working closely with Ministers to make sure we achieve that goal.
As for the funding model, I just do not know where the Reform party stands from one day of the week to the next. I heard the leader of the hon. Member’s party on the radio this morning doing the dance of the seven veils. He is normally very good at being a straight-talking politician—that is how he likes to present himself—but I cannot follow what the hon. Member for Clacton (Nigel Farage) thinks about this issue. Does he support a taxpayer-funded universal NHS free at the point of use? [Hon. Members: “No!”] I do not think he does. Does he support the European-style insurance system? I think he probably does—it is the only European thing he has ever supported, by the way. We are in no doubt: the NHS needs reform, but it needs the Reform party like a hole in the head.
Mr James Frith (Bury North) (Lab)
I commend not only my right hon. Friend and his team on today’s 10-year plan but also the leadership and Budget of our right hon. Friend the Chancellor, who made today and the next 10 years of our NHS possible. For too long, the NHS has been stuck in crisis mode. My right hon. Friend the Secretary of State will remember taking an important call while in my constituency, and he will know that life expectancy in Bury North can vary by seven years in wards just one mile apart. In East ward, Redvales and Moorside, where he took that call, child poverty rates now reach 42%. Can I ask him to ensure that those wards get a healthy share of the new funding for working-class communities, so that we can start to close the health gaps and give every child the chance of a long, healthy life?
Wes Streeting
My hon. Friend is absolutely right; it was on a snowy day of campaigning for him in Bury North that I received the phone call that would change my life, giving me my kidney cancer diagnosis. Despite that fact, I have since been back to Bury North; I am not saying that it was his bad luck—
The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)
It was not causation.
Wes Streeting
It was coincidence rather than causation, as my hon. Friend the cancer Minister says—although, given both our experiences, we will rethink our visit schedule to Bury.
On a serious note, my hon. Friend the Member for Bury North (Mr Frith) is absolutely right to make the link between poverty, particularly child poverty, and ill health. The last Labour Government lifted 400,000 children out of poverty; I am so proud to think that when in the first year of this Labour Government we chose to extend free school meals to half a million children from low-income families, with that one measure on one day we lifted 100,000 children out of poverty. That is the difference Labour Governments make, and that is how we will deliver not just an NHS fit for the future, but a fairer, more equal, more just society.
Greg Smith (Mid Buckinghamshire) (Con)
I look forward to studying the detail of this plan, but I welcome the Secretary of State’s commitment to neighbourhood health centres and likewise his commitment in a previous answer to rural communities. May I therefore offer him a golden opportunity? He will have heard me over many years in this House call for funding to build a new health centre in the village of Long Crendon, which lost its GP practice during the pandemic. They have the land, they have the planning permission and it will cost less than his lower number of £200 million to build. Will he convert words to delivery and commit to Long Crendon?
Wes Streeting
I thank the hon. Gentleman for his support with the plan, which I am sure is in no way connected to the fact that he wants some money out of us for that neighbourhood health centre. I will take his question as the first bid we have had from those on the Opposition Benches, and I look forward to receiving those representations from him.
Sojan Joseph (Ashford) (Lab)
The Secretary of State will know how important improving mental health support is to me. I hope that what the 10-year plan says about access to mental health provision will help to address the long waiting times for mental health services that the Government inherited. I particularly welcome what he said about using the NHS app for patients to self-refer for various treatments. I hope that that will cover talking therapies as well. Does he share my belief that opening up access to talking therapies in that way will enable more people to get that effective treatment at the right time, so that they can better manage their condition?
Wes Streeting
I thank my hon. Friend for his service to our country and our NHS. We are so lucky to have his expertise in the House. I am really proud that this Government will deliver mental health support in every primary and secondary school in the country and neighbourhood mental health services in every community. We will also ensure that people who are in mental health crisis do not end up in busy, noisy, overwhelming A&E departments, but will instead go to new mental health emergency departments, which we aim to roll out across 50% of type 1 A&E departments—either co-located or, if not, certainly nearby. I look forward to working with him on that.
My hon. Friend is quite right to emphasise the importance of talking therapies. That is how we not only help people to achieve their best when they are young and in education, but ensure that people are supported to stay in the world of work or to find work. We know there is a demonstrable link between mental health and wellbeing, good work and good outcomes. That is very relevant this week.
Clive Jones (Wokingham) (LD)
I welcome the Secretary of State’s 10-year plan. In October, in response to my Westminster Hall debate on the national cancer plan, the Government committed to publishing one later this year. I am confident that that will happen in the autumn, and the wider cancer community is equally enthusiastic. However, the 10-year plan announced today makes only a brief mention of the national cancer plan. Can the Secretary of State confirm that improved diagnosis, improved screening for at-risk groups, improved treatment outcomes, concentration on rare cancers and cancers in young people, better and continued workforce planning, more support and funding for research, better relationships with drug companies and much more will be part of the national cancer plan?
Wes Streeting
I thought for a moment there that the hon. Gentleman, having called for the plan, was going to write it. I can reassure him that he has covered all the right areas; I am delighted that he is as enthusiastic as we and the whole cancer community are about the plan. We deliberately did not go into specific conditions in the 10-year plan for health, because otherwise it would have turned into a Christmas tree, with every condition group trying to attach its bauble to it, but it is really important that this 10-year plan creates the rising tide that lifts all ships—including, as he notes, not just common conditions, but the rare ones too.
Marsha De Cordova (Battersea) (Lab)
I congratulate the Secretary of State on bringing forward a bold and ambitious plan for our national health service. We know that by 2050 there will be up to 4 million people living with sight loss, so we also need eye healthcare that is fit for the future. Can my right hon. Friend tell me that his plan will end the postcode lottery, join up primary and secondary care, tackle the challenges with the workforce and provide a proper high-quality sight loss eye care pathway and investment in research and innovation, so that we can end avoidable sight loss once and for all?
