Renewed Women’s Health Strategy for England
Wes Streeting Excerpts(3 days, 14 hours ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
Today the Government are publishing the renewed women’s health strategy for England. The health system is failing women across the country. This strategy will tackle medical misogyny and give greater choice, voice and power to women. This ambitious strategy renewal is made possible by the record £26 billion in funding for the NHS, secured by the UK’s first female Chancellor.
Women across England have repeatedly told us the same stories: that their symptoms are dismissed, their pain normalised, their concerns not believed, and that their voices carry too little weight in decisions about their own care. These experiences are not isolated or incidental. They reflect a healthcare system that has not been designed around women’s needs. That failure to listen has contributed directly to worsening outcomes, poorer experiences and widening inequalities.
The consequences are clear. Women are living longer but spending more of their lives in poor health. Many face long waits for gynaecology services, repeated appointments without answers, delayed diagnosis of conditions such as endometriosis, and avoidable pain during procedures. These failures are felt most acutely by women living in deprivation, disabled women, and by women from some ethnic minority backgrounds, who are least likely to be heard and most likely to experience harm as a result.
The previous Government first published its women’s health strategy in 2022. This plan was underpinned by substantial engagement, including almost 100,000 individual responses and over 400 submissions from organisations and experts to a call for evidence. Those submissions starkly demonstrated the many ways in which we have a health service that is not built for women.
However, its actions have not translated into meaningful improvements in women’s access, quality of care, experience or outcomes—or reductions in inequalities. This renewed strategy is our response to that failure. It recognises that this approach did not deliver for women, and sets out how change will happen through more fundamental reform as we deliver the 10-year health plan.
Through this strategy we will ensure our NHS transformation delivers for women: the community shift, with new neighbourhood women’s health services enabling faster diagnosis and treatment; the digital shift, with women’s health pathways prioritised in NHS Online; and the prevention shift, seizing opportunities from genomics to help manage lifetime risk of breast and ovarian cancer as well as major conditions like cardiovascular disease. These reforms will be underpinned by a new diverse and devolved operating model with women’s voices and choices at its heart, including rolling out patient-reported outcome and experience data in core women’s health pathways. This transformation will be bolstered by our focus on research and innovation. Through the National Institute for Health and Care Research, the Government are funding research into areas of unmet need for women’s health—including to improve care for young women living with intense period pain, and first of its kind technology to treat threatened miscarriage. The NIHR is also embedding new sex and gender policies into health research, so that findings are genuinely representative and no woman is left behind by science.
We set out clear accountability for delivery and will be transparent on progress in improving women’s services, outcomes and experience. An overall metric against which we will judge progress is to improve healthy life expectancy in the poorest parts of the country to at least 61 years, delivering our commitment to halving the gap in healthy life expectancy between the richest and poorest regions, while increasing it for everyone. Other improvements will start immediately and continue over the next 10 years including:
shorter waits for gynaecology care,
fewer painful procedures without informed consent or a choice of pain relief,
easier access to contraception and screening close to home,
better information and more control over their health through digital services,
being listened to and taken seriously at the first time of asking,
more digital therapeutics bespoke to women,
more women in life science and tech leadership.
Women’s voices are the foundation of this strategy. This Government have listened to what women want and need. The renewed women’s health strategy puts the 10-year health plan’s new care model into action to deliver faster, tangible improvements across four outcomes that matter most to women across England. The renewed strategy sets out how the Government will:
make women’s voices and choices central in healthcare: investing in new ways for women’s voices to be heard and acted upon throughout the NHS including action to tackle outdated and misogynistic practices around pain relief and a new trial in gynaecology services which would vary the amount NHS trusts are reimbursed depending on women’s feedback on their experiences, including pain management.
transform NHS performance in services that matter most to women: women will be directed to the right professional first time, along with marrying redesigned local services with online support to cut waiting lists and ensure women no longer face years-long waits for diagnosis and treatment for conditions like endometriosis.
support all women to lead healthy, prosperous lives including a new programme to improve education for girls about their menstrual health, and expanding access to musculoskeletal hubs in the community, supporting long-term health and tackling a major driver of health-related economic inactivity.
create an approach to research and development that works for and empowers women, including launching a Femtech challenge fund to accelerate adoption of innovations that could transform women’s healthcare and an accelerator for female founders with innovations addressing women’s health priorities.
This marks a decisive shift from identifying problems to delivering change. By listening to women’s voices, improving performance where it matters most, and tackling the drivers of poor health and inequality, we will ensure women and girls receive the care, respect and outcomes they deserve.
This work builds on the Government’s action to reform women’s health, including free emergency contraception in pharmacies, at-home HPV testing kits, gynaecology as the first specialty for NHS Online and the introduction of bereavement leave for miscarriage. From this year, the standard NHS health check offered to all adults aged 40 to 74 will also include a question about menopause symptoms, giving up to 5 million women an easier route to advice and support.
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Oral Answers to Questions
Wes Streeting Excerpts(4 days, 14 hours ago)
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Jen Craft (Thurrock) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
Under Labour, the NHS is on the road to recovery: with an extra £26 billion invested, 2,000 extra GPs and 100 community diagnostic centres now open weekdays and weekends, waiting lists are coming down and patient satisfaction is going up—lots done, but so much more to do to ensure that that improvement is felt everywhere. Where trusts underperform, we will send crack teams of top clinicians into those struggling trusts to cut waiting times faster. No more turning a blind eye to failure: this Government, unlike our predecessors, will do whatever it takes to improve the NHS in every part of the country—lots done; lots more to do.
Jen Craft
I welcome the Secretary of State’s work in improving the NHS and turning fortunes around, but as he has said, that is unfortunately not the case in every area of the country, including my own. Mid and South Essex NHS foundation trust, which looks after constituents in my area including at Basildon university hospital, has been named as one of the challenged trusts in the intensive recovery programme, which I strongly welcome. The issues with the trust are not just recent but historical—they sometimes go back decades—and quite frankly, my constituents are not getting the healthcare they deserve. Will the Secretary of State set out what the recovery programme looks like and how my constituents can be assured that they will get the level of healthcare they deserve?
Wes Streeting
I am grateful to my hon. Friend for her question and for the work that she has been doing on behalf of the people of Thurrock to speak up consistently for improving services and to expose failures at her local trust. As I told listeners to BBC Essex this morning, I will always report back on the things that this Government are doing well but I will also acknowledge where we are not seeing improvement fast enough. I am sorry to say that Mid and South Essex is one such trust, despite the best efforts of frontline staff. That is why we announced that Mid and South Essex is one of the first providers to be put in the new intensive recovery programme. We are sending in teams of clinical experts to identify the root causes of failure and a new chief executive will take up post shortly and get a grip on the issues at the trust so that we deliver for patients.
James Wild (North West Norfolk) (Con)
At the Queen Elizabeth hospital in King’s Lynn, nearly half of patients are waiting more than 18 weeks from referral to treatment and the trust is now part of the national improvement programme. Last month’s elective sprint delivered 2,000 additional elective activities, with evening and weekend working. Will the Health Secretary ensure that additional support is provided so that increased level of activity continues in the months to come?
Wes Streeting
I think that was a rare acknowledgment from the Conservative Benches that things are finally moving in the right direction, thanks to the work of this Labour Government. I am very grateful for the hon. Gentleman’s support. He is absolutely right that we need to provide digital support. That is why we have the biggest capital allocation in the history of the NHS and we continue to press on with the technological improvements and data infrastructure that is needed to provide the improvements that staff are working so hard to deliver.
Mike Kane (Wythenshawe and Sale East) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
I remain deeply concerned by the state of the maternity services that we inherited. Although the majority of births go well, I know through the courage of families and concerned staff of the devastating impact that comes from failures in care. That is why I asked Baroness Amos to chair an independent investigation into maternity and neonatal care. However, that has not stopped us from acting now, with an extra 2,000 midwives, over £149 million invested to address critical safety risks on the maternity and neonatal estate, and a £25 million boost for trusts to tackle causes of maternal death, enhance bereavement services and improve triage services. We are already making progress—lots done, but I would be the first to say on this issue: so much more to do.
Mike Kane
The nation should be grateful for this Secretary of State and for what he is doing for maternal services, yet at Wythenshawe hospital in my constituency, the most recent Care Quality Commission report rated maternity services inadequate for safety. What assurances can the Secretary of State give that the improvements that he has outlined will be felt by mums locally?
Wes Streeting
My hon. Friend is absolutely right to present those issues and to be honest about the challenges that have been raised in his local trust. I assure him that following an inspection by the CQC, NHS trusts take action to address the recommendations cited in the report. Already, £40 million in funding has been allocated to Wythenshawe hospital to ensure that safety issues are addressed, with work scheduled for completion by 2028. In addition, through the new maternity and neonatal taskforce, the first meeting of which I have already chaired, we will act swiftly to translate the final recommendations of the independent investigation into a new national action plan so that services improve in my hon. Friend’s part of the country and across the whole of England.
Sir Jeremy Hunt (Godalming and Ash) (Con)
The Secretary of State and I are equally frustrated that more progress has not been made despite numerous inquiries dating right the way back to the Morecambe Bay inquiry in 2014, which I commissioned. Does he agree that one reform that could make an enormous difference would be full continuity of care for every pregnant mum, so that from the moment someone knows they are pregnant, a team of clinicians led by a named senior clinician would be responsible for that mother and child, from pre-birth to birth to post-birth, and no one would ever be in any doubt about where the buck stopped?
Wes Streeting
There is so much evidence to underpin the importance of continuity of care. I do not want to get ahead of the recommendations of the Amos investigation, but there is much to commend what the right hon. Gentleman says. Even with the best planning, the challenge for maternity units is that they are often both elective and emergency, with women arriving when they are not necessarily expected to, so we have to bear those considerations in mind, but the idea of women and partners knowing the team that will be responsible for their care in advance is a compelling one.
Mr Connor Rand (Altrincham and Sale West) (Lab)
A four-month-old baby in my constituency died after being placed in an unsafe sleeping position by someone who called themselves a maternity nurse despite having no medical qualifications. The coroner who worked on the case has called on the Secretary of State to regulate the infant sleep industry urgently. As it stands, anyone can call themselves a maternity nurse and create the illusion of expertise, all while providing life-threatening advice on sleep for babies. I know that the Secretary of State is aware of this case and is working on this issue, but can he provide an update on what he is doing to prevent a tragedy such as the one in my constituency from ever happening again?
Wes Streeting
I thank my hon. Friend for raising that absolutely horrific case; my sincere condolences go to the family for the loss of this poor baby. No patient should ever believe that someone is a trained professional, only to discover that they have no formal qualifications. This Government are protecting the professional title of nurse, so that no other families have to endure the suffering of his constituents. We will shortly be seeking widespread input to get that right, and we will be making changes in this Parliament. We will absolutely be addressing the issues that have been raised as a direct result of this tragedy.
Sir Roger Gale (Herne Bay and Sandwich) (Con)
Does the Secretary of State understand that the remarks that he made on Sky television prior to the recess about the maternity unit at the Queen Elizabeth the Queen Mother hospital in Margate were ill informed, anachronistic, deeply offensive and damaging to morale? I was heavily involved, and have been since, in the events following the death of baby Harry Richford at the hospital, and also in Bill Kirkup’s report. Massive improvements have been made since then, but the thing that is missing is the funding that was promised by the previous Government for the improvement of the real estate. When is that money going to be forthcoming?
Wes Streeting
We are investing in the maternity estate, and I am always ready to acknowledge improvements, but for the avoidance of doubt, I am not here to protect the professional blushes of NHS leaders and staff where services fall short. I am here to protect patients, and in this area, over and above any other, I will continue to put that principle first.
Helen Morgan (North Shropshire) (LD)
Baroness Amos’s recent review found that England’s maternity system was not working: poor quality care covered up, systemic issues around racism and even collapsing ceilings in maternity units. Poor maternity care has not only left many families devastated at a time that should have been joyful for them, as too many of my constituents know; it also costs the NHS £1.3 billion every year in medical negligence payments. Liberal Democrats are calling for a consultant to be present on every maternity unit 24 hours a day, seven days a week, and for guaranteed one-to-one midwifery care for every woman who is in labour as part of a £600 million-a-year maternity rescue package. Does the Secretary of State agree that that would be money very well spent, preventing families from experiencing the heartbreak of an injury or even worse to their new baby or mum, and saving the taxpayer billions every year?
Wes Streeting
I thank the Liberal Democrat spokesperson for raising this issue. I do not want to pre-empt the Amos investigation. I think there is an issue with the presence of consultants and other staff who are meant to be on-call and available, and we need to address that. The purpose of the investigation is to produce a strong evidence base and then a clear set of actions to provide much-needed clarity in an area that has been drowning in recommendations and needs clear direction. I would be surprised if the issue of appropriate staffing were not mentioned by Baroness Amos.
David Davis (Goole and Pocklington) (Con)
Afzal Khan (Manchester Rusholme) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
It is vital that all forms of discrimination in the NHS are tackled, including Islamophobia and anti-Muslim hatred. As a former chair of the all-party parliamentary group on British Muslims, I am delighted that the Government have adopted a definition of anti-Muslim hostility that we will use to tackle this prejudice across the NHS, including in training for the NHS’s 1.5 million staff. My hon. Friend will know that I have serious concerns about the effectiveness of regulators in tackling racism, and we will be taking further action to ensure high standards, conduct and behaviour are upheld, so that the NHS is safe for all staff and patients.
Afzal Khan
The Health Secretary has long campaigned on tackling anti-Muslim hostility, and I know that we are both proud that this Government have adopted a working definition of it. According to the Muslim Doctors Association, almost 40% of Muslim healthcare professionals have been verbally abused by colleagues about their faith, and the British Islamic Medical Association has repeatedly found that Islamophobia is a persistent and under-recognised issue in healthcare. Will he commit to a rapid review specifically to look into anti-Muslim hostility experienced by patients and staff in the NHS?
