Oral Answers to Questions

Wes Streeting Excerpts

Tuesday 24th January 2023 Commons Chamber

[Mr Speaker]

I call the shadow Secretary of State.

[Wes Streeting (Ilford North) (Lab)]

Labour founded the NHS to be free at the point of use, and we want to keep it that way. Given that the Prime Minister has advocated charging for GP appointments, and one of the Secretary of State’s predecessors has urged him to charge for A&E visits, will he take this opportunity to rule out any extension to user charging in the NHS?

[Steve Barclay]

I can see from your reaction, Mr Speaker, and the reaction of colleagues in the House, that that is a misrepresentation of the Prime Minister’s position. For the majority of its existence, the NHS has been run by Conservative Governments. We remain committed to treatment free at the point of use. That is the Prime Minister’s position and the Government’s position.

[Wes Streeting]

I note that the Secretary of State did not rule out any future extension of user charging, and I am sure that patients will have noticed too. Given that the chief executive of NHS England has said that the NHS needs to expand training; that many of the Secretary of State’s own Back Benchers are echoing Labour’s calls to double the number of medical school places; and that he has no plan whatsoever to expand NHS medical school training places, nursing and midwifery clinical training places, to double the number of district nurses qualifying, or to provide 5,000 more health visitors, is it not time for the Conservatives to swallow their pride, admit that they have no plan and adopt Labour’s workforce plan instead?

[Steve Barclay]

I am not surprised that the hon. Gentleman wants to misrepresent the Government’s plan, not least because his own plan is disintegrating before his own Front Bench. The hon. Member for York Central (Rachael Maskell), who spoke earlier, contradicted his point. Not only have the hon. Gentleman’s Front-Bench colleagues contradicted it; even the deputy chair of the British Medical Association has said that Labour’s plan would create higher demand and longer waiting times. I am not surprised that the hon. Gentleman does not want to talk about his own plans anymore; that is why he has taken to distorting ours.

NHS: Long-term Strategy

Wes Streeting Excerpts

Wednesday 11th January 2023 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I beg to move,

That this House condemns the Government for failing to recognise the current crisis in the National Health Service; regrets that, as a result of Government mismanagement, hundreds of lives may be being lost every week due to the collapse of emergency care while patients are finding it impossible to get a GP appointment, ambulance or operation when they need one; calls on the Prime Minister to acknowledge the crisis and act with the necessary urgency to mitigate the impact on patients; and further calls on the Secretary of State for Health and Social Care to ensure the NHS is never in this situation again by bringing forward a long-term strategy which will end delayed hospital discharges, provide the NHS with the necessary staff to treat every patient in good time, and reform primary and community care to reduce the number of people needing hospital treatment.

I rise to support the national health service, which is going through the biggest crisis in its history, and most importantly, to defend the patients who are suffering as a direct result of 13 years of Conservative mismanagement of the NHS. This winter has shown just how high a price patients are paying: NHS staff are walking out on strike—in the case of nurses, for the first time in their history—patients are waiting entire days for an ambulance to arrive, and then days on end in A&E before they are admitted; there were 50,000 needless, preventable deaths last year, which experts have blamed on unacceptably long waiting times; and there have been hundreds of avoidable deaths every week this winter, because emergency care has collapsed.

The Secretary of State for Health and Social Care says that he disputes those figures from the Royal College of Emergency Medicine and the Office for National Statistics, but I invite him to listen to some of the stories behind the numbers. An 89-year-old fell in the bathroom and waited nine hours for an ambulance. The sepsis that caused him to fall killed him. His consultant said:

“Had I seen him within a couple of hours it could have been avoided. Maybe.”

Teresa Simpson, a 54-year-old woman from Hull, suffered a cardiac arrest and lost oxygen supply to the brain. She waited 16 hours for an ambulance, which arrived only when her husband phoned 999 a second time, after she had become lifeless. She passed away. A consultant in the north of England described a scene in a hospital waiting room this winter when a patient collapsed:

“They get CPR on the floor. I am forced to declare his time of death in front of frightened, horrified members of the public and his wife. On the floor of the waiting room. He was elderly and frail and hadn’t wanted to bother us. We had run out of trolleys and beds. In the whole hospital. This was by 10am.”

The Prime Minister refuses to describe this as a crisis.

Our motion before the House calls for a long-term plan to end delayed discharges, give the NHS the staff it needs to treat patients on time, and reform primary and community care, so that fewer people end up in hospital.

[Alun Cairns (Vale of Glamorgan) (Con)]

Will the hon. Member give way?

--- Later in debate ---

[Wes Streeting]

The Government do not have a plan, but perhaps the right hon. Gentleman will surprise me by telling me, against all hope and expectation, that they do.

[Alun Cairns]

Clearly, some of the statistics and cases that the hon. Member highlights are distressing and no doubt need to be investigated. The Prime Minister has rightly prioritised waiting times as one of his key commitments this year. How does the hon. Member account for the performance in Wales, which is worse than in England on all the statistics that we highlight, in spite of the Labour party having been in charge of the NHS there for more than 20 years?

[Wes Streeting]

I am grateful for the right hon. Gentleman’s intervention, because it brings me directly to the Government’s amendment to the motion, which is not a plan but a litany of excuses for the situation across the United Kingdom, including in Wales. I will run through them. By way of excuse, they say that the situation is challenging across the United Kingdom, and they are right: in Wales, the NHS is struggling; in Scotland, the NHS is struggling; and in Northern Ireland, the NHS is struggling. What do all parts of the United Kingdom have in common? Thirteen years of Conservative underfunding.

I will tell the right hon. Gentleman that, as he knows perfectly well as a Welsh Member, the reason why the Welsh NHS struggles more than England overall is the age profile of the population, the number of disabled people in Wales and the level of deprivation. The same disparities between Wales and England overall also explain the enormous health inequalities within England, which is why health outcomes in my city—in London—are so much better than in so many parts of the north or south-west of England. And you know the way to deal with that? It is genuine levelling up. But if people want a Government who tackle health inequalities so that every person in every part of the United Kingdom gets good-quality healthcare, they need to elect a Labour Government here in Westminster. That is the truth that the right hon. Gentleman does not want to admit.

I know that SNP Members will not be here today, because we are talking about England, but here is another truth that Nicola Sturgeon does not want to admit either: people in Scotland will be better off under a Labour Government too. She knows that just as well as anyone else.

When Conservative Members are not talking about other parts of the United Kingdom, they say that health pressures exist right across the world, but international pressures do not explain why the average wait for an ambulance is 14 minutes in France, while heart attack victims and stroke victims routinely wait an hour for an ambulance here in England. International pressures do not explain why it is that, over the past year, one in six UK adults had a pressing need for medical examination or treatment but could not get access. They do not explain why this is the highest figure out of 36 European countries and almost triple the EU average. Their excuses about international pressures do not explain why cancer outcomes in England are behind other comparable countries. None of that explains why the state of the NHS is as bad as it is today, but perhaps the hon. Member for Bosworth (Dr Evans), who was trying to intervene, wants to stand up and justify why it is that, after 13 years of Conservative Government, his constituents are waiting an average of an hour for a heart attack or stroke case.

[Dr Luke Evans (Bosworth) (Con)]

I am grateful to the hon. Member for giving way, and there are two points that I would like to pick up, seeing as he has come back to me on the second one. The first one, about comparable data, is really important. Does Labour have a position on sharing data between Wales, for example, and England, because the data is not comparable, which makes it very difficult to work out what is going on? Secondly, a plan was brought forward by the Government. It is called the NHS White Paper, which was brought forward by the NHS to transform the NHS with the integrated care boards, which are now in place. The people on those boards—42 of them—are the best people to make that change.

[Wes Streeting]

I find it astonishing. The hon. Gentleman’s position seems to be this: the Government have a plan, after 13 years, and apparently that plan is in progress. So why is it that so many Conservative Members just this week have stood up to talk about the fact that their constituents cannot see a GP, they cannot get an ambulance when they dial 999, and they are waiting hours on end in A&E departments? I know they like three-word slogans, but is the latest Conservative slogan on the NHS really “Crisis, what crisis?”?

[Lee Anderson (Ashfield) (Con)]

I have received several emails from Labour party members in Ashfield asking me to back the Labour party’s fully costed NHS plan. Could the hon. Member please send me a copy?

[Wes Streeting]

I would be delighted. I can barely believe it. Honestly, I can barely believe it. This is the second time this week that Conservative MPs have said, “We need to see Labour’s plan, because we haven’t got one.” I would be absolutely delighted. The hon. Member can even sign it and put it in one of his party’s fundraisers—God knows he is going to need it at the next general election. I will tell him what the plan is: it is a fully funded, fully costed plan to deliver the biggest expansion of NHS staff in history—doubling the number of medical school places; 10,000 more nursing and midwifery clinical training places; 5,000 more health visitors; and doubling the number of district nurses. That is my plan. Where is their plan?

The Government amendment refers to funding and states that they are putting in an extra £14.1 billion. I wonder how much of that will be swallowed up by the inflation caused by their catastrophic mismanagement of the economy. People are not just paying the Truss and Kwarteng premium; this is the price of 13 years of low growth, low productivity, high taxes and stagnation. Every penny will be swallowed up by higher inflation. That is the truth. Why do people talk about 13 years of underfunding? It is because they know it did not need to be like this, and because they saw what the last Labour Government did. With Labour, per capita spending on health increased by 5% each year, and we were able to do that because we grew the economy. Under the Conservatives, spending per capita fell during the coalition years, fell in the following two Parliaments, and even the increases that the Government promise today will not match the investment that Labour put in. That is the price of Tory economic failure.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

My hon. Friend is making an outstanding opening speech. My constituent told me last week about his relative who has multiple myeloma and had a stem cell transplant last year. She had a bad viral infection for three weeks, which is a serious issue after chemotherapy and a transplant. My constituent was asked by her consultant to take his relative to another hospital, because no beds were available at the hospital where she was being treated. She was treated in the corridor and waited 24 hours for a bed. Does my hon. Friend agree with my constituent that that hospital and its staff were not to blame and that, with underfunding and no strategy for the NHS now or in the future, the fault lies squarely with this Government?

[Wes Streeting]

I wholeheartedly agree. We hear this time and again. When patients are struggling to get access, and experiencing appalling delays in accident and emergency, they do not blame the staff. They know that the staff of the NHS are busting a gut, but those staff are suffering in the same way as patients because of 13 years of Conservative mismanagement. The only part of the Government’s amendment that I agree with is the part that praises NHS staff. Why is the Secretary of State’s Prime Minister bringing in his “sack the nurses” Bill next week? How many nurses will he sack? How many paramedics or junior doctors will he sack? The only people who need the sack are this Government—[Interruption.] Perhaps the hon. Member for East Worthing and Shoreham (Tim Loughton) agrees.

