Health and Care System: Tackling Antisemitism and Racism
Wes Streeting Excerpts(3 days, 7 hours ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
Today I am updating the House on urgent action to tackle antisemitism and racism across the NHS.
The NHS is a universal service which demands the highest standards of care and respect for all patients, regardless of their background. It is unacceptable that many people, including those in the Jewish community, do not currently feel safe working in or using the NHS.
The vast majority of doctors, nurses and healthcare workers embody the very best of our country. But recent cases have exposed something deeply troubling.
That is why we are taking immediate action.
I have commissioned Lord Mann, the Government’s adviser on antisemitism, to conduct a rapid review into how healthcare regulators can better tackle racism. As well as addressing the real challenges of antisemitism, I also expect Lord Mann’s recommendations to improve the NHS’s ability to tackle all forms of racism in its ranks.
At the same time, all 1.5 million NHS staff will be required to complete updated mandatory antisemitism and anti-racism training, with existing equality, diversity and human rights programmes being expanded.
We are also asking NHS England and all Department of Health and Social Care arm’s length bodies to explicitly adopt the IHRA working definition of antisemitism to ensure consistency across the health system. NHS trusts and integrated care boards are being strongly encouraged to follow suit. The Government are also reviewing the recommendations of the independent working group on Islamophobia.
NHS England is reviewing the uniform and workwear guidance last updated in 2020, in light of recent successful approaches rolled out at University College London Hospitals NHS foundation trust and Manchester University NHS foundation trust. NHS England will engage stake- holders on its proposals and issue new guidance shortly. The principles of this guidance will be that religious freedom of expression will be protected, patients feel safe and respected at all times, and that staff political views do not impact on patients’ care or comfort.
Together, these actions will help us build a health and care system where everyone feels safe to work and be treated.
[HCWS971]
Primary Care Clinicians: Jess’s Rule
Wes Streeting Excerpts(5 days, 7 hours ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
On 23 September, this Government announced the introduction of Jess’s rule—“three strikes and we rethink”—in England. Under this new rule, we are asking GPs and other clinical staff working in primary care to reflect, review and rethink when a patient comes in for the third time with the same symptom or concern.
Re-evaluation may be particularly important if the condition remains unexpectedly unresolved, the symptoms are worsening, or there is still no confirmed diagnosis. Listening carefully to the patient’s symptoms and concerns, and recognising that they are an expert in their own body, remains crucial.
This call for change follows the tragic death of Jess Brady in December 2020. Jess was just 27 when she died of stage 4 adenocarcinoma. In the five months leading up to her death, she had 20 appointments with her GP practice. Tragically, her cancer remained undiagnosed until she was admitted to hospital, by which time it was too late. Her story, and the tireless efforts of her parents Andrea and Simon Brady, prompted an important and necessary reflection on how we can better support clinical teams in identifying serious conditions earlier, especially in younger adults, whose symptoms may not always align with typical diagnostic expectations. Her story should never be forgotten.
This initiative is jointly led by the Department of Health and Social Care and NHS England, and is supported by the Royal College of General Practitioners, reflecting a united commitment to improving early diagnosis and patient safety across the healthcare system.
At its heart, Jess’s rule provides clear, structured guidance that sharpens and reinforces the intuition which so often saves lives. It is there to back those instincts with a prompt for timely, proactive action when something does not feel right. By reviewing patient records and questioning initial assumptions, we hope to ensure that fewer serious conditions are missed, especially among young adults who may not fit typical diagnostic patterns.
We know that the practice of “three strikes and rethink” is commonplace. Every day, clinicians across the country are doing an extraordinary job, making complex decisions under immense pressure, often with limited time and information. Jess’s rule is designed to support them in this challenging work, offering a prompt for reflection and reinforcing the instincts they already rely on every day.
I want to pay tribute to Jess’s parents, Andrea and Simon. They have shown extraordinary courage and determination in the face of unimaginable loss. They have worked tirelessly to raise awareness of Jess’s story, and to ensure that what happened to Jess drives lasting change in how we think, how we listen, and how we act in primary care.
I would like to recognise the work of Dr Claire Fuller, Dr Kiren Collison and the entire team at NHS England. Jess’s story is included in the “Primary Care Patient Safety Strategy”, published in 2024, which highlight the importance of re-evaluation when a diagnosis remains unclear. Dr Fuller’s leadership has been instrumental in developing and embedding Jess’s rule.
Finally, I would like to acknowledge the support of the Royal College of General Practitioners in taking this work forward. Under the leadership of Professor Kamila Hawthorne, the RCGP has partnered with Jess’s family’s charity, the CEDAR Trust, to develop an online resource to support GPs in earlier cancer detection. This resource is available to all healthcare professionals registered on the RCGP’s learning platform.
Jess’s rule is more than a clinical process, It is a vital step toward ensuring that patient concerns are taken seriously, that patterns are reviewed carefully, and that every opportunity is used to identify serious conditions as early as possible. We owe that to Jess. And we owe it to every patient who places their trust in our health system when they seek help.
[HCWS961]
Baby Loss
Wes Streeting Excerpts(6 days, 7 hours ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
I thank all right hon. and hon. Members who have taken part in this extremely powerful debate. I thank my hon. Friend the Member for Rossendale and Darwen (Andy MacNae), the right hon. Member for Godalming and Ash (Sir Jeremy Hunt) and my hon. Friend the Member for Sherwood Forest (Michelle Welsh) for securing the debate, and the Backbench Business Committee for granting it.
Before I get into the substance of the debate, since this is Baby Loss Awareness Week, I want to put on record my thanks to the all-party parliamentary groups on baby loss, on maternity and on patient safety for their work in raising awareness; and charities such as Tommy’s, Sands, the Miscarriage Association and Bliss, which give bereaved families a voice and incredible support, and which deserve special recognition. I am extremely grateful to Members from across the House who have named local charities, run by those—often with lived experience—who play such a crucial role in improving services, so that others do not have to experience the torture that they have experienced.
It is such organisations that drove the adoption of baby loss certificates, introduced by the last Government and expanded by this one. I, too, thank Tim Loughton for his work, and my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson) for her leadership in this space. Not everyone will choose to have a certificate, but the option is now there for all parents who have experienced losing a pregnancy to have that loss recognised officially. I know that this has meant so much to those who have taken up that option, and to those who are providing the service, particularly staff in the NHS Business Services Authority, who have shared with Ministers their pride—many of them having that experience of loss themselves—of being part of the solution. I am of course delighted that the Government in Wales have also taken up this option.
Given the time available, there is simply no way of doing justice to the contributions that we have heard from Members across the House and the stories that they have shared with us. However, if there is one thing I have learned in my time as Secretary of State working on these issues it is that words will not do any justice to these families. What people want to see is action, and what they need to experience is justice.
I really do want to say a heartfelt thank you to Members across the House who have had the courage to share their personal stories. In particular, my hon. Friend the Member for Rossendale and Darwen, by talking about his daughter Mallorie, has given a voice to many fathers and partners who too often feel airbrushed from the conversation and absent from consideration. I think it is very poignant that he opened the debate for us this evening.
This is no exaggeration, but my hon. Friend the Member for Gedling (Michael Payne) talked about the leadership of my hon. Friend the Member for Sherwood Forest, and it is truly extraordinary that, in the aftermath of such an awful bereavement with the loss of her father, she was back to work in a matter of days, so that she could be there with families in Nottingham to support them in their ongoing campaign for justice.
Of course, my hon. Friends the Members for Sheffield Hallam (Olivia Blake) and for Clapham and Brixton Hill (Bell Ribeiro-Addy) and the hon. Member for Carshalton and Wallington (Bobby Dean) all shared their stories, because others who have spoken previously had the courage to share their own experience. I pay particular tribute to my hon. Friend the Member for Washington and Gateshead South. I have certainly never forgotten her speech about Lucy, and she really has blazed a trail for others to follow.
I can honestly say that, in the last year, the most difficult meetings have been those with victims of the NHS. I think we should pause for a moment just to reflect on how outrageous that sentence is—victims of the national health service. They are people who, in their moments of greatest vulnerability, placed themselves and their lives and the lives of their unborn children in the hands of others, but who instead of finding themselves supported and cared for, found themselves victims. It is truly shocking.
I have heard dozens of stories, each unique, each told with heartbreaking clarity and each with a common theme: that what should have been a moment of joy became a terrifying ordeal. I have had complete strangers describe to me, a Government Minister, their experience of injuries endured in childbirth. Women have had to share with me, a total stranger, what it has done to their sex lives and what it has done to their continence. I have had fathers share with me for the first time their attempts at suicide, and the impact that their loss and grief has had on their mental health. We also heard from my hon. Friend the Member for Erewash (Adam Thompson) of the harm done to young people, in this case young Ryan, who was with us in the Gallery today. I have seen photographs of parents’ children. I have seen the ashes of their children in the tiniest boxes. I have seen more courage than I could ever imagine mustering if I had to walk a day in their shoes.
Each time they have met me—each time they have met anyone—they have had to relive the trauma inflicted on them by the state. Perhaps what is most shocking of all is that if there is another theme that ties these families together, it is the fact that they have had to battle time and again for truth, for justice, for answers, for accountability and for change, so that other families do not have to experience what they are going through.
I cannot thank enough the Members on both sides of the House who have placed on record not just the stories, but the names of the children we have lost, so that they can stand on the record there for all time, a stain on the history of our national health service, but also a galvanising call to action. I hope there is some small comfort for families who have been with us in the Chamber this evening to hear the debate, or who have watched online, to know that Parliament is listening, that we are learning, and that, crucially, we are acting.
Many Members have remarked on my personal responsibility and the responsibility that weighs heavily on my shoulders to get this right. We have been joined by some of the Nottingham families this evening. When I have met them, they have arranged themselves around a horseshoe table in date order, with those whose experience goes back furthest sat to my left, and those most recently sat to my right. I go back to Nottingham regularly and honestly dread the prospect of going to another meeting with another family arriving on my right-hand side at that end of the table with another story to tell, but one that has happened on my watch.
We know how serious these situations and challenges are. We have an implicit message from the system that tells women not to have a miscarriage at the weekend. We have women who are classed as having a normal birth still leaving traumatised and scarred. We still use terms such as “normal” to describe a particular type of birth for ideological reasons. All these things need to change.
