NHS 10-Year Plan

Wes Streeting Excerpts

Thursday 3rd July 2025 Commons Chamber

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

With permission, Madam Deputy Speaker, I shall make a statement to the House on “Fit for the Future”, the Government’s 10-year health plan for England.

There are moments in our national story when our choices define who we are. In 1948, the Attlee Government made a choice founded on fairness: that everyone in our country deserves to receive the care they need, not just the care they can afford. It enshrined in law, and in the service itself, our collective conviction that healthcare is not a privilege to be bought and sold, but a right to be cherished and protected.

Now it falls to our generation to make the same choice: to rebuild our national health service, and to protect in this century what Attlee’s Government built for the last. That is the driving mission of our 10-year plan.

In September, Lord Darzi provided the diagnosis: the NHS was broken by 14 years of Conservative under-investment, and by their catastrophic top-down reorganisation. In the past year, Labour has put the NHS on the road to recovery. We promised 2 million extra appointments; we have delivered more than 4 million. We promised 1,000 new GPs on the frontline; we have recruited 1,900. We have taken almost a quarter of a million people off waiting lists, cutting them to their lowest level in two years. And we have launched an independent commission, chaired by Baroness Casey, to build a national consensus around a new national care service to meet the needs of older and disabled people into the 21st century.

Today, the Prime Minister has set out our prescription to get the NHS back on its feet and make it fit for the future. Our plan will deliver three big shifts. The first is from hospital to community. We will turn our national health service into a neighbourhood health service. The principle is simple: care should happen as locally as it can—digitally by default, in a patient’s home if possible, in a neighbourhood health centre when needed, and in a hospital where necessary.

We will put neighbourhood health centres in every community, so people can see a GP, nurse, physio, care worker, and therapist, and they can get a test, scan or treatment for minor injuries, all under one roof. The NHS will be organised around patients, rather than patients having to organise their lives around the NHS. It will be easier and faster to see a GP. We will train thousands more, end the 8 am scramble, provide same-day consultations, and bring back the family doctor. If you are someone with multiple conditions and complex needs, the NHS will co-create a personal care plan, so your care is done with you, not to you.

Pharmacies will play an expanded role in the neighbourhood health service. They will manage long-term conditions, treat conditions such as obesity and high blood pressure, screen for disease and vaccinate against it. We will also reform the dental contract, to get more dentists doing NHS work, rebuilding NHS dentistry.

Over the course of this plan, the majority of the 135 million out-patient appointments done each year will be moved out of hospitals. The funding will follow, so a greater share of NHS investment is spent in primary and community care.

The second shift is from analogue to digital. No longer will NHS staff have to enter seven passwords to login to their computers, or spend hours writing notes and entering data. Our plan will liberate frontline staff from the parts of the job that they hate, so they can focus on the job that they love—caring for patients. For the first time ever, patients will be given real control over a single, secure and authoritative account of their data. The single patient record will mean that NHS staff can see medical records and know a patient’s medical history, so they can provide them with the best possible care.

Wearable technology will feed in real-time health data, so patients’ health can be monitored while they stay in the comfort of their own home, with clinicians reaching out at the first signs of deterioration. The NHS app will become the front door to the health service, delivering power to the patient. You will be able to: book and rearrange appointments for you, your children or a loved one you care for; get instant advice from an AI doctor in your pocket; leave feedback on your care and see what feedback other patients have left; choose where you are treated; book appointments in urgent care so you do not wait for hours; and refer yourself to a specialist where clinically appropriate. Of course, patients can already do all that, but only if they can afford private healthcare. With Labour’s plan, every patient will receive a first-class service—whatever their background and whatever they earn.

The third shift is from sickness to prevention. Working with the food industry, we will make the healthy choice the easy choice to cut calories. We will roll out obesity jabs on the NHS. We will get Britain moving with our new NHS points scheme, and we will update school foods standards so that kids are fed healthy, nutritious meals. We will tackle the mental health crisis with support in every school to catch problems early, 24/7 support with virtual therapists for those with moderate need, and dedicated emergency departments for patients for when they reach crisis point.

The science is on our side. The revolution in artificial intelligence, machine learning and big data offers a golden opportunity to deliver better care at better value. New innovator passports and reform of the National Institute for Health and Care Excellence and the Medicines and Healthcare products Regulatory Agency will see medicines and technology rapidly adopted. Robotic surgery will become the norm in certain procedures, so patients recover from surgery at home rather than in hospital beds. The NHS will usher in a new age of medicine, leapfrogging disease so that we are predicting and preventing, rather than just diagnosing and treating. It is therefore the ambition of the plan to provide a genomic test for every newborn baby by 2035. Thanks to my right hon. Friend the Chancellor, this plan is backed by an extra £29 billion a year by the end of the spending review period, as well as the biggest capital investment in the history of the NHS.

Alongside investment comes reform. This plan slashes unnecessary bureaucracy and devolves power and resource to the frontline. It abolishes more than 200 bodies, because listening to patients, guaranteeing safety and protecting whistleblowers is core business for the NHS and should never have been outsourced. The plan commits to publishing league tables to rank providers. We will intervene to turn around failing providers, and we will reinvent the foundation trust model in a new system of earned autonomy. Pay will be tied to performance, so that excellence is recognised and failure has consequences. Tariffs will be reduced to boost productivity. Block contracts will end, with funding tied to outcomes. The plan gives power to the patient, so hospitals are financially rewarded for better service. It closes health inequalities by investing more in working-class communities, and it establishes a national investigation into maternity and neonatal services to deliver the truth, justice and improvement that bereaved families deserve.

I am sometimes told that NHS staff are resistant to change. On the contrary, they are crying out for it. They suffer the moral injury of seeing their patients treated in unfit conditions. They are ones driving innovation on the frontline, so their fingerprints are all over this plan. The public are desperate for change too. Each of us has our own story about the NHS and the difference it made to our lives. We also know the consequences of failure. To succeed, we need to defeat the cynicism that says that nothing ever changes.

We know that the change in our plan is possible because it is already happening. We have toured the length and breadth of the country and scouted the world for the best examples of reform. If Australia can effectively serve communities living in the outback, we can surely meet the needs of rural England. If community health teams can go door to door to prevent illness in Brazil, we can certainly do the same in Bradford. We know that we can build the neighbourhood health service, because teams in Cornwall, Camden, Northumbria, and Stratford—where I was with the Prime Minister and Chancellor this morning—are already showing us how to do it. We will take the best of the NHS to the rest of the NHS. We will apply to best examples of innovation from around the world to benefit people here at home. Above all else, we will give power to the patient. This plan fulfils Nye Bevan’s commitment in 1948 to put a megaphone to the mouth of every patient. It will restore the founding promise of the NHS to be there for us when we need it.

Of course, we know that there are those on the right who are willing us to fail. They will exploit the crisis in the NHS in order to dismantle it. The hon. Member for Clacton (Nigel Farage) and his cronies argue that universal healthcare could be afforded in the 20th century but not in the 21st. Labour rejects their declinist pessimism and so do the public. But that is the choice—it is change or bust, and we choose change.

We know that the British people are counting on us. It falls to us to ensure that the NHS not only survives but thrives, and we will not let our country down. Of course, if we succeed, we will be able to say with pride that will echo down the decades of the 21st century that we were the generation who built an NHS fit for the future and a fairer Britain where everyone lives well for longer. I commend this statement to the House.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Secretary of State.

[Edward Argar (Melton and Syston) (Con)]

I thank the Secretary of State for his typical courtesy in providing advance sight not only of his statement but of his plan. I am grateful, and others on the Government Front Bench might learn a thing or two from him. I am pleased to see the plan published. This Secretary of State is a rare thing these days: one whose announcements do tend to survive largely intact for more than a week. In the case of the plan, it is vital that it does stick.

The Secretary of State is not known to be short on ambition, and to be fair that is reflected in his plan; it is ambitious. I believe that his long-term goals are right and that the reforms he has set out build on the reforms that the Conservatives set out and carried out. The desire to shift care from hospital to community, to better use technology and to move to prevention is not new at all, but it remains vital.

The NHS undoubtedly needs reform, not just more cash—it is not fiscally sustainable in the long term to have 38% of day-to-day Government spending going on the NHS—so we need to focus on outcomes, not just inputs. But the plan, while welcome, is still sketchy on some of the details of delivery and how it will be paid for without the funds that the Secretary of State mentioned being eaten by pay rises and by inflation, as well as how that shift will be staffed. Greater use of the app is right, and builds on the amazing work done on the app by my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay) when he was Secretary of State. Greater use of technology and of genomics is right, and the Secretary of State’s big five tech bets are largely right, but, as he knows, tech alone will not deliver this; people will, so a workforce plan that is clearly aligned with his strategy is vital.

Neighbourhood health centres are one of the measures at the heart of the Secretary of State’s plan. The concept is an interesting one, but it does throw up a number of questions that I hope he can answer in the spirit in which they are asked. Will the providers of those new centres be NHS public sector organisations, private sector organisations or a mixture? How will the centres fit with GP provision and other services without duplication or fishing in the same pool for staff? What assessment has he made of the cost of new buildings and technology to go in them? How many centres does he envisage, and by when? Crucially, how will he ensure that a public-private partnership model will avoid the downsides of the Blair- Brown private finance initiative model?

I ask those questions from a desire not to see this fail but to succeed, because it is in all our interests that the Secretary of State does succeed, but that will take time. Given that, on page 71 of his plan he talks about the need for “immediate opportunities” to be seized. Although there will be others, may I take the opportunity to suggest just one? He should deliver on the pre-election commitment for fracture liaison services to be delivered in all communities, as campaigned for by the Royal Osteoporosis Society, The Mail on Sunday, the Express and many others. That policy would deliver savings within the comprehensive spending review period. Similarly, Melton Mowbray in my constituency has a fantastic community hospital—there will be many up and down the country—and I hope that such hospitals will be a part of delivering more services in the community.

On maternity care, I welcome the Secretary of State’s commitment to a national investigation into maternity scandals, but I hope that will not stop him from delivering on the work done by the hon. Member for Canterbury (Rosie Duffield) and Theo Clarke, which included measures that can be implemented now to help improve maternity safety.

On systems reform, may I offer the Secretary of State a couple of words of caution? One is on folding the Health Services Safety Investigations Body into the Care Quality Commission, even as a discrete entity within it. HSSIB is not a regulator and is not designed as such, and it is important that those distinctions are not blurred in making that change. Similarly, may I urge him to be wary of further moving integrated care boards to larger geographies—they are at risk of becoming again the old regional health authorities—as that will move them further away from the local communities they serve and the entities providing social care in those communities with whom they must interact?

That brings me finally to a significant question hanging over the plan. Unless we move faster to adjust to the challenges of social care and put it on a sustainable footing, these reforms risk failing to seize the genuine opportunity presented. In the move from cross-party talks to an independent commission, we risk losing that opportunity. Crucially, I ask the Secretary of State again to consider bringing forward the end date of that commission so that we can go further and faster on social care.

I have often said to the Secretary of State that where he is wrong we will rightly hold him to account and challenge him, but where he is right we will offer constructive support. The plan, by and large, does say the right things. We must shift to outcomes and not focus continually on inputs, and we must do that through real and genuine reform. The challenges he faces will be in the detail, much of which is still to be confirmed, and crucially for the Government, in the actual delivery. He should not underestimate those challenges. I will work with him to improve the plan where it needs it, but I will support him where he pledges and brings genuine reform to our healthcare system. His plan will have a key test: will patients see the difference, and when will they see the difference? In all that we do, it is vital, as we reform our NHS, that patients are at the heart of our deliberations and our plans.

[Wes Streeting]

I thank the shadow Secretary of State for his constructive approach to what does need to be a successful plan for the next decade, to get our NHS back on its feet, to make it fit for the future and to make sure we improve the health of the nation. Aside from the lines that he was no doubt given to trot out at the beginning—he almost said them with conviction—we know that we can count on him to be rather more serious and sensible than the display we saw from the Opposition yesterday.

I turn to the shadow Secretary of State’s points. He was right to say that investment needs to go alongside reform. That is why the spending review only a matter of weeks ago set out the Chancellor’s commitment to the NHS and NHS reform. The Government are providing a £29 billion real-terms increase—a £53 billion cash increase—in annual NHS day-to-day spending by 2028-29. That funding will support the first steps towards delivering the reforms, the service improvements and the new technology set out in the plan.

But investment alone is not enough. One of the reasons we are paying more and more for worse and poorer outcomes is that we have the wrong care in the wrong place at the wrong time. Contrary to what we read in some newspaper columns—on the radio this morning I heard the hon. Member for Clacton once again attacking the NHS’s equitable principles and funding model—the problem is not the model of funding; it is the model of care. That is why the shift to neighbourhood health is essential for delivering better outcomes for patients and better value for taxpayers.

The technology coming down the track, and indeed the technology we already have, will drive the big productivity gains in the system that have eluded us. In recent years, the previous Government invested in more staff, but they put all those staff in hospitals to work in an undercapitalised NHS. If there are more inputs but not the enablers to deliver the service, we do not see the responding improvements in output and impact. That drives poorer productivity, poorer value for money and poor outcomes for patients, and that is the approach that we are changing.

If, for example, we roll out, as we will, ambient AI to all GPs, and we make sure that in their interactions with patients we liberate them from being glued to the screen, filling out the forms and drafting the letters, because that is all done automatically before the GP spends a few moments checking over to make sure it is right—if we can just save 90 seconds in every GP appointment—we will save the equivalent time of 2,000 more GPs. That is how we get more bang for the buck, that is how we drive productivity improvements and that is how we deliver better care and better value.

That is why the previous Government’s workforce plan was not right. It assumed that the NHS just needed growth at the same rates and in the same way as always. In fact, so implausible were the assumptions in that plan that if we had continued with the rate of growth that they had set out, by the end of the century 100% of our entire country would be working in the NHS. I know we love the NHS and we love the people who work in it, but I do not think that everyone in our country can or should be working in the national health service. To reassure the right hon. Gentleman, we will, this autumn, set out a new workforce plan that aligns with this 10-year plan.

The shadow Secretary of State asked about neighbourhood health centres. We aim to go for 250 to 300 new neighbourhood health centres by the end of this plan and 40 to 50 over the course of this Parliament. They will be NHS providers and we will have a combination of new builds and the refurbishment and rejuvenation of underutilised existing estate, both in the NHS and in the public sector. Therefore, the cost of each neighbourhood health centre will vary, from the low millions to around £20 million, depending on whether it is an upgrade, a refurb and expansion or a new build.

Given the undercapitalisation of the NHS that we inherited, even the record investment from public sources that the Chancellor has provided will not be enough to deal with the capital backlog. That is why, as set out in the Government’s infrastructure plan, with care and caution, and keeping in mind the mistakes that were made by the private finance initiative, we are looking at alternative private sources of investment to make sure that we can go further and faster on capital improvement, particularly in the neighbourhood health service.

The right hon. Gentleman asked me to commit again to fracture liaison services. Those services have a demonstrable impact on keeping people well and providing both better outcomes for patients and better value for taxpayers. That is why we want to see them rolled out across the country.

On maternity, I welcome his support for the investigation. NHS England is in the third year of the three-year plan put in place by the previous Government and we have sought to support that progress and not to interfere. Yet as we have seen, even with the most recent CQC report into the trust in Nottingham, we have so much more to do and an entire change in approach and culture is needed, let alone a change in practice and behaviour. I am committed to working with all parliamentary party groups across this House and to making sure that the expertise and insight that we have right across these Benches, on both sides of the Chamber, help us to drive maternity improvements.

He asked about us rolling HSSIB into the CQC. Let me provide him with this reassurance. HSSIB has been a really effective body, but we cannot justify the duplication of back-office functions and the inefficiency that comes with that. However, the CQC, when we came into office, was in such a dire state that we had to replace the leadership and we have in place an improvement plan. The House therefore has my assurance that we will not roll HSSIB into the Care Quality Commission until we are assured that the CQC is back to the standards that we expect for it to perform its core duties today, let alone the work it will do with HSSIB housed within the CQC.

On ICBs, I will not measure success through the number of bodies in the NHS; I think that has led us to where we are. However, I am committed to making sure that as we devolve more power, more responsibility and more resource closer to the frontline, to system leaders and to provider leaders, we also make sure that we have in place democratic accountability, so that Members of Parliament, local councils and metro mayors can influence and shape healthcare where they live.

The right hon. Gentleman also asked about social care. We are not waiting for Casey. The spending review gave an additional £4 billion to social care. We are delivering the biggest expansion of carer’s allowance since the 1970s and a significant increase in the disabled facilities grant. The Deputy Prime Minister and I will also shortly set out how we will deliver the first every fair pay agreements for the care workforce, building real social care progression.

On neighbourhood health, social care has to be part of it. In the context of this plan, social care features because it has a role to play on admission avoidance and speeding up delayed discharges. However, we know that social care is important in its own right and that is why it is important that it has its own commission.

Finally, the shadow Secretary of State asked about whether people will see and feel these improvements. We know on the Government Benches that we will be judged by results and by whether people can feel the change that we are delivering. All I would say to people watching our proceedings today is this: in our first year, we promised 2 million more appointments to cut waiting lists—we doubled that; we promised to deliver 1,000 more GPs—we have almost doubled that; and we promised that people would see the NHS moving in the right direction—waiting lists are at the lowest point for two years. We know that there is more to do, but I hope that the progress people have seen under this Labour Government reassures them that, when it comes to our national health service, if anything, we under-promise and over-deliver. We know that people will see and feel the change. I say respectfully, given the shadow Secretary of State’s constructive tone, that that will be the difference between a Labour Government and a Conservative one.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the Chair of the Health and Social Care Committee.

[Paulette Hamilton (Birmingham Erdington) (Lab)]

As the acting Chair of the Health and Social Care Committee, I am delighted that the 10-year plan was finally launched today. I thank the Secretary of State for Health and Social Care for presenting it to the House.

The plan represents a major opportunity for constructive reform of the health and social care system, and I am delighted that the Secretary of State will come to the Committee on 14 July to be scrutinised on it. Many organisations have waited patiently for the 10-year plan to be published. Will the Secretary of State explain how the plan will help restore the promise of a first-class service in the NHS?

[Wes Streeting]

I thank my hon. Friend for her question and for the leadership she is showing to the Select Committee while the substantive Chair, the hon. Member for Oxford West and Abingdon (Layla Moran), is off on mat leave. What a delight it was to see the Committee Chair on the Terrace this week with her new baby. That was really delightful and we wish her well.

One of the exciting things for me about today’s launch is just how widespread the support has been from across a range of different organisations that we will need to work with to deliver the plan. Whether it is the royal colleges and the trade unions, the organisations that represent patients, the wide range of healthcare charities or, crucially, frontline staff, everyone is up for this change and everyone is desperate for it to succeed.

We will not get everything right and we will make mistakes along the way. We will listen and always learn and reflect. We know in the Government that we cannot do this without effective leadership from Ministers, but nor can Government do this alone. It is now our responsibility to mobilise the more than 1.5 million people who work in the NHS, the more than 1.5 million people who work in social care and our whole country behind a national mission to get our NHS back on its feet, to make sure it is fit for the future and to make sure, fundamentally, that we attack the injustices that lead to ill health, so that we have a fairer Britain where everyone lives well for longer.

[Mr Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

I thank the Secretary of State for early sight of the plan this morning. After years of Conservative failure, a plan for the future of the NHS is welcome and Liberal Democrats support the Secretary of State in his vision to shift the NHS to a community-focused, preventive service. However, I seek his reassurance on some questions.

In the 143 pages of the 10-year plan, there is only a passing reference to social care. Everyone knows that we cannot fix the NHS without fixing social care. With so many people unable to return home from hospital to get the care they need, solving the crisis in social care is a huge part of moving care out of hospital and into the community. Will the Secretary of State bring forward the Casey review, so that it reports in full this year, and reinstate the cross-party talks, so that consensus can be reached on the future of care?

I welcome the idea of a neighbourhood health centre, but how does that interact with the plan for GPs? The 10-year plan implies that GP contracts will encourage them to cover a huge geographic area of 50,000 people. In North Shropshire, that would be two or three market towns combined and would span dozens of miles. Can the Secretary of State reassure me that there will still be a physical health centre, accessible to all, and that in areas with little public transport in particular, people will be able to access care when they need it?

Finally, the plan hinges on the shift to digital solutions, and that is not without risk. The use of the NHS app is critical to what happens. How will the Secretary of State ensure that those without a smartphone—because they cannot afford one, do not feel confident using one or simply do not have adequate broadband or internet—can access the NHS? Many elderly and disabled people in particular who are digitally excluded will feel worried by today’s announcement.

[Wes Streeting]

I welcome the Liberal Democrat support for the plan, and the constructive way in which Liberal Democrats have sought to work with us since the general election in pursuit of better health and social care services. I understand the point the hon. Member makes on social care. I will not repeat at length the points I made to the shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar), but I hope the House is reassured by the action we are already taking on social care, whether through greater funding, the expansion of the carer’s allowance, increasing the disabled facilities grant, the fair pay agreements, and ensuring a partnership with social care to deliver better neighbourhood health services.

Given what we have said about the importance of data, digital connections and better systems, I should say that in some parts of the country, the social care system is ahead of the NHS; it makes better use of data, and joins up systems in a more effective and efficient way. The NHS can learn lots from social care, as well as the other way round. I will take on board the representations of the Liberal Democrat and Conservative Front Benchers on speeding up the Casey commission—that is duly noted.

I absolutely reassure the hon. Member for North Shropshire (Helen Morgan) on the point that she raises about neighbourhood health centres. One of the reasons we want to devolve so much power in the NHS is that I genuinely think that the closer decisions are made to the communities they serve, the better the outcomes and the provision. A one-size-fits-all approach to neighbourhood care simply will not work. My constituency is on the London-Essex border, and there are three hospitals within a 15-to-20 minute drive of where I live. In many rural towns, coastal communities and villages across the country, there is not even one hospital within that distance. In fact, people are driving huge distances across the country to get to a hospital. On our priority of rolling out neighbourhood health centres, I want to reassure Members on both sides of the House that we will start with the areas of greatest inequality and need, and communities where people have to travel far to their nearest hospital, so that people can genuinely receive care closer to home and, indeed, at home. Technology can play a big role in that.

I understand the cynicism about digital roll-out. Government IT projects do not have a great reputation historically; let us be clear about that. We are learning from past mistakes and ensuring that we have the right experts in the room to help us. So much of that is about the digital clinical leadership helping to marry the best scientific and technological minds in our country to the best clinical and scientific experience to ensure that we get this absolutely right. We cannot afford to fail or be left behind. The tragedy in the country today is that there are so many brilliant innovators in life sciences and med tech who are designing and making things here in Britain, but when it comes to scaling up, they are shipping out, because the NHS has been a poor partner and a poor customer. We will change that; we will create more in Britain, and ensure that it is rolled out right across the country. Staff will be liberated from the drudgery and toil of unnecessary bureaucracy and admin that can be automated, and patients will have more ease, convenience, choice and control at their fingertips. This revolution is happening, and it is crucial that no one is left behind.

I take seriously the point the hon. Member made about the digitally disconnected, and there are two responses to that. First, people like me who book via the touch of a button free up telephone lines, get out of the way of reception desks, and free up more capacity for face-to-face and telephone appointments. I believe strongly in horses for courses, and in patient choice. Those patients who want to pick up the phone or who want to be seen face to face must be given that choice and control, and we will give it to them.

Secondly, working with the Science, Innovation and Technology Secretary, we will deal with the fundamental problem of digital disconnection in our country. I knocked on the door of one of my party members when I was canvassing down her street because I had heard she was ill. She opened the door, and I asked if she was okay and if she needed anything from the shops. She looked me up and down as if I had just said the most ridiculous thing and said, “Oh no, dear. Thank you very much, but I do my shopping online with my iPad.” We should not assume that because people are older, they are naturally digitally disconnected. They are some of the most tech-savvy people, and we have to ensure that those skills are enjoyed by all, in keeping with the NHS’s principle of ensuring that healthcare is available universally to everyone, regardless of their ability to pay.