Wes Streeting
I congratulate my hon. Friend on her consistent campaigning on this issue, which has done so much to keep it on the national agenda. We will support more eye care services being delivered in the community, helping to create capacity within secondary eye care services too. Patients can be assured that optometrists have the training to manage a wide range of eye conditions safely in the community. We will also support improved IT connectivity between primary and secondary care, which has been shown to improve the referral and triage of patients, and enable the better use of technology to support local services.
Of course, there are still challenges: ophthalmology is one of the largest out-patient specialties, representing 8% of the total NHS waiting list, and the Royal College of Ophthalmologists workforce census found that 76% of units do not have enough consultants to meet demand. We will address those issues; we are working across both the public and the independent sectors to ensure that people receive the care they need, when they need it. A lot has been done but, as my hon. Friend says, there is so much more to do.
Liz Jarvis (Eastleigh) (LD)
I welcome this plan. As the Secretary of State is aware, my constituents Charlotte and James Bassett have been fighting for answers since the death of their baby daughter Norah in 2019. What assurances can he give my constituents that any recommendations by the national maternity and neonatal taskforce will be implemented quickly?
Wes Streeting
I thank the hon. Member for the outstanding way she has represented her constituents since she arrived in this House—not only on this issue, but on many others. I reassure her that we will work with families in a spirit of co-production to ensure that we identify what has gone wrong, so that families receive truth and accountability for failures and the reassurance of knowing that improvements will be made so that other families do not have to suffer in the way that they have. Things have gone so badly wrong, but I am confident that, with the approach we are setting out, we will be able to make rapid improvements, and I will keep the House regularly informed.
Sam Rushworth (Bishop Auckland) (Lab)
I thank the Secretary of State for this wonderful statement, delivering on a commitment that we made together at the Richardson community hospital in Barnard Castle two years ago to move services back into the community. I want to ask him about the use of bank staff in the NHS: not only is it a massive waste of money, but it has created a situation where only one in five of this year’s midwifery graduates feels confident of getting a job. On behalf of Mrs Rushworth, who is one of those, her friends, and nurses and midwives in the north-east who have contacted me about this issue, what will the Secretary of State do to ensure that those who have given 2,300 hours of unpaid labour to the NHS and are graduating with tens of thousands of pounds of debt can get a job?
Wes Streeting
I remember that visit to Barnard Castle—unlike visits by some people from Westminster, I was not there to get my eyes tested and my visit was perfectly within the rules. My hon. Friend is right to emphasise the importance of neighbourhood health, which is in the plan, and of reducing the cost of agency spend in the NHS. I want staff to feel that they are part a team and for there to be more flexible working, so that people do not feel that they have to resort to agency work to receive flexibility. I am proud that within our first year we have saved a billion pounds in agency expenditure, getting better outcomes for patients and better value for taxpayers.
Ben Obese-Jecty (Huntingdon) (Con)
The Secretary of State will be aware that the Carr-Hill formula has not been updated since its introduction in 2004: the staff market forces factor is based on earnings data from 1999 and the population density data that is used is the rurality adjustment from 2001, but the population of Huntingdonshire has increased by 30,000 since that time. I know that the Department has not conducted an impact assessment on the benefit of updating the formula, but the Secretary of State has announced that he will do so and that there will be sharp focus on money following need. Given that Huntingdon is a quickly growing region, where thousands more homes are set to be built in the next 10 years, will he clarify for my constituents that the formula will be updated and that GP surgeries in Huntingdon will receive a fairer allocation of the global sum funding?
Wes Streeting
I can give the hon. Gentleman the assurance that we are reforming the Carr-Hill formula and ensuring that funding is based on need. I am delighted to be working closely with the British Medical Association’s general practitioners committee on the reforms that we are making in this and other areas of general practice.
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
I welcome this brilliant plan. I particularly love the double helix that is featured on the front cover, because genetic discoveries have the greatest promise of all. If we all knew a little bit more about our health, we might all look after it a little bit better. Does the Secretary of State agree that the single patient record, with easy patient access, will be transformative?
Wes Streeting
Given my hon. Friend’s expertise, I am delighted that he has welcomed the plan so enthusiastically. I wholeheartedly agree with what he said. I give him 10 out of 10 for his product placement of the 10-year plan and, in particular, his remarks on the design of the front cover, which I will pass on to the team.
Martin Wrigley (Newton Abbot) (LD)
Having secured a Westminster Hall debate on the issue, I am delighted to hear the Secretary of State reconfirm that the Carr-Hill formula will be revised and changed. I am also delighted with the ambition of the new plan, and I think it is very good in an awful lot of ways. Will the Secretary of State remember that GP surgeries are businesses? To correctly plan, they need confirmation and positive indications of where their funding will go over a multi-year period. If that is always in the front of his head, then all will go well. I have scanned the plan and read about the new choice charter, the Care Quality Commission and the National Quality Board. However, I am concerned that the ICBs are becoming more powerful and unaccountable to local neighbourhoods. The regulators are good and will keep them systemically accountable, but we are missing Healthwatch. I am disturbed that Healthwatch has been cancelled as the patient advocate, giving the patient’s voice in local areas. Will the Secretary of State reassure us that there will be some way of getting individual advocacy, as well as regulation?
Wes Streeting
I welcome the hon. Gentleman’s support for the plan. Success has many masters, and I thank him for putting the Carr-Hill formula on the parliamentary agenda through his debate. I can reassure him about a few things. First, what the Chancellor has done in the spending review gives us the advantage of medium-term certainty, so the NHS will now be in the business of medium-term planning with the system, which enables it to make better use of the money that is allocated. Secondly, we are ending Healthwatch—I express my thanks to the people who have worked in Healthwatch for many years—but we are giving power directly to the patients. Alongside that, we are looking at what we can do to strengthen democratic accountability from elected representatives, to ensure that the patient voice and interests are protected.
