Oral Answers to Questions
Wes Streeting Excerpts(4 months, 2 weeks ago)
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Jon Pearce (High Peak) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
First, may I welcome my hon. Friend the Member for Norwich North (Alice Macdonald) to the House, and say what an absolute privilege it is to have been appointed Secretary of State for Health and Social Care? We have our work cut out for us, with not only the worst economic inheritance since 1945, for which the Conservatives should show more humility, but the worst crisis in the history of our national health service, which we see reflected particularly in NHS dentistry. Some 13 million people in England have unmet need for NHS dentistry, or 28% of the country, and it is disgraceful that rotting teeth are the most common reason for children aged between five and nine being admitted to hospital. During the general election campaign, I pledged to meet the British Dental Association immediately to start conversations on contract reform, and I did exactly that. I look forward to working with dentists and others from across the sector to reform the dental contract and rebuild NHS dentistry.
Alice Macdonald
I welcome my right hon. Friend to his place. Norfolk is a dental desert and my constituents are suffering. As well as reforming the contract, we need to train more dentists. In the east of England we do not have a dental school, but the University of East Anglia has put forward proposals for one. Will he meet me, other hon. Members from Norfolk and representatives from the University of East Anglia to discuss this important proposal?
Wes Streeting
It is appalling that Norfolk and Waveney are so poorly served in terms of dentistry. There are only 36 dentists per 100,000 people, compared with the national average of 53, so when my hon. Friend says that her community is a dental desert, Members should know that it is the Sahara of dental deserts. We will work with partners to ensure that patients across the country can access a dentist when they need one. I am aware, not least thanks to her advocacy and the advocacy of other Labour MPs across Norfolk, of the University of East Anglia’s proposal, and I would be delighted to meet her and my colleagues.
Lewis Atkinson
My constituents in Sunderland Central tell me that NHS dentistry is broken. It is not just that they cannot access routine care, but that if they are struck with, for example, excruciating toothache, they cannot access urgent appointments either. I therefore ask my right hon. Friend what steps he is taking, alongside the welcome reform of the dental contract, to ensure that urgent dental services are available locally in places such as Sunderland.
Wes Streeting
I welcome my hon. Friend; he certainly has big shoes to fill in Sunderland Central and is a worthy successor to his predecessor. He is absolutely right that alongside contract reform we need urgent action. That is why we committed to providing 700,000 additional urgent appointments and recruiting dentists to where they are most needed, and I am delighted to report that dentists stand ready to assist. We are working with the BDA urgently to get those appointments up and running as soon as possible, and we will keep the House informed on progress as we do.
Jon Pearce
High Peak is also a dental desert. We spoke to one practice that said it got as many calls for registrations as it did for appointments. Often those calls are deeply distressing, with elderly people unable to eat because they need their dentures sorted. What first steps is the Secretary of State able to take to cure 14 years of Conservative failure in NHS dentistry?
Wes Streeting
I welcome my hon. Friend to the House. He is absolutely right to point out that these challenges have been 14 years in the making, and it will take time to fix the damage that the Conservatives have done to our national health service. We will start with 700,000 urgent appointments, as we promised, and we will continue with contract reform, which is essential. I reassure him that as we do, we will have the needs of all communities in our country at heart, especially rural communities such as his that have particular challenges. I look forward to involving him and keeping him up to date on progress as we make it.
Dame Harriett Baldwin (West Worcestershire) (Con)
The NHS dental recovery plan was launched earlier this year, and the Secretary of State has on his desk news about the impact that it is having. Could he share with the House how much the plan has increased appointments in the Worcestershire and Herefordshire integrated care board area?
Wes Streeting
The Conservative party lauded that plan during the general election, when I think the public delivered their verdict on the progress that it had made. NHS dentistry is non-existent in huge parts of the country. We will stick with some aspects of the previous Government’s dental recovery plan because they are the right solutions, but there are gimmicks that we will not proceed with. We will come forward with a serious plan to reform the dental contract, which the Conservatives committed to in 2010 but failed to do in every single year of their 14 years.
Layla Moran (Oxford West and Abingdon) (LD)
I have a constituent who has been trying to get a dentist appointment for a year. They have painful abscesses, cannot sleep and cannot eat using the right side of their mouth. We need to get on with this. I note that a review of the NHS has been launched, but the British Dental Association is concerned that that review will delay the changes to NHS dentistry that are so desperately needed. Will the Secretary of State give us a timeline for when we will see change?
Wes Streeting
I am grateful to the hon. Member for her question and congratulate her on her re-election to the House. She is right to point to the detrimental impact that the Conservatives’ failure is having on people’s lives. In fact, in 1948, when the national health service was founded, Nye Bevan received a letter from a woman who had worked her entire life in the Lancashire cotton mills about how the dentistry she was given by the national health service had given her dignity and the freedom to associate in any company. What a tragedy that 76 years later, the Conservative party has squandered and destroyed that legacy to the point where people are suffering not just pain and agony, but the indignity of being unable to find a job and unable to socialise in polite company because they are ashamed of the state of their rotting teeth.
The hon. Member is absolutely right: Lord Darzi is conducting a review on the state of the NHS, and it will report in September. That is not preventing us from making progress, talking to the BDA and working within the Department and across the sector to get those 700,000 appointments up and running as a matter of urgency. I look forward to reporting the progress to her and other right hon. and hon. Members.
Joe Robertson (Isle of Wight East) (Con)
As the right hon. Gentleman is aware, there is a particular shortage of NHS dentists in coastal and rural communities such as mine on the Isle of Wight. Will he therefore commit to the previous Government’s plan for 240 golden hellos for newly qualified dentists by the end of the year to address that issue?
Wes Streeting
I welcome the hon. Member to the House—it is a rare thing to welcome new Conservative Members, and he is welcome. He is absolutely right to touch on the workforce issues in NHS dentistry, and to say that we need to incentivise dentists, on two fronts: we need them to commit to and do more work in the NHS—we are looking at a range of things in that regard—and we need to ensure that we get more dentists to the areas in which they are most needed. We will certainly support incentives to that effect.
Saqib Bhatti (Meriden and Solihull East) (Con)
I welcome the right hon. Member and his new team to their places in the Department. The shadow Secretary of State, my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins), prioritised access to care, including NHS dentistry, when she was Secretary of State. The dental recovery plan that she launched announced new dental vans to provide access to care to our most rural communities and coastal communities in England. We had agreed with NHS England that the first vans would be on the road by this autumn, and I know that that timescale was welcomed by colleagues across the House. Will he confirm that dental vans will be on the road by this autumn?
Wes Streeting
I could not have picked a better example of the previous Government’s desperately low ceiling of ambition than the fact that, after 14 years, they laud their triumph of dental vans roaming the country in the absence of actual dentists and dental surgeries. What an absolute disgrace. I accept that the shadow Secretary of State for Health and Social Care was just the last in a very long list of Health and Social Care Secretaries who had the chance to fix the problems. It was not all on her, and it is important that I say that—not least because of the Conservative leadership election that will be taking place soon.
I congratulate the shadow Minister, the hon. Member for Meriden and Solihull East (Saqib Bhatti), on his appointment, but he sat behind Secretaries of State as their Parliamentary Private Secretary year after year, week after week, looking at the utterly abysmal failure of their record. When it comes to criticising this Government on the actions that we will take, the Conservatives do not have a leg to stand on.
Steff Aquarone (North Norfolk) (LD)
Cat Smith (Lancaster and Wyre) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
It is painfully clear that the previous Government’s new hospital programme—they said that they would deliver 40 new hospitals by 2030—is not deliverable in that timeframe. I want to see the new hospital programme completed, but I am not prepared to offer people false hope about how soon they will benefit from the facilities they deserve. That is why I have asked officials as a matter of urgency to report to me on the degree to which the programme is funded along with a realistic timetable for delivery. We will not play fast and loose with the public finances, nor will we play fast and loose with people’s trust as the previous Government did.
Cat Smith
Lancaster’s royal infirmary is at capacity. It is a Victorian hospital, and I am sure it was cutting-edge back then, but it is now not fit for purpose. Yesterday, the joint investment strategic committee expressed its support for the new build scheme in Lancaster, so it will soon be on the Secretary of State’s desk. Will my right hon. Friend commit to meeting me and other interested local MPs in north Lancashire to ensure that, after 14 years of chaos under the Conservatives, the Labour Government will deliver a new hospital for Lancaster?
Wes Streeting
I was about to say, Mr Speaker, that the good people of Lancaster and Wyre will be delighted to have sent my hon. Friend to Parliament, because she is second only to you in collaring me about a local hospital project—you are the holder of that record. There is a serious point: thanks to her determined efforts to collar me around the parliamentary estate, I know the particular urgency around land. A scheme will be put to me shortly, which I will consider carefully, and I will look at the programme in the round and ensure that I am able to come back to this House and to the country with promises that we can keep and that the country can afford.
James Wild (North West Norfolk) (Con)
During the general election campaign, Labour said it was
“committed to delivering the new hospitals programme, including modernising the QEH at Kings Lynn to address its potentially dangerous RAAC”.
Will the Secretary of State honour that pledge, which was made to my constituents and to the staff at QEH, and approve the business case submitted by the trust for the new multi-storey car park, which is a key enabling project for the new hospital that we need by 2030?
Wes Streeting
Hospitals with reinforced autoclaved aerated concrete are at the top of my list of priorities. I am extremely concerned about the dire state of the NHS estate. Once again, I think that is a bit rich from Opposition Members, whose party was in government only weeks ago. They had a Prime Minister local to that hospital, and they did not do anything when they had the chance, but they should not worry—we will clean up their mess.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
I congratulate the right hon. Gentleman on his position. I should declare that I have been working in the NHS for 23 years, currently as an NHS consultant paediatrician. I look forward to using that experience in my new role as shadow Minister of State to scrutinise the Government constructively.
Under the new hospital programme, the previous Government had already opened six hospitals to patients, with two more due to open this financial year and 18 under construction. The Government are now putting that at risk by launching a review of that work, delaying those projects, which are vital to patients across the country. Could the right hon. Member please confirm when the review will be completed?
Wes Streeting
First, I welcome the hon. Lady to her new post. I must say I preferred her much more as a Back-Bench rebel than a Front-Bench spokesperson, but I have enormous respect for her years of contribution to the NHS and the experience that she brings to this House. I always take her seriously.
However, on this one, once again I say to the Opposition that they handed over an entirely fictional timetable and an unfunded programme. The hon. Lady might not know because she was not there immediately prior to the election, but the shadow Secretary of State, who is sitting right next to her, knows exactly where the bodies are buried in the Department, where the unexploded bombs are, and exactly the degree to which this timetable and the funding were not as set out by the previous Government.
Daisy Cooper (St Albans) (LD)
I welcome the Secretary of State and his Ministers to their roles, but let me gently warn him that if he intends to run a contest on which Member can harangue him the most on crumbling hospitals, our 72 Liberal Democrat MPs say, “Challenge accepted.”
Under the Conservatives, the new hospital programme ground to a halt. We know the terrible stories of nurses running bucket rotas and all the rest. We have the worst of all worlds at the moment: trusts such as mine in west Hertfordshire are champing at the bit to get going but cannot, and are being held back. Other trusts have capital funds that they want to spend but are not allowed to because of outdated rules, and there are industry concerns that the one, top-down, centralised approach of the Conservatives could decimate competition in that industry, when we need a thriving industry to rebuild our hospitals and primary care. What is the Secretary of State’s response to that approach?
Wes Streeting
I welcome the hon. Lady back to her place. We worked constructively on the Opposition Benches together and, regardless of the size of the Government’s majority, we intend to work constructively with her on this side of the election, too. By extension, I congratulate her colleagues on their election. I have discovered that I have 72 new pen pals, all sitting there on the Liberal Democrat Benches, and they have been writing to me about a whole manner of projects. My colleagues and I will get back to them.
The hon. Lady is right that this is not just about the new hospitals programme, important though that is; the condition of the whole NHS estate is poor. In fact, backlog maintenance, the direct cost of bringing the estate into compliance with mandatory fire safety requirements and statutory safety legislation, currently stands at £11.6 billion. That is the legacy of the last Conservative Government.
Bell Ribeiro-Addy (Clapham and Brixton Hill) (Lab)
Carolyn Harris (Neath and Swansea East) (Lab)
The Secretary of State for Health and Social Care (Wes Streeting)
Our NHS is broken. This Government have been honest about the problems we face because we are serious about fixing them, and we have not wasted a moment. We have appointed Lord Darzi to carry out an independent investigation of the state of our NHS, we are resetting the relationship with junior doctors with negotiations starting today, and we are laying the foundations for the delivery of 40,000 more appointments a week to cut waiting lists. The Gracious Speech kick-started a decade of national renewal, with modernisation of the Mental Health Act as well as the smoking reform, which will ensure that this generation of young people is the first smoke-free generation, and will be the first step towards ensuring that that generation is the healthiest in history.
Carolyn Harris
During their free NHS 40-plus health checks, women are assessed for conditions that may affect them as they grow older, but menopause is not included. To include it would be cost-neutral and would not only help millions of women to recognise the symptoms, but prevent needless GP appointments when those symptoms start to develop. Along with Menopause Mandate, I have been campaigning tirelessly on this issue. Will the Secretary of State please look into it as a matter of urgency?
Wes Streeting
I am delighted to see my hon. Friend back in the House. She campaigns relentlessly on this vital issue, and it would be very risky for me to do anything other than agree to meet her, because I share her view that progress needs to be made on it.
Victoria Atkins (Louth and Horncastle) (Con)
May I welcome the Secretary of State and his ministerial team to their places, and wish them well in their endeavours? With your indulgence, Mr Speaker, I should also place on the record my thanks to my superb team of former Ministers, to those in the private office and to officials in the Department for their hard work and support, as well as thanking the doctors, nurses and social care and health professionals with whom I have had the pleasure of working.
Now, to business. In opposition, the Secretary of State described the 35% pay rise demand by the junior doctors committee as “reasonable’. What he did not tell the public was that this single trade union demand would cost an additional £3 billion, let alone the impact on other public sector workers. Will he ask the Chancellor to raise taxes, or will she ask him to cut patient services to pay for it?
Wes Streeting
May I welcome the shadow Secretary of State to her new position? She has behaved in her typically graceful and decent way. I enjoyed working with her on that basis, and will continue to do so. Although, I must confess that when I heard about the “abominable” behaviour of the shadow Health Secretary, I thought, “What on earth have I done now?” Then I remembered that our roles have swapped, and that it was not me they were referring to.
What I said was that the doctors were making a reasonable case that their pay had not kept in line with inflation, but we were clear before the election that 35% was not a figure we could afford. We are negotiating with junior doctors in good faith to agree on a settlement that we can deliver and that the country can afford.
Victoria Atkins
I am afraid I do not like it when Secretaries of State do not answer questions, and I am sorry to say that the right hon. Gentleman gave another non-answer, as has been the case for those on the Government Front Bench. I have a question that I hope he will be able to answer. The final act of the Conservative Government was to protect children and young people by banning private clinics from selling puberty blockers to young people questioning their gender. Will the right hon. Gentleman confirm that he will resist the voices of opposition on the Benches behind him and implement in full all of Dr Cass’s recommendations, including exercising “extreme caution”, as she said, in the use of cross-sex hormones in young people? They and their parents deserve certainty from this Government.
Wes Streeting
Obviously, there is a judicial review of the former Secretary of State’s decision, which I am defending. The matter is sub judice, so I will steer clear of it.