[Several hon. Members rose—]

[Jen Craft (Thurrock) (Lab)]

Thank you, Mr Deputy Speaker. The heart, soul and lifeblood of our NHS are the people who work in it. I doubt there is anyone in this House who does not owe a personal debt of gratitude to a health care worker. Can the Secretary of State reassure me that the fingerprints of NHS workers are all over this 10-year plan, and that it has been designed and produced with all their valuable inputs?

[Wes Streeting]

I certainly can give my hon. Friend that reassurance. We launched the biggest consultation since the NHS began. We had over 270,000 contributions, 250,000 thousand responses and almost 2 million visits to the change.nhs.uk website, so I can absolutely give people the assurance that staff and patients’ fingerprints are all over the plan. That is why we have such a rich plan, in which people can have confidence.

[Sir Jeremy Hunt (Godalming and Ash) (Con)]

There is much to welcome in today’s plan, particularly the proposal to bring back family doctors, which I tried to do but frankly did not succeed in doing when I was Secretary of State, so we all wish him well with that, but does he agree that as we seek to transform out-of-hospital care, it is vital that we do not take our eye off the ball and allow another Mid Staffs inside hospitals? Does he also agree that it is essential that the CQC gives overall ratings and calls a spade a spade when it comes to the quality of care in hospitals, so that we know whether the care delivered by hospitals in our constituencies is outstanding or good, and if not—if it requires improvement or is inadequate—that action can be taken, and lives can be saved?

[Wes Streeting]

I strongly agree with my predecessor on that. It is important that the CQC’s reports and judgments can be understood by the public and the people responsible for carrying out the improvements that it recommends. Via the NHS app, we will have much more transparency for patients about the range of providers, the quality of services and the views of other patients. That will give patients the freedom to choose, in a more data-driven way, where and when they are treated. There is also the importance of data-driven face-to-face inspections by experts. We can also have early warning systems that would alert people who hold his office and mine that something is going seriously wrong, so that we can intervene before more lives are lost unnecessarily.

[Mr Deputy Speaker]

I call Select Committee member Josh Fenton-Glynn.

--- Later in debate ---

[Wes Streeting]

I thank my hon. Friend for that question. On whether people feel cautious optimism or quiet scepticism based on the experience that he describes, I have heard the same thing so many times. “I love AI, genomics and machine learning—yep, great. But can you just give me the basic technology that works?” Well, I can confirm that in 2026-27 we will make sure that we create a single log-on for staff. I am not holding my breath for that to be the front-page splash tomorrow, but that one thing, as well as saving loads of staff time, will give them confidence that genuine change is coming.

[Sir Edward Leigh (Gainsborough) (Con)]

As always, the Secretary of State makes a good fist of an impossible job, but I think we all know in our heart of hearts that this model, which takes 38% of public funding, is unsustainable in the long term. He mentions the Australian outback; I have been a voice in the wilderness, urging him to replicate the excellent Australian system, which is a mix of public and private. I will not do that again now, but may I ask him to at least look at Australia’s pharmaceutical benefits scheme, which ensures national procurement of medicines, so that people who have a medical card there get their medicines cheaper than people here?

[Wes Streeting]

I am always willing to search the world for ways to spend taxpayers’ money more effectively, and the right hon. Gentleman makes some good arguments on making sure that we get a good deal on medicines pricing, and on using the real procurement power of the single payer model—but therein lies the answer to the other part of his challenge. It is the single payer model, created in 1948, that makes the NHS ideally placed to get much better value in procurement, and to harness and lead the revolution in AI, machine learning, genomics and big data, in a way that many insurance-based systems struggle with. I assure him that if there were a better way of funding the NHS, I would have the political courage to make the argument, but we looked at other systems of funding and concluded that that is really not the problem. It is not the model of funding; it is the model of care, and that is what we are going to sort out.

[Alex McIntyre (Gloucester) (Lab)]

When I knock on doors in my Gloucester constituency, I hear time and again about the importance of tackling the 8 am scramble for a GP appointment, and the difficulty many of my constituents faced under the Conservative Government getting the care they needed. Will my right hon. Friend explain how Labour’s 10-year plan for health will deliver on the Government’s mission to get treatment out of hospitals and into the community, so that every one of my constituents can get the care they need in the community in which they live?

[Wes Streeting]

I am grateful to my hon. Friend for his question; he is such a strong voice for the people of Gloucester. We are already delivering improvements in general practice, with 1,900 more GPs employed on the frontline, £900 million more for general practice, and the first contract agreed with GPs for quite some years. We are working in genuine partnership with GPs, who will be at the centre of the neighbourhood health service and of neighbourhood health centres. I am determined to ensure that we do things with our friends in general practice, not to them. Where things are working, I have no interest in going in like a bull in a china shop and imposing top-down change unnecessarily; we learned that lesson from Lord Lansley. I am confident that we have a plan that GPs will relish and embrace, and that they will feel reassured that the future of general practice is bright. After years of campaigning for a Government to rebuild general practice, they finally have a Government who are on their side.

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

I thank the Secretary of State for his statement on his plan. I note the comments on the National Institute for Health and Care Excellence and the Medicines and Healthcare products Regulatory Agency, but the Scottish Medicines Consortium is the envy of the other three nations. I would like to offer him an early win. There is a drug, Enhertu, for the treatment of women with secondary breast cancer; it prolongs life. It is available in Scotland and in 20 other nations. Will he review the situation in England under this plan?

[Wes Streeting]

We work closely with NICE to make sure that we consider, in an evidence-based way, the case for prescribing new medicines. We want patients to have access to the latest treatments and technology, and we work with the pharmaceutical industry to get as many medicines as possible to patients. We definitely need growth in this area.

I have a counter-offer for the hon. Gentleman. I notice that the Scottish Government are now on their fifth health plan; none of the others has worked. We are always willing to help, and I will put a copy of the plan in the post to my Scottish counterpart, but I will not hold out much hope. In England and Wales, where a Labour Government are in place, waiting lists are falling; in Scotland, waiting lists are rising, and we have heard astonishing admissions of failure from Ministers whose party has been in power for almost 20 years. It is very clear: Scotland needs an alternative. Scotland’s NHS needs an alternative: Scottish Labour.

[Clive Efford (Eltham and Chislehurst) (Lab)]

I welcome my right hon. Friend’s statement. Yesterday was one year to the day since I completed my radiotherapy treatment for prostate cancer. I was very lucky—my cancer was caught at stage 3 and was treatable—but I had to ask my GP for the prostate-specific antigen test that got me my treatment. I know my right hon. Friend has that said he wants to see a national screening programme aimed particularly at black men over 45, one in four of whom will get prostate cancer, people like me who have a family history of prostate cancer, and men over the age of 50. Will he ensure that we have a national screening programme as part of the 10-year plan?

[Wes Streeting]

My hon. Friend is absolutely right about the importance of screening, and it is brilliant to see him fighting fit. That is exactly the sort of outcome that we want from effective diagnosis and treatment. He is also right to highlight the racial inequalities in this area. It cannot be right in this decade of the 21st century that black men are twice as likely as white men to die of prostate cancer. The national cancer plan will come out later this year, and the screening committee is looking at the case he makes. He will find at the centre of the 10-year plan a commitment not just to diagnose earlier and treat faster, but to tackle the gross health inequalities that blight our society in a way that is simply not tolerable in the 21st century.

[Sir Julian Lewis (New Forest East) (Con)]

Does the NHS 10-year plan include an assisted dying scheme? If the present private Member’s Bill runs out of time at the end of this parliamentary Session, and thus falls, will the Secretary of State reintroduce the legislation as a Government Bill in the next parliamentary Session?

[Wes Streeting]

I am grateful to the right hon. Gentleman for that question—[Laughter.] Given that the Bill is still passing through Parliament, assisted dying is not referred to in this 10-year-plan, but I assure both this House and the other place that regardless of different views among Ministers and across the House, we will abide by the law of the land. We will abide by the will of this House and the other place. If the Bill times out in the other place, I have no doubt that someone else will bring it back. I suspect it will not be a Government Bill.

It is important that we have the debate and that we scrutinise the legislation well. I am proud of the way the House has conducted the debate. My hon. Friend the Minister for Care, who is not in his place now, along with the Minister of State, Ministry of Justice, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), have done an exemplary job in supporting people on both sides of the debate to give the Bill the detailed scrutiny that it had here and that it will no doubt have in the other place. That is a credit to this House.

[Mr Clive Betts (Sheffield South East) (Lab)]

Let me say to the Secretary of State: well done. This is a really ambitious and excellent programme.

On the subject of cancer care, in the past few years we have both had good experiences of the NHS at its best, but it is important to improve services by getting the NHS to work with universities and the voluntary sector in local cancer alliances. Will he look at what I think is an unintended consequence of that? If a local cancer alliance is funded by an NHS trust, its funding continues; if it is funded by an ICB, as the South Yorkshire cancer alliance is, its funding will be cut in line with the rest of the ICB’s budget. That is not fair. Whether an alliance suffers cuts depends on which organisation funds it. Will he see if he can rectify that?

[Wes Streeting]

I am grateful for my hon. Friend’s support. Given his expertise, it means a lot. I am especially grateful to the GPs in his constituency with whom he and I spent time; that experience really had an impact on my thinking about neighbourhood health.

On cancer, I am happy to look at the issue he raises with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton). We want to get this right. Cancer alliances have played a valuable role, and we want to see that approach to joined-up working between research, diagnostics and treatment go from strength to strength, so I will happily pick that up.

[Ellie Chowns (North Herefordshire) (Green)]

In the constructive spirit that has characterised much of this discussion, I welcome much of what the Secretary of State has announced today: bringing care closer to people in their homes, investing more in prevention—it is all good stuff. But there seems to be a missed opportunity here. In the 143 pages of this document, there is virtually no mention of social care. Lord Darzi told us last year that we cannot fix the NHS without fixing social care. Six months ago today, the Secretary of State promised cross-party talks and urgent work on the Casey commission, but the commission is delayed and the cross-party talks have never materialised. Will the Secretary of State please treat the care crisis with the urgency it deserves and bring forward that work, so that we can build the necessary cross-party consensus to fix the care crisis?

[Wes Streeting]

First, I thank the hon. Member for the Green party’s support for so much of the 10-year plan. She is right to highlight the importance of social care to resolving the NHS crisis. Let me reassure her that we are acting urgently as we await the first report of the Casey commission. The Chancellor did that with the Budget and the spending review, providing £4 billion more of investment. We have done that with the biggest increase in carer’s allowance since the 1970s, and with the disabled facilities grant, which does not just mean more ramps and home adaptations but more freedom, more dignity and more independence for disabled people. The Deputy Prime Minister and I will shortly set out how we will deliver fair pay agreements, and social care will absolutely be part of the neighbourhood health team. I hope that that reassures the hon. Member.

Let me also reassure parties across the House that we will wait for the Casey commission to launch. I would like to be able to proceed with the actions we will be taking in this Parliament and, crucially, with the long-term plan for social care in a cross-party way, to build that genuine national consensus—I would be delighted to achieve that.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the Chair of the Housing, Communities and Local Government Committee.

[Florence Eshalomi (Vauxhall and Camberwell Green) (Lab/Co-op)]

I thank the Secretary of State for this really ambitious and bold plan to make sure our NHS is fit for the future. He will be aware that Professor Ian Abbs, the chief executive of St Thomas’ hospital in my constituency, will step down later this year. I want to thank him for his dedication and compassion in leading St Thomas’, especially during the covid crisis, when the hospital cared for so many patients, including the then Prime Minister in his crucial hour.

The Secretary of State may be aware that Royal College of Nursing analysis shows that by 2029, 11,000 nurses may have left the profession after working less than 10 years in the service. Nurses cite exhaustion, mental health and stress as their reasons for leaving the profession. Can he give us an update on how we will ensure we have a workforce that is fit, so that we can achieve our ambitious 10-year plan for the NHS?

[Wes Streeting]

I am so grateful to my hon. Friend for her question. I pay tribute to Professor Ian Abbs. He is an outstanding NHS leader, and we have loved working with him. As with many people of his calibre moving on from their positions of leadership in the NHS, it is a bit like the Hotel California—you can check out any time you like, but you can never leave. We will not let him drift off into a quiet retirement; we are determined to make use of his expertise.

My hon. Friend is absolutely right to raise the importance of nursing. Nurses and midwives will play an increasingly important role in neighbourhood health. They are central to our shift to a modern, digital NHS. They are clinical leaders in their own right. Following the 10-year health plan, the chief nursing officer for England will work with the professions to develop a strategy that will make nursing and midwifery modern careers of choice, to address the decline in applications. As I have set out this week, we are looking forward to working closely with the Royal College of Nursing and Unison—of which, I should say, I am a member—to make sure that the status, the conditions and the impact of nursing on our NHS go from strength to strength, because nurses are the backbone of the NHS. We would not have a national health service without them.

[Sir Bernard Jenkin (Harwich and North Essex) (Con)]

I join others in welcoming much of the Secretary of State’s plan, but I want to return to the question of the Health Services Safety Investigations Body, to which my right hon. Friend the Member for Melton and Syston (Edward Argar) referred. I welcome the tone of the Secretary of State’s response to that part of my right hon. Friend’s questions, but will he agree to meet those of us from the Select Committee—a cross-party group of people—who campaigned over many years to bring this body, which is still in its infancy, into existence before making any further decisions on it?

As my right hon. Friend says, HSSIB is not a regulator, and to put it in with a regulator will create confusion about what it is. If he were Secretary of State for Transport, he would never dream of putting the air accidents investigation branch into the Civil Aviation Authority, because they have completely different and separate functions. That needs to be understood across the health service, and it is obviously not well understood at the moment.

[Wes Streeting]

I welcome the hon. Member’s constructive approach. Of course, we are happy to receive representations on HSSIB. I would just like to outline the problem we are trying to solve, which is that the patient safety landscape is increasingly cluttered. We have far too many bodies trying to do the same thing, cutting across each other, and for frontline staff and leaders on the receiving end of those many and often competing instructions, it can actually make things less safe rather than more safe. I really value the expertise in the Health Services Safety Investigations Body. We do not want to see that expertise lost, nor do we want to move it into the CQC prematurely, before the CQC is ready to receive it. I hope that that reassures him, but we are happy to have that conversation.

[Rachael Maskell (York Central) (Lab/Co-op)]

I congratulate my right hon. Friend, his Ministers and officials on putting together a vision for the NHS for the next 10 years. It will optimise how we live, but it is also really important that we can palliate how we die. Could he set out how he will ensure that we do not have a postcode lottery for specialist palliative care services, so that we can palliate well for everybody across our country? Will he meet with the leaders of the independent commission on palliative and end-of-life care to ensure that we get this right really quickly and for the future?

--- Later in debate ---

[Wes Streeting]

I am grateful to my hon. Friend for her question. We want a society where everyone receives high-quality, compassionate care from diagnosis through to end of life. Palliative and end-of-life care services will have a big role to play in our shift out of hospitals and into the community, the emphasis on personalisation for patients and their families, and the joining up between primary and community care services. I would be delighted to hear more from the commission. It is really important that we get this right. Regardless of where people stood on the debate about assisted dying, the one thing that united everyone across the House was a belief that palliative care needs to be so much better than it is today, and that is what we will work on together.

[Richard Tice (Boston and Skegness) (Reform)]

There is much that unites us in this House about the excellence in this 10-year plan—in particular the fact that the NHS needs reform and that, of course, healthcare should always be free at the point of delivery. But brilliant frontline staff, doctors and nurses say to me that the issue is the bureaucracy and the unnecessary processes and procedures, including in social care. Can the Secretary of State reassure the House that the senior management of the NHS are absolutely determined to reduce the bureaucracy, in particular around technology and the delays caused by GDPR?

[Wes Streeting]

The NHS leadership are absolutely determined to work with us to reduce waste, inefficiency and bureaucracy. We have in Sir Jim Mackey an outstanding chief executive of the NHS, and he and his team are working closely with Ministers to make sure we achieve that goal.

As for the funding model, I just do not know where the Reform party stands from one day of the week to the next. I heard the leader of the hon. Member’s party on the radio this morning doing the dance of the seven veils. He is normally very good at being a straight-talking politician—that is how he likes to present himself—but I cannot follow what the hon. Member for Clacton (Nigel Farage) thinks about this issue. Does he support a taxpayer-funded universal NHS free at the point of use? [Hon. Members: “No!”] I do not think he does. Does he support the European-style insurance system? I think he probably does—it is the only European thing he has ever supported, by the way. We are in no doubt: the NHS needs reform, but it needs the Reform party like a hole in the head.

[Mr James Frith (Bury North) (Lab)]

I commend not only my right hon. Friend and his team on today’s 10-year plan but also the leadership and Budget of our right hon. Friend the Chancellor, who made today and the next 10 years of our NHS possible. For too long, the NHS has been stuck in crisis mode. My right hon. Friend the Secretary of State will remember taking an important call while in my constituency, and he will know that life expectancy in Bury North can vary by seven years in wards just one mile apart. In East ward, Redvales and Moorside, where he took that call, child poverty rates now reach 42%. Can I ask him to ensure that those wards get a healthy share of the new funding for working-class communities, so that we can start to close the health gaps and give every child the chance of a long, healthy life?

--- Later in debate ---

[Wes Streeting]

My hon. Friend is absolutely right; it was on a snowy day of campaigning for him in Bury North that I received the phone call that would change my life, giving me my kidney cancer diagnosis. Despite that fact, I have since been back to Bury North; I am not saying that it was his bad luck—

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

It was not causation.

[Wes Streeting]

It was coincidence rather than causation, as my hon. Friend the cancer Minister says—although, given both our experiences, we will rethink our visit schedule to Bury.

On a serious note, my hon. Friend the Member for Bury North (Mr Frith) is absolutely right to make the link between poverty, particularly child poverty, and ill health. The last Labour Government lifted 400,000 children out of poverty; I am so proud to think that when in the first year of this Labour Government we chose to extend free school meals to half a million children from low-income families, with that one measure on one day we lifted 100,000 children out of poverty. That is the difference Labour Governments make, and that is how we will deliver not just an NHS fit for the future, but a fairer, more equal, more just society.

[Greg Smith (Mid Buckinghamshire) (Con)]

I look forward to studying the detail of this plan, but I welcome the Secretary of State’s commitment to neighbourhood health centres and likewise his commitment in a previous answer to rural communities. May I therefore offer him a golden opportunity? He will have heard me over many years in this House call for funding to build a new health centre in the village of Long Crendon, which lost its GP practice during the pandemic. They have the land, they have the planning permission and it will cost less than his lower number of £200 million to build. Will he convert words to delivery and commit to Long Crendon?

[Wes Streeting]

I thank the hon. Gentleman for his support with the plan, which I am sure is in no way connected to the fact that he wants some money out of us for that neighbourhood health centre. I will take his question as the first bid we have had from those on the Opposition Benches, and I look forward to receiving those representations from him.

[Sojan Joseph (Ashford) (Lab)]

The Secretary of State will know how important improving mental health support is to me. I hope that what the 10-year plan says about access to mental health provision will help to address the long waiting times for mental health services that the Government inherited. I particularly welcome what he said about using the NHS app for patients to self-refer for various treatments. I hope that that will cover talking therapies as well. Does he share my belief that opening up access to talking therapies in that way will enable more people to get that effective treatment at the right time, so that they can better manage their condition?

[Wes Streeting]

I thank my hon. Friend for his service to our country and our NHS. We are so lucky to have his expertise in the House. I am really proud that this Government will deliver mental health support in every primary and secondary school in the country and neighbourhood mental health services in every community. We will also ensure that people who are in mental health crisis do not end up in busy, noisy, overwhelming A&E departments, but will instead go to new mental health emergency departments, which we aim to roll out across 50% of type 1 A&E departments—either co-located or, if not, certainly nearby. I look forward to working with him on that.

My hon. Friend is quite right to emphasise the importance of talking therapies. That is how we not only help people to achieve their best when they are young and in education, but ensure that people are supported to stay in the world of work or to find work. We know there is a demonstrable link between mental health and wellbeing, good work and good outcomes. That is very relevant this week.

[Clive Jones (Wokingham) (LD)]

I welcome the Secretary of State’s 10-year plan. In October, in response to my Westminster Hall debate on the national cancer plan, the Government committed to publishing one later this year. I am confident that that will happen in the autumn, and the wider cancer community is equally enthusiastic. However, the 10-year plan announced today makes only a brief mention of the national cancer plan. Can the Secretary of State confirm that improved diagnosis, improved screening for at-risk groups, improved treatment outcomes, concentration on rare cancers and cancers in young people, better and continued workforce planning, more support and funding for research, better relationships with drug companies and much more will be part of the national cancer plan?

[Wes Streeting]

I thought for a moment there that the hon. Gentleman, having called for the plan, was going to write it. I can reassure him that he has covered all the right areas; I am delighted that he is as enthusiastic as we and the whole cancer community are about the plan. We deliberately did not go into specific conditions in the 10-year plan for health, because otherwise it would have turned into a Christmas tree, with every condition group trying to attach its bauble to it, but it is really important that this 10-year plan creates the rising tide that lifts all ships—including, as he notes, not just common conditions, but the rare ones too.

[Marsha De Cordova (Battersea) (Lab)]

I congratulate the Secretary of State on bringing forward a bold and ambitious plan for our national health service. We know that by 2050 there will be up to 4 million people living with sight loss, so we also need eye healthcare that is fit for the future. Can my right hon. Friend tell me that his plan will end the postcode lottery, join up primary and secondary care, tackle the challenges with the workforce and provide a proper high-quality sight loss eye care pathway and investment in research and innovation, so that we can end avoidable sight loss once and for all?

[Wes Streeting]

I congratulate my hon. Friend on her consistent campaigning on this issue, which has done so much to keep it on the national agenda. We will support more eye care services being delivered in the community, helping to create capacity within secondary eye care services too. Patients can be assured that optometrists have the training to manage a wide range of eye conditions safely in the community. We will also support improved IT connectivity between primary and secondary care, which has been shown to improve the referral and triage of patients, and enable the better use of technology to support local services.

Of course, there are still challenges: ophthalmology is one of the largest out-patient specialties, representing 8% of the total NHS waiting list, and the Royal College of Ophthalmologists workforce census found that 76% of units do not have enough consultants to meet demand. We will address those issues; we are working across both the public and the independent sectors to ensure that people receive the care they need, when they need it. A lot has been done but, as my hon. Friend says, there is so much more to do.

[Liz Jarvis (Eastleigh) (LD)]

I welcome this plan. As the Secretary of State is aware, my constituents Charlotte and James Bassett have been fighting for answers since the death of their baby daughter Norah in 2019. What assurances can he give my constituents that any recommendations by the national maternity and neonatal taskforce will be implemented quickly?

[Wes Streeting]

I thank the hon. Member for the outstanding way she has represented her constituents since she arrived in this House—not only on this issue, but on many others. I reassure her that we will work with families in a spirit of co-production to ensure that we identify what has gone wrong, so that families receive truth and accountability for failures and the reassurance of knowing that improvements will be made so that other families do not have to suffer in the way that they have. Things have gone so badly wrong, but I am confident that, with the approach we are setting out, we will be able to make rapid improvements, and I will keep the House regularly informed.

[Sam Rushworth (Bishop Auckland) (Lab)]

I thank the Secretary of State for this wonderful statement, delivering on a commitment that we made together at the Richardson community hospital in Barnard Castle two years ago to move services back into the community. I want to ask him about the use of bank staff in the NHS: not only is it a massive waste of money, but it has created a situation where only one in five of this year’s midwifery graduates feels confident of getting a job. On behalf of Mrs Rushworth, who is one of those, her friends, and nurses and midwives in the north-east who have contacted me about this issue, what will the Secretary of State do to ensure that those who have given 2,300 hours of unpaid labour to the NHS and are graduating with tens of thousands of pounds of debt can get a job?