Sonia Kumar (Dudley) (Lab)
As an NHS physiotherapist, I warmly welcome the Secretary of State’s statement and the ambition set out in the 10-year plan. In Dudley, we are already seeing the positive changes of a Labour Government in bringing down waiting lists. With renewed focus on community care, will my right hon. Friend commit to empowering allied health professionals to lead the neighbourhood health centres, building on the successful model that we have seen in Suffolk and North East Essex? Does he agree that we need more healthcare on the high streets?
Wes Streeting
My hon. Friend is absolutely right and it is brilliant to have her expertise represented on the Government Benches. She is right about the importance of physiotherapy, not just for improved and better-quality recovery, but for admission avoidance. I want physios and other allied health professionals to be at the heart of the neighbourhood health service, and I know that she will hold us to account to ensure we deliver.
Iqbal Mohamed (Dewsbury and Batley) (Ind)
I also welcome the statement and the 10-year plan, and I offer my full support for most of the elements. Staying focused on the positive, I hope to be permitted to raise three points.
First, Dewsbury and Batley is unfortunately one of the many constituencies with dental deserts. Dewsbury West, a ward with over 20,000 residents, has no dentist, so how will the 10-year plan and the Government address that for my constituents?
Secondly, I fully support the plans to move healthcare into communities. In Dewsbury, we have a local hospital in the heart of the community that, with the right investment, could serve many more. Will the Secretary of State confirm that the Government will build on what we have, rather than fragment it?
Finally, Dewsbury and Batley is home to a wonderfully diverse community, but has some of the most deprived neighbourhoods, with the associated healthcare inequalities. Will the Secretary of State agree to visit my constituency so he can hear from my constituents and healthcare professionals, and ensure that their challenges are addressed?
Wes Streeting
In that constructive spirit, I can assure the hon. Gentleman that those things are contained in the 10-year plan for health. These changes are only possible because people voted Labour and because we have a Labour Government. In that spirit, he can be assured that in the run-up to the next general election, I will be pounding the streets of Dewsbury.
Anna Dixon (Shipley) (Lab)
I congratulate my right hon. Friend, his team and the amazing NHS staff on over-delivering on Labour’s promises, and for this amazing, ambitious 10-year plan that will ensure the NHS is fit for the future. I particularly welcome the “My Carer” feature on the NHS app that will allow family and unpaid carers to communicate with the care team for a loved one. Will my right hon. Friend explain how this plan will deliver benefits for disabled people and their carers?
Wes Streeting
I am grateful to my hon. Friend for her question: I can tell that she has already read a lot of the plan, not least because she had such a heavy role in shaping it, bringing her expertise to bear as we were deliberating. I also thank her constituents in Shipley, who took part in the engagement and consultation that she did locally; I hope they feel that their fingerprints are on this plan. She talks about the “My Carer” feature of the NHS app, which will make an enormous difference. I hope that the people who tend to be heavier users of health services feel that they have more power, choice, agency and control. That has to be true not just for people with physical disabilities, but people with learning disabilities. We have to ensure that the NHS is genuinely there for everyone, and that everyone has agency, voice, personalisation, power and control—that is what this plan will deliver.
Tom Gordon (Harrogate and Knaresborough) (LD)
I welcome the 10-year plan; its focus on prevention is right. I notice that there are a number of references to diabetes in the plan, but none to type 1 diabetes. We already have simple blood tests for biomarkers that identify people who are likely to develop type 1 diabetes, and immunotherapy, which can delay onset, is being assessed for NHS use. All the components of a national screening system are already there, so we have the opportunity to change how people are diagnosed with type 1 diabetes and the potential to eliminate life-threatening diabetic ketoacidosis, which can be how people present in hospital and find out that they have got type 1 diabetes. Will the Secretary of State clarify if the references to diabetes screening will be pertinent in relation to type 1 diabetes in specific? Will he meet me and the all-party parliamentary group for diabetes to learn from Italian lawmakers about their national type 1 diabetes screening programme?
Wes Streeting
I give the hon. Gentleman the assurance that we will be delivering on type 1 diabetes, as well as type 2 diabetes. He is right about the breakthroughs in science that allow us to predict and diagnose faster. Through its emphasis on technology, the plan will deliver wearables that will enable people to track their blood sugar levels in real time and enable insulin to be deployed at precisely the right time, in precisely the right amount, to provide stability, certainty and peace of mind. That will not only be important for adults with type 1 diabetes, but for parents who worry about their children. When they send them off to school or to play with friends, they will have the peace of mind that they can monitor their condition, and be reassured that they will be alerted if something does not look right. That is the peace of mind that everyone deserves and that is what this plan will deliver. I am sure the relevant Minister will be delighted to meet the APPG.
Jon Pearce (High Peak) (Lab)
I very much thank the Secretary of State for his statement and the NHS 10-year plan. As someone who represents one of those rural constituencies without an acute hospital, I very much welcome the plan to move from hospitals into communities. The Conservatives broke their promise to deliver a health hub for Buxton in my constituency, and a plan is ready to go. Will the Secretary of State meet with me to discuss the opportunities for that plan to deliver for my local constituents?
Wes Streeting
As soon as my hon. Friend got to his feet, I knew exactly where the question was going. I was delighted to spend time campaigning for him in his constituency, and I know that the focus on neighbourhood health will be particularly welcome to people living in rural communities just like his. I would be delighted to meet with him to discuss his proposal, not least because he will hound me relentlessly if I say anything other than yes.
Jim Shannon (Strangford) (DUP)
In a week that has been quite difficult, it is a real joy to have some good news in the Chamber in the 10-year plan. I thank the Secretary of State very much for that statement and for the positive fashion in which it was delivered. He says that it will deliver a health plan for all, but I have a quick question in relation to care in the community. Patients are taking up beds in hospitals who cannot get home, because the care in the community is not there. There are those who want to go to their homes, but the staff are not there to look after them. As the Secretary of State will know, I always try to do things in a positive fashion. When it comes to finding and training people, will he consider training through schools and colleges for specific roles in care in the community and encourage pupils from a young age to see those as careers that they wish to be part of? I know the Secretary of State will do this, but will he share all that good news with the Minister in the Northern Ireland Assembly?