[Tim Loughton (East Worthing and Shoreham) (Con)]

When the last Labour Government left power, they were spending 8% of GDP on the NHS. Last year that figure was 10.6%, which is average for the EU nations. Why did the last Labour Government so chronically underfund the NHS?

[Wes Streeting]

The hon. Gentleman has got some brass neck. I have already given him figures showing that per capita funding increased by 5% under the last Labour Government—[Interruption.] And as for GDP, perhaps he should look at growth figures and ask why the economy is so much smaller than it would have been if we had had a Labour Government managing the economy well. That is the truth; it is a simple fact. If not, perhaps he wants to explain how his Government will put more money into the NHS, but I did not hear that commitment.

[Mr Toby Perkins (Chesterfield) (Lab)]

I thank my hon. Friend for his excellent speech. I do not quite know why I have intervened, because I am very much enjoying watching him flay the bowling to the boundary when he gets questions from Conservative Members. He is absolutely on to something in relation to the money that has been wasted in our NHS by the failure to plan for NHS staffing. Is not the reality that far too much money is being spent on agency workers because there is no long-term strategic plan for NHS staffing?

[Wes Streeting]

My hon. Friend is absolutely right. We are spending £3 billion on agency costs that would surely be better spent on ensuring that we have a serious workforce plan, and on hospital departments that are staffed by regulars who get to know their shift, get to know their colleagues, and get to know their patients and communities.

Let me turn to what the Secretary of State for Department for Business, Energy and Industrial Strategy said about ambulance staff, because I think he irresponsibly suggested that ambulance staff have not committed to minimum service levels for category 2 calls today, which is just not true. I think he ought to apologise to ambulance workers.

[Dr Luke Evans]

rose—

[Dame Angela Eagle (Wallasey) (Lab)]

rose—

[Wes Streeting]

I will give way to my hon. Friend the Member for Wallasey (Dame Angela Eagle), who has been waiting.

[Dame Angela Eagle]

On minimum service guarantees, does my hon. Friend think that the Conservative party has a brass neck to try to enforce minimum service guarantees, which are always made by agreement on any strike anyway, but says nothing at all about the catastrophic loss of service guarantees because of their mismanagement and underfunding on every other day?

[Wes Streeting]

My hon. Friend brings me neatly to the argument that I want to make about minimum service levels. Let me tell the Health Secretary who they are talking about when the Government attack ambulance crews. Donna Wilkins called an ambulance when she became concerned that her disabled son James may have been having a stroke, which is a listed side-effect of the medication that he takes. She and James waited in an ambulance for nine hours outside the Royal Bournemouth Hospital because there were no beds. Paramedics waited with them for the full nine hours. They chatted with James, loaded his favourite TV shows on their phone for him to watch and ran into the hospital to bring tea for Donna and soft food for James, who has problems with swallowing, which they spoon fed him. This is who NHS staff are. This is who ambulance crews are. These are the very staff the Government would have sacked with the legislation that they are bringing forward next week. As my hon. Friend said, what brass neck from this Government to talk about minimum standards on strike days when they cannot deliver basic minimum standards on any other day of the year.

The two-month target from GP referral to cancer treatment has not been met since 2015. Four in 10 people are waiting more than four hours in A&E. The four-hour target for A&E waits has not been met since 2015. The 18-week treatment target for elective care has not been met since 2016. One in seven people cannot get a GP appointment when they try. More than 1.3 million waited more than a month to get a GP appointment in November. How much more evidence do the Government want that they are incapable of delivering the minimum basic standards that patients deserve every single day of the year?

This has to be seen to be believed: the Government are planning an advertising campaign to urge patients to stay away from the NHS with the tagline “Help us help you.” Do they not see the risk in patients not coming forward for help when they need it? Can they not understand that people are fed up with being told that they have to protect the NHS, rather than the other way round? Instead of asking the public to help the NHS, the public want the Government to help the NHS to help them.

[Andy McDonald (Middlesbrough) (Lab)]

I do not know whether my hon. Friend is as horrified as I am by the juvenile and facile comments from the Conservative Benches, or whether he heard today on Radio 4 about the 600,000 people who every single month are waiting for four hours or more to get into A&E and be treated. As a direct result, horrifyingly, each and every month, hundreds and hundreds of people are dying needlessly in our country. That is on this Government’s watch. Should they not be hanging their heads in shame?

[Wes Streeting]

I wholeheartedly agree with my hon. Friend—avoidable and preventable. The Chancellor wrote an entire book about getting the number of preventable deaths down to zero, because that is where the figure should be, so to have 50,000 preventable, avoidable deaths reported is a badge of shame for the Government.

Worst of all, the height of the Prime Minister’s ambition is to stop making things worse. If we have 7.1 million people waiting for treatment, rather than 7.2 million people, apparently that is a job well done in the Prime Minister’s book. Our NHS needs to be rebuilt and renewed, but all he offers is managed decline. His five pledges have the bar set so low that even his predecessor could meet those promises.

If hon. Members want to know what real ambition and action look like, it is this: 89,000 more nurses; 44,000 more doctors; waiting times cut from 18 months to 18 weeks; 3 million more operations carried out each year; banning smoking in pubs; the largest hospital building programme in history promised and delivered; 100 new walk-in centres; GP appointments guaranteed within two days; free prescriptions for cancer patients; appointments with a cancer specialist within two weeks of referral; waiting lists cut to their lowest point in history; and patient satisfaction at its highest levels in history. That is the difference that a Labour Government make.

[Mrs Natalie Elphicke (Dover) (Con)]

On delivery by Labour, over the many years of a Labour Government, Dover and Deal saw its health service absolutely decimated, service by service. What has happened under a Conservative Government? There has been a new hospital built for Dover, the first dementia village in the country, built for Dover and Deal, one of the first 40 diagnostic covid hubs, delivered for Dover and Deal, and a new GP training centre, delivered for east Kent. Of course, there is more to do on health, but we have the plan—

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. Interventions must be brief by definition.

[Wes Streeting]

I cannot believe that the Member for Dover and Deal seems to be standing up and telling her constituents that when it comes to the NHS they have never had it so good. I know she is desperate and scraping the barrel because Prime Minister after Prime Minister have broken their promises on immigration and the Prime Minister is not dealing with small boat crossings, but I am afraid that pretending the NHS is working will not save her at the next general election.

To govern is to choose and the last Labour Government showed that investment plus reform equals better standards for patients. You do not need to do A-level maths to get to that equation. The right hon. Member for Gainsborough (Sir Edward Leigh) asked his Health Secretary:

“What is our long-term plan? We cannot leave the Labour party to have a long-term plan while we do not. How are we going to reform this centrally controlled construct?...What is the Secretary of State’s plan?”—[Official Report, 9 January 2023; Vol. 725, c. 297.]

What indeed is the Secretary of State’s plan? He has been in power for 13 years. His Government have presided over this record and still, after 13 years, they have no plan. Conservative Members asked what my plan was and I outlined it: a fully costed, fully funded plan to deliver the biggest expansion of NHS staffing—[Interruption.] They are saying, “Where is it?” I will repeat it for them again: double the number of medical school places; 10,000 more nursing and midwifery clinical training places; 5,000 more health visitors; and doubling the number of district nurses qualifying, paid for by abolishing non-dom tax status, because we believe that people who make Britain their home should pay their taxes here, too.

I understand that, in their partisan fury, because they cannot bear the fact that Labour has a plan and they do not, Conservative Members cannot swallow humble pie enough to take our plan and run with it. If they do not believe me, they should at least believe their own Chancellor, because this is what he said about Labour’s plan:

“I very much hope the government adopts this on the basis that smart governments always nick the best ideas of their opponents.”

If we were in any doubt already, this is not a smart Government and it will take a Labour Government to deliver Labour’s plan. That is why we end up with these sticking plasters, as we saw on Monday, to deal with this crisis.

Why did the Government choose to leave 230,000 patients languishing on NHS waiting lists when the spare capacity was there for them to be treated in the private sector? We know what our priority is: get patients treated as quickly as possible, pull every lever available to make it happen and make sure that patients do not have to pay a penny. The Government could act on doctors’ pensions to stop doctors retiring early for no reason other than that there is a financial disincentive to stay, but they still have not done it. They could bring strikes to an end by negotiating with the unions instead of threatening to sack the staff, but they still have not done it.

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

I want to give the hon. Member an idea to nick. He mentioned earlier the chronic situation with cancer waiting times, with 40%-plus of people diagnosed with cancer waiting two months to be seen. I wonder if he is aware of the work of the all-party parliamentary group on radiotherapy; I chair the group and his hon. Friend, the hon. Member for Easington (Grahame Morris), is a vice-chair. Fifty per cent. of people with cancer need radiotherapy. We spend 5% of the cancer budget on it. The average across developed nations is about 9%. Will he agree to give a bit of time to come to the group’s inquiry on 18 January? In looking at Labour’s plan, will he consider how we can fund radiotherapy, so we can treat people and do not have so many avoidable deaths?

[Wes Streeting]

Unlike the Government, we are happy to look at good ideas wherever they come from. I do not know whether I can make 18 January, but I am certainly happy to meet the hon. Gentleman so that we can ensure that Labour’s plan tackles the appalling waits that we are seeing for cancer treatment.

[Vicky Ford (Chelmsford) (Con)]

Will the hon. Gentleman give way?

[Wes Streeting]

I have to make progress. I know that Conservative MPs were not interested in speaking in this debate, but many Labour Members were.

We cannot continue pouring money into 20th-century healthcare that is not fit for the future. We do not focus nearly enough on prevention, early intervention and care in the community. Because people cannot see a GP, they end up in A&E, which is worse for them and more expensive for the taxpayer. Because people cannot get the mental health support they need, they reach a crisis point, which is worse for them and more expensive for the taxpayer. Because people cannot get the social care they need, they are left stuck in hospital, which is worse for them and more expensive for the taxpayer. That is why the next Labour Government will agree a 10-year plan with the NHS to shift the focus of healthcare out of the hospital, into the community and closer to patients, which is where it should be.

[Marsha De Cordova (Battersea) (Lab)]

My hon. Friend makes an excellent case, showing that Labour is the only party with a plan to deliver for the NHS. He will know that prevention and early intervention are key for people who are losing their sight. More than 650,000 people are currently on waiting lists. We know that 50% of all sight loss is avoidable, but many people are completely losing their sight because they are not getting early intervention and appointments. Does he agree that the Government need to get on with having a plan to tackle the eye health crisis in our NHS?

[Wes Streeting]

My hon. Friend has campaigned so determinedly on the issue, and she is absolutely right. When I spoke about self-referral in an interview with The Times, it was partly with ophthalmology in mind. In the vast majority of cases and for the vast majority of conditions, self-referral will not be appropriate and it is right that people see a GP before being referred to specialist services. But when people go and see someone who is trained and qualified to investigate their eyes, and that person makes a clinical judgment that they need to see a specialist, how can it be that, rather than being referred straight to the specialist, they are sent off to a GP first? That is absolutely crazy. It is wasting valuable doctors’ appointments and is lengthening waiting times for patients.