[Wes Streeting]

I remember that visit to Barnard Castle—unlike visits by some people from Westminster, I was not there to get my eyes tested and my visit was perfectly within the rules. My hon. Friend is right to emphasise the importance of neighbourhood health, which is in the plan, and of reducing the cost of agency spend in the NHS. I want staff to feel that they are part a team and for there to be more flexible working, so that people do not feel that they have to resort to agency work to receive flexibility. I am proud that within our first year we have saved a billion pounds in agency expenditure, getting better outcomes for patients and better value for taxpayers.

[Ben Obese-Jecty (Huntingdon) (Con)]

The Secretary of State will be aware that the Carr-Hill formula has not been updated since its introduction in 2004: the staff market forces factor is based on earnings data from 1999 and the population density data that is used is the rurality adjustment from 2001, but the population of Huntingdonshire has increased by 30,000 since that time. I know that the Department has not conducted an impact assessment on the benefit of updating the formula, but the Secretary of State has announced that he will do so and that there will be sharp focus on money following need. Given that Huntingdon is a quickly growing region, where thousands more homes are set to be built in the next 10 years, will he clarify for my constituents that the formula will be updated and that GP surgeries in Huntingdon will receive a fairer allocation of the global sum funding?

[Wes Streeting]

I can give the hon. Gentleman the assurance that we are reforming the Carr-Hill formula and ensuring that funding is based on need. I am delighted to be working closely with the British Medical Association’s general practitioners committee on the reforms that we are making in this and other areas of general practice.

[Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)]

I welcome this brilliant plan. I particularly love the double helix that is featured on the front cover, because genetic discoveries have the greatest promise of all. If we all knew a little bit more about our health, we might all look after it a little bit better. Does the Secretary of State agree that the single patient record, with easy patient access, will be transformative?

[Wes Streeting]

Given my hon. Friend’s expertise, I am delighted that he has welcomed the plan so enthusiastically. I wholeheartedly agree with what he said. I give him 10 out of 10 for his product placement of the 10-year plan and, in particular, his remarks on the design of the front cover, which I will pass on to the team.

[Martin Wrigley (Newton Abbot) (LD)]

Having secured a Westminster Hall debate on the issue, I am delighted to hear the Secretary of State reconfirm that the Carr-Hill formula will be revised and changed. I am also delighted with the ambition of the new plan, and I think it is very good in an awful lot of ways. Will the Secretary of State remember that GP surgeries are businesses? To correctly plan, they need confirmation and positive indications of where their funding will go over a multi-year period. If that is always in the front of his head, then all will go well. I have scanned the plan and read about the new choice charter, the Care Quality Commission and the National Quality Board. However, I am concerned that the ICBs are becoming more powerful and unaccountable to local neighbourhoods. The regulators are good and will keep them systemically accountable, but we are missing Healthwatch. I am disturbed that Healthwatch has been cancelled as the patient advocate, giving the patient’s voice in local areas. Will the Secretary of State reassure us that there will be some way of getting individual advocacy, as well as regulation?

[Wes Streeting]

I welcome the hon. Gentleman’s support for the plan. Success has many masters, and I thank him for putting the Carr-Hill formula on the parliamentary agenda through his debate. I can reassure him about a few things. First, what the Chancellor has done in the spending review gives us the advantage of medium-term certainty, so the NHS will now be in the business of medium-term planning with the system, which enables it to make better use of the money that is allocated. Secondly, we are ending Healthwatch—I express my thanks to the people who have worked in Healthwatch for many years—but we are giving power directly to the patients. Alongside that, we are looking at what we can do to strengthen democratic accountability from elected representatives, to ensure that the patient voice and interests are protected.

[Sonia Kumar (Dudley) (Lab)]

As an NHS physiotherapist, I warmly welcome the Secretary of State’s statement and the ambition set out in the 10-year plan. In Dudley, we are already seeing the positive changes of a Labour Government in bringing down waiting lists. With renewed focus on community care, will my right hon. Friend commit to empowering allied health professionals to lead the neighbourhood health centres, building on the successful model that we have seen in Suffolk and North East Essex? Does he agree that we need more healthcare on the high streets?

[Wes Streeting]

My hon. Friend is absolutely right and it is brilliant to have her expertise represented on the Government Benches. She is right about the importance of physiotherapy, not just for improved and better-quality recovery, but for admission avoidance. I want physios and other allied health professionals to be at the heart of the neighbourhood health service, and I know that she will hold us to account to ensure we deliver.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

I also welcome the statement and the 10-year plan, and I offer my full support for most of the elements. Staying focused on the positive, I hope to be permitted to raise three points.

First, Dewsbury and Batley is unfortunately one of the many constituencies with dental deserts. Dewsbury West, a ward with over 20,000 residents, has no dentist, so how will the 10-year plan and the Government address that for my constituents?

Secondly, I fully support the plans to move healthcare into communities. In Dewsbury, we have a local hospital in the heart of the community that, with the right investment, could serve many more. Will the Secretary of State confirm that the Government will build on what we have, rather than fragment it?

Finally, Dewsbury and Batley is home to a wonderfully diverse community, but has some of the most deprived neighbourhoods, with the associated healthcare inequalities. Will the Secretary of State agree to visit my constituency so he can hear from my constituents and healthcare professionals, and ensure that their challenges are addressed?

[Wes Streeting]

In that constructive spirit, I can assure the hon. Gentleman that those things are contained in the 10-year plan for health. These changes are only possible because people voted Labour and because we have a Labour Government. In that spirit, he can be assured that in the run-up to the next general election, I will be pounding the streets of Dewsbury.

--- Later in debate ---

[Anna Dixon (Shipley) (Lab)]

I congratulate my right hon. Friend, his team and the amazing NHS staff on over-delivering on Labour’s promises, and for this amazing, ambitious 10-year plan that will ensure the NHS is fit for the future. I particularly welcome the “My Carer” feature on the NHS app that will allow family and unpaid carers to communicate with the care team for a loved one. Will my right hon. Friend explain how this plan will deliver benefits for disabled people and their carers?

[Wes Streeting]

I am grateful to my hon. Friend for her question: I can tell that she has already read a lot of the plan, not least because she had such a heavy role in shaping it, bringing her expertise to bear as we were deliberating. I also thank her constituents in Shipley, who took part in the engagement and consultation that she did locally; I hope they feel that their fingerprints are on this plan. She talks about the “My Carer” feature of the NHS app, which will make an enormous difference. I hope that the people who tend to be heavier users of health services feel that they have more power, choice, agency and control. That has to be true not just for people with physical disabilities, but people with learning disabilities. We have to ensure that the NHS is genuinely there for everyone, and that everyone has agency, voice, personalisation, power and control—that is what this plan will deliver.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I welcome the 10-year plan; its focus on prevention is right. I notice that there are a number of references to diabetes in the plan, but none to type 1 diabetes. We already have simple blood tests for biomarkers that identify people who are likely to develop type 1 diabetes, and immunotherapy, which can delay onset, is being assessed for NHS use. All the components of a national screening system are already there, so we have the opportunity to change how people are diagnosed with type 1 diabetes and the potential to eliminate life-threatening diabetic ketoacidosis, which can be how people present in hospital and find out that they have got type 1 diabetes. Will the Secretary of State clarify if the references to diabetes screening will be pertinent in relation to type 1 diabetes in specific? Will he meet me and the all-party parliamentary group for diabetes to learn from Italian lawmakers about their national type 1 diabetes screening programme?

[Wes Streeting]

I give the hon. Gentleman the assurance that we will be delivering on type 1 diabetes, as well as type 2 diabetes. He is right about the breakthroughs in science that allow us to predict and diagnose faster. Through its emphasis on technology, the plan will deliver wearables that will enable people to track their blood sugar levels in real time and enable insulin to be deployed at precisely the right time, in precisely the right amount, to provide stability, certainty and peace of mind. That will not only be important for adults with type 1 diabetes, but for parents who worry about their children. When they send them off to school or to play with friends, they will have the peace of mind that they can monitor their condition, and be reassured that they will be alerted if something does not look right. That is the peace of mind that everyone deserves and that is what this plan will deliver. I am sure the relevant Minister will be delighted to meet the APPG.

[Jon Pearce (High Peak) (Lab)]

I very much thank the Secretary of State for his statement and the NHS 10-year plan. As someone who represents one of those rural constituencies without an acute hospital, I very much welcome the plan to move from hospitals into communities. The Conservatives broke their promise to deliver a health hub for Buxton in my constituency, and a plan is ready to go. Will the Secretary of State meet with me to discuss the opportunities for that plan to deliver for my local constituents?

[Wes Streeting]

As soon as my hon. Friend got to his feet, I knew exactly where the question was going. I was delighted to spend time campaigning for him in his constituency, and I know that the focus on neighbourhood health will be particularly welcome to people living in rural communities just like his. I would be delighted to meet with him to discuss his proposal, not least because he will hound me relentlessly if I say anything other than yes.

[Jim Shannon (Strangford) (DUP)]

In a week that has been quite difficult, it is a real joy to have some good news in the Chamber in the 10-year plan. I thank the Secretary of State very much for that statement and for the positive fashion in which it was delivered. He says that it will deliver a health plan for all, but I have a quick question in relation to care in the community. Patients are taking up beds in hospitals who cannot get home, because the care in the community is not there. There are those who want to go to their homes, but the staff are not there to look after them. As the Secretary of State will know, I always try to do things in a positive fashion. When it comes to finding and training people, will he consider training through schools and colleges for specific roles in care in the community and encourage pupils from a young age to see those as careers that they wish to be part of? I know the Secretary of State will do this, but will he share all that good news with the Minister in the Northern Ireland Assembly?

[Wes Streeting]

I can absolutely give the hon. Gentleman that assurance. We will ensure that we are delivering that intermediate care in the community through not just the NHS, but our partners in social care. I have a really good relationship with Mike Nesbitt, my counterpart in Northern Ireland, so I am happy to share our learnings there. The hon. Gentleman is absolutely right to emphasise the importance of ensuring that it is not just the sons and daughters of doctors, but more working-class people from backgrounds such as mine who get to go into medicine. That is exactly what this plan will deliver.

[Ms Polly Billington (East Thanet) (Lab)]

It is thanks to the Secretary of State and, indeed, our Chancellor that we already anticipate a £10 million state-of-the-art health hub in Thanet, which is opening this autumn. That will have a community diagnostic centre, expanded GP services, podiatry, cardiac and respiratory teams, MRIs and support for mental health. That is exactly what this 10-year plan is about. I welcome that introduction, especially in a growing community such as Thanet, but what considerations has the Secretary of State given to Chris Whitty’s report into health in coastal communities in the 10-year plan? Coastal communities in particular suffer from high levels of poor health and underperform in terms of services.

[Wes Streeting]

I can certainly give my hon. Friend the assurance that Chris Whitty’s work as chief medical officer had a big bearing on our thinking about how we meet the needs of rural and coastal communities and tackle health inequalities. His analysis is clear: we need people not just living longer, but living well for longer. We need to push illness much later into old age so that people can live life to the full until the very end. That must apply to everyone, not just the privileged few. My hon. Friend’s constituents will really benefit from this plan as well as the new facilities coming later this year.

[Caroline Voaden (South Devon) (LD)]

I really welcome this 10-year plan, especially the shift from hospital to community. I am excited by the digital transformation, and I hope it works in the broadband blackspots of South Devon. I will ask the Secretary of State about the shift from sickness to prevention. Will he tell the House what conversations he has had with the Ministry of Housing, Communities and Local Government and the Treasury about ringfenced funding for leisure centres, swimming pools, outdoor education centres, safe cycle routes and footpaths? We can do so much more to promote and embed healthy lifestyles, particularly in our children and young people, but it will take investment. We need to spend to save. Is that part of the 10-year plan?

[Wes Streeting]

I really welcome that support, and that is an absolutely great question. On the point about connectivity, I will ensure that the Science Secretary receives those representations and dons his skinny jeans and flip-flops and comes down to improve connectivity for her community—he is committed to doing that for people right across the country. The hon. Lady is absolutely right: we have to ensure that people in every part of the country have access to all those things that make life worth living, such as grassroots sport, culture, leisure, recreation, clean air, parks and open spaces. She has my assurance that, working with the Deputy Prime Minister and my right hon. Friend the Secretary of State for Culture, Media and Sport, we will bring those opportunities to everyone, not just the wealthiest areas or big cities.

[Sally Jameson (Doncaster Central) (Lab/Co-op)]

Will the Health Secretary outline how the 10-year plan will quickly deliver on the Government’s aim to go from an analogue to a digital service? That is important to Doncaster hospital, which is still on paper records. Will he also ensure that the deaf community is considered and that BSL and easy-read materials are woven into any digital roll-out?

[Wes Streeting]

I can absolutely give my hon. Friend that assurance. The great opportunity for technology is that we can design in accessibility; I had a great meeting here with some of my constituents who suffer from hearing loss. We have a great opportunity for the NHS to once again be the great social leveller, providing quality care to everyone, whatever their background, and personalised care that meets their needs. We need to have better digital connectivity and AI-enabled hospitals. My hon. Friend’s constituents will know how hard she bangs the drum here for investment in her local hospital, and that is very much on my mind.

[Olly Glover (Didcot and Wantage) (LD)]

I thank the Secretary of State for his statement and his previous answer on dentistry, but I will push him a little further. My constituency, along with all of Oxfordshire, is an NHS dental desert. Having met with dental providers, they say that the key to changing that is reforming the NHS dental contract. I note that the 10-year plan includes a commitment to doing that, but no timescales are provided. Can the Secretary of State enlighten the House?

[Wes Streeting]

Yes, I certainly can. The proposals we are consulting on represent an important step towards the fundamental reform to the dental contract that we committed to in our manifesto, and that will begin this year. There are no perfect payment models. Careful consideration needs to be given to any potential changes in a complex dental system so that we deliver genuine improvements for patients and the profession, but we are committed to working with the British Dental Association. The Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock), is working hard to fix the mess left by the previous Government.

[Kevin McKenna (Sittingbourne and Sheppey) (Lab)]

On behalf of the small and often oppressed community of health policy geeks, I thank the Secretary of State for giving us a Christmas present in July—I will be pressing Ctrl+F through it all weekend. I also really thank him and his team for threading through this plan a real commitment to the quality of work for the NHS workforce. I can see already some really strong, concrete suggestions for how we can make the working lives of people in the NHS better. Most importantly of all, people in Sittingbourne and Sheppey are really glad to see that the idea of a neighbourhood health service is well fleshed out. Again, with a health policy geek hat on, we know it is the funding and the funding models that really matter, so I really commend the review of the funding formula, particularly towards rural and coastal communities. How will the Secretary of State ensure that with this new funding formula, he and his team at the centre will keep a tight grip on what happens at ICB and other levels closer to the ground to ensure that that funding gets to the areas with the most need?

[Wes Streeting]

I am so grateful to my hon. Friend for his support; as he implies, he brings so much expertise to this place. As we embark in this brave new world of devolution of power, resources and control, we keep a close eye on outcomes. I am counting on local communities, Members of Parliament, mayors, councils and local authorities also to ensure that we have democratic accountability and oversight to ensure the resources we provide are spent to the best effect and have a real impact. I pay tribute to the policy geeks of the world in health and social care for their contribution to this 10-year plan. Health geeks of the world, unite! You have nothing to lose but your chains!

[Several hon. Members rose—]

--- Later in debate ---

[Jas Athwal (Ilford South) (Lab)]

I also thank my right hon. Friend the Secretary of State for a bold and ambitious plan. Over the past few months, I have had the privilege of connecting with some really inspiring people across my constituency, such as Jagdeep Aujla. His Dopamine Warriors boxing club, which the Secretary of State visited some weeks ago, sets a powerful example. Jagdeep’s boxing club offers a safe, empowering space for people living with Parkinson’s to connect with each other, maintain their fitness, and slow the progression of the condition. Will my right hon. Friend outline how the Government’s 10-year health plan will support the shift from hospital to community, so that more support is available on people’s doorsteps, particularly organisations such as the Dopamine Warriors?

[Wes Streeting]

I am grateful to my hon. Friend and parliamentary neighbour for his question. He is right that I recently had the joy of visiting Jagdeep and the Dopamine Warriors in my constituency—they do brilliant work, which underscores why we have to work in partnership with community groups and the voluntary sector. They provide great support for patient groups and their families in a way that would not be nearly so good even if the NHS tried to provide it, so I can absolutely assure my hon. Friend that that partnership will be at the heart of the 10-year plan. I also note that he is campaigning for an upgrade to the A&E at Queen’s hospital in Romford. As he knows, I am not empowered to make that decision, but my hon. Friend the Minister for Secondary Care will have heard that case.

[Matthew Patrick (Wirral West) (Lab)]

I thank the Secretary of State, because with this NHS plan, ambition is back. That ambition matters to my constituents, who for too many years have seen a health service in decline. I brought many of those constituents to a community meeting so that their experience and expertise could be shared and fed straight into this plan. Could the Secretary of State set out how this plan gives power to patients and puts them back in the driving seat?

[Wes Streeting]

I thank my hon. Friend and his constituents for the feedback from that event, which I received and is reflected in this plan. There is much in the plan about power to the patient—more ease, convenience, choice and control, not just through the app but through a number of mechanisms, including new patient power payments that will give patients real bite if they are receiving poor-quality care. That is thanks to my hon. Friend and his constituents.

[Sarah Russell (Congleton) (Lab)]

I thank the Secretary of State for the 10-year plan. Moving quickly on the dentistry contract is extremely important to my constituents, but I want to raise the fact that, at the moment, parents in my constituency are frightened. They are frightened about how long it takes them to get diagnoses for their children, particularly in relation to neurodiversity; about the lack of support once they do get those diagnoses; and about the lack of child and adolescent mental health services. They are also frightened that their neurodiverse children are being removed from those services on the basis that autism is apparently regarded by some people in our local services as inherently anxiety-creating and therefore children with that diagnosis do not need mental health support. Can the Secretary of State tell me how my constituents will benefit from this plan when it comes to the support children need with their health?

[Wes Streeting]

I thank my hon. Friend and her constituents. She held—I think—four events across her community to feed into this plan, and we really valued that feedback. I hope people feel that their fingerprints are on this plan. It sets out our ambition to make this the healthiest generation of children who ever lived, whether that is through better access to mental health support and services, recognising the importance of meeting neurodiverse need, or the focus on physical activity, good diet, nutrition and access to sport, media and culture for everyone, especially children from the most disadvantaged backgrounds. I hope the plan reflects the ambition we heard from my hon. Friend’s constituents.

[Leigh Ingham (Stafford) (Lab)]

I congratulate the Secretary of State and his entire team on their hard work—this document is outstanding, and I look forward to implementing it across Stafford, Eccleshall and the villages. My constituents participated in three consultation events to feed into this project, so it is really important that patient voices are all over it. A specific concern that came through was that 450 systems are used in Stafford hospital for digitisation and patient records, and they do not talk to each other, which is leading to discrepancies in patient care. Can the Secretary of State give me more information about how the improvement in digitisation will improve patient care on the frontline?

[Wes Streeting]

I thank my hon. Friend for her support, and her constituents for giving up their time to take part in those events, which fed directly into the plan. I hope they see their input reflected in the results. She is quite right that we need to fix those basic systems and make sure that people across different parts of the NHS are able to interface and join up care around the patient. The capital and tech investment ringfenced by the Chancellor will have a really big impact, and I hope my hon. Friend’s patients and NHS staff will begin to feel that impact.

[Andrew Pakes (Peterborough) (Lab)]

I put on record my thanks to the Secretary of State for his statement today, and to the Chancellor for the financial and economic work she has put in. Labour Members know that governing well is a team sport, and it is when people in government work together that we succeed best for the people we seek to serve.

Despite the best efforts of important surgeries such as Thistlemoor in my constituency, too many parts of Peterborough are left out as a result of two challenges. The first is the postcode lottery; too many things seem to happen in other parts of our county, and we know that working-class communities are too often left behind. The second challenge is that the NHS is just too complex. Even when we have services in the community, people struggle to know which bit to access—is it the pharmacist, the GP surgery, or the hospital? Can the Secretary of State confirm that the 10-year plan will seek to simplify the system, and to put patients in the driving seat and bureaucracy in the bin?

[Wes Streeting]

I can absolutely give my hon. Friend that reassurance. It is about time that we design care around the patient, rather than ask the patient to do the running around on behalf of the NHS. That will be a big shift in practice and culture. Of course, as my hon. Friend says, it is only thanks to the decisions taken by the Chancellor that we are able to match the reform and ambition of this plan with the investment we need. That is why I was delighted to be joined not just by the Prime Minister, but by my right hon. Friend the Chancellor this morning in Stratford to kick off the 10-year plan—not least because she is the one who pays the bills, and we are very grateful to her for it.

[James Asser (West Ham and Beckton) (Lab)]

One of the issues with the health service that my constituents most often ask me about is the struggle to get basic appointments. That is leading people to the hospital, which is unable to cope with the sheer numbers, and in a populous, fast-growing borough, that is creating unsustainable pressure. As such, I welcome my right hon. Friend’s remarks about the move from hospital to community. Does he agree that getting primary care right is at the centre of getting the NHS right, and can he assure my constituents that they will get what they want: appointments when they need them, as they need them, in their local community?

[Wes Streeting]

I am very grateful to my hon. Friend— I know his constituency well, and he has been a powerful voice for his constituents since he arrived in this place. He is absolutely right that we need good general practice and accessible neighbourhood health services that are available to everyone, especially in areas of high need and health inequalities, as we see in the London borough of Newham. I hope his constituents really feel the impact of this plan as we roll it out during this Parliament and across the next decade.

[Jayne Kirkham (Truro and Falmouth) (Lab/Co-op)]

The Secretary of State mentioned community health teams in Cornwall taking services directly to people, even in their homes. I am so pleased with the focus on how to deliver healthcare in sparsely populated rural and coastal areas. Can the Secretary of State confirm that this focus will run through the 10-year plan, so that across the country people can access care as equally as possible at local level—and specialist services such as robotic surgery and mental health emergency hubs—no matter where they live?

[Wes Streeting]

My hon. Friend is absolutely right. I have been delighted to spend time with her in her constituency to make sure that this Government understand the needs of every part of the country and different types of community. We need to ensure that, when we think about health services, the pitch we have in our mind’s eye is meeting the needs not just of big cities or large towns, but of rural and coastal communities that have been left behind for too long. I hope that my hon. Friend’s constituents will really feel the benefit of the innovation that is at the heart of this 10-year plan, and of the focus on community services and neighbourhood health. From what they have seen so far, they can trust that if we do not deliver for them, my hon. Friend will be the first to tell us.

[Dr Lauren Sullivan (Gravesham) (Lab)]

I thank the Secretary of State for his statement today. I welcome the move to community delivery, greater accountability of providers and ICBs, and power to the patients. As a research scientist—I declare an interest as an unpaid visiting researcher at the Francis Crick Institute— I welcome the recognition of the need for scientists and diagnostics to get ahead of disease. What conversations has the Secretary of State had, and what actions has he taken, with the National Institute for Health and Care Excellence and other regulatory bodies in relation to the amazing new technologies, devices and drugs and how we can get them into the NHS faster?

[Wes Streeting]

We are so lucky to have my hon. Friend’s scientific expertise on our Benches, and we are also lucky that, despite being elected, she is doing research on behalf of the country in her spare time—goodness knows where she finds it. We welcome her public service. We need to see investment in new medicines and technology as an investment rather than a cost. That is how we deliver better care, better value for taxpayers and better outcomes, and it is how we close health inequalities. This is the most exciting revolution taking place in the world, and it is happening right here in England. We have got to make sure that the NHS benefits from it.

[Navendu Mishra (Stockport) (Lab)]

This weekend will mark the 77th anniversary of the national health service, and I take this opportunity to thank all NHS staff at Stepping Hill hospital in Stockport. I pay tribute to the work of the British Dental Association, because week in, week out, Members from all parts of the House receive correspondence on NHS dentistry and the lack of it. I take this opportunity to invite the Secretary of State to visit Stockport. I know that he comes to Bury often, so when he is up in Greater Manchester, will he join me in Stockport to speak to patients, parents and frontline dental staff about the crisis?