Wes Streeting
Those statistics are shocking and a stark reminder that the NHS is not immune from the prejudices at large in wider society. All Muslim staff and patients—indeed, people of all faiths—should feel safe and confident as patients and staff in the NHS. As my hon. Friend knows, I am awaiting the review being conducted by Lord Mann. As well as looking at antisemitism, it will include recommendations that I have no doubt will apply in tackling Islamophobia and racism more generally. I am very happy to meet my hon. Friend and I do meet, and would be very happy to meet again, the BIMA to discuss how we tackle this pernicious hatred in our national health service and what more may need to be done, in addition to any recommendations Lord Mann makes.
Jim Shannon (Strangford) (DUP)
I welcome the Secretary of State’s commitments about hostility to those of the Muslim faith, but I want to make a point about those of the Jewish faith. The Secretary of State referred in his reply to people of all faiths, and that includes those of the Jewish faith. However, we are well aware of recent newspaper headlines, including about a person who supports Palestine Action and one person who has made slurs against those of Jewish faith and Israeli nationality. Is it not time to ensure that everyone in the NHS, irrespective of their religious beliefs, is respected? I respect everybody’s beliefs. I am sure that the Secretary of State will tell me that that is the case in the NHS—I hope that it is.
Wes Streeting
The hon. Gentleman is right. I only wish that I could tell him that it was the case that Jewish patients and staff are always being treated in the way that they deserve to be, but unfortunately I have heard first-hand accounts of Jewish people being afraid to disclose their race and faith when completing forms. That is not just a question of indignity; it is a question of safety because risk factors, particularly those related to genetics, need to be taken into account by the NHS, and it is about the provision of things that lead to people having a dignified and high-quality experience, such as the provision of food. I am afraid to say that I have also heard about shocking racism experienced by Jewish staff in the NHS from patients and from other NHS staff. That has got to stop.
Finally, all staff in the NHS have a right to speak and express opinions in a democracy, but all of them must always ask themselves, especially when writing on social media, “Will a particular comment or a particular action make my patients feel more safe or less safe in my hands? Will they question my commitment to treating all people fairly and equally or not?” That is the standard on which too many doctors have fallen short, and that is before I get to the explicit, vile racists whom we are taking on.
John Whitby (Derbyshire Dales) (Lab)
Samantha Niblett (South Derbyshire) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
We inherited from the Conservatives an NHS facing the worst crisis in its history, with waiting lists at a record 7.6 million and public satisfaction at record lows. This Labour Government are getting the NHS back on its feet and making it fit for the future. We have delivered record numbers of appointments, tests and surgeries. Since we took office, waiting lists have been down to the lowest level in nearly three and a half years, and we are driving modernisation through our 10-year plan. Lots has been done, but there is so much more to do with a Labour Government.
Tom Rutland
Waiting lists at my local acute trust are down by more than 20,000 since the general election, which I welcome, but musculoskeletal waits remain a challenge in Sussex, with the Sussex MSK service holding about 10% of NHS England’s overall MSK waiting list. What more can be done to improve the performance of the service and get my constituents off the waiting list, back to health and back to work?
Wes Streeting
I am grateful to my hon. Friend for all the work he is doing, including with our Labour team in Worthing, to improve the health of people across his constituency. I congratulate staff at University Hospitals Sussex on the progress that they have made in bringing waiting lists down. To help them to go further, I am delighted to announce that my hon. Friend’s local community diagnostic centre in Southlands hospital will benefit from a new multimillion-pound MRI scanner to drive down waiting times, including for MSK patients. We are combining investment with modernisation to send crack teams of top clinicians to MSK community services, drive down waiting times and improve outcomes. That is the difference that a Labour Government make.
Samantha Niblett
Recently, University Hospitals of Derby and Burton NHS foundation trust took part in the Q4 sprint, which involved out-patient appointments and surgical procedures. The work focused mainly on areas such as gynaecology, trauma and orthopaedics, general surgery, and ear, nose and throat, reflecting where that trust’s waiting lists are longest. We have seen a significant drop in the 18-week position, which apparently is a key marker of overall access to care. At the start of the sprint, around 56% of patients were being treated within 18 weeks; as of last week, that figure had increased to 60.2%. A lot of work has been done, so will the Secretary of State join me and the chief executive officer, Stephen Posey, in thanking the teams involved in helping to deliver that sprint? More importantly, what assurances can he give that this is not just a one-off? We have people in South Derbyshire and across the country who need consistently good and quick care.
Wes Streeting
I thank my hon. Friend, and join her in congratulating Stephen and the whole team at University Hospitals of Derby and Burton trust on their hard work to drive down waiting lists and waiting times. We are not complacent; we have set ambitious targets and invested in modernisation to simplify pathways, increase clinical capacity and improve patients’ experience. We have managed to cut waiting lists despite resident doctors’ strike action—I fear we may have to continue doing that. Through our investment and modernisation, waiting lists and waiting times are coming down, and we have shown that the NHS is on the road to recovery. Our foot is on the accelerator, with lots done, but lots more to do.
Layla Moran (Oxford West and Abingdon) (LD)
Making sure that our GP surgeries are revving on all cylinders is key to ensuring that people get the access to NHS treatment that they need. The Secretary of State will know of my campaign to get a new site for Summertown health centre—in fact, we have been trying to meet to talk about it for over 14 months—but we are now at a key moment. The council and the local practices are at a point where, if we do not get a decision in the next few weeks, we risk losing the opportunity. However, there is a block, which is the district valuer. It often asks for rents far below market value, so what is the Secretary of State doing across Government to make sure that the role of district valuers in ICBs is reassessed?
Wes Streeting
The Chair of the Health Committee raises a very important point, and—not least given the timeliness of the issue—I would be very happy to meet her very soon.
Edward Argar (Melton and Syston) (Con)
Among the things that can help reduce waiting lists and waiting times is increased use of existing community hospital facilities, such as Melton Mowbray hospital in my constituency. Will the Secretary of State join me in calling on the local ICB and University Hospitals of Leicester NHS trust to invest in moving more services out of inner-city acute settings and into Melton hospital, so that more of my constituents can get the treatments they need nearer to home?
Wes Streeting
The right hon. Gentleman is absolutely right that we need to see more services moving out of hospital and into the community. That is why I am proud that we are announcing a new wave of community diagnostic centres and expanding lots of existing provision, as well as improving same-day emergency care and urgent treatment centres in hospitals. He has raised the issue of the Melton Mowbray site; I am sure the local commissioners responsible for that will want to look at it, but I also know that I owe him a meeting, so I will follow up with him directly.
Mrs Elsie Blundell (Heywood and Middleton North) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
No, it wasn’t—not at all.
Mrs Hodgson
Unlike the Conservative party, we trust our GPs. This will be consultant-led advice and guidance, on which GPs will then decide.
Matt Bishop (Forest of Dean) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
I am delighted to announce that we are investing in 36 new and better community diagnostic centres in shopping centres and high streets across England. This is what a Labour Government deliver: the biggest expansion in diagnostics in a generation, shorter waits for tests, checks and scans, and an NHS on the road to recovery. It is a record that the Tories could not touch, the Scottish National party cannot match, Plaid Cymru cannot sustain, and Reform would destroy. On 7 May, people can only trust Labour with the NHS.
Matt Bishop
A constituent of mine, Emma, has been left with significant injuries following poor maternity care during childbirth. For more than 20 years she has been fighting for, but has been denied, corrective treatment on the NHS because it has been deemed cosmetic, despite the clear impact on her mental health and relationships. What steps can the Secretary of State take to ensure that women in such circumstances have access to the treatment that they need?
Wes Streeting
I am grateful to my hon. Friend for raising that case. It is shocking but sadly not surprising, because the injuries sustained by women during childbirth are often completely ignored as well as going unaddressed. We have to learn from the case raised by my hon. Friend to ensure that constituents such as his are not fighting for the care that they deserve, and we will act on those lessons.
Stuart Andrew (Daventry) (Con)
The latest industrial action by the British Medical Association has now ended, yet many will be appalled by reports of individuals boasting online that
“the ability to have 10 days off will make turnout quite high.”
Does the Secretary of State agree that this behaviour is indefensible and represents a slap in the face to patients whose treatments have been cancelled, as well as to the NHS staff who have been left to pick up the pieces?
Wes Streeting
Yes. It reflects very poorly on the BMA and the cavalier way in which it has inflicted disruption and a £300 million bill on the country in straitened times. It was also unnecessary. Although the resident doctors committee chose to reject a generous offer, that did not mean that it needed to rush out and announce six days of strike action the very same day. With the BMA, strike action is a first resort, not a last resort. It needs to change its tune, because the country cannot afford to fund its reckless behaviour.
Stuart Andrew
This is a rare occasion, as I agree with the Secretary of State. The increasingly militant stance adopted by the BMA is plainly out of step with some resident doctors, who continue to report for duty. The Government’s handling of this dispute has been marked by inconsistency. First, they attempted to buy their way out of trouble, then they withdrew the training places that this House voted for. Instead of persisting with a failed strategy, is it not time for the Government to heed our calls and bring forward legislation to ban doctors from striking?
Wes Streeting
The Government’s approach has been consistent. We recognise that resident doctors suffered years of pay erosion and worsening conditions under the Conservatives. We came in and sought to address that substantially with a 28.9% pay rise and an offer on the table that would have gone further on pay, gone further on training places and cancelled exam fees, which is the best deal that anyone will have got in the entire public sector. Resident doctors have rejected that approach, but the shadow Secretary of State reminds the BMA that however much it might disagree with this Labour Government, the alternatives are far worse. It is far better to work with us than against us, but we will not cave.
Joe Powell (Kensington and Bayswater) (Lab)
Clive Jones (Wokingham) (LD)
Wes Streeting
I am delighted that, as well as announcing the £10 million needed to purchase the new site for the Royal Berkshire, we are investing in the existing estate; that is what local residents deserve. I was delighted to make that announcement last week with our brilliant Labour Reading council team. It once again underlines that Labour councils work much better with a Labour Government, and people should remember that on 7 May.
Gurinder Singh Josan (Smethwick) (Lab)
Wes Streeting
I wish a happy Vaisakhi to all who are celebrating today.
Let me reassure my hon. Friend that he is absolutely right. As I reported only this morning on BBC West Midlands, we are bringing down waiting lists in his area and across the west midlands, and we will make further and faster progress; that is what a Labour Government do. We are much more able to improve the health of our nation by working with Labour councils across the country.
Sir John Whittingdale (Maldon) (Con)
Wes Streeting
I know the Minister for Secondary Care has met the right hon. Gentleman. I know that the ICB will have been disappointed. There will be further ways to do this, and it should keep trying.
Lauren Edwards (Rochester and Strood) (Lab)
The James Williams healthy living centre recently opened in Chatham town centre in my constituency. It means that more of my constituents can receive care closer to home, rather than travelling to the other end of Medway to visit the hospital. May I invite the Secretary of State to attend its official opening in the summer, so he can see at first hand the fantastic new facilities?
Katie Lam (Weald of Kent) (Con)
Wes Streeting
The Medical Training (Prioritisation) Act 2026 is making a difference. It has reduced competition from four to one to less than two to one, a fact that the British Medical Association might wish to acknowledge. We are absolutely up for looking at that issue as part of the workforce plan. I suspect that we will have to do that without the BMA, rather than with it, since it will be out on strike while we are getting on with governing.
Dame Siobhain McDonagh (Mitcham and Morden) (Lab)
At 2 pm today, many Members of this House will be attending the funeral of our dear friend Phil Woolas, the Member for Oldham East and Saddleworth from 1997 to 2010, who passed away from a glioblastoma brain tumour on 14 March. I am sure that everybody would wish to send their condolences to his widow Tracey, sons Josh and Jed, and his mother and brother, but does the Secretary of State agree with me that condolences are no longer enough, given that there has been no improvement in treatment for the condition in 40 years?
Wes Streeting
Absolutely. I join my hon. Friend in paying tribute to Phil Woolas, who was an outstanding Member of this House and is dearly missed. I know the whole House will join her in sending condolences to Tracey, Josh and Jed, and their thoughts will be with them today. I am pleased to report that the National Institute for Health and Care Research brain tumour research consortium, backed by over £25 million-worth of investment, aims to unlock new treatments and transform outcomes. Earlier this year, we announced £3 million, with Cancer Research UK, for the brain tumour centre of excellence, including the glioma centre of excellence. Only recently, I was at Edinburgh University looking at progress there. It feels like we could be close to major breakthroughs, but she is absolutely right to hold NIHR and NHS England’s feet to the fire on this issue, and I will continue to join her in that.
Alison Bennett (Mid Sussex) (LD)
Cerys was just 22 when she took her life while an in-patient at Park House in Greater Manchester. The coroner described the unit as “a shambles”. Cerys’s was just one of a number of deaths at the unit. There is a national pattern of mental health trusts failing to learn and act when tragedy occurs. Although reports on preventing future deaths are issued, there is no mechanism to ensure that their recommendations are acted on. How can accountability be strengthened?
Wendy Chamberlain (North East Fife) (LD)
Twenty-two people a day are diagnosed with lobular breast cancer, including my colleague Councillor Fiona Corps in North East Fife, but many more are living with it, because researchers and clinicians know so little about it. In advance of vigils next week, can we ensure funding for the Moon Shot Project, to give these women hope?
Wes Streeting
We strongly support the aims of the Moon Shot Project; the challenge has been getting the proposal to a suitable standard for funding. The moment we overcome that obstacle, the money will be there.
Ian Lavery (Blyth and Ashington) (Lab)
The infected blood inquiry recommended action to protect the safety of haemophilia care, but there is mounting concern among clinicians and patients alike that recommendation 9 is not being implemented. Will the Minister meet me and members of the all-party parliamentary group on haemophilia and contaminated blood to discuss these real concerns?