Labour is willing to look with an open mind at how we improve the patient journey. It is that fresh thinking that the NHS needs and is so badly missing from this Government. That touches on what I have been saying about the need to fix the front door to the NHS in primary care, with more care in the community. Our plan to recruit more doctors will deliver better access to GPs and ease pressure on accident and emergency departments.

We have to take a look at the GP partnership model, which under this Government is withering on the vine. By 2026, a majority of GPs will be salaried. There are three routes: let it wither on the vine, as the Conservatives are doing; accept that it is in decline and have something better to follow as it phases out over time, which is how we would approach it; or accept that GP partnership is valuable, in which case we should rebuild it. I am open-minded about whether we phase out GP partnerships or whether we rebuild general practice, but what we cannot do is what the Conservatives are doing, which is allowing general practice to wither on the vine. That is exactly what they have done.

Do you know what I found most remarkable today, Mr Deputy Speaker? In advance of this debate, I received a letter from the Minister, no less—the hon. Member for Harborough (Neil O’Brien), who is unfortunately not in his place—telling me that the current system of general practice is working. Bad news for you guys sat opposite, who are facing the patients and the voters at the next general election: your Ministers think that general practice is working. Your Ministers are therefore not looking at plans to fix it. Your Ministers are leaving you hanging out to dry at the next general election, because patients can see that only Labour is thinking about how to fix the front door to the NHS and rebuild general practice.

Our plan to recruit 8,500 mental health workers and provide community mental health clubs in every community—a plan championed by my hon. Friend the Member for Tooting (Dr Allin-Khan)—will deliver faster treatment, supporting schools and easing pressure on hospitals, as well as general practice.

Then there is the exit door of the hospitals to social care. Labour’s commitment to deliver better pay and better terms and conditions for care workers will reduce the 400,000 delayed discharges every month and provide a better quality of care for not just older people but working-age disabled people. There are so many people in hospital who would not need to be there if we could provide quality care in their homes, which is why our commitment to double the number of district nurses qualifying every year is central to our policy. We will also give every child a healthy start to life, with 5,000 more health visitors. [Interruption.]

The Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield) has just said, from a sedentary position, “We need more GPs.” I know we need more GPs. Patients know we need more GPs. So why have the Government cut more than 5,000 GPs in the last decade?

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

We have seen 13 years of failure in social care, with promises made and nothing ever delivered. There are now 165,000 social care vacancies, which is why the NHS is logjammed. Does my hon. Friend agree that it is time to pay our social workers a fair wage? Agenda for Change is a framework already built; let us give social workers a decent wage for the excellent work that they do.

[Wes Streeting]

My hon. Friend has consistently made the powerful case that pay and terms and conditions are directly linked to retention. No wonder we are losing so many people, not just from the NHS but from social care, to other employers in sectors such as retail. Earlier today, in this Chamber, I heard the Prime Minister say that as the minimum wage increased care workers would benefit, which tells us that care professionals are on the minimum wage while doing a really difficult job. No wonder they are going off to other jobs that cause less stress and anxiety and are better paid. This is not the way to run a social care system. We understand that, but the Government do not.

[Vicky Ford (Chelmsford) (Con)]

Will the hon. Gentleman give way?

[Wes Streeting]

No, because I must conclude my speech now. So many other Members want to speak that it would be unfair to take up more of their time.

This year marks the 75th anniversary of the NHS. For 75 years it has been there for us when we need it, founded by Labour but built by the British people, a public service, publicly funded, free at the point of need. Those are the values that are written into the DNA of the NHS. They are British values, they are Labour values, and it now falls to us, the party that created the NHS, to make sure that it is fit for the future.

I know, and the Opposition know, that the biggest obstacle to that change is no longer a busted, discredited Conservative Government on their way out, but the belief among too many people in our country that voting does not change anything, that politics does not matter, and that things cannot get better. I urge people throughout the country to ask themselves this simple question: are you better off than you were 13 years ago? Are your NHS services better off than they were 13 years ago? Are your public services better off than they were 13 years ago?

Labour has a plan; the Conservatives do not. Labour has a proud record of 13 years in government; the Conservatives do not. Only Labour can offer Britain the fresh start that it needs.

[Several hon. Members rose—]

NHS Winter Pressures

Wes Streeting Excerpts

Monday 9th January 2023 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

Happy new year to you, Mr Speaker, and to the rest of the House. I thank the Secretary of State for Health and Social Care for advance sight of his statement.

This winter has seen patients waiting hours on end for an ambulance, A&E departments overflowing with patients, and dedicated NHS staff driven to industrial action—in the case of nurses, for the first time in their history—because the Government have failed to listen and to lead. I notice that the Secretary of State did not talk about the abysmal failure of his talks with nurses and paramedic representatives today. Let me say to him: every cancelled operation and delayed appointment, and the ambulance disruption due to strikes, could have been avoided if he had just agreed to talk to NHS staff about pay. Today, he could have opened serious talks to avert further strikes. Instead, he offered nurses and paramedics 45 minutes of lip service. If patients suffer further strike action, they will know exactly who to blame.

Of course, the Prime Minister has already shown that he is not interested in solving problems; he resorts to the smokescreen of parliamentary game playing by bringing in legislation to sack NHS staff for going on strike. I ask the Secretary of State, in his sacking NHS staff Bill, how many nurses is he planning to sack? How many paramedics will he sack? How many junior doctors will he sack? The Government have the audacity to ask NHS staff for minimum service levels, but when will we see minimum service levels from Government Ministers and the entire Government?

After arriving at the Derriford Hospital in Plymouth, an 83-year-old dementia patient waited in the back of an ambulance outside A&E for 26 hours before being admitted. That was on 23 December, when no strikes were taking place; the Secretary of State should listen. The patient’s family found him in urine-soaked sheets, and since arriving in hospital, he has contracted flu. His daughter said of the hospital staff:

“They’re polite, they’re caring, and they are trying their best. It’s just impossible for them to do the work they want to do.”

Let me say what the Health Secretary and Prime Minister refuse to admit: the NHS is in crisis—the biggest crisis in its history. That is clear to the staff who have been slogging their guts out over Christmas and to everyone who uses it as a patient; the only people who cannot see it are the Government.

What has been announced today is yet another sticking plaster when the NHS needs fundamental reform. The front door to the NHS is blocked, the exit door is blocked, and there are simply not enough staff. Where is the Conservatives’ plan to fix primary care, so that patients can see the GP they want in the manner they choose? After 13 years of Conservative government, they do not have one. Where is the plan to recruit the care workers needed to care for patients once they have been discharged from hospitals, and to pay them fairly so that we do not lose them to other employers? After 13 years of Conservative government, they do not have one. Where is the plan to train the doctors, nurses and health professionals the NHS needs? After 13 years of Conservative government, they do not have one.

Well, we do. The Secretary of State is welcome to nick Labour’s plan to abolish non-dom tax status and train 7,500 more doctors and 10,000 more nurses and midwives every year; to double the number of district nurses; and to provide 5,000 more health visitors—a plan so good that the Chancellor admitted that the Conservative Government should nick it. After 13 years of mismanagement, underfunding and costly top-down reorganisations, however, all the Conservatives have to offer the NHS is a meeting and a photo op in Downing Street.

The collapse of the health service this winter could be seen coming a mile away—health and social care leaders were warning about it last summer—so why is the Secretary of State announcing these measures in the middle of January? Why have care homes and local authorities been made to wait until this month for the delayed discharge fund to reach them? It is simply too little, too late for many patients.

In fact, this Government are so last minute that, after announcing this plan last night, they found an extra £50 million and sent out another press release. I know most of us are happy to find a spare fiver lying around the house that we did not know was there, but this Prime Minister seems to have 50 million quid stuck down the back of the sofa. What on earth is going on? No wonder they cannot get money to the frontline: the left hand does not know what the right hand is doing.

It is intolerable that patients who are fit and ready to leave hospital are then stuck there for months because the care they need is not available in the community. They are not bed blockers, and they are not an inconvenience to be dropped off at a hotel and forgotten about. They need rehabilitation at home, rather than a bed in a care facility. Vulnerable patients deserve proper support suited to their needs, or they will fall ill again and go back to hospital. What about all these beds the NHS is procuring, and what about the capacity that families need? I will tell hon. Members what will happen: they will not get the care, and they will be coming right back through the front door of A&E, with the cycle of broken systems repeating itself again and again. Where is the choice and control for patients and their families who may not want to be discharged to a hotel?

I am afraid that, after 13 years, this just is not good enough. The Prime Minister might not rely on the NHS, but millions of ordinary people do. They are sick and they are tired of waiting. There have been 13 years of Conservative Government now—13 years—and look at what they have done to the NHS. Did the Health Secretary listen to himself as he described the situation in hospitals of people waiting on chairs for discharge, the trolleys in the corridors and people waiting longer than ever? Whose fault is it? It is not that of the NHS staff he is threatening to sack, but of the Conservative Ministers who have made disaster after disaster. After 13 years of Conservative Government it is clear that the longer they are in power, the longer patients will wait. Only Labour can give the NHS the fresh start and fresh ideas it needs.

[Steve Barclay]

The hon. Member talks about a fresh start, but even his own shadow Cabinet colleagues do not seem to agree with his plans. His own deputy leader seemed to distance herself from his plans to use the private sector, and his own shadow Chancellor seems to have distanced herself from his plans for GPs. Perhaps he can share with the House exactly how much his unfunded plans for GPs will cost, because the chief executive of the Nuffield Trust has said:

“It will cost a fortune”,

and is

“based on an out of date view”.

The point is that he has no plans that his deputy and his own colleagues support, and he has not set out how he would fund those plans in a way that does not divert resource from other parts of the NHS.

The hon. Member talked about pressure, yet there was no mention of the fact that the NHS in Wales, the NHS in Scotland and, indeed, health systems across the globe have faced significant pressure as a result of the combination of covid spikes and flu spikes, particularly in recent weeks. This is not a phenomenon limited to England and the NHS; this is a pressure that has been reflected internationally, including for the NHS in Wales.

The hon. Member refers to talks with the trade unions, and it is right that we are engaging with the trade unions. I was pleased to meet the staff council of the NHS today. Indeed, the chair of the NHS staff council, Sara Gorton, said the discussions had made “progress”, notwithstanding one trade union leader who was not in the talks giving an interview outside the Department to comment on what had and had not been said in those talks. We want to work constructively with the trade unions on that.