Wes Streeting
I can absolutely give the hon. Gentleman that assurance. We will ensure that we are delivering that intermediate care in the community through not just the NHS, but our partners in social care. I have a really good relationship with Mike Nesbitt, my counterpart in Northern Ireland, so I am happy to share our learnings there. The hon. Gentleman is absolutely right to emphasise the importance of ensuring that it is not just the sons and daughters of doctors, but more working-class people from backgrounds such as mine who get to go into medicine. That is exactly what this plan will deliver.
Ms Polly Billington (East Thanet) (Lab)
It is thanks to the Secretary of State and, indeed, our Chancellor that we already anticipate a £10 million state-of-the-art health hub in Thanet, which is opening this autumn. That will have a community diagnostic centre, expanded GP services, podiatry, cardiac and respiratory teams, MRIs and support for mental health. That is exactly what this 10-year plan is about. I welcome that introduction, especially in a growing community such as Thanet, but what considerations has the Secretary of State given to Chris Whitty’s report into health in coastal communities in the 10-year plan? Coastal communities in particular suffer from high levels of poor health and underperform in terms of services.
Wes Streeting
I can certainly give my hon. Friend the assurance that Chris Whitty’s work as chief medical officer had a big bearing on our thinking about how we meet the needs of rural and coastal communities and tackle health inequalities. His analysis is clear: we need people not just living longer, but living well for longer. We need to push illness much later into old age so that people can live life to the full until the very end. That must apply to everyone, not just the privileged few. My hon. Friend’s constituents will really benefit from this plan as well as the new facilities coming later this year.
Caroline Voaden (South Devon) (LD)
I really welcome this 10-year plan, especially the shift from hospital to community. I am excited by the digital transformation, and I hope it works in the broadband blackspots of South Devon. I will ask the Secretary of State about the shift from sickness to prevention. Will he tell the House what conversations he has had with the Ministry of Housing, Communities and Local Government and the Treasury about ringfenced funding for leisure centres, swimming pools, outdoor education centres, safe cycle routes and footpaths? We can do so much more to promote and embed healthy lifestyles, particularly in our children and young people, but it will take investment. We need to spend to save. Is that part of the 10-year plan?
Wes Streeting
I really welcome that support, and that is an absolutely great question. On the point about connectivity, I will ensure that the Science Secretary receives those representations and dons his skinny jeans and flip-flops and comes down to improve connectivity for her community—he is committed to doing that for people right across the country. The hon. Lady is absolutely right: we have to ensure that people in every part of the country have access to all those things that make life worth living, such as grassroots sport, culture, leisure, recreation, clean air, parks and open spaces. She has my assurance that, working with the Deputy Prime Minister and my right hon. Friend the Secretary of State for Culture, Media and Sport, we will bring those opportunities to everyone, not just the wealthiest areas or big cities.
Sally Jameson (Doncaster Central) (Lab/Co-op)
Will the Health Secretary outline how the 10-year plan will quickly deliver on the Government’s aim to go from an analogue to a digital service? That is important to Doncaster hospital, which is still on paper records. Will he also ensure that the deaf community is considered and that BSL and easy-read materials are woven into any digital roll-out?
Wes Streeting
I can absolutely give my hon. Friend that assurance. The great opportunity for technology is that we can design in accessibility; I had a great meeting here with some of my constituents who suffer from hearing loss. We have a great opportunity for the NHS to once again be the great social leveller, providing quality care to everyone, whatever their background, and personalised care that meets their needs. We need to have better digital connectivity and AI-enabled hospitals. My hon. Friend’s constituents will know how hard she bangs the drum here for investment in her local hospital, and that is very much on my mind.
Olly Glover (Didcot and Wantage) (LD)
I thank the Secretary of State for his statement and his previous answer on dentistry, but I will push him a little further. My constituency, along with all of Oxfordshire, is an NHS dental desert. Having met with dental providers, they say that the key to changing that is reforming the NHS dental contract. I note that the 10-year plan includes a commitment to doing that, but no timescales are provided. Can the Secretary of State enlighten the House?
Wes Streeting
Yes, I certainly can. The proposals we are consulting on represent an important step towards the fundamental reform to the dental contract that we committed to in our manifesto, and that will begin this year. There are no perfect payment models. Careful consideration needs to be given to any potential changes in a complex dental system so that we deliver genuine improvements for patients and the profession, but we are committed to working with the British Dental Association. The Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock), is working hard to fix the mess left by the previous Government.
Kevin McKenna (Sittingbourne and Sheppey) (Lab)
On behalf of the small and often oppressed community of health policy geeks, I thank the Secretary of State for giving us a Christmas present in July—I will be pressing Ctrl+F through it all weekend. I also really thank him and his team for threading through this plan a real commitment to the quality of work for the NHS workforce. I can see already some really strong, concrete suggestions for how we can make the working lives of people in the NHS better. Most importantly of all, people in Sittingbourne and Sheppey are really glad to see that the idea of a neighbourhood health service is well fleshed out. Again, with a health policy geek hat on, we know it is the funding and the funding models that really matter, so I really commend the review of the funding formula, particularly towards rural and coastal communities. How will the Secretary of State ensure that with this new funding formula, he and his team at the centre will keep a tight grip on what happens at ICB and other levels closer to the ground to ensure that that funding gets to the areas with the most need?
Wes Streeting
I am so grateful to my hon. Friend for his support; as he implies, he brings so much expertise to this place. As we embark in this brave new world of devolution of power, resources and control, we keep a close eye on outcomes. I am counting on local communities, Members of Parliament, mayors, councils and local authorities also to ensure that we have democratic accountability and oversight to ensure the resources we provide are spent to the best effect and have a real impact. I pay tribute to the policy geeks of the world in health and social care for their contribution to this 10-year plan. Health geeks of the world, unite! You have nothing to lose but your chains!