Bob Blackman (Harrow East) (Con)
It is welcome news that NHS England has reduced the faecal immunochemical test threshold from 120 micrograms to 80 micrograms, bringing England into line with Scotland and Wales. We now need investment in endoscopy and other related treatments to ensure that people suffering from bowel cancer are spotted early and given the ultimate chance of survival. Could Ministers look at further investment here to increase survival rates?
Wes Streeting
Yes; as part of our national cancer plan, we absolutely want to see survival rates improve in the way the hon. Gentleman describes. I welcome the new Minister working on this—the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson)—to her place, and thank my hon. Friend the Member for West Lancashire (Ashley Dalton) for all her leadership in this area, too.
Daniel Francis (Bexleyheath and Crayford) (Lab)
My constituent Harley Harris is 15. He has spondylocarpotarsal synostosis syndrome, which has caused his spine to curve 120° and damaged his lungs, leaving him with significantly reduced lung function and in continual pain. Harley needs lifesaving surgery, but his family have been unable to get a referral to have it performed in the UK. Will the Minister commit to urgently reviewing Harley’s case to ascertain what support can be provided to him and his family?
Ben Coleman (Chelsea and Fulham) (Lab)
Will the Secretary of State join me in welcoming the success of sickle cell bypass units in north-west London and across the country in reducing pressure on emergency departments, while improving care for sickle cell patients, who have historically been overlooked? Does my right hon. Friend recognise that the future of these units is threatened, and will he meet me to discuss the need for ongoing central funding, so that these vital and efficient services are not lost?
Wes Streeting
I congratulate the units on their work. I appreciate concerns about sickle cell services, which we must maintain. I am aware of some of the other challenges we have had to address in London, where we have got to a good place. It is so important that we work together—that Labour’s investment and modernisation works alongside NHS leaders and those promoting public health—and work with great Labour councils, like my hon. Friend’s.
Resident Doctors: Industrial Action
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 will make a statement on the proposed industrial action by resident doctors.
Yesterday evening, the British Medical Association called its latest round of strikes for 7 to 13 April, immediately following the long Easter bank holiday weekend. The announcement came just hours after its resident doctors committee rejected an historic deal that would have boosted pay, created jobs, improved career prospects and put money back in the pockets of its members. This was deeply disappointing after months of highly constructive and good-natured talks between the Government and the leadership of the RDC. In that context, the fact that the BMA’s immediate response was to call such extensive strike action, rather than return to the table, speaks volumes about what we are up against.
I will set out how we have reached this regrettable position. Since the start of this year, the Government have been holding extensive and intensive discussions with the BMA resident doctors committee leadership, who engaged in good faith. I have spoken personally to or met with the chair several times, and those engagements were, of course, on top of the near-daily dialogue that his team held with officials from my Department.
Together, we got further than many thought possible. As a result of our discussions, a landmark deal was put formally to the full resident doctors committee on 22 March. Based on our engagement with the BMA officers, we were optimistic that it would be received positively, although I was aware of the officers’ preference that it should be a deal over two years rather than three years, and that they had expected the independent recommendation of the Review Body on Doctors’ and Dentists’ Remuneration—the DDRB—to come out slightly higher than it did. Regrettably, despite the deal having been designed with and supported by the BMA leadership, the committee itself rejected it yesterday.
I will run through what the RDC has unilaterally rejected on behalf of the 81,337 resident doctors in this country. The headlines of the deal are: reform of the pay structure, so resident doctors would benefit from more frequent pay rises at each stage of their training; pay rises over three years baked in, linked to the independent DDRB recommendations, as requested by the BMA; and reimbursement of Royal College exam fees from April this year, which resident doctors currently pay out of pocket. They can be as much as £2,200 for psychiatry, £2,300 for paediatrics and £3,700 for ophthalmology. Other headlines are: contract reform for locally employed doctors to ensure they also benefit from greater job security, equal opportunities for pay progression, and improved terms and conditions; and up to 4,500 more specialty training places created over the next three years, including 1,000 for this year’s applicants.
Alongside the deal, the Government have just passed the Medical Training (Prioritisation) Act 2026, so that domestically trained resident doctors no longer compete on equal terms with overseas graduates for specialist jobs. The Act will reduce the competition ratio for jobs from almost 4:1 to almost 2:1. The deal also follows the 28.9% pay rise already delivered by the Government.
As a result of the proposed package, resident doctors would have seen an average pay rise of 4.9% this year; starting pay for new graduates entering the profession this year would have been nearly £12,000 higher than four years ago; the lowest-paid foundation year ones and foundation year twos would have seen a pay boost of at least 6.2% and 7.1%, respectively, this year; and there would have been 1,000 more resident doctor jobs in a matter of days from this April.
Along with pay decisions that I have already taken, the package would have meant that, this year alone, resident doctors would have been, on average, 35.2% better off than four years ago. There are not many, if any, professions in our country for which that is true. The DDRB recommendation is 3.5%, which is significantly less than what is on offer as a result of pay structure reform.
The BMA has pointed to the war in Iran as reason to reject the deal. I will spell out the consequences of what this country is facing. The Government want to see de-escalation and a swift resolution to the conflict, with a negotiated agreement that puts tough conditions on Iran, specifically in relation to its nuclear ambitions. However, we are planning on the basis of a prolonged conflict, because that is the prudent thing to do. In that eventuality, there would be an impact on the economy and on the public finances. Were that to happen, a future offer to resident doctors would not look better than what is on offer today.
The Government’s tolerance for costly and disruptive action that undermines a critical public service is fast diminishing. In three years’ time, I do not want resident doctors to look back on this moment with regret as they turn down three years of guaranteed pay rises, more money in their pockets through reimbursement of exam fees, and more jobs. The BMA is choosing more strikes. As a direct result of its decision, and despite our best efforts, resident doctors will be worse off. Indeed, on the very day that 1,000 more specialty training places would have opened up for resident doctors with this deal, the BMA will be on strike, demanding more job opportunities.
Let me turn to the impact on patients and the NHS. Yesterday, the British social attitudes survey revealed that patient satisfaction has increased for the first time since before the covid pandemic. Dissatisfaction has seen the sharpest decline since 1998. Patient satisfaction with access to GPs has gone from 60% when this Government came to office to more than 75% today. Wating lists are the lowest they have been for three years, four-hour performance in A&E is the best for four years, and ambulances are arriving faster than they have for half a decade. All of this has been achieved despite the BMA’s strikes, so I want to reassure patients that the NHS’s recovery will continue.
In the most recent round of strikes, the NHS team pulled together and delivered 95% of planned elective activity. I am confident that we will see the same outstanding efforts if further action is taken. But to the BMA, I say: we can achieve so much more, and the improvements can be so much faster, if you take this deal and stop your strikes. Strikes have a significant financial cost. Every penny spent on keeping the show on the road during strikes is a penny that cannot be spent on improving staff pay and working conditions or better care for patients. The impact on the other staff working in the NHS, who are left to pick up the pieces, is severely felt.
So I am asking the BMA’s resident doctors committee to reconsider. I will meet again with its officers. I also repeat my offer to meet with the entire committee, who have thus far refused to meet me since I became Secretary of State. Indeed, they are the only group of people I have offered to meet who have declined, which I find extraordinary in these circumstances. The deal on the table shows what we can achieve when we work together. In contrast to my predecessors, I have shown good intent from the outset. I have listened to the complaints that resident doctors have about their working lives—I agree with them, and I want to work with them to improve their working conditions as we improve the NHS.
But when it comes to making a deal, the reality is that it takes two to tango. The BMA has until next Thursday to reconsider before we have to call time on the extra jobs, and the focus of the NHS and my Department turns to minimising the disruption from this unnecessary and unwarranted strike action, which would also consume the money set aside for this deal. But there will be a cost to the NHS, to staff and to patients. This was an historic opportunity, developed in tandem with the BMA leadership. I urge the committee to reconsider. I urge the BMA to call off its industrial action. I commend this statement to the House.
Madam Deputy Speaker (Caroline Nokes)
I call the shadow Secretary of State.
Stuart Andrew (Daventry) (Con)
I am grateful to the Secretary of State for advance sight of his statement. Only yesterday he was boasting about progress in the NHS. Today we are back here again, facing more strikes, more disruption and more uncertainty for patients—quite the contrast. In opposition, he made resolving these strikes sound straightforward: “Just get around the table. Just negotiate. Just sort it out.” He repeatedly stated that the power to stop the strikes lay in the Government’s hands. Well, the power is now in his hands. He has had every opportunity to prove it, and yet here we are again. Not so easy after all, is it?
The Government came into office promising to end these disputes. Instead, they have conceded heavily on pay, at enormous cost, and still failed to make it work. The Secretary of State says a comprehensive deal was on the table, developed with the BMA leadership. Despite that, we still face further strikes, so what exactly has this strategy achieved? After all the concessions, all the cost and all the disruption, there is still no resolution. If, as he says, the BMA leadership helped to shape the deal, why did it not secure the support of the wider committee? This morning, the chair of the BMA’s resident doctors committee said that all the Secretary of State needs to do to avoid these strikes is come back with a better offer. That was the Secretary of State’s argument in opposition, too. He has now had every opportunity to test that theory in government, and it has not worked, just as we warned.
There is also an irony here that will not be lost on the public. The BMA says that a 3.5% pay rise for doctors is a “crushing blow”, yet it is offering its own staff just 2.75%. While it demands more from the taxpayer, it will not even meet its own standard for fairness. The inconsistency is obvious and hypocritical.
The Government’s own position on affordability no longer seems to add up. In October, Ministers were clear that anything above 2.5% would have consequences for wider NHS commitments. They said that every additional 0.5% would cost around £750 million, yet we are now beyond what they previously said was affordable, so what has changed? Were those warnings overstated, or are other parts of the health budget now going to pay the price? The Secretary of State even pointed to global events as a reason for future constraints. That is a long way from “just negotiate and sort it out”. After repealing minimum service levels, the Government cannot now be surprised that patients are once again exposed to greater disruption.
Labour promised to end the strikes. It paid a very high price, and it still did not get the result. Ultimately, it is patients who are caught in the middle of all this, but it is unfair on others in the NHS, too. Consultants are left picking up the pieces yet again. Other doctors and NHS staff are expected to carry the burden and keep services running—they do not get to walk away. That is not sustainable, and it is not fair.
The Secretary of State says he may now have to call time on the extra jobs he announced. Were those jobs ever truly secured, or were they always conditional on the BMA accepting the deal in full? When he says that strike action will consume the money set aside for this deal, is he not really admitting that his own approach has ended up burning through the very resources he said would improve pay, jobs and conditions? What is the cost of this latest round of strikes expected to be, and where will that money now come from? What assessment has he made of the impact on patient safety, consultant morale and the training progression of junior doctors? What is his plan to end this dispute, rather than simply manage the next round of disruption?
Patients need certainty. The NHS needs stability. That is why we have been clear that doctors should not be allowed to strike and that minimum service levels must be restored to protect patient safety.
Wes Streeting
I thank the shadow Secretary of State for his response and questions. Beneath some of the criticism of the Government was a consistent message about the unreasonable and unnecessary position of the BMA, but let me address his criticism none the less.
The shadow Secretary of State accused me of “boasting” yesterday about the progress this Government are making on the NHS. For once, I cannot say we are following the pattern of our predecessors, because of course, they did not make any progress. From the moment they entered government, we saw the NHS begin to slide in the worst direction, to the extent that we went into a modern health emergency—the pandemic—woefully underprepared, leaving our country more damaged as a result. I am proud of the progress we are making. We know that what we have seen in terms of results and patient satisfaction are grounds for optimism, not cause for complacency. What we are trying to do as a Government is absolutely essential for the country, to give it back an NHS that is there for people where they need it, when they need it. That is why the BMA’s position is both disappointing and self-defeating for all of us.
The shadow Secretary of State talked about the approach I took in opposition. There is a difference between the approach that this Government have taken and the approach of our Conservative predecessors. We have always been prepared to get around the table; we never close the door. As I said from the other side of the House, the power to end strikes does sit with the Government when they are willing to compromise, willing to negotiate and willing to treat the workforce with respect. That is what this Government have done, in contrast to our Conservative predecessors, which is why it is so disappointing that with a deal available—a good deal—the BMA is turning away.
The BMA should reflect not just on the contrast with the past, but on the contrast with the future. There is no more pro-NHS, pro-doctor Health Secretary or Government waiting in the wings. I am not even sure that the alternative is a Conservative Health Secretary; that person may well come from Reform UK—the party whose Members occasionally turn up and sit in the corner, when they can be bothered and when they are not flouncing out in a hissy fit. Catch them on a good day and Reform Members may even say the quiet bit out loud: they do not believe in the NHS. They do not believe in it as a public service free at the point of use, and they are certainly not going to treat the BMA or resident doctors with more respect or generosity than a Labour Government. I think the BMA needs to reflect on that.
The shadow Secretary of State asked about affordability. One of the great things about the deal that we agreed is that it is affordable because it involves productivity gains—not just the productivity gains that we have already achieved in the NHS, the target being 2% and the reality that we have achieved 2.7%, but the productivity gains built into the pay structure reform.
The shadow Secretary of State asked about the jobs. I will be honest, and I am sure NHS chief executives will want to say more about this. The fact is that I and Jim Mackey have had to do a considerable degree of persuading and arm-twisting to persuade NHS trusts to create additional specialty training places, because they have not been convinced of their necessity or utility. Part of their reservation has been about the conduct of resident doctors and the BMA. I have had a hard job to do to sell that. Those jobs will not materialise if the BMA rejects this deal, I am afraid. There is a not a “something for nothing” culture here.