The hon. Member says that we are only announcing measures today, but again, he seems to have written those comments before he got a copy of the statement. The integrated care boards took operational effect in July last year—[Interruption.] Because they are scaling up, we are putting control centres in place and we are integrating health and social care. In the autumn statement, we announced £500 million for discharge, a further £600 million next year and £1 billion the year after, recognising that there is significant pressure, and that is ramping up. NHS England set out its operational plans in the summer, including the 100-day discharge sprint. That, for example, set out the greater use of virtual wards, which is new technology being rolled out at scale. It also announced the extra 7,000 community beds. Indeed, we also set out the additional measures in our plan for patients.

What is clear when we have a sevenfold increase in flu in a month—50 cases admitted last year compared with 5,100 this year—is that there is a combination of a surge in demand on top of the existing high-level position, and the surge in demand corresponds with a constraint on supply as staff absences also increase because of flu, so during the Christmas period community services are more constrained. Those two things together have created significant pressure on our emergency departments. That is why in the engagement I have had with health leaders the two key messages they gave to me were the importance of getting flow into hospitals, which is constrained by the high bed occupancy—that is why getting people out of hospital is so central to relieving pressure—and, within the emergency departments specifically, the need to decompress those services with same-day emergency treatment and having short stay post-emergency departments. That is a better way to decompress those emergency departments—through the triaging and bringing other clinical specialties closer to the front door. We have listened to the NHS frontline and those were the two key requests made to me, alongside other issues such as care quality inspections and how to make them more flexible. However, alongside those immediate pressures, we need to recognise that we had pressures last summer during the heatwave and we had pressures in the autumn, which is why we have announced a wider set of measures today.

So we have listened and we have acted; we have taken measures to deal with the immediate pressure, but we have also set out how we will build further capacity that will go through into the autumn. Alongside that, we have signed deals, for example with Moderna and BioNTech, and we are bringing forward the life science investment so that that has a better impact on pressures on the frontline.

NHS Industrial Action: Government Preparations

Wes Streeting Excerpts

Monday 12th December 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on Government preparations for industrial action in the NHS.

[The Minister of State, Department of Health and Social Care (Will Quince)]

I am grateful to the hon. Member for his question, which I am taking on behalf of the Department as the Secretary of State is attending a Cobra meeting on contingency planning for industrial action in the NHS. He also came before the House on the subject twice last week: at departmental questions and for the Opposition day debate.

We are all hugely grateful for the hard work and dedication of NHS staff, so we deeply regret that some union members have voted for industrial action. Our priority must be to keep patients safe. That begins with keeping the door open. The Secretary of State wrote to the Royal College of Nursing on Saturday asking for further discussions as a matter of urgency. At the same time, we are working with the NHS to minimise the disruption to patients if the strikes do go ahead. We are engaged with providers, professional bodies and trade unions to agree safe levels of cover should any action take place.

In addition, this afternoon, Ministers—including the Secretary of State—are attending a Cobra meeting focused on our contingency plans. Our plans draw on extra support from a range of places, including service personnel and the private sector. While we aim to minimise disruption, with the NHS already under significant pressure from the covid pandemic and winter pressures, we remain deeply concerned about the risk that strikes pose to patients.

I want to be clear that, even at this moment of uncertainty, people must keep coming forward to get the care that they need. People should continue to use NHS 111 if they need medical help and dial 999 in the event of an emergency. For more routine treatment, hospitals will do everything they can to ensure that planned procedures go ahead, but it is inevitable that any strike would mean some patients would have their treatment delayed. People will be contacted if their appointments need to be changed.

It is our hope that patients can be spared from unnecessary and unjustified strikes. Industrial action is in no one’s best interests, especially in this difficult winter. We have had constructive meetings with the leadership of several unions, including the RCN, Unison, Unite and the GMB, and we look forward to further discussions to find a way forward together that is in the best interests of the patients we all serve.

[Wes Streeting]

Thank you, Mr Speaker, for granting this urgent question. The power to stop these strikes likes squarely with the Government and the Secretary of State. The Royal College of Nursing and Unison have said that they will call off strikes this week if the Government are willing to negotiate with them seriously on pay. That reasonable offer of compromise is surely too good to refuse, so what on earth are the Government playing at? After 12 years of Conservative government, patients can no longer get seen on time and staff have been pushed to breaking point—and the Government cannot even be bothered to try to negotiate to prevent strikes from going ahead, at the worst possible time for patients and the NHS. The Government should ask themselves why, under a Conservative Government, nurses feel they have to take industrial action for the first time in more than 100 years and why ambulance workers are set to follow them for the first time since 1989.

It should be obvious by now what the Conservative agenda is. The Government know that patients are going to suffer this winter and they have no plan to fix the problems of their own making, so instead of taking responsibility for their failure they want to use nurses and paramedics as scapegoats to avoid the blame. It is a disgusting plan, it is a dangerous plan, and it is a plan that will not work. The public know that the power to stop these strikes is in the Government’s hands. If they fail to act now, patients will never forgive them.

How many operations have already been cancelled? How does the Minister expect those on the waiting list to feel if their operations are cancelled because of the Government’s gross negligence? Can he tell patients which services will be impacted if these strikes go ahead? Is the Secretary of State not embarrassed at Cobra today, asking the Army to come in to clean up the Government’s mess?

Even at this last minute, it is not too late to prevent strikes from going ahead. Perhaps the Minister can tell us whether the meeting with the RCN later today will involve discussions on pay. And if not, why not? Because that is all it takes: just a few minutes or a few hours of talk can avoid strike action. Why will they not do it?

[Will Quince]

The fact is that Labour is all over the place when it comes to strikes. They criticise Ministers while admitting that the unions’ pay demands are unaffordable. The hon. Gentleman and his party leader are too tied to their union paymasters to be on the side of patients. He knows that we have an independent pay review body, and is important that both sides respect that independent body. We accepted the independent body’s recommendations for this year’s increase in full, meaning that over 1 million NHS staff have been given at least a £1,400 increase in their pay. That is on top of a 3% pay rise last year at a time when pay was frozen across the wider public sector. The RCN, one of the unions taking action, is asking for an increase that is 5% above the retail prices index. Based on latest figures, that is an increase of 19.2%, or the equivalent of 6.5% of the NHS budget. To meet such demands, we would have to take money away from clearing the elective backlog that the hon. Gentleman referred to, something no responsible Government would wish to do.

Throughout this period, we have always sought to have a balanced process. Those in the private sector will not be getting a 19% uplift, and there is a clear need to be fair to the wider economy. We have to avoid inflationary pressures that would make us all poorer in the end.

We will continue to listen to colleagues’ concerns, not just about pay but many other issues affecting the working lives of those in the NHS. We will work with them to make improvements in a range of areas, from working conditions to patient safety, because we believe there is so much that we can agree on. Strike action is in no one’s best interest. We will keep working so that the NHS continues to be there for those who need it most.

Oral Answers to Questions

Wes Streeting Excerpts

Tuesday 6th December 2022 Commons Chamber

[Mr Speaker]

I call the shadow Secretary of State.

[Wes Streeting (Ilford North) (Lab)]

The chairman of the Conservative party claims that NHS strikes are exactly what Vladimir Putin wants, so why is not the Health Secretary negotiating to prevent them from going ahead?

[Steve Barclay]

I have seen the hon. Gentleman make that claim across the media a number of times. Just to reassure him, my door is open and I have been clear with the trade unions that I am available; I am available to them this afternoon or tomorrow. It is not I who set a precondition for those talks. When I met the trade unions, they raised a number of issues; not only pay, but safety of staff and other conditions, the estate, tech and so forth, and I am happy to engage with them on those points.

[Wes Streeting]

We get the warm words about wanting to negotiate, but a Government source briefed The Times last week that the Secretary of State’s plan is to wait for public sentiment to turn against striking nurses, saying:

“This is going to affect a lot of people…it could have a big impact on a lot of them and…in the end they will get fed up”.

He knows that this winter is going to be the most difficult that the NHS has ever faced, and he is using nurses as scapegoats to avoid the blame. That is the shameful truth, isn’t it?

[Steve Barclay]

First, it is a bit bizarre that, at departmental questions, the best the hon. Gentleman can manage is “a Government source”. Secondly, the revelation from that Government source is that this will affect “a lot of people”. I do not think that comes as any surprise. That is why we regret the action and are very open to having talks. The point is that he himself does not support the 19% pay demand of the trade unions. He stands here saying that we should be talking while he himself does not accept their proposal.

NHS Workforce

Wes Streeting Excerpts

Tuesday 6th December 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I beg to move,

That this House recognises that the National Health Service is facing the worst workforce crisis in its history with a shortage of 9,000 hospital doctors and 50,000 nurses; condemns the Government’s failure to train enough NHS staff to tackle this crisis; regrets that, as a result, patients are finding it impossible to get a GP appointment, ambulance or operation when they need one; calls on the Government to end the 200-year-old non-domiciled tax status regime which currently costs taxpayers £3.2 billion a year; and further calls on the Government to use part of the funds raised to invest in the NHS workforce by doubling the number of medical training places, delivering 10,000 more nursing and midwifery clinical placements, training twice the number of district nurses per year and delivering 5,000 more health visitors to guarantee that the NHS has the staff to ensure every patient can access the care they need.

The NHS is facing the worst crisis in its history. Seven million people are waiting for NHS treatment, and they are waiting longer than ever before; 400,000 patients have been waiting for more than a year. Heart attack and stroke patients are waiting an hour for an ambulance, on average, when every minute matters. “24 Hours in A&E” is not just a TV programme; it is the grim reality facing patients in an emergency. Behind those statistics are people being held back from living their lives: people forced to give up work because they cannot stand the pain; young people, still bearing the scars of lockdown, unable to get the mental health support they need to step into adulthood; families losing loved ones for no other reason than that the NHS was unable to treat them in time.

My friend and colleague the shadow Leader of the House shared with me an email from one of her constituents. A patient with suspected cancer was urgently referred by his GP, which ought to mean being seen by a specialist within a fortnight. Four weeks later he had heard nothing. He phoned the hospital and was told, “two weeks currently means six weeks” and that he would be contacted, not seen, within the next two weeks. He has now had his appointment, during which the doctor identified cancerous cells. He has been told that he will wait up to eight months to have that cancer removed. He said that until waiting lists are down,

“more people will die unnecessarily from cancer. I hope not to be one of them.”

That is not uncommon. That is where we are. That is why Labour is today putting forward our plan to solve this crisis, make the NHS fit for the future, and get patients treated on time again.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

Yesterday I spoke to a paramedic who had been with a patient with sepsis, waiting for two and a half hours to be taken in. There were 98 calls at that same Yorkshire hospital waiting to go in. Are we now post-crisis and in complete breakdown, and do we need Labour’s plans to come in now, and not have to wait?

[Wes Streeting]

I strongly agree with my hon. Friend. As the Leader of the Opposition has said, the NHS is not on its knees; it is on the floor. How many times were we told during the pandemic that restrictions were needed to stop the NHS falling over? It has now fallen over, and for the first time in its history people no longer feel certain that, when they phone 999 or arrive at A&E, they will be seen in time. It is the first time in our country’s history that people have not felt confident that emergency medicine will be there for them when they need it.