We heard from my hon. Friends the Members for Clapham and Brixton Hill, for North West Leicestershire (Amanda Hack) and for Wolverhampton North East (Mrs Brackenridge) the shockingly wide race and class inequalities. We should not kid ourselves that these are statistical anomalies or just institutional failures, because I have heard time and again direct first-hand experiences of overt racism: black women told that it was assumed that that they would be “a strong black woman” and so would not need so much pain relief; and examples of Asian mothers described as divas. Perhaps most shockingly of all, taking a step back and looking at the overall picture, we have had the normalisation of deaths of women and babies. We have levels of loss and death in this country that are simply not tolerated in others. We have a shocking culture of cover-up and backside covering, as we have heard across the Chamber this evening.
Recognising that I cannot respond to every individual point that has been made in the debate, I will undertake to write to Members across the House with detailed answers to the questions they posed. I want to conclude by making this point, which is about trust. We are setting out the rapid investigation led by Baroness Amos because I need to act urgently on the systemic challenges. I want to acknowledge openly and publicly that not all families are with me on this; many have concerns, and they wonder whether this will be just another review that sits on the shelf. I want to conclude by assuring those families and this House of my personal commitment to ensuring that that is not the case, and not just through leading the taskforce that will implement the recommendations myself, but by giving a promise to this House and to those families, in the spirit set out by my hon. Friend the Member for Sherwood Forest, that grief must be the engine of change. The stories I have heard from those families at first hand will be the steel in my spine to deliver the change they need.
Medical Evacuation of Children: Gaza
Wes Streeting Excerpts(1 month, 2 weeks ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
Today I want to update the House on the evacuation of children in urgent need of medical care from Gaza to receive specialist treatment in NHS hospitals across the UK. This was announced by the Prime Minister on 25 July, and a further update was published on gov.uk on 22 August.
No one who has watched the intolerable humanitarian crisis unfolding nightly on our TV screens can fail to be distressed by the devastating consequences for the people of Gaza. They are exhausted, scared and hungry. And they are dying. As of now, there are also no fully functioning health facilities and the few that remain open are operating under the most extreme and dangerous conditions. Water, fuel and medical supplies are all in short supply. Missile strikes are a constant hazard. It is a soul-destroying situation that compels us to act.
That is why a cross-Government taskforce, on the orders of the Prime Minister, are working urgently to get some of the critically ill and injured children medically evacuated from Gaza. We expect the children and their immediate family members to arrive in the UK over the course of the autumn where they will receive first-class care, from first-class medics in surroundings that are safe and welcoming. This is a UK-wide process, and I am grateful to the Administrations in Scotland, Wales and Northern Ireland for their willingness to participate.
The UK Government are partnering with the World Health Organisation, which works on the ground and plays a critical role in supporting medical evacuations from Gaza. Participation in the UK Government evacuation is solely through the WHO supported process, and the UK Government cannot consider direct requests for assistance. The WHO will provide a list of potential patients assessed as priority cases by Gazan medical specialists, for an expert NHS clinical leaders team to review. Gazan children needing highly specialist medical care will then be matched with locations where capacity exists within the NHS to treat them.
Mindful that for these gravely weak and vulnerable children this is a potentially hazardous journey, children will only be transferred to the UK where it is clinically safe to do so and in the interests of each individual patient. As such, we will ensure medical assessments are undertaken before they travel.
On arrival in the UK, patients and their immediate family members will be granted access to the NHS, housing and other services for an initial two years. Should these individuals and their families wish to remain in the UK beyond that, they can apply for further permission to stay under existing routes within the immigration rules.
Robust security checks will be undertaken on all individuals who enter the UK as part of this process. Biometrics will be collected as part of the visa application process and prior to the final decision on the terms on which they will be granted entry to the UK.
The Government are working with both the NHS and the relevant local authorities to make sure both the children and their immediate families receive the help and support they need for the duration of their time in the UK. These are the innocent victims caught in the crosshairs of a bloody and brutal conflict. The least we in Britain can do is play our part and do our utmost to help them.
I expect to provide a further update to the House when the first cohort of children have arrived in the UK.
[HCWS899]
Oral Answers to Questions
Wes Streeting Excerpts(2 months, 3 weeks ago)
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Sojan Joseph (Ashford) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
This Government inherited an intolerable situation in A&E, where over a decade of Tory failures left patients waiting in pain. We are doing the hard work needed to start repairing that damage. Our new urgent and emergency care plan is backed by nearly £450 million, which will mean 800,000 fewer A&E patients waiting more than four hours this year, new urgent treatment centres, mental health crisis centres and almost 400 replacement ambulances. Those are just some of the steps that we are taking to rebuild our national health service.
Lillian Jones
I welcome the progress this UK Labour Government have made in reducing A&E waits in England. That sadly contrasts with a crisis in Scotland, where recent figures revealed 2,472 Scots waited over eight hours to be seen. Jackie Baillie rightly warned that
“Lives are being put at risk”
under the SNP, and it has been years since the Scottish Government last met any of their targets. Does the Secretary of State agree that only Labour in Westminster and in Holyrood has a serious plan to back NHS staff and cut waiting times?
Wes Streeting
I agree with my hon. Friend. There is no sign of the SNP Members this morning. They have obviously clocked off for the summer—or maybe they are just sparing their blushes, because the party has been in power for close to two decades in Scotland and has been steadily driving the NHS into the ground. The chair of BMA Scotland has said,
“the NHS is dying before our eyes”
with the SNP. It is on its fifth NHS recovery plan in less than four years. Scotland needs a new direction with a Scottish Labour Government. Working in partnership, we will fix the NHS across the United Kingdom and make it fit for the future.
Sojan Joseph
One of my first visits after being elected last year was to the A&E department at the William Harvey hospital in my constituency, where 19 patients were being treated in the corridors and others faced long waits for treatment. I therefore welcome the progress that has been made so far on reducing A&E waiting times. However, too many people end up at A&Es like the one at the William Harvey because they have no other option. What are the Government doing to increase care options in local communities, including the use of virtual wards to ensure that more people are treated closer to home and that patients in A&E are those in an emergency?
Wes Streeting
My hon. Friend is absolutely right. It is unacceptable that corridor care became the norm under the Conservatives. We will not accept it as normal; it is not acceptable. Ahead of this winter, we will require local NHS systems to develop and test plans to significantly increase the number of people receiving urgent care services outside hospital, including more paramedic-led care in the community, more patients seen by urgent community response teams, and better use of virtual wards. Together, we will improve our emergency services and make sure that people get the right care in the right place and at the right time.
David Simmonds (Ruislip, Northwood and Pinner) (Con)
The Government have spoken passionately about how minor injuries units, such as the one at Mount Vernon hospital in my constituency, help to take the pressure off A&E by diverting less urgent cases for treatment elsewhere. I am grateful to the Secretary of State for his time for a brief discussion about that last week. Will he now respond to the 25,000 local people and my constituency neighbours, including the right hon. Member for Hayes and Harlington (John McDonnell), who are joining my campaign to save the minor injuries unit? Will he intervene with the Hillingdon hospitals NHS foundation trust to prevent the unit’s closure?
Wes Streeting
Configuration of services is a matter for local commissioners. However, let me take this opportunity to reassure the hon. Gentleman that I have taken into account representations received from my right hon. Friend the Member for Hayes and Harlington (John McDonnell), as well as his letter. I apologise to him for the delay in response, but I assure him that he will get one.
Mr Will Forster (Woking) (LD)
In June, just 66% of patients admitted to Woking’s local A&E at St Peter’s hospital were seen within four hours. That is way below both the national target and the national average of 76%. Will the Secretary of State agree to investigate that to find out why my constituents of Woking are facing such lengthy and unreasonable waiting times?
Wes Streeting
As the hon. Gentleman knows, urgent and emergency care services have been struggling right across the country, but he is right to identify where there are serious and significant variations in performance. One of the focuses of this Government is to try to reduce unwarranted variation from one NHS provider to another, so that we get consistently good standards of care across the country. I commit to write to him to further explain why there are particular challenges in his area and what we can do together to help resolve them.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
Respiratory syncytial virus—RSV—is a common reason for attendance at A&E and admission to hospital among older people, and I have raised this repeatedly. Last week, the Joint Committee on Vaccination and Immunisation recommended that the RSV vaccine programme should be extended to the over-80s and those living in adult residential care homes. Can the Minister confirm that these vaccines will be available in time for this winter season?
Wes Streeting
I can certainly reassure the shadow Minister on this. The Minister for Public Health has already accepted that recommendation and is working at pace on implementation. May I wish the hon. Lady well in the Opposition reshuffle?
Laura Kyrke-Smith (Aylesbury) (Lab)
Joe Powell (Kensington and Bayswater) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
The driving force behind this Government’s approach to health is the principle that whoever a person is and whatever their background, they should receive the same world-class services as everyone else, based on need and not the ability to pay. That is why at its core, our 10-year plan for health looks to stamp out health inequalities, freeing up billions to move critical resources such as medicines and equipment to the regions and patients that need them most. Only a Labour Government will protect the NHS as a service free at the point of use, rebuild it, and make it fit for the future for everyone in our country.
Perran Moon
Meur ras, Mr Speaker. Carn to Coast runs GP surgeries across my Camborne, Redruth and Hayle constituency, including the surgery where my father practised for over 30 years. It is struggling under intense pressure, with deep-rooted health inequalities linked to the surrounding areas of deprivation. While I welcome the review of the Carr-Hill formula as part of the 10-year health plan, will the Secretary of State come to Cornwall and visit a Carn to Coast health centre with me, to see the innovative work that is already being undertaken and to discuss how the reforms will support health outcomes in the most deprived areas?
Wes Streeting
I can certainly give my hon. Friend that commitment. The damage that was wreaked by the previous Government, not just across our health service but across every other part of Government, means that the gap between the health of the poorest parts of our country and that of the wealthiest has widened enormously. We have seen real challenges in general practice, which is why there are 300 more patients per GP in the poorest communities compared with the richest, and that particularly affects rural and coastal communities with higher levels of deprivation. We are going to carry out a review of the Carr-Hill formula. That formula has to work for general practice, and I would be delighted to come and see the work that the team at Carn to Coast are doing.
Joe Powell
In Kensington and Bayswater, there is now a staggering 19-year gap in life expectancy between men living in Notting Dale and those living in Holland Park—which are just hundreds of metres apart—and that gap has grown in recent years. The Minister knows that this is a whole-of-society issue to do with housing, employment and education, but can he outline what steps the Department are taking to help inner-city areas with very high levels of health inequality, such as that experienced by my constituents in Kensington?