[Wes Streeting]

My hon. Friend is right about the importance of dental services, and I hope that his constituents begin to feel the benefit. I also know he is leading the charge on the campaign for Stepping Hill hospital. He regularly raises it with me and other Ministers, and I would be delighted to try to visit his constituency as soon as my diary allows.

[Sarah Edwards (Tamworth) (Lab)]

I thank the Secretary of State for this welcome news. The Sir Robert Peel centre, part of the University Hospitals of Derby and Burton NHS trust, is now running at full throttle, with a range of diagnostic services and treatment options. I congratulate the trust and the Minister on opening that community diagnostic centre, which, as part of the NHS 10-year plan, will transform lives and access to speedy healthcare. Will he celebrate this hospital’s transformation to unlock more than 1,000 treatments a week in Tamworth and the villages?

--- Later in debate ---

[Wes Streeting]

I am so grateful to my hon. Friend for that question, as it gives me the chance to say an enormous thank you to everyone involved. I hope that people are beginning to feel the benefits and will see the change that comes from having a great Labour MP and a Labour Government who deliver the change that our country desperately needs.

[Louise Jones (North East Derbyshire) (Lab)]

My constituents raise issues with accessing the NHS, particularly local GPs and primary services, at every chance they have. I welcome the bold, big ambition of this 10-year health strategy. Can the Secretary of State outline how it will make a big difference in our small towns and villages?

[Wes Streeting]

Neighbourhood health cannot just be about large towns and cities. It has to meet the needs of every community, and the approach we are taking, with care closer to home or, indeed, in the home will benefit everyone, but it will disproportionately benefit people such as those in my hon. Friend’s constituency. That is the benefit of having a great Labour MP like her and a Labour Government delivering results.

[David Burton-Sampson (Southend West and Leigh) (Lab)]

I thank the Secretary of State for his statement and the 10-year plan, which I welcome. I am already seeing the benefits of this Government’s commitment to reforming the NHS in my constituency, with a second linear accelerator radiotherapy machine coming to Southend hospital and investment in four of my GP surgeries, with new space being developed for more appointments. As he knows, however, I care greatly about men’s mental health. How does this 10-year plan begin to address the challenges we face in that area?

[Wes Streeting]

I am delighted with the work that my hon. Friend is doing to assist us with the development of a new men’s health strategy, including a focus on men’s mental health, which he has raised so powerfully on more than one occasion in this House. I hope he will be pleased with the results. By working closely with him, voluntary sector organisations and the NHS, we will make sure we get it right.

[Jess Asato (Lowestoft) (Lab)]

I hugely welcome the NHS 10-year plan, and its recognition that victims of domestic abuse are more likely to experience worse NHS access and worse outcomes, and will die younger. Domestic abuse costs the NHS £2.3 billion a year. Will the Secretary of State agree to work with Standing Together and other domestic abuse charities to ensure that the NHS treats domestic abuse as the public health emergency that it is?

[Wes Streeting]

I am so grateful to my hon. Friend for that question, and for the expertise she brings to the House on this issue. She is absolutely right: it is the NHS’s responsibility to meet the needs of everyone, whatever their background and whatever the circumstances of their requirement for access to the NHS. That is so often where eyes first spot the telltale signs of violence against women and girls and domestic abuse. It is not the job of the Home Office to tackle this issue; it is the job of all of us across Government. She has my assurance that I will work closely with my right hon. Friend the Home Secretary to make sure that the NHS plays its part in keeping women and girls safe, alive and well.

[Alex Baker (Aldershot) (Lab)]

I warmly welcome the Government’s 10-year plan. It is a proud day to sit on these Benches. I also welcome the Government’s commitment to rebuilding Frimley Park hospital in my community in wave 1 of the new hospitals programme. The brilliant staff there, who are currently working in a hospital riddled with reinforced autoclaved aerated concrete, deserve that more than anyone. Can the Secretary of State help me out by bringing to life what healthcare will look like for people in my community of Aldershot, Farnborough, Blackwater, Hawley and Yateley over the next decade as a result of this plan?

[Wes Streeting]

I am grateful to my hon. Friend for that question, and to her constituents for taking part in her local engagement event. This plan will ensure that more people receive the right care in the right place at the right time. It will deliver more neighbourhood health services under one roof, and more choice, convenience, power and control over healthcare. It will deliver access and support at the touch of a button, and personalised care. We are completely changing how we deliver healthcare in this century and meeting the needs of everyone. Thinking particularly about her constituency, we are making sure that we are supporting our armed forces, veterans and their families, so that they receive great outcomes, thanks to a great Labour MP in Aldershot and a Labour Government who deliver. I know that she will hold our feet to the fire to make sure that we deliver.

[Chris Vince (Harlow) (Lab/Co-op)]

I thank the Health Secretary for his statement, and I promise not to lobby him too much on the potential move of the UK Health Security Agency to Harlow, although perhaps I should also lobby for a neighbourhood health centre. Instead, can I ask him to set out how the 10-year plan will ensure a shift from sickness to prevention? Medical professionals in my local hospital, the Princess Alexandra, emphasised that issue when I met them recently.

[Wes Streeting]

My hon. Friend is right that we need to not just treat sickness, but prevent illness. That was a strong message that we got from the public. He will see lots of good stuff on prevention in the plan, and I know that he will welcome it. On the location of the UK Health Security Agency, he may have inadvertently misled the House: he said he did not want to lobby me too much, but that is absolutely not true; he will not leave me alone on this issue. He lobbies me every single day. I can assure him we will make a decision on that issue shortly.

[Mr Deputy Speaker (Sir Roger Gale)]

I am sure that the hon. Member for Harlow will wish to correct the record.

--- Later in debate ---

[Wes Streeting]

Absolutely, and the people of Watford can see the difference a Labour Government can make, thanks to their sending a Labour MP to the House. They saw what happened when they sent a Tory, and they cannot send a Liberal Democrat to this place and trust them to deliver. They need a Labour Government to deliver Labour change. I am delighted that my hon. Friend is here, and we are making a real difference together. Thanks to the engagement events he held with his constituents in Watford, their ideas are reflected in this plan. That is thanks to their hard work and his advocacy.

[Lewis Atkinson (Sunderland Central) (Lab)]

It falls on each Labour Government to reform and renew the NHS in the service of patients, and that includes mental health patients; from my consultations, I know that they are a key priority for the people of Sunderland Central. I welcome the plan’s emphasis on empowering patients by providing them with information and choice through the NHS app, including on waiting times, but the Secretary of State will know that information about mental health waiting times is often poor, as are the waiting times themselves. In the 10-year plan, will he commit to making sure that empowerment applies equally to people seeking mental health services and those seeking physical health services?

[Wes Streeting]

My hon. Friend is absolutely right. We in this place are so lucky to have his expertise and his leadership of the Back-Bench health and social care committee of the parliamentary Labour party. Sunlight is the best disinfectant, and I am concerned that we do not give enough profile to paediatric waits and mental health waits. With more transparency, information and access, we will be able to demonstrate improvements over the course of this Parliament and the next decade.

[Michelle Welsh (Sherwood Forest) (Lab)]

Families affected by failing maternity services were ignored for far too long, and we have a system of accountability that is broken. I am pleased that the Secretary of State’s plan has a strong focus on patient outcomes and experiences, and that maternity care will be at the forefront. I am also pleased to see that the single patient records will be rolled out in maternity services first. It is vital that women feel heard and seen throughout their pregnancy journey, and that crucial information no longer falls through the cracks of numerous systems that do not sync up.

I express my heartfelt thanks to the Secretary of State for really listening, for speaking to families across the country, and for coming to Nottinghamshire twice. I can honestly say that his reaction moved me. Not only was he listening; he cares and is determined that things will change, and they will. As chair of the APPG on maternity, and as a harmed mother, I thank him. Can he tell me a bit more about how maternity services will be incorporated into his plan for a neighbourhood health service?

[Wes Streeting]

I am so grateful to my hon. Friend for all the work she does as chair of the all-party parliamentary group, for the personal and professional experience that she brings to this House, and for the wisdom, advice and insight that she has offered to help me make better decisions. I am absolutely determined to work with families, especially those who have suffered such grave injustice at the hands of the NHS. It is a wonderful institution, but sometimes when it fails, it fails spectacularly. The culture of denial and cover-up cannot be allowed to persist, and I will work with my hon. Friend to make sure that we end it.

On neighbourhood health, it is so important that we engage with families early, especially where they may be at greater risk of complicated pregnancy or harm, because we know this is an area of grotesque health inequalities. After birth, it is really important that we have strong health visiting, and care in the community and the home that does not just consider the interests of the baby, but asks questions of the mother. How is she feeling? How is she recovering? Is her partner coping? We have to look at the whole family, and I am sure we will get it right. I am determined to get this right, and it will be in no small part thanks to my hon. Friend’s leadership and support.

[Jim Dickson (Dartford) (Lab)]

I thank the Secretary of State for both his statement and the 10-year plan. I am delighted that residents in Dartford were able to play a full part in shaping its priorities through our consultation meeting in February. They will be really pleased to see not only the additional GP appointments, but the pressure being taken off their local hospital, Darent Valley, through the provision of better and more community services. The hospital was designed with a much smaller community in mind and is now suffering the consequences. Can the Secretary of State give me an idea of the pace of the roll-out of neighbourhood health centres? We could certainly do with one in Dartford.

[Wes Streeting]

I am grateful to my hon. Friend for his question—representation duly received. I reassure him that one of the ways we will ease the pressure valve on our hospitals is by doing more neighbourhood health. That helps to drive admission avoidance, speed up delayed discharges, and get much more effective flow of patients through hospitals. That is our commitment. We aim to roll out 40 to 50 neighbourhood health centres over the course of this Parliament, and if we can go faster, we will. I have no doubt that my hon. Friend, as a strong representative for Dartford, will make more representations to us shortly.

[Kevin Bonavia (Stevenage) (Lab)]

I thank the Secretary of State and everyone involved in creating this well-designed and excellent 10-year plan. There is so much good stuff in it, but I particularly like the approach of shifting treatment from hospitals to neighbourhoods and homes. Many of my constituents in Stevenage have been taken to Lister hospital when they do not want or need to be there, but we have an alternative. The Minister for Social Care and my hon. Friend the Member for Welwyn Hatfield (Andrew Lewin) recently joined me on a visit to the Hertfordshire community NHS trust’s “hospital at home” service. Is that something that the Secretary of State and the health team are determined to roll out?

[Wes Streeting]

I can give my hon. Friend that assurance. The change will mean that people in Stevenage start to feel real improvements in their ability to access the NHS. Of course, that is in no small part thanks to this country’s amazing life sciences sector, which has its beating heart in Stevenage.

[Andrew Cooper (Mid Cheshire) (Lab)]

I add my congratulations to my right hon. Friend, his team and NHS staff, who have put this plan together so that the NHS does not just survive but thrives. Last weekend, I met a family in Winsford who, that morning, had received a bill of £180,000 for their mother’s care. The daughter said to me, “Andrew, I don’t know how I can possibly pay this.” The previous Government failed to get a grip on the issue. The plans that the Secretary of State has set out to increase carer’s allowance and the disabled facilities grant will make a big difference, as will the introduction of fair pay agreements across the adult social care sector. Can he confirm that he will do everything he can to accelerate and implement the outcome of Baroness Casey’s cross-party commission, so that the issue is resolved once and for all?

[Wes Streeting]

I can certainly give my hon. Friend that assurance. It is precisely because of examples of the sort that he has shared with the House that we have to get this right, so that we relieve families of such catastrophic care costs. Just as the NHS replaced fear with high-quality care for all, we have to alleviate the fear of families who require care, because the situation that he describes blights too many families across our country.

[Mark Sewards (Leeds South West and Morley) (Lab)]

May I briefly commend the Health Secretary for his comments on the morning media about events in this place yesterday? Empathy is in short supply in politics, and we could do with a bit more of it.

I really welcome the 10-year health plan, and specifically the focus on outcomes and the transformation of the NHS into a neighbourhood health service, complete with health centres. The plan states the criterion for deciding the first locations of these health centres: they will be the areas with the greatest need. Will the Health Secretary expand on that criterion, and perhaps tell me what I need to do to get a health centre for Leeds South West and Morley?

[Wes Streeting]

I knew exactly where that question was going, because my hon. Friend has been such a strong champion of his constituency since he arrived in this place. I am committed to rolling out neighbourhood health across the country, and to making sure that we particularly benefit the communities with the greatest need that are the most poorly served. This is in no small part possible thanks to the leadership of the Chancellor of the Exchequer and the wise decisions that she has taken. Not only have we delivered investment in the NHS, but interest rates have fallen four times, wages are finally rising at a higher rate than the cost of living, and we have the fastest-growing economy in the G7. That is the leadership that we need from the Chancellor, and it is here to stay.

[Mr Deputy Speaker (Sir Roger Gale)]

Finally, and with thanks for his patience, I call Richard Baker.

[Richard Baker (Glenrothes and Mid Fife) (Lab)]

Thank you very much, Mr Deputy Speaker—persistence pays off.

Will my right hon. Friend assure me that he will report regularly to this House on progress against this excellent plan? I hope that will help us to evidence the case for investment in community health facilities in Scotland, which have long been promised but not been delivered by the SNP, including the much-needed new health centre in Lochgelly in my constituency.

[Wes Streeting]

I can absolutely give my hon. Friend that assurance. I just feel so sorry for him, because he comes here to stand up for his constituents, knowing full well that while they have a Labour Government who are delivering the biggest increase in investment to the devolved Administrations since devolution began, the SNP, which has been in government for almost two decades, is squandering the money and the opportunity. People will not get change in his constituency, or across the rest of Scotland, if they face more of the same from the SNP. Scotland needs an alternative, and Scotland’s NHS needs an alternative. That alternative is Scottish Labour and the leadership of Anas Sarwar and Jackie Baillie, and it cannot come soon enough.

[Mr Deputy Speaker (Sir Roger Gale)]

May I thank the Secretary of State for answering in excess of 65 questions, and the shadow Secretary of State for being in attendance throughout the entire proceedings?

NHS Maternity and Neonatal Services

Wes Streeting Excerpts

Monday 23rd June 2025 Written Statements

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

I am today announcing that I will be launching a national, independent investigation into maternity and neonatal care.

Although pregnancy and childbirth should be a time of joy, for some people this time can bring anxiety, harm or trauma and, in some cases, profound loss. I have listened to families who shared their experiences of unacceptable care, and they have shared with me the multitude of issues that exist across the system. It is clear that we are not listening as much as we should to women and their partners when they raise concerns—and for some women this is even worse, depending on their skin colour or language. We are not always identifying when things are going wrong in maternity and neonatal units quickly enough, and nor are we tackling these failings at the core. The system as a whole is then not supporting harmed or bereaved families when they rightly seek answers and accountability. Ultimately, we are not providing the care that families deserve. This is not the case across the board as many women receive excellent care. However, it is unacceptable that this is not the experience that all women have. We must urgently reset our approach to maternity and neonatal care.

That is why we are announcing this independent investigation: to understand the systemic issues behind why so many women, babies and families experience unacceptable care, and to rapidly put in place solutions to improve maternity safety and quality.

This will be a rapid investigation and will have two core roles. It will conduct urgent reviews, by the end of this year, of up to 10 trusts where there are specific issues. We will work with families and the NHS to develop criteria for selecting trusts.

Secondly, it will undertake a rapid, systemic investigation into maternity and neonatal care in England, reporting by December 2025. This will synthesise the findings and recommendations from all other reviews to recommend one set of national actions to drive the improvements needed to ensure high-quality care and that women are listened to. I will be engaging with families in determining the membership of the investigation team and its terms of reference.

I am also establishing a national maternity and neonatal taskforce, which I will chair. It will be made up of a breadth of independent clinical and international expertise, with family and charity representatives. It is imperative that this includes the voices of families who have experienced harm or loss, so I will also be continuing to meet families throughout the year. I will also ensure that membership is representative of those who can speak to the inequalities within maternal health.

The recommendations will inform the development of a new, national maternity and neonatal action plan, which we will develop with families. The action plan will lead to rapid improvement of maternity and neonatal quality and safety, and ensure that any families in the future who are harmed or bereaved will get answers about what happened, see that lessons are learnt and that there is accountability where appropriate.

In relation to calls for local reviews, I have informed families that this work will include a review into nine specific cases at University Hospitals Sussex NHS Foundation Trust. I am currently discussing with Leeds families the best way to grip the challenges brought to light in that trust by their campaigning, reports in the media, and the latest Care Quality Commission report.

We must also act now to resolve the issues we know exist. Repeated inquiries have identified significant issues across services, from a lack of compassionate care, concerns over safety, and issues in culture and leadership, and there remain stark inequalities faced by women in deprived areas or of black and Asian ethnicity.

This is why, alongside the independent investigation, I am taking immediate measures to start changes so desperately needed. We are introducing measures to hold the system to greater account and improve transparency. The worst-performing trusts will be held to account by the NHS chief executive, to ensure that the necessary improvements are made faster and deeper. This year we will introduce a new early warning system, powered by a real-time data tool, to detect safety issues earlier and allow action to be taken more swiftly to improve outcomes.

To improve safety, we will roll out new best practice standards to tackle the leading causes of maternal mortality and morbidity. We are also taking action to reduce the stark and completely unacceptable inequalities in maternity care. We will deliver an anti-discrimination programme to support trust leadership, ensuring that all families and staff will experience an environment free from discrimination and racism, and benefit ethnic minority mothers. These actions will support our manifesto commitment to set a target to close the black and Asian maternal mortality gap.

Through the investigation, and these immediate actions, I want to challenge and support maternity and neonatal services to provide compassionate, high-quality care to all families at their most vulnerable and life-changing moments.

[HCWS726]

Oral Answers to Questions

Wes Streeting Excerpts

Tuesday 17th June 2025 Commons Chamber

[Joe Powell (Kensington and Bayswater) (Lab)]

15. What steps his Department is taking to tackle building maintenance backlogs in the NHS estate.

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

The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), sends her apologies due to a family issue. She is very much in our thoughts today.

Thanks to the decisions taken by my right hon. Friend the Chancellor at the spending review, health capital budgets will increase to £14.6 billion by the end of the spending review period. That will deliver the largest-ever health capital budget in NHS history. Across this settlement, more than £5 billion will be invested to address the most critical building repairs, reducing the most serious and critical infrastructure risks and rebuilding the broken NHS left by the Conservatives.

[Helen Maguire]

While I welcome the recent announcement of £12 million of extra funding for Epsom and St Helier university hospitals NHS trust, it is quite frankly a drop in the ocean in comparison with the scale of need, because the current backlog at the trust costs £150 million. Patients and staff deserve safe and modern facilities, not patchwork repairs. I therefore ask the Secretary of State to meet with me and visit Epsom and St Helier hospitals to see at first hand the scale of the challenge and how we can accelerate progress.

[Wes Streeting]

I absolutely appreciate the challenges that the hon. Member describes, having met with the trust myself. The Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth) and I have both met with local MPs about the challenges facing Epsom and St Helier. Lord Darzi’s investigation found that the Conservatives left a £37 billion black hole in NHS capital. We are reversing that trend, with the largest-ever capital budget for health. The £12.1 million for Epsom and St Helier trust for estate safety is in addition to the £207 million of capital that the NHS South West London integrated care board is receiving, including for maintenance backlogs. It will take time, but brick by brick Labour is rebuilding our NHS.

[Joe Powell]

The Imperial College healthcare NHS trust has the largest high-risk repair backlog in the country. The support from the Government estates safety fund is very welcome, but to solve this problem we ultimately need a new St Mary’s hospital. Will the Secretary of State join me in praising the work of the new three-year St Mary’s taskforce, which aims to get to full planning consent and explore different financing models so that we can finally get this hospital built?

[Wes Streeting]

I thank my hon. Friend for the work that he and my hon. Friend the Member for Cities of London and Westminster (Rachel Blake) are leading in partnership with the trust and Westminster city council to ensure that the people of his constituency have the hospital they deserve. As he knows, this will be the most complicated scheme in the new hospital programme, but that is no excuse for the years of delay that the scheme has faced. The trust now boasts the biggest high-risk repair backlog in the country, so my hon. Friend is right to ensure that this is not allowed to be put in the “too difficult” pile again. We look forward to engaging constructively and doing everything that we can to expedite the progress that is desperately needed for his community and our city.

[Caroline Voaden (South Devon) (LD)]

2. What steps he is taking to support rural pharmacies.

--- Later in debate ---

[Luke Murphy (Basingstoke) (Lab)]

9. What steps he is taking to improve access to GPs.

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

The Government inherited a ludicrous situation whereby patients could not get a GP appointment and GPs could not get a job, so one of my first acts was to cut red tape to give practices flexibility to hire GPs, along with an extra £82 million investment. Thanks to that combination of investment and reform, this Government have recruited an additional 1,700 GPs to the frontline since July, exceeding our target of 1,000. We have invested an extra £889 million in general practice this year, taking action to bring back the family doctor. We do not pretend to have solved all the problems, but change has begun and the best is still to come.

[Naushabah Khan]

I welcome the Government’s commitment to restoring the family doctor, and the recruitment of 1,700 additional GPs nationwide, but my constituency has yet to benefit from that. Concern has been expressed to me about the expansion of the additional roles reimbursement scheme to include only newly qualified GPs, which it is feared may be too restrictive. I have met local GP partners who share that concern, so will the Secretary of State meet us to discuss how the scheme can better support areas such as mine?

[Wes Streeting]

We are investing an extra £900 million in general practice, and have reformed the GP contract to help bring back the family doctor and end the 8 am scramble. That contract reform included further changes to make it easier to recruit GPs through the scheme. As my hon. Friend will see shortly when we publish the 10-year plan for health, general practice is at the heart of our proposals to build a neighbourhood health service. I am keen to work with her and with GPs to make it even easier to ensure that qualified GPs can get jobs and patients can get GP appointments, and I should be delighted to meet her.

[Luke Murphy]

After 14 years of the Conservatives running down the frontline of the NHS, many people in Basingstoke still struggle to gain access to their GPs. One issue that patients and GPs raise time and again is the lack of capital investment in new provision to meet growing housing need. Chineham medical practice, for example, was built to serve just 8,000 patients but now serves more than 18,000, and is set to serve many thousands more in the years to come. What more are the Government doing to enable every patient in Basingstoke to see their GP when they need to?

[Wes Streeting]

My hon. Friend is absolutely right. Just as this Government are delivering record home building with a huge target to build the homes that Britain needs, we also need to ensure that people get the local services that they deserve. That is exactly why this Government have invested an extra £102 million this year to create additional clinical space in over 1,000 GP practices, which will create new consultation rooms and make better use of existing space to deliver more appointments. I know the Chineham medical practice was one of the practices put forward by its integrated care board for funding, so I hope we will see that practice benefiting from this investment in the near future as we rebuild our NHS.

[Clive Jones (Wokingham) (LD)]

The Government’s additional roles reimbursement scheme led to just three new GPs for my constituents in Wokingham, which is a drop in the ocean. More needs to be done to deliver GP practices in new developments such as Arborfield in south Wokingham. Why did Ministers not support the Liberal Democrat amendment to the Planning and Infrastructure Bill that would have made commitments to build GP surgeries in all new housing developments legally binding?

[Wes Streeting]

Probably because being that prescriptive about every housing development is not sensible, even if the thrust of what the hon. Member describes—that as new housing development is built, we need to ensure that local infrastructure goes alongside it—is the right approach. I take what he says about the number of GPs, and as I have said, we do not pretend to have fixed all the problems in 11 months, but with respect, those are three more GPs than were there before. I know there is more to do, but give me time, and we will rebuild general practice for his constituents and anyone else’s.

[Jess Brown-Fuller (Chichester) (LD)]

Access to GPs in my constituency of Chichester is being undermined by the closure of the Westbourne branch of Emsworth medical practice at the end of this month. Patients will now have to travel to Emsworth, but we are talking about a small rural village, and there is no public transport to get my elderly and vulnerable patients to that medical practice over the border. Will the Secretary of State please meet me to urgently discuss how we can protect this vital service in a rural village in Chichester?