The Conservatives blame the crisis in the NHS on everything from the weather to the pandemic, and even NHS staff. Of course there is no doubt that the pandemic has made things worse, but the Government—the Conservative party—sent the NHS into the pandemic with 100,000 staff shortages. They spent a decade disarming the NHS, before sending it into the biggest fight it has ever faced. They cannot pretend that the NHS was well prepared. The problem for the Conservative party is that people are not stupid. Their memories are not that short. They know that the NHS was struggling to treat them on time before the pandemic, and they know who is to blame.

[Dr Luke Evans (Bosworth) (Con)]

Is not the point that health is devolved across four different nations, which are each led by a different party? Does this mean that the pandemic has hit all health services, including across the western world? This is a rising tide of the problem of the pandemic and dealing with an ageing population. This is not party political at all, and it is remiss of the hon. Gentleman to try to make it that. What does he say to that?

[Wes Streeting]

I would say two things. As I have already said, I accept that the pandemic made the challenge right across the United Kingdom worse. I also accept that, in every part of the United Kingdom, the NHS is under severe pressure. I would say two things in response. First, even if some of our friends on the SNP Benches do not want to acknowledge it, there is no doubt that every part of the United Kingdom would be better off with a Labour Government and every part of the NHS in every part of the United Kingdom would be better off if there were a Labour Government, because the investment that we are proposing in NHS staff today would benefit countries right across the United Kingdom. [Interruption.] In response to the outgoing hon. Member for Peterborough (Paul Bristow), do not say that politics does not make a difference. Do not expect the people to believe that somehow there was an inevitable sense of decline in the NHS. I am sure people remember that, when Labour was last in government, we delivered the shortest waiting times and the highest patient satisfaction in history.

[Paul Bristow (Peterborough) (Con)]

rose—

[Wes Streeting]

Is the hon. Member planning to cross the Floor? I look forward to hearing from him.

[Paul Bristow]

Certainly not. The hon. Member’s plan seems to be simply vote Labour—there is no detail to it and nothing else to it. I suggest that he looks at the good people of Wales, who suffer under a socialist healthcare system. They are certainly not very happy, are they?

[Wes Streeting]

I do not pretend that our plan is not vote Labour, but of course those are the means by which we get to better ends. What we propose today is the biggest expansion of the NHS workforce in history. I will explain how that will benefit patients across the country and how we will pay for it. I think that people in Peterborough, 2,788 of whom are waiting more than a month to see a GP, will welcome Labour’s plan for investment. That is why, after the next general election, Peterborough will have a Labour MP.

[Emma Hardy (Kingston upon Hull West and Hessle) (Lab)]

I want to raise the case of my constituent, Mr Simpson, whose wife died last Tuesday after waiting 16 hours for an ambulance. On 29 November, his wife was confused. At 3 pm, he first called for an ambulance and was told that one might be sent and that he might hear from the service. At 6 pm, he rang the ambulance again. The person wanted to speak to his wife, but she was very confused and unable. He tried to give her a drink at 2.30 am; there was still no ambulance. His wife went to sleep, but she was still moving a bit. He fell asleep. He woke at 7.30 am and found that his wife was not moving; she had passed away. All the while they were still waiting for the ambulance to arrive. I do not believe for one moment that that happened because the ambulance service does not care. Does my hon. Friend agree that the service is desperately understaffed, desperately short of resources and in desperate need of adequate funding?

[Wes Streeting]

I thank my hon. Friend for raising that heartbreaking case. It is every family’s worst nightmare. All of us now know someone who is waiting for treatment. Many of us know someone who has called for an ambulance and waited for hours and hours—and, in some cases, given up on it and gone to hospital. I have spoken to ambulance service staff who, like many other staff across the NHS, feel a real sense of deep personal moral injury because they know that, despite their best efforts and busting a gut at work every single day, their best simply is not good enough because the system has collapsed. Ambulance turnaround times are not fast enough because A&E waiting times are too high. That is because people cannot see a doctor and the social care is not available, so the beds are full of people who are well enough to go home and would be better off at home. This is the problem in the NHS: the whole system is broken. I am afraid to say that political decisions made in this place by the Conservative party have led us to this tragic situation.

[Andy McDonald (Middlesbrough) (Lab)]

My hon. Friend is making an excellent case. At the James Cook University Hospital in Middlesbrough, the number of people still in hospital who could be discharged into social care amounts to three full wards. That is the situation that we have got to. It is a perfect storm, with ambulances queueing outside and people turning up at A&E because they cannot get to a GP. That will only ever be addressed if we also address staffing in our GP services to ensure that they can attract people who are offered Agenda for Change terms and conditions to alleviate the backlog. Does he agree that we need to invest in all the elements along that supply chain?

[Wes Streeting]

My hon. Friend is absolutely right. This is the tragedy of where we have got to on social care in particular. The Government have allocated half a billion pounds to alleviate pressure this winter, but not a penny of it has reached social care providers. Not a penny of it is currently being worked in action to try to deal with delayed discharges. I have no doubt whatsoever that one reason why it has taken so long from that commitment to getting money to the frontline is the constant churn of Ministers that we saw over the summer. The absolute circus that we saw in the Conservative party has had a direct impact on the competence of effective Government in this country. We now have ineffective Government, so even when the Government seek to do the right thing and allocate the resources, they cannot get the money out the door far enough because Ministers seem to change week in and week out.

[Jim Shannon (Strangford) (DUP)]

I commend the shadow Secretary of State for what he is saying. When it comes to staffing issues, one thing should clearly be done. Does he agree that part of the reason why we rely so heavily on agency staff is because our NHS staff have migrated to agency working, where there is less pressure, so the Government should spend less money on agency workers and give our NHS staff greater support and appropriate pay so that they can stay in the NHS?

[Wes Streeting]

I strongly agree with the hon. Gentleman. I will come shortly to talk about industrial action, but this should be at the heart of the Secretary of State’s thinking. The demands from staff trade unions, whether on pay, terms and conditions or the wider pay machinery, should be seen not just as a negotiation with staff unions but as a retention issue. We are losing staff faster than we can recruit them in some places—especially in areas such as midwifery—and if we lose the staff that we have, even Labour’s plans to undertake the biggest recruitment in the NHS’s history would not be as effective as they would be if we kept staff in the service today. That is why I urge the Secretary of State to treat those NHS staff with respect, get their representatives around the table, and negotiate a solution.

I am aware that the situation in the NHS in Northern Ireland is the worst that we see throughout the United Kingdom. The shadow Secretary of State for Northern Ireland, my hon. Friend the Member for Hove (Peter Kyle), visited NHS services in Northern Ireland only recently. I have no doubt that we need to get effective governance back up and running again in Northern Ireland as well. I urge the Government to discharge their responsibilities in that area, too. Certainly, when Labour was last in government, I do not remember Labour Prime Ministers taking such a complacent, lackadaisical or indeed absent approach to the governance of Northern Ireland. I hope that we can see a breakthrough of the deadlock so that the people of Northern Ireland get the Government they deserve in Stormont, as well as the United Kingdom getting the Government it deserves here in Westminster.

Waiting lists were already at a record 4.5 million before the pandemic. Ambulances were taking longer than is safe to reach patients in an emergency before the pandemic. Patients were waiting longer than four hours in A&E before the pandemic. The 18-week guarantee for elective treatment had not been met for four years before the pandemic, and more patients have waited longer than two months to start their cancer treatment every year since 2010. From the moment the Conservatives entered power, things began to deteriorate. It is not just that the Conservatives did not fix the roof while the sun was shining; they blew off the roof and ripped up the floorboards, and then they wonder why the storm did so much damage.

[Charlotte Nichols (Warrington North) (Lab)]

My hon. Friend mentioned cancer diagnosis rates. I believe he will be aware that one in four people diagnosed with pancreatic cancer dies within a month of their diagnosis, with 70% receiving no treatment at all because they die before they could be treated. Does he agree that cancer diagnosis rates are a disgrace and that early intervention, early diagnosis and early treatment are vital for people with all forms of cancer, particularly the most aggressive types such as pancreatic cancer, to have any chance of survival?

[Wes Streeting]

My hon. Friend is absolutely right. One reason why this country has much poorer cancer outcomes than many comparable economies is precisely because of late diagnosis. I know from my own experience how vital early diagnosis can be for good cancer outcomes. I am terrified by the fact that, within those 7 million patients waiting in the elective backlog, there will undoubtedly be cases of undiagnosed cancer and other conditions. If the NHS had eyes on the patients, they would be detected faster, patients would receive treatment much more quickly and the outcomes would be better. One of the tragedies for the NHS is that, because we do late diagnosis, we get more expensive and less effective treatment. If we could diagnose faster, patients would get better outcomes and taxpayers better value for money. That is the kind of reform to the model of care that Labour would like to see.

[Wera Hobhouse (Bath) (LD)]

On diagnosis, access to GPs is also a vital part of the puzzle. Is it not terrible that the Government are not listening to GPs, who say they need a different visa system? They cannot recruit enough GPs into the system because the Government are so stuck with these immigration rules, and the Home Office does not want to change certain parts of the visa system?

[Wes Streeting]

I am grateful for that intervention. We are in the worst of all worlds on immigration and the NHS. The Government try to have it both ways. They talk tough on rhetoric, so we end up with a very bureaucratic, ineffective and costly system, but because they fail to invest in our own homegrown talent, they are over-reliant on immigration from other countries, including those who desperately need their own doctors and nurses. I do not think it is good enough, after 12 years of Conservative Government, that we are turning away bright potential doctors, nurses and allied health professionals because the Government cannot be bothered to pull their finger out and train our own homegrown talent. We need to see improvement, so we that can draw the best international talent and make the system smooth, efficient and effective, but it is also crucial that we train our own homegrown talent.

Turning to more of the Conservatives’ excuses—we have heard the excuses of the pandemic—let us now look at the excuse they are planning to deploy this winter. There is no denying that this winter could be the most challenging the NHS has ever faced. The Royal College of Nursing, for the first time in its more than 100-year history, is planning to undertake strike action. Just this lunchtime we got strike dates from Unison, the GMB union and Unite the Union. That raises the question: why are the Government not even trying to stop the strikes in the NHS from going ahead? Surely, when the NHS already lacks the staff it needs to treat patients on time, the Government ought to be pulling out all the stops, getting around the table and negotiating to stop industrial action? So why aren’t they?