Several hon. Members rose—
Jas Athwal (Ilford South) (Lab)
I also thank my right hon. Friend the Secretary of State for a bold and ambitious plan. Over the past few months, I have had the privilege of connecting with some really inspiring people across my constituency, such as Jagdeep Aujla. His Dopamine Warriors boxing club, which the Secretary of State visited some weeks ago, sets a powerful example. Jagdeep’s boxing club offers a safe, empowering space for people living with Parkinson’s to connect with each other, maintain their fitness, and slow the progression of the condition. Will my right hon. Friend outline how the Government’s 10-year health plan will support the shift from hospital to community, so that more support is available on people’s doorsteps, particularly organisations such as the Dopamine Warriors?
Wes Streeting
I am grateful to my hon. Friend and parliamentary neighbour for his question. He is right that I recently had the joy of visiting Jagdeep and the Dopamine Warriors in my constituency—they do brilliant work, which underscores why we have to work in partnership with community groups and the voluntary sector. They provide great support for patient groups and their families in a way that would not be nearly so good even if the NHS tried to provide it, so I can absolutely assure my hon. Friend that that partnership will be at the heart of the 10-year plan. I also note that he is campaigning for an upgrade to the A&E at Queen’s hospital in Romford. As he knows, I am not empowered to make that decision, but my hon. Friend the Minister for Secondary Care will have heard that case.
Matthew Patrick (Wirral West) (Lab)
I thank the Secretary of State, because with this NHS plan, ambition is back. That ambition matters to my constituents, who for too many years have seen a health service in decline. I brought many of those constituents to a community meeting so that their experience and expertise could be shared and fed straight into this plan. Could the Secretary of State set out how this plan gives power to patients and puts them back in the driving seat?
Wes Streeting
I thank my hon. Friend and his constituents for the feedback from that event, which I received and is reflected in this plan. There is much in the plan about power to the patient—more ease, convenience, choice and control, not just through the app but through a number of mechanisms, including new patient power payments that will give patients real bite if they are receiving poor-quality care. That is thanks to my hon. Friend and his constituents.
Sarah Russell (Congleton) (Lab)
I thank the Secretary of State for the 10-year plan. Moving quickly on the dentistry contract is extremely important to my constituents, but I want to raise the fact that, at the moment, parents in my constituency are frightened. They are frightened about how long it takes them to get diagnoses for their children, particularly in relation to neurodiversity; about the lack of support once they do get those diagnoses; and about the lack of child and adolescent mental health services. They are also frightened that their neurodiverse children are being removed from those services on the basis that autism is apparently regarded by some people in our local services as inherently anxiety-creating and therefore children with that diagnosis do not need mental health support. Can the Secretary of State tell me how my constituents will benefit from this plan when it comes to the support children need with their health?
Wes Streeting
I thank my hon. Friend and her constituents. She held—I think—four events across her community to feed into this plan, and we really valued that feedback. I hope people feel that their fingerprints are on this plan. It sets out our ambition to make this the healthiest generation of children who ever lived, whether that is through better access to mental health support and services, recognising the importance of meeting neurodiverse need, or the focus on physical activity, good diet, nutrition and access to sport, media and culture for everyone, especially children from the most disadvantaged backgrounds. I hope the plan reflects the ambition we heard from my hon. Friend’s constituents.
Leigh Ingham (Stafford) (Lab)
I congratulate the Secretary of State and his entire team on their hard work—this document is outstanding, and I look forward to implementing it across Stafford, Eccleshall and the villages. My constituents participated in three consultation events to feed into this project, so it is really important that patient voices are all over it. A specific concern that came through was that 450 systems are used in Stafford hospital for digitisation and patient records, and they do not talk to each other, which is leading to discrepancies in patient care. Can the Secretary of State give me more information about how the improvement in digitisation will improve patient care on the frontline?
Wes Streeting
I thank my hon. Friend for her support, and her constituents for giving up their time to take part in those events, which fed directly into the plan. I hope they see their input reflected in the results. She is quite right that we need to fix those basic systems and make sure that people across different parts of the NHS are able to interface and join up care around the patient. The capital and tech investment ringfenced by the Chancellor will have a really big impact, and I hope my hon. Friend’s patients and NHS staff will begin to feel that impact.
Andrew Pakes (Peterborough) (Lab)
I put on record my thanks to the Secretary of State for his statement today, and to the Chancellor for the financial and economic work she has put in. Labour Members know that governing well is a team sport, and it is when people in government work together that we succeed best for the people we seek to serve.
Despite the best efforts of important surgeries such as Thistlemoor in my constituency, too many parts of Peterborough are left out as a result of two challenges. The first is the postcode lottery; too many things seem to happen in other parts of our county, and we know that working-class communities are too often left behind. The second challenge is that the NHS is just too complex. Even when we have services in the community, people struggle to know which bit to access—is it the pharmacist, the GP surgery, or the hospital? Can the Secretary of State confirm that the 10-year plan will seek to simplify the system, and to put patients in the driving seat and bureaucracy in the bin?
Wes Streeting
I can absolutely give my hon. Friend that reassurance. It is about time that we design care around the patient, rather than ask the patient to do the running around on behalf of the NHS. That will be a big shift in practice and culture. Of course, as my hon. Friend says, it is only thanks to the decisions taken by the Chancellor that we are able to match the reform and ambition of this plan with the investment we need. That is why I was delighted to be joined not just by the Prime Minister, but by my right hon. Friend the Chancellor this morning in Stratford to kick off the 10-year plan—not least because she is the one who pays the bills, and we are very grateful to her for it.