To go back to first principles, we are wholeheartedly committed to the full implementation of the Cass review, which will deliver material improvements in the wellbeing, safety and dignity of trans people of all ages. I think that is important. I want to reassure LGBT+ communities across the country, particularly the trans community, that this Government seek a very different relationship with them. I look at the rising hate crime statistics and trans people’s struggles to access healthcare, and I look at their desire to live freely, equally and with dignity. That is what we will work with them to deliver.
Mr Speaker
Order. I understand that today is a new start with Question Time, but we have to be short and speedy. That is the whole idea of oral questions, because otherwise Members are not going to get in.
Blake Stephenson (Mid Bedfordshire) (Con)
Wes Streeting
I am proud that the Deputy Prime Minister will be delivering the commitment to build 1.5 million new homes. It is absolutely vital that the infrastructure needed is delivered alongside those new homes, and we and other colleagues across Government will be working very closely with the Deputy Prime Minister to make sure that the social infrastructure is also provided.
Tom Rutland (East Worthing and Shoreham) (Lab)
Victoria Collins (Harpenden and Berkhamsted) (LD)
Wes Streeting
I warmly welcome the hon. Member to her place. She is absolutely right to raise the plight of unpaid family carers. They are part of the team, as far as this Government are concerned, so as we set out our 10-year plan for social care as part of our ambition to build the national care service, we will make sure that unpaid family carers are very much at the centre of our thinking, in no small part thanks to her representations.
Sean Woodcock (Banbury) (Lab)
Wes Streeting
Of all the issues that keep me awake at night, maternity safety is top of the list. We have already heard about the staffing shortages and the actions we will take to address that, but I also want to reassure people that, as we build our 10-year plan for the NHS, patient voices, including those of recent and expectant mothers, will be part of that process.
Kit Malthouse (North West Hampshire) (Con)
During the election campaign the Prime Minister came to Basingstoke on a visit and specifically promised to replace Basingstoke hospital by 2030. Can we rely on that promise?
Wes Streeting
I would not rely on anything the former Prime Minister said—[Interruption.] Oh, our Prime Minister? I thought the right hon. Gentleman was talking about the former Prime Minister. In that case, I can reassure him that we are absolutely committed to the new hospitals programme. On the budgets and the timescales, as I have said, we will come forward with an honest appraisal of what we have inherited from the last Government and what we will be able to deliver within reasonable timescales.
Matt Western (Warwick and Leamington) (Lab)
Dan Tomlinson (Chipping Barnet) (Lab)
Wes Streeting
I am delighted to welcome my hon. Friend to his place. I am personally grateful to the Royal Free hospital for saving my life when I went through kidney cancer. NHS waiting lists stand at 7.6 million, which was still rising as this Government took office. Our 40,000 extra appointments, scans and procedures and our doubling of the number of diagnostic scanners will make a real difference to getting that backlog down to where it should be.
Lee Anderson (Ashfield) (Reform)
During the general election campaign, the Health Secretary visited King’s Mill hospital in Ashfield, and I am sure that helped me to get re-elected. King’s Mill was built on a private finance initiative deal by the last Labour Government and is going to cost £3 billion for a £300 million hospital. Will the Secretary of State please now assure me and the people of Ashfield that this will never happen again?
Wes Streeting
Despite my best efforts, the hon. Gentleman is back. I congratulate him through gritted teeth.
I was very impressed by what I saw at King’s Mill hospital, and I am proud of the last Labour Government’s record of delivering the shortest waiting times and the highest patient satisfaction in history. As I said during the election campaign, we will build on that success and learn from some of our shortcomings, too.
Danny Beales (Uxbridge and South Ruislip) (Lab)
Wes Streeting
I welcome my hon. Friend to his place. Better late than never, as they say.
I have been to Hillingdon hospital, which has amazing staff and appalling buildings. That is why the people of Hillingdon, and people right across the country, deserve honesty, clarity and certainty about the new hospitals programme. This Government will provide it and stick to it.
Esther McVey (Tatton) (Con)
Does the Secretary of State agree that handing over powers to the World Health Organisation, undermining the UK’s ability to make its own sovereign decisions, would be unacceptable?
Wes Streeting
The World Health Organisation is an intergovernmental arrangement. It is of vital importance that, first and foremost, we agree only to things that are in our national interest, but we should not lose sight of the fact that there are lots of things that we need to do together in pursuit of our national interest, from tackling antimicrobial resistance to preventing future pandemic threats. That is exactly what we will do.
Marsha De Cordova (Battersea) (Lab)
Wes Streeting
I would be delighted to do that. As my hon. Friend knows, we visited Specsavers during the election campaign. There are lots of high street opticians, and they can make a real difference to cutting the backlog. The Conservatives should have gone to Specsavers, and this Government will.
Wendy Chamberlain (North East Fife) (LD)
My constituents have struggled to get pre-diagnosis ADHD and autism support for their young daughters. We cannot diagnose children at a very young age, but that does not mean that families do not need help. Can the Minister confirm what engagement he will have with support organisations such as the National Autistic Society to ensure that best practice means that families are not struggling for support?
NHS
Wes Streeting Excerpts(6 months, 2 weeks ago)
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Wes Streeting (Ilford North) (Lab)
Let me start with a few points of genuine consensus. First, I associate myself and my party wholeheartedly with the right hon. Lady’s remarks about the hon. Member for South Thanet (Craig Mackinlay) and the extraordinary courage and strength he has shown. I greatly welcome her reassurance to victims of the contaminated blood scandal and the emphasis she placed on the cross-party commitment to continue at pace to deliver justice, whatever the outcome of the general election. I also welcome what she said about the justifiably cautious and responsible approach she is taking in relation to puberty blockers in the light of the Cass review.
That is the end of the consensus, however, because after 14 years of Conservative incompetence, neglect and vandalism, the national health service has never been in a worse state. The Government cut 2,000 GPs and now it is impossible to get an appointment. They wasted billions of pounds on top-down reorganisations, recruitment agencies and crony contracts for useless personal protective equipment instead of training the workforce the NHS needs. They forced nurses out on strike for the first time in history; and now the Prime Minister shamelessly tries to blame them for his own failures, sending the country into an election with strike action still looming. He promised to cut waiting lists; they are up to 7.5 million. Even their claim that waiting lists have fallen in the last six months has been achieved only by excluding the community figures—fiddling the figures. He promised to build 40 new hospitals and the Government have failed to build a single one. They hold people in this country in such contempt: the Conservatives think the public are so stupid that they will fall for the same recycled soggy promise all over again. Vast swathes of the country have been left without a single NHS dentist, forcing people in Britain, in 2024, to perform DIY dentistry on themselves.
After 14 years, the fundamental promise of the NHS has been broken: people can no longer be sure the NHS will be there for them when they need it. Listening to the Prime Minister’s interviews this morning, it is clear he has given up on the NHS. He has called this election with no plan to cut waiting lists, no plan to end the strikes, and no plan to reform the service. The Conservatives have taken the NHS to breaking point; if they are given five more years, they will finish the job.
This election is the country’s chance to turn the page on 14 years of failure, to end the chaos in the NHS and to rebuild our NHS. No part of our country is crying out louder for change than our health service—not just investment but reform, because if the NHS is to be there for us free at the point of use for the next 75 years, as it has been in the last, it must change. Only Labour can deliver that change.
Our damp squib of a Prime Minister is dripping into this election with a puddle not a plan. In contrast, Labour has a plan to get our NHS back on its feet and make it fit for the future. [Interruption.] Conservative Members ask what it is: give the people what they want—40,000 extra appointments a week at evenings and weekends to cut waiting lists; double the number of scanners, with AI-enabled scanners diagnosing patients faster; 700,000 emergency dental appointments and reform of the contract to rescue NHS dentistry; double medical school places and train thousands more nurses, GPs and midwives, delivering Labour’s workforce plan; bring back the family doctor so patients can see the same GP for each appointment; 8,500 mental health professionals to treat people on time, with mental health support in every school and hubs in every community, alongside landmark reform of the Mental Health Act 1983. That is Labour’s plan, and that is just the start. More than that, unlike the Conservatives, we have a record on the NHS to be proud of: a record of the shortest waiting lists and the highest patient satisfaction in history. We did it before, and we will do it again. That is why representatives of the nationalist parties in Wales and Scotland know, and even admit in private, that a Labour Government in Westminster will be a rising tide that lifts all ships across our United Kingdom.
I say to people that it is not enough to send MPs to Westminster to oppose the Conservatives; they need to send Labour MPs to replace the Conservatives. If they are given five more years, nothing will change. The chaos will continue, and the NHS crisis will get worse. As we approach this general election, be in no doubt: the only way to deliver the change our country needs is to vote Labour. I have every hope that our country will do just that.
Victoria Atkins
I know that the hon. Gentleman has spent a lot of time in recent days studying that infamous pledge card. It has obviously taken up a lot of space in his brain, because he seems not to have understood that not only did we settle months ago with the consultants, so they are not on strike, but we have arrived at a settlement with the specialty and specialist doctors, which is going out to ballot. He asked about junior doctors, and he has obviously missed the news that we have just entered mediation with them. We are bringing together, with the workforce plan, the progress we are making on working conditions. The Labour party does not like conversations about mediation—no, no, no —because we all know that Labour MPs are beholden to their trade union masters and have never condemned a single strike that has affected our constituents and their access to healthcare.
The hon. Gentleman asks about the new hospital programme, and I was wondering whether he would. It is, as some might say in politics, bold. I have taken the trouble—it was a lot of trouble—to read the Labour party’s health mission. One of its pledges is that one of the first steps of a Labour Government would be to pause all capital projects in the NHS. Our constituents should be clear: the Conservatives have a new hospital programme, which we are delivering; the Labour party has a no new hospital programme.
The hon. Gentleman also talked about the ideas for the NHS—ones he could not quite remember over the weekend—and the number of appointments that Labour would bring. I think it was appointments, because when he was asked to clarify whether he meant appointment or treatments, he could not define it. I hate to break it to him, but there is a difference between an appointment and, for example, a triple heart bypass. I would love to know whether he is talking about appointments or treatments. Just to help him understand the scale of NHS England’s activities on a weekly basis, it provides 575,000 out-patient appointments a week. His pledge sounds like a big number, but the truth is that it will not even touch the sides, even when Labour has worked out where the sides are.
The hon. Gentleman also bravely talks about the Cass review, and I genuinely welcome the fact that he has thrown away his long-held principles and relied on the evidence that Dr Cass provided, but I wonder whether he ought to have a conversation with his fellow shadow Cabinet members, because they announced a policy this week that is self-identification by the back door. They want to put the responsibility for self-identification and the gender recognition certificate process on the shoulders of our GPs, when we have been clear that we want our GPs focusing on the 60 million more appointments they are making in the past year. He does not understand—[Interruption.] Forgive me, he is chuntering at me, and he needs to go away and read the Gender Recognition Act 2004, because it is a panel that looks after that process, and Labour is seeking to change that to make it a single GP.
The hon. Gentleman talks about the record of the Conservative party, and we are proud of it. I am particularly proud of the fact that we have record funding under the Government for mental and physical health. I wonder whether he is quite so proud of the record in Wales. By the way, Labour runs the NHS in Wales; I wish I had responsibility for Wales, but I only have responsibility for England.
Victoria Atkins
It is going better than it is in Wales. Under the Labour-run NHS in Wales, a quarter of people are on a waiting list in that part of the NHS. The number of patients waiting two years is higher in Wales than it is in England. Patients are waiting on average six weeks longer in Labour-run Wales than in England. If that performance were replicated here in England, waiting lists could be as much as six million higher. The choice is clear: unfunded Labour failure or a clear plan for a more secure future with the Conservatives.
Oral Answers to Questions
Wes Streeting Excerpts(7 months, 2 weeks ago)
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Wes Streeting (Ilford North) (Lab)
Happy St George’s day, Mr Speaker.
Westminster is awash with rumours that the Prime Minister will call a July general election, presumably to avoid giving his Rwanda gimmick the time to fail. I have a very simple question for the Minister: will he repeat the pledge that the Prime Minister made last year and promise that NHS waiting lists will be lower at the time of the general election than when the Prime Minister came to office?
Andrew Stephenson
The Prime Minister has been very clear that getting waiting lists down is one of his top priorities, but he has also been clear that performance has been disappointing. One reason is that 1.4 million procedures have had to be rescheduled because of industrial action. I would gently ask the shadow Secretary of State whether he condemns those strikes.
Wes Streeting (Ilford North) (Lab)
The Health Secretary has promised that the Government will provide an extra 2.5 million dental appointments this year, but the dentistry Minister, the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), says the figure has
“a high likelihood of not being reliable”.
Which one of them is wrong?
Victoria Atkins
I am delighted to be able to tell the hon. Gentleman that we have modelled down the ambitions, so the figure we initially provided was higher than 2.5 million appointments. That is because we are focused on delivering the dental recovery plan, rather than overpromising.
The hon. Gentleman finds it easy to call our children short and fat, but he shies away from welfare reform, calling it shameless and irresponsible. He says he is ready to stand up to middle-class lefties, but Labour has never put patients first by condemning the unions that strike. He makes glossy promises about reforming the NHS in England, yet Labour has failed completely—
Mr Speaker
Order. I gently say that we need to get a lot of Back Benchers in, and I am sure both sides want to do that.
Wes Streeting
The last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history, which is a record that the right hon. Lady’s Government cannot begin to touch.
Back to dentistry, the chief dental officer says the announcement is “nowhere near enough.” The British Dental Association says:
“This ‘Recovery Plan’ is not worthy of the title.”
It also says that the recovery plan will not stop the “exodus” of dentists and will not meet the Government’s targets. Who should the public trust, and why should they trust the Health Secretary to deliver when her own adviser, her own Minister and, crucially, dentists all say that she is brushing the truth under the carpet?
Victoria Atkins
Again, let us bring ourselves back up to date. I know the Labour party likes looking back to the last time it found favour with the British public, but Wales is the up-to-date record of today. Labour’s lamentable record of running the NHS in Wales speaks for itself. If the hon. Gentleman is so set on reform, why on earth is he not helping his Labour colleagues in Wales to do exactly as he is promising? It is because they are empty promises, and because the hon. Gentleman and, I am afraid, the Labour party will step back from reform rather than grappling with the issues, as we are doing with our recovery plan.
Finally, on the dental recovery plan, within a month of the new patient premium being switched on, hundreds of surgeries have opened to new patients, which means that patients in the hon. Gentleman’s constituency and elsewhere are getting the care they need.
Tobacco and Vapes Bill
Wes Streeting ExcerptsTuesday 16th April 2024
(7 months, 3 weeks ago)
Commons ChamberRead Full debate Tobacco and Vapes Bill 2023-24 View all Tobacco and Vapes Bill 2023-24 Debates Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Wes Streeting (Ilford North) (Lab)
Until the early 2000s, every pub you walked into was filled with smoke. One in every four people in this country was a smoker. The last Labour Government banned smoking in public places, which had an enormous impact on the health of our nation. The following year, there were 1,200 fewer hospital admissions for heart attacks, according to the British Medical Journal. Since 2007, the number of people who smoke has been cut by almost a third. Our understanding of second-hand smoke grew, and there was a cultural change around where it was acceptable to smoke. Even at home, people went outside to smoke, instead of smoking in front of their children.