The Secretary of State said in Health questions earlier that his door is open—as if we can just sort of wander in off the street into the Department of Health and Social Care, where there will be a cup of tea and a biscuit waiting, and he will be just waiting for the negotiations. That is not how this works. Everyone knows that is not how it works. He had a nice little meeting with unions after the summer, after Labour complained that we had not seen a meeting between a Secretary of State and the unions since the right hon. Member for Bromsgrove (Sajid Javid). Goodness me, we have had three Secretaries of State since then—and two of them are the Secretary of State on the Front Bench today. Why on earth are they not sitting around the table and conducting serious negotiations? I will tell you why, Mr Deputy Speaker: they know that patients are going to suffer this winter and they do not have a plan to fix it, so instead of acting to improve care for patients and accept responsibility, they want to use nurses as a scapegoat in the hope that they avoid the blame. We can see it coming a mile off. It is a disgusting plan, it is dangerous and it will not work.

If I am wrong, perhaps Conservative Members could explain why the Government are not trying to prevent the strikes from going ahead. Perhaps they could explain why the Secretary of State ignored all requests from the health unions for meetings and conversations this summer while the ballot was under way. Perhaps they could explain what the Government’s plan for the NHS is this winter. Perhaps they could explain why a Government source told The Times newspaper that

“Ministers plan to wait for public sentiment to turn against striking nurses as the toll of disruption mounts”.

They said the quiet bit out loud and they gave the game away.

What else would explain the unedifying and embarrassing spectacle of the chair of the Conservative party going on national television to accuse nurses of doing the bidding of Vladimir Putin? I should not have to make this point, but nurses are not traitors to this country. They bust a gut day in, day out to look after all of us. We clapped them during the pandemic and now the nurses are clapped out. They are overworked, overstretched and undervalued by this Government. Let me say to the chairman of the Conservative party that he would speak with greater authority on what is in Britain’s national interests if he did his patriotic duty in his own tax affairs.

When it comes to sending a message to Vladimir Putin, why does the burden consistently fall on the working people in Britain? Why is it that NHS staff must make huge sacrifices because of the invasion of Ukraine, yet people who live in Britain but do not pay their fair share of taxes here do not have to lift a finger? When it comes to paying the bills, the first and last resort of this Conservative Government is always to pick the pockets of working people, yet the enormous wealth of tens of thousands of non-doms is left untouched. They may blame covid, they may blame health professionals, they may even blame the weather, but it is 12 years of Conservative mismanagement and under-investment that has left the NHS without the doctors, nurses and staff it needs, and patients are paying the price.

I am sure every Member of this House, indeed everyone in the country, knows someone who has been let down when they needed healthcare in recent months. They all say the same thing: the NHS staff were brilliant, but there simply are not enough of them. There is no NHS without the people to run it, yet today there are more vacancies in the NHS than ever before: 9,000 empty doctor posts, 47,000 empty nursing posts, and midwives leaving faster than they can be recruited. There are 4,600 fewer GPs than there were a decade ago, and the right hon. Member for Bromsgrove admitted last year that the Government are set to break their manifesto promise to recruit them back.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I was looking at a message from a constituent this morning who told that he went to A&E having waited four weeks for a GP appointment. Does that not speak to a lack of investment in the NHS workforce over 12 years and a lack of adequate planning? I know how hard GPs work in my constituency, but the lack of GP availability to staff surgeries and provide those appointments is placing unneeded pressure on A&E. That is on this Government’s watch.

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. As we see so often with this Government, they make promises but break them. They try to fool the public into thinking they are delivering more GPs—or indeed more police officers—when it was the Conservative party that cut them. They try to give with one hand, but they take with the other, and after 12 years people have had enough.

Of course, it is not only the promise to recruit more GPs that the Conservatives are breaking. We had the promise of 40 new hospitals, which the Secretary of State repeated today, yet in response to the question posed by the right hon. Member for Uxbridge and South Ruislip (Boris Johnson), the Secretary of State said that of those 40 new hospital schemes

“five hospital schemes are in construction, two are now completed and we aim to announce the next eight by the end of this year.”

So, where are the other 25? Where are these 40 new hospitals? As far as I can tell, they exist only in the imagination of the former Prime Minister. Yet the script has not changed—Ministers are still here claiming 40 new hospitals.

When I visited Leeds with the shadow Chancellor, my right hon. Friend the Member for Leeds West (Rachel Reeves), I saw a vast pile of dirt where a new building was due to go up. We heard today that the Government cannot even negotiate an agreement with the hospital to get the site working and get the new facilities built. With every minute, every month and every year of delay construction costs are going up, so taxpayers are left in the worst of all worlds: broken promises, no 40 new hospitals, and paying through the nose for the ones that are being built because of Government incompetence.

We see the tragic consequences of the shortages and broken promises in the NHS. My hon. Friend the Member for Rotherham (Sarah Champion) raised the tragic case today at Health questions of a five-year-old boy who had what his doctor described as the worst case of tonsilitis he had ever seen. He was turned away from hospital, with his parents told there were no beds and not enough doctors. His infection worsened and five-year-old Yusuf later passed away. His death certificate recorded the primary cause of his death as pneumonia and the secondary cause as tonsilitis. What kind of country are we living in when a five-year-old boy can die of tonsilitis? This is criminal.

I met Yusuf’s uncle, Zaheer Ahmed, last week, and I did not know what to say to that poor man and his grieving family, who lost that little boy in the most unimaginable circumstances. I invite the Secretary of State to meet Yusuf’s family to hear how that little boy was failed and to hear at first hand about some of their interactions with the NHS, which I thought were completely unacceptable and intolerable. On that note, I welcome the independent inquiry that has been committed to. That is really important for the family who have been failed in this heartbreaking case. We do not want to see more cases like that.

At the heart of the crisis in the NHS—as with so many of the problems facing our country—is a failure to plan. The NHS has not had a workforce plan since 2003. That would be unacceptable in a multinational company one one-hundredth the size of the NHS. The failure to plan means that short-term fixes are always favoured over what is in patients’ long-term interests. That is why the Government cut the nursing bursary and why, this summer, in the middle of the biggest crisis in the history of the NHS, they took the infuriating decision to cut a third of medical school places.

[Dr Luke Evans]

Will the hon. Gentleman give way?

[Wes Streeting]

The hon. Gentleman has been to medical school; does he think that it was a good idea to cut the number of places this summer?

[Dr Evans]

When we talk about Labour’s record on training, the hon. Gentleman may forget that, in 2007, the medical training application service ended up in judicial review. Many of my colleagues moved out of disciplines that they loved dearly because of Labour’s mess in making those plans. He has been speaking for almost half an hour, setting out his exposé of what is going on in the health service, but I am yet to hear a plan. I hope that he will spend the next half an hour telling us about the detailed plan of how we get to 10,000 new medical places, because when it comes to firms in hospitals, there is not enough space for medical students to get that experience, so I am looking for him to solve that problem.

--- Later in debate ---

[Wes Streeting]

The hon. Gentleman is not looking forward to me solving the problem half as much as I am looking forward to solving the problem. As far as I am concerned, the general election cannot come soon enough. I say to Government Members, “Be careful what you wish for”, because I intend, indeed, to set out Labour’s plans in detail. I am happy to stretch that to half an hour if that is where the demand takes us.

[Daisy Cooper (St Albans) (LD)]

rose—

[Wes Streeting]

I give way to my Liberal Democrat friend.

[Daisy Cooper]

I am grateful for a number of the interventions, not least the most recent one. Is it not true that, as hospital trusts meet with regard to the new hospital programme today, they will discuss how big the new hospitals should be? Given that we need more space to train the doctors and nurses of the future, does the hon. Member agree that it would be criminal if they tried to cut corners by planning hospitals that are smaller than they need to be?

[Wes Streeting]

I wholeheartedly agree. I seemed to hear from the Health Secretary this afternoon a one-size-fits-all approach from the Government, as though every hospital’s needs will be the same and we can import a standardised model for every hospital site. I would be happy to be proven wrong, and I would be even happier if the Secretary of State got the ball rolling on some plans that are already agreed, and on which trusts have spent a significant amount of time and taxpayers’ money. I would be even more delighted if we got some of those hospitals open, but I would wager that when we get to the end of the Government’s life, we will not have seen anything like 40 new hospitals delivered or even in the pipeline.

[Peter Dowd (Bootle) (Lab)]

My hon. Friend is making a compelling case. I think I know where we could get some of the money from for training places, and perhaps he will agree. We forgo about £3.2 billion in revenue from non-doms every year. There are 68,000 non-doms, there or thereabouts, which works out at about £44,000 a non-dom. Does he think that he could do much with that?

[Wes Streeting]

My hon. Friend has led me neatly towards setting out Labour’s plans, which rely on people who come to this country and make Britain their home actually paying their taxes here. That is the right and fair thing to do, and I think people across the country would agree that we need nurses more than we need non-doms.

[Charlotte Nichols]

I have listened with interest to what has been said about the new hospital building programme, not least because we have been waiting for a new hospital in Warrington for a very long time. We recently opened the new Health and Social Care Academy at Warrington & Vale Royal College with some of our town deal fund money, but surely people need excellent, cutting-edge training facilities to go into in a hospital once they leave the college. The Government’s lack of progress on building us a new hospital in Warrington undermines some of the other excellent work that we are doing locally to try to train up the people we need to fill those workforce shortages.

--- Later in debate ---

[Wes Streeting]

I totally agree, and I heard of a really awful case in Warrington the other day. A Warrington resident who contacted me said that they waited 12 hours in agonising pain in accident and emergency before giving up and going home after midnight because she simply could not take it any more. The A&E department was so packed that she could overhear other patients’ conversations with clinicians, including sensitive medical information. Those are the kinds of conditions that patients are experiencing and in which the poor NHS staff have to work. It is simply unacceptable.

[Claire Hanna (Belfast South) (SDLP)]

I thank the hon. Gentleman for being so generous in giving way. Does he agree that keeping the working environment safe is core to workforce planning, retaining the people who are trained and stopping spending eye-watering sums on agency nurses? He outlined many scenarios in which staff are forced to work in unsafe conditions. Does he agree that the core message coming from health unions is their desire to have appropriate staffing levels to provide the service on which all our constituents rely?

[Wes Streeting]

I strongly agree. In fact, I spoke to the general secretary of Unison last week. She said that as the unions look at safe staffing levels in critical services, in their determination to maintain patient safety in the event that industrial action goes ahead, they have found that on non-strike days, the NHS already operates at staffing levels below what the union would intend to operate on a strike day. That is an unbelievable state of affairs.

I am really worried about industrial action. Like patients across the country, I do not want industrial action to go ahead—it will mean ambulance delays, cancelled operations and even greater pressures on the NHS—but the tragedy is that we see the conditions that I just described every single day in the NHS. Pat Cullen from the Royal College of Nursing said, “We are striking for patients”. I have heard that line time and again from RCN members. It is partly about NHS staff’s pay and the conditions in which they work, but more than anything else, they are telling me that they voted for industrial action—some for the first time in their entire careers—because they have had enough and can no longer suffer the moral injury of going to work, slogging their guts out and going home petrified that, despite their best efforts, they still did not deliver the care that patients deserved. What an intolerable situation they find themselves in. Their backs are against the wall, and that is why the Government should negotiate.