[Wes Streeting]

I can well understand the hon. Member’s concern and her constituents’ concern. Practice closures are hard on communities wherever they are, but they disproportionately hit rural communities and those that suffer with poor transport connectivity. I would urge her in the first instance to raise the specific local issues with the ICB. However, I reassure her and other right hon. and hon. Members that the needs of rural, coastal and remote communities are very much in our mind—and, crucially, in the 10-year plan—and our thinking about how we build genuine neighbourhood health services in all types of neighbourhood.

[Tim Farron (Westmorland and Lonsdale) (LD)]

5. What steps his Department plans to take to ensure mental health services are fully staffed in rural areas.

--- Later in debate ---

[Lillian Jones (Kilmarnock and Loudoun) (Lab)]

16. What steps his Department is taking to tackle wasteful spending in the NHS.

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

This Government are delivering record investment in our NHS, but that investment is drawn from taxpayers, and we have a responsibility to every taxpayer in the land—as well as to patients—to ensure that every single penny is well spent. That is why that investment is matched with bold reform, so that we get as much value as possible for every penny. The abolition of NHS England will slash duplication and unnecessary bureaucracy, and I am pleased to report to the House that we have slashed spending on agency staff by almost £1 billion compared with last year. All those savings are being reinvested into frontline care.

[Mark Ferguson]

From speaking to my local NHS trust in Gateshead, I know the value it places on driving costs down, but it still faces financial pressures. Key among those are issues related to the digital capital gap. We are really keen in Gateshead to improve that situation and to allow more people to access the NHS remotely. Will the Secretary of State meet me and Gateshead NHS trust to talk about how we can tackle that?

[Wes Streeting]

I would be delighted to do so. My hon. Friend is absolutely right: we have to ensure that the NHS is not only benefiting from, but at the forefront of the revolution taking place in digital services and medical technology. It is key to driving productivity and financial sustainability. That is why, at the spending review, the Chancellor announced that we would invest up to £10 billion in NHS technology and digital transformation; unlike our predecessors, we will not raid tech budgets to plug shortfalls in day-to-day spending. Just this month, we announced the modernisation of the NHS app, so that patients can receive test results and book appointments, saving £200 million in stamps, envelopes and letters.

[Lillian Jones]

I thank the Secretary of State for his earlier reply. In Scotland, there are more quangos than MSPs. After four years and £30 million of taxpayers’ cash down the drain, the SNP has scrapped its plans for a national care service—its flagship policy—which was seen as a significant setback for Scottish social care reform, and now we have people going to the pub in chauffeur-driven ministerial cars. Will the Secretary of State advise his Scottish counterpart on how to stop wasting Scottish taxpayers’ money?

[Wes Streeting]

Given the state of the NHS in Scotland, I suspect my counterpart needed to go and drown his sorrows. The truth is that the longer the SNP is in government, the longer the NHS in Scotland is on the road to nowhere. The SNP is now on its fifth health plan in four years. Thanks to the decisions taken by the Chancellor, it is not just the NHS in England that is receiving record investment, but the Scottish Government. I have used that investment to cut waiting lists by almost a quarter of a million people; the same could be true in Scotland, if the Scottish people boot out the SNP and elect Anas Sarwar and Jackie Baillie to deliver the change that Scotland’s NHS needs.

[Danny Kruger (East Wiltshire) (Con)]

A good way to save money in the NHS is to invest in palliative and end-of-life care, because it averts costs that would otherwise go into the acute sector, including into ambulances. However, this Government are taking money from that sector through their national insurance rises. Given that integrated care boards are supposed to commission palliative care, will the Secretary of State commit in the 10-year health plan to a proper revenue funding model for hospices, and for a minimum service specification for palliative care?

[Wes Streeting]

I can reassure the hon. Member that end-of-life care is featured in the 10-year plan for health. I also recognise the pressure on our hospice sector, which is why this Government, as well as delivering £26 million through the children’s hospice grant, committed £100 million of capital investment— the biggest in a generation for our hospices. None the less, hospices do rely on the generosity of donors and I am keen to work in partnership with the sector to look at what more we can do to encourage investment. The final thing I would say is that the Opposition parties welcomed the investment in the national health service while opposing the means of raising it. They cannot have it both ways; either they support the investment and the revenue raisers or they have to be honest with the public that they would be cutting the NHS.

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

One of the most egregious examples of waste in recent years was the almost £10 billion spent on useless personal protective equipment during the pandemic. When the Treasury eventually recovers some of that money, will the Secretary of State assure me that Scottish taxpayers will benefit in the usual way through the usual channels?

[Wes Streeting]

Fiscal decisions and spending are matters for my right hon. Friend the Chancellor, but let me reassure the hon. Gentleman of two things. First, the way in which the taxpayers of this country were ripped off during a national emergency was a total disgrace, and this Government are determined to get our money back and reinvest it in frontline services, where it should always have been. Secondly, I can reassure him that, so long as there is a Labour Government here in Westminster, Scotland will continue to benefit from the investment it needs to sort out its public services. Now it just needs a Labour Government in Scotland to spend that money wisely.

[James Asser (West Ham and Beckton) (Lab)]

8. What steps he is taking to help reduce waiting times in A&E departments.

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

This Government are committed to fixing the NHS and reducing A&E waiting times. Our new urgent and emergency care plan is backed by nearly £400 million of investment to deliver new urgent treatment centres, mental health assessment centres and almost 400 new ambulances. Alongside that investment, we are reforming urgent and emergency care so that more patients are treated at the scene or in their homes where appropriate, which is better for them and will help to unclog A&E departments. Lots has been done, but there is much more to do.

[James Asser]

The Minister for Secondary Care recently visited my constituency and saw the pressures that Newham hospital A&E was under. That is partly due to the pressures left by the previous Conservative Government, and partly due to capacity issues resulting from a massive growth in population in the borough. Further pressures will come as we regenerate the massive areas of brownfield site in the Royal Docks. Can the Secretary of State reassure my constituents that, as well as the excellent work being done on day-to-day capacity, we will be looking at infrastructure over the longer term to make sure that we are not only dealing with the growth that we have had, but future-proofing for the population growth to come?

[Wes Streeting]

I know that my hon. Friend the Minister for Secondary Care enjoyed her visit, and I thank the staff at Newham hospital for the work they do, which also benefits my constituents. We need to make sure that we are supporting hospitals across our country to meet need, because we are part of a wider ecosystem—I noticed that that point was also powerfully made by the hon. Member for Romford (Andrew Rosindell) in his question. My hon. Friend the Member for West Ham and Beckton (James Asser) is right to raise increasing demand and pressures, which is why we will shortly publish our 10-year plan for health. I am happy to report that Whipps Cross and Newham hospitals have also been provisionally allocated £28 million this year to improve buildings and estates.

[Mr Louie French (Old Bexley and Sidcup) (Con)]

The Government continue to claim that they wish to expand community diagnostic centres to speed up scanning and treatment of patients and therefore reduce demand on the likes of A&E. If that is the case, why are they cutting the revenue tariffs that were available to the community diagnostic centres under the previous Conservative Government, which has already impacted the financial viability of the CDCs and access for patients?

[Wes Streeting]

I think the hon. Gentleman will find that, since this Government came to power, we have reduced the size of NHS waiting lists by a quarter of a million. NHS waiting lists are coming down—latest figures show that this is the first time in 17 years that waiting lists have fallen in the month of April—so we are making progress, not least thanks to the investment that we are putting into community diagnostic centres. The hon. Gentleman has some brass neck to complain about NHS services under this Government, when we are cleaning up the mess that the previous Government left behind.

[Mr Speaker]

It would also help to extend the hours at Chorley A&E.

--- Later in debate ---

[Charlie Dewhirst (Bridlington and The Wolds) (Con)]

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

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

Waiting lists are at their lowest level for two years, we have taken almost a quarter of a million patients off waiting lists and for the first time in 17 years waiting lists were cut in April. There is a long way to go, but this Government are finally putting the NHS on the road to recovery. Through our plan for change, I have announced that the NHS will also be at the forefront of the revolution in life sciences. Through the NHS app, patients will be linked up with relevant trials to boost our life sciences sector, generate investment for the NHS and develop the medicines of the future.

[Charlie Dewhirst]

It is nearly four years since Professor Sir Chris Whitty published his striking report on health in coastal communities. Covid inevitably delayed implementation, so will the Secretary of State look again at that report, deliver on the chief medical officer’s recommendations and ensure that my constituents in Bridlington and The Wolds can access the health services that they need?

[Wes Streeting]

The hon. Gentleman is right to commend Sir Chris Whitty’s report. We have taken that into consideration, as well as the wider consultation we did in preparation for our 10-year plan for health, which will commit to tackling the gross health inequalities that affect our country, particularly in rural and coastal communities.

[Chris Bloore (Redditch) (Lab)]

T2.   Will the Secretary of State join me in welcoming the recent NHS waiting list figures that show that the Worcestershire acute hospitals NHS trust has seen a fall of over 6,000 since this Government came into office? Does he agree that progress like this shows that, in partnership with our hard-working NHS staff, we can be the generation that takes the NHS from the worst crisis in its history to the NHS that people deserve?

[Wes Streeting]

I absolutely agree with my hon. Friend. It is thanks to the fact that his constituents sent him to this House of Commons that we have a Labour Government able to deliver, with him, for his community.

[Mr Speaker]

I call the shadow Secretary of State.

[Edward Argar (Melton and Syston) (Con)]

May I, through the Secretary of State, pass on my best wishes to the Under-Secretary of State for Health and Social Care, the hon. Member for West Lancashire (Ashley Dalton)? In front of the Health and Social Care Committee in January, NHS England’s then chief financial officer set out that pretty much all the additional funding to the NHS last year would be absorbed by pay rises, national insurance contributions and inflation. What proportion of the latest additional funding will be absorbed in the same way?

[Wes Streeting]

First, I just do not buy the argument that investing in our staff is somehow not investing in the NHS. Who on earth do the Opposition think provides the treatment, delivers the care, organises the clinics and delivers the services? Even in this great new world of technology, the NHS will always be a people-based service and I am proud that this is a Government who deliver for staff. We are also waging war on waste, and that is how we can deliver fair pay for staff and improve care for patients. If only the Conservatives had done that when they had the chance.

[Edward Argar]

The right hon. Gentleman could not answer that question, but hopefully we will get a more positive response to this one. I recently had the privilege of meeting Dr Susan Michaelis and her husband Tristan, who have set up the Lobular Moon Shot Project, which large numbers of Members of all parties across the House have backed. They are seeking £20 million over five years—a tiny sum in the context of the overall NHS budget—to research lobular breast cancer, which Susan is currently battling, to help improve outcomes. Her immediate ask is even simpler: it is for the Secretary of State to meet her in person to discuss the campaign and its aims. He is a decent man. Will he agree to do that?

[Wes Streeting]

I thank the shadow Secretary of State for his question and, even more importantly, I thank the amazing campaigners for what they are doing. This is probably the easiest question he is ever going to ask me. The answer is, of course, an emphatic yes.

[Katrina Murray (Cumbernauld and Kirkintilloch) (Lab)]

T4.   One of the main concerns I have about assisted dying is that it should never be easier to help someone die than it is to help them live. If passed, the Terminally Ill Adults (End of Life) Bill would make thousands of terminally ill people every year eligible to end their lives on the NHS. Does our health service have the money to fund this service as well as its priority of bringing down waiting lists?

[Wes Streeting]

Can I first thank my hon. Friend the Minister for Care for the considerable amount of work he has done to support the House as it makes its deliberations on this important issue? Of course, the Government are neutral; it is for the House to decide. There is not money allocated to set up the service in the Bill at present, but it is for Members of this House and the other place, should the Bill proceed, to decide whether to proceed. That is a decision that this Government will respect either way.

[Katie Lam (Weald of Kent) (Con)]

T3.   The UK is desperately short of doctors, but thousands of applicants will be turned away due to a lack of training places. This is not a situation of the Minister’s making, but he has now been in post for a year. Can he assure us that nobody—no union, no Treasury Minister—will prevent him from doing what needs to be done and lifting the training cap?

[Wes Streeting]

I should just say for the record that it is thanks to my friends at the Treasury that we are able to do so much to invest in our health service. It is important to put that on record ahead of the Budget. The hon. Lady raises a really serious issue, and we are looking carefully at what we can do to ensure that we get great people into our health service and that they can look forward to a great career. We are not in the right place as a country now; we need to be in a better place. The 10-year plan will set out our ambitions on workforce and we will publish a new workforce plan later this year.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

T5. It is 16 months since the publication of the Hughes report, but those patients harmed by sodium valproate continue to await the outcome on the redress that the Government will provide. Will the Secretary of State please provide an update on when they can expect an announcement on the redress that will be made available to them?

[Graham Leadbitter (Moray West, Nairn and Strathspey) (SNP)]

My constituency, in Scotland, has a significant shortage of health and social care workers, despite extensive efforts to advertise recruitment to get people in, as replicated in parts of England, Wales and Northern Ireland. The rug has been pulled out from under that by the changes to immigration policy and visas for that sector. Will the Secretary of State commit to pushing this harder in Cabinet to ensure that we can have more geographic and sectoral visas?

[Wes Streeting]

I am really proud of the contribution that overseas workers make to health and social care services across our country. If they all left tomorrow, the services would simply collapse. But I think there is an overreliance on overseas staff in health and care services, and that is contributing to levels of net migration that are simply unsustainable. I have a responsibility to help the Home Secretary bring those numbers down and to give opportunities, through better pay and career progression, to home-grown talent, and that is what we will do.

[Markus Campbell-Savours (Penrith and Solway) (Lab)]

T6.   I have received many emails regarding poor service from pharmacies in my constituency. In Maryport, residents report opening times not as advertised, long queues, low stocks and delays receiving vital medication. Will the Minister tell the House how this Government will ensure that the public get the best quality service from our local pharmacies?

--- Later in debate ---

[Bob Blackman (Harrow East) (Con)]

The Secretary of State may well be aware of the greater awareness among young people of nicotine pouches. That seems to be a gap in the Tobacco and Vapes Bill currently going through Parliament. Will he commit to look at this issue to ensure that it is covered and that we bar this alongside other forms of tobacco and nicotine?

[Wes Streeting]

As the hon. Gentleman knows through bitter experience, that rotten industry always finds a way, and we have to keep on top of it and tackle the scourge of nicotine addiction. He knows about this issue better than most, he having campaigned so assiduously on it, and he is right to raise it, so let us look at what we can do to strengthen the Bill, if we can, as it goes through Parliament.

[Peter Lamb (Crawley) (Lab)]

T7. What steps is the Secretary of State taking to enable access to non-hormonal, non-steroidal oral contraceptives?

[Sarah Bool (South Northamptonshire) (Con)]

In Prime Minister’s questions last week, I raised the need for a universal national screening programme for type 1 diabetes. Will the Secretary of State agree to meet me to discuss this, so that it could form part of the 10-year plan, given that it fits so neatly into prevention of issues such as diabetic ketoacidosis over treatment?

[Wes Streeting]

I was in the Chamber to hear the hon. Member’s question. Obviously we are led by clinical advice when it comes to decisions on screening programmes, but I understand the case she makes. I would be delighted to ensure that she gets a meeting with the relevant Minister.

[Mr Richard Quigley (Isle of Wight West) (Lab)]

T8. Earl Mountbatten hospice in my constituency delivers outstanding care across the community. Despite that, Hampshire and Isle of Wight integrated care board plans to cut its funding by £1.4 million, while other hospices in the region have their funding increased. I am deeply concerned that the cut will affect our local health services. Will the Minister meet me to discuss how we can restore that essential funding and protect hospice care for my constituents?

--- Later in debate ---

[Mr Joshua Reynolds (Maidenhead) (LD)]

I have raised with Ministers before my concerns about the closure of St Mark’s walk-in urgent care centre in Maidenhead. Frimley ICB has confirmed yet again that it will not reopen the centre, against the will of the majority of Maidenhead residents. Will the Secretary of State meet me and local campaigners to see how we can finally get St Mark’s walk-in centre back open after five years of closure?

[Wes Streeting]

I know that the hon. Gentleman’s constituents will have noted, through his representations as a constituency MP, that he could not have fought harder to save that service. We devolve these sorts of decisions to ICBs, in order that they make decisions closer to the communities that they serve, with the conviction that those sorts of decisions are better taken locally than centralised in Whitehall. I understand the case that he makes, but having given ICBs a challenge, resources and freedom, we Ministers must resist the temptation to meddle every time they make decisions that they believe are right for the community, even if those decisions are controversial.

[Will Stone (Swindon North) (Lab)]

Will the Minister look into minimising the pain of patients going through hysteroscopy and biopsy procedures by requesting that medical professionals fully brief them on anaesthetics and pain relief in advance of procedures to ensure that they can plan accordingly?

--- Later in debate ---

[Wes Streeting]

Absolutely: the NHS always does better under a Labour Government.

[Nesil Caliskan (Barking) (Lab)]

Barking community hospital in my constituency has been providing antenatal services to mothers in Barking for many years, and women also use its services to give birth. I was therefore really disappointed when I heard last week that the maternity birthing unit is likely to close. Many in my community are deeply concerned. They are being redirected to Newham hospital, which the Care Quality Commission has rated as “requires improvement”. Women deserve to give birth in a safe clinical environment. Will Ministers ensure that additional attention and resources are provided to Newham hospital, so that it improves its standards and my constituents who are being redirected to give birth there can do so in a safe clinical space?

[Wes Streeting]

Making sure that women are giving birth safely is the ultimate priority and the least that women deserve. I understand my hon. Friend’s anxiety about this reconfiguration, and she is right to raise that with the ICB in the first instance. We are happy to meet her as Ministers, too. The crucial thing is that the services are configured and delivered in a way that prioritises the safety of women and their babies.

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

In March, the Minister for Care told me that no decision could be taken on a new dental school at the University of East Anglia until the spending review settlement was known. Now that we know it, will he instruct the Office for Students to allocate new training places at the UEA from 2026?

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

Between 2001 and 2011, the 15% health inequalities weighting in NHS allocations made a positive, measurable difference to the health of deprived people. Unfortunately, it was cut to 10% in 2015. With the spending review’s increase in funding to the NHS, when will the health inequalities weighting reach 15%?

[Wes Streeting]

I am really grateful to my hon. Friend for her question. She is right to highlight the importance of funding following inequalities to redress that imbalance. I think she will be pleased with where we are with the 10-year plan for health, and I would be delighted to meet her to discuss it.

[Richard Foord (Honiton and Sidmouth) (LD)]

People in East Devon have been told that they must now travel to Exeter for audiology services that they previously received at their local community hospital. What steps are the Government taking to encourage new providers to restore accessible audiology services?

[Wes Streeting]

That has been a running theme this morning, which will not be lost on Ministers. We will ensure, as we deliver neighbourhood health services, that people can receive care closer to home, wherever they live. We have heard that message loud and clear today, and I think the hon. Member will see that priority reflected in our 10-year plan for health.

[Peter Swallow (Bracknell) (Lab)]

I declare an interest, as my brother is a GP. When my residents are able to get a GP appointment, they are frustrated when they are sent halfway across the borough to a different surgery from the one they are registered with by their primary care network. Can we address that, and is it part of our proposals in the new GP contract?

[Wes Streeting]

We do want to put GPs at the heart of neighbourhood health services, and we want people to have care close to home. There are benefits to primary care working at scale, so I would not want to criticise them for doing that. The important thing is different courses for different horses. Some of us are much more mobile, more active and more online and would welcome that flexibility. For others, continuity of care that is close to home, or indeed in their home, is important. It is important that people get the right care, in the right place, at the right time, wherever they live, and that is what we will deliver.

[Sir Jeremy Wright (Kenilworth and Southam) (Con)]

I am grateful for the consideration the Secretary of State has already given to finding a fairer and more effective way of compensating those injured by a covid vaccination, but he knows that those who are profoundly affected by such injuries are anxious for news. Can he give me, and indeed them, a progress report?

[Wes Streeting]

I reassure the right hon. and learned Gentleman, the constituents of his I have met and other campaigners that I am having discussions with the Cabinet Office about how we deal with that and other issues that have been raised this morning, including the sodium valproate scandal. He knows the complexities involved, and I have been grateful for his advice as a former Attorney General. I do not have specific progress to report now, but I reassure him and campaigners that this issue has not gone off the boil and we are working to find a resolution.

[Claire Hazelgrove (Filton and Bradley Stoke) (Lab)]

The challenge of finding and keeping an NHS dentist is raised with me time and again across the Filton and Bradley Stoke constituency, and I welcome the early action that this Labour Government have taken to introduce more than 19,000 urgent care appointments across our integrated care board area. What will be the next steps to help ensure that NHS dentistry is opened up again to everybody?

[Blake Stephenson (Mid Bedfordshire) (Con)]

The Secretary of State will know that my local ICB in Bedfordshire, Luton and Milton Keynes is set to merge with Hertfordshire, Cambridgeshire and Peterborough. The new ICB will cover a population of about 3 million people. Given the difficulties we have had securing a GP surgery in Wixams, will the Secretary of State set out how supersizing that quango will help rural mid-Beds to get the local healthcare it needs?

[Wes Streeting]

May I respectfully say that that was part of the problem with Conservative thinking? They thought that the answer to the NHS crisis was more quangos, and they measured success in the number of ICBs, not the number of appointments and the size of the waiting list. We are taking a different approach, slashing bureaucracy and reinvesting in the front line. We are not centralising but decentralising, and cutting waiting lists—a record that the Conservative party cannot begin to touch.

[Perran Moon (Camborne and Redruth) (Lab)]

A couple of weeks ago at my constituency surgery, though tears my constituent Amy explained how, following a hip operation in 2008, she suffered progressive nerve damage due to repeated failures in diagnosis, referral and treatment. Despite raising concerns for years, she was told that her pain was common. A nerve test in 2015 confirmed damage, and further tests last year showed a significant deterioration. After 17 years she has only now been offered surgery. All Amy wants to know is what steps are being taken to ensure that no other patient is left permanently disabled due to such prolonged and systemic failure—

[Mr Speaker]

Order. That is very important, but why does the hon. Member not want others to get in?

[Wes Streeting]

First, on behalf of the NHS I apologise to my hon. Friend’s constituent. That is an intolerable situation, but sadly not rare or exceptional. There is too much of that happening, and a culture of cover-up and covering reputations, rather than being honest with patients about failures. We are changing the culture. Safety is at the heart of the 10-year plan, and I would be delighted to talk to my hon. Friend further about his constituent’s case.

[Jim Shannon (Strangford) (DUP)]

This morning I attended an event about bladder cancer. Bladder cancer is the fifth highest killer in the United Kingdom, and people were anxious to meet the Minister and discuss those matters. Will he agree to meet bladder cancer organisations to take forward their four objectives to make things better for people in the United Kingdom?

[Wes Streeting]

I am sure my hon. Friend the Under-Secretary of State for Health and Social Care (Ashley Dalton), who is the Minister responsible for cancer, would be delighted to meet campaigners, particularly as we put together the national cancer plan. We want to ensure that we capture every type of cancer, and genuinely improve cancer care for everyone in our country.

[Oliver Ryan (Burnley) (Ind)]

The Minister may have seen my constituent Mollie Mulheron recently featured on “Newsnight”. Our local ICB recently refused her access to fertility treatment after recovery from an aggressive cancer with a high likelihood that her illness will return. Will the Minister meet me and Mollie to discuss that issue, and access to fertility treatment for cancer survivors and patients?

[Wes Streeting]

Yes, I will make sure that my hon. Friend gets that meeting.

NHS Workforce

Wes Streeting Excerpts

Thursday 22nd May 2025 Written Statements

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

Today I am formally accepting the headline pay recommendations for NHS staff from the NHS Pay Review Body, the Review Body on Doctors and Dentists Remuneration, and the Senior Salaries Review Body. We are working closely with payroll systems to ensure staff receive their backdated pay uplifts from August.