I say to the crab people who still believe that they are pursuing a really effective “bank and build” strategy that they should look at what they are confronting now, and look their members and their colleagues in their eye. This is not bank and build any longer; this is a high-and-dry strategy, and it is not going to work. That is why it is important that we end this dispute and that we do it together, in the spirit of partnership. There is still time to do that—there is still a week. The door is not closed; the offer is still there, and I urge them to take it before it goes.
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
I share the frustrations of Ministers and of the Government. I know that they have worked really hard on this. Dr Fletcher of the BMA has also worked hard, and I am sure that there is a deal to be done somewhere. The Medical Training (Prioritisation) Act 2026, to prioritise UK graduates, was very welcome, but I wonder whether we can also do something to fix the foundations of medical careers, by devising a much better system than the crazy foundation lottery that sends a doctor from Norwich to Belfast and a doctor from Belfast to Norwich. That would be a great expression of good will. Meanwhile, I am sure that my colleagues in the NHS will work around this strike—our patients will be safe—and I am sure that our NHS will continue to improve under this brilliant Labour Government.
Wes Streeting
I thank my hon. Friend for his support in trying to influence a more constructive approach, for the advice that he has given me and members of the resident doctors committee, and for the experience that he brings to these exchanges. He is right to praise Jack Fletcher for the constructive approach that he and his officers have taken. It has not been easy, but I know that officials have enjoyed the constructive engagement, and I thank enormously the officials who have worked tirelessly on this. I think all those involved in the discussions, on both sides of the table, are disappointed by the outcome, and that is why I urge the BMA to seize the offer before it is too late.
My hon. Friend talks about other changes, such as to placements and rotations. I think that BMA officers recognise my desire to not only do this deal, but to create a new business as usual with the BMA, where we have people around the table on a regular basis looking at what we can do to improve the health service for patients and staff and to make real progress on those issues. We cannot do that if we are in conflict. That is the tragedy of the position we find ourselves in. I think we have built trust through engagement and dialogue with the BMA committee officers. It is only disappointing that members of the committee are not prepared to get around the same table as me, because if they did, they might realise the sincerity and the opportunity.
Madam Deputy Speaker (Caroline Nokes)
I call the Liberal Democrat spokesperson.
Helen Morgan (North Shropshire) (LD)
People across the country will be extremely concerned about the prospect of further strikes, having faced so much disruption already in recent years. It is important to recognise that the strike is a symptom of an NHS still coming to terms with the damage caused by the previous Conservative Government. Doctors are burnt out from working in high-pressure environments under poor conditions—often trying to save lives on corridors with no space or privacy. However, we all know how difficult public finances are, and that is now being compounded by Donald Trump’s reckless war in the middle east. Therefore, a further 26% pay rise is not affordable or realistic at the moment, and it is time the BMA recognised that.
There is much more the Government could be doing to support both staff and patients. The BMA has a mandate to strike until August, yet patients struggle to get GP appointments and suffer months of pain while stuck on waiting lists. How will the Secretary of State stop the situation dragging on throughout the year and causing yet more harm to patients?
We must also show staff and patients that things will get better. Lib Dem plans to recruit and retain more GPs, offer one-to-one midwife care and fix the social care crisis would offer the NHS the hope that is needed by easing pressure on staff and patients. Will the Secretary of State consider fixing crumbling hospitals as a priority, to give staff and patients the working conditions and dignity that they need and deserve?
At Shropshire’s major hospitals, it is common to see ambulances queuing up outside, unable to offload their patients, while staff inside are struggling to cope with patients in corridors. Will the Secretary of State commit to ending the misery of corridor care by the end of this Parliament? I welcome his intention to build additional training places, but will he outline a timetable for publication of the workforce plan, because that is critical for the future of our NHS?
Wes Streeting
I thank the Liberal Democrats for their support. I really hope that resident doctors appreciate that this is a party with a spokesperson who supports the NHS and wants to see it improving, but, even from the vantage point of opposition, is clear that what the BMA is demanding is unaffordable. We know from experience that it is easier to make promises in opposition than to have to deliver them in government, so when an Opposition party is also saying that the demands are unaffordable, resident doctors should accept that. [Interruption.] Thank you for the noises off from the Conservative Front Bench.
I reassure the Liberal Democrats that we are committed to ending corridor care by the end of the Parliament. I am really impressed by some of the progress that we have seen recently in some hospitals: Queen’s hospital in Romford has shown it can be done and other hospitals are showing real progress. We are determined to put the foot down on the accelerator. We will absolutely see capital investment to improve the NHS estate. We have 2,000 more GPs now than when we came into office—the highest number of GPs on record, in fact—although there is more to do.
Let me give this commitment to the “Agenda for Change” workforce. So much of the oxygen and airtime has been consumed by doctors, but 1.5 million people work in the NHS, many of whom will never be paid as much as the lowest paid doctor. They have been overlooked for too long, and we are determined, through the negotiations and discussions that we are having with “Agenda for Change” unions, to put that right. That will be my focus for the future of the workforce.
Laurence Turner (Birmingham Northfield) (Lab)
I declare an interest as chair of the GMB’s parliamentary group. The week after next, there will be another strike, when GMB members of the BMA’s own staff go out on industrial action, as has already been referenced. Their employer’s offer is 2.75%, which is lower than the 3.5% for doctors that the BMA called a “crushing blow”. Does the Health Secretary agree with the GMB union when it says:
“These strikes have laid bare the BMA’s ongoing hypocrisy”?
Wes Streeting
It is frankly breathtaking hypocrisy. It rather looks like doctors in their ivory tower saying one thing, and lecturing us about what is and is not affordable, but when it comes to how their subs are spent and how their own union behaves towards its own staff, not being prepared to pay them. I have been very complimentary about the officers who have been engaged with Ministers and my officials in recent weeks to try to get this deal over the line; so have BMA staff. I am stunned by the BMA’s unwillingness to practise what it preaches. I will not be joining resident doctors on the picket line. I should have declared, Madam Deputy Speaker, that I am GMB member, so if there is one picket line that I will be visiting during the doctors’ strikes, it may well be that one.
Madam Deputy Speaker (Caroline Nokes)
I call the Chair of the Health and Social Care Committee.
Layla Moran (Oxford West and Abingdon) (LD)
This is clearly the wrong move again. It is really stark; we keep hearing from patients across the country about how much they want the NHS to improve, but this is another blow to them, and they may even wonder if it is safe to go into their local hospital during the strike period.
I am grateful to the Secretary of State for coming to the Committee and talking about corridor care. The really interesting thing about that session was that the hospitals that have turned things around did so because of leadership from the top. Their executives and board members were going into hospitals out of hours and on weekends to speak with resident doctors, nurses and patients, to see what things were like on the ground. When was the last time the Secretary of State did that? This is not a “gotcha” moment—I have not done that recently, but I want to. If we are to lead a change in culture in the NHS, we should all show how we would do it, and should urge board members and executives to do the same, in every hospital across the country.
Wes Streeting
The Chair of the Health and Social Care Committee is absolutely spot on. I am relieved to report that I was doing exactly what she mentions only last Friday; I was walking the corridors of Queen’s hospital in Romford. I was there in January as well, seeing the worst of the situation. I have been spending time on the frontline in the places that were under the most pressure, just as I did last winter. I went along, not to look down my nose at people, but to listen, and to see at first hand what was happening, why it was happening, and what we need to do differently. The team at Queen’s hospital can really take pride in what they have achieved, but we have to sustain that progress. Last week, there were no trollies on the corridor, and in February they saved 10,000 corridor hours. That is thanks to brilliant frontline staff and senior clinical leadership on the front door, and we will see that again during strikes.
There is a certain irony about the fact that during resident doctors’ strikes, urgent and emergency care improves, because we have more experienced, senior clinical decision makers in urgent and emergency care. There is something to learn from that. I do not say that to denigrate resident doctors for a moment—they are learning and building their experience, and we do not want to lose that—but we are seeing that improvements can be made, and have to be made everywhere. We have to see this as a priority, because corridor care can never be the safest care, and it is never dignified care.
Sir Julian Lewis (New Forest East) (Con)
One thing we have not yet heard is the Secretary of State’s assessment of the motivation of the BMA committee members who are so militantly rejecting a deal that he evidently regards as generous. As he says, they are refusing even to sit down and talk with him. What is behind that? Why are they behaving in what appears to be an unreasonable and extreme way? To what extent does he think they represent resident doctors?
Wes Streeting
If the committee had ever taken me up on my offer to meet the entire committee, I might be able to answer the question, but since it has never done so, I do not know. It is for resident doctors to decide, based on what I have set out, if the committee’s rejection of this offer is reasonable.
Given the material benefits that the offer would bring to resident doctors in a matter of days—an additional 1,000 jobs and significant pay uplifts—and what that would mean for the next few years, I have to be clear that this is our best and final offer. We cannot go any further. If I may say so, we are at a point where the public would judge that we have gone as far as we can; I think quite a lot of people in the country who are watching would say that we have gone further than we should. I do not take that lightly. Resident doctors should not look a gift horse in the mouth, and I hope that they will make those representations to their committee.
David Reed (Exmouth and Exeter East) (Con)
I thank the Secretary of State for his robust view and position on the BMA. In reference to what was said by the Liberal Democrat spokesperson, the hon. Member for North Shropshire (Helen Morgan), on the inflationary pressures that we will feel as a result of the conflicts in the middle east, do the figures for the three-year deal use the inflationary projections from the Office for Budget Responsibility and the Bank of England? If not, given that this is all about pay, and that the BMA will always come back for more—I think it is being unreasonable at the moment—does the Secretary of State agree that we need new rules around minimum service levels if we want to have a reliable NHS in this new world?
Wes Streeting
Pay structure reform and future pay are linked to the DDRB, which is an independent pay review body; its recommendations are one of the things that the BMA wanted the deal to be shaped around. The Government’s position on minimum service levels has been clear.
The hon. Gentleman sets out an alternative position from the Conservative party. I think the BMA should look at that, and judge whether it would be better to do a deal with this Government and move forward constructively. Does it honestly think that if it hampers NHS progress, and goes on endless strikes over the coming years, it will have a better Government to work with at the end of this? I do not think so.
I ought to say one final thing, which we should take really seriously. I have been thinking about this issue in the context of the covid inquiry report, and where we are in terms of threats to this country, the war in Iran, and the war in Ukraine. This country was more exposed during the pandemic than it might have been if the NHS had been in better shape. This country faces some serious threats in the world, and the NHS is not in good enough shape. In that context, we have to start thinking about whether the actions of the BMA are tolerable.
Review Body on Doctors and Dentists Remuneration: Pay Recommendation
Wes Streeting Excerpts(3 weeks, 3 days ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
I hugely appreciate the incredible work of talented staff across our NHS. That is why I am formally accepting the headline pay recommendation from the Review Body on Doctors and Dentists Remuneration to give them a well-deserved pay rise. This means:
Over 165,000 doctors working in hospital and community health sector will receive a 3.5% pay rise.
For GPs and other general practice staff there will be a 3.5% increase to the pay elements of the GP contract.
Increased funding for the additional roles reimbursement scheme will also be provided to facilitate uplifts for staff in line with DDRB and NHSPRB recommendations.
For dentists there will be a 3.75% increase to the pay elements of the NHS dental contract.
Community dental service dentists, who are salaried, will also receive a 3.75% pay rise.
We are working closely with payroll systems to ensure pay uplifts will be implemented as soon as possible.
These awards are above forecast inflation over the 2026-27 pay year, meaning that the Government are delivering a real-terms pay rise, on top of those in preceding years, underlining the extent to which we value our doctors and dentists. We are in the process of concluding business planning across DHSC and its arm’s length bodies and that will take the DDRB recommendations into account. The existing challenging, productivity and efficiency commitments required by ICBs and providers to deliver break-even positions are the foundations of the Government’s ability to agree this within the existing settlement. This additional pressure above the Government’s affordability position set out in its evidence to the DDRB will be managed by DHSC and ALBs (including NHS England central budgets) so the DDRB increases will not be paid for by cutting frontline services.
I am grateful to the chair and members of the DDRB for their thoughtful consideration of the evidence presented to them; their report recognises the vital contribution that NHS staff make to our country. DDRB have examined the economic picture, and evidence on recruitment, retention, motivation and morale to reach their recommendations.
The DDRB made a further two recommendations, which are not directly related to headline pay, targeted at specific parts of the remit group. I am grateful for these recommendations. However, we need further time to carefully consider these, working with our partners to determine the best way forward. To avoid delays to pay uplifts reaching NHS staff, we will respond separately to these recommendations in due course.
We will continue to implement commitments to improve the support NHS staff receive and their experience at work. Ensuring the NHS is a great place to work is fundamental to improving the patient experience: from reducing the backlog in elective care, to ensuring timely access to GP appointments.
Next Steps
We have listened to the workforce and understand the difficulties they face when pay awards are not delivered on time. Last year, this Government committed to speeding up the pay review process, remitting the pay review bodies months earlier than in previous years, and also submitting written evidence earlier. I am pleased to be announcing the pay awards earlier than the previous year, which means that doctors and dentists will see pay in their pay packets closer to April. We will continue work across Government to keep bringing forward the pay round for all public sector staff.
The DDRB report will be presented to Parliament and published on gov.uk. I will update the House at the earliest opportunity on ongoing negotiations with the BMA Resident Doctors Committee.
[HCWS1462]
Meningococcal Disease Outbreak
Wes Streeting Excerpts(3 weeks, 5 days ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
I am updating the House on the ongoing outbreak of invasive meningococcal disease in Kent. My heartfelt condolences go to the families of the two young people who have sadly died, and my sympathies are with all those who remain in hospital. This is a distressing time for many.