Wes Streeting
I am grateful to my hon. Friend for pointing out those stark differences in healthy life expectancy within a single inner London borough that contains some of the richest people on earth, as well as some of the poorest in our country. As for what we are doing as a Government, in addition to making sure that funding follows need and that we are tackling deprivation, our approach to neighbourhood health should make sure that we are working proactively in those communities that have the highest level of need, including pockets of deprivation within areas of higher affluence. Of course, as our plan recognises and as our mission-driven approach addresses, there are so many social determinants of ill health, including poverty, a lack of good work, damp housing, dirty air, and an inability to access culture and leisure opportunities that are affordable for everyone, not just the privileged few. Those are the issues that this Government are addressing, consistent with the Labour values that got us elected.
Sir Oliver Dowden (Hertsmere) (Con)
For residents of New Court Place care home in Borehamwood, wheelchairs are their lifeline. However, they are being badly let down by AJM Healthcare, their NHS wheelchair provider, with multiple unresolved assessments, bad communications and waiting times for repairs and replacements unbelievably extending to four years. Residents with physical and intellectual disabilities feel let down, overlooked and traumatised. In tackling health inequalities, can I urge the Secretary of State to look urgently at this provider and come to the aid of people who desperately need our help?
Wes Streeting
I can certainly give the right hon. Gentleman the assurance that my Department will look into the provider that he raises. One reason I was proud that this Government increased the disabled facilities grant is that it means not just more ramps, handrails and accessible kitchens and bathrooms, but dignity, independence, freedom and quality of life. That is precisely what the right hon. Gentleman’s constituents are being deprived of if they do not have wheelchairs that meet their needs. I would be delighted to look into this, and I am extremely angry that the failures he raises require me to do so.
Calum Miller (Bicester and Woodstock) (LD)
Does the Secretary of State agree that public health is at the heart of addressing the long list of inequalities he has just highlighted? I am deeply concerned that a major reorganisation of local government and the cutting of budgets to the integrated care board will undermine the co-ordination that currently exists in Oxfordshire to deliver public health. Can the Secretary of State assure me and my constituents that public health will continue to be a priority at the heart of the prevention strategy, and that funding for public health will rise in future years to make that possible?
Wes Streeting
I can certainly give the hon. Gentleman reassurance that the work we are doing to streamline and rationalise the amount of money we are spending on NHS bureaucracy means that we will free up resources that can be spent on the frontline, improving patient care and public health. Thanks to the decisions taken by my Department, the Deputy Prime Minister and, of course, my right hon. Friend the Chancellor of the Exchequer, investment in public health is rising and the spending power of local authorities is improving. That is all good news for public health.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
Tackling health inequalities requires a strong workforce. I recently met a constituent who is about to qualify as a nurse, but she has been unable to find work. She is not alone; this is a widespread problem. The reasons she has been given include recruitment freezes to save money and nurses brought in from overseas instead. We need more nurses to tackle health inequalities, so will the Secretary of State ensure that trusts are funded to support and employ new nurses, and to prioritise British nurses for British jobs?
Wes Streeting
I can certainly assure the shadow Minister that the chief nursing officer and I are working proactively to deal with nursing unemployment. We are also working with the leadership of the NHS to make sure that we are reducing our reliance on overseas workers. Grateful though I am to all the healthcare workers who come from overseas to work in our health and care services—the service would fall over tomorrow if they all left, so we should be extremely grateful—there is certainly an overreliance, and that is what we are addressing. I have to say to the shadow Minister, though, that both those issues are a result of appalling workforce planning, for which the previous Government bear a huge amount of responsibility.
Michelle Scrogham (Barrow and Furness) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
It is only with proper investment and reform that we will bring care closer to people’s homes and into the community. Our 10-year health plan will roll out a neighbourhood health service in every community, as one-stop shops for health and care services that meet the needs of local populations, including rural and coastal communities like my hon. Friend’s constituency. The previous Government failed to move care into the community. We have already hit the ground running on delivering the 10-year health plan, and launched the national neighbourhood health implementation programme on 9 July to start that work at pace.
Michelle Scrogham
My constituents in Barrow and Furness very much welcome the Government’s move towards delivering more neighbourhood health services, but my right hon. Friend will be aware of the great concern locally about the proposal from Lancashire and South Cumbria integrated care board to permanently end level 3 critical care at Furness general hospital. More than 10,000 people have signed my petition just this week to oppose that move. Will the Secretary of State please ensure that decision makers meet me and representatives locally to explore an alternative path forward that ensures patient safety, protects the integrity of our hospital and reflects the area’s growing population?
Wes Streeting
That was just one of many instances in which my hon. Friend has made the voices and views of people across Barrow and Furness heard loudly and clearly in this place and across government. In response to her question, I say yes, absolutely: on such an important matter her local commissioners should be meeting her, as the local Member of Parliament, and I think I can commit to that on their behalf. While such decisions must be made locally and clinically led, they must also be made in partnership with the local authority and the local community. We must ensure that we are engaging democratically elected representatives, and I will ensure that my hon. Friend secures that meeting.
Sir Jeremy Hunt (Godalming and Ash) (Con)
My constituents in Cranleigh have no train service and no direct bus service to the Royal Surrey County hospital in Guildford, which is a big issue for older residents who do not drive. Does the Secretary of State agree that some of the empty rooms in Cranleigh Village hospital could provide a very good opportunity for the expansion of neighbourhood health services, and if he has not been briefed on this pressing issue by his officials, may I brief him, or one of his Ministers, on it in the autumn?
Wes Streeting
That sounds like another bid for a neighbourhood health centre in the right hon. Gentleman’s constituency, but I am sure that local commissioners will be delighted to hear the case he has made, given the experience that he brings to bear.
Robin Swann (South Antrim) (UUP)
The Secretary of State for Health and Social Care (Wes Streeting)
Before this Government came to office, strikes were crippling the NHS. Costs ran to £1.7 billion in just one year, and patients saw 1.5 million appointments rescheduled. Strikes this week are not inevitable, and I sincerely hope that the British Medical Association will postpone this action in order to continue the constructive talks that my team and I have had with its representatives in recent days. Our priority is to keep patients safe regardless, and we will do everything we can to mitigate the impact on them and the disruption that will follow should these totally unnecessary and avoidable strikes go ahead.
Robin Swann
In a previous role, I found that health workers took industrial action only in extreme circumstances, so I agree with the Secretary of State that if the strikes can be prevented, they should be. During previous resident doctors’ strikes, elective or scheduled procedures were usually postponed, or planned to be postponed, to free up senior doctors to cover their work, but I note that the chief executive of NHS England has instructed hospitals to continue those procedures. Has the Secretary of State made any assessment of the impact that would have not just on patients but on the staff who would have to remain?
Wes Streeting
The approach we are taking is different from that taken during previous periods of strike action. NHS leaders have made it clear to me that those earlier strikes caused much wider harm than had previously been realised. There is no reason why planned care—appointments relating to cancer, for example, as well as other conditions—should be treated as being less important than, or playing second fiddle to, other NHS services. That is why the chief executive of NHS England has written to NHS leaders asking them to keep routine operations going to the fullest extent possible, as well as continuing priority treatments. It will be for local leaders to determine what is possible given staffing levels, which is why it is so important for resident doctors to engage with their employers about their determination—or not—to turn up at work this week, and why I must again spell out the serious consequences for patients should these avoidable and unnecessary strikes go ahead.
Lorraine Beavers (Blackpool North and Fleetwood) (Lab)
Healthcare assistants at Blackpool teaching hospitals NHS foundation trust have been underpaid on the wrong band for years, but the trust has consistently failed to put that right, and as a result staff have been left with no choice but to be balloted for strike action by Unison from today. Healthcare assistants play a vital role in our NHS, but is it any wonder that they often feel undervalued and demoralised when they are not paid the correct rate for the duties that they undertake? Does the Secretary of State agree that Blackpool’s healthcare assistants are worth just as much as those in the rest of the north-west and that the trust should pay up now?
Wes Streeting
I should declare that I am a member of Unison. The issue that my hon. Friend raises is a serious one. We obviously do not want to see strike action impacting on her local constituents, and my Department will do everything we can to help bring an end to the dispute.
I will make a more general point: these sorts of choices and trade-offs about resources are precisely why the BMA resident doctors, having received a 28.9% pay rise from this Government in the last year, ought to remember the responsibility that I and they have to some of their lower-paid colleagues. Resources are finite, and it is important that I act in the interests of all NHS staff and have particular concern for those who work extremely hard but are not properly rewarded.
Edward Argar (Melton and Syston) (Con)
The resident doctors’ strike is unnecessary, irresponsible and wrong. Recently, and again today from the Dispatch Box, the Secretary of State has been resolute in not giving in to the BMA resident doctors committee’s demands. Although I do not know the details of the current status of his discussions with the committee, may I encourage him to remain firm in his stance and, while being fair to doctors, to always ensure that he puts the interests of patients and taxpayers first?
Wes Streeting
Once again, the House is speaking with one voice, and I hope that the BMA understands the strength of feeling on both sides of the House about the unnecessary and irresponsible nature of the proposed strike action this week. Discussions in recent days have been constructive, and I hope that gives grounds for the postponement of strike action so that we can work together to avert it—not just this week, but altogether.
Lewis Atkinson (Sunderland Central) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
Under this Government, waiting lists have fallen by more than a quarter of a million in our first year, but strike action puts that hard-won progress at risk. If strikes do go ahead, we will do everything we can to minimise the disruption to patients, who will bear the brunt of cancellations. We continue to work with the BMA resident doctors committee in the hope that its members will do the right thing and call off the strikes. None the less, if they go ahead, we stand ready, responsive and resolute.
Lewis Atkinson
There were 5,448 drug-related deaths in 2023—the highest figure ever—and an 84% increase from the number that led the previous Government to publish their drugs strategy, which was supposed to save lives. Does the Secretary of State agree that the existing drugs strategy is not fit for purpose, and will he urgently start work on replacing it with a public health-led drugs strategy to tackle this public health emergency?
Wes Streeting
I am extremely grateful to my hon. Friend for his question. The number of drug-related deaths remains far too high, and we are committed to saving lives through access to high-quality treatment. For 2025-26, my Department is providing £310 million in addition to the public health grant to deliver the recommendations from Dame Carol Black’s independent review, but there is much more to do. We look forward to working with my hon. Friend to achieve success.