James Asser (West Ham and Beckton) (Lab)
One of the issues with the health service that my constituents most often ask me about is the struggle to get basic appointments. That is leading people to the hospital, which is unable to cope with the sheer numbers, and in a populous, fast-growing borough, that is creating unsustainable pressure. As such, I welcome my right hon. Friend’s remarks about the move from hospital to community. Does he agree that getting primary care right is at the centre of getting the NHS right, and can he assure my constituents that they will get what they want: appointments when they need them, as they need them, in their local community?
Wes Streeting
I am very grateful to my hon. Friend— I know his constituency well, and he has been a powerful voice for his constituents since he arrived in this place. He is absolutely right that we need good general practice and accessible neighbourhood health services that are available to everyone, especially in areas of high need and health inequalities, as we see in the London borough of Newham. I hope his constituents really feel the impact of this plan as we roll it out during this Parliament and across the next decade.
Jayne Kirkham (Truro and Falmouth) (Lab/Co-op)
The Secretary of State mentioned community health teams in Cornwall taking services directly to people, even in their homes. I am so pleased with the focus on how to deliver healthcare in sparsely populated rural and coastal areas. Can the Secretary of State confirm that this focus will run through the 10-year plan, so that across the country people can access care as equally as possible at local level—and specialist services such as robotic surgery and mental health emergency hubs—no matter where they live?
Wes Streeting
My hon. Friend is absolutely right. I have been delighted to spend time with her in her constituency to make sure that this Government understand the needs of every part of the country and different types of community. We need to ensure that, when we think about health services, the pitch we have in our mind’s eye is meeting the needs not just of big cities or large towns, but of rural and coastal communities that have been left behind for too long. I hope that my hon. Friend’s constituents will really feel the benefit of the innovation that is at the heart of this 10-year plan, and of the focus on community services and neighbourhood health. From what they have seen so far, they can trust that if we do not deliver for them, my hon. Friend will be the first to tell us.
Dr Lauren Sullivan (Gravesham) (Lab)
I thank the Secretary of State for his statement today. I welcome the move to community delivery, greater accountability of providers and ICBs, and power to the patients. As a research scientist—I declare an interest as an unpaid visiting researcher at the Francis Crick Institute— I welcome the recognition of the need for scientists and diagnostics to get ahead of disease. What conversations has the Secretary of State had, and what actions has he taken, with the National Institute for Health and Care Excellence and other regulatory bodies in relation to the amazing new technologies, devices and drugs and how we can get them into the NHS faster?
Wes Streeting
We are so lucky to have my hon. Friend’s scientific expertise on our Benches, and we are also lucky that, despite being elected, she is doing research on behalf of the country in her spare time—goodness knows where she finds it. We welcome her public service. We need to see investment in new medicines and technology as an investment rather than a cost. That is how we deliver better care, better value for taxpayers and better outcomes, and it is how we close health inequalities. This is the most exciting revolution taking place in the world, and it is happening right here in England. We have got to make sure that the NHS benefits from it.
Navendu Mishra (Stockport) (Lab)
This weekend will mark the 77th anniversary of the national health service, and I take this opportunity to thank all NHS staff at Stepping Hill hospital in Stockport. I pay tribute to the work of the British Dental Association, because week in, week out, Members from all parts of the House receive correspondence on NHS dentistry and the lack of it. I take this opportunity to invite the Secretary of State to visit Stockport. I know that he comes to Bury often, so when he is up in Greater Manchester, will he join me in Stockport to speak to patients, parents and frontline dental staff about the crisis?
Wes Streeting
My hon. Friend is right about the importance of dental services, and I hope that his constituents begin to feel the benefit. I also know he is leading the charge on the campaign for Stepping Hill hospital. He regularly raises it with me and other Ministers, and I would be delighted to try to visit his constituency as soon as my diary allows.
Sarah Edwards (Tamworth) (Lab)
I thank the Secretary of State for this welcome news. The Sir Robert Peel centre, part of the University Hospitals of Derby and Burton NHS trust, is now running at full throttle, with a range of diagnostic services and treatment options. I congratulate the trust and the Minister on opening that community diagnostic centre, which, as part of the NHS 10-year plan, will transform lives and access to speedy healthcare. Will he celebrate this hospital’s transformation to unlock more than 1,000 treatments a week in Tamworth and the villages?
Wes Streeting
I am so grateful to my hon. Friend for that question, as it gives me the chance to say an enormous thank you to everyone involved. I hope that people are beginning to feel the benefits and will see the change that comes from having a great Labour MP and a Labour Government who deliver the change that our country desperately needs.
Louise Jones (North East Derbyshire) (Lab)
My constituents raise issues with accessing the NHS, particularly local GPs and primary services, at every chance they have. I welcome the bold, big ambition of this 10-year health strategy. Can the Secretary of State outline how it will make a big difference in our small towns and villages?
Wes Streeting
Neighbourhood health cannot just be about large towns and cities. It has to meet the needs of every community, and the approach we are taking, with care closer to home or, indeed, in the home will benefit everyone, but it will disproportionately benefit people such as those in my hon. Friend’s constituency. That is the benefit of having a great Labour MP like her and a Labour Government delivering results.
David Burton-Sampson (Southend West and Leigh) (Lab)
I thank the Secretary of State for his statement and the 10-year plan, which I welcome. I am already seeing the benefits of this Government’s commitment to reforming the NHS in my constituency, with a second linear accelerator radiotherapy machine coming to Southend hospital and investment in four of my GP surgeries, with new space being developed for more appointments. As he knows, however, I care greatly about men’s mental health. How does this 10-year plan begin to address the challenges we face in that area?
Wes Streeting
I am delighted with the work that my hon. Friend is doing to assist us with the development of a new men’s health strategy, including a focus on men’s mental health, which he has raised so powerfully on more than one occasion in this House. I hope he will be pleased with the results. By working closely with him, voluntary sector organisations and the NHS, we will make sure we get it right.