[Yasmin Qureshi (Bolton South East) (Lab)]

My hon. Friend is making an excellent speech. Does he agree that it is completely reprehensible for Government Ministers, when talking about potential pay strikes by nurses, to say that by going on strike, they are somehow enabling Putin’s regime?

[Wes Streeting]

That was a reprehensible thing to say and it shows how desperately the Government are scraping the barrel to make excuses for their negligence and mismanagement of the NHS.

As I said, I found it astonishing that this summer, in the middle of the biggest crisis in the history of the NHS, the Government took the infuriating decision to cut a third of medical school places. Thousands more straight-A students in Britain who want to help have been turned away from training to become doctors. It is like the clip of the former Deputy Prime Minister Nick Clegg saying in 2010 that there was no point in building new nuclear power stations because they would not come online until 2022. This country needs Governments who think beyond short-term electoral cycles and put the long-term interests of the country first. That is the approach that Labour would take, but it has been sadly missing for the past 12 years.

Just as the Government failed to build our energy security, leaving us exposed to Putin’s war in Ukraine, they failed to train the staff the NHS need, leaving us exposed as the pandemic struck. Their failure to prepare has left us in the ludicrous situation in which UK universities are now offering medical degrees only to overseas students. That’s right: the Government are refusing to allow bright British students to achieve their dreams of becoming doctors, so Brunel University is forced to take exclusively students from overseas. The Chair of the Select Committee on Education, the hon. Member for Worcester (Mr Walker), has warned that there is a real risk that medical schools will

“only train overseas students who go off and get jobs elsewhere”.

What a criminal mismanagement of our higher education system. What a failure to plan to meet our staffing needs with our own home-grown talent.

[Taiwo Owatemi (Coventry North West) (Lab)]

My hon. Friend is making an excellent point. Given that there were nearly 30,000 medical school applications last year from British students who really want to study medicine, does he agree that it is absolutely disgraceful that the Government have a cap of 7,500? That shows that we are not investing in our workforce or in home-grown British doctors. It is appalling that the Government cannot see the importance of that.

[Wes Streeting]

I wholeheartedly agree. To deal with that problem—and, indeed, to satisfy the demands of the Conservative party, which looks to Labour for answers—we are putting forward a plan today to solve the crisis, to bring down waiting times, to get patients the treatment they need and to build a healthy society.

Where the Conservatives are holding the best and brightest students back from playing their part in the health of our nation, Labour will unleash their talent in the NHS: we will double medical school places, training 15,000 doctors a year so that patients can see a doctor when they need to. Where the Conservatives have left nurses working unsafe hours, unable to spend the time they need with patients to provide good care—where the Conservatives have left the NHS so short of midwives that expectant mothers are turned away from maternity units that do not have the capacity to deliver their child—Labour will act: we will train 10,000 more nurses and midwives every year.

We will go further. The way we deliver healthcare has to change. For many patients, a hospital is not the best place to be, yet in the past 12 years all the other parts of our health and care service have been eroded by underinvestment. When our society is ageing and people increasingly want to be cared for in the comfort of their own home, surrounded by their loved ones, why have four in 10 district nursing posts been cut? Labour is proud to have district nursing at the heart of our plans to modernise the NHS, and we will double the number of district nurses qualifying every year.

Many colleagues across the House have campaigned for years on the importance of the early years of a child’s development. All the evidence says that the first 1,000 days of a child’s life are vital to their development and life chances, yet the number of health visitors has been cut in half since 2015. Labour will ensure that every child has a healthy start to life, training 5,000 more health visitors. That is what our motion would deliver.

[Munira Wilson (Twickenham) (LD)]

The hon. Member raises children and early intervention, but one area he has not touched on is the tidal wave of cases relating to children and young people’s mental health. As we all see in our casework every week, children and young people who have not been treated early get worse and worse and therefore get referred to acute services. In the past year, referrals to child and adolescent mental health services have gone up almost 25% and consultant psychiatrist numbers have come down. In terms of early intervention, we are not seeing enough mental health support in our schools. In Richmond, we cannot recruit clinical psychologists even though we have the money to do so. Does the hon. Member agree that we really need to focus on the future of this country—our children—by training more psychiatrists, counsellors and psychologists?

[Wes Streeting]

I totally agree. We have had lots of perfectly good speeches from Conservative Prime Ministers over the past 12 years, and we have had more than our fair share of unbelievably bad Conservative Prime Ministers over the same period. One thing that each of those speeches has had in common is warm rhetoric and no delivery. We are not prepared to make the same mistake, so although it is not on today’s Order Paper, I am pleased to confirm that my right hon. and learned Friend the Leader of the Opposition has announced a mental health pledge that will mean 8,500 more mental health professionals being recruited. It will enable us to provide mental health hubs in every community, dedicated mental health support in every school and the aim of guaranteeing treatment within a month.

Our pledge will be transformational to mental health support in this country. It will particularly benefit young people, whose mental health and wellbeing have borne the brunt of the pandemic. It will really help to free up capacity for GPs and accident and emergency departments, which are increasingly seeing mental ill health cases coming through their door because the specialist support that people need is unavailable. Our plan, like our motion on today’s Order Paper, is fully costed and fully funded and will make a real difference to patients. Just as the Conservative party is welcome to steal Labour’s NHS workforce pledge, it is very welcome to steal our mental health plan too.

As well as recruiting the doctors, nurses and allied health professionals we need, we also need to keep the staff we have.

[Mike Amesbury (Weaver Vale) (Lab)]

Why does my hon. Friend think Government Members are so keen on protecting non-dom status? What is the interest there?

--- Later in debate ---

[Wes Streeting]

That is an excellent question that the Secretary of State is really well placed to answer. It is not as if people in Downing Street do not know what non-dom status is or how it is currently accessed. I do not know whether the Chancellor’s reluctance to abolish non-dom status is because he does not want bad relations with his next-door neighbour. We have all been in that situation—everybody needs good neighbours—but I think a little neighbourly discomfort on Downing Street is a price worth paying to improve the healthcare available to people on streets up and down the rest of the country.

We need to keep the staff we already have. On a visit to a hospital recently, I spoke to a nurse about whether she was planning to vote for industrial action. She said yes: pay was an issue, but what really motivated her decision was the stress, the burnout and going home at the end of the day with the moral injury of worrying that she had not delivered the care patients deserve because she was too overstretched. I asked her what would make the most difference. She said, “I just want to know that the cavalry is coming—that it is worth staying in the job because things are going to get better.” She knows how long it takes to train nurses—she has been through it herself—and how long it takes to train doctors. She can accept that, but what she cannot accept is a future in which, because we did not act today or because the incoming Government did not act after the general election, she is still working understaffed shifts in overstretched hospitals a decade down the line.

Labour’s message to NHS staff is that the cavalry is coming with Labour. We will train a new generation of doctors, nurses and midwives so that staff are not driven out of the service and patients are treated on time. Of course more can be done to keep staff from leaving. We have been calling on the Government for months to fix the perverse incentives in doctors’ pensions that are forcing them into early retirement. The Government have just launched a consultation that might lead to changes in spring 2023. What good is that when the NHS is on the cusp of the worst winter crisis in its history?

The Government announced in the autumn statement that, for the first time ever, they would count the number of staff the NHS need—a truly groundbreaking act! Counting the number of people we need is a good start, but Labour has committed to an independent workforce body that will look at retention and better professional development so that staff can build and progress their careers in the health service. With the number of care workers falling for the first time, where is the Government action to stop the exodus of care workers to places like Amazon? Providing fair pay and terms and conditions for care workers is not only the just thing to do, but one of the best things that the Government can do to ease pressure on the NHS.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

Is there not a need for urgent thinking about the impact of inflationary pressures on all the UK’s health systems in the UK? According to a report published yesterday by the Wales Governance Centre at Cardiff University, inflation will eat into the Welsh budget to the tune of £800 million next year and £600 million in 2024-25. Health is at the heart of the Welsh budget, and this will inevitably have a huge impact on health delivery in Wales. I am not sure what the English figures are, but the cash-terms increases in the autumn statement are highly unlikely to compensate for the inflationary pressures that will also affect the English health budget.

[Wes Streeting]

The hon. Gentleman is right: inflation is a big problem, and it is a problem made in Downing Street. We are all paying a very heavy price for more than a decade of Conservative mismanagement of the economy. Yes, we can all point to the spectacular success that was the mini-Budget, which crashed the economy and left everyone picking up the pieces, but even that does not explain more than a decade of low growth, low productivity and higher taxes. That is where the Conservative party has left us, and that is why it is not just a change of NHS policy we need, but a change of economic policy. Goodness me, the Conservatives have had enough goes at it. They have had enough Chancellors this year. Even The Spectator has lauded the shadow Chancellor as the Chancellor of the year, because she has the plan that the country needs. Business leaders know it, we know it, the country knows it, and I suspect that even Conservative Members know that it is true.

Let me now turn to our NHS workforce plan. When I say that it is a serious plan, the House should not just take my word for it. It has been endorsed by the Royal College of Physicians, the Royal College of Psychiatrists, and Universities UK. It has widespread and cross-party support. I was particularly pleased by the support expressed by one correspondent, who wrote in September:

“I very much hope the government adopts this on the basis that smart governments always nick the best ideas of their opponents. They also ditch the bad ones of their predecessors such as blocking an enlightened amendment to the Health Act that would have sorted out workforce planning”.

I should like to thank the Chancellor for his endorsement. I was with him in the Lobby to support that NHS workforce amendment when Conservative Members, no doubt including the Secretary of State, were voting the other way. May I invite the Secretary of State to use that quote in any future negotiations in which he engages at the Treasury? I am just trying to be helpful.

While the Secretary of State is there, perhaps he could suggest that the Treasury take a proper look at the non-dom tax status. The Chancellor admitted after the latest Budget that his team had not even calculated how much the tax status was costing the Treasury and how much scrapping it would raise, at the same time as expecting us to believe that it would not work and that the sums produced by independent academics would not add up, although he had not even bothered to commission Treasury sums of his own.

Politics is about choices. The Conservatives are choosing to protect non-dom tax status, benefiting a few wealthy individuals, while millions of people cannot get a GP appointment or an operation when they need one. The Conservatives are choosing to protect non-dom tax status, benefiting a few wealthy individuals, while millions of people are left waiting in agony on NHS waiting lists. And, of course, the Conservatives are choosing to protect non-dom tax status, benefiting a few wealthy individuals, when they know that it is not just the health of the nation that is being harmed by record NHS waiting lists, but the health of our economy. Patients need treatment more than the wealthiest need a tax break. Those who live in Britain should pay their taxes. The Labour party is clear about where we stand: we need nurses, not non-doms.