A study in Scotland found that whereas hospital admissions for children with asthma were increasing by 5% a year before the smoking ban, admissions were down by 18% in the three years following Labour’s legislation. In short, Labour helped to build a healthier society: smoking was down, the number of patients needing treatment was down, NHS beds were freed up and lives were saved. But there is more to do. During the 13 years when Labour was last in office, life expectancy was extended by three and a half years, but in the 14 years that the Conservatives have been in office, it has grown by just four months. For men, it is beginning to decline. We are falling into ill health earlier in life today than we were a decade ago, which is a shameful indication of our country’s decline.
What more motivation could this House need for once again taking seriously the health of our nation? Today, smoking remains a scourge on our society. Some 75,000 GP appointments every month are to deal with the impacts of smoking. The cost to our economy, after taxes, is £10 billion. Around 80,000 of our friends, neighbours and colleagues lose their lives to smoking every year. It is a lethal addiction, a scourge on society, an enormous burden on our NHS and a drag on our economy, and it is time to consign it to the dustbins of history. Let us act today so that the next generation of young people can live healthier, happier and longer lives than the generations before them.
Labour will give our wholehearted support to this Bill. In fact, we needed no persuasion. In an interview with The Times in January last year, I said that it was time for a New Zealand-style smoking ban. I argued that a progressive ban would have a transformational impact on the health of individuals, the health of the nation as a whole and the public finances.
After around two and a half years in this job, I am getting used to the Government nicking Labour’s policies. In the last year alone, the magpies opposite have swooped in on Labour’s NHS workforce plan, Labour’s plan to recruit dentists in the most under-served areas, Labour’s plan for a windfall tax on oil and gas giants, and Labour’s plan to abolish the non-dom tax status. Even so, I was shocked when I saw that the Conservative party—the party of Ken Clarke—is nicking the Labour party’s plan for a progressive ban on tobacco. Of all the policies that the Conservatives have adopted from the Labour party in the past few years, nothing shows our dominance in the battle of ideas more than this latest capitulation.
Where Labour leads, the Conservatives follow. Indeed, when I first floated this proposal, Conservative MPs called it “nanny state” and
“an attack on ordinary people and their culture”,
and I was accused of “health fascism”. What irony, when Conservative MPs are overseas today in Brussels, lining up with the European far right. Anyway, it is water off a duck’s back to me. I am delighted that just a few months later the Prime Minister announced this policy at the Conservative party conference, and that a Conservative Health Secretary has brought this progressive ban before Parliament today.
However, it seems that not every Conservative Member got the memo. It has been widely reported, and we have seen indications of it today, that there are still Members on the Conservative Benches—as many as 100, if we believe rebel Tory briefings to the media, although in our experience these Tory rebellions tend to evaporate when the moment comes—who resist the new interventionist consensus, who continue to fly the flag for small-state libertarianism, and who believe that the Health Secretary and the Prime Minister have surrendered to the lobbying of big health and those tyrants in Action on Smoking and Health, the British Heart Foundation, Cancer Research UK, Diabetes UK, Alzheimer’s Research UK, Mind, Asthma and Lung UK, the Royal College of Physicians, the Royal College of General Practitioners, the Royal College of Paediatrics and Child Health, the Royal College of Midwives and the British Medical Association. Well, we happily align ourselves with big health in defence of the nation and we are only too happy to defend the Health Secretary against the siren voices of big tobacco that we see gathered around our former Prime Minister, the right hon. Member for South West Norfolk (Elizabeth Truss), in the corner of the Chamber today.
Sir Jake Berry
On the issue of unity, does the hon. Gentleman agree with the comment made by his colleague the hon. Member for York Central (Rachael Maskell) that if we bring in a progressive ban on cigarettes, we should mirror it with a similar ban on vaping? If he becomes Health Secretary, will that become the policy that he will promote?
Wes Streeting
My hon. Friend the Member for York Central made the really good point—a point that needs to be well understood in the context of this debate—that vaping is undoubtedly, unquestionably a useful smoking cessation tool, but we should not send the message to the country that vaping is good for our health or that it is without harmful consequences. When it comes to banning things, it should be on the basis of evidence and there should not be a predisposition to ban. I have not yet seen evidence to persuade me that vaping is harmful enough to introduce a ban of the sort suggested by my hon. Friend the Member for York Central. I hope I can reassure the right hon. Gentleman that, when the general election eventually comes, the Labour party will not go around trying to ban things left, right and centre, but I certainly want to consign to the history books the 244,000 people on NHS waiting lists in his area as a direct result of the policies of the Government whom he supports and has served.
Wes Streeting
I will happily give way. Perhaps the right hon. Gentleman would like to take the opportunity to apologise to his constituents in Rossendale and Darwen for his abysmal record in government.
Sir Jake Berry
I will resist the hon. Gentleman’s offer. He has just said that vaping should only ever be used to help people to stop smoking cigarettes. If this Bill passes, it will be illegal for people who are now aged 15 ever to smoke cigarettes, so there will be no requirement in his world for them ever to vape. So I repeat the question, which he has refused to answer: will the Labour party bring forward—this is supported by his own party—a ban on vapes to mirror the tobacco ban? Yes or no?
Wes Streeting
The record will show that I answered the right hon. Gentleman’s question. I talked about banning things and taking away people’s choice, and there are plenty of things that we do on a daily basis that might be harmful to our health in some way. Indeed, participating in most physical contact sports carries a risk of injury, but we are not going to ban football, rugby or boxing. I refer him to my previous answer, which is that I have not seen evidence to persuade me to ban vaping in the way that this Government are proposing to phase out smoking. I have answered that question already and I answer it again now, but I am sure that it will not be lost on the people of Rossendale and Darwen that he did not take the opportunity to apologise to the 244,000 people in his area who are stuck on record long waiting lists.
Once again, the Prime Minister has shown that he is too weak to stand up to his party. The psychodrama in the Conservative party is being put before the interests of the country. In the press today, the Secretary of State for Business and Trade, the right hon. Member for Saffron Walden (Kemi Badenoch) is the latest to let it be known that she will be opposing this Bill. Journalists were helpfully pointed towards comments about her belief in the limits of the state made during her last leadership campaign. I say “her last leadership campaign”, but I am sure that it will not be her last leadership campaign. Indeed, I do not think it has ever stopped. Anyway, that is what she said. In fact, she bemoaned Governments who try to “solve every problem”. Well, if she has a problem with Governments solving problems, she must be delighted with the record of this Government, who can barely solve any problems. They cannot even solve the chaos in their own party.
The Business Secretary is not the only one who is desperate to tell Conservative party members that they oppose this Bill. The former Prime Minister joins us today. The right hon. Member for South West Norfolk and recently declared candidate to be the next leader of the Conservative party, has said that the Bill is “profoundly unconservative”. A stopped clock is right twice a day, and I find myself agreeing with the former Prime Minister. This is absolutely an un-Conservative Bill. It is a Labour Bill, and we are delighted to see the Government bring it forward. [Interruption.] Yes, even this stopped clock is right twice a day for the Trussites in the corner. The right hon. Lady is in fine company when it comes to former Prime Ministers. Boris Johnson has said that this proposal is
“absolutely nuts…It’s just mad”.
Well, now he knows how the rest of us felt when he was Prime Minister.
The right hon. and learned Member for Fareham (Suella Braverman) could not be with us today because she is currently in Brussels surrounded by the police who are trying to shut down the event she is attending with some far right fanatics, with whom she has much in common. A source close to the right hon. and learned Lady has said that she is “not a fan” of the Bill. Well, now she knows how the rest of us feel about her, too.
Some dark horses have also spied an opportunity to play to the gallery. It seems that even my former bête noire, the Secretary of State for Environment, Food and Rural Affairs, the right hon. Member for North East Cambridgeshire (Steve Barclay), fancies his chances in the ongoing battle for the Conservative leadership, because he too has come out against this Bill. To be fair, he has a strong case for the leadership of the Conservative party. As Health Secretary, he had to face a workforce in constant dispute with him, which is good practice for dealing with the party, and he has to deal with a steady stream of toxic sewage in his current job, so who could be more experienced in coping with the travails of the modern Conservative party than the right hon. Gentleman?
I want to praise the one member of this Government who has consistently made the case for the Government’s Bill. No, of course I am not talking about the Prime Minister. Since his party conference speech in October he has shrunk away from the debate, once again too weak to stand up to his own party, and instead left it to others to make the case for him. To her credit, the Health Secretary has cast aside any leadership ambition she may have once held and come out in full-throated defence of Labour’s policy. So let me assure my comrade opposite that we will stand with her today in the voting Lobby, even as the forces of conservatism stand against her.
Sara Britcliffe (Hyndburn) (Con)
Going back to the subject of what we are trying to debate rather than playing a political game, I hope that the hon. Gentleman is not going to pick up a sheet and throw some figures at me, because this is a serious question. When my hon. Friend the Member for Dartford (Gareth Johnson) asked a question about a consultation on vaping, those on the Opposition Front Bench shook their heads at the idea. Can I ask why? As a former smoker myself, I have moved to vaping in order to quit smoking, and I genuinely think that this issue needs to be considered. I ask the hon. Gentleman a simple question: why does the Labour party think a consultation should not go ahead?
Wes Streeting
I am grateful to the hon. Lady for her intervention. It falls to me to defend the Government against their own Members, but to be fair to this Government, they have consulted on measures to clamp down on inappropriate vaping. They have consulted, and we have been urging them to go faster in cracking down on the sale of vapes to under-age people in this country—a generation of young people who have become addicted to nicotine. I will talk about that further on in my speech.
The Government have consulted and the Bill will go through the legislative process. We will no doubt have a rigorous debate today and in the Bill Committee. It will then report to this House and then go to the House of Lords, where it will be continue to be scrutinised, and it is unacceptable that there are still people who would tie the Health Secretary’s hands behind her back and slow her down when urgent action is needed to clamp down on the people who are selling nicotine to children. Those people are addicting children to nicotine. I do not understand why on earth the Trussites in the corner are trying to tie the hands of their own Health Secretary when she is trying to do the right thing by young people.
Sara Britcliffe
The hon. Member is putting me on the wrong side of this argument as a former smoker, so I would appreciate it if he had a little bit more respect. What I am trying to ask is this: why does he not agree that people who are using vaping as a substitute for smoking should be consulted on what they believe should happen through this Bill?
Wes Streeting
I do not know whether there is a problem with the speaker system in here, because this is the second time I have had an intervention after answering the question. I have already said that the Government have consulted on measures to clamp down, and I am absolutely not against the Government talking to people who, like the hon. Lady, have used vaping as a smoking cessation tool. In fact, I fully support the point she is making, which is that vaping can be a really effective tool to help smokers to quit smoking. I am in favour of that; that is good for health. If the Government want to talk to and engage with people who vape as part of the passage of this Bill, that is absolutely fine. What I am not in favour of is tying the Secretary of State’s hands when she wants to do more, and more quickly, to prevent children becoming addicted to nicotine.
Victoria Atkins
Just to be clear, we will consult on this. It is a simple question that requires a simple answer: will Labour consult further?
Wes Streeting
Mr Deputy Speaker, we are now in this parallel universe where the Secretary of State is asking me, the shadow Secretary of State, whether I am going to consult on her Bill. Now, I am willing to help her out, but if she wants me to sit on that side of the Chamber and run the Department of Health and Social Care, I am ready and willing, but we need a general election to do that. I do not understand—this is just extraordinary. I feel like I am living in a parallel universe this afternoon. It was bad enough when the former Prime Minister, the right hon. Member for South West Norfolk, walked in with her book and her fan club, and now we have the absurd spectacle of the Secretary of State asking me whether I will run the consultation on her Bill. This is extraordinary. I will allow her to correct the record and save her blushes.
Victoria Atkins
The hon. Gentleman is not listening. He has been asked repeatedly whether he supports the concept of a consultation on vaping in order to ensure that these regulations are drawn up properly. He is not listening. He refuses to answer the question. We on this side of the House are clear: we want to get this right and we will consult. I am simply asking whether he will answer the questions that he has been asked.
Wes Streeting
Honestly, Mr Deputy Speaker, you just can’t help some people. I am trying to help the Secretary of State out and defend her against her own side, and now, to curry favour with them, she has turned on me. Now I know what it is like being in the Conservative party. This is like a 1922 committee meeting—absolutely absurd.
For the final time, let me just explain the situation we find ourselves in today. The Secretary of State is currently in government. This is her Bill. She is taking it through Parliament. She is perfectly able to run a consultation. I will support her in running a consultation, if that is the support she needs. [Interruption.] I am so pleased. If only I had known it was that easy. If all she needed was a bit of moral support from me to run the consultation, then you go, comrade—don’t you worry; I have got your back, and it is absolutely fine.
I am trying to be helpful to the Secretary of State this afternoon, but I just have to say to her that I am not sure that the best way to persuade her colleagues was to invoke the great cigar chomper, Winston Churchill. Some have estimated that Churchill went through 160,000 cigars in his time. Indeed, on one occasion, at a lunch with the then King of Saudi Arabia, Churchill was told that no smoking or drinking would be permitted in the royal presence. He responded:
“If it was the religion of His Majesty to deprive himself of smoking and alcohol, I must point out that my rule of life prescribed as an absolutely sacred rite smoking cigars and also the drinking of alcohol before, after and, if need be, during all meals and in the intervals between them.”
I appreciate the Health Secretary’s efforts, but I fear that Lord Soames was probably on to something when he said that his grandfather certainly would not have approved of this Bill.
Just before any Conservative Members decide to wage yet another culture war and accuse me of talking down one of Britain’s greatest Prime Ministers, I would just add to the historical record that it was thanks to the Labour party that it was Winston Churchill, not Lord Halifax, who became the leader of our country at a crucial time, and thank goodness that he did. Nevertheless, I do commend the Secretary of State on a good effort—she was close, but no cigar. Anyway, let us go back to the economic arguments of the Bill.
Vicky Ford
I want to go back to the point about consultation. I think that the hon. Gentleman has agreed that, for people who smoke cigarettes, moving on to vapes can be helpful. What he may not know is that people who have moved on to those vapes tell us that, if they are unflavoured and just taste of nicotine, they taste revolting. That is why many vapes are flavoured. That is why my hon. Friend the Member for Hyndburn (Sara Britcliffe) may be so concerned about making sure that people’s views are listened to before flavours are removed from the market.
It appears to me that the hon. Gentleman did not get that point, because he was refusing to believe that any such consultation was important. Therefore, out of respect to the people who use these products to stop smoking, can he confirm again that if he is in government at the time, soon after this Bill is passed, he will consult people and listen to their views before banning the products they use?
Wes Streeting
I am grateful to the right hon. Lady for her intervention. I think she makes a perfectly sensible point, actually, and I am perfectly open to lobbying from Conservative Members on how a Labour Government will behave after the general election—she seems to think it is a foregone conclusion, but I certainly do not; we will be working hard for every vote. I can reassure her that our concern has been about children becoming addicted to nicotine. In relation to adult use of vapes as a tool for stopping smoking, I think she makes an absolutely reasonable point about flavourless vaping, and of course she is right that we need to ensure that we get the regulation right on that so that we do not unwittingly deter people from stopping smoking. However, as I will come on to talk about when I come to the vaping section of the Bill, there is no excuse whatsoever for the kinds of flavourings and marketing of vapes that we have seen, which I believe have been deliberately and wilfully designed to addict young people to what is, let us not forget, a harmful substance. I make that very clear.
Anyway, back to the Bill—someone has to defend it, and I get the sense that there are not going to be too many on the Government side, so I will have a go at doing what the Prime Minister is too weak to do and take on the arguments of his own party. They say that the progressive ban on smoking is unconservative. Let me tell them what is unconservative: the heaviest tax burden in 70 years, and it will get heavier if we do not act to prevent ill health.