Edward Argar (Melton and Syston) (Con)
Dementia is one of the greatest health challenges that we as a society face today and in the future, but too many people with dementia end up in hospital, rather than being treated in more appropriate community settings. The 10-year NHS plan offers a real opportunity to shift care into the community and away from acute settings, including for dementia. Will the Secretary of State commit to working with Dementia UK, the Alzheimer’s Society and other fantastic charities as he develops the implementation of his 10-year NHS plan to ensure that it truly delivers for people with dementia and those who care for them?
Wes Streeting
I absolutely agree with what the shadow Secretary of State has said. All three shifts—from hospital to community, from analogue to digital, and from sickness to prevention—ought to benefit people with Alzheimer’s, dementias and other neurological conditions, as will the pioneering science that we need in this country, which I know he is so passionate about.
Edward Argar
Maintaining the focus on local communities, the fantastic St Mary’s birth centre in Melton Mowbray, in my constituency, has recently been temporarily closed by the local NHS trust for six months due to staff shortages. Although I appreciate that the Secretary of State does not have powers over such temporary closures and that local NHS leaders have engaged constructively, many local people fear that “temporary” could risk becoming permanent. If that risk looks like becoming a reality by the end of the summer, will the Secretary of State or one of his Ministers pre-emptively agree to meet me at that point to discuss it?
Mr Speaker, if I may briefly crave your indulgence at what is my last Dispatch Box appearance for the foreseeable future, may I take the opportunity—after seven years, almost continuously, on the Front Bench in government and in opposition—to thank you, to say that it has been a privilege, and to tell the Secretary of State that it has been a pleasure to shadow him? I think he knows it, but I genuinely wish him well.
Wes Streeting
I absolutely give the right hon. Gentleman the assurance that I would be happy to meet him about his constituency issue, or indeed anything else. For all of the exchanges that we have across these Dispatch Boxes on issues of disagreement, what is not always readily understood beyond this House is the extent to which those on both sides work extremely constructively together, on the enormous number of issues that we have in common, in pursuit of the national interest. The virtues of wisdom, kindness and selfless dedication to public service are not the preserve of one side of the House. The right hon. Gentleman has those qualities in abundance, and we wish him very well, personally and professionally.
Jas Athwal (Ilford South) (Lab)
Wes Streeting
I deplore Israel’s attacks on healthcare workers, as well as those on innocent civilians trying to access healthcare or vital aid. These actions go well beyond legitimate self-defence and undermine the prospects for peace. I will be in touch with the World Health Organisation to offer my support following the intolerable incident yesterday. I sincerely hope that the international community can come together, as my right hon. Friend the Foreign Secretary has been driving for, to ensure that we see an end to this war, but also the recognition of the state of Palestine while there is still a state of Palestine left to recognise.
Jess Brown-Fuller (Chichester) (LD)
Carers across the country have launched a protest from home today, with the Carers Trust. Their faces are projected on screens around Parliament Square because they are unable to leave their loved ones to protest in person. The Government’s pledge for the carer’s allowance review to report by early summer looks set to be broken. Can the Secretary of State today commit to ending the cliff edge for carer’s allowance and to introducing a statutory guarantee for respite care so that carers know that he is listening?
Wes Streeting
I thank the hon. Member for her question, and for making everyone aware of the powerful protest taking place today, which so visibly reminds us that lots of people’s voices may not be heard if they cannot participate in person. It is a reminder of the challenges that people face. I will undertake to raise her concerns with my right hon. Friend the Work and Pensions Secretary, and I give carers across the country the assurance that we are working as fast as we can. Having delivered the biggest expansion of carer’s allowance since the 1970s, we want to ensure we deliver for this extremely important group of people, whom we are lucky to have in our society.
Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)
Wes Streeting
I can absolutely give my hon. Friend that reassurance. It was appalling that the previous Government not only cancelled lots of the deprivation-linked funding put in place by the Labour Government but threw all that progress into reverse. That is not the approach that this Government will take. We will have funding based on need, not pork barrel politics. I can assure my hon. Friend that his constituents in Stoke-on-Trent will benefit from our sincere commitment to tackling health inequalities.
David Davis (Goole and Pocklington) (Con)
Wes Streeting
I can certainly give the right hon. Gentleman the assurance that we are looking right across NHS estates to make sure we are making best use of them, particularly in the context of neighbourhood health. I have heard the case he has made about how neighbourhood health services could be provided on that site. I hope commissioners have heard the case, but if not I will make sure that they do and that he gets the relevant meetings he needs.
Josh Dean (Hertford and Stortford) (Lab)
Wes Streeting
When this Labour Government came to office, we promised 2 million more appointments, but we have actually delivered 4.5 million. We have cut NHS waiting lists month after month, and they are now at their lowest level in two years. Of course there is more to do. I regret that we had to delay Watford general hospital; the previous Government left a plan that was not credible and had no available funding. We are cleaning up their mess, and the hon. Member has a cheek to complain about it.
Daniel Francis (Bexleyheath and Crayford) (Lab)
The report, “Barriers for adults with Cerebral Palsy on achieving full life participation”, published by the former all-party parliamentary group on cerebral palsy, highlighted the cliff-edge in support for those with cerebral palsy when they transition at the age of 18 and the need to end the separation of neuro and musculoskeletal knowledge within the NHS, given that cerebral palsy is a neuromusculoskeletal condition, and that those living with it need easy and ready access to both areas. I would therefore be grateful if I could understand—
Lee Anderson (Ashfield) (Reform)
Brierley Park medical centre applied for funding from the primary care utilisation and modernisation fund earlier this year. It has been successful, but it has not yet had the money, and the money must be spent by the end of the year. Will the Secretary of State please tell my medical centre when it will receive this vital funding?
Wes Streeting
The hon. Gentleman is absolutely right about the timeliness of decision making and the need to release funding when it is allocated. I shall make sure that my Department looks into that, and write to him with an answer.
Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
I commend my right hon. Friend for his work on reducing waiting lists, but at the Homerton in Hackney, because of a system-wide funding failure, deficit reduction money was removed three months into a 12-month agreement, which reduced the opportunity to drive down waiting lists still further. Will he or one of his colleagues meet me to discuss this issue and see what we can do to drive down those waiting lists?
Wes Streeting
We are taking action to deal with the over-running of budgets and the reckless spending across the NHS and to bring deficits under control, but I would be delighted to meet my hon. Friend.
Lincoln Jopp (Spelthorne) (Con)
Spelthorne residents Emma and John lost Holly to cancer in October last year. They set up the charity Holly’s Heroes in her name. Before she died, Holly was given a wheelchair by the NHS, and Emma and John cannot now give it back to the NHS for love nor money. I have raised this with the chief executive of the trust, but can the Secretary of State reassure me that this practice is not replicated nationwide?
Wes Streeting
We absolutely need to look at reducing waste in the NHS, so I would be delighted to pick up that case. Can I also say an enormous thank you to Holly’s family for the work they are doing in such unimaginable circumstances? I really admire people who put themselves forward to serve others in that way after such a painful experience.
Jen Craft (Thurrock) (Lab)
Last Friday I brought together GPs, housing developers, the local authority, the ICB, and anyone else you care to name, to try finally to solve the issue of our having one of the most under-doctored areas in the country for primary care. Among the many issues raised was a particularly niche one: thanks to NHS Property Services demanding a late payment from a couple of GP surgeries, which were unaware that they were due to pay this rent, those surgeries now face the possibility of having to pay a bill that equates to the cost of one GP’s salary for a year. That cannot be right.
Wes Streeting
I would be delighted to look at the issue that my hon. Friend raises. I am only sorry that I missed the party last week.
Tim Farron (Westmorland and Lonsdale) (LD)
Lancashire and South Cumbria integrated care board is having to make savings of £142 million this year, and the backdrop to that is a loss of wards at Barrow, Lancaster and Kendal. We hear a lot about additional money for the NHS. Why is none of it coming to Cumbria?
Wes Streeting
It is not the case that none of the money is going to Cumbria. We are taking action to deal with the persistent overrunning and over-spending of NHS budgets, which was an intolerable situation that we had to get a grip on. We are investing £26 billion more in the NHS, and that will rise over the course of this Parliament. We will make sure that every part of the country gets its fair share, not least through the deprivation-linked funding that I mentioned. I know that it is bumpy for ICBs as we get them back to balance, but believe me it will be worth it in the end when we have a sustainable NHS that is fit for the future.
Cat Eccles (Stourbridge) (Lab)
In 2020, a consultation was carried out to give prescribing rights to operating department practitioners, but despite positive discussions with the Department we are no further forwards and OPDs and allied health professionals are being held back. Does the Secretary of State agree that expanding their roles within scope of practice will improve efficiency, patient care and professional development?
Wes Streeting
We are keen to address these sorts of issues through our workforce planning and to ensure that staff are working to the top of their licensing capability, always within the training provided. That way we can get the best possible value for taxpayer money and, most importantly of all, the best outcomes for patients.
Damian Hinds (East Hampshire) (Con)
Does the Secretary of State agree with me about the importance of step-down provision, provided by community hospitals such as Petersfield and Alton, both for patient care and for relieving pressure on acute hospitals, such as Queen Alexandra and Basingstoke?
Wes Streeting
Yes, and that is why we are reforming the better care fund.
Josh Fenton-Glynn (Calder Valley) (Lab)
Key to the shift to prevention is making sure that people can stay in their own homes or get home from hospital. The Health and Social Care Committee found that such provision costs the NHS £1.9 billion every year. Can the Secretary of State update me on what we are doing to get the social care system working?
Wes Streeting
Thanks to the decision that the Chancellor has taken, spending power in social care is rising—not just through Department funding but in the spending power of local authorities. My hon. Friend is absolutely right: we have to get the right care in the right place at the right time. That often means better care for patients and better value for taxpayers.
Tessa Munt (Wells and Mendip Hills) (LD)
At midnight, The Times published an article on the ME final delivery plan, carrying quotes from three ME campaign groups. The charity Action for ME published a five-page briefing at the same time, and “BBC Breakfast” also featured the plan, so they had all read the plan. I checked with the relevant officers and went to the House of Commons Library about half an hour ago, and no plan has been published. More than 12 hours after the Department’s press release, no MP can access the plan. Is this how it should be?