I would like to pay tribute to frontline staff in Kent, across the NHS and in the UK Health Security Agency for their rapid and professional response to this unprecedented outbreak. While individual cases of meningococcal group B disease are not uncommon, an outbreak of this scale is highly unusual, which is why additional measures are being taken.
As of 5 pm on 22 March, a total of 29 cases of invasive meningococcal disease have been identified, comprising 20 confirmed and nine probable cases. Of the confirmed cases, 19 have been confirmed as being meningococcal group B—or MenB—and one is awaiting serogrouping. Some cases might be confirmed or downgraded in the coming days. UKHSA is reviewing the relevant results with hospital clinicians and is communicating with patients.
The outbreak remains geographically localised and the risk to the wider population continues to be low. All cases to date have links to Canterbury. Sixteen cases—confirmed and probable—are higher education students, including 13 from the University of Kent and two from Canterbury Christchurch University. Three confirmed cases are associated with three secondary schools in Kent. Twenty-two cases are known to have attended Club Chemistry in Canterbury, which remains closed. UKHSA continues active contact tracing to identify individuals at increased risk.
From the outset, local NHS teams and national public health experts have been working closely with businesses, universities, schools and colleges to protect students, families and the wider community. Clear advice on symptoms and when to seek medical attention has been provided, and frontline clinicians have been alerted to ensure early recognition of cases.
A single course of antibiotics is highly effective at reducing transmission. Immediately after the outbreak was identified, UKHSA deployed 50,000 doses of stockpiled antibiotics to the local area to ensure rapid access for those at highest risk. As of 5 pm on 22 March, 12,837 doses of antibiotics had been administered.
Although preventive antibiotics remain the primary tool to control the outbreak, targeted meningitis B vaccination has also been introduced to provide longer-term protection for students and young people in the area. Vaccination is being offered to all those who have received preventive antibiotics, and to years 12 and 13 students in schools and colleges in Kent where confirmed or probable cases have been identified. Further use in other age groups or settings may be recommended following individualised risk assessments with affected settings.
Anyone who visited Club Chemistry in Canterbury between 5 and 15 March has been offered a vaccine and antibiotics as a precaution, after a suspected case revisited the venue shortly before it closed voluntarily. This extension ensures that those most likely to have been exposed are provided with protection as early as possible. Details of vaccination sites are available on the NHS Kent and Medway integrated care system website.
As of 5 pm on 22 March, 9,611 vaccinations had been administered to those at highest risk. I strongly encourage all eligible individuals to take up this offer.
Recognising the anxiety felt by many parents and young people, 20,000 doses of the vaccine have been released to the private market by GSK to ease the pressure on local pharmacy supplies.
Routine vaccination programmes, including the UK’s infant meningitis B programme, are determined by the Joint Committee on Vaccines and Immunisations, which assesses evidence on clinical effectiveness, cost-effectiveness, safety and population impact. As I told the House on 17 March, in the context of the current meningococcal disease outbreak, I have asked the JCVI to re-examine eligibility for meningitis vaccines to assess, for example, an expanded offer to older children and/or young adults. The JCVI will provide updated advice to the Department on whether, and to what extent, a vaccine programme for older children and/or young adults would be clinically effective as well as an assessment of the cost-effectiveness of such a vaccination programme.
UKHSA continues to support education settings, working closely with the Department for Education. All affected education settings remain open. Children and young people should attend their education setting normally, unless specifically told otherwise by a health professional. Attendance supports the education, health and wellbeing of children and young people.
As part of the investigation, UKHSA laboratories have completed initial genetic analysis of a meningococcal strain isolated during this outbreak. Results confirm that the Bexsero vaccine currently being offered should provide protection. The strain belongs to a group of bacteria known as group B meningococci, sequence type 485 belonging to the larger clonal complex ST-41-44. Similar strains have been circulating in the UK for around five years, but further detailed analysis on this strain is occurring with academic experts. UKHSA has published the genome data to support wider national and international research.
Meningococcal disease is a serious illness that can cause meningitis, which is an inflammation of the protective membranes surrounding the brain, and sepsis—blood poisoning.
Symptoms include a rash that does not fade when pressed with a glass, sudden high fever, severe or worsening headache, stiff neck, vomiting or diarrhoea, joint or muscle pain, dislike of bright lights, cold hands and feet, seizures, confusion or delirium, and sleepiness or difficulty waking. The onset can be extremely rapid. Anyone experiencing symptoms should urgently seek medical attention. Early treatment saves lives.
I want to thank everyone who has worked tirelessly to care for those affected and keep people safe. To the UKHSA and other public health officials working to contain the outbreak. The NHS team who stood up a vaccination programme within one day of it being announced, distributed antibiotics, and those caring for young patients in hospital. The school, college and university staff keeping students and parents informed, helping young people through the distress of this outbreak, and keeping their education going. And the thousands of students, pupils, and other members of the public who have so readily and responsibly come forward for antibiotics and vaccination.
[HCWS1434]
Meningitis Outbreak
Wes Streeting Excerpts(1 month ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Wes Streeting)
With your permission, Mr Speaker, I will make a statement on the outbreak of meningococcal disease in Canterbury and east Kent.
My thoughts, and I am sure the thoughts of the entire House, are with the families and friends of the two young people who have sadly died. I cannot begin to understand what they must be going through. This is an unprecedented outbreak. It is also a rapidly developing situation. With these considerations in mind, it is absolutely paramount that we stick to the facts, which is what I intend to do.
This is the current situation: as of 9.30 am today, the UK Health Security Agency has confirmed four cases of group B meningococcal disease, with another 11 cases under investigation. The two deaths are associated with this cluster. The majority of cases link back to the Club Chemistry nightclub over the dates of 5, 6 and 7 March, and their associated networks. Club Chemistry is currently closed voluntarily. Going forward, these figures will be updated publicly by UKHSA each day at 9.30 am.
Let me now turn to the timeline of this outbreak. UKHSA was notified about the first case on Friday 13 March. In line with established protocol, health officials began identifying and tracing the patient’s immediate close contacts, who were offered prophylactic antibiotics as a matter of urgency.
On Saturday, UKHSA was in touch with the University of Kent to ensure it had the necessary support, advice and guidance and to establish where the patient was living. Also on Saturday, the French authorities alerted UKHSA to a second confirmed case in France, from an individual who had attended the University of Kent. Both cases lived in private accommodation and at that stage there was no apparent link between the two.
At 7 pm on Saturday evening, hospitals reported that a number of severely unwell young adults were presenting with symptoms consistent with meningococcal disease. Contact tracing of these individuals began immediately and continued into Sunday morning, 15 March. All those traced were offered precautionary antibiotics. So far, 700 doses have been administered.
Recognising the scale of the potential outbreak, at 10 am on Sunday, UKHSA stood up a full-scale response, including preparations for more widespread distribution of antibiotics on campus. By 5 pm on Sunday those antibiotics were in place and distribution began to students in the two halls of residence where we were aware of cases, and by 6 pm, a public health alert was issued.
It is important that the House, and the wider public, understands that even before the public health alert was issued, students and young people who had been in close contact with suspected cases were being offered antibiotics. This is precisely what one would expect as a rapid response, and I am confident UKHSA acted as quickly and as comprehensively as possible.
In addition to cases involving students at the University of Kent, two cases were identified involving sixth-formers in year 13, one of whom has sadly died. The UKHSA made contact with the headteachers at both schools first thing on Monday morning and has worked closely with the schools to provide information, advice and support, including a letter to parents that was issued the same day. We are working closely with the Department for Education on wider communications to schools across the Kent area, and a briefing with schools has taken place this morning.
The strain associated with this outbreak is meningitis B, known as menB. It is an uncommon but, as we have seen, serious and potentially lethal strain of meningococcal disease. The onset of illness is often sudden, and early diagnosis and treatment with antibiotics are vital. It does not spread very easily. The bacteria are passed to others after a long period of close contact—for example, through living with someone in shared accommodation, through prolonged kissing, or through sharing vapes and drinks. However, the symptoms are easily mistaken for other common conditions, and even for something like a hangover.
Let me set out the current advice from the UKHSA. Anyone who attended Club Chemistry on 5, 6 or 7 March, and anyone who believes that they were in close contact with someone who is confirmed or suspected to have meningitis, should attend a treatment centre and receive antibiotics. There are four centres open in Canterbury today, with 11,000 doses available on site. Details about the location of those centres are available on the UKHSA website and are being promoted by the UKHSA, the NHS, my Department, schools and the university, as well as the BBC, and I encourage all media outlets to do the same. There is no need to book an appointment.
A single course of antibiotics is highly effective in preventing the contraction and spread of this disease in 90% of cases. If you become worried about yourself, your child or a friend, particularly if symptoms are getting worse, please seek medical help urgently. Anyone with symptoms should call NHS 111 or, in an emergency, dial 999 to seek medical attention.
People are understandably asking about a vaccine. From 2015, the menB vaccine has been available on the NHS as part of routine childhood immunisations, but clearly most students will not be vaccinated. Given the severity of the situation, I can confirm to the House that we will begin a targeted vaccination programme for students living in halls of residence at the University of Kent in Canterbury, which will begin in the coming days. The UKHSA will provide further advice on other cohorts in the coming days.
On the question of wider eligibility, we obviously follow the expert independent advice of the Joint Committee on Vaccination and Immunisation. In the light of this latest outbreak, I will ask it to re-examine eligibility for meningitis vaccines. I will do so without prejudicing its decision, because we have to follow the clinical advice on this. I will keep the House updated as the situation unfolds, and I commend this statement to the House.
Wes Streeting
I thank the shadow Secretary of State for his constructive response and support as we respond to this incident, and I welcome the way in which he has rightly brought scrutiny to the response. I should say from the outset that once we are through this, we will obviously look at the handling of the UKHSA’s response at every point, because there are always things that we can learn from and seek to do better.
The balance that needed to be struck in the public communication was to ensure that people were informed in a timely way, but also that, first, we did not spread unnecessary anxiety and concern, and secondly, having been made aware of the risk, there was a channel through which people could receive support. As I set out in the timeline, in response to individual cases, thorough contact tracing was undertaken and antibiotics were offered in cases of direct contact. By 5 pm on Sunday, the antibiotics were more widely available, and public communication went out at 6 pm. The schools were identified over the course of Sunday—that was not a straightforward experience.
The two schools identified, Simon Langton grammar school and Queen Elizabeth’s grammar school in Faversham, were both contacted first thing on Monday. We are also looking at Norton Knatchbull school in Ashford, where there may potentially be another case. We are working closely with those schools and have stood up wider school briefing. We will look carefully at whether we could have done more, and more quickly, to identify those schools and make contact ahead of Monday morning.
The shadow Secretary of State asked about the criteria for educational settings and the wider availability of vaccinations. We are looking at this issue actively with the UKHSA and will make announcements about further cohorts in the coming days. Turning to local NHS capacity, the NHS in the south-east region is supporting the UKHSA, which is the lead agency, in the response to the bacterial meningitis outbreak. Kent and Medway integrated care board has stood up, and is currently operating, a hub at the University of Kent site to deliver prophylaxis to students, and a second site has also been opened. We have obviously made sure that appropriate support is in place for hospitals responding to patients presenting at those hospitals.
The shadow Secretary of State asked about the supply of antibiotics and vaccinations. We are confident that we have the right levels in place to respond, and as we think about potentially widening cohorts, we will obviously make sure that supplies are available in a timely and effective way.
Naushabah Khan (Gillingham and Rainham) (Lab)
I thank the Secretary of State for his statement, and I particularly welcome his announcement that he is reviewing the ongoing use of the vaccine and considering expanding it to a wider cohort. Given that the University of Kent also has campuses in Medway, could he inform me what work he is doing with the university to ensure that the spread across other campuses is monitored on a regular basis, and that if there is any potential for this outbreak to spread further, it is being reviewed regularly?
Wes Streeting
I am grateful to my hon. Friend for her question, which raises an important point—the shadow Secretary of State also raised it—about public health information. There are exams taking place at the University of Kent this week, but many students may have returned home, and indeed there will be some students at the University of Kent in Canterbury who commute in from the surrounding area. We have four sites available on and around the campus: the senate building at the University of Kent, the Gate clinic at Kent and Canterbury hospital on Ethelbert Road in Canterbury, Westgate Hall in Canterbury, and the Carey building at the Thanet community health hub in Broadstairs, which is planned to be open from Tuesday 17 March. We are also making sure that students who have gone home and who may wish to access antibiotics because of risk factors or concern about symptoms are able to contact their GPs and receive support locally.
Alison Bennett (Mid Sussex) (LD)
I thank the Secretary of State for advance sight of the statement. Like other hon. Members who have spoken, first and foremost my thoughts are with the family and friends of the two young people who have lost their lives, and everyone who has been touched by this devastating outbreak. It is understandable that many young people and their families will be feeling anxious. With that in mind, is the Secretary of State confident that this outbreak is contained and has not yet spread beyond those present at the initial event?
It is not unreasonable for young people and their families elsewhere in the country to be wondering whether they should be seeking catch-up vaccines. Young people will not have been protected by the menB vaccine that is available to those born after 2015. Is the Secretary of State confident that there is sufficient stock to deliver protection to all those who need it? As well as talking to the JCVI, will he involve Meningitis Now, which has called for teenagers and young people born prior to 2015 to be vaccinated against meningitis B on the NHS?
Vaccination rates are falling in the UK, including for meningitis. For that reason, all politicians and political parties have a moral duty to support science over conspiracy theories. It is deeply regrettable that certain parties have not been responsible in this respect in recent months, and I and my Liberal Democrat colleagues are worried that these avoidable deaths will become more common should a conspiracy theory narrative persist. We must encourage those communities and healthcare workers who are not currently taking up vaccines to do so. We must build trust, tackle disinformation and encourage people—regardless of where they live—to take up lifesaving vaccines.