If we continue down the road that the Conservatives have put us on, with more and more people suffering, falling sick and falling out of the workforce, we will not just be letting those people down; we will all be paying a heavy price for it too. The costs of sickness and disability benefits are due to rise on the Government’s watch, from £65 billion this year to over £90 billion by the end of the next Parliament.
The budget for the NHS is £165 billion this year, and the health service is not coping with existing demands. If society continues to get less healthy, those demands will only rise. If the health service and our welfare service are to be made sustainable for the future, then we must act to prevent ill health in the first place. What better way to do that than by wiping out the leading cause of cancer? It is not just our public finances that are held back by ill health; so too is our economy.
Alexander Stafford
I am trying to follow the hon. Gentleman’s argument to its logical conclusion. He talks about substances that are bad—addictive and harmful to people’s health—and have a huge impact on the NHS through those costs, but there are so many more things that are in fact worse for health. Sugar and salt are highly addictive. Does this mean that Labour’s plan is to ban foods with high levels of salt or sugar? Logically, that is the next step, and therefore, if we need to protect the NHS and cut costs, we should be banning anything that is slightly bad for us, rather than actually taking a better enjoyment of life and saying, “A little bit of what you fancy every now and again is okay, and good for your mental health.”
Wes Streeting
I think that is extraordinary. I do not think that smoking is slightly harmful; I think it is the single biggest cause of cancer, and I think that the costs to people’s health, to our national health service and to our economy are enormous. This sort of argument—that if we ban smoking for young people, we have to ban everything else—is absurd. I think that the Secretary of State just pointed out the absurdity of it when she pointed to a whole range of harmful things in our country that are already banned.
Let me put the question back to the libertarian wing in the corner of the Chamber. Will the new modern Conservative party not ban anything? Will we have a libertarian dystopia in which people are free to do whatever they want in the name of liberty? [Interruption.] I am just trying to help the Secretary of State by taking on the libertarians in the corner. I would be very sad if she wants me to give in to them but, with 187,000 people on the waiting list in the local area of the hon. Member for Rother Valley (Alexander Stafford), I think we should do something about it.
Sir Simon Clarke (Middlesbrough South and East Cleveland) (Con)
I proudly call myself a libertarian, because I believe in the fundamental value of freedom of decision making. On what we should and should not ban, I would argue there is a very substantial difference between banning class A and class B drugs, which do immense harm in all our communities, and banning tobacco. We already struggle to stop the former, so why on earth would we try to create and police a huge black market in the latter?
Wes Streeting
I admire the right hon. Gentleman for sticking to his convictions as a libertarian in making that case, even though I strongly disagree with him, but how far does his commitment to libertarianism go? He is defending the right of our country’s children to become addicted to nicotine for the rest of their life, which is an extraordinary argument. There are 356,000 people in his local area on NHS waiting lists. Does he want a future where that gets worse and the disease burden and cost pressures rise? When he was in government, the low-tax Conservatives crashed our economy and sent people’s mortgages through the roof, and rents, bills and the tax burden rose. That is their record. I wish he would do more to stand up for his low-tax convictions than his libertarian desire that children growing up in our country today should become addicted to nicotine. I have to respectfully disagree with him.
Compared with three years ago, half a million more people are out of work due to long-term sickness. People’s careers are being ruined by illnesses that prevent them from contributing to Britain’s economic success. We cannot build a healthy economy without a healthy society. Not only is there a moral argument for backing this progressive ban, based on the countless lives ruined by smoking and our shared determination to make sure that children growing up in Britain today will not die as a result of smoking, but there is an economic argument, too.
It is certainly true that vaping is less harmful than smoking and is a useful smoking cessation tool, but vapes are harmful products none the less. In the past few years, entirely on the Conservatives’ watch, a new generation of children have become hooked on nicotine. An estimated quarter of a million children vape today, and there is no doubt that this is the result of vaping companies’ decision to target children. On any high street in the country today, people can buy brightly coloured vapes and e-liquids with names such as “Vimto Breeze” and “Mango Ice”. They are designed, packaged, marketed and deliberately sold to children. The effect of this new nicotine addiction on our country’s young people should trouble us all.
Ms Lyn Brown
A couple of years back, Newham did a survey and discovered that 4% of year 6 children—that is 10 and 11-year-olds—had already vaped. I met Community Links in Canning Town in January, and it has been working on projects to tackle misinformation. Its students explained to me that they and their friends have been encouraged to believe that vaping is somehow safe and will not cause them the same problems with nicotine. Surely we can all agree that the voices of young people need to be heard and that they need to be encouraged and assisted to tackle the misinformation about vaping that is clearly out there.
Wes Streeting
I strongly agree with my hon. Friend, and I am very familiar with Community Links, which does brilliant work. We should take the voices of children and young people seriously—the right hon. Member for Chelmsford (Vicky Ford) made that point earlier.
Teachers monitor school toilets where children congregate to vape. Kids are making up excuses to leave their classroom in order to satisfy their nicotine cravings, and children in primary school, aged 9 or younger, have ended up in hospital because of the impact of vaping. Paediatric chest physicians report that children are being put in intensive care units for conditions such as lung bleeding, lung collapse and lungs filling up with fat. One girl who started vaping at school told the BBC that she has
“no control over it…I start to get shaky and it’s almost all I can think of.”
The question that must be asked of Conservative Members should not be whether they will take action today, but what has taken them so long. In 2021, Labour supported an amendment to the Health and Care Act 2022 to ban the branding and marketing of vapes to appeal to children—Conservative MPs voted it down. In 2023, my hon. Friend the Member for Denton and Reddish (Andrew Gwynne) led a debate on an Opposition day motion on the same proposed ban—once again, Conservative MPs failed to support it. Thanks to their delay in acting against this, and thanks to their awful, shocking complacency, thousands more children have taken up vaping and become addicted to nicotine. Can the Health Secretary tell the House whether the Government’s delay in acting against youth vaping had anything to do with the £350,000 donation her party received from the boss of a major vaping company that sells vapes with flavours such as “Blue Razz Lemonade” and “Strawberry Mousse”?
We are an ageing society facing rising chronic disease. We are approaching these challenges with an NHS already in the worst crisis in its history, with the longest waiting lists and lowest patient satisfaction on record, 121,000 staff vacancies across the health service and 14,000 fewer hospital beds than in 2010. If we do not act today to ease the pressures coming down the track, they threaten to overwhelm and even bankrupt the health service.
Prevention is better than cure. This progressive ban must be the beginning of a decade in which we shift the focus of healthcare in this country from sickness to prevention, which is mission critical to making sure the NHS can be there for us in the next 75 years, just as it has been there for us in the past 75 years.
If the Government are serious about taking on this challenge, Labour has many more plans that they can adopt before they finally call the general election. They could adopt our children’s health plan to give every child a healthy start to life. They could ban junk food ads aimed at kids so that children are not targeted by unhealthy food. They could tackle the mental health crisis facing young people, with support in every school, hubs in every community, and 8,500 more mental health professionals to cut the disgracefully long waiting times for treatment.
They could treat the 152,000 children who have been on NHS waiting lists for more than 18 weeks, ending long waits for children for good. We will do it by providing 2 million more operations, and by providing evening and weekend appointments to beat the Tory backlog. We will have supervised toothbrushing in schools to tackle the moral emergency of children needing to have their rotting teeth pulled out, which is the No. 1 reason why children aged six to 10 end up in hospital. We will have breakfast clubs in every primary school so that kids start the day with hungry minds, not hungry bellies. We will digitise the red book, making sure that all kids are up to date on their checks and vaccines. And we will once again put an end to measles in this country, after it has been allowed to return on the Government’s watch.
We want the next generation to be chasing their dreams, not a dentist appointment. They should aspire to reach their potential, not to reach a doctor. Labour’s plan is to make sure that today’s children are part of the healthiest generation that has ever lived, and this ban is just the start.
The Prime Minister may be too weak to whip his MPs to vote for this important Bill, but Labour will put country first and party second. We will resist the temptation to play games on votes. Instead, we will go through the Lobby to make sure this legislation is passed so that today’s young people are even less likely to smoke than they are to vote Conservative.
I commend this Bill to the House.
Several hon. Members rose—
Elizabeth Truss
I will not give way to the hon. Lady—[Hon. Members: “Oh.”] I will not give way. I will give exactly as much opportunity as the Opposition gave me to talk about my private Member’s Bill, which I shall come on to later.
The problem is that the instinct of this establishment, which is reflected in cross-party consensus in the Chamber, is to believe that it—that the Government—is better at making decisions for people than people themselves. I absolutely agree that that is true for the under-18s. It is very important that we protect people while they are growing up until they have decision-making capability. However, I think the whole idea that we can protect adults from themselves is hugely problematic and effectively infantilises people. That is what has been going on. We are seeing, not just on tobacco but on sugar, alcohol and meat, a group of people who want to push an agenda which is about limiting personal freedom. I think that that is fundamentally wrong.
I go out canvassing a lot in my Norfolk constituency. People raise all kinds of issues with me on the doorstep. They are concerned about immigration. They are concerned about the cost of energy. They are concerned about the rise of China. They want to support Ukraine. Not a single voter has ever said to me, “My big concern is adults smoking.” This proposal has not come from people—our constituents—talking to us. It has come from a group of people who, by and large, work in a professional capacity pushing these policies. When my right hon. Friend the Member for Suffolk Coastal (Dr Coffey) was Secretary of State for Health and Social Care, this proposal was sitting on her desk, so it is not new. I am pleased to say that she put it in the bin, but unfortunately since then it seems to have been pulled out of the bin and resuscitated. My real fear is that this is not the final stage that the health police want to push.
Elizabeth Truss
They are the health police, and people are concerned about this. They want to be able to make their own decisions about what they eat, what they drink and how they enjoy themselves. If the hon. Gentleman does not understand that, I suggest that he starts listening to the public.
What I also find extraordinary is the fact that almost four weeks ago I put a private Member’s Bill to Parliament to ban under-18s from being able to access puberty blockers and cross-sex hormones in the private sector and on the national health service. Children have been taking those drugs, and that has had life-changing effects on them. They have prevented them from having their own children, created problems with their physique and their bodies, and damaged their health.
Not only did the Labour party not support my private Member’s Bill but its Members talked and filibustered—they talked about ferrets—so much that I was not even able to speak. These are the same people who are saying that in future we should ban cigarettes for 30-year-olds, yet they will not vote to ban puberty blockers and cross-sex hormones for the under-18s. Thank goodness that Hilary Cass has come forward with her report. I welcome the support of the Health and Social Care Secretary for that report, but that is what we should be legislating on. We should be legislating on implementing the recommendations in the Hilary Cass report to prevent real danger to our children, rather than a virtue-signalling piece of legislation about protecting adults from themselves in future.
I am afraid that too many Members of Parliament have gone along with this orthodoxy. I am not surprised that that is the case for Labour and Liberal Democrat Members, who generally do not support freedom. They believe that the Government know best—the state knows best—and we understand that. I am disappointed, however, that a Conservative Government has introduced the Bill. The only other country in the world where such a Bill was brought forward was New Zealand, under a very left-wing Prime Minister. That Bill has now been reversed under the new conservative Government in New Zealand. I have a message for my colleagues on this side of the House. If people want to vote for finger-wagging, nannying control freaks, there are plenty of them to choose from in the Opposition, and that is the way they will vote. If people want to have control over their lives, if they want to have freedom, that is why they vote Conservative. We have to stand by our principles and ideals even if—
Elizabeth Truss
No, I am not giving way to the party that filibustered on my Bill and stopped us taking action to protect children. That was a disgrace.
Elizabeth Truss
I certainly do not support the liberalisation of those drugs. We know that people who become addicted to heroin and cocaine are a huge danger to other people and to their families; it destroys society. That is not the level of danger that tobacco poses, so those are very different scenarios.
I will come to my conclusion, because I know that a lot of people want to speak in the debate. What I ask is that Members do not just follow the instructions of the health lobby. We have heard about what the chief medical officer says. I know from being a Government Minister that there are often schemes pushed by officials and civil servants because, fundamentally, there is a belief that government knows best. I want Members of Parliament to think not just about what happens if we ban smoking for people who are over the age of 18, but about the implications for shopkeepers who have to identify whether people are the right age. Will it mean that people have to carry ID into shops with them into their 40s? What are the practical implications? It is a very dangerous precedent to start saying that some adults can have the freedom to smoke and some cannot. That is a fundamental problem. It is fundamentally unconservative, it is unliberal and I will not be supporting the Bill.
Wes Streeting
On a point of order, Mr Deputy Speaker. Is it in order for Members of this House to attack individual officers, such as the chief medical officer, or the civil service more generally, when they cannot answer back? Ultimately, advisers advise and Ministers decide. If people do not like Government policy or its consequences, they should take responsibility as Ministers and not attack officials who cannot answer back.
Mr Deputy Speaker (Mr Nigel Evans)
I will allow that to rest on the record.
Cass Review
Wes Streeting Excerpts(7 months, 3 weeks ago)
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Wes Streeting (Ilford North) (Lab)
I thank the Secretary of State for advance sight of her statement and, even more importantly, Dr Hilary Cass and her team for the thoughtful and thorough way in which they have undertaken their work. Dr Cass has navigated the complexities and sensitivities of the subject with academic rigour, providing an evidence-led framework for children to receive the best possible healthcare. I also pay tribute to journalists such as Hannah Barnes and the whistleblowers who together helped to shine a light on what was going on at the Tavistock clinic.
At the heart of the complexity around this issue are two things that are true simultaneously. There are trans adults in this country who have followed a medical pathway and who say that, for all the pain and difficulty that involved, it was not just life-affirming; it was lifesaving. There are also people in this country who followed a medical pathway but who say it was a disaster that ruined their lives irreversibly, and they ask how anyone could have let that happen. For the sake of all those children, young people and now adults—but particularly those being referred into gender identity services today—we have a duty to get this right.
What has emerged in the Cass review is a scandal. It is a scandal that children and young people are waiting far too long—often years—for care while their wellbeing deteriorates and their childhood slips away. It is scandalous that medical interventions have been made on the basis of shaky evidence. It is scandalous that, despite all that, some NHS providers refused to co-operate with Dr Cass’s review. Perhaps the worst scandal of all is that the toxicity of this discussion means that people have felt silenced, and it required investigative journalism to prompt the review to take place. This particularly vulnerable group of children and young people are at the wrong end of all the statistics for mental ill health, suicide and self-harm. There is no doubt that they have been very badly let down, so we owe it to them to approach this discussion with the same care and sensitivity with which Dr Cass undertook her review.
Parts of the report will sound familiar to anyone acquainted with the NHS today. Children and young people face unacceptably long waiting lists and are unable to get the mental health support and assessments they require, and services face significant staff shortages, with a lack of workforce planning driving all of that. As with so many parts of the NHS today, the report paints a picture of a service unable to cope with demand. Dr Cass is clear that care must be personal and holistic. Will the Secretary of State set out how she plans to cut waiting times for assessments for mental health and neurodevelopmental conditions?
Waiting lists are so bad in some cases that children are passing into adulthood before they have had their first appointment with gender identity services, leaving them facing a cliff edge. Cass recommends follow-through services up to the age of 25 to ensure continuity of care. Will the Secretary of State indicate how long she thinks it will take to establish those services?