National Security Investment
Wes Streeting Excerpts(3 months ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
I am today confirming that the Government will proceed with the construction of a new, state-of-the-art health security campus—including new high containment laboratory facilities—in Harlow, Essex. This site will replace the UK Health Security Agency’s (UKHSA) existing facilities in Colindale and Porton Down and will form part of the Government’s network of national biosecurity centres as announced in the national security strategy. This decision reflects the hard work and extensive campaigning by the hon. Member for Harlow and is a vote of confidence in Harlow’s potential.
This facility represents the most significant investment of its kind in a generation. The programme is a multi-billion-pound investment, with £250 million to be spent over this Parliament to kickstart delivery of the new facility. It will consolidate, into a single purpose-built site, the critical high-containment laboratory functions as well as the existing research and diagnostic functions of our existing facilities in one location and will also serve as UKHSA’s corporate headquarters.
The new Harlow site will strengthen the UK’s pandemic preparedness, reinforce national security, and provide world-leading capability to detect, assess and respond to health hazards.
In addition to the public health benefits, this development will support economic growth and create an estimated 1,600 additional high-skilled jobs. It will enable closer collaboration between leading scientists and the life sciences sector. The Harlow site offers strategic opportunities for new partnerships and scientific innovation and will further enhance the Oxford–Cambridge corridor as a major engine of national prosperity.
UKHSA will finalise the design of the Harlow site before construction begins, with phased occupation of the facility starting in the mid-2030s. The site will be fully operational by 2038. A period of dual running with existing sites will ensure a safe and effective transition of operations. UKHSA will maintain operations at Colindale and Porton Down until Harlow is fully validated and operational.
This decision will affect approximately 1,650 UKHSA staff across the Colindale and Porton Down sites and staff at its headquarters in Canary Wharf. UKHSA will work closely with affected staff throughout the transition period, recognising the unique and vital expertise of its workforce.
The Defence Science and Technology Laboratory (Dstl) site at Porton Down is not affected by this decision and will remain in operation on its existing site.
[HCWS843]
Vaccination Coding in General Practice
Wes Streeting Excerpts(3 months ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
I would like to update the House of an important issue affecting the NHS’s provision of vaccinations.
An issue has been identified in the use of Accurx batch messaging, a system that allows GP practices to send the same message to a group of patients, via email, NHS app or SMS. In some cases, when invitations have been sent to patients inviting them to receive a vaccination, the code for a completed vaccination was selected on the system, rather than the code for an invitation. This did not affect patients being invited to receive a vaccination, but their record on the GP practice system was updated to say, incorrectly, that they had received a vaccination.
This has affected around 57,000 records across 337 GP practices. Our investigation suggests that this has primarily affected records in relation to vaccinations for the respiratory syncytial virus vaccination—a maximum of 2% of vaccines administered—but also some other vaccinations. For anyone to miss the opportunity to be invited to receive a necessary vaccination is extremely regrettable, and we are taking steps to resolve this. There is currently no evidence that anyone has been harmed as a result. Not everyone whose record has been affected will have missed out on a vaccination, as an initial vaccination invitation will have been sent out and a direct invitation is not the only route to securing a vaccination. We would strongly encourage anyone eligible to come forward for their vaccinations when invited, to get vital protection.
Accurx has amended its clinical coding to prevent this happening again. GP practices affected will review patient records, to make sure that anyone due a vaccination who has not received one is offered one as soon as possible, and that records are accurate and up to date. On average, an affected GP practice will have to review less than 200 cases and NHS England and integrated care boards will support them in this process. A detailed root cause analysis will be carried out to ensure that we learn from this and avoid similar issues in the future.
[HCWS850]
Independent Review of Physician Associates and Anaesthesia Associates
Wes Streeting Excerpts(3 months ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
In November 2024, I asked Professor Gillian Leng CBE to undertake an independent review of physician associates and anaesthesia associates in England, and to set out recommendations to ensure the safety of the roles and their contributions to multidisciplinary healthcare teams.
Today I want to update the House on next steps following the publication of the review.
Professor Leng sets out 18 recommendations that will give much-needed clarity, certainty and confidence to staff and patients. The Government are accepting these recommendations in full.
The overarching recommendations include: renaming the role of “physician associate” to “physician assistant” and “anaesthesia associate” to “physician assistant in anaesthesia” to reflect their position as a supportive, complementary member of the medical team; providing ongoing opportunities for training and career development; making it easier for others to identify these roles; establishing permanent faculties to provide professional leadership and set clear professional standards; greater clarity in the differences between the regulatory requirements of doctors and assistant roles; training in line management and leadership for doctors, with additional time allocated; redesigning models of multidisciplinary working; and improvements in safety reporting.
For physician assistants specifically, Professor Leng has recommended that their initial practice is clearly defined in line with job descriptions; they do not see undifferentiated patients (except within clear national clinical protocols); that newly qualified physician assistants should gain at least two years’ experience in secondary care, to enhance clinical skills, prior to taking a role in primary care or a mental health trust; and that they should form part of a clear team structure and have a named supervisor.
For physician assistants in anaesthesia, the review recommends full compliance with the existing Royal College of Anaesthetists scope of practice; that any further expansion of the role should be taken forward in conjunction with the Royal College of Anaesthetists; and that there should be an ongoing national audit of safety outcomes in anaesthesia, to gain assurance around the safety of the physician assistants in anaesthesia role.
Implementing the recommendations will require organisations to work together and take action. Some actions will be implemented immediately, while others will require wider input, with benefits being fully realised over time. I have asked NHS England to move with immediate effect to implement those recommendations which most directly affect patient safety, including moving to the use of physician assistants and physician assistants in anaesthesia titles and ensuring that physician assistants do not see undifferentiated patients, except within clearly defined national clinical protocols.
The NHS is its people, and physician assistants and physician assistants in anaesthesia can play a vital role in the delivery of the shifts set out in the 10-year health plan for England. The findings in this report demonstrate that, when integrated appropriately, physician assistants can improve access, enhance capacity, and provide continuity of care, while physician assistants in anaesthesia can help expand theatre capacity and flexibility in anaesthesia services.
However, the review is clear that change is needed. It sets out the fundamental issues that need to be tackled to effectively and consistently embed change into the NHS workforce. These recommendations provide a practical way forward on title, ongoing development and practice that we can all have confidence in.
I would like to express my immense gratitude to Professor Leng and her team for their effort and dedication in carrying out this considered, complex and comprehensive review. I also want to extend my thanks to all those who have engaged constructively with the review, including those resident doctors who have respectfully raised concerns, and physician assistants and physician assistants in anaesthesia who make valuable contributions across the NHS and have been subject to intense scrutiny.
We will consider Professor Leng’s findings and recommendation in detail in conjunction with the 10-year health plan. The lessons learned in the review will be embedded into the upcoming workforce plan to improve how we effect change in the NHS, and ensure the mistakes of the past are not repeated in the future. We will work with key partners, including NHS England in advance of publishing a fuller response, setting out a clear implementation plan to make the required changes in due course.
[HCWS830]
Fuller Inquiry Phase 2 Report
Wes Streeting Excerpts(3 months ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
Today, the independent inquiry into the issues raised by the actions of David Fuller has published its phase 2 and final report. It focuses on whether procedures and practices in hospital and non-hospital settings sufficiently safeguard the security and dignity of the deceased and would prevent a recurrence of the issues identified by the inquiry, as well as considering the role of regulation.
I wish to pass my thanks on to any individual or organisation who has provided evidence to this important independent inquiry. I extend my heartfelt condolences to the families of the victims and assure them that we are committed to learning from these events.
In 2023, the independent inquiry, chaired by Sir Jonathan Michael, published its phase 1 report, which set out how Fuller was able to commit such shocking crimes, undetected for so long at Maidstone and Tunbridge Wells NHS trust. The trust set out its progress implementing all the inquiry s recommendations via an assurance statement in February 2024.
A phase 2 interim report was published in October 2024. The inquiry’s chair expedited the inquiry’s work on the funeral sector in light of reports of cases of neglect. The interim report presented preliminary findings and recommendations on the funeral sector in England. The Government committed to responding to these recommendations as part of the final phase two Government response.
The overall conclusion of today’s final report is that current arrangements for the care of people after death are partial, ineffective and in some areas completely lacking. The overarching recommendation for Government is that there should be statutory regulation to protect the security and dignity of people after death, regardless of the setting or institution.
Today’s report makes 75 detailed recommendations in total, including 19 for trusts and 25 for local authorities focusing on access, dignity, security, and wider processes and procedures to protect deceased individuals. A smaller number of recommendations—31—focus on independent hospitals, medical education, hospices, ambulance services, care homes, the funeral sector and faith organisations, making specific recommendations to improve the care of the deceased. This includes recommendations for the UK Government to establish an independent statutory regulatory regime for the funeral sector.
Every deceased individual deserves to receive the highest standard of care and dignity. The Government will work to ensure this is the case, across all settings, be that in the NHS or other settings including local authority mortuaries, hospices, ambulance services, care homes, funeral homes, and faith organisations.
The Government recognise the urgency of the concerns raised by the inquiry’s recommendations and will respond at pace. This will include an interim update on progress this year and a final response by summer 2026.
[HCWS824]
Resident Doctors: Industrial Action
Wes Streeting Excerpts(3 months, 1 week ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
With your permission, Madam Deputy Speaker, I will make a statement on planned industrial action by resident doctors.
Today’s waiting list figures show that after 14 years of decline, the NHS is finally moving in the right direction. Since July, we have cut waiting lists by 260,000. We promised to deliver an extra 2 million appointments in our first year, and have more than doubled that figure, delivering 4.6 million more appointments. For the first time in 17 years, waiting lists fell in the month of May, and they now stand at their lowest level in more than two years. That is what can happen when NHS staff and a Labour Government work together. We have put the NHS on the road to recovery, but we all know that it is still hanging by a thread, and that the BMA is threatening to pull that thread.
On Tuesday this week, I met the co-chairs of the BMA’s resident doctors committee to discuss the results of its ballot for industrial action. In that meeting, and in a letter I sent yesterday, I offered to meet the BMA’s full resident doctors committee and work with it to improve its members’ working lives. Since the start of this year, I have offered repeatedly to meet the entire committee, but it still has not taken up my offer. Instead of agreeing to talk, the BMA responded by announcing five days of strike action. Its planned strike action will run from 7 am on Friday 25 July to 7 am on Wednesday 30 July. These strikes are unnecessary, given this Government’s willingness and eagerness to work together to improve resident doctors’ working conditions. Following a 28.9% pay rise thanks to the actions of this Government, the BMA’s threatened industrial action is entirely unreasonable. I am asking it again today to pause, call off the strikes, and instead work with the Government to rebuild its members’ working conditions and rebuild our NHS.