Wes Streeting
I thank the Liberal Democrat spokesperson for her response, and I strongly endorse what she said about the importance of vaccination. When it comes to determining which vaccines are available and to which cohort, we follow the advice of the JCVI, but if one good thing can come out of this awful situation, I hope it is general public awareness of the importance of taking up vaccinations where they are available. They remain one of the best public health tools available to us.
On the one hand, it is a very good thing that few people alive in this country today remember the dark days when this country did not have a national health service and did not have vaccination available for common treatments. It is wonderful that we now live in a country where the memories of some of those everyday conditions being widespread killers are distant, but there is also a real risk of a return to those Victorian conditions, because of the misinformation and irresponsible anti-science political positioning that we see in certain corners of even this House. I hope that politicians in particular will think carefully and responsibly about our shared duty to the public in helping people be protected.
On the specific concerns that the Liberal Democrat spokesperson raised, the public health risk to the wider population remains low, but we are actively contact tracing and offering antibiotic prophylaxis to those in close contact with cases. The antibiotics are one course, and they are effective in 90% of cases. I once again emphasise to those watching that if you or someone you know develops symptoms of meningitis or septicaemia, you should seek medical help urgently by calling 111 or 999, particularly if symptoms deteriorate. If you are one of those students at the University of Kent who may have left campus and would otherwise have been visiting one of those four sites, we are making arrangements for you to be able to see your GP and receive the antibiotics there.
Sojan Joseph (Ashford) (Lab)
I thank the Secretary of State for his statement. I pay tribute to all the health leaders in Kent and the school leaders for their calm and quick actions yesterday and over the weekend. I was able to get a briefing from UKHSA yesterday morning and also was able to visit my local hospital, the William Harvey, which has made immediate changes to accident and emergency to take care of those patients who are turning up. There is much speculation on social media and in local newspapers that vape sharing might be the reason behind this outbreak. I am not asking the Secretary of State to comment on that speculation, but can he reinforce the public health message? Can he offer advice to young people and parents in the Kent area on precautions they should be following at this time?
Wes Streeting
I thank my hon. Friend for his support for the local health system and for engaging so actively with my Department and the UKHSA team in response to this incident. He is absolutely right to press on public advice. It might be helpful to be clear that transmission requires close and prolonged contact, such as someone living in the same household or intimate contact such as kissing or the sharing of vapes or drinks. It is those sorts of things where the risk of spread exists. This disease is not like some of the other respiratory conditions that we have seen recently. It is important that people understand how it is spread, because they may find that reassuring. A range of symptoms can present, including a rash that does not fade when pressed with a glass, the sudden onset of high fever, a severe and worsening headache, stiff neck, vomiting and diarrhoea, joint and muscle pain, dislike of bright lights, very cold hands and feet, seizures, confusion or delirium, and extreme sleepiness or difficulty waking. Those symptoms can also apply to a wide range of other conditions. As ever, if in doubt, the best thing to do is to seek medical advice, whether that is calling 111, or in an emergency dialling 999, or seeing your GP. I urge everyone to share the public health information that is disseminating online, so that we can spread facts rather than misinformation.
Layla Moran (Oxford West and Abingdon) (LD)
I share my condolences with those families and communities affected by this outbreak. I cannot begin, as the Secretary of State said, to imagine what they must be thinking and feeling during this time. I also thank those staff who have been involved in the response. I echo the Secretary of State’s hope that from this tragedy will come greater public awareness, but may I add that there should be an increased laser-like focus on vaccination and immunisation from the highest levels of Government? He may be aware that the Select Committee did a one-off inquiry into vaccination and immunisation. I have to be honest with him: our letter to the Department is one of the strongest we have ever sent. We have deep concerns. We use words such as “complacent”, although I do not think that applies to this specific case. I believe that UKHSA has taken this matter incredibly seriously and the mobilisation has happened, although that is despite, not because of, the level of underlying resilience in the system. Will the Secretary of State undertake to look at what we have sent him and his Department? Will he undertake to lead the response himself, not just on this incident but on all vaccination trends in this country from now on?
Wes Streeting
May I first welcome what the Chair of the Select Committee has said about the response to this incident? She is right to press more broadly on vaccination. The winter campaign that we have just run was more successful than last winter’s, but on her point about complacency, I would be the first to say that even with that improvement, we are still not doing well enough as a country on vaccination rates. I am particularly concerned about childhood vaccination. I can give her the assurance that I and our new public health Minister, my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson)—I welcome her to the Front Bench—will look at that issue carefully. We take it seriously, and we will reply directly to the Committee with actions and with the seriousness that the letter warrants. To reassure the Chair of the Select Committee, I am already talking to my right hon. Friend the Secretary of State for Education about what more the Department for Education, the NHS and the Department of Health and Social Care can do together to ensure that we improve childhood immunisation as well as wider vaccine uptake across the population.
Kevin McKenna (Sittingbourne and Sheppey) (Lab)
My heart also goes out to everyone affected by this terrible and unfolding tragedy. I think particularly of my constituents in Sittingbourne and Sheppey, many of whom are students who attend the universities in Canterbury or who go to school in Faversham. Many are staff there, too. It will be particularly hard on my constituent, Sue, whose son died of meningitis a few years ago. She has been tirelessly campaigning for a change in the law on the duty of care for people in those situations. Matthew would be alive today if action had been taken swiftly enough by the people who were with him. What more can we do to ensure that everyone on the ground across Kent and more widely knows what to do if they see the signs and symptoms of meningitis?
Wes Streeting
My hon. Friend raises such an important point. Let me, through him, convey my thoughts and condolences to Matthew’s family and, via them, to so many families across the country for whom the news headlines will be particularly painful, because they have lived through and are still living with grief and loss as a result of this devastating disease and the loss it can bring about. My hon. Friend is absolutely right that we need to ensure not only that there is wider public understanding of the signs and the symptoms, but that we are not complacent about that within the health system. Sometimes, in busy A&E departments, GP practices or pharmacies, things can get missed. It is important that we that we pick those concerns up and act quickly. I know that there are views on vaccination and the need for more widespread vaccination. I have asked the JCVI to look at that, but we will follow the scientific evidence.
Helen Whately (Faversham and Mid Kent) (Con)
I thank the Secretary of State for his statement, and for his communications with me.
Juliette was a schoolgirl in year 13 at Queen Elizabeth grammar school in my constituency. She died of meningitis this weekend. Her headteacher said of her:
“She was incredibly kind, thoughtful and intelligent”,
and that she had been “treasured”. I too am a parent of a year 13 student and my heart goes out to Juliette’s family, and also to the family of the university student who has died.
Sixth-formers and university students mix in the same crowded venues in Canterbury, so the Government must fully consider the risk to schoolkids as well as the students in the universities. I am grateful to the NHS and the UKHSA for the action that they have already been taking locally, but many parents feel that they are not receiving enough information, and schools have also found themselves struggling to obtain guidance. May I ask the Secretary of State why there was no contact with schools until Monday, whether all school pupils who went to Club Chemistry have been identified and invited for treatment, and whether he will roll out the vaccination programme to local schools, including residential schools in the area?
Wes Streeting
I thank the hon. Member for repeating that wonderful and moving tribute to Juliette from her headteacher, which brings into sharp relief the devastating impact that this has had and the anxiety that many other parents will be feeling, in common with her. I also thank her for the proactive way in which she has been in contact with me and with the UKHSA over the weekend. She is asking the right questions. We will obviously review this and return to her and to the House with more detail, but I understand that on Sunday identifying the schools concerned posed some challenges and that contact was made on Monday morning. We need to look hard at whether more could and should have been done to be in touch with those particular schools on Sunday, but also with schools more generally.
The hon. Member was right to point out that there will have been other sixth-formers over the age of 18 in the nightclub, including, perhaps, some who should not have been there. It is important for us to have a grip on who those young people are, to ensure that they have access to high-quality health information and advice and know where to go if they are concerned. I am confident that the four hubs that I mentioned will reach those young people and that the flow of information is improving, but the hon. Member is right to press and probe on whether we could and should have been more effective in communicating with schools, as we certainly were in communicating with the university.
Jim Dickson (Dartford) (Lab)
I thank the Secretary of State for his statement, and I echo his words and those of other Members about the tragic loss of two young lives to meningitis as a result of this outbreak. Many Dartford residents remain understandably concerned, and I therefore welcome his assurance and those of the UKHSA that the outbreak is linked to a very specific venue and event. It has of course been encouraging to see the swift action from health authorities, as well as local public health teams, to trace those who attended Club Chemistry, and to offer preventive antibiotics to tackle the outbreak. Can the Secretary of State confirm for my constituents that those who attended the club should go immediately to designated sites for antibiotics, and that anyone else experiencing symptoms should contact their GP or dial 111 as soon as they can?
Wes Streeting
My hon. Friend is entirely right. I did not respond to a linked question from the shadow Secretary of State earlier, so let me let me respond to both questions now.
All cases are currently being treated as being connected with the Club Chemistry incident and cluster, but we are not taking that for granted: we remain open-minded and assess it continually as information comes in from patients and their families, which can take time because they are often very sick. Via the UKHSA, we are providing the opening times and locations of the four hubs. If people fear that they have been in close contact and are worried about the risk to themselves, they can come forward for antibiotics, which will be made available to them.
Rosie Duffield (Canterbury) (Ind)
I thank the Secretary of State and his team for their engagement with this awful situation in Canterbury. As he can imagine, all in my constituency have been devastated by the tragic death of Juliette Kenny and another student from this cruel disease, and I thank my constituency neighbour, the hon. Member for Faversham and Mid Kent (Helen Whately), for her lovely tribute to my constituent.
We have been inundated by questions from extremely worried constituents, and the Secretary of State has answered some of them in his statement. The main question has been about the roll-out of the vaccine, and I was really pleased to hear that that will happen soon. Worried parents and vulnerable students are telling me that communications from their education settings are not consistently clear, and one school has been closed to those in year 13. What is the Secretary of State’s message about attendance in person?
There are reports from medics on the frontline in the hubs that the service has been overwhelmed by requests for antibiotics, with people presenting with mild colds and coughs. Will the Secretary of State make very clear once again exactly why and when people should turn up? The time for addressing the concerns about the roll-out of information is not now, but hopefully we can drill down on that when this horrible event is over.
Wes Streeting
I thank the hon. Member for her proactive approach over the weekend and in recent days, given the impact that this is having on her constituency and the devastating impact on her constituents. Let me reassure her about two things.
First, we are not advising that there should be school closures. I think it important once again to underscore the nature of the transmission of this disease, which is close personal contact, such as kissing, sharing vapes—which I am concerned about in the context of young people—and sharing drinks. Obviously, if people live together in a household, some of those things are even more likely to occur, but the general risk is low. I want people to think carefully about their own situation, but they should not be unnecessarily worried or anxious.
Secondly, on antibiotics access, students at schools who have had close contact with those who were at Club Chemistry can attend the sites that provide antibiotics. That message went out to all Kent schools this morning, so hopefully there will be an improvement in the flow and accuracy of information going to schools.
The hon. Member was absolutely right to say that once this incident has passed we will need to look back and reflect on what was done and when, and what we can learn from that. At the same time, I am keen to ensure that we are listening, getting active feedback from Members across the House, and improving in real time as well. We will keep these channels open, not just through questions today but through briefings with Members, so that we can get feedback from local elected representatives, which in the hon. Member’s case and others has been extremely valuable.
Dr Lauren Sullivan (Gravesham) (Lab)
I send my condolences to the families affected, and to all those who have lost young lives to meningitis in the past. I welcome the Secretary of State’s targeted vaccine programme, as well as the roll-out to deliver antibiotics at pace. Vaccines are the most effective and powerful way in which to protect individuals and the community at large, but we know that infectious diseases mutate, and we must be ready. Will the Secretary of State commit to future work to examine the menB vaccine to ensure that it provides wider protection? Would it be considered as part of the package including the MMR vaccine that is offered to students and young people before they embark on life?
Wes Streeting
We can be proud in the United Kingdom that this was the first country in the world to roll out the menB vaccine. As for who might be eligible in the future and on what basis, we always rely on the advice of the JCVI, which is independent and is based on the data and on scientific research. However, owing to the nature of this outbreak and the speed at which we have seen the disease spread, I am asking the JCVI to look again at the advice that it has provided, without prejudice to any decision that it might make. Given our most recent experience and what we have seen in recent days, I think it prudent for the JCVI to take those factors into consideration and issue fresh advice to the Government.
Tom Tugendhat (Tonbridge) (Con)
I thank the Secretary of State and the medical teams who have responded incredibly quickly, particularly UKHSA, which has done a phenomenal job in tracing and in making sure that we have preparations in place. There are lessons to be learned, but we will park that for a moment.
May I ask about the antibiotics? People from not just east Kent but Tonbridge were at Club Chem on the relevant days and, for very understandable reasons, they do not particularly want to go all the way back to Canterbury; many of them are feeling rather nervous about it. Is there a reason why the antibiotics are not available in Tonbridge, as I have been told by one of the medical groups in the town? Is there a possibility that the antibiotics will be spread, so that people can receive them in other locations?
Wes Streeting
Following the right hon. Member’s question, I will ask whether expansion to Tonbridge would be a sensible thing to do, given the number of people who may have been in Club Chemistry on the relevant dates. I take his point about some people not being willing or able to travel to the four sites that have been made available in Broadstairs and Canterbury. None the less, and not least because some students have left university for the Easter break, we are making sure that GPs are able to prescribe antibiotics through the NHS. I know he is talking about different cases—they will not be students—but we will make sure that people can get access to antibiotics via their GP. If I have not fully answered his question—he is shaking his head—I will catch him after this session to make sure that I do.