Jess Asato (Lowestoft) (Lab)
I hugely welcome the NHS 10-year plan, and its recognition that victims of domestic abuse are more likely to experience worse NHS access and worse outcomes, and will die younger. Domestic abuse costs the NHS £2.3 billion a year. Will the Secretary of State agree to work with Standing Together and other domestic abuse charities to ensure that the NHS treats domestic abuse as the public health emergency that it is?
Wes Streeting
I am so grateful to my hon. Friend for that question, and for the expertise she brings to the House on this issue. She is absolutely right: it is the NHS’s responsibility to meet the needs of everyone, whatever their background and whatever the circumstances of their requirement for access to the NHS. That is so often where eyes first spot the telltale signs of violence against women and girls and domestic abuse. It is not the job of the Home Office to tackle this issue; it is the job of all of us across Government. She has my assurance that I will work closely with my right hon. Friend the Home Secretary to make sure that the NHS plays its part in keeping women and girls safe, alive and well.
Alex Baker (Aldershot) (Lab)
I warmly welcome the Government’s 10-year plan. It is a proud day to sit on these Benches. I also welcome the Government’s commitment to rebuilding Frimley Park hospital in my community in wave 1 of the new hospitals programme. The brilliant staff there, who are currently working in a hospital riddled with reinforced autoclaved aerated concrete, deserve that more than anyone. Can the Secretary of State help me out by bringing to life what healthcare will look like for people in my community of Aldershot, Farnborough, Blackwater, Hawley and Yateley over the next decade as a result of this plan?
Wes Streeting
I am grateful to my hon. Friend for that question, and to her constituents for taking part in her local engagement event. This plan will ensure that more people receive the right care in the right place at the right time. It will deliver more neighbourhood health services under one roof, and more choice, convenience, power and control over healthcare. It will deliver access and support at the touch of a button, and personalised care. We are completely changing how we deliver healthcare in this century and meeting the needs of everyone. Thinking particularly about her constituency, we are making sure that we are supporting our armed forces, veterans and their families, so that they receive great outcomes, thanks to a great Labour MP in Aldershot and a Labour Government who deliver. I know that she will hold our feet to the fire to make sure that we deliver.
Chris Vince (Harlow) (Lab/Co-op)
I thank the Health Secretary for his statement, and I promise not to lobby him too much on the potential move of the UK Health Security Agency to Harlow, although perhaps I should also lobby for a neighbourhood health centre. Instead, can I ask him to set out how the 10-year plan will ensure a shift from sickness to prevention? Medical professionals in my local hospital, the Princess Alexandra, emphasised that issue when I met them recently.
Wes Streeting
My hon. Friend is right that we need to not just treat sickness, but prevent illness. That was a strong message that we got from the public. He will see lots of good stuff on prevention in the plan, and I know that he will welcome it. On the location of the UK Health Security Agency, he may have inadvertently misled the House: he said he did not want to lobby me too much, but that is absolutely not true; he will not leave me alone on this issue. He lobbies me every single day. I can assure him we will make a decision on that issue shortly.
Mr Deputy Speaker (Sir Roger Gale)
I am sure that the hon. Member for Harlow will wish to correct the record.
Wes Streeting
Absolutely, and the people of Watford can see the difference a Labour Government can make, thanks to their sending a Labour MP to the House. They saw what happened when they sent a Tory, and they cannot send a Liberal Democrat to this place and trust them to deliver. They need a Labour Government to deliver Labour change. I am delighted that my hon. Friend is here, and we are making a real difference together. Thanks to the engagement events he held with his constituents in Watford, their ideas are reflected in this plan. That is thanks to their hard work and his advocacy.
Lewis Atkinson (Sunderland Central) (Lab)
It falls on each Labour Government to reform and renew the NHS in the service of patients, and that includes mental health patients; from my consultations, I know that they are a key priority for the people of Sunderland Central. I welcome the plan’s emphasis on empowering patients by providing them with information and choice through the NHS app, including on waiting times, but the Secretary of State will know that information about mental health waiting times is often poor, as are the waiting times themselves. In the 10-year plan, will he commit to making sure that empowerment applies equally to people seeking mental health services and those seeking physical health services?
Wes Streeting
My hon. Friend is absolutely right. We in this place are so lucky to have his expertise and his leadership of the Back-Bench health and social care committee of the parliamentary Labour party. Sunlight is the best disinfectant, and I am concerned that we do not give enough profile to paediatric waits and mental health waits. With more transparency, information and access, we will be able to demonstrate improvements over the course of this Parliament and the next decade.
Michelle Welsh (Sherwood Forest) (Lab)
Families affected by failing maternity services were ignored for far too long, and we have a system of accountability that is broken. I am pleased that the Secretary of State’s plan has a strong focus on patient outcomes and experiences, and that maternity care will be at the forefront. I am also pleased to see that the single patient records will be rolled out in maternity services first. It is vital that women feel heard and seen throughout their pregnancy journey, and that crucial information no longer falls through the cracks of numerous systems that do not sync up.
I express my heartfelt thanks to the Secretary of State for really listening, for speaking to families across the country, and for coming to Nottinghamshire twice. I can honestly say that his reaction moved me. Not only was he listening; he cares and is determined that things will change, and they will. As chair of the APPG on maternity, and as a harmed mother, I thank him. Can he tell me a bit more about how maternity services will be incorporated into his plan for a neighbourhood health service?
Wes Streeting
I am so grateful to my hon. Friend for all the work she does as chair of the all-party parliamentary group, for the personal and professional experience that she brings to this House, and for the wisdom, advice and insight that she has offered to help me make better decisions. I am absolutely determined to work with families, especially those who have suffered such grave injustice at the hands of the NHS. It is a wonderful institution, but sometimes when it fails, it fails spectacularly. The culture of denial and cover-up cannot be allowed to persist, and I will work with my hon. Friend to make sure that we end it.