Labour welcomed the decision by NHS England last month to stop the routine prescription of puberty blockers to under-18s. The loophole that exists for private providers risks sparking a black market. The Secretary of State has said that she expects private clinics to follow the report’s recommendations to follow the evidence. I underline our support for her expectations on compliance. Can she give an indication of whether she thinks that further regulation may be needed to ensure adequate enforcement of the recommendations?
The refusal of adult gender services to share data on the long-term experience of patients is inexcusable—as the Secretary of State said, it is deplorable. The data does not belong to them; it belongs to the NHS and, crucially, to patients. I welcome their coming forward now, but how was this allowed to happen, and what accountability does she think would be appropriate?
This report must provide a watershed moment for the NHS’s gender identity services. Children’s healthcare should always be led by evidence and be in the best interests of children’s welfare. Dr Cass’s report has provided the basis on which to go forward. The report must also provide a watershed moment for the way in which our society and our politics discuss this issue. There are children, young people and adults—including trans children, young people and adults—in this country who are desperately worried and frightened by the toxicity of this debate. There are healthcare professionals who are scared to do their job and make their views known. Dr Cass said that
“toxic, ideological and polarised public debate has made the work of the Review significantly harder”
and it will hamper the research that is essential to finding a way forward.
Even in a general election year, there is surely one issue on which we can down tools and work together: the pursuit of the healthcare of vulnerable people. I pay tribute to the right hon. Member for Bromsgrove (Sir Sajid Javid). We had many scraps across the Dispatch Box, but for his role in commissioning this review he deserves our thanks and respect. I hope to work constructively with the Health Secretary to put children’s health and wellbeing above the political fray.
Victoria Atkins
I welcome all those who have changed their minds about this critical issue. In order to move forward and get on with the vital work that Dr Cass recommends, we need more people to face up to the truth, no matter how uncomfortable that makes them feel. I hope the hon. Gentleman has the humility to understand that the ideology that he and his colleagues espoused was part of the problem. He talked about the culture and the toxicity of the debate. Does he understand the hurt that he caused to people when he told them to “just get over it”? Does he know that when he and his friends on the left spent the last decade crying, “Culture wars,” when legitimate concerns were raised created an atmosphere of intimidation, with the impact on the workforce that he rightly described? People were scared or worried to go into it.
Does the hon. Gentleman now have the good grace to apologise to those who have been maligned in public life—including his own female colleagues—and for the chilling effect that this has had on clinicians, journalists and campaigners who were trying to raise the alarm? I say that because I want to believe the hon. Gentleman when he says that he has turned a corner on this issue. We have to start with a new page, for the sake not just of the children and young people we are looking after but of their families, many of whom will be watching this, living with the consequences of the ideology and secrecy, wondering how on earth the hon. Gentleman talks about general elections when, every single minute and day, their children have to live with treatment that can never be reversed.
Oral Answers to Questions
Wes Streeting Excerpts(9 months ago)
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Wes Streeting (Ilford North) (Lab)
The simple fact is that the Conservatives have been in power for 14 years, and general practice has never been in a worse state. Despite slogging their guts out, GPs are struggling because this Government have cut 2,000 GPs since 2015, making it even harder for patients to get an appointment. Given that, why has the Government decided that the NHS needs what the Institute for Fiscal Studies has described as the biggest funding cut since the 1970s?
Victoria Atkins
It has been a very long time since Labour were in government, but even the hon. Gentleman knows that Ministers will never comment on fiscal events the day before they occur. Let me introduce some facts into his analysis. We have now delivered on our manifesto commitment for 50 million more general practice appointments per year, with 363.8 million booked in the last 12 months. That compares with 312 million deliveredin the 12 months to December 2019. [Interruption.] If the hon. Gentleman stopped shouting, perhaps he would be able to hear me. About 62,000 more appointments were delivered per working day last December, excluding covid vaccinations. We have our primary care recovery plan, and it is working. Of course there is more to do, but even the hon. Gentleman would not be so churlish as to deny those extra 50 million appointments.
Wes Streeting (Ilford North) (Lab)
With a general election in the air, I welcome what the Secretary of State has said about baby loss certificates and Martha’s rule—there is genuine cross-party agreement on this. I also thank her for advance notice of today’s important written ministerial statement.
However, with a general election in the air and given the Secretary of State’s principled, vocal and consistent opposition to funding the NHS by abolishing the non-dom tax status, on a scale of one to 10—one being utterly shameless and 10 being highly embarrassed—how red-faced will she be when the Chancellor adopts Labour’s policy tomorrow?
Victoria Atkins
One of the joys of being at the Government Dispatch Box is that not only do we have to deal with very serious matters, such as I have just set out, but we get to have a knockabout on the Labour party’s electioneering. The hon. Gentleman will know the Conservatives’ proud record on funding our NHS since 2010. I invite him to wait for tomorrow’s Budget to see what more this Conservative Government are doing to support our constituents, and to help our economy grow for a bright future.
Wes Streeting
The Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield), has said that the policy will be
“as much use as an ashtray on a motorbike.”—[Official Report, 28 February 2023; Vol. 728, c. 710.]
As she speeds down the A23 back to Lewes, to defend her constituency against the Liberal Democrats, how on earth will she feel with all those embers of the Conservatives’ 14-year record blowing in her face?
Is it not now clear that, with the Government having adopted Labour’s workforce plan, Labour’s dentistry recruitment plan and now Labour’s NHS funding plan, when it comes to a record to be proud of, and when it comes to finding the answers, only Labour can deliver an NHS that is fit for the future?
Victoria Atkins
The Leader of the Opposition is a former barrister, and barristers like to rely on evidence, so let me give some evidence on what the Labour-run NHS in Wales looks like. People are almost twice as likely to be waiting for treatment under the Labour-run Welsh NHS—21.3% of people in Wales are waiting for hospital treatment after a consultant referral, compared with 12.8% in England. Patients in Labour-run Wales are, on average, waiting five weeks longer for NHS treatment than patients in England, and the number of patients in Wales who are escaping to seek treatment in England has increased by 40% in two years. But don’t worry, folks, according to the Leader of the Opposition this is the blueprint—
NHS Dentistry: Recovery and Reform
Wes Streeting Excerpts(10 months ago)
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Wes Streeting (Ilford North) (Lab)
I wholeheartedly associate myself and my party with the Secretary of State’s remarks on sending our best wishes to His Majesty the King. Having gone through a cancer diagnosis myself, I particularly send best wishes to his family, for whom a diagnosis is often more difficult than for the person receiving it.
Also in the generous spirit in which we have begun, may I thank the Health and Social Care Secretary for accidentally e-mailing me her entire plan yesterday? That goes above and beyond the courtesy that we normally expect. I look forward to receiving her party’s election manifesto any day now—but of course we will have to write ours first to give her party some inspiration.
After 14 years of Conservative Government, NHS dentistry is in decay. Eight in 10 dentists are not taking on new patients, and in the south-west of England the figure is 99%. One in 10 people has been forced to attempt DIY dentistry—Dickensian conditions!—because they cannot see an NHS dentist, and they cannot afford to go private. [Interruption.]
Mr Speaker
Order. Mr Baker, I am sorry, but I don’t want any more heckling from you; you did a little bit earlier. I wanted everybody to listen to the Secretary of State, and I expect them to do the same for the shadow Secretary of State.
Wes Streeting
Don’t worry, Mr Speaker: I will come back to the Parliamentary Private Secretary shortly. Tooth decay is the No.1 reason for children aged six to 10 being admitted to hospital. Unbelievably, there have been reports of Ukrainian refugees booking dentist appointments back home and returning for treatment, because it is easier to fly to a war-torn country than it is to see an NHS dentist in England. Well, at least one Government policy is getting flights off the ground—and it is certainly not the Government’s Rwanda scheme failure.
Let us look at the human consequences of this Conservative tragedy. Labour’s candidate in Great Yarmouth, Keir Cozens, told me about Jeanette, a young woman in her 30s who has struggled with gum and mouth problems all her life. She used to be able to get treatment; now she cannot find an NHS dentist in all of Norfolk to take her. She cannot afford to go private. It hurts to smile, it hurts to laugh, and the pain is so great that Jeanette does not go out anymore. Just this week, she resorted to trying to remove her tooth herself. That is not right for anyone of any age, but Jeanette should be in the prime of her life. Will the Secretary of State apologise to Jeanette and the millions like her for what the Conservatives have done to NHS dentistry?
After 14 years of neglect, cuts and incompetence, the Government have today announced a policy of more appointments, recruiting dentists to the areas most in need and toothbrushing for children. It sounds awfully familiar. They are adopting much of Labour’s rescue plan for dentistry. Does that not show that the Conservatives are out of ideas of their own, and are looking to Labour to fix the mess they have made? I say: next time Conservative Ministers say that Labour does not have a plan, or that Labour’s plan is not credible, don’t believe a word of it.
There are some differences between our two parties’ approaches. Labour is pledging an extra 700,000 urgent and emergency appointments, which are additional to the appointments announced today. Can the Health Secretary confirm that the Government’s plan does not provide any additional emergency support? Labour proposed supervised early-years toothbrushing, and Conservative MPs accused it of being “nanny state”. Does the Health Secretary stand by that label, or does she now support children under five being supported in brushing their teeth?
The key difference is that we recognise that our plan is a rescue plan, and that to put NHS dentistry back on its feet, immediate reform of the dental contract is needed. Without that, the Government’s plan is doomed to fail. Do not just take my word for it; the British Dental Association has said that the plan will not stop the exodus of dentists from the NHS, will not provide a dentist for every patient who needs one, and will not put an end to this crisis.
I come to the Parliamentary Private Secretary, the hon. Member for North Norfolk (Duncan Baker), and the miserable script that the Whips are spreading out on the Table. If Labour’s contract is to blame, why have the Government not reformed it in 14 years, and why are they not reforming it now? In 2010, the Conservatives promised in their election manifesto to reform the dental contract. They are bringing back not just Lord Cameron, but his broken promises. People have been desperately trying to get dental care for years, but there was nothing from the Conservative party. Now that we are in an election year, the Conservatives are trying to kick the can down the road, and are scrambling for a plan. They only discover their heart when they fear in their heart for their political futures, and the consequences have been seen: queues around the block in Bristol.
Finally, the Secretary of State is promising reform after 2025 and after the next general election. Who is she trying to kid? After 2025, the Conservatives will be gone, and if they are not, NHS dentistry will be. How many more chances do they expect? How many more broken promises will there be? We had 2010, 2015, 2017 and 2019. Their time is up, and it is time for Labour to deliver the change that this country needs.
Victoria Atkins
I tried to help the hon. Gentleman by giving him an advance copy of my speech yesterday, yet that was his speech. This Government are focused on delivering for patients. Perhaps I can help him understand the difference between the Opposition’s proposals and the Government’s fully funded dental recovery plan. The Opposition’s ambitions reach only as far as 700,000 more appointments. Our plan will provide more than three times that number of appointments across the country—that is 2.5 million, to help him with his maths. We are offering golden hellos to 240 dentists who will work in hard-to-reach and under-served areas; their proposals cover only 200. They have no plan for training more dentists; we set out in the long-term workforce plan last year, and again in the dental recovery plan, that we will increase training places for dentists by 40% by 2031.
Then we have the centrepiece of the Opposition’s proposals: making teachers swap their textbooks for toothbrushes—an idea that is hated by teachers and that patronises parents. We believe that most parents do a great job of looking after their children. I know that the Labour party does not agree with that; the hon. Gentleman called our children short and fat on a media round. We believe that most parents do a great job, and that is why we support pregnant mums-to-be, and support parents in family hubs and nurseries. We will not wait until reception class, by which time children have already got their teeth.
I want to dwell on the experience of anybody living under Labour in Labour-run Wales. Health services in Wales are devolved, and the Leader of the Opposition has called Wales “the blueprint” for how the Opposition will run our health system. Welsh Labour has the highest proportion of NHS dental practices not accepting new adult patients, and the joint highest proportion of those not accepting new child patients. In Wales, 93% of NHS dental practices are not accepting new adult patients. That is a higher figure than for any other nation in the UK. Some 86% of practices there are not accepting new child patients, which is the joint highest figure with Northern Ireland. Our plan is fully funded, but how will Labour pay for its plan? By using the magical money tree. The list of policies funded by the non-dom policy is as long as my arm. In 2022, it promised to fund a workforce plan. Last September, it became breakfast club meals. By October, it morphed into 2 million appointments and scanning equipment. By Christmas, it was funding a dentistry plan. It is the same old Labour: it has no plan.
NHS Dentistry
Wes Streeting Excerpts(11 months ago)
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Wes Streeting (Ilford North) (Lab)
I beg to move,
That this House recognises that NHS dentistry is in crisis, with eight in 10 dentists in England not taking on new NHS patients and vast parts of the country considered so-called dental deserts, where no dentists are available; regrets that this has led to people resorting to DIY dentistry or attending A&E to access urgent care; is concerned that tooth decay is the most common reason children aged six to 10 are admitted to hospital; and therefore calls on the Government to provide an extra 700,000 urgent appointments a year, introduce an incentive scheme to recruit new dentists to the areas most in need and a targeted supervised toothbrushing scheme for three to five year-olds to promote good oral health and reform the dental contract to rebuild the service in the long-run.
Happy new year, Mr Speaker.
After 14 years of Conservative neglect and mismanagement,
“NHS dentistry in England is at its most perilous point in its 75-year history.”
That is the conclusion of the Nuffield Trust think-thank, and who can blame it? Eight in 10 NHS dentists no longer take new patients. According to the NHS, no dentist is taking on new adult patients in entire constituencies such as Broxtowe, Bolsover, Stoke-on-Trent South and Stroud. Five million patients tried but failed to get an appointment in the past two years. Millions more needed dental care but did not bother trying to book an appointment because they knew it would be impossible. Tooth decay is now the No. 1 reason why children aged six to 10 end up in hospital. We face the moral outrage of one in 10 Brits saying that they have been forced to attempt dentistry themselves because the NHS was not there for them when they needed it. This is Dickensian—DIY dentistry in 21st-century Britain. Is there any greater example of the decline that this country has been subjected to under the Conservatives?
Sarah Champion (Rotherham) (Lab)
May I add Rotherham to the list that my hon. Friend is quoting? To give an example, one of my constituents has been trying for more than a year to register with an NHS dentist. He has now had to go private for the consultation, which said:
“Your teeth are in a very poor condition with most of your remaining teeth decayed and unsaveable. All your teeth except 2 …need extracting.”
He has been living for more than a year on painkillers and soup. I have raised this with the Minister and got no satisfaction. This is what Tory Britain is doing to dentistry.
Wes Streeting
I totally agree with my hon. Friend. We have heard so many heartbreaking stories like the one she mentions from her constituency. A service that once was there for all of us when we needed it is almost gone for good.
Anthony Mangnall
Is there any greater landmine of a Labour legacy than the 2006 contract that it designed, which is pulling us down? Labour Members need look no further than their own designs on the NHS. We are sorting out their mess.
Wes Streeting
The sound you can hear, Mr Speaker, is the scraping of the barrel. How has the hon. Gentleman got the brass neck to stand up, after 14 years of his party in government, and say that a contract agreed in 2006 is the problem? If only the Conservatives had been in government for 14 years to sort it out.