I hugely appreciate the work of so many talented staff across the NHS. Accepting these recommendations gives them the pay rise they deserve. These awards are above forecast inflation over the 2025-26 pay year, meaning that the Government are delivering a real-terms pay rise, on top of the one provided last year, underlining the extent to which we value our nurses, doctors, and other NHS staff. These pay awards sit alongside wider work to improve the support NHS staff receive and their experience at work. This includes our recent announcements on tackling violence and aggression, improving nursing career progression and job evaluation and supporting newly qualified staff. Improving the experience of work is fundamental to improving the patient experience, from reducing the backlog in elective care to ensuring timely access to GP appointments.

I am grateful to all chairs and members of the NHSPRB, DDRB and SSRB for their thoughtful consideration of the evidence presented to them, and their reports that recognise the vital contribution that NHS staff and leadership make to our country. The pay review bodies have examined the economic picture and evidence on recruitment, retention, motivation and morale to reach their recommendations. Through their deliberations, they have made recommendations above the level we stated as affordable in our evidence. I am however accepting their headline pay recommendations as fair and well-evidenced uplifts for public servants. To maintain financial prudence, I have had to make difficult decisions on other areas of spend to afford these uplifts.

This Government have shown their willingness to make the difficult decisions needed to improve outcomes for the public from the health system. Over the past few months, we have identified how extra funds will be freed up by cutting duplication and waste, and through abolishing NHS England, and reshaping and reducing integrated care board costs by 50% to empower NHS staff and deliver better care for patients. Through NHS planning guidance, I have already outlined a significant productivity and efficiency ask for NHS systems to deliver in 2025-26 —that is, through reductions in use of temporary staffing. As a result of the savings found, none of the pay increases will be paid for by cutting frontline services.

The next steps in our plan for reform will be set out in the upcoming 10-year plan and workforce plan refresh, with its laser focus on shifting care from hospitals and into the community, as we work to get the NHS back on its feet and fit for the future. Driving these efficiencies will enable us to deliver on our objective for the NHS as set out in our plan for change—making the NHS work for patients and staff.

Pay awards

The DDRB recommended a headline 4% increase to salary scales, pay ranges and the pay elements of contracts from 1 April 2025. It also recommended that an extra £750 be added to the pay points for doctors and dentists in training. In accepting these recommendations, we have committed to:

uplifting pay points for doctors and dentists in training (circa 77,000 doctors) by 4% plus £750 on a consolidated basis;

uplifting the salaries of consultants (c.63,000 doctors) by 4% on a consolidated basis;

uplifting the pay range for salaried general medical practitioners (c.15,000 doctors) by 4%, uplifting the pay element of the GP contract by 4%, uplifting the minimum and maximum of the pay range for salaried GPs by 4%, and uplifting the GP educators pay scale by 4% all on a consolidated basis;

uplifting the pay element of the general dental practitioners contract (c.24,000 dentists) and the pay scale for salaried dentists by 4% on a consolidated basis;

uplifting the pay scales of specialist and associate specialist doctors on all contracts by 4% on a consolidated basis.

uplifting flexible pay premia by 4% on a consolidated basis.

The DDRB made a further five recommendations, which are not directly related to headline pay, targeted at specific parts of the remit group. We need further time to carefully consider these, working with our partners to determine the best way forward. To avoid delays to pay uplifts reaching NHS staff, we will advise Parliament separately on our response to these recommendations in due course.

The NHSPRB recommended a 3.6% pay increase to all Agenda for Change staff, alongside a recommendation to provide the NHS staff council with a funded mandate for pay structure reform. In accepting these recommendations, we have committed to:

uplifting all pay points of Agenda for Change staff (c.1.4 million staff) by 3.6% on a consolidated basis, taking effect from 1 April 2025.

issuing the NHS staff council with a funded mandate for 2026-27 to begin to resolve outstanding concerns within the Agenda for Change pay structure.

Given the difficult financial landscape, we will need to carefully consider as part of the SR the funding for the mandate for 2026-27, but we will work in partnership with the NHS staff council to deliver these changes from 1 April 2026.

The SSRB recommended a 3.25% cent uplift for all executive and senior managers and very senior managers in the NHS in England from 1 April 2025. In accepting this recommendation, we have committed to a 3.25% uplift for executive and senior managers and very senior managers in the NHS in England.

The SSRB also made two further recommendations. First, they recommended that an additional 0.5% of the ESM and VSM pay bill in each employing organisation be used to address specific pay anomalies, targeted at mitigating the effects of pay overlaps with the Agenda for Change pay scale. We are rejecting this recommendation on the basis that, in the current fiscal context, we believe an award of 3.25% well compensates VSMs and ESMs for the work that they do, and because previous measures of this sort have not seen widespread use by employers. Secondly, the SSRB recommended that the ESM pay framework should be withdrawn. I will be considering this in light of the abolition of NHS England and the consolidation of arm’s-length bodies, and will report back to Parliament separately on our response to this recommendation.

This pay award follow publication of the new VSM pay framework on 15 May, which envisages rewards for senior leaders who are successfully improving performance, and will ensure that the NHS continues to develop and attract the best talent to the most senior positions.

We will also bring forward legislation to uplift the member contribution tier thresholds in the NHS pension scheme in line with the Agenda for Change pay award. This will mean that these staff feel the full benefit of the award, and do not move into the next pension contribution tier solely as a result of this pay rise.

Next steps

We have listened to the workforce and know that it is not acceptable that pay awards are not delivered on time. This Government are committed to NHS staff receiving their pay uplifts at the beginning of the financial year. Last year, this Government committed to speeding up the pay review process, remitting the PRBs months earlier than previous years and submitting written evidence earlier too. This means that pay awards for 25-26 will pay in packets two months sooner than last year. But we recognise that there is more to do. That is why, this year, I am committing to remitting the health PRBs in July, with an ambition to implement awards as soon in 2026-27 as possible.

The reports of the DDRB, NHSPRB and SSRB will be presented to Parliament and published on gov.uk.

[HCWS663]

Mental Health Bill [Lords]

Wes Streeting Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

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

I beg to move, That the Bill be now read a Second time.

I want to place on record my thanks to Baroness Merron for her leadership of the Bill’s progress in the House of Lords, and to thank Members on both sides of that House for their contribution to scrutiny of it. I particularly thank Baroness May of Maidenhead for the constructive way in which she has engaged the Government, and for commissioning Sir Simon Wessely to undertake the review of mental health that underpins so much of the Bill.

At the general election, Labour stood on a manifesto commitment to modernise the Mental Health Act 1983, and I am proud to say that we are delivering on that promise in the first Session of this Parliament. In doing so, we are providing a once-in-a-generation opportunity to profoundly transform the way in which we view and support people with serious mental illnesses. The measure of a society is how it treats its most vulnerable citizens, and when it comes to the treatment of people with serious mental illnesses, we are falling well short of the humane, compassionate society that we aspire to be. Patients live 15 to 20 years less than the average, and they are often accommodated far away from their families and loved ones. The facilities in which they are housed can be completely unsuitable. During his investigation last year, Lord Darzi found nearly 20 patients in a mental health facility who were forced to share two showers and live among an infestation of rats and cockroaches.

Patients are denied the basic choice and agency that is awarded to NHS patients with physical illnesses. People from ethnic minority communities, especially black African and Caribbean men, are more than three times as likely to be sectioned. Although they are very different conditions, people with a learning disability and autistic people are often lumped in with those who have mental illness, reflecting an outdated lack of medical understanding.

[Sir Jeremy Hunt (Godalming and Ash) (Con)]

The Health Secretary will have been briefed by the Minister for Care about the tragic murder of Christopher Laskaris, the son of my constituent Fiona Laskaris, and the lack of a voice for parents, who know their own children extremely well, in very difficult situations like this. Have the Government considered whether they might table an amendment to make things like Christopher’s tragic murder less likely in the future?

[Wes Streeting]

I am extremely grateful to the right hon. Gentleman for his intervention, and I place on record my thanks to Fiona for her campaigning work in circumstances that are completely unimaginable for those who have not walked in her shoes and experienced the kind of grief that she is experiencing. I know that my hon. Friend the Member for Rother Valley (Jake Richards) has been campaigning assiduously on this issue; similarly, we have had representations from the hon. Member for Dorking and Horley (Chris Coghlan), who is in his place, and the right hon. Gentleman. We are carefully considering the arguments that have been made, and looking at what we can do in this Bill to advance things in the way that Fiona and others like her would like to see. We will continue that engagement throughout the passage of the Bill, and see if there is a workable way in which we can improve it to ensure that others do not have to go through the unimaginable heartbreak that Fiona is living with every day.

[Peter Swallow (Bracknell) (Lab)]

My right hon. Friend is touching on ways to strengthen this Bill even further. He will know that the Joint Committee on Human Rights has just this morning published our report on the Bill. We have praised it for all that it will do to address a number of inequalities, but we have picked out one or two areas where it could go even further. I know that he will not yet have had a chance to look at our report, but will he arrange for a meeting with members of the Committee and the relevant Minister to discuss our findings?

[Wes Streeting]

I wish I could correct my hon. Friend and say that I have already read in detail the feedback from the Joint Committee on Human Rights, but he is right: I have not yet had a chance to do that. However, I can assure him that I and my hon. Friend the Minister for Care will look at the Committee’s report. We would be very happy to meet members of the Committee to discuss in further detail their findings and recommendations.

We want to ensure that the Bill is as strong as it can be, given the length of time that has passed since the Mental Health Act was reformed. Indeed, the Mental Health Act is as old as I am. [Interruption.] Thank you for those interventions. I assure Members heaping compliments across the Chamber that it will not affect investment decisions in their constituencies, but I am none the less very grateful.

There is a serious point here: whereas attitudes to mental health have come on in leaps and bounds in the past four decades, the law has been frozen in time. As a result, the current legislation fails to give patients adequate dignity, voice and agency in their care, despite the fact that patients have consistently told us that being treated humanely, and making decisions about their own care, plays a vital role in their recovery.

When patients are detained and treated without any say over what is happening to them, it can have serious consequences for their ongoing health. To quote one of the many patients who bravely shared their experiences with Sir Simon Wessely’s independent review:

“Being sectioned was one of the most traumatic experiences of my life. Sadly, as a result of being sectioned I developed PTSD”—

post-traumatic stress disorder—

“as the direct result of the way I was treated”.

Sir Simon’s review was published seven years ago. It shone a light on a group of people who had been hidden, ignored and forgotten. In the time that has passed since, the case for change has only snowballed. The Bill now takes forward Sir Simon’s recommendations.

The review stressed that legislation alone would not fix the system; culture and resources matter too. This was echoed in Lord Darzi’s investigation into the NHS, which uncovered some hard truths: a dramatic rise in the use of restrictive interventions on children; and 345,000 patients waiting more than a year for their first appointment with mental health services—more than the entire population of Leicester—of whom 109,000 were under the age of 18. This Bill does not solve every problem in our mental health services, but it marks a vital step in our plans to improve the quality of care, combat long-standing inequalities, and bring about a stronger focus on prevention and early intervention in mental health.

[Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)]

Does my right hon. Friend agree that while we are seeing record levels of mental health problems in our young people, investment in community services for people with mental health problems must be a priority?

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. As he has heard many times from this Dispatch Box, we want to see a shift in the centre of gravity in the NHS out of hospitals and into the community as one of the three key shifts that will underpin our 10-year plan for health, which we will be publishing in the not-too-distant future.

The Mental Health Act is designed to keep patients and the public safe, but it is clear to anyone who has seen how patients are treated that it does so in an outdated and blunt way that is unfit for the modern age. It is too easy for someone under the Act to lose all sense of agency, rights and respect. It is sometimes necessary to detain and treat patients, but there is no reason why patients experiencing serious mental illness should be denied the choice and agency they would rightly expect in physical care. Not only should the health service treat all its patients with dignity and respect anyway, but giving people a say over their own care means that their treatment is more likely to be successful. In the foreword to his independent review, Sir Simon Wessely said:

“I often heard from those who told me, looking back, that they realise that compulsory treatment was necessary, even life-saving, but then went on to say ‘why did it need to be given in the way it was?’”

Another patient in the 2018 review said:

“I felt a lot of things were done to me rather than with me”.

We need to get this right. We need to give these patients a voice.

[Jim Shannon (Strangford) (DUP)]

I commend the Secretary of State for bringing this Bill before the House. On all occasions when I have inquired of him, he has been keen to share ideas and thoughts on legislation in relation to Northern Ireland. On mental ill health, deprivation and poverty, the figures for Northern Ireland are some of the highest in the United Kingdom, which worries me as the MP with responsibility for my constituents back home in Strangford. I know he will, but will the Secretary of State share all the ideas in the Bill with Mike Nesbitt—the Health Minister back home—so that Northern Ireland can also benefit?

[Wes Streeting]

I am happy to reaffirm that we have a really strong working relationship with Minister Mike Nesbitt and the Northern Ireland Executive, and we are keen to share insight wherever we can.

The hon. Gentleman makes a very important point, which refers back to the remarks I made about the limitations of the legislation. Reform of the statute book is important in terms of how the law treats people. But as well as reforming the model of care, clinical pathways and looking at new treatments, innovations and technologies, we also need to focus on prevention, attacking the social determinants of ill health, including mental ill health, of which poverty is a key driver of stress, anxiety, depression and worse. That is why the Government will keep such a focus not just in our 10-year plan for health, but more broadly across public policy.

The current legislation has left many people with a learning disability and many autistic people in mental health hospitals, when they could receive much better care elsewhere. Around four in 10 people with a learning disability or autism could be cared for in the community. The Bill aims to improve the care and treatment people receive when detained, while keeping patients and the public safe. Through the Bill, we are: strengthening and clarifying the criteria for detention and community treatment orders to better support clinicians in their decision-making; introducing increased scrutiny and oversight for compulsory detention and treatment; and providing patients with a clear road to recovery by introducing statutory care and treatment plans for all patients detained under the Act, except if under a very short-term section.

[Jen Craft (Thurrock) (Lab)]

Does the Secretary of State agree that a proper community treatment plan for those with learning disabilities and autism is not just reliant on the actions of his Department, but a cross-Government effort and an integrated care system at a local level?

[Wes Streeting]

My hon. Friend is absolutely right. I am very glad that my Department is working closely with other Departments across a range of issues, in particular with my right hon. Friend the Secretary of State for Work and Pensions on the link between employment, welfare and health, and with my right hon. Friend the Secretary of State for Education on the reform of special educational needs and disabilities, and the interface between health and education services—I could go on. The point is that a wide range of factors have an impact on people’s health and wellbeing. Indeed, people’s health and wellbeing can have an impact on a wide range of aspects of their lives, which is why we have to work in a mission-driven cross-Government way.

[Alison Bennett (Mid Sussex) (LD)]

I thank the Secretary of State for giving way; he is very kind. I was interested, when he was talking about the impacts of mental health on society at large, whether he has given consideration to the Carers Trust proposal, which would amend the Bill so that when a parent has a mental health crisis, checks and safeguards are put in place to ensure that any young carers in that family are suitably cared for?

[Wes Streeting]

I am grateful to the hon. Member for that intervention and for raising the very serious issue—an issue of increasing prevalence—of the impact of parental mental ill health on children and young people. We are very happy to look at the Carers Trust proposal, and to take representations on that and other issues as the Bill progresses through its Commons stages. We want to ensure that we get not just the legal basis of mental health provision in the right place, but practical care. As we think about children and young people’s mental health and wellbeing, we also need to take into account their parents’ mental health and wellbeing through that lens, too.

Patients’ choices and needs will always be taken into account, thanks to the introduction of a new clinical checklist. It requires clinicians to involve patients and those close to them in decisions affecting their care, while retaining the power to treat individuals compulsorily where absolutely necessary.

[Richard Baker (Glenrothes and Mid Fife) (Lab)]

Does the Secretary of State agree that that should be a case of “only when absolutely necessary”? In my previous role, I provided advocacy for the family of a young man who has been in a state hospital in Scotland for 17 years under a compulsory treatment order. His family live several hours away in north-east Scotland. That is, in my view, a horrendous infringement of his and their human rights. Will he share any learnings from the action the Government are taking, which is so welcome, on how community treatment can be placed effectively for people who are going through such horrific restrictions on their rights to family life?

[Wes Streeting]

My hon. Friend’s question raises two key issues with the provision of mental health services. First, we must ensure that the bar is set in the right place for compulsory treatment. Secondly, we must ensure that both compulsory and voluntary treatment in a hospital setting is within a reasonable distance of family, friends and loved ones. My hon. Friend powerfully describes the impact of such cases, where there is not just a deprivation of liberty, but an impact on an entire family. We need to do much better on both sides of the border when it comes to the appropriate placement of people in mental health settings.

There will always be times when patients hit crisis points and lack the ability to express what they want. To ensure that their voice is not lost and that professionals are working with patients, the Bill introduces duties to encourage people to make an advance choice document while they are well. This document provides a record of their wishes for use by mental health professionals, should the patient later experience a crisis that renders them incapable of making their own decisions.

[Samantha Niblett (South Derbyshire) (Lab)]

I was 11 years old when my mum first tried to take her own life; she was sectioned several times over the coming years, and until I was an adult. How will this new way of treating people and making that part of the community, as well as looking after the children of those impacted, be measured over time so that we know it is successful?

[Wes Streeting]

I am extremely grateful to my hon. Friend for sharing such personal lived experience of the issues we are debating this afternoon. I encourage her to take every opportunity to share those experiences directly with Ministers or through the passage of this Bill, which others in a similar situation will also have had, so that we can provide the best possible support for people experiencing a mental health crisis and for their loved ones, who also experience an enormous amount of pain and anxiety in supporting someone going through acute mental illness.

We are also updating the outdated nearest relative provisions to allow patients to choose someone to be their nominated person, which gives that individual important powers to represent the patient’s interests when they cannot represent themselves. One patient explained:

“My mother used to perform this role, but she now has Alzheimer’s and she lacks capacity. Under the current system, I cannot specify who I wish to serve as my nearest relative. The responsibility would automatically go to my oldest sister—a sister I do not get on with”.

Our reforms will ensure that this statutory role is not chosen for the patient, but is rather the choice of the patient.

Advocacy services are often a lifeline for those who find themselves in the vulnerable position of being detained, giving a voice to those who may otherwise feel voiceless. Patients have reported that an advocate can ensure that

“their voice and opinion is valued and listened to. They came to my meetings, valued my opinion and put my views across to other people. People listened to my advocate.”

We are also extending advocacy services to patients who come to hospital voluntarily and making changes to improve advocacy uptake among those who are detained, as well as working to change the culture of our health and care services so that everyone is listened to and so that patients do not have to rely on an advocacy service to get their voice heard.

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

I am grateful to the youthful Secretary of State for giving way. In the past few months, I have had a number of constituents describe the difficulties they have had in transitioning from care provided by child and adolescent mental health services to adult mental health services—a critical transition. They specifically faced difficulties in accessing the same medication when they turned 18 that they had previously been reliant on as young people. Can the Secretary of State describe to me how either the Bill or the change in culture for which he is advocating will improve the situation for people like my constituents?

[Wes Streeting]

I am grateful for that intervention. The hon. Gentleman raises what is, frankly, the depressingly familiar issue of the transition from youth and adolescent services to adult services, which applies across such a wide range of public services. It is so frustrating that we are still, in this decade of the 21st century, describing a problem that was prevalent in the ’90s and noughties.

None the less, we are working to improve not just the law, but the performance in this space. Many of the changes we will be looking to make under the auspices of our 10-year plan are about better joining up of data, information and patient records, better care planning for patients and designing services around patients so that everyone—whatever their age or stage of treatment—receives joined-up services, with clinicians having a full picture of that patient’s experience. Hopefully, that will also help to deal with some of the cliff edges and bumps in the road that people can often experience when transitioning from one part of the NHS to another, whether that is from youth and adolescent services to adult services or the interface between primary and secondary care.

[Helen Morgan (North Shropshire) (LD)]

I welcome this piece of legislation, which I think is generally in a very good place. I have had a tragic situation in my constituency, where somebody who had been admitted to hospital in a suicidal state discharged themselves, after which, unfortunately, no follow-up care was provided, and they took their own life. It has been devastating for their family. Would the Secretary of State consider looking at how the community supports people experiencing a mental health crisis who might have discharged themselves, and how we can keep them safe in future?

[Wes Streeting]

I am very grateful to the hon. Lady for that intervention. The Bill deals to an extent with cases that would fall under the category she describes, in particular through reforms to community treatment orders. However, it would not necessarily cover the full extent of the sorts of people who might find themselves in that position, which is where I think we can use technology—which is not the answer to every problem in the health service, by the way. However, through better use of data, patient records and analytics, we will be better able in the future to predict risk and prevent tragedies as in the case the hon. Lady describes, which are a tragedy not just for those whose lives are cut needlessly short, but for those who live their lives with that intolerable grief and loss for the many years that follow.

It is a shameful truth about our society that people with a learning disability or autism are detained, sometimes for years, with little or no therapeutic benefit. The Bill will put an end to that injustice, limiting detentions so that people with a learning disability and autistic people are no longer detained beyond 28 days unless they have a co-occurring mental health condition that would benefit from treatment in hospital. This will require the necessary community provision in place to support people with a learning disability or autism, and we are working to set out what strong community services look like and on the resources required to implement them, so that there are robust alternatives to hospital care.

To help to plug the flow of inappropriate admissions to hospital, the Bill places a duty on integrated care boards to improve monitoring and support for people with a learning disability or autism who may be at risk of future detention. The Bill will introduce statutory care, education and treatment reviews to ensure that patients are safe and receiving the right care and treatment when detained, and that a plan to discharge them to the community is being worked up. We will also remove prison and police cells from the definition of “places of safety”. Police cells are for criminals, not patients in desperate need of medical help.

Throughout the development of these reforms, we have maintained the central purpose of the Mental Health Act—to keep individuals and the wider public safe. The vast majority of people with mental illness, including severe mental illness, present no risk to themselves or others, and, for the majority of people, treatment can be provided without compulsion. However, there are some people whose illness, when acute, can make them a risk to themselves, and sometimes to others.

No one knows this better than the families of Ian Coates, Barnaby Webber and Grace O’Malley-Kumar, the victims of Valdo Calocane’s violent rampage in Nottingham, whose campaign for justice and accountability has been truly awe-inspiring, or indeed the family of Valdo Calocane, with whom I have also spent time, listening to their experience of feeling badly let down by health services. As the independent investigation into the murders found, both he and his victims were failed by the health service, and their families have been left to live with the consequences with a level of pain the rest of us can scarcely imagine. I would like to place on the record my thanks to all four families for meeting me as my team and I worked on the Bill.

Thanks to the amendments that we are making to the Mental Health Act, decision makers will have to consider the risk of serious harm when making decisions to detain. That will ensure that any risks to the public and patients are considered as part of the assessment process. We will also introduce a new requirement for the responsible clinician to consult another person when deciding whether to discharge a patient, putting in place robust safeguards against the release of potentially dangerous people.

Finally, as I have said, legislation alone will not fix the wider issues of increasing mental health needs and long waiting times. To do that, the Government are investing in earlier intervention to meet patients’ needs and prevent them from reaching crisis point.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

Will the Secretary of State give way?

[Wes Streeting]

I am just coming to my conclusion, I am afraid.

In the past 10 months, we have met the mental health investment standard for 2025-26; invested an extra £680 million in mental health services this year, which is a real-terms increase; funded mental health support teams in schools for almost an extra 1 million pupils; invested an extra £26 million to build new mental health crisis centres; funded NHS talking therapies for an additional 380,000 patients; and begun recruiting the 8,500 mental health professionals we promised in our manifesto. That is all part of the additional £26 billion this Labour Government are investing in health and care services—investment that was opposed by every party on the Opposition Benches; investment that is happening only because we have a Labour Government.

Mental health reform is not just about changing laws; it is about changing lives. The action we are taking will provide support and care to people at their most vulnerable, modernise our mental health services to keep us all safe, and create a safety net that any of us might need one day. I commend the Bill to the House.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Secretary of State.