On neighbourhood health, it is so important that we engage with families early, especially where they may be at greater risk of complicated pregnancy or harm, because we know this is an area of grotesque health inequalities. After birth, it is really important that we have strong health visiting, and care in the community and the home that does not just consider the interests of the baby, but asks questions of the mother. How is she feeling? How is she recovering? Is her partner coping? We have to look at the whole family, and I am sure we will get it right. I am determined to get this right, and it will be in no small part thanks to my hon. Friend’s leadership and support.
Jim Dickson (Dartford) (Lab)
I thank the Secretary of State for both his statement and the 10-year plan. I am delighted that residents in Dartford were able to play a full part in shaping its priorities through our consultation meeting in February. They will be really pleased to see not only the additional GP appointments, but the pressure being taken off their local hospital, Darent Valley, through the provision of better and more community services. The hospital was designed with a much smaller community in mind and is now suffering the consequences. Can the Secretary of State give me an idea of the pace of the roll-out of neighbourhood health centres? We could certainly do with one in Dartford.
Wes Streeting
I am grateful to my hon. Friend for his question—representation duly received. I reassure him that one of the ways we will ease the pressure valve on our hospitals is by doing more neighbourhood health. That helps to drive admission avoidance, speed up delayed discharges, and get much more effective flow of patients through hospitals. That is our commitment. We aim to roll out 40 to 50 neighbourhood health centres over the course of this Parliament, and if we can go faster, we will. I have no doubt that my hon. Friend, as a strong representative for Dartford, will make more representations to us shortly.
Kevin Bonavia (Stevenage) (Lab)
I thank the Secretary of State and everyone involved in creating this well-designed and excellent 10-year plan. There is so much good stuff in it, but I particularly like the approach of shifting treatment from hospitals to neighbourhoods and homes. Many of my constituents in Stevenage have been taken to Lister hospital when they do not want or need to be there, but we have an alternative. The Minister for Social Care and my hon. Friend the Member for Welwyn Hatfield (Andrew Lewin) recently joined me on a visit to the Hertfordshire community NHS trust’s “hospital at home” service. Is that something that the Secretary of State and the health team are determined to roll out?
Wes Streeting
I can give my hon. Friend that assurance. The change will mean that people in Stevenage start to feel real improvements in their ability to access the NHS. Of course, that is in no small part thanks to this country’s amazing life sciences sector, which has its beating heart in Stevenage.
Andrew Cooper (Mid Cheshire) (Lab)
I add my congratulations to my right hon. Friend, his team and NHS staff, who have put this plan together so that the NHS does not just survive but thrives. Last weekend, I met a family in Winsford who, that morning, had received a bill of £180,000 for their mother’s care. The daughter said to me, “Andrew, I don’t know how I can possibly pay this.” The previous Government failed to get a grip on the issue. The plans that the Secretary of State has set out to increase carer’s allowance and the disabled facilities grant will make a big difference, as will the introduction of fair pay agreements across the adult social care sector. Can he confirm that he will do everything he can to accelerate and implement the outcome of Baroness Casey’s cross-party commission, so that the issue is resolved once and for all?
Wes Streeting
I can certainly give my hon. Friend that assurance. It is precisely because of examples of the sort that he has shared with the House that we have to get this right, so that we relieve families of such catastrophic care costs. Just as the NHS replaced fear with high-quality care for all, we have to alleviate the fear of families who require care, because the situation that he describes blights too many families across our country.
Mark Sewards (Leeds South West and Morley) (Lab)
May I briefly commend the Health Secretary for his comments on the morning media about events in this place yesterday? Empathy is in short supply in politics, and we could do with a bit more of it.
I really welcome the 10-year health plan, and specifically the focus on outcomes and the transformation of the NHS into a neighbourhood health service, complete with health centres. The plan states the criterion for deciding the first locations of these health centres: they will be the areas with the greatest need. Will the Health Secretary expand on that criterion, and perhaps tell me what I need to do to get a health centre for Leeds South West and Morley?
Wes Streeting
I knew exactly where that question was going, because my hon. Friend has been such a strong champion of his constituency since he arrived in this place. I am committed to rolling out neighbourhood health across the country, and to making sure that we particularly benefit the communities with the greatest need that are the most poorly served. This is in no small part possible thanks to the leadership of the Chancellor of the Exchequer and the wise decisions that she has taken. Not only have we delivered investment in the NHS, but interest rates have fallen four times, wages are finally rising at a higher rate than the cost of living, and we have the fastest-growing economy in the G7. That is the leadership that we need from the Chancellor, and it is here to stay.
Mr Deputy Speaker (Sir Roger Gale)
Finally, and with thanks for his patience, I call Richard Baker.
Richard Baker (Glenrothes and Mid Fife) (Lab)
Thank you very much, Mr Deputy Speaker—persistence pays off.
Will my right hon. Friend assure me that he will report regularly to this House on progress against this excellent plan? I hope that will help us to evidence the case for investment in community health facilities in Scotland, which have long been promised but not been delivered by the SNP, including the much-needed new health centre in Lochgelly in my constituency.
Wes Streeting
I can absolutely give my hon. Friend that assurance. I just feel so sorry for him, because he comes here to stand up for his constituents, knowing full well that while they have a Labour Government who are delivering the biggest increase in investment to the devolved Administrations since devolution began, the SNP, which has been in government for almost two decades, is squandering the money and the opportunity. People will not get change in his constituency, or across the rest of Scotland, if they face more of the same from the SNP. Scotland needs an alternative, and Scotland’s NHS needs an alternative. That alternative is Scottish Labour and the leadership of Anas Sarwar and Jackie Baillie, and it cannot come soon enough.
Mr Deputy Speaker (Sir Roger Gale)
May I thank the Secretary of State for answering in excess of 65 questions, and the shadow Secretary of State for being in attendance throughout the entire proceedings?
NHS Maternity and Neonatal Services
Wes Streeting Excerpts(1 month ago)
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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 month, 1 week ago)
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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.