Here is the other rub: we do not pretend that everything was perfect under the last Labour Government. In fact, reform of the NHS dentistry contract was in Labour’s 2010 manifesto, because we recognised that it needed to change. Had we been elected in 2010, we would have delivered. It was also in the Conservatives’ 2010 manifesto and 2015 manifesto. It was probably in the 2017 and 2019 manifestos, too, and they have not delivered. We have 14 years of Conservative failure. How dare the hon. Gentleman have the brass neck to stand up and blame someone else.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
It is of great interest, is it not, that there is not one Member from the governing party in Scotland present for this debate? I can tell the House that dental services in my constituency in remote Scotland have gone backwards in a big way, and I am shocked that none of them are here to hear this.
Wes Streeting
It is deeply disappointing. Let me assure the hon. Gentleman that as with the last Labour Government—13 years that created a rising tide that lifted all ships across the country, when we had an NHS with the shortest waiting times and the highest patient satisfaction in history—the next Labour Government will deliver a rising tide to benefit people across the country.
Alex Cunningham (Stockton North) (Lab)
The British Dental Association highlights that:
“Hormonal changes during pregnancy can make gums more vulnerable to plaque”,
and:
“Changes to dietary habits, and morning sickness”
can also impact on oral health. After being told of the importance of seeing a dentist after suffering multiple miscarriages, a constituent tells me that she has been struggling for three years to see a dentist within a 50-mile radius of her home. Dentists say that they are going private and are helping only with emergencies. Surely that is evidence of a colossal failure of Tory Government dental policy, and even the most vulnerable are suffering.
Wes Streeting
I wholeheartedly agree with my hon. Friend. In fact, he has the ability, as the Labour MP for Stockton North, to speak for his residents. If only other people across the country had MPs standing up for them. Chris Webb, Labour’s candidate in Blackpool South, reported to me that pregnant mothers have been telling him they cannot get an NHS dentist, despite being entitled to free NHS check-ups and treatment. Alice Macdonald, Labour’s candidate in Norwich North, reported similar conversations to me. Expectant mothers have told her that they have been travelling hundreds of miles to see a dentist when we know that pregnant women probably need that support more than many others. What an indictment of 14 years of Conservative Government.
Mr Ben Bradshaw (Exeter) (Lab)
Did my hon. Friend see the report in today’s Times that showed that NHS dentists are performing only 75% of the procedures they are contracted to do? In Devon and Somerset, where the situation is the worst in the country, it is only 26.5% and 30%. Not only have this Government delivered an NHS desert in Devon and Somerset, but they are wasting masses of public money. What is my hon. Friend going to do about it when he is Health Secretary?
Wes Streeting
I strongly agree with my right hon. Friend. Things are so desperate. He mentioned the south-west in particular, and Devon and Cornwall have been particularly poorly served. Jayne Kirkham, Labour’s candidate in Truro and Falmouth for this year’s general election, reported to me that a local dentist handed their contract back before Christmas, meaning that 3,000 people lost their NHS dentist overnight. There are currently no dentists in Truro and Falmouth taking on adult NHS patients. Contract reform is urgent, so where is it? They have had 14 years, so where is the recovery plan that the Health Secretary mentions in her amendment?
Several hon. Members rose—
Wes Streeting
I must make some progress.
Turning to other parts of the country, Keir Cozens, Labour’s candidate in Great Yarmouth, has been running a campaign on the state of dentistry in Great Yarmouth. He has heard heartbreaking stories of broken teeth left for months with people in pain, of children unable to be seen, of at least one person a day going to accident and emergency with dental issues, and of people performing DIY dentistry at home after buying kits from Amazon. No one should be doing that, but people are desperate. DIY dentistry does not work, and before you know it, people are back in A&E waiting for expensive emergency dental treatment. I have heard similar stories from Kevin Bonavia, Labour’s candidate in Stevenage. He tells me that people turning to DIY is shockingly common.
No one voted for this. None of the five Conservative Prime Ministers, the seven Conservative Chancellors or the eight Conservative Health Secretaries told the public that this was what the future held, but this is what they have done to dentistry. It is the way all our public services are going, and it is why the Conservative party cannot be allowed five more years to finish the job.
Jim Shannon (Strangford) (DUP)
I thank the shadow Secretary of State for bringing this debate forward. The stats from the British Dental Association cannot be ignored. In its survey, 41% of practice owners and 38% of associate dentists said that they would like to leave NHS dentistry as soon as possible. This debate will resonate with many people out there. Does he agree with the chair of the Northern Ireland Dental Practice Committee that now is the time for the funding allocation to pay for a better contract and for training more dedicated dentists who will commit to the NHS, rather than private practice?
Wes Streeting
I agree with the hon. Gentleman about the urgency of the situation. There is a different path available to us. We can revive our public services and give our country back what we used to take for granted. Labour’s plan would take immediate steps to rescue NHS dentistry, with 700,000 more urgent appointments and the recruitment of new dentists in the areas most in need. We would also take the necessary steps to rebuild NHS dentistry over the long term, including reforming the dental contract and introducing supervised toothbrushing for three to five-year-olds in primary schools, so that poor oral health is prevented and demands on the service reduced.
In fact, some of my Labour colleagues are not even waiting for the general election to start making a difference. Labour’s candidate in Stroud, Simon Opher—himself a GP—has spearheaded a campaign working with local dentists and the integrated care board. From opposition, he has more than trebled the number of emergency appointments available each day across Gloucestershire, pioneered a new dental stabilisation scheme for people not known to a local practice, opening up more than 130 appointments a week, and introduced supervised toothbrushing in 14 local primary schools. If that is the difference Simon is making in opposition, imagine what he will be able to do as a Labour MP working with a Labour Government. That Government cannot come soon enough.
Catherine West (Hornsey and Wood Green) (Lab)
My hon. Friend is making an excellent speech. Does he agree with me and my constituent in Crouch End who has not had a check-up since 2019 that the link between poor oral health and oral cancer is serious? That could be contributing to the terrible problem we have with cancer waiting times.
Wes Streeting
I totally agree with my hon. Friend. Prevention is better than cure. It is a truism, and it is also the foundation pillar of what would be Labour’s 10-year plan for reform and modernisation of our national health service. A part of that plan is before the House today, and Government Members will have to explain to their constituents, only months, if not weeks away from a general election, why they are refusing to support it.
The Government’s amendment to the motion promises that the dental recovery plan is coming soon, but it was due last summer; now, they cannot put a date on when the plan will arrive, when it will be implemented or even say what it is. Conservative Ministers have taken a look at the state of NHS dentistry, at the millions of people across the country who cannot get an appointment to see a dentist and at children in their own constituencies whose teeth are rotting, and their conclusion is: what is the rush? Let me tell them why they should get their skates on.
A 17-year-old boy in Plymouth had to undergo emergency surgery on an abscess in his mouth last year. He spent two months trying to book an NHS dentist—he said that he was on hold for about three hours per day. According to figures on the NHS website, no dentists are taking on new NHS patients in the Plymouth, Moor View constituency. It was left too late, and when he finally got the healthcare he needed, he required emergency surgery, which has left him scarred for life.
In Worthing West, Labour’s candidate Dr Beccy Cooper told me of an 82-year-old great-grandfather on pension credit who told her that he will not be going back to an NHS dentist before he dies. He tried to get an NHS dentist in Worthing, but no one will take him on the NHS to receive low-cost treatment. Dr Beccy Cooper also tells me that residents who cannot get a dentist are being told to look for one in Hampshire, more than 60 miles away from where they live.
Ian Lavery (Wansbeck) (Lab)
On that important point, a couple who moved into new housing in my constituency tried to get an NHS dentist for over a year without any success whatsoever. They have got two options: they either go private or use their previous dentist, who is 20 miles away. That is wholly unacceptable. Will my hon. Friend simply explain how Labour’s plan will eradicate this unacceptable issue?
Wes Streeting
My hon. Friend is absolutely right. We will have: 700,000 appointments, making a difference straightaway; supervised toothbrushing for three to five-year-olds to reduce future demand on NHS services; and reform of the NHS dentistry contract so that we can rebuild an NHS dentistry service worthy of the name. That change cannot come soon enough.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
My constituent Amy has been in contact with me about the difficulties that she and her five children have had getting NHS dentist appointments. She explained that her husband was in the military and therefore they had to move home frequently, and each time they moved they found it harder to get an NHS dentist. Does my hon. Friend agree that that is a shameful way to treat people who have served and given so much to our country?
Wes Streeting
I agree. I am afraid that when it comes to serving personnel and veterans, there is a gulf between what the Government say and promise and what they do; that is not the only example.
One thing not in the Government’s amendment to Labour’s motion is a pledge to protect the NHS dentistry budget. That is odd, because the Prime Minister promised to do exactly that 18 months ago. The truth is that the Prime Minister broke that pledge in November when he gave the go-ahead for dentistry underspends to be raided, effectively waving the white flag on the future of the service. Can you believe it? Despite everything we have heard, there are dentistry underspends, and the Prime Minister thinks that other things are greater priorities than this crisis. The consequences of that decision are now being felt. The budget in some areas of the country is running out and dentists are having to stop NHS work for the remainder of the year. It is so deeply frustrating.
NHS dentists want to do more NHS work; it is the Government who are standing in their way. The Nuffield Trust’s stark report into the crisis suggested that NHS dentistry may have to be scaled back and made available only to the least well-off. Such an approach would be the end of NHS dentistry as a universal public service, yet that is exactly the approach that the Government are piloting in Cornwall. Children, the over-80s and those with specific health needs are given treatment; everyone else has to go private or go without. They will not admit it, but this is the future under the Tories: further neglect, decline and patients made to go without.
Worse still, NHS dentistry is the ghost of Christmas yet to come under the Tories. That is not partisan overreaction on our part; that is according to the lead author of the Nuffield Trust’s report. He wrote:
“For the wider health system, the lessons are troubling: without political honesty and a clear strategy, the same long-term slide from aspiration to reality could happen in other areas of primary care too.”
What has happened to NHS dentistry under the Tories is coming to the rest of the NHS if they are given another five years. That is not the continuity that the country is looking for—it is looking for change with Labour.
Wera Hobhouse (Bath) (LD)
My Bath constituency is also described as an NHS dental desert. The only option for people is to go private. The hon. Member has already said that it is Dickensian. Does he agree that it is not just a health problem but an equalities issue that the Government fail to recognise?
Wes Streeting
I totally agree. In fact, Claire Hazelgrove, Labour’s candidate in Filton and Bradley Stoke—next-door to the forthcoming by-election—was telling me about problems in her constituency and that exact challenge of people being left without or having to go private. One patient told her that her dental practice was now only seeing private patients. That same patient cares for her 84-year-old dad with dementia, who needed a tooth removal to allow him to eat. His appointment was also cancelled. That is what is happening before our eyes.
What of those who cannot afford it? Anna Dixon, Labour’s candidate in Shipley, told me of a woman in her town who had been turned away as an NHS patient and could not afford to go private. She was struggling with pain, it was affecting her eating, and she was at her wits’ end. With the Tories, if you have not got the money, you have not got the care.
Kerry McCarthy (Bristol East) (Lab)
As a neighbouring MP, I thank my hon. Friend for mentioning Claire Hazelgrove, our candidate in Filton and Bradley Stoke, who is doing tremendous work on this. I have done a survey of my constituency and have found that about 98% of Bristol NHS practices are not taking on new patients. One issue I have also come across is that, even when people do have access to an NHS dentist, they cannot afford even those lower fees, and as a result they are being removed from the active patient list and losing access to that. We can understand how, during the cost of living crisis, people might delay a check-up for a few months because there are so many other pressing demands on their budgets.
Wes Streeting
I totally agree, and I do not think we should be complacent about this as a country. The NHS is already becoming a two-tier healthcare system, where those who can afford to go private are paying and the rest are left with an increasingly poor service for poor people. Government Members protest now, but they admit their goals once they leave the Department for Health and Social Care. The Health Secretary’s predecessors may not have said it when they were in her place at the Dispatch Box, but, as soon as they were out the door of the Department, the right hon. Members for West Suffolk (Matt Hancock) and for Bromsgrove (Sir Sajid Javid) said what they really believe: patients should be charged for GP appointments. Well, why stop there with this Conservative philosophy? Why not go further? That is the future for the health service if the Conservative party is given another five years. That is the risk facing patients across the country, and that is the choice facing voters at the next general election: further neglect, mismanagement and decline under the Conservatives or change with Labour and a decade of national renewal.
On NHS dentistry, the need for change could not be clearer. By the Conservative party’s own admission, it does not have a plan—just the vague promise of one coming in the future. All it does have is a record of 14 years of failure. If we stick to the current path, full universal access to NHS dentistry may be gone for good. The Conservatives may be happy to wave goodbye to this vital public service, but that is not the Labour way. With Labour, there is a clear plan, with immediate steps to tackle the crisis and long-term reform to rebuild dentistry. There will be more appointments, more dentists, more support for children and long-term reform to put the service on a sustainable footing, paid for by abolishing the non-dom tax status. That is because Labour believes that people who live and work in Britain should pay their taxes here, too. It does not matter whether they live on Downing Street or any other street: if they make their money here in Britain, they should pay their taxes here, too.
Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)
My hon. Friend is making an excellent speech. Abby Lane, in my constituency, has contacted over 30 dental practices. Not one is accepting her and her one-year-old child, who desperately needs dental treatment. Is it not the case that we now need to reform the system so that local commissioners can ensure that dental commissioning is happening in local areas where there is need, and not just have this patchwork system where dentists are fleeing because it is not paying well enough?
Wes Streeting
I totally agree. The tragedy is that if we look at the system as a whole and think about the pressure the whole system is under, and if we got NHS dentistry right, we would not only be saving patients untold pain, but saving the NHS money. As Lucy Rigby, Labour’s candidate in Northampton North, reported to me, in 2022 tooth decay forced 625 of her local patients to A&E—worse for them and more expensive for the taxpayer.
If Tory Members disagree with charging non-doms their fair share, maybe they could explain in their own contributions why they disagree. I am sure that their constituents would love to hear their defence of the non-doms, and we would be happy to give them space on Labour leaflets to quote their arguments back at them and let the public decide. I would particularly like to know why the Prime Minister is so wedded to this tax break for the wealthiest.
While Tory Members are set to oppose Labour’s rescue motion today, I understand that our plan on supervised toothbrushing for three to five-year-olds has received an endorsement from an unlikely source. On his podcast, former Conservative Chancellor George Osborne said:
“That really is the nanny-state in action.”
Coming from the Chancellor who introduced a sugar tax, I am sure George meant that as a compliment. Of course, Conservative Members may not see it the same way, just as they do not agree with Labour’s proposal to phase out smoking for children. Don’t worry, we have the Prime Minister’s back on that one; it is, after all, our proposal. But I ask those who attack our plan as nanny-state, what is the alternative? If a child cannot see a dentist and their parents will not do the responsible thing and make sure they clean their teeth, then should we just shrug our shoulders and do nothing while children’s teeth rot?
The problem for the small-statists on the Conservative Benches is this. Too many children today are not cleaning their teeth. Their teeth are rotting and they end up having them pulled out in hospital, which is worse for them and more expensive for the taxpayer. Last year, the NHS spent £80 million on tooth extraction. Toothbrushing in schools would cost a fraction of that, yet the Conservatives choose to waste taxpayers’ money, burning through taxpayers’ cash on the altar of ideological dogma and putting children through unnecessary misery, because it fits their confused ideology.
That is the irony of the Conservative party. Tories say that they believe in a small state and low taxes, yet they have left our country with the highest tax burden since the 1950s. The NHS receives £169 billion a year, yet it is going through the biggest crisis in its history. Because they do not understand that prevention is better than cure. Because they have refused to undertake meaningful reform. Because they treat taxpayers’ money with utter carelessness and contempt. And so they have left us with an NHS that gets to people too late, delivering worse care for patients at greater cost to the taxpayer. We are paying more and getting less. That is Tory Britain. No wonder Tory candidates are so worried.