Daniel Francis (Bexleyheath and Crayford) (Lab)
May I share my condolences with the friends and families of the two young people who have very sadly lost their lives? Nine years ago, I saw my own daughter have a 42-minute seizure. Thanks to the work of the NHS and the drugs, she recovered from meningitis B, but I know exactly how terrifying that situation can be. For lots of families around the country, their children are currently at university and are hundreds of miles away. What advice can the Secretary of State give families about the conversations they should have with their young people in Canterbury about the health advice that they should seek and the symptoms that they should look for?
Wes Streeting
I thank my hon. Friend for sharing his awful experience, and for once again emphasising the importance of good public health information and advice, including for parents whose students will still be in Canterbury and who may therefore be particularly worried. UKHSA is now advising anyone who visited Club Chemistry on 5, 6 or 7 March to come forward for preventive antibiotic treatment as a precautionary measure; it can be collected from four sites. If they or people they know develop symptoms of meningitis or septicaemia, they should urgently seek medical help by going to the nearest accident and emergency department or dialling 999. If it is not an emergency but people are concerned, they can contact their GP or NHS 111.
Symptoms of meningitis and septicaemia can include a rash that does not fade when pressed with a glass; a sudden onset of high fever; a severe and worsening headache; a stiff neck; vomiting and diarrhoea; joint and muscle pain; a dislike of bright lights; very cold hands and feet; seizures; confusion or delirium; and extreme sleepiness or difficulty waking. I want to underscore that the general risk of transmission is low and that it takes place through close, direct and prolonged personal contact through things like kissing or sharing vapes and drinks. We need to get the balance right between promoting awareness—people thinking about their own situation and whether any of these factors apply to them—and not spreading unnecessary anxiety, because most people, including the overwhelming majority of students at the universities and people in Canterbury, will not be at risk.
Kirsty Blackman (Aberdeen North) (SNP)
Our thoughts are with everyone involved in this matter, particularly all those who are dealing with it, including medical professionals, university staff and UKHSA. I understand that the Secretary of State’s immediate priority today will be this specific outbreak. Dr Amirthalingam from UKHSA was on BBC Radio 4 this morning and suggested that the progression of the outbreak is atypical. Will the Secretary of State give a reassurance that the devolved health authorities will be given updates if there is another atypical progression anywhere else in these islands?
Wes Streeting
The hon. Member is absolutely right about the atypical nature of this outbreak. I can reassure her and the House that UKHSA is in regular contact with the devolved Administrations.
Clive Efford (Eltham and Chislehurst) (Lab)
My heart goes out to the bereaved families affected by this terrible tragedy. Their pain must be unimaginable, and I wish those who are being treated in hospital a swift recovery. I commend UKHSA for its swift response; notwithstanding any lessons that need to be learned, it seems to have reacted very quickly and effectively. How confident can we be that the outbreak is contained within the identified area, and is there a contingency plan for any outbreaks in other areas? As a south-east London MP, I have concerned constituents.
Wes Streeting
I am very grateful to my hon. Friend for his question, and I am mindful of the concerns of neighbouring communities across his part of London and the wider south-east. I can provide reassurance on two points. The general risk is low because of the nature of the transmission of this disease and because of the active contact tracing that is under way, on which UKHSA has done a particularly impressive job, given the unusual nature of this outbreak. We can be reasonably confident that we are tracing people and managing risk in that way. Even as students return home from university, we are managing the risk, proactively contacting people and making antibiotics available. We are preparing for a targeted vaccination campaign in the coming days, but we are also considering the wider cohorts that UKHSA may deem necessary to vaccinate.
Dr Neil Shastri-Hurst (Solihull West and Shirley) (Con)
I know from my time in medicine that all those involved in combating this outbreak will be working at pace, and they have our utmost respect. However, there will be concern about the report in The Independent in the last hour or so that certain pharmacies in the region are running out of or running low on the menB vaccine. Will the Secretary of State commit to looking into that personally and ensure that we get a robust supply chain?
Wes Streeting
I can understand that some people may choose to buy the vaccine, but I will reassure the hon. Gentleman on two points. First, we have a significant stockpile of vaccines. Secondly, we are taking an evidence-based approach to vaccination, starting with the targeted vaccination programme that UKHSA is preparing. We are thinking about additional cohorts, and we always keep an eye on our medicine supply more generally.
Jas Athwal (Ilford South) (Lab)
I thank my right hon. Friend the Secretary of State for his statement. Parents of teenagers and students across the country will be looking on with increasing anxiety. What is the Secretary of State’s advice to parents in other parts of the country, particularly those in the Kent area? What exactly are the symptoms that they should be looking for?
Wes Streeting
I am very grateful to my hon. Friend for his question, and I know that lots of parents will be concerned about this issue. As I have said, the first thing that individuals should do is think about their risk of exposure. We have already made available the four hubs for people to come forward and get antibiotics, and we will continue to contact people actively and trace the outbreak.
As I have previously said, there is a range of symptoms: a rash that does not fade when pressed with a glass; a sudden onset of high fever; a severe and worsening headache; a stiff neck; vomiting and diarrhoea; joint and muscle pain; a dislike of bright lights; very cold hands and feet; seizures; confusion or delirium; and extreme sleepiness or difficulty waking. Those symptoms can apply to a range of conditions, but it is good to be cautious. Students who may have been at Club Chemistry on the dates concerned should not write off some of the symptoms as a hangover. It is better to be reassured than to be ignorant, so seeking medical attention and advice is the right thing to do, rather than simply writing off the symptoms as something else. I urge parents to give that advice to young people, and students to follow the advice.
Vikki Slade (Mid Dorset and North Poole) (LD)
Meningitis is one of the worst nightmares that parents worry about, particularly when their teenagers leave home and are living away. My constituent Vicki Purdey from Corfe Mullen had her life changed by meningitis two years ago, and she is still unable to walk unaided. She is calling for meningitis awareness in schools, particularly via PSHE lessons, and at university through freshers’ packs. Will the Secretary of State talk to his colleagues in the Department for Education to progress this, given the high-risk nature of those in this age group and the fact that they will not have been vaccinated as they were born before 2015?
Wes Streeting
I think that is a really constructive suggestion, and we will absolutely look at it.
In reply to the right hon. Member for Tonbridge (Tom Tugendhat), who had left us but has just returned fleetingly to his place—it is an amazing skill he has—I think his question was about the availability of antibiotics in Tonbridge, not necessarily at a distribution centre. I would just reassure him that there are sufficient antibiotic stocks at the university, hospitals and the ambulance service, and we are working with local resilience partners to ensure effective distribution. However, I will pick up his point about Tonbridge, given the proximity and the likelihood that many residents will have been at the club in question.
James Asser (West Ham and Beckton) (Lab)
I join other hon. Members in sending my condolences to the families of the students who have died. As my right hon. Friend will be aware, I was once upon a time the National Union of Students officer responsible for national health campaigning, and a meningitis outbreak on campus was always one of our great anxieties. We used to run awareness campaigns that, as we know from feedback at the time, enabled students to be aware of the symptoms and get urgent medical treatment.
Although this is a localised outbreak, there will obviously be anxiety among parents and students across the country. Would the Department work with the national meningitis charities, the National Union of Students and university authorities to run a national awareness campaign, so that the symptoms he has outlined are fully understood, and students are aware of them and can understand what to do if they spot them?
Wes Streeting
Like my hon. Friend, I am a member of the NUS mafia in this place, and I well understand the enormous value that students’ unions bring to promoting student welfare and raising awareness. I think he is absolutely right about the risks of meningitis and other infectious diseases on university campuses, and to suggest that we should work with the meningitis charities, the NUS, student unions and others to see what more we can do not just in response to this outbreak in Kent, but more generally to raise awareness among groups of students, who, because of the nature of their studying and living conditions, can be more prone to the spread of infectious diseases.
Edward Argar (Melton and Syston) (Con)
I associate myself with the Secretary of State’s remarks: the thoughts of all of us in this House are with the families of those, tragically, who have died and all those who have been affected.
While there are understandably questions about vaccination and antibiotic eligibility, it is important that decisions continue to be guided by clinical experts, and in this country we have some of the best in the world. I welcome the Secretary of State asking the JCVI to review the eligibility criteria, but will he please be unequivocal—I think he has alluded to this—in saying that he will continue to be guided by its expert clinical advice in any decisions he subsequently makes?
Wes Streeting
I am extremely grateful to the right hon. Gentleman for raising that question and making that point. It sometimes feels that barely a month, if not a week, goes by in this job when I am not regularly exhorted to make a political decision overriding clinical advice. I think that is the wrong thing to do and it sets a dangerous precedent, particularly when others in this House might be minded to make ideological judgments about science and medicine that are neither good science nor good medicine. There is an important principle to defend here, which is that where we are making clinical decisions, they should be based on good, high-quality clinical advice on the basis of robust evidence and data. I give him the assurance that I will continue to follow clinical advice, and he is absolutely right to raise this particular point of principle.
Danny Beales (Uxbridge and South Ruislip) (Lab)
I, too, welcome the Secretary of State’s statement and join him in expressing our sympathies with and condolences to the families who have lost young people in recent days.
Obviously, parents and students are very concerned at the moment, and there are reports online that private pharmacies are selling vaccinations for several hundreds of pounds. Can the Secretary of State assure this House that NHS England and the Department of Health are monitoring any possible price gouging on vaccinations and that there is no profiteering following these tragic events?
I echo the comments of the Chair of the Health Committee. We recently looked at vaccinations, and there have recently been a number of outbreaks of different diseases across the country, some of which are associated with declining vaccination rates—although that is not directly related to this incident. Will the Secretary of State update us on his thoughts about whether the last Government’s 2023 vaccination strategy needs a fresh look in order to deal with both uptake and responses to outbreaks?
Wes Streeting
I thank my hon. Friend for the excellent work he does as a member of the Select Committee, and reassure him that we are taking the Committee’s letter and advice very seriously. I think he is right to ask us to look again at the 2023 strategy.
I also reassure my hon. Friend that to price gouge or profiteer in this situation would be a totally immoral and irresponsible thing to do. More generally, we are not advising the public to pay for a vaccine. If it is decided that any vaccination is required, that will be offered on the NHS. The menB vaccine is already offered to infants, and the menACWY vaccine, for adolescents and young adults, is free on the NHS. That is the advice. I understand that people may wish to make individual choices, but the advice stands, and I would urge people not to allow themselves to be ripped off by those trying to exploit understandable public anxiety.
Sir Julian Lewis (New Forest East) (Con)
I have heard a suggestion that this type of meningitis is more widespread in some countries than in others. Is there any truth in that, and if there is, would there be wisdom in suggesting to young people travelling to the countries concerned that they ought to add the vaccination as a prophylactic against that possibility?
Wes Streeting
I am not sure about the point of prevalence, but we will look carefully at the genesis of this outbreak. Of course, in common with the point raised by my hon. Friend the Member for West Ham and Beckton (James Asser), we will think about what advice ought to be offered. As ever when it comes to travel advice, we rely on the evidence available, and with our partners at the Foreign, Commonwealth and Development Office, we regularly offer good travel advice to British citizens travelling abroad where there may be exposure to greater health risks.
Carla Lockhart (Upper Bann) (DUP)
Given that we are nearing the Easter holidays, what discussions has the Secretary of State had with the Minister of Health in Northern Ireland about ensuring that students travelling home are aware of the situation and the need to take precautions?
Wes Streeting
I reassure the hon. Member that UKHSA is in close contact with all the devolved Administrations to make sure they understand the nature of this outbreak, what we are seeing and how we are responding, and we are also helping the devolved Administrations to manage risk through contact tracing. We will continue that regular contact.
Sir Gavin Williamson (Stone, Great Wyrley and Penkridge) (Con)
I thank the Secretary of State for his statement. Obviously, we are rapidly approaching the time when, right across the country, university students will be dispersing and heading away from halls of residence and their campuses. What actions is the Secretary of State taking—working not just with universities, but with health authorities and other bodies right around the country—to make sure that any cases that may be dispersed around the country are quickly acted on?
Wes Streeting
I thank the right hon. Gentleman for his question. I can reassure him that, through partners in the NHS, we are ensuring that antibiotics are available to GPs to prevent students from necessarily having to return to Canterbury, especially if they have travelled a long distance to get home. There is obviously a widespread public awareness of the outbreak, so in all our NHS settings there will be a particular vigilance for these types of cases, which are rapidly reported. I am also reassured by the extent to which contact tracing with UKHSA is effective, and people are responding accordingly.
Shockat Adam (Leicester South) (Ind)
I thank the Secretary of State for his statement. I, too, would like to express my condolences to the families and loved ones of the two young people who have passed away, and send my best wishes to those who are in hospital. As the father of a daughter at university, I cannot imagine what they must be going through.
Many students have expressed to newspapers such as The Guardian their concerns about returning home where they have vulnerable loved ones, citing a mother coming back from hospital or those who live with their grandparents. Does the Health Secretary have any advice for students returning home to loved ones on not spreading the disease to them?
Wes Streeting
I am grateful to the hon. Member for his question. It is worth bearing in mind that the transmission of this particular disease is through close and prolonged personal contact. Therefore, the risk of transmission is much lower than other outbreaks of disease we have seen in this country in recent years, in particular respiratory diseases and some of the concerns people had around flu over the winter. We are actively contact tracing and making antibiotics available. It is for individuals to make their own judgments about their own risk of exposure, and what that means in terms of close personal contact. More generally, if students returning home from university are sat next to someone on a train, for example, that is not close prolonged personal contact. I hope that reassures people that, through contact tracing, the availability of antibiotics and the standing up of the targeted vaccination campaign, we are actively managing the risk of transmission, and that the risk to the general public is very low.