Before this Government came into office, a toxic combination of Conservative mismanagement and strikes was crippling the NHS. The cost to the NHS ran to £1.7 billion in just one year; patients saw 1.5 million operations and appointments cancelled, and people’s lives were ruined. Phoebe suffers from a genetic condition: neurofibromatosis, which causes non-cancerous tumours on the outside of her body. Her first operation at Great Ormond Street hospital was cancelled twice—at first due to strikes, and then because there was not the capacity to treat her. Phoebe loves going to school, and it is an absolute tragedy that her education was set back. She was prevented from doing what she loves because the NHS was not there for her when she needed it, but this year, when Phoebe’s family contacted Great Ormond Street in March, her surgery was scheduled less than two weeks later. Compared with what she went through two years ago, the difference was night and day.
That is the difference a Labour Government make, and it is why this Government were absolutely right to end the strikes when we came to office. I am so proud of what we have achieved together with NHS staff. In the words of one NHS leader I spoke to recently, there is light at the end of the tunnel and, for the first time, it is not an oncoming train. That has only been possible because of the deal this Government negotiated.
When we agreed that deal to end the strikes last year, resident doctors did not just receive a 22% pay rise; the Government also gave a genuine commitment to build a new partnership with those we now call resident doctors, based on mutual respect. I have personally ensured that that commitment was followed through. A new exception reporting process has been agreed with resident doctors in principle, so that doctors are paid for the work they are asked to do. A review of rotational training is under way and almost complete to reduce disruption to resident doctors’ lives. We promised to tackle GP unemployment, and we have delivered with an extra 1,900 GPs on the frontline who were otherwise facing unemployment. I am determined to go further to tackle doctor unemployment.
When I say to resident doctors that I want to tackle the bottlenecks they face, and the unfair competition for specialty training places, and to create more training places, they can judge me not just by my words, but by my actions. When the pay review body recommended a 5.4% average pay rise for resident doctors this year, we accepted that and funded it in full. Those are not grounds for industrial action. Indeed, in the history of British trade unions, it is completely unprecedented for a pay rise of 28.9% to be met with strikes. The BMA itself described this pay rise as “generous”.
Thanks to this Government, the average annual earnings per first year resident doctor last year were £43,275. That is significantly more, in a resident doctor’s first year, than the average full-time worker in this country, and it is set to increase further with this year’s pay award. For resident doctors in their second year out of medical school, their average annual earnings rose to £52,300 last year. In core training years, resident doctors earned an average of £67,000. Specialty registrars earned on average almost £75,000. There is no question but that these are highly trained, highly skilled medics who work hard for their money, but to threaten strikes in these circumstances is unreasonable and unnecessary, so it is no wonder that the BMA has lost the public’s support.
At the beginning of this dispute, resident doctors faced a Conservative Government cutting their pay and refusing to talk to them. A clear majority supported action as a result. In February 2023, 56% of the public backed junior doctor strikes. Today, that support has collapsed. Just one in five people believe that the BMA is doing the right thing. Patients are begging resident doctors not to walk out on them, and I hope the BMA is listening, because many resident doctors are.
For the first time since the BMA’s campaign began, a majority of BMA resident doctors did not vote for strike action. They can see that the Government have changed and our approach has changed, yet the BMA’s tactics have not. Resident doctors have received the highest pay award in the public sector, both this year and last year, so renegotiating this year’s pay award would be deeply unfair to all other public servants. Such a deal would be paid for by their future earnings, and with the greatest respect to resident doctors, there are people working in our public services who are feeling the pinch more than they are.
Even if it would not be unfair on public sector workers, it is unaffordable. It should be apparent to anyone that the public finances this Government inherited are not awash with cash, so I will not and cannot negotiate on this year’s pay award, and I am not going to lead resident doctors up the garden path by making promises unless I know I can keep them. As I have said in person, in writing, in private and in public, I am willing and ready to get around the table and work together to improve the working conditions of resident doctors. There is so much more that we can do together. I do not just hear the complaints that resident doctors have about their placements, rotations and bottlenecks— I agree with them. I know the NHS has been a bad employer, and I am determined to change it. My offer to talk comes with no preconditions attached. I will also say this to resident doctors directly: consider very carefully the consequences of your actions.
Madam Deputy Speaker (Caroline Nokes)
Order. May I suggest to the Secretary of State that his statement has already taken 10 minutes and he has not asked for additional time? Does he wish to consider whether his statement is to the House, or to those outside the House? He might like to make a few closing remarks.
Wes Streeting
Thank you, Madam Deputy Speaker. I will move to closing. I did share the statement in advance, including with Opposition parties and the Speaker’s Office. I just say to resident doctors, and it is important that the House knows what we are saying to them, that they should carefully consider the consequences of their actions. Five days of strike action mean patients and their families receiving the phone call they are currently dreading, being told that the operation or appointment they have been waiting for—often for far too long—is being cancelled and delayed. I know how I would feel if that happened to a member of my family, and I ask them to consider how they would feel if that happened to a member of theirs. While they are out on the picket line, protesting the 28.9% pay increase they have had, their friends and colleagues and other NHS staff—many of whom are paid less and receive less than them—will be inside, picking up the pieces and working in harder conditions to cover for the consequences of resident doctors’ actions.
In conclusion, the strikes are not only unnecessary and unreasonable, but unfair. They are unfair on patients, unfair on other NHS staff, and unfair to the future of the NHS, which is in jeopardy. The tragedy is that they will never have had a Secretary of State as sympathetic to their legitimate complaints as this one. If they want to know what the alternative is, its Members are not sat here. They have not even bothered to show up today, and that party does not even believe in the NHS. The grass is not greener on the other side. I ask them not to squander this opportunity. At this stage, we can still come out of this dispute with a win for the BMA’s members, a win for the NHS and a win for patients, but if the BMA continues down the path of strike action, it will lose its campaign, resident doctors will be worse off, and the heaviest price of all will be paid by patients. I commend this statement to the House.
Madam Deputy Speaker (Caroline Nokes)
I call the shadow Secretary of State.
Edward Argar (Melton and Syston) (Con)
I am grateful to the Secretary of State for his typical courtesy and advance sight of his statement. I also note that he is among the most assiduous of Ministers in volunteering himself to this House to be questioned on issues of importance. I am, however, afraid it comes as no surprise that we are here today discussing likely industrial action on this Government’s watch. Last year, we warned the Government that caving in to union demands for above-inflation pay rises without any conditions or strings attached would set a dangerous precedent. It would send a message that the Government were weak, and we warned that the unions would simply come back for more. Unfortunately, events in recent days have shown that we were right.
The public will be understandably concerned about what this industrial action will mean for them and the provision of local NHS services. For patients with an appointment scheduled or even on a waiting list, that concern will be particularly acute. Let me be clear: this BMA strike action—as the Secretary of State has said, it is supported by less than 50% of those eligible to vote—is irresponsible, wrong and unnecessary. On that, I agree with the Secretary of State.
Will the Secretary of State enlarge on the additional steps that he is taking to seek to resolve the industrial dispute and prevent the strike action from going ahead? I heard what he said about his willingness to talk. Does he anticipate further meetings before strikes start on 25 July, and does he anticipate a risk of any other parts of the NHS workforce balloting for strike action?
If this strike action does take place, what steps are being put in place to minimise disruption, what is the plan to protect patients who will need to access NHS services over this period, and can the Secretary of State guarantee that emergency cover will remain and that there will be minimum service levels in place? More broadly, and based on the previous strikes, how many appointments do the Government anticipate are at risk of being cancelled or postponed, and has he assessed what impact the decision by the BMA will have on his aim of reducing waiting lists and meeting his 18-week target?
The previous chief financial officer of NHS England said that nearly all the money allocated to the NHS at the autumn Budget will be eaten up by NHS pay settlements, the national insurance hike and increased inflationary costs, just to maintain services at their existing level. Following the recent spending review and the Chancellor’s announcement of additional funding, how much of that does the Secretary of State anticipate will be spent on staffing costs, including the already agreed pay award and the national insurance increase, and how much of it will actually make it to the frontline in the form of additional care, or to fund the reforms that he set out recently?
What does the Secretary of State anticipate will be the long-lasting impact of strike action on relations between the Government and trade unions in the health space? The 10-year plan was published just last week. As I said at the time, it is sensible and I am supportive of what he has set out in that, but concerns have been raised about its deliverability. The Secretary of State has said previously that he will need to work with the unions to deliver on the plan. Is he still confident that that will be possible? Does he believe that they will agree to the changes that are required, or is there a risk of further strike action over the coming years because doctors have sensed a weakness?
In opposition, the Secretary of State had some very strong and well-articulated views on industrial action. He said strike action was
“playing politics with our NHS”.
On that, I agree with him. He said that
“the Government ought to be pulling out all the stops”—[Official Report, 22 December 2022; Vol. 724, c. 218.]
and that
“the power to stop these strikes is in the Government’s hands.”—[Official Report, 12 December 2022; Vol. 724, c. 732.]
He is the Secretary of State now. Does he agree that the power to stop these strikes is in his hands?
Our message to the Government is clear. The Secretary of State needs to do what he has said he will do: face down union pressure and deliver an affordable settlement that is fair to staff, patients and, crucially, taxpayers. On his watch, resident doctors are set to leave the frontline to go on to the picket line—whether that happens will be down to him. Sadly, Labour’s weakness is fuelling this crisis. If the Government do not get a grip now, a summer of discontent and strikes risks turning into a summer of chaos, and it will be patients who pay the price.
Wes Streeting
I think the shadow Secretary of State’s memory is letting him down. Let me just remind him that before the general election, and after months of refusing to meet the BMA, the Conservatives finally entered negotiations, but not before strikes were left to run and run—at a cost of £1.7 billion to the taxpayer—and 1.5 million operations, appointments and procedures were cancelled. They also offered the BMA junior doctors a pay rise, which was only about 4% of the pay rise that we eventually agreed. Imagine what would have happened if the Conservatives had pulled their finger out and got the doctors around the table sooner, and had not been quite so intransigent.