[Edward Argar (Melton and Syston) (Con)]

I thank the Secretary of State for bringing the Bill before Parliament. The last update to the Mental Health Act, in 2007, took eight years following the Richardson review, and this Bill has been a similarly long time in the making, so I welcome the speed with which he has moved on it since taking office. Although we may tussle on occasion, as I have said since the election, we on the Conservative Benches will not oppose for the sake of opposition. We will be constructive, working to improve legislation and supporting the Government where we believe they are doing the right thing, and I recognise the Secretary of State’s constructive approach to the Bill.

At the outset, let me join the Secretary of State in paying tribute to the families of Calocane’s victims in Nottingham for what they have done subsequently—their campaigning, their dedication and their work, including on this legislation—and for the incredible dignity with which they have conducted themselves in unthinkable circumstances.

As the Secretary of State mentioned, the Mental Health Act 1983—I will not miss the opportunity to allude to his youthfulness—governs the compulsory detention and medical treatment of people with severe mental illness for the safety and protection of themselves and those around them. He also set out that sadly, all too often, those with learning disabilities or autism have been conflated with that group. We must take this opportunity to address that, and the Bill rightly seeks to do so. In the more than 40 years that have followed the 1983 Act, healthcare, treatments and, crucially, our understanding of mental health illnesses have come on in enormous strides. It is not only important but right that our laws are updated to reflect the modern world and the knowledge that we have today.

We are debating measures that impact those with the most severe mental health issues and their families, but as was highlighted in interventions on the Secretary of State, we should not forget the broader context, the challenges posed by mental health issues more broadly, or the importance of continued investment in this space. We should also recognise the many organisations that do amazing work both to educate society about mental ill health and to support people with mental health illnesses.

Let me take this opportunity to pay tribute to my right hon. Friend the Member for Godalming and Ash (Sir Jeremy Hunt), who has just left the Chamber, for the work that he did on mental health as Secretary of State. I think it is fair to say that, away from the to and fro of party politics, the current Secretary of State shares my right hon. Friend’s passion and determination to address these issues. As he said, we have done much, but I believe we can and must continue to strive to do better.

Keeping legislation up to date is particularly important for a measure such as the Mental Health Act, which gives the state the power to deprive people of their liberties in order to protect the safety of the individual and those around them and to carry out treatment. Those powers should only ever be used when absolutely necessary, and it is therefore right that they are reviewed and updated to ensure that they remain relevant, proportionate and appropriate.

The most recent update to the Mental Health Act, in 2007 under the last Labour Government, introduced community treatment orders and independent mental health advocates and changed the detention criteria. Since then, as the Secretary of State alluded to, trends have emerged that have raised concerns. The overall number of detentions under the Act has been rising steadily. There were around 52,500 recorded detentions in England in 2023-24, including 963 of children aged 17 and under. That is a 2.5% increase on the previous year and around 14% higher than in 2016-17. In the same year, 2023-24, black people were 3.5 times more likely than white people to be detained under the Act, and seven times more likely to be placed on a community treatment order. The reasons for that are likely to be complex, and I will return to them later.

That is why in 2017, just 10 years after the previous update, the then Prime Minister, Theresa May—now Baroness May—commissioned an independent review of how the Mental Health Act was used and how it could be improved. The review considered not only the trends in detentions, but wider concerns about whether some processes were out of step with what should exist in a modern mental health system, including the balance of safeguards, patient choice and patients’ agency in their own care, and the effectiveness of community treatment orders. Sir Simon Wessely published the report of his review in 2018, and I take this opportunity to put on the record again our thanks for his important work.

[Wes Streeting]

Hear, hear.

[Edward Argar]

The previous Government published a draft Mental Health Bill based on the recommendations in the report, giving others the opportunity to have their say. The draft Bill was subject to pre-legislative scrutiny by a Joint Committee of Parliament, allowing Members of both Houses to thoroughly review it and make recommendations before the final version was introduced.

Given the importance of this area of policy, which can have such a profound impact on people’s lives, I believe it is right that we took the time to get this right. The work to update the Mental Health Act started under the previous Government and we had a commitment in our election manifesto to update the law in this area, and that has been carried on by the new Government. We continue to believe that this is the right thing to do, so I put on the record our in-principle support for the Government on the Bill.

I pay tribute to my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) for his work in this space as a shadow Minister. Not only does he have professional expertise, but he has brought it to the House’s deliberations on this legislation. I suspect that we may hear from him a little later.

There are many areas of the Bill that we welcome, including the strengthening of the patient’s right to express a treatment preference, the expansion of access to independent mental health advocates, and the removal of police and prison cells as places of safety so that patients can be treated in an appropriate setting. That said, of course we will not stand back without scrutinising and seeking constructively to improve the Bill as it passes through the House. Part of our role as the Opposition is to engage constructively in the scrutiny of legislation—to ask questions, to probe further, to seek to prevent unintended consequences, and to identify potential problems and ensure that they are aired in Committee—in order to improve it for everyone’s benefit, and that is what we shall do. I know that my hon. Friend the Member for Hinckley and Bosworth (Dr Evans) will approach the Public Bill Committee in that vein.

We very much welcome efforts to improve patients’ voice and involvement in their own care, including through greater use of advance choice documents. In its current form, the Bill places a duty on NHS England and integrated care boards to make patients aware of their option to have such a document, but this could be as simple as having a poster on a noticeboard, for instance. It does not necessarily require a conversation. Introducing it as a legal right for patients who are being treated or for someone who is at risk of detention would mean that they have to be specifically told about the option, allowing them to make a deliberate decision. I suspect that in Committee we may gently press the Minister to go further in strengthening the patient’s right to have their voice heard. I have been on a number of Bill Committees, and gently hinting to the Minister areas where we might press further may make his and his officials’ lives a little easier when amendments are tabled in Committee.

We were pleased that peers passed an amendment to better protect children who require a nominated person, removing the discretion where a court order regarding parental responsibility is in place. However, we believe there is more we can do to support and protect children, particularly regarding age-appropriate settings for treatment. I hope that when the Minister for Care winds up, or in Committee, he will explore in greater detail the steps the Government are taking to reduce the number of children being treated on adult mental health wards and to ensure that lessons are learned at both national and local service provider level.

Thirdly, we are conscious that a number of elements of the Bill will require additional resources to be put in place. The removal of police and prison cells—sensibly—as places of safety will require sufficient alternative capacity for people to be treated when they are detained. What approach do the Government intend to take in addressing this?

Increasing the frequency with which patients can apply to the mental health tribunal to have their detention reviewed and widening automatic referrals will potentially increase demand and pressure on the system. We know that the legal system is already under pressure, and the impact assessment acknowledges that there will be impacts and costs, so is the Minister confident that the system has the capacity to handle the additional demands? If not, what steps are being taken with the Ministry of Justice to address that?

[Edward Argar]

The hon. Gentleman is right to highlight both the costs and the investment that is needed, but the cost does not detract from the importance of and need for the measures set out in the legislation. He points out that as a proportion of overall health spending, mental health spending has fallen slightly in the latest figures. I hope that the Minister in his wind-up will address how the Government will ensure that this legislation, which enjoys broad support across the House, has the resources behind it to deliver the outcomes we all wish to see in practice?

[Wes Streeting]

Will the right hon. Member give way?

[Edward Argar]

I will regret doing so, but of course I give way to the Secretary of State.

--- Later in debate ---

[Wes Streeting]

I should point out for the record that mental health spending has increased in real terms this year, thanks to the decisions the Government have taken. As a proportion of spend on health services overall, it is true to say that it has decreased by 0.07%, but that does not take into account the fact that as well as investing heavily in our elective backlog and in clearing waiting lists, we are investing in general practice, which will benefit enormously people with mental ill health.

[Edward Argar]

The Secretary of State was kinder than he normally is, and I am grateful to him for acknowledging the reduction in the proportion of mental health spending—it is slight, but it is none the less a reduction. I hear what he says more broadly, but I hope that he and the Minister will reiterate their commitment to ensuring that the legislation succeeds, which we all wish for, and that the pressures it may place on parts of the system will be addressed and not simply be absorbed within the system. I suspect that the Minister will come to that in his concluding remarks.

While it is the right principle to direct more mental health patients away from in-patient hospital settings and to community treatment settings where clinically appropriate—this is key, and goes to the Secretary of State’s point—we must ensure that the NHS has the capacity to provide community treatments when the Bill is on the statute book. The Government accepted that the reforms will take a number of years to implement, given the need to recruit and train more clinical and judicial staff, but what is the plan and how much will it cost? Will it be phased in over a number of years?

The NHS workforce plan will nearly double the number of mental health nurses by 2031-32, but the Secretary of State has said that he intends to update the plan. It would be helpful if, during the Bill’s passage, he or the Minister could tell either the Bill Committee or this Chamber what the changes that he envisages making through this legislation will mean for the workforce.

We recognise the significance of the provisions limiting the detention of patients with a learning disability or autism. Under the Bill, they can be detained for treatment only if they have a co-occurring mental health condition that requires hospital treatment and meet the criteria in the Mental Health Act 1983. Autism alone would no longer justify continued detention under the 1983 Act; in theory, this will ensure that those with autism receive the appropriate support in the right setting, as we would all wish. What steps are being taken to ensure that there are sufficient services, with sufficient capacity, to properly support people with autism and learning disabilities? Can he confirm that under this legislation, there will always be a central role for professional clinical judgments on these matters?

This debate in part follows on from concerns being raised about racial disparities in the application of the Mental Health Act. Can the Secretary of State or the Minister provide more evidence to help the House better understand this issue? What research has been undertaken, or is being planned, to enable us to understand what is behind the statistics?

We welcome this important opportunity to look again at how we treat and protect people with the most severe mental illnesses, and to ensure that our laws remain relevant and proportionate in the modern world, empowering people and treating them humanely. Updating the Mental Health Act is the right thing to do, and we will work constructively with the Government to improve the safety, treatment, agency and, crucially, dignity of mental health patients who are detained, and of the wider public.

Better Care for Veterans: National Training and Education Plan

Wes Streeting Excerpts

Thursday 8th May 2025 Written Statements

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

As the nation marks the 80th anniversary of VE Day, we are announcing a new national training and education plan to transform healthcare for the armed forces community across England.

The Government are proud of the courage and dedication of our armed forces. It is our duty to ensure that those who have been injured or are unwell, whether physically or mentally, receive the very best possible care. However, the NHS is not currently set up to provide the best possible services to the armed forces community. Too many veterans still struggle to navigate civilian healthcare systems and may not self-identify as veterans to NHS staff, putting them at risk of missing out on the additional support and bespoke services that are already available. That is why we are rolling out the national training and education plan—to help guarantee that armed forces veterans and their families benefit from the improved and targeted healthcare that they deserve. The plan will train and educate NHS staff across the country to meet the unique health needs of veterans, serving personnel and their families.

NHS staff across England will receive dedicated training to help them identify and support patients with military backgrounds. GPs, NHS doctors, nurses and managers will work with regional trainers to make sure they embed this support into their services. The three-year training programme, backed by £1.8 million, will be rolled out across England from October 2025.

This announcement sits within wider Government commitments to veterans, including putting the armed forces covenant fully into law, and the newly announced Operation Valour, a £50 million boost in funding to ensure that veterans across the UK have easier access to essential care and support. The national training and education plan will ensure that the NHS is set up to fulfil the armed forces covenant, with the appropriate training and education required to develop a skilled, educated and inclusive NHS primary, community and secondary care workforce, to meet the evolving needs of the armed forces community within the NHS in England. This new training is part of our plan for change to fix the NHS and make sure it works for everyone, including those who have risked everything to serve our country.

[HCWS624]

Oral Answers to Questions

Wes Streeting Excerpts

Tuesday 6th May 2025 Commons Chamber

[Jo Platt (Leigh and Atherton) (Lab/Co-op)]

14. What steps he is taking to shift care from hospitals into the community.

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

Despite my best efforts, may I welcome the hon. Member for Runcorn and Helsby (Sarah Pochin) to her place? Being a Member of Parliament is a privilege, and I know how special it is to sit on these Benches having been sent here by constituents. Regardless of our political differences, I wish her well personally.

As part of our 10-year plan for health, we want to deliver a real shift in the centre of gravity in the NHS, so that people get more care closer to home and, indeed, in their home, too. The NHS is as much a neighbourhood health service as a national health service. We have already made progress in shifting care to the community: providing more than £889 million in funding for GPs; agreeing the GP contract for the first time since the pandemic; and recruiting more than 1,500 GPs on to the frontline. Our 10-year plan will set out how we will continue to transform the NHS into a neighbourhood health service.

[Jessica Toale]

I am deeply concerned about the quality of healthcare for people experiencing homelessness in my constituency of Bournemouth West. HealthBus, a local charity, is doing great work in getting out into the community to treat people where they are and to prevent them from having to go into hospital, but it is not getting the funding that it needs and has discovered serious discrepancies in the way that the local integrated care board commissions services, particularly in relation to health inequalities. Can the Secretary of State tell me how this Government are prioritising health outcomes for people experiencing homelessness, and will he meet me and HealthBus to discuss how we can support its important work?

[Wes Streeting]

The founding mission of the NHS was to be there for people whenever they fall ill, so that they never have to worry about the bill. Unfortunately, thanks to the disaster and the failures of 14 years of Conservative Government, too many people in our country today experience the fear that Nye Bevan sought to eradicate. As my hon. Friend would expect, tackling health inequalities for homeless people and other vulnerable groups is central to the values of this Labour Government. Those values will be reflected in our 10-year plan for health. I would be delighted to hear from her further on what we can do to improve services in her area.

[Jo Platt]

I thank the Secretary of State for his announcement this morning regarding GP services. One way that pressure is eased in our GP services is through charities such as Compassion in Action, which provides non-clinical, whole-person care in my constituency. It receives GP referrals from across Leigh and aligns with the Government’s aim to shift care from hospitals to communities. Will the Minister join me in thanking the staff and the founder, Pam Gilligan, and agree to come for a tour of the facilities and to see at first hand the impact that they have?

[Wes Streeting]

I wholeheartedly join my hon. Friend in thanking Pam and everyone at Compassion in Action for the work that they do. At the heart of our approach to health is a recognition that Government action is essential for improving health outcomes in the country, and that Government acting alone will not be sufficient. That is why working with the voluntary sector, employers, trade unions, community groups and all of us as individual citizens is vital for tackling health inequalities and improving care in our country. I would be delighted to ensure that one of the team pays a visit to the charity as soon as possible.

[Mr Speaker]

Stuart Anderson, welcome back.

[Stuart Anderson (South Shropshire) (Con)]

Community hospitals can reduce pressure on major hospitals, especially in rural communities such as mine. Will the Secretary of State lay out his plans to support community hospitals in South Shropshire?

[Wes Streeting]

At the heart of this Government’s approach is investment in, and reform of, the NHS to ensure that we deliver better outcomes for patients. That means the biggest devolution of power in the history of the NHS with more decisions taken closer to patients and to their communities, and more power in the hands of patients, too. Community hospitals have a vital role to play, and thanks to this Government’s decision to deliver £26 billion more into our NHS—opposed by the Conservative party—we will no doubt be able to make further and faster progress.

[Susan Murray (Mid Dunbartonshire) (LD)]

In my constituency there is an ageing population in need of local healthcare services. Will the Secretary of State meet his Scottish counterpart to discuss the need for increased access to community healthcare, and specifically the need for a new health and care centre within my constituency?

[Wes Streeting]

The hon. Member will be delighted to know that only last week I met with my counterparts in Scotland, Wales and Northern Ireland to talk about how we can work together to improve health and care throughout the United Kingdom of Great Britain and Northern Ireland. She will know that health is devolved, but thanks to the decisions taken by this Labour Government, the Scottish Government have just been delivered the biggest financial settlement since devolution began. That might mean that they finally make some progress on their waiting lists in Scotland, where one in six Scots are on a waiting list and the SNP is on its fifth NHS reform plan in four years.

[Alex Ballinger (Halesowen) (Lab)]

3. What steps his Department is taking to support GPs to spend more time with patients.

--- Later in debate ---

[Natasha Irons (Croydon East) (Lab)]

6. What plans he has to reform NHS health and social care services.

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

People deserve the very best health and care. Our plan for change is already bringing waiting lists down. Our 10-year plan for health will set out how we improve access and make the three shifts that I described earlier, so that the NHS is fit for the future. At the same time, we are rebuilding adult social care now and for the future. Baroness Casey’s independent commission has launched, and it will set out through its work how we will create a national care service. All that is made possible thanks to the investment decisions taken by the Chancellor in her Budget. That investment was opposed by the Conservative party, which shows that only Labour can be trusted to invest in and modernise our NHS.

[Natasha Irons]

Last week, the Centre for Young Lives published a report on the state of mental health support for children and young people across England. It outlines that despite an ongoing crisis in mental health among young people,

“There remains a 55% treatment gap”

between adult and children’s mental health, and that

“fewer than 10%...of ICBs have a dedicated strategy”

for supporting children’s mental health. Will the Secretary of State consider strengthening statutory guidance for ICBs to ensure they assess the local need of children and young people, publish treatment gap data on an ongoing basis, and create joined-up, community-based mental health support for our young people?

[Wes Streeting]

Young people’s mental health is a priority for this Government. That is why we set out in our manifesto our commitment to making sure that mental health support is available in every primary and secondary school in the country. We have walk-in mental health services in every community, and we invest in the mental health workforce, so that we can cut waiting times. I am also working closely with the Secretary of State for Education to make sure that our education and health services work together, so that children get the very best start in life, and so that we look after mind, body, soul, aspiration and futures.

[Joe Robertson (Isle of Wight East) (Con)]

The Chancellor increased the cost of employing people in social care by raising national insurance contributions for social care employers, and then exempted NHS employers from those increased costs. When will this Government properly support social care and relieve the sector from pressures caused by the Chancellor under this Government?

[Wes Streeting]

Thanks to the decisions taken by this Chancellor, we are putting £26 billion more into health and social care. Thanks to the decisions taken by this Chancellor, the spending power of local authorities has risen. Thanks to the decisions taken by this Chancellor, we have delivered the biggest expansion of carer’s allowance since the 1970s. Thanks to the decisions taken by this Chancellor, we have significantly increased the disabled facilities grant, not just last year but this year. That is the investment delivered by a Labour Government, and opposed by the Conservatives and Reform, and it shows that only Labour can be trusted with our NHS.

[Mr Speaker]

You will have another chance in a minute! I call the shadow Minister.

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

This Government have been in power for 10 months. Two months ago, Labour postponed the cross-party talks on social care. When will they be rescheduled?

[Wes Streeting]

As I have announced to the House, Baroness Casey’s independent commission is up and running. She is making contact with parties across the House as part of the work of her commission, and it is for her to decide the basis on which she engages with parties. I look forward to working with parties at the conclusion of the process.

[Dr Evans]

I thank the Secretary of State for that change, making the process no longer cross-party. The Government have said that the changes will not be implemented fully until 2036. Only this week, the Health and Social Care Committee released its new report on social care and the huge cost of inaction. The report called for new actions that could be taken now, such as the publishing of annual assessments of unmet care needs for adults, and annual estimates of how much delayed discharges cost the NHS. Will the Secretary of State commit to those two today?

[Wes Streeting]

I take the Select Committee seriously, and I will look carefully at its report, but the shadow Minister has some brass neck. He mentions this Government having been in office for 10 months, but the Conservatives had more than 10 years in office, and we are picking up the pieces from the mess they left behind. That is why they were kicked out of government, and why they are being kicked out of opposition. Looking at this lot, I think: this must be how the islanders felt, looking at the dodo.

[Manuela Perteghella (Stratford-on-Avon) (LD)]

7. What recent assessment he has made of the adequacy of access to emergency dentistry.

--- Later in debate ---

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

10. What progress he has made on the abolition of NHS England.

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

As the Prime Minister and I announced, NHS England will be brought back into the Department to put an end to the duplication, waste and inefficiency resulting from two organisations doing the same job. That is the final nail in the coffin of the disastrous 2012 reorganisation, which led to the longest waiting times, lowest patient satisfaction and most expensive NHS reorganisation in history. Since the announcement, we have set up a joint board, assessed resources and responsibilities across existing organisations, developed proposals about the role, functions and structure of the new centre, and started detailed operational and legislative planning.

[Gregory Stafford]

The Secretary of State claims to support change, yet delays to NHS reorganisation, including to the promised abolition of NHS England, suggest otherwise. Is it not the truth, as he outlined in his Guardian article, that he is bogging the system down in a slow, top-heavy restructuring, while resorting to tax rises, instead of delivering the decentralised, locally delivered, value-for-money healthcare that our constituents deserve?

[Wes Streeting]

A lot of words and not a lot of sense. We are reforming the NHS and, as a result of these changes, redirecting hundreds of millions of pounds to the frontline. What was the Conservative party’s response to the abolition? The shadow Chancellor of the Duchy of Lancaster, the hon. Member for Brentwood and Ongar (Alex Burghart), said it could be a “great thing”, but it

“could be a total disaster”.

Will they let us know when they have made their mind up?

[Anna Dixon (Shipley) (Lab)]

The Lansley reforms were implemented top down by the Conservatives. The idea that the NHS could ever be truly independent, when it is there to serve us—the taxpayer and the general public! Does the Secretary of State agree that it is absolutely the right decision to move funding away from the centre to the frontline to prioritise patients in the NHS’s work?

[Wes Streeting]

My hon. Friend has huge experience in this area, and she is absolutely right. What we saw under the Conservatives was bloated bureaucracy—layer upon layer of checkers, when we need more doers. That is why frontline staff, patients and provider leaders all welcome the changes that we are making, so that we can invest more into our frontline.

[Mr Speaker]

I call the shadow Secretary of State.

[Edward Argar (Melton and Syston) (Con)]

The Health Service Journal reports that officials have acknowledged that the first draft of a high-level plan for merging NHS England and DHSC has been delayed. When we ask any written question about the merger, the standard answer seems to be:

“Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to determine the structure and requirements needed to support the creation of a new centre for health and care.”

Even when we ask a question specifically about the size of the transformation team, the answer is virtually identical. The Government either wilfully decide not to answer, or simply do not know. As with so many things, the Government go for the headline-grabbing announcement and talk the talk on reform, without having done the actual work to deliver it. My question to the Secretary of State is simple: when will that first high-level plan for the merger, with a full assessment of costs and savings, be published?

[Wes Streeting]

Honestly, the right hon. Member had his chance—he was the Minister who took forward the last reform Act, under the Conservative Government. He failed in that task, and now he turns up without a shred of remorse or a shred of humility, attacking this Government for cleaning up the mess that the Conservatives left behind. They are not a party of government—they are not even a party of opposition any more. They are a total irrelevance.

[Josh MacAlister (Whitehaven and Workington) (Lab)]

11. What steps his Department is taking to implement neighbourhood health centres.

--- Later in debate ---

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

Reducing hospital backlogs is a key priority in this Government’s plan for change, as the 18-week standard for elective care has not been met for almost a decade. Our elective reform plan sets out how we will return to that standard by the end of this Parliament, through a combination of investment and reform. Since July, the waiting list has reduced by over 219,000 and we have delivered an extra 3 million appointments, exceeding our manifesto pledge and doing it earlier than planned.

[Adam Jogee]

I am grateful to the Secretary of State for his answer and for the progress made, but there is still more to do. My constituent in Newcastle-under-Lyme has recently been recovering from brain surgery at the Royal Stoke university hospital. However, she has faced multiple setbacks due to failures in the duty of care, including scalding injuries and a severely mishandled admission process. She is now receiving the correct care, but she had to wait many months to be admitted to the correct ward, and has been given limited time for rehabilitative treatment. Does the Secretary of State agree that to tackle backlogs, our hospitals must have the resources they need to provide the right care the first time round, so that patients are given the time and support to fully and effectively recover?

[Wes Streeting]

I am grateful to my hon. Friend for his question, and horrified to hear about his constituent’s experience. This Government will never brush problems under the carpet or pretend that things are better than they are, and I know that for all the progress we have made in the past 10 months, there is still so much more to do. When we publish our 10-year plan for health, we must ensure that quality and safety are at the heart of every patient interaction. My hon. Friend is right about the need for investment. That is why we are investing £26 billion in the NHS and social care, and why it is so disappointing that the Opposition parties voted against it.