Before this debate, I happened on a letter on Facebook from the hon. Member for Darlington (Peter Gibson) who is, happily, in his place. First he talks about the state of dentistry in his constituency—we obviously agree with him there—and then he says:
“I was shocked to learn at the end of last year that little to no progress has been made by the Health Board in our region who are responsible for commissioning this service to you.”
Let us assume it was in anticipation of Labour’s motion, which he is going to vote against because the Whip has been cracked. He goes on to say:
“I have today written to the Chief Executive following on from the meetings I had last year, and will be raising this issue in today’s dentistry debate in the House of Commons.”
What that is, and what voters will see it for, is just one of what will no doubt be countless examples of Tory MPs and Tory Ministers, after 14 years of their failure and mismanagement, pointing the finger of blame at someone else, hoping that voters in Darlington and elsewhere will blame local NHS managers and local NHS commissioners for 14 years of failure. If it is really the case that his integrated care board is to blame for why people in Darlington cannot get a dentist, why are people struggling in Newcastle-under-Lyme? Why are they struggling in Northampton North? Why are they struggling in Shipley? Why are they struggling in Filton and Bradley Stoke? Why are they struggling in Worthing West, Stroud, Stevenage, Great Yarmouth, Truro and Falmouth, Blackpool South, Stockton South and every other constituency in the country? Stop blaming other people for your Government’s failures.
Peter Gibson (Darlington) (Con)
I am very grateful to the hon. Gentleman for giving way and I appreciate that he gave me notice that he was going to mention my constituency. What he failed to do in his contribution was read out the letter in full. He has also not anticipated the full content of my speech, which highlights all the work I have been doing in my constituency to tackle the failure by the ICB to deliver the missing contract.
Wes Streeting
I could quote the full letter, but it does not help the hon. Gentleman. He misses the fundamental point. This is not just a failure in Darlington. This is not just a problem in the north-east of England. It is the south-west of England, it is the south-east of England, it is the west midlands, it is the east midlands, it is the north-west, it is Cumbria—it is right across the country. In fact, even in London, my city, which has the best NHS dentistry provision in the country—so much for levelling up—dentistry is still in a poor condition. That is why people in Darlington are looking to Labour and, I hope, Lola McEvoy, to take responsibility, show some leadership, back good Labour policies and rescue NHS dentistry in Darlington. The general election cannot come soon enough.
The choice is clear. Under the Tories, NHS dentistry is dying a slow death. The only chance for survival is change with Labour. Labour’s plan will deliver: 700,000 more dental appointments a year for those most in need; new dentists recruited to dental deserts where there is not a single dentist taking on new patients; toothbrushing in primary school for three to five year-olds to promote good health and prevent demand on the NHS; and reform of the dental contract after 14 years of failure, so that once again every patient who needs a dentist can get one. Politics is about choices. Labour chooses to rescue NHS dentistry, not give the wealthiest a tax break. Labour’s plan is fully costed, fully funded, and will make a real difference to people across the country. The Tories have left our country toothless. Labour will give our country its smile back and give its NHS back, too.
Victoria Atkins
I thank my right hon. Friend, and indeed my friend, my Lincolnshire neighbour, who knows as well as I do the pressures that we face in ensuring that our constituents receive the same quality of care that we expect across England. He was right to draw attention to the—I would argue—badly drafted contract of 2006, but he also touched on the complexity involved in finding systems that would work better.
Victoria Atkins
I cannot wait to reach the part of my speech that will deal with the hon. Gentleman’s suggestions, but first I will allow him to intervene, because I enjoy this back and forth.
Wes Streeting
So do I. The Secretary of State is far more entertaining than her predecessor. Given that she is painting a picture of improvement, how does she explain the story in The Times which revealed that NHS dentistry activity is now falling in 2023-24 compared with 2022-23? Is it not the case that things are going backwards rather than forwards? How does the Secretary of State explain that, and when are we going to see her plan?
Victoria Atkins
I am grateful to the hon. Gentleman for raising that point, because according to the latest statistics available to me, 18.1 million adults were seen by an NHS dentist in the 24 months up to 30 June 2023. That is an increase of 10%, and what does it mean in reality? It means that over 1.7 million more adults were seen than in the previous year. I know that we are all concerned about the health of children; some 6.4 million children were seen by an NHS dentist in the 12 months up to 30 June 2023, an increase of 14%, which means, in real terms, an increase of 800,000 on the previous year.
I accept, of course, that there is more to do, and we will be setting that out in our dental recovery plan shortly, but this is not just about big numbers. [Interruption.] The hon. Gentleman asks when “shortly” will be. As he knows full well, “shortly” is a little shorter than “in due course” and a little longer than “imminently”.
We have introduced several simple and effective measures to improve the nation’s dental health. The Health and Care Act 2022 made it simpler to expand water fluoridation schemes, because raising the fluoride level to 1 mg per litre is a straightforward way to prevent tooth decay. It has proved effective in parts of England as well as Canada, the United States, Ireland and Australia, and the chief medical officer has concluded that there is “strong scientific evidence” that water fluoridation can drive down the “prevalence of tooth decay”.
Victoria Atkins
I am going to plough on, I am afraid.
Earlier, Labour Front Benchers—perhaps not understanding that they were doing so—set out the philosophical difference between our two parties on how to grow the economy. As our economy grows, we on the Conservative side of the House want to attract the best and the brightest from around the world to work in our NHS, in our tech sector, in our life sciences industry, in our movie industry—hon. Members may know that it filmed “Barbie” this year—and in many other thriving industries. Labour, however, apparently wants to shut the door by taxing such people on earnings they make outside the UK. I speak, of course, of non-domiciled tax status.
If I may correct the hon. Member for Ilford North, because I appreciate that he has not spent any time on the Front Bench, last year alone non-domiciled taxpayers paid £8 billion in UK taxes on their UK earnings. That is equivalent to more than 230,000 nurses. Labour wants to put that at risk and put the UK at a disadvantage in the highly paid, highly competitive, highly mobile international labour market. This really is yet another branch of the magic money tree that Labour has always been looking for, to which they apparently want to add £28 billion a year of taxes or increased borrowing and increased inflation.
How they want to spend this money is interesting as well, because in 2022 Labour promised that their non-domiciled taxation would fund a workforce plan. Last September, it became breakfast club meals. Then, by October, it had morphed into 2 million hospital appointments and MRI and CT scanners. Now, apparently, it is funding a dentistry plan. One wonders how all these magic branches on the magic money tree will add up to all the promises made so far.
Victoria Atkins
I will resist, but only because I am going to ask the hon. Gentleman to intervene in a moment—he should be careful what he wishes for. I also notice that he talked about reform of the dental contract but did not give any detail. Government is not as easy as selling a book. It cannot be cut and pasted from Wikipedia, as some on the Labour Front Bench seem to like to do. It is about being clear on what you would do differently. Now, Labour in Wales is of course running the Welsh NHS. They do like to do things differently. People there are almost twice as likely to be waiting for health treatment as in England.
Victoria Atkins
I thank my hon. Friend, who represents a Welsh constituency. The chair of the British Dental Association wrote to the Labour Welsh Government to complain about their plan and, I understand, used words such as “toxic mix of underinvestment” and “untested targets.” The picture in Wales, if it is the Leader of the Opposition’s blueprint, is perhaps not as convincing as the shadow Health Secretary would have us believe.
The fundamental difference between the current systems in England and Labour-run Wales is that Wales has a capitated list system for dentistry. I am willing to give way so that the shadow Health Secretary can clarify whether he wants to bring in that system.
Wes Streeting
I cannot believe that is meant to be the right hon. Lady’s big “Gotcha.” She cannot even tell us when she will bring forward her plan, let alone what is in it. They have had 14 years to come up with a plan. This is absolutely astonishing. As much as I enjoy these partisan knockabouts at the Dispatch Box, the sight of the Health Secretary giggling and laughing at her own jokes will be of small comfort to people who are literally pulling out their own teeth.
Victoria Atkins
Just to cut through all the froth, the hon. Gentleman has not, in fact, answered my invitation. Does he wish to have a capitated list system, as they have in Wales, or does he have other plans? Could he please answer?
Wes Streeting
Like any responsible Government, we would consult the dentistry profession, the BDA, and come up with a serious programme for dentistry reform. If the right hon. Lady wants to ask me questions and have me answer them, the Government should call a general election and I will happily oblige.
Victoria Atkins
Again, cutting through the froth, the hon. Gentleman called this debate and has not set out his plan. He knows full well that this is an Opposition day debate and I am responding to Labour’s motion by moving an amendment. He has no plan on dentistry. When I asked him to clarify whether he will follow the capitated system in Wales, he declined to answer. I assume that is because he knows we tested a prototype system based on the Welsh capitation approach here in England, and the results were clear. It worsened access and widened oral health inequalities.
The hon. Gentleman quoted the Nuffield Trust, placing great emphasis on it, in his opening speech. As he agrees so much with the Nuffield Trust’s report, does he also agree with its former chief executive who said that his ideas on general practice represent
“an out of date view”
and “will cost a fortune”?
It is becoming increasingly clear that the Labour party’s approach to our NHS is empty words about reform followed by the phrase “funded by non-doms.” We are very lucky in this country—on this side of the House we consider ourselves blessed—to have incredible dentists working across the NHS.
Here are some facts for Opposition Members. There are now 1,352 more dentists working in the NHS than 14 years ago, thanks to the stewardship of this Conservative Government. I thank them and their colleagues for everything they do, and we are backing them to build a brighter future for NHS dentistry by taking concrete steps to improve recruitment and retention. That is why our long-term workforce plan, the first in NHS history, will expand dentistry training places by 40%, providing more than 1,100 places by 2031, which will be the highest level on record under any Government.
Over the same period, this Government’s plan will also increase training places for dental therapists and hygiene professionals to more than 500. The importance of the long-term workforce plan to dentistry’s future was recognised across the sector, and Professor Kirsty Hill, who chairs the Dental Schools Council, backed our plan:
“Expansion is a significant and positive development, and we commend the government for recognising the importance of increasing dental hygiene and dental therapist positions. These roles play a vital role in enhancing capacity and improving care.”
NHS Winter Update
Wes Streeting Excerpts(11 months ago)
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Wes Streeting (Ilford North) (Lab)
I thank the Secretary of State for advance site of her statement and wish her and the whole House a happy new year.
Unfortunately, the NHS is beginning 2024 the same way it ended 2022—on strike. This week’s industrial action by junior doctors is the longest strike in the history of the NHS at the worst possible time, because even before the strikes this week the NHS was struggling to stay afloat this winter. Hospitals were declaring critical incidents before the strikes. Patients were waiting dangerously long for ambulances and in A&E before the strikes. Ambulances were queueing up outside hospitals for hours to hand over patients before the strikes. The truth is, before the strikes, and before the pandemic, the NHS has been facing winter crisis after winter crisis as a direct result of the Conservatives’ failure—their failure to train enough staff, their failure to arm the health service with modern technology, and their failure to reform.
In January last year, the Prime Minister published an urgent and emergency care recovery plan, promising
“the largest and fastest-ever improvement in emergency waiting times in the NHS’s history”.
Instead, heart attack and stroke victims are waiting even longer for an ambulance, and A&E waiting times are the worst they have been all year. The Prime Minister promised 800 more ambulances, but the Government have now admitted that they are just replacing existing ambulances. He promised that 50,000 patients a month would be treated in virtual wards, but in reality it is fewer than 8,000 patients. Is not the truth that the Conservatives have once again sent the NHS naked into the winter, and patients are paying the price?
Given how ill-equipped the Government left the NHS, and given the desperate pleas from NHS leaders for the strikes to be resolved, why on earth did the Government choose to sit back and let this damaging strike action go ahead? Not only did the Health Secretary allow talks with the junior doctors to collapse and refuse to reopen negotiations until tomorrow, when the damage will have been done; at the 11th hour, as junior doctors stood on the edge of this strike action, she chose to push them straight into it. In what way was it helpful for the Secretary of State, in a series of broadcast interviews, to patronise junior doctors by rebranding them as “doctors in training”? A junior doctor can have 10 years’ experience under their belt; they do not expect to be trolled by Ministers who have been in office for barely 10 minutes.
In the Prime Minister’s interview on the BBC yesterday, we saw why he has allowed the strikes to go on for so long without intervening himself: he is using industrial action as an excuse for the state his party has left the NHS in after 14 years. He would rather blame NHS doctors and nurses than take a shred of responsibility himself. Meanwhile, patients cannot get an appointment, cannot get the surgery they need and cannot see a GP, NHS dentistry is decaying, and the NHS itself is on life support. While he was bragging about all the parts of the NHS that are not currently on strike—that is how low he now sets the bar—he seemed to have forgotten that nurses are still in formal dispute. Is he so uninterested in our nation’s health service that he did not know? Was he trying to pull the wool over the voters’ eyes? Or is he just another Tory Prime Minister asleep at the wheel as he drives the country off a cliff?
There was one thing that the Prime Minister got right in his interview with Laura Kuenssberg yesterday. Whether the question was on the NHS, immigration or the economy, his response was the same: ask the Leader of the Opposition. It seems that even this Conservative Prime Minister knows that if we want serious solutions to the problems facing the country today, there is only one place to look, and that is the Labour party.
Mr Deputy Speaker
Order. The hon. Gentleman has been here long enough to know that people do not give way during a statement.
Wes Streeting
Patients are sick and tired of waiting—waiting for ambulances, waiting for a GP appointment, waiting for their operation and waiting for a general election that cannot come soon enough. Why do the Conservatives not get out of the way and let Labour fix the mess they have made?
Victoria Atkins
I welcome the hon. Gentleman back from his world tour promoting his book. It is very nice to meet him for the first time across the Dispatch Box. While he was away in sunnier climes, he may have missed what is actually happening in Wales, which interestingly has been described by the Leader of the Opposition as the “blueprint” for how Labour will run the NHS, were it ever to come into government. Interestingly, in the Labour-run Welsh NHS, people are almost twice as likely to be waiting for treatment, and they are waiting an average of five weeks longer for NHS treatment under Labour in Wales than they do in England. Indeed, the number of patients in Wales seeking treatment in England has increased by 40% in two years because of the experiences that people are having in Wales.
I will just correct the hon. Gentleman on a couple of other things, too. Just to help him understand, we are delivering the 800 new ambulances—those are new ambulances—at pace at the request of the NHS, just as we are putting in 5,000 extra beds in hospitals across England, because we understand the point about capacity and we want to help the NHS look after people in a timely and efficient manner.
I will also just correct him again on the doctors in training point. I am surprised he has come on to that at this point, but had he spoken to his friends in the BMA, he would have understood that that is the phrase that the BMA is using. It has passed a motion to stop using the phrase “junior doctors”. [Interruption.] Yes, the BMA passed a motion. The hon. Gentleman referred to doctors, but he perhaps does not understand the complexities of contractual negotiations. The phrasing is used to denote those professionals who are still on formal training pathways who are not specialty doctors or consultants. That terminology has been agreed with the BMA.
In terms of the strikes themselves, I note—I know that those sat behind me on the Government Benches noted it, too—that the hon. Gentleman did not condemn the strikes. I am happy to give way, if he would like to confirm whether he condemns the strikes. Unfortunately, he has missed his chance to do so, but I suspect that everybody, including the patients at home waiting for appointments, will see the Labour shadow Minister’s failure to condemn these strikes. That is because, in line with public sector strikes more generally, the Labour movement will always prioritise union harmony over patient safety. That is not what we as Conservatives do; we will always put patient safety first.