The shadow Secretary of State is right to say that I criticised my predecessors for their unwillingness to negotiate. The difference between me and them is that I have acted. Resident doctors have had a 28.9% pay increase thanks to the decisions that I have taken as Secretary of State, with the support of the entire Government. They have a Secretary of State who does not slam the door in their face, but who is open to working with them to improve their conditions.
The responsibility for these strikes lies squarely with those running the BMA’s resident doctors committee. Despite failing to get a majority of their members to vote for strike action for the first time in their campaign, they are still proposing to lead their members out on a five-day strike. They even made the announcement on the day that I had already written to them to suggest that we meet to avert unnecessary strike action.
The shadow Secretary of State is right to talk about the jeopardy facing the future. Because we produced our 10-year plan in partnership with patients, the public and NHS staff, there is not only much in it that resident doctors should welcome, but much that they suggested. Our 10-year workforce plan will set out training, education and retention of the workforce, and we will work closely with resident doctors on standards. They should start to experience an improvement in their working conditions on everything from the availability of nutritious food and drink to reducing violence against staff and tackling discrimination. We have already committed to prioritise UK graduates for training, and we have started a conversation on contractual reform with trade unions across the board. We are determined to recruit more people locally and to tackle social disadvantage, access to medicine and all the issues that are at the forefront of the minds of resident doctors, such as placements, rotations and future career progression, including specialty bottlenecks. I absolutely want to work with them.
These are not conditions for strikes. These are conditions to work in partnership with the Government, just as other NHS unions and so many other trade unions across the public sector do. I say to resident doctors once more that sitting in front of me is the ghost of Christmas past. Reform—its Members are not in their place today—is the ghost of Christmas future. Perhaps BMA members might consider that they are lucky to have the ghost of Christmas present in front of them.
Alex McIntyre (Gloucester) (Lab)
I am glad the Secretary of State has reminded Conservative Members that they have rather short-term memories. When I took my place in this House last year, thousands of my residents in Gloucester were on NHS waiting lists—many of them for longer than 18 months. Since this Labour Government took power last year, the number has come down by 92%, in part thanks to the hard work of resident doctors in my constituency. Does the Secretary of State agree that strike action by the BMA will put that recovery at risk? Will he invite its members to meet my residents who are still on the waiting lists left behind by the Conservative party, so that they can explain why the 28.9% pay rise, which many of my constituents will not receive this year, is not enough?
Wes Streeting
I completely agree with my hon. Friend. I urge BMA members to consider not just the significant progress that they have already made by working with a Labour Government, but the wider context in which we are operating. It is not just resident doctors who have seen their pay eroded over more than a decade of Conservative Government; it is the entire public sector. It is not just resident doctors who are working in crumbling buildings with out-of-date equipment and technology; it is the same in our schools, our hospitals, our prisons and the entire public sector estate.
This Government are facing enormous challenges across our economy, and we cannot sort out every issue that we inherited overnight, or even in one year—it is going to take time. BMA members should be proud of the progress that we have made together, and reassured that we want to make further progress with them, but there has to be some give and take here, and there has to be some reasonableness. Given the potential consequences of their action for patients, for their fellow staff and for the future of the NHS, the strike action is unreasonable, unnecessary and deeply unfair.
Madam Deputy Speaker (Caroline Nokes)
I call the Liberal Democrat spokesperson.
Alison Bennett (Mid Sussex) (LD)
People across the country, and NHS patients in particular, will be disappointed to hear of yet more strike action by resident doctors this July, especially after the immense disruption of recent years. I and my Liberal Democrat colleagues fully recognise that this dispute does not come out of nowhere. The previous conservative Government left our NHS under unbearable strain, with doctors working under intense pressure in crumbling hospitals and often without the resources they needed. My constituents, and people across the country, need and deserve a well-functioning NHS.
Over the past three years, doctors have received a 28.9% pay rise following earlier strikes. The BMA is now calling for a further 29% increase, but we have to be honest: after years of economic mismanagement by the Conservatives, the public finances are in a dire state. That kind of increase does not feel affordable or realistic right now. That said, we cannot ignore the reality of working conditions in our NHS. Doctors are expected to save lives in collapsing wards and to deliver care in corridors, rather than in safe clinical settings. It is degrading and dangerous for both staff and patients. We need constructive dialogue, not escalation, to resolve this dispute swiftly and fairly, and most importantly, we need urgent action to rebuild our NHS and restore working conditions that our doctors and patients can be proud of.
First, will the Secretary of State improve staff morale by committing to end the dangerous and dehumanising practice of corridor care? Secondly, does he not see that by dragging out social care reform, delayed discharges and corridor care are only going to worsen doctors’ experiences of working in the NHS, weakening morale and lowering care standards?
Wes Streeting
I am grateful to the Liberal Democrat spokesperson, and I think I can reassure her on a number of fronts. First, she is absolutely right to call out the disgrace that is corridor care. Despite the best efforts of staff, who suffer the moral injury of treating patients in that situation, in too many parts of the NHS we have patients being treated on trolleys in corridors. In this decade of the 21st century, I think that is unacceptable, as is the emerging nomenclature that has started to describe these as “temporary escalation spaces”, because we are in danger of normalising what should be considered unacceptable practice. That is why this Government will shortly begin transparently publishing corridor care data showing the number of patients being treated on trolleys in corridors. I am sure there will be moments when that might cause Ministers and NHS leaders to blush, but frankly, until corridor care is consigned to history, so we should. Sunlight is the best disinfectant, and by publishing the data we will hold ourselves to account, and I am sure this House will hold us to account to ensure that we deliver the conditions that staff and patients deserve.
I also reassure the hon. Member that, while the Casey commission is under way, work on social care goes on, whether that is the £4 billion increase in investment in social care through the decisions taken by my right hon. Friend the Chancellor, or other improvements such as to carer’s allowance, the disabled facilities grant and uplifts in funding for local authorities. However, I am also committed to ensuring that, as we improve the flow of patients through our hospitals and deal with the scourge of delayed discharges, we are a lot better at thinking about how we use the taxpayer pound to best effect to deliver the right care, in the right place and at the right time. That will often mean using NHS resources to commission social care to help tackle delayed discharges, and we will be keeping a close eye on that.
Finally, I thank the hon. Member for joining the voices of reason in this Chamber. I hope it is not lost on the BMA and resident doctors watching that this is not a case of an intransigent Government unwilling to work with and support them who are trying to face down, for political and ideological purposes, a trade union speaking up for its members. This Labour Government have delivered a 28.9% pay increase and we are willing to work further to improve conditions for resident doctors. That work can start now, and I am ready to meet the BMA immediately.
There are other voices of reason in this Chamber, including among the Liberal Democrats, who recognise the pressure on the public finances. They recognise that we are trying to do many things across the NHS that will also directly benefit resident doctors, such as making sure they have the right kit and are working in decent buildings. We are improving the conditions that they are working in and that patients are treated in so that, together, we are building in, working in and being treated in an improving NHS. That is the prize, and that prize is being thrown into jeopardy by the resident doctors’ actions. If they go down this path, with all of the consequences that will follow, I am afraid—for them, let alone for the NHS and for the country—things will get worse rather than better, and I urge them not to take that course of action.
Warinder Juss (Wolverhampton West) (Lab)
Does my right hon. Friend agree that we were right to settle the strikes last year, for the sake of ensuring the future of the NHS, protecting the interests of the public and showing our doctors that they are valued, that that will always be his position, and that it is therefore somewhat surprising that resident doctors have decided to call this strike?
Wes Streeting
I strongly agree with my hon. Friend—he is absolutely right. I am happy to stand corrected, but there is genuinely no historical precedent in the history of British trade unionism for a trade union to have successfully negotiated with the Government of the day a 28.9% increase for its members and then go out on strike. I think that undermines the BMA, and the more reasonable voices in the BMA with whom we continue to work constructively. It certainly undermines our NHS.
It also reinforces the grossly unfair caricature, which is often thrown at trade unions by the Conservatives, that they are all unreasonable, do not want to work with the Government of the day and are only interested in combat and agitation. In my experience, the vast majority of trade unions and trade unionists are interested in constructive engagement, striking good deals and moving forward the interests not just of their members, but of our whole country. I urge the BMA resident doctors committee to stand in that proud tradition of British trade unionism and in the proud traditions of the wider Labour movement, but I am afraid I do not see those traditions or behaviours reflected in the current approach of the BMA RDC.
Sir Edward Leigh (Gainsborough) (Con)
We can all argue about the past, but if it helps the Secretary of State, I think we should just say today that the whole House absolutely 100% supports him in his robust attitude. [Hon. Members: “Hear, hear.”] Of course we all love doctors, but the starting salary is not so very bad. They have a job—a very good job—for life, which most people do not have, and he could also mention that they have a much better career structure than most people. A far higher proportion of them get the top job—namely, as a consultant—and the consultant’s starting salary of £110,000 a year is not a bad whack.
Wes Streeting
First, I think that the right hon. Member’s opening statement and the response across the House underline to the BMA and the resident doctors committee that they do not have support across this House—from the left across to the right, with maybe one or two noises off—and that is not typical in my experience of being in this House for the last decade.
I think the career of resident doctors and the prospects they can look forward to, which the right hon. Member described, have worsened. That is one of the things that is at the heart of the dispute they have taken up with the previous Government and now with this one. Many of the things doctors used to be able to look forward to—guaranteed jobs and progression into consultant roles or general practice—have steadily eroded. We have far too much doctor unemployment and far too many specialty bottlenecks. We have what I think is a really unreasonable set of behaviours towards resident doctors in terms of placements, rotations and the ability to take time off work to attend weddings and other important life moments. The tragedy of the position we find ourselves in is that I recognise that and I want to address it. We can do that together without the need for strike action, and those are not reasons for strikes. Worse still, especially at a time when I am prioritising dealing with doctor unemployment, they are inflicting further costs on the NHS, patients and the taxpayer. That makes my freedom and flexibility and my resources to deal with those issues more limited—that is the tragedy of their tactics.
Emma Foody (Cramlington and Killingworth) (Lab/Co-op)
I thank the Secretary of State for his statement and the ongoing work to get the NHS back on its feet after it was pushed to the brink under the previous Government. Strikes inevitably have a financial and a human cost to them, and the next round of strikes will undoubtedly have that too, meaning that the NHS will take a financial hit. Can he share the impact that this will have on the system? For example, can he guarantee that the cost of these strikes will not lead to job cuts?