NHS Mental Health Spending
Wes Streeting Excerpts(1 month ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
Today, I am publishing the annual statement for NHS mental health spend. The Health and Care Act 2022 introduced a statutory requirement to publish a statement setting out expectations for NHS mental health services spending before the end of each financial year. 2025-26 2026-27 Recurrent NHS baseline (£billion) 180.8 191.6 Total forecast mental health spend (£billion) 15.7 16.1 Mental health share of recurrent baseline (%) 8.68 8.40
The Government are committed to improving and supporting the nation’s mental health, focused on delivering better outcomes rather than just inputs—giving people the right support, at the right time. This priority runs consistently through our manifesto, the 10-year health plan and NHS England’s medium-term planning framework. We recognise that more must be done to reduce unacceptable waits and ensure services meet the needs of the population. That is why the medium-term planning framework sets such ambitious goals for integrated care boards over the next three years to drive improvements across mental health services, including putting mental health support in every school by 2029, expanding NHS talking therapies and individual placement support, and reducing the number of inappropriate out-of-area placements by the end of March 2027.
The Government have already taken action to improve mental health care, including through the Mental Health Act 2025, which ensures more personalised and compassionate care for people with severe mental illness. I have also launched an independent review into prevalence and support for mental health conditions, ADHD and autism, so that we can build an improved system that prevents mental ill health and delivers improved outcomes. Later this year, we will publish a new modern service framework that will set out what excellent care should look like for people with severe mental illness. Alongside this, we are confronting the root causes of mental ill health through cross-Government action, including through our suicide prevention strategy and men’s health strategy, and I fully support the efforts of the Secretary of State for Science, Innovation and Technology to make the online world safer for children.
On funding, real-terms spending on mental health continues to increase year on year, reflecting this Government’s commitment to improving mental health services. For 2026-27, mental health spending is forecast to reach a record £16.1 billion, up from £15.7 billion in 2025-26. This represents a real-terms increase of around £140 million compared with 2025-26. Real-terms growth in budgets will enable continued delivery of the ambitions set out in the 10-year health plan and the medium-term planning framework.
Spending for 2026-27 also includes ringfenced service development funding: firstly, to expand access to NHS talking therapies and individual placement and support, ensuring we reach those most in need while also supporting economic growth; and secondly, for accelerating the expansion of mental health support teams in schools and colleges to 100% coverage by 2029.
We are also making significant capital investment over the spending review period. Some £473 million of mental health capital funding has been made available over 2026-27 to 2029-30, as set out in NHS England’s capital guidance, published in November. This funding is available to systems to invest in community-based mental health centres, establish mental health emergency departments and reduce inappropriate out-of-area placements and locked inpatient rehabilitation.
Critically, financial safeguards remain in place. I am pleased to update the House that in 2025-26, all integrated care boards are forecast to meet the mental health investment standard, which sets a minimum rate of growth in annual spend on mental health services. These figures are based on data up to December, as full-year data are not yet available. To maintain this progress, the Government are requiring all integrated care boards to meet the mental health investment standard over the next three years. As this statement must be issued before the start of the new financial year, the figures for 2026-27 represent the best current estimates, based on projections that take account of the medium-term planning framework allocations published on 17 November 2025.
The proportion of overall NHS spend allocated to mental health in 2026-27 is forecast to be 8.4%, 0.28 percentage points lower than in 2025-26. This is a consequence of significant additional investment in other core areas, including those that benefit mental health services such as the substantial amounts going into NHS technology and digital transformation, general practice, community-based services, and neighbourhood health centres. These system-wide improvements are focused on fixing the fundamentals of the NHS and, although they are not counted in pure mental health service spend, will deliver significant benefits for mental health services and patients. There are also important areas of mental health-related expenditure not captured in the share of spend figure, such as prescribing mental health medication, continuing healthcare and NHS England’s investment in training the mental health workforce.
The 2025-26 NHS baseline has been restated to include the 2025-26 pay uplift. The 2026-27 NHS baseline has been updated to reflect last year’s spending review settlement, including some items which were not previously included in the baseline for this assessment, but are now recurrently part of the NHS budget. Total forecast mental health spend includes integrated care board expenditure contributing to the mental health investment standard, as well as NHS England’s service development fund and specialised commissioning spend on mental health. It also incorporates the £117 million from the autumn statement 2023 for the expansion of NHS talking therapies—protected in the 2024 Budget settlement—and the £65 million from the spring and autumn Budgets 2024 to expand individual placement and support. The figures exclude capital funding.
Through setting clear expectations for integrated care boards, increasing investment in mental health, and maintaining firm financial safeguards, this Government are committed to delivering the ambitious reform agenda set out in the 10-year health plan and medium-term planning framework. This approach supports a shift away from input-based requirements towards a clearer focus on the outcomes that matter most for people with mental health needs, ensuring that services deliver the improvements in experience and care that the public rightly expect.
[HCWS1397]
Leeds Teaching Hospitals NHS Trust: Independent Review of Maternity and Neonatal Services
Wes Streeting Excerpts(1 month, 1 week ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
Yesterday, alongside bereaved and harmed families from Leeds, I announced the appointment of Donna Ockenden as chair of the independent review into maternity and neonatal services at Leeds Teaching Hospitals NHS trust.
Donna Ockenden brings considerable experience as a nurse and midwife, and a strong record of exposing systemic failings in maternity care. Her leadership of the maternity reviews at Shrewsbury and Telford Hospital NHS trust and Nottingham University Hospitals NHS trust demonstrates her commitment to ensuring that families’ voices are heard and acted upon and her appointment will help us rebuild the confidence of families.
As well as the harrowing accounts that families have shared with me over the last few months, Leeds is one of the largest teaching hospitals in Europe and its perinatal mortality rates remain higher than comparable trusts.
The terms of reference for this review are now being finalised. It will examine stillbirths, neonatal deaths, serious incidents, hypoxic injuries and maternal deaths occurring between 1 January 2011 and 31 December 2025 —with the chair’s discretion to bring in more recent cases that would significantly add to the review’s findings. We will be taking an “opt-out” approach so that no voices are missed: all families whose care meets the criteria for the review will automatically be included unless they wish otherwise. As well as clinical care, the review will consider governance, accountability and how the trust handles concerns raised by women, families and staff. It will set out clear, evidence-based actions to improve safety, quality and equity of care.
The Government will work with Donna Ockenden and families to finalise the terms of reference, ensuring their experiences and priorities shape the scope of the review. Individual clinical case reviews are expected to begin in August.
I want to personally thank Leeds families for the openness and courage they have shown in sharing their accounts with me over recent months. I do not underestimate the trauma that they have experienced by revisiting their experiences in those meetings. This review must deliver for them and their babies and for all families who rightly expect safe, high-quality NHS maternity care. Donna Ockenden’s leadership will help drive the lasting change that is urgently needed.
We recognise that some of the issues being identified at Leeds may exist in other trusts across the country. While many women have expressed satisfaction with their care during pregnancy and birth, stark inequalities remain and maternal mortality has worsened. This is unacceptable and it is why I commissioned the rapid national investigation led by Baroness Amos, who has engaged with hundreds of families and staff to inform her interim findings published last month. Her final recommendations will be published in June. I will shortly launch the national maternity and neonatal taskforce that will turn these recommendations into the action needed to deliver lasting improvements.
In the meantime, we have taken immediate action to improve safety. This includes: investing over £130 million to make maternity and neonatal units safer; rolling out programmes to reduce avoidable brain injury and give early warning signals about possible issues with care; launching an anti-discrimination programme; and backing Martha’s rule which gives families the right to an urgent second opinion.
I want to reassure women who are accessing maternity care at Leeds Teaching Hospitals NHS trust that significant action is already under way to improve maternity and neonatal services, under the national oversight of NHS England. Over 500,000 women across the whole country give birth every year and the vast majority of those are safe. I encourage any woman who has concerns about her pregnancy to speak to their midwife.
While change will not happen overnight, we are determined to ensure all women receive safe, personalised, and compassionate care. This Government will not rest until women, babies and families get the care they need.
[HCWS1393]
Masculinising and Feminising Hormones: NHS England Policy
Wes Streeting Excerpts(1 month, 1 week ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
Today I am updating the House about NHS England’s decision to consult on a new clinical commissioning policy on the prescribing of masculinising or feminising hormones for children and adolescents with gender incongruence or dysphoria.
The safety and wellbeing of children and young people is paramount, and children’s healthcare must always be led by evidence and expert scientific and clinical advice. We are committed to ensuring that NHS children and young people’s gender services provide high-quality care for those with gender incongruence or dysphoria.
Currently, MAF hormones are only available to children and young people aged 16 and 17, and only in very limited circumstances. In line with the Cass review, which this Government and NHS England are committed to implementing, MAF hormones can only be prescribed with “extreme caution” and where there is a strong clinical rationale for not waiting until age 18.
Following an independent review of evidence, this consultation proposes that MAF hormones should no longer be available as a routine commissioning option through the NHS CYP gender service. The consultation, which will last for 90 days, sets out this proposal, and asks consultees whether all relevant evidence has been considered. NHS England will carefully consider the responses to inform next steps.
Throughout the consultation period and until NHS England has responded to the consultation, NHS England is pausing its existing clinical policy with immediate effect to safeguard children and young people. This means that no new prescriptions for MAF hormones will be initiated through the NHS CYP gender service, at least until the point when a final policy is determined, following full consideration of consultation feedback.
The full range of clinical support interventions, described by the national service specification, remain available for patients who are in the CYP gender service, including psychological and psychosocial support. Individuals who are on the national waiting list for CYP gender services will either have had previous arrangements made for them to access local CYP mental health services, or they would have had contact with CYP mental health services or NHS paediatric services at the point of referral, with care plans in place.
Young people aged 16 and 17 years who are receiving existing NHS prescriptions of MAF hormones may continue their prescriptions under the care of the NHS CYP gender service. Each individual’s lead clinician will need to undertake a review of the circumstances of the patient’s care plan and make a shared decision with the young person—and family, as appropriate—about the future treatment approach within an enhanced informed consent process.
Evidence base
NHS England can only commission treatments based on evidence of clinical effectiveness, and with appropriate assurances around safety. This important principle applies to all treatments, not just for gender incongruence and dysphoria.
In 2021, an independent evidence review by the National Institute for Health and Care Excellence found that there is very limited evidence about the safety, risks, benefits and outcomes regarding the prescribing of MAF hormones to young people under 18 years of age.
In line with the Cass review, NHS England made changes to its existing clinical policy to place restrictions on the use of MAF hormones. This meant that MAF hormones could only be prescribed to 16 and 17-year-olds if a recommendation for their use was supported by the NHS CYP gender service and a national multi-disciplinary team.
Dr Cass also recommended that NHS England review its policy on MAF hormones. NHS England began that review in 2025, and commissioned an independent third party to undertake a further evidence review of published evidence. This included research that had been published since NICE’s review of the evidence in 2021.
The evidence reviews found very limited and weak evidence to support the continued access to MAF hormones by children and young people under the age of 18 years. After careful consideration, NHS England has concluded that there is not enough evidence to support the safety and clinical effectiveness of MAF hormones to make the treatment routinely available.
In addition to NHS England’s consultation, the Government have been examining the private prescribing of MAF hormones by the independent sector, including overseas practitioners. The Department will continue to closely monitor this position with regards to any implications and next steps. NHS England will reissue guidance from May 2025 that advises GPs not to agree shared care arrangements with unregulated providers who offer access to masculinising and feminising hormones to under 18s.
The Department is also awaiting the results of the Medicines and Healthcare products Regulatory Agency’s engagement on the Pathways trial, following concerns that it raised regarding the protocol. Any potential implications of this revised prescribing policy for the Pathways trial will be considered and discussed with the regulators during the period of consultation, and any further announcements will be made in due course.
[HCWS1391]
Gender Recognition: Data Linkage Study
Wes Streeting Excerpts(1 month, 3 weeks ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
Today, I have laid the Gender Recognition (Disclosure of Information) (England) Order 2026 in Parliament. The order will come into force on 20 March 2026.
This Government have always made it clear that anyone accessing gender services deserves high-quality, evidence-based care and support. Laying this order will facilitate delivery of the data linkage study and is another step to achieving our manifesto commitment to implement recommendations of the independent Cass review.
The study was planned to take place during the lifespan of the Cass review, and a statutory instrument was brought forward in 2022 to protect those disclosing protected information for the study. However, it is well documented that some clinics did not share data to allow the study to commence and the study was therefore not completed as planned. Further to this, it is the Government’s view that the 2022 order now needs to be updated to sufficiently protect those who will now be sharing information for the purposes of the study.
This order will revoke the 2022 order and will ensure that information that may otherwise be protected under the Gender Recognition Act 2004 can be lawfully disclosed for the specific purpose of the data linkage study. This order makes technical changes to reflect that NHS England is now delivering the study, that the study is being completed as a recommendation (rather than during the lifetime) of the Cass review, and to update the list of organisations contributing to the study.
The data linkage study is a retrospective study based on an analysis of routine data collected for a cohort of adults who, as children, were referred into a former model of NHS gender care, the Gender Identity Development Service. The study requires no active patient participation and instead relies on an analysis of information already held within health records and other nationally held databases. The study aims to learn more about the needs of individuals referred to GIDS, their healthcare experience, and associations identifiable in the data which may tell us more about the intermediate outcomes for this cohort.
Since assuming responsibility for the data linkage study, NHS England has taken time to undertake due diligence work on the data sources critical to the study, and to work with organisations to refine the planned approach to data sharing. Some small but important improvements have been proposed in the study design that will better support the collaboration of organisations on whom the study team will be reliant for data, including adult gender clinics. It is my clear expectation that all relevant organisations will now provide the data required to complete this study.
Alongside the laying of this order, updated data linkage study research approvals are also in progress. As with usual research practice, the finalised data linkage study protocol will be made public once independent research and ethical approvals have been appropriately secured, at which point the study can begin.
We are determined to continue our work to improve the lives and healthcare of transgender people in this country. We will continue to implement the recommendations of the Cass review.
[HCWS1369]