[Wera Hobhouse (Bath) (LD)]

On a recent visit to the breast unit of the Royal United hospital in Bath, specialists told me about a red flag system that could help to speed up care. If someone has a red flag symptom, such as a lump or a bleeding nipple, the triage team can book them straight into the breast clinic, rather than waiting to see a GP. Does the Secretary of State support such an approach?

[Wes Streeting]

I thank the hon. Member for her extremely constructive contribution. That is exactly why at the heart of our plans for reform and modernisation, we are placing such an emphasis on digital and technological transformation. We have such rich data about the experiences of our patients, but we are not using it effectively enough. If we use the information more effectively and efficiently, we can spot and identify risk much more proactively, and ensure that people get timely access to urgent care and treatment when they need it.

[Dr Marie Tidball (Penistone and Stocksbridge) (Lab)]

I am grateful to the Secretary of State for the work that he and his team have done to reduce NHS waiting times month on month for the last six months. However, the backlog that grew under the last Conservative Government is still impacting on my constituents. I have listened to countless constituents who have told me about the upsetting impact of long waiting times for an ADHD diagnosis for children. That is having a detrimental knock-on impact on access to support, including child and adolescent mental health services and shared care agreements, and there is a lack of support for adopted children. I welcome the news that waiting lists have gone down, but will the Secretary of State set out how his work will be targeted at bringing down waiting lists for ADHD diagnoses in my constituency, to ensure consistency in diagnosis rates across trusts?

[Wes Streeting]

I am so grateful to my hon. Friend for her question, and I pay tribute to my right hon. Friend the Secretary of State for Education, who is leading cross-Government work in that area. We have a taskforce that is specifically looking at the issues that my hon. Friend raises, and together we are looking to ensure that our education and health services are better joined up to meet the needs of young people. I am working with my hon. Friend the Member for Whitehaven and Workington (Josh MacAlister) and drawing on his experience to look at how we can improve the health and care of care-experienced young people and young adults. I hope we will have lots of progress to report on those issues.

[Lee Anderson (Ashfield) (Reform)]

One way to reduce the backlogs is to reduce or put an end to health tourism in this country, whereby people come to this country, get their treatment, and then nip back to where they come from. Does the Secretary of State think it is a good idea that people entering this country should provide evidence of health insurance or be refused entry?

[Wes Streeting]

When any of us travel abroad, we expect to take out travel insurance and pay for our healthcare needs overseas, and that is the standard that we expect for visitors to our country. We have lots more to do to improve on that front. I deplore the comments made by the hon. Gentleman’s party leader, who said that he does not support a taxpayer-funded NHS for the British people. He might want that debate, and the Leader of the so-called Opposition says that she wants that debate, but as far as Labour is concerned, we are clear about where we stand. Under Labour, the NHS will always be a national health service, publicly funded and free at the point of use.

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

15. What steps he is taking to reduce the reliance of the NHS on private healthcare providers.

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

This Government are taking a hard-headed approach to cutting waiting times. We are investing an extra £26 billion in our NHS, and where the independent sector has spare capacity, we will pay to get NHS patients treated faster and free at the point of use. So far, our approach to investment and reform has cut waiting lists by more than 200,000. Perhaps the hon. Member will tell us how it is going in Scotland.

[Seamus Logan]

The Secretary of State claimed this morning on BBC Radio 4’s “Today” programme—a most excellent programme—that Labour is the only party that can be trusted with the national health service. Can he confirm that no aspect of the NHS whatsoever, whether it is ownership of the estate, the provision of specialist services or any other form of privatisation, will be included in the much-promised trade deal between the UK and the United States? No more excuses, Secretary of State: just give a direct answer to a direct question.

[Wes Streeting]

I have said it before, and I will say it again: the NHS will be privatised over my dead body. This party founded the NHS as a publicly funded public service, free at the point of use. We use the independent sector to cut waiting lists, and guess what? The SNP-led Government in Scotland do the same thing. We have made it clear that the NHS is not up for sale in any trade deal. That is clear and unequivocal. The hon. Gentleman can sling mud as much as he likes, but he cannot run from the SNP’s abysmal record on the NHS over 18 long, poor years.

[Yuan Yang (Earley and Woodley) (Lab)]

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

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

GPs are at the front door to our NHS. Today, I can announce that we are supporting more than 1,000 surgeries across the country to modernise their buildings, backed by more than £102 million—the biggest public investment in GP facilities for five years. Following years of neglect, this vital funding will create additional space to see more patients, boost productivity, improve patient care and enable 8 million more family doctor appointments each year.

[Yuan Yang]

I very much welcome today’s announcement on refurbishing 1,000 GP surgeries across the country, because I have made it my priority to meet with as many GPs as possible in my constituency. Our local GPs have told me that our health centres need more physical space in order to accommodate growing local needs and facilitate the expansion of healthcare into the community. Is the Secretary of State willing to meet me and my local GPs to discuss how we can better improve the physical space needed for care to be brought closer to people’s homes?

[Wes Streeting]

I would be delighted to do so. Since we came into government, we have made this announcement today, put £889 million into general practice and agreed a contract with GPs, including reform for patient access and services. We are fixing the front door to the NHS, but of course that will take time. We recruited 1,500 more GPs by the end of March, but day by day, week by week, month by month and year by year, people should see improvements in their GP services thanks to Labour.

[Mr Speaker]

I call the shadow Minister.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Taking medicines on time is important, especially for those with conditions such as diabetes and epilepsy. Dr Acheson, an A&E consultant who has time-critical medicines for his own Parkinson’s disease, understands that well. He has been running a quality improvement programme to ensure that time-critical medicines are given on time in A&E. Will the Secretary of State lend that project his support and commit to reviewing how time-critical medicines are delivered on wards?

[Wes Streeting]

I thank the shadow Minister for her constructive question. I would be delighted to hear more about that initiative. She is absolutely right about timely access to medicines, and through a combination of service reform and the modernisation of technology, we can assist clinicians and patients to help them to manage their medication and ensure that people get timely access to medicines.

[Dr Johnson]

I thank the Secretary of State for that answer, and I would be delighted to meet him to discuss it further.

Unfortunately, when Labour negotiates, Britain loses. The Government capitulated to union demands with nothing in return. It is therefore of no surprise to anyone that within months, they are back in dispute with resident doctors and the British Medical Association has announced a ballot for strike action. What will the Secretary of State do to protect patients and taxpayers?

[Wes Streeting]

I will tell the hon. Lady what we are not going to do: we are not going to see £1.7 billion wasted on strikes by resident doctors or 1.5 million cancelled operations and appointments, which is exactly what happened on the Conservatives’ watch. Within three weeks, we ended the strike by resident doctors and we have cut waiting lists by 200,000 as a result. As I have said to resident doctors, their pay offer will be fair and neither staff nor patients want to go back to the bad old days of strikes under the Tories. They had an unwilling and incalcitrant Government under the Conservatives, who were unwilling to work with resident doctors, but we want to work with them to deliver better care for patients.

[Mr Richard Quigley (Isle of Wight West) (Lab)]

T3. I pay tribute to my 17-year-old constituent, Arlo Lambie, who tragically died on 13 April following the diagnosis of a grade 4 brain tumour. I knew Arlo—he was a fun and bright lad who will be sadly missed. While Arlo’s parents, Ellie and Alex, wish to put on record their thanks for the “incredible and compassionate care” Arlo received at St Mary’s hospital on the Isle of Wight, they want to know what steps the Secretary of State is taking to improve NHS access to breakthrough treatments to ensure that the commercial interests of pharmaceutical companies do not take precedence, so that children with brain cancer, like Arlo, are given the best possible chance to survive for longer.

--- Later in debate ---

[Helen Morgan (North Shropshire) (LD)]

In his statement to the House just after Christmas, the Secretary of State acknowledged that cross-party consensus is essential to delivering meaningful social care reform. The Liberal Democrats support him in that endeavour, but we still do not have a date for those cross-party meetings, so will he give us one now?

[Wes Streeting]

Dates for meetings with the commission are now a matter for the independent commission.

[Josh MacAlister (Whitehaven and Workington) (Lab)]

T6.   West Cumbria, like many parts of the UK, is a dental desert. In some communities, urgent dental access centres have proved to be a real success at building up dental services, so will the Minister support my campaign to introduce an urgent dental access centre in west Cumbria?

[Sir Jeremy Hunt (Godalming and Ash) (Con)]

T2. The chief executive of the Royal College of Midwives has said that the axing of the maternity safety ringfenced pot would be a “wrecking ball” to the efforts being made to improve maternity safety. Just a single or a small group of babies being spared lifelong disability would pay for the cost of that ringfenced pot many times over. I know that the Secretary of State cares about this matter deeply, so will he reconsider?

[Wes Streeting]

The funding is still there, but as many people have urged me, including the right hon. Gentleman, we are taking the decision to give more freedom and flexibility to independent care boards, systems and providers to determine how they can best spend NHS resources on services to improve patient care, safety and outcomes. Everyone will know that maternity safety is understandably a priority for this Government. We expect the NHS to deliver on maternity safety standards and will hold it to account on that.

[Olivia Bailey (Reading West and Mid Berkshire) (Lab)]

T7.   Residents in Theale and across my constituency tell me time and again how hard it is to get a GP appointment, which causes distress and sometimes dangerous delays. Will the Secretary of State outline how his programme of reform and investment will end the 8 am scramble for good and deliver more GP appointments for my constituents?

--- Later in debate ---

[Bob Blackman (Harrow East) (Con)]

T4. One of the great frustrations for medical professionals and patients alike is when patients have appointments but do not turn up. What action will the Secretary of State take to ensure that the system penalises people who miss appointments, so that patients can get the treatment they need when they need it?

[Wes Streeting]

We are absolutely convinced that better use of digital tools will enable us to reduce the number of missed appointments significantly and factor in the likelihood of no-shows, so that we can reduce waste and eliminate inefficiency. I understand the case for penalties that the hon. Gentleman is making, but that is not a route we want to go down until we have made those improvements and judged how effective they have been.

[Jim Dickson (Dartford) (Lab)]

T9. Far too many promises made by the last Government—promises that care would be moved out of hospitals and into the community—turned out to be hollow. From speaking to residents in Dartford, I know that hospital and community services have struggled to keep pace with new housing developments in the constituency. I am pleased to say that later this year in Dartford we will be seeing an expansion of our state-of-the-art community diagnostic centre, taking care closer to where people live. Does the Secretary of State agree that this is the start of Labour getting on with finally delivering that big shift, and will he visit Dartford with me—

--- Later in debate ---

[Blake Stephenson (Mid Bedfordshire) (Con)]

T5. Residents in Mid Bedfordshire are concerned about the standards of maintenance at our two local hospitals. What action are the Government taking to support our hospitals in Luton and Bedford to catch up on maintenance backlogs?

[Wes Streeting]

Thanks to the investment that the Chancellor committed to, we are investing in the NHS estate, which is in a sorry state. I am afraid that that is an investment that the hon. Gentleman did not vote for, and his constituents will be fuming when they find out who was responsible.

[Mr Bayo Alaba (Southend East and Rochford) (Lab)]

I recently heard from Chelsea, a constituent of mine, who raised concerns about her grandmother Anna’s care. After a delayed discharge, she was released with the wrong equipment, which sadly resulted in her falling out of bed and sustaining a further injury. Ensuring that patients are discharged in a safe and timely manner is key to continuing the Department’s significant progress in cutting waiting lists for treatment, so what steps is the Secretary of State taking to promote integrated working between services to support discharge into the community for patients?

[Wes Streeting]

I am extremely sorry to hear about that particular case. It is really important that we support and facilitate better discharge, which is why we are reforming the better care fund and looking to better integrate health and social care services through our 10-year plan. I would be delighted to hear further from my hon. Friend about what we can do to improve in his area.

[Tessa Munt (Wells and Mendip Hills) (LD)]

T8. I have a constituent who has broken and rotting teeth. His GP referred him to the local dental hospital, but he has been refused treatment because the hospital said that the surgeon would take a referral only from a dentist, which my constituent and many others in Somerset just do not have. What does the Minister suggest my constituent should do to stop the pain?

--- Later in debate ---

[Ellie Chowns (North Herefordshire) (Green)]

Yesterday’s report from the Health and Social Care Committee is explicit that we cannot build an NHS fit for the future without effectively reforming social care. Back in January, the Secretary of State promised cross-party talks as well as Baroness Casey’s commission. He cannot outsource political leadership to Baroness Casey. Political will is the sticking point with the reform of social care. Will he show that leadership and bring the parties together to find the solutions to unblock this crisis?

[Wes Streeting]

Since we came into government, we have already taken action on social care with the investment we have put in—the biggest expansion of carer’s allowance and the funding for home adaptations through the disabled facilities grant. Now that the commission is up and running, there will be cross-party engagement, but it is an independent commission and for Baroness Casey to decide how to engage.

[Catherine Atkinson (Derby North) (Lab)]

Last week, this Labour Government announced the freezing of prescription charges, putting pounds back in the pockets of people in Derby. I have visited pharmacies, including the Littleover pharmacy, which provide essential care and support for their communities. The Conservatives underfunded pharmacies and more than 750 closed across England between 2021 and 2024. What is the Minister doing to support community pharmacies so that we do not lose these vital local services?

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

I welcome today’s announcement of new money for GPs’ surgeries, but GPs in my constituency tell me that they cannot get capital out of the integrated care board and that the Valuation Office Agency consistently undervalues the cost of rents, making future building impossible. Will the Secretary of State agree to meet me, and GPs from my constituency, in order to understand the problem better?

[Wes Streeting]

Thanks to the investment that we have announced, those practices will be upgraded. I advise the hon. Gentleman to engage with his local ICB. We are happy to receive representations if we can help, but let me gently point out that the investment is only possible thanks to the decisions made by the Chancellor, which he opposed.

[Sonia Kumar (Dudley) (Lab)]

Ladies Walk NHS health centre in Sedgley is a vital hub for my constituents, providing essential services such as phlebotomy and diabetic foot care, but owing to the inaction of the Conservative council this much-needed community asset faces closure in 2026, leaving residents without access to critical care. Will my hon. Friend agree to meet me to discuss urgent steps to safeguard the future of the centre and ensure that Sedgley residents continue to receive the NHS services on which they rely?

--- Later in debate ---

[Vikki Slade (Mid Dorset and North Poole) (LD)]

Last month I began to receive concerning emails from employees of the NHS trusts in my constituency, saying that the trusts were seeking to create a subsidiary company and move staff into it. They are really worried about their future rights. I know how important it is to the Secretary of State that people have good employment rights. What steps is he taking to ensure that there is full consultation with staff before the creation of subsidiaries, and to prevent the creation of two-tier employment practices in the NHS with no continuity of service?

[Wes Streeting]

While I understand the desirability of such arrangements for NHS trusts, this Government are absolutely clear that staff must be in receipt of good NHS terms and conditions, and must feel part of the NHS workforce and the NHS family. I would be happy to receive further representations from the hon. Lady.

Independent Commission on Adult Social Care: Terms of Reference

Wes Streeting Excerpts

Tuesday 6th May 2025 Written Statements

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

The Independent Commission on Adult Social Care, chaired by Baroness Louise Casey of Blackstock DBE CB, formally launched on 29 April with a meeting with people with first-hand experience of the social care system. Today, I am updating the House that we have published the terms of reference. A copy has been placed in the Libraries of both Houses and on gov.uk at https://www.gov.uk/government/publications/independent-commission-into-adult-social-care-terms-of-reference/independent-commission-into-adult-social-care-terms-of-reference A copy can also be found on the commission’s website at https://caseycommission.co.uk/about/terms-of-reference/

The commission, reporting to the Prime Minister, will work with people drawing on care and support, their families, staff, parliamentarians, local government and the public, private and third sectors to make clear recommendations to define and build the adult social care system that will meet the current and future needs of our population. The commission will consider older people’s care and support for working-age disabled adults separately, recognising that these services meet different needs.

Split over two phases, the commission will set out a vision for adult social care, with recommended measures and a road map for delivery:

The first phase, reporting in 2026, will identify the critical issues facing adult social care and set out recommendations for effective reform and improvement in the medium term. It will recommend tangible, pragmatic solutions that can be implemented in a phased way to lay the foundations for a national care service. The recommendations of this phase will be made within the Government’s spending plans which will be set out at the spending review.

The second phase, reporting by 2028, will make longer-term recommendations for the transformation of adult social care. It will build on the commission’s first phase to deliver a more preventative model of care needed to support our ageing population, and how to best create a fair and affordable adult social care system for all.

The challenges facing adult social care—from inconsistent standards of care to an undervalued and overstretched workforce, and a lack of support for unpaid carers—are complex and deeply rooted. There have been plenty of good ideas in the past 15 years, but we have been missing the broad consensus we need to find a solution around what our country wants from social care so that it stands the test of time.

That is why Baroness Casey has been tasked with starting a national conversation on what people expect from adult social care as well as building cross-party consensus. Given the independent nature of the commission, Baroness Casey and her team will take any future discussions with political parties forward.

While an independent commission is necessary to address the challenges facing the sector, the Government are taking immediate action to improve it. We are making available up to £3.7 billion of additional funding for social care authorities in 2025-26, we have increased the carer’s allowance earnings limit and introduced legislation that is paving the way for the first ever fair pay agreement in adult social care. The Government are also taking forward a range of initiatives for 2025-26 including announcing new measures to professionalise the workforce, uplifting the disabled facilities grant, promoting better use of care technologies, enabling frontline care and health staff to digitally share up-to-date information, and changes to the better care fund.

I am confident that, with Baroness Casey’s leadership and experience chairing this momentous commission, and with help and support from across the House, she will set us on the road to fundamental reform that will build an adult social care system fit for the future.

[HCWS615]

NHS Prescription Charges

Wes Streeting Excerpts

Tuesday 29th April 2025 Written Statements

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

The Prime Minister, my right hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer), has announced that NHS prescription charges in England will be frozen for the first time in three years. This builds on wider Government action as part of the plan for change to tackle the cost of living crisis, and will save patients around £18 million in 2025-26.

The single charge for prescriptions in England will remain at £9.90. The cost of prescription prepayment certificates will also remain the same, with three-month PPCs staying at £32.05,12-month PPCs at £114.50, and the hormone replacement therapy PPC staying at £19.80.

The charges freeze will also apply to NHS wigs and fabric supports; these prices will remain at current levels:

Surgical brassiere £32.50

Abdominal or spinal support £49.05

Stock modacrylic wig £80.15

Partial human hair wig £212.35

Full bespoke human hair wig £310.55

Around 89% of prescription items in England are already dispensed free of charge to children, over-60s, pregnant women, and those with certain medical conditions. This freeze will not impact current exemptions. All working-age adults who would normally pay for their prescriptions, which is estimated to be around 40% of the population, could benefit from the freeze.

In addition to the freeze on charges, the NHS low income scheme offers help with prescription payments; there are free prescriptions for eligible people in certain groups, such as pensioners, students, and those who receive state benefits or live in care homes.

The prescription charge freeze builds on wider government action to tackle the cost of living, including the roll-out of free breakfast clubs, expanded childcare through 300 new school-based nurseries, lowering the cost of school uniforms, and extending the fuel duty freeze—all aimed at easing financial pressures on families across the country.

This announcement also follows news last month of the Government agreeing funding with Community Pharmacy England worth an extra £617 million over two years. The investment comes alongside reforms to deliver a raft of patient benefits, as part of the Government’s agenda to shift the focus of care from hospitals into the community, so that people can more easily access care and support on their high streets.

Alongside action to rebuild the NHS, the Government’s plan for change is focused on growing the economy to improve living standards across the country. The charges freeze will help contribute to this.

[HCWS611]

2023 Agenda for Change Deal: Non-pay Workstreams

Wes Streeting Excerpts

Wednesday 23rd April 2025 Written Statements

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

Today I am updating the House on work under way to improve the working lives of NHS staff.

The 2023 Agenda for Change (AfC) pay deal, agreed between the previous Government and the NHS Staff Council, included 10 commitments to look at issues that impact NHS staff. Some of these commitments have already been fulfilled; however, five of the commitments involved representatives from the Department, the NHS Staff Council, NHS Employers and NHS England working collaboratively to produce recommendations for Government to consider.

These five commitments included: identifying ways to support the fair and consistent application of the NHS job evaluation scheme (JES), ways to improve nurse career progression, options to tackle violence and aggression against NHS staff, ways to reduce agency spend through the NHS terms and conditions, and options to improve support for newly qualified healthcare registrants.

I have now carefully considered each of the 37 recommend- ations that have been made, in the context of the extremely challenging fiscal situation and other departmental priorities.

I am delighted to inform Members that I will be taking forward 36 out of the 37 recommendations at this time, which will have a considerable and positive impact on the NHS workforce. The full list of recommendations has been published at https://www.nhsemployers.org/articles/nhs-staff-council-joint-statement-2023-non-pay-commitments I will continue to update my colleagues as we work in partnership with NHS Employers to improve the working lives of colleagues across the NHS.

The NHS should always be a great place to work, regardless of job role or location. Staff should be free from fear of violence, aggression or discrimination and I know that the Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth), looks forward to working closely with colleagues in the Social Partnership Forum to implement all the recommendations to better protect staff from the risk of violent behaviour. This includes encouraging a reporting culture where all incidents of violence and aggression are reported, the consistent collection of data, and developing a standard approach to post-incident support for all staff that are impacted.

Supporting career progression for our nurses is another important aspect of this work. As a result of these recommendations, our ethnic minority and internationally educated nurses should receive better and more consistent support for their career progression through six-monthly career reviews and more consistent recognition of their overseas experience. In combination, all the recommendations will have a positive impact on the experience of our highly valued nursing staff.

I wanted to take this opportunity to particularly highlight the importance of accurate and consistent application of the NHS job evaluation scheme (JES). Staff should expect to be paid correctly for the work that they are asked to deliver by their employer, as is their contractual right. That is why I am particularly pleased to be accepting the package of recommendations relating to improving local job evaluation practice.

The NHS JES underpins the AfC contract as the mechanism for determining the pay bands for all posts under the NHS terms and conditions (Agenda for Change). It is the responsibility of each NHS employer to comply with the Equality Act 2010 which mandates equal pay for work of equal value.

All NHS organisations should have the necessary resources and skills in place to be confident that they are correctly and robustly applying the NHS JES; however, we know this is not the case. While I know there are some areas where this is working well, this is not consistent across all organisations. I want to be clear that my expectation is that the NHS JES is applied correctly and robustly throughout the whole of the NHS, underpinned by partnership working between employers and trade unions at a local level, to ensure that all staff are paid correctly for the work they are asked to deliver.

Further information and guidance will be developed with the NHS Staff Council to support local partnerships to apply the NHS JES correctly.

These recommendations will restore confidence in the NHS JES and build essential capacity to enable proper application of the scheme. With the roll-out of a new national job evaluation software solution, we are seeking to monitor banding outcomes and improve efficiency by making the current administrative functions easier and more consistent, which will in turn reduce administrative costs locally.

Next steps

I have now instructed officials to work with NHS England, the NHS Staff Council, the Social Partnership Forum and NHS Employers to agree an implementation plan to phase the delivery of the non-pay measures over the next two years. This will minimise the potential impact on resource across the system.

This Government have ambitious plans for the NHS, and we are getting the health service back on its feet through our plan for change, delivering over 2 million extra appointments and cutting hospital waiting lists. A vital part of these plans is to improve the working lives of our NHS staff, and that is why we are announcing this support package to tackle violence and improve career progression opportunities for staff. We recognise that NHS productivity can be impacted by poor workplace experience for staff, which we are addressing through these measures. We are in the process of developing a 10-year health plan and a refreshed long-term workforce plan to set this out comprehensively. This work will ensure that we not only have the right people in the right places to deliver the care patients need, but also that the NHS is a great place to work for our staff.

I am incredibly grateful to all those involved who worked so hard to produce these recommendations.

I will continue to keep Parliament updated on the progress of this work.

[HCWS597]