Wes Streeting
In all honesty, I am afraid I cannot give my hon. Friend that assurance. NHS finances are precariously balanced. We have been relative winners across the Budget and the spending review set out by my right hon. Friend the Chancellor of the Exchequer, but we are asking a lot of the system. As well as the progress and improvements we want in the NHS, we inherited a lot of mess to clean up, and that will take time and resource. Every penny spent on the price of failure through strike action is a penny that could have been spent on driving improvements in the service—improvements for patients and for staff—and on creating the jobs and opportunities that mean doctors do not graduate into unemployment and that mean resident doctors can progress into specialty training posts. That is why I say clearly and unequivocally to the BMA that if this strike action goes ahead, with all the costs, pain and misery that will follow, it will not just be patients—or, indeed, this Government—who suffer, but the BMA.
Sir John Hayes (South Holland and The Deepings) (Con)
I have known the Secretary of State a long time. I knew him before he was an important man—although he was always important to me, of course. He will know that as a Minister, I worked with the trade unions in every sector for which I was responsible, as the RMT and the University and College Union will confirm, and I was also a member of the Association of Teachers and Lecturers. I entirely endorse and amplify what he says. Responsible trade unionism requires people to be reasonable, and reasonable people in this House know that this strike against this background is entirely unacceptable, as he has described.
I ask the Secretary of State this: will he ensure that this unhappy, unwholesome and unhealthy action does not jeopardise the health of my constituents, and will he write to the local authorities—the integrated care boards—in my area and others to set out how they can minimise the impact of this action? The last thing that you want, Madam Deputy Speaker, or that I or any Member across this House wants, is for those at risk to be put at greater risk as a result of this irresponsible action by these militant people.
Wes Streeting
I thank the right hon. Gentleman for his question. He is that rare beast: a Tory trade unionist. He raises the serious point of the consequences of strike action. I will, of course, keep the House updated, but I want to reassure the House that we are taking every step possible to mitigate the disruption that these strikes will cause. That will come at a financial cost and a cost to patients because of the disruption that will follow. It will also come at a cost to other staff, many of whom are paid less than resident doctors, who will be left at work with more pressure and in harder conditions, picking up the pieces because of the actions of their colleagues who were given a higher pay rise, but who will be stood outside protesting the 28.9% pay rise that they received.
I assure the House that we will do everything we can to mitigate the impact of the strikes on patients and the disruption that will follow. What I cannot say to the House, however, is that we can offset or cancel the impact or detriment felt by patients. We will look carefully at the data on the experience and impact of the strikes that occurred during the previous round of negotiations. I will ensure that that information is published so that the House can see the impact of the previous strikes, so that we can brace ourselves for what may lie ahead.
Lewis Atkinson (Sunderland Central) (Lab)
Anyone who has ever worked in healthcare knows that it is a team sport and that delivering excellent care requires a range of staff across the allied health professions including nurses, doctors, administrative staff and estate staff. Does the Secretary of State agree that it is therefore essential that all NHS staff groups have confidence that their pay is being set fairly, and that going beyond the independent pay review body’s recommendations for one set of staff would undermine the “one NHS” team ethos that so many have worked to build?
Wes Streeting
I strongly agree with what my hon. Friend says. I have been personally invested in our relationship with resident doctors and in the deal we struck—not just because it was one of the first things we did when we came into office, and because I am very proud of what we have achieved together, but because I had and still have a huge amount of support and sympathy for resident doctors and a determination to address the issues they are raising. However, I reassure my hon. Friend and the House that resident doctors are one part of the NHS workforce—a valued part—but I have responsibility for the entire workforce. We set ourselves the task of building an NHS fit for the future, but we cannot do it on our own as a Government; it requires the whole team to pull together.
I will be honest with my hon. Friend: I feel a considerable degree of discomfort when I look back at a whole number of deals and pay awards, under this Government and our predecessors, where the “Agenda for Change” workforce have been left further behind. I will be honest with the House: at this moment, I have to resolve the immediate action that is being proposed by the BMA, but I am not going to allow the reform we have committed to with the “Agenda for Change” unions to be deprioritised —we owe that to them. We owe it to the nurses and to all the “Agenda for Change” staff to ensure that they are paid fairly, are given a fair day’s pay for a fair day’s work, and receive the terms and conditions that they deserve. My priority at this stage is the “Agenda for Change” reform. Of course, I will do everything I can to resolve the resident doctors strikes, but what I cannot do is reopen this year’s pay award.
Several hon. Members rose—
Robin Swann (South Antrim) (UUP)
I agree with the Secretary of State when he tells the BMA resident doctors that they will never have another Secretary of State as sympathetic to their legitimate complaints— I recognise that, having worked with five of his predecessors. My experience tells me that what happens here with the BMA often filters through to the devolved nations. What engagement has he had with his counterparts on the proposed industrial action so that there can be a combined resolution and message to the BMA?
Wes Streeting
I reassure the hon. Gentleman that I will obviously engage with my counterparts in the devolved Administrations. While health is a devolved matter, the decisions that we take in this place, and what is going on in the English health system, have a bearing on other health systems, and vice versa.
I am almost tempted to call back the right hon. Member for North East Cambridgeshire (Steve Barclay), who is still a Member of this House, to remind the BMA what it went up against twice before; indeed, I could call back any of my Conservative predecessors to remind the BMA that the grass is not greener on the other side of this House. It currently has a Secretary of State who has shown through actions, not just words, a willingness to work together, and I hope that it rediscovers the spirit of partnership that we had last year.
Mr Connor Rand (Altrincham and Sale West) (Lab)
We all know how vital resident doctors are to the functioning of our national health service. In the light of that, will the Secretary of State join me in once again urging the BMA resident doctors committee to get back around the table to engage in serious talks and to take up his offer to meet in the interests of all NHS staff and patients, so that we can rebuild the national health service in the way the public expect?
Wes Streeting
Quite aside from the fact that I offered to meet the entire resident doctors committee back in January, although it has never taken me up on that offer—I would definitely be outnumbered in that meeting— I can reassure the House, in all seriousness, that I met its co-chairs on Tuesday afternoon, immediately after the publication of the ballot result. I followed up in writing yesterday morning to reaffirm what I said in person, which was to express our willingness to meet immediately, without preconditions, to avert this strike action. That offer remains, and I am very happy to meet them on that basis.
Mr Andrew Snowden (Fylde) (Con)
My wife has a long-term chronic health condition; she has had to have two major lifesaving surgeries, and has had countless stays in hospitals. We have seen the fantastic work that many doctors and consultants do, but we have also seen the impact it has when there are cancellations and delays, or when no doctors are available.
Many people will have been flabbergasted by the sheer scale of the pay rise that was awarded in the first place, without anything in return to deliver the NHS reforms that the Government seek. Those people will now be absolutely outraged that the BMA is going on strike after having a near 30% pay increase. I plead with the Secretary of State to hold the line in these negotiations, and to take away the cross-party support he has in holding the line against the BMA on this issue.
Wes Streeting
We will not be reopening this year’s pay award because we simply cannot afford to, and it would not be fair on others in the NHS workforce, regardless. I honestly do not regret the deal that we struck last year, without which we would not have made the progress that we have on NHS waiting lists, which are now at their lowest level in two years. We have made that considerable progress by working together.
I do not think that the staff themselves are the drain on productivity; instead, the obstacles we face are the systems and pathways in which staff work and the conditions in the NHS—we are in real agreement on those things. I urge the BMA to keep all that under consideration before its next public intervention, which I hope will be to accept the offer to get around the table to avert the strike action that I think the whole House agrees is unnecessary, unreasonable and unfair.
Jas Athwal (Ilford South) (Lab)
I thank my right hon. Friend for his statement, which was delivered with the humility and pragmatism that is his usual professional style. After a 28.9% pay rise thanks to this Labour Government, does the Secretary of State agree that the public are not only dismayed by the actions of the BMA, but distraught and that, once again, it will be the patients who will suffer the most by this action, which is so unnecessary at this particular moment?
Wes Streeting
I entirely agree with my hon. Friend. It will be patients who suffer the most. I also urge the BMA to consider the impact on its whole membership, because it is other staff who are left picking up the pieces, and other staff who are tired—literally tired—of working in an NHS that is far from its best. To resident doctors in particular, I say that the cost of this will also be borne by them. There are choices and trade-offs in politics, especially when resources are tight. We can and we will act to deal with specialty bottlenecks. We can and we will act to tackle doctor unemployment, but our ability to do so is undermined, if not diminished, if we are instead paying the cost of this unnecessary, unreasonable and unfair strike action.
Jim Shannon (Strangford) (DUP)
I thank the Secretary of State for his statement today and fully support the line of action that he has taken. Indications that the majority of doctors in the BMA did not vote to strike makes this strike action even more difficult to understand. The Secretary of State is clearly trying to find a way forward. The way to do that is through finding solutions. Reviewing conditions of work, such as those that see junior doctors working 84 hours within the space of a week, would be helpful. Perhaps this action is not only about pay, but about the expectations of these young people who have life and death in their hands for 13 hours for six out of seven days a week.
Wes Streeting
The hon. Gentleman makes an entirely reasonable point. Pay is important—people have to be able to pay their bills and lead a good life—but so too are their working conditions. I am absolutely determined to work with resident doctors to make progress not just on pay, which we have already done, but on the conditions in which they are working. Given where we are with both of those things—the improvement on pay and the willingness to work together to improve conditions—they are not grounds for strike action.
Anna Dixon (Shipley) (Lab)
I congratulate my right hon. Friend on showing great leadership when he came into office to get those doctors back to work and end the strikes. The result of that has been falling waiting times and waiting lists, and I have seen the benefit of that for my constituents in Shipley; they are not having to wait for operations and diagnostic tests in the NHS. Does he agree that this is no time for strike action, and that, should the BMA and the resident doctors go ahead with this strike, this will adversely affect patients and waiting times?
Wes Streeting
I entirely agree with my hon. Friend. Looking back at all the contributions this morning, I have been struck by the fact that, quite extraordinarily, the entire House, on both sides of the Chamber, has spoken with one voice. There has been total unanimity across this House during these exchanges that the proposed strikes are unreasonable, unnecessary and unfair. For the avoidance of doubt, let me tell the BMA and the resident doctors committee that this House has spoken with one voice to say: abandon this rush to strike, get around the table and work with us to rebuild resident doctors’ working conditions and to continue rebuilding our national health service. I thank the House for its support.
Madam Deputy Speaker (Caroline Nokes)
I thank the Secretary of State for his statement today.