Building an NHS Fit for the Future
Wes Streeting Excerpts(1 year ago)
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Wes Streeting (Ilford North) (Lab)
I congratulate the Minister on being the great survivor of the Department of Health and Social Care. She must surely be due a carriage clock or the long service medal by now. The only long-term decision for a brighter future seems to be that she is still in her place, although she did not offer much of a brighter future.
More positively, I see far more than one nervous face on the Government Benches—I see lots of nervous faces among those contemplating the next general election—but one is undoubtedly that of the hon. Member for Uxbridge and South Ruislip (Steve Tuckwell). I congratulate him on his election and wish him well for his maiden speech, which I can confidently say will be the best speech we hear from those on the Conservative Benches all day.
At a time when patients cannot get a doctor’s appointment, families are struggling to pay the mortgage and major conflicts are having an impact on our economy and security, the Prime Minister has spent the past five days deciding whether to sack his Home Secretary for publicly disobeying him, undermining the police and inflaming tensions on our streets. Finally, having had the sheer poor judgment to have appointed someone to such high office when she had already been forced to resign for a serious national security leak, he has summoned up the guts to sack the worst Home Secretary in history. Yet, as we see, the merry-go-round of the Conservative clown show continues. After 13 years, the Conservatives have run out of names at the bottom of the barrel, so they are starting all over again. May I offer my sympathies to the Conservative Members who did not get the call from No. 10 today? What kind of message does it send to their constituents that their own party leader cannot find a suitable candidate for Foreign Secretary among the 350 Conservative MPs who sit in this House?
The arsonist has today returned to the fire, because when it comes to the national health service, Lord Cameron has quite a lot to answer for as the architect of austerity and the biggest top-down reorganisation in the history of the NHS—a £3 billion disaster that has led straight to the biggest crisis in the history of the NHS. That is before we even begin to take into account his record of ushering in the “golden” age between Britain and China; taking 20,000 police officers off our streets; and having food bank Britain leave more than 1 million people dependent on charity to feed themselves and their families. That is Lord Cameron’s legacy and as the current Prime Minister admits, “some mistakes were made”. Who is he trying to kid when he tells us that this recycled Conservative Government offer the change our country needs?
I would welcome the Secretary of State for Health and Social Care, the hon. Member for Louth and Horncastle (Victoria Atkins) to her position, but of course she is not here this afternoon, having just been appointed earlier today. She is the fifth Secretary of State for Health and Social Care that I have faced in this job in less than two years, although, to be fair, two of those appointments were the right hon. Member for North East Cambridgeshire (Steve Barclay). The Government said they would make
“Long-term decisions for a brighter future”,
but they cannot even deliver a long-term Secretary of State for Health.
We know where the Secretary of State is—she will be in the Department being briefed about the challenges of the job and being brought up to speed. No doubt she and new Ministers will want to review the decisions she is inheriting and to start to think afresh about whether she wants to proceed with those decisions as they have been working through the machine. That is why it is so grossly irresponsible to change Ministers every five minutes and constantly churn from one face to another, when it is clear to everyone but the Prime Minister that it is not just a change of faces around the Cabinet table that we need, but a change of Government.
As the Secretary of State sits in the Department being briefed by her civil servants, I will help them out with the induction by offering her a primer on what she inherits: millions of patients a month unable to get a GP appointment when they need one; 24 hours in A&E—not just a television programme, but a reality for far too many; ambulances not arriving on time, if they arrive at all; the 12th month of the worst strikes in the history of the National Health Service; NHS dentistry in managed decline, to the point where people are forced to pull out their own teeth—DIY dentistry in 21st century Britain; a generation of young people who have paid the price for lockdowns with their mental health, forced to wait years for the support they need; the longest waiting lists and the lowest patient satisfaction in history. That is the record of the Secretary of State’s seven predecessors: failure, upon failure, upon failure, upon failure, upon failure, upon failure, upon failure.
Barbara Keeley (Worsley and Eccles South) (Lab)
My hon. Friend is absolutely right about that list of failures—it is shocking. I would like to add to the list that over 2,000 autistic people or people with learning disabilities are detained in inappropriate units, when this Government promised over 10 years ago to close them all down.
Wes Streeting
I thank my hon. Friend for her intervention. As I make progress through my speech I will come back to the breath-taking complacency about mental health we heard from the Minister a moment ago.
Given the scale of the crisis and given that the Prime Minister has made fixing waiting lists one his five priorities, hon. Members might have expected something in the King’s Speech to deal with it. Instead, we got nothing on the NHS as it heads into its most challenging winter yet and we got nothing on social care, just kicking the can down the road and delaying reforms until after the election. There was nothing on dentistry, despite even Conservative Back Benchers crying out for a rescue plan, and nothing on mental health, despite the Conservative party committing to reform, not just in its last manifesto but in its last two manifestos.
It was the longest King’s Speech in almost a decade, with the fewest Bills. Does that not just sum up the modern Conservative party? Plenty of slogans, but no solutions. What we got was a Bill that will not come into effect until after the general election and a sack-the-nurses Bill. On the tobacco and vapes Bill, the question is not whether Labour will support it, but whether the Conservative party will support it. Government Members will remember that I first proposed that smoking ban back in January. I say they will remember, because they made their feelings known in newspapers at the time. They called it “nanny state” and
“an attack on ordinary people and their culture”.
They accused me of “health fascism”. Well, they can now make their considered and nuanced views known to the new Secretary of State—I am sure she is looking forward to receiving them. It just demonstrates that where Labour leads, the Government follow.
The Prime Minister may be too weak to whip his Back Benchers to vote that crucial measure through, but on the Opposition Benches we will put country first and party second. Labour MPs will go through the voting Lobby and make sure that the legislation is passed, so that young people today are even less likely to smoke than they are to vote Conservative.
I am afraid to disappoint the Government, but we will not be supporting the other Bill in the King’s Speech that relates to health. Most people look at the crisis in the NHS and think it needs more doctors and nurses. The Conservative party looks at the health service and concludes that we need to sack more doctors and nurses. The Government are saying that public servants should be sacked for failing to provide minimum standards on strike days, but the Government have not met the four-hour A&E standard since 2015; they have not met the standard for treatment within 18 weeks since 2016; and they were doing so badly on meeting cancer waiting time standards that they have simply got rid of the standards altogether. If the Conservatives are proposing to sack doctors and nurses for failing to provide minimum service levels, can we now sack Ministers for failing to meet minimum standards on non-strike days?
The new Health and Social Care Secretary has an opportunity to break with the past year. Strikes are crippling the NHS and they are putting patients in harm’s way. Her predecessor may have thought that they were a useful excuse for his failure, but they were, and are, a misery for patients and staff alike. The Government must stop the scapegoating of NHS staff, go into these negotiations with good faith, work at finding a solution, and, finally, bring these strikes to an end. There will be no progress on turning around our national health service until the Government make some progress.
When summing up I hope the Minister will explain why action was not taken on the Mental Health Act 2007, because, I am afraid, the Minister’s opening remarks were entirely unsatisfactory. The Bill has gone through Committee. It has cross-party support. It is ready to go, so where is it? The treatment of people with learning disabilities and autism under the current Act shames our society. The disproportionate impact on black people, who are four times more likely to be sectioned than white people, is appalling. Prisons and police cells are no place for people with mental ill-health. Surely that is not controversial in 2023. It is, as the former Prime Minister, the right hon. Member for Maidenhead (Mrs May), said, “a burning injustice”. I cannot understand why the Government have broken their promise to address that matter finally.
It is long past time that mental health was treated with the same seriousness as physical health. Labour will not only reform the Mental Health Act in our first King’s Speech, but recruit thousands more mental health professionals, provide hubs in every community, and set up mental health support in every school, so that young people can get the help they need when they need it. [Interruption.] The Minister says that they have done that. What planet is she living on? This is the problem with these Ministers. Even when the faces change, the lines remain the same. The Minister has not changed, but she is still reading from the same failed script. This is the problem with the Conservative party. Its message to the country is simple: “You have never had it so good. Everything is going really well. The reason we are churning all the Ministers in our Cabinet is that they are doing such a good job. It is job done and time to give someone else a chance.” I am afraid that that is why these Conservatives are so out of touch and will struggle at the next general election if their message to the country is that it has never had it so good.
Furthermore, unlike this Government, who crashed the economy in the most reckless way, we will pay for our policies, making sure that they are fully costed and fully funded—in this case, by ending tax breaks for private schools and private equity fund managers. Politics is about choices: Labour chooses the wellbeing of the many, not the interests of the few, and we will fight the election on those lines any time. I say call the election tomorrow, because we are ready.
When it comes to dentistry, I should also say farewell to two former Ministers, the hon. Members for Colchester (Will Quince) and for Harborough (Neil O’Brien). As the hon. Member for Harborough departs Government, I hope that he does not take with him his pledge to bring forward a recovery plan for NHS dental services. It has been seven months since he announced that such a plan would be forthcoming, yet it is now nowhere to be seen. Indeed, last week, integrated care systems were given permission to raid their dentistry budget underspends and to remove the ringfence. That follows a pilot in Cornwall, trialling making NHS dentistry available only to children and the most vulnerable. It is the managed decline of NHS dentistry before our eyes. If people want to know what the future of the NHS would look like with five more years of the Conservative Government, they need only look at the ghost of Christmas past in NHS dentistry. The Conservatives blame the previous Labour Government, but they have been in power for 13 years. In 2010, we stood on a manifesto committed to reforming the NHS dental contract. They have had 13 years to do it, and they have failed again and again, leaving us in the situation that we are in today, with Dickensian stories of desperate people performing DIY dentistry and tooth decay being the most common cause of children aged six to 10 being admitted to hospital. It did not need to be this way.
I say to the new Secretary of State and her team that she may not have a plan, but Labour does, and she is more than welcome to nick it. We will deliver 700,000 more urgent appointments a year, recruit dentists to the areas most in need, introduce supervised toothbrushing in schools to prevent children’s teeth from rotting, and reform the NHS dental contract so that everyone who needs an NHS dentist can get one—
Wes Streeting
The Minister says, “Is that it?”. It is 700,000 more NHS dentistry appointments than her Government are providing. It is ridiculous. The extent to which Ministers continue to parrot these ridiculous lines is embarrassing. If they want to intervene, make my day. I am perfectly prepared to confront any Member with their own Government’s record. Of course, they do not want to defend the Government’s record; they have a hard enough time doing that on the doorstep.
Turning back to His Majesty’s Gracious Speech, there may not have been any Bills for the health service last week, but we did see the white flag being waved on the Prime Minister’s pledge to cut waiting lists. Hospitals received a letter telling them to cut the number of operations and appointments they are aiming to offer this year. At the same time, an extra funding pot was announced, so we are literally paying more and getting less. No wonder the NHS is in such a state. No wonder waiting lists have trebled since 2010. No wonder hundreds of thousands more patients are waiting for treatment today than when the Prime Minister first made his pledge.
Jim Shannon (Strangford) (DUP)
I want to make a plea for those 10,000 young people with cystic fibrosis, who have to take multiple medications and endure daily physiotherapy, blood tests, X-rays, and hospital visits—waiting on many occasions—as part of their normal routine just to stay well. The shadow Secretary of State and the Labour Opposition have given a commitment to endeavour to do better for the NHS. Will he do better for those 10,000 young people who have cystic fibrosis?
Wes Streeting
I am very grateful to the hon. Member for his intervention. I am deeply concerned about the situation facing children with cystic fibrosis in particular, given that there is radically life-extending treatment available that offers the hope to those young people not just of longer, happier, healthier lives, but of reduced admissions to hospital. It is right that the National Institute for Health and Care Excellence makes those judgments in a rigorous way, looking at the evidence. I hope that it will be successful in bringing down the price of those drugs by negotiating with the pharmaceutical companies to make sure that we can get affordable drugs to families who desperately need them and are desperately anxious that the announcement they have read about means shorter lives for their children. No family should go through that agony, and I hope that a resolution can be found.
The Government and the previous Health Secretary got into the habit of stealing Labour’s policies—I say that not as a complaint, but as an invitation. It is clear that the Government do not have a plan to cut NHS waiting lists, but we do: £1.1 billion will be paid straight into the pockets of hard-pressed NHS staff to deliver 2 million more appointments a year at evenings and weekends, paid for by abolishing the non-dom tax status, because patients need treatment more than the wealthiest need a tax break—[Interruption.] Conservative Members groan when we mention charging non-doms their fair share, they groan when we talk about closing private equity loopholes and they groan when we talk about taxing private schools fairly. They did not groan when taxes went up on working people. They did not groan when benefits were cut for the poorest people.
We know who the Conservatives are in it for. They are in it for the few; we champion the interests of the many. That is the Labour difference. We believe strongly that people who live or work in Britain should pay their taxes here too. There is still time for the new Secretary of State to lobby the Chancellor ahead of the autumn statement. This genuinely is an oven-ready plan, unlike some of the plans we have heard from the Conservatives, and I encourage the new Secretary of State to nick it.
After 13 years, we have an NHS that gets to people too late. We have a hospital-based system geared towards late-stage diagnosis and treatment, which delivers poorer outcomes at greater cost. We have an analogue system in a digital age. We have a sickness service, not a health service, with too many lives hampered by preventable illness and too many lives lost to the biggest killers. It could not be clearer: the longer we give the Conservatives in power, the longer patients will wait. This was an empty King’s Speech from a Government who have run out of road, run out of steam and run out of ideas; a Conservative party too busy tearing itself apart to govern the country; a Prime Minister who cannot decide whether it is time for a change or to go back to year zero.
The future of the NHS after another five years of the Tories is emerging before our eyes: a two-tier health service, where those who can afford it go private, and those who cannot are left waiting behind—our NHS reduced to a poor service for poor people; our country viewed as the sick man of Europe. It does not have to be that way. The Prime Minister was right when he said,
“It’s time for a change”,
but only Labour can deliver it.
Labour has a different vision for our country in which no one fears ill health or old age; people have power, choice and control over their own health and care; the place people are born, or the wealth they are born into, does not determine how long they will live or how happy their lives will be; patients benefit from the brightest minds developing cutting-edge treatments and technology; and children born in Britain today become the healthiest generation that ever lived.
Only Labour has a plan to get the NHS back on its feet and make that vision a reality: a plan to cut waiting lists, delivering 2 million more appointments a year; a rescue plan for NHS dentistry, delivering 700,000 more appointments, recruiting dentists to the areas most in need, introducing toothbrushing for three to five-year-olds in schools and having an NHS dentist for all who need one; a plan to double the number of scanners so that patients are diagnosed earlier; a plan to recover our nation’s mental health from the damage of lockdowns; a plan to cut red tape that ties up GPs’ time, so that we can bring back the family doctor; a plan for the biggest expansion of NHS staff in history—a plan so good that the Government adopted it and gave us a head start; and a plan to reform the NHS to make it fit for the future. To those who say that that cannot be done and that things cannot be better, I say this: the last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history. We did it before and we will do it again.
It is not a change of faces we need but a change of Government. It is time to call a general election and give the British people the choice: more of the same with the Conservatives or a fresh start with Labour. Call a general election now, so that Labour can give Britain its future back.
Mr Speaker
We come now to a maiden speech, so there will be no interruptions. I call Steve Tuckwell.