We have a plan. The Conservatives do not. We have a record of delivering in government. The Conservatives do not. It is not just the House that faces a choice today; at the next election, the country will face a choice between more of the same with the Conservatives and the fresh start that Britain needs with Labour.

[The Secretary of State for Health and Social Care (Steve Barclay)]

The hon. Member for Ilford North (Wes Streeting) said that Labour has a plan. Let us look at that plan. More than a fifth of the entire population of Wales are waiting for planned care, and 60,000 people in Wales are waiting for more than two years. So we can see exactly what Labour’s plan in government delivers. He asked us to remember when Labour was last in power, and we still do. We remember the letter that said there was no money left. [Interruption.] He has just had plenty of time in which to discuss these matters. I did not feel the need to hector him, because I thought his points had so many flaws that it was important for the House to be able to hear them. He obviously feels that he did not make his case effectively, and would like to have another go. Does he want to have another go?

[Wes Streeting]

indicated dissent.

[Steve Barclay]

He does not want to intervene, so let me deal first with what he left out. His speech, like his motion, ignored a number of salient points. He did not mention, for example, the autumn statement, which one would have thought was fairly significant, providing an extra £6.6 billion for the NHS over the next two years. The NHS Confederation, no less, has described the day of that settlement as a “positive day for the NHS”, and the chief executive of NHS England has said that it should provide “sufficient” funding to fulfil the NHS’s key priorities.

The hon. Gentleman chose not to mention that significant funding. He also—much to the surprise of the House, perhaps—chose not to mention the uplift for social care that was announced in the autumn statement. Opposition Members often call for more funding, so I would have thought that they would be keen to hear about the extra £6.6 billion of additional funding for the NHS, about the biggest funding increase for social care provided by any Government in history, and about the £8 billion that we have committed to elective care. That, bizarrely, was also missing from his speech. He talked about the backlogs—those in England, that is; the backlogs in Wales are much greater—but he did not talk about that £8 billion for elective care, which will fund the building of diagnostic centres and surgical hubs in the constituencies of many Opposition Members.

--- Later in debate ---

[Steve Barclay]

Can I just answer the hon. Member for Bath (Wera Hobhouse)? I have taken a number of interventions. The hon. Lady is intervening on an intervention.

We must look at the increase in doctors in primary care of over 2,300, and we currently have over 9,000 GP trainees, but the hon. Member for Bath’s wider point is correct. It is not simply about the number of GPs; it is about ensuring that the wider primary care force operate at the top of their licence. It is also about access for patients, and avoiding the 8 am Monday crunch when lots of people make calls at the same time. That is why we are looking at the better use of telephony in the cloud and the latest that technology offers. It is also why we have the opportunity, through Pharmacy First, to make better use of what the pharmacists throughout our pharmacy network can do. It is about increasing the number of GPs, yes, but it is about the wider workforce, the use of technology and the use of different patient pathways, too.

Another omission from the motion is that there are around 90,000 more GP appointments every working day, excluding covid vaccinations, than there were last year. When I hear people say that they cannot see their GP, it is worth putting it in context—[Interruption.] The shadow Secretary of State is chuntering again. Does he want to have another go?

[Wes Streeting]

I am surprised and grateful that the Secretary of State has given way. His position seems to be, “You’ve never had it so good.” People cannot get an appointment to see their GP, they are waiting for ambulances and they cannot get into A&E and be seen within a reasonable period of time, but under this Government patients have apparently never had it so good.

[Steve Barclay]

As the hon. Gentleman knows, I have been at pains to point to the huge pressure the pandemic has generated, which he seems unwilling to accept.

In Wales, 60,000 people have been on a waiting list for more than two years, which is a huge example of what a Labour Government deliver in practice. Everyone recognises the huge demand for GP appointments, and there is no single solution, but GPs are seeing more people. Forty per cent. of appointments are booked for the same day, and almost 40% of patients have continuity of care.

--- Later in debate ---

[Steve Barclay]

As part of making things easier, I set up a taskforce in the Department over the summer to look at how we can increase the numbers. We have increased the number of nurses recruited internationally, and care workers are on the shortage occupations list. If there are particular issues that the hon. Lady wishes to highlight, I would be happy to look at them with her, but we are keen to attract talent.

[Wes Streeting]

For clarity, is it the Secretary of State’s position that we are turning away thousands of talented people who want to study medicine and other health professional courses because we do not need them as we are recruiting from overseas?

[Steve Barclay]

No, of course not. The hon. Gentleman knows that is not the case. It is a bit like when he goes around the media to charge the Government with refusing to talk to the unions. Simply misrepresenting our position is not a fair reflection of Government policy.

The motion talks about workforce, and this Government have committed to increasing the number of international recruits in the NHS. The Leader of the Opposition seems to think we should not be encouraging that. That is the wider point to make. Of course, that sits alongside domestic recruitment, which is why, as I said a moment ago—again, the hon. Member for Ilford North has chosen to ignore this—we have had a 25% increase in medical undergraduate places, with five new medical colleges set up by the former Prime Minister, my right hon. Friend the Member for Maidenhead (Mrs May). That underscores this Government’s commitment to increasing the number of doctors in training.

Oral Answers to Questions

Wes Streeting Excerpts

Tuesday 1st November 2022 Commons Chamber

[Mr Speaker]

I call the shadow Secretary of State.

[Wes Streeting (Ilford North) (Lab)]

I welcome the Secretary of State back and welcome his team, but I have had boxes of cereal with a longer shelf-life than Conservative Secretaries of State. As a consequence of the turnover and chaos, the truth is that the NHS is not prepared for this winter—it cannot even get allocated funds out of the door.

Let us turn to the future. Over the summer, the Prime Minister promised to establish a “vaccines-style taskforce” to tackle the Conservatives’ NHS backlog on “day one” and to have overall waiting list numbers falling by next year. May I ask the Secretary of State who is on that taskforce, how many times it has met and what its programme of work is?

[Steve Barclay]

I am grateful that the hon. Gentleman raises the issue of vaccines; in fact, I raised it in Cabinet today. The UK is the first country in the world to have introduced bivalent vaccines targeted both at omicron and at the original strain of covid-19. We have now made the covid vaccine and the flu vaccine available to all over-50s; I hope that Members across the House will promote that. I think the UK can be very proud of its work to roll out vaccines against both covid and flu, which are a key part of preventing some of the pressure on our A&Es.

[Wes Streeting]

I can forgive the Secretary of State for mishearing the question, but what I find unbelievable is that it seems as if this is the first time he has heard about the Prime Minister’s own proposed taskforce to deal with the Conservatives’ NHS backlog. That is what the Prime Minister promised, and that is what I asked the Secretary of State about. This is obviously another case of the Conservatives over-promising and under-delivering.

If the Secretary of State cannot stand by the Prime Minister’s pledges, what about the views of the man next door? When we announced our policy to train a new generation of doctors and nurses, paid for by abolishing non-doms, it was welcomed by the Chancellor as—and I quote—“something I very much hope the government also adopts on the basis that smart governments always nick the best ideas of their opponents.” In the spirit of constructive opposition that the Secretary of State asks for, Labour has a plan to tackle the staffing crisis. The Conservatives do not. It is fully costed and paid for, so will he nick it?

[Steve Barclay]

The hon. Gentleman skirts over the fact that it is this Government who have opened five new medical schools, who have significantly boosted medical undergraduate training, who are investing more in our NHS as per the long-term plan, who have invested a further £36 billion as part of our covid response, and who are investing in technology and the skills of the workforce as a whole. We are boosting the number of medical trainees and—I touched on this question earlier—we are also boosting the number of doctors in training to be GPs.

Urgent and Emergency Care

Wes Streeting Excerpts

Monday 5th September 2022 Commons Chamber

[The Secretary of State for Health and Social Care (Steve Barclay)]

With permission, Mr Deputy Speaker, I would like to make a statement on our support for urgent and emergency care. I know that this is an issue of great concern to right hon. and hon. Members, and I wanted to update the House at the earliest opportunity on the work that has been undertaken over the summer.

Bed occupancy rates have broadly remained at winter-type levels, with covid cases in July still high, with one in 25 testing positive—that compares with about one in 60 currently. This is without the decrease in occupancy that we would normally expect to see after winter ends, and ambulance waiting times have also continued to reflect the pressures of last winter, although I am pleased to see recent improvements. For example, the West Midlands service is meeting its category 2 time of less than 18 minutes.

I would like to update the House on the nationwide package of measures we are putting in place to improve the experience of patients and colleagues alike. First, we have boosted the resources available to those on the frontline. We have put in an extra £150 million of funding to help ambulance trusts deal with ambulance pressures this year. On top of that, we have agreed a £30 million contract with St John Ambulance so that it can provide surge capacity of at least 5,000 hours per month. We are also increasing the numbers of colleagues on the frontline. We have boosted the national 999 call handler numbers to nearly 2,300, which is about 350 more than we had in September last year, and we have plans to increase this number further to 2,500 by December, supported by a major national recruitment campaign. By the end of the year we will have also increased 111 call handler numbers to 4,800. As well as that, we have a plan to train and deploy even more paramedics, and Health Education England has been mandated to train 3,000 paramedic graduates nationally each year, which is double the number of graduates that were accepted in 2016.

Secondly, we are putting an intense focus on the issue of delayed discharge, which, as many Members know, is the cause of so many of the problems we see in urgent and emergency care—I think that is recognised across the House. This is where patients are medically fit to be discharged but remain in hospital, taking up beds that could otherwise be used for those being admitted. Delayed discharge means longer waits in accident and emergency, lengthier ambulance handover times and the risk of patients deteriorating if they remain in hospital beds too long—this is particularly the case for the frail and elderly. The most recent figures, from the end of July, show that the number of these patients is just over 13,000—these are similar numbers to those for the winter months. We have been working closely with trusts where delayed discharge rates are highest, putting in place intensive on-the-ground support.

More broadly, our national discharge taskforce is looking across the whole of health and social care to see where we can put in place best practice and improve patient flow through our hospitals. As part of that work, we have also selected discharge frontrunners, who will be tasked with testing radical solutions to improve hospital discharge. We are looking at which of these proposals we can roll out across the wider system and launch at speed. Of course, this is not just an issue for the NHS. We have an integrated system for health and care and must look at the system in the round, and at all the opportunities that can make a difference. For instance, patients can be delayed as they are waiting for social care to become available, and here too, we have taken additional steps over the summer. We have launched an international recruitment taskforce to boost the care workforce and address issues in capacity. On top of that, we will be focusing the better care fund, which allows integrated care boards and local authorities to pool budgets, to reduce delayed discharge. In addition, we are looking at how we can draw on the huge advances in technology that we have seen during the pandemic and unlock the value of the data that we hold in health and care, including through the federated data platform.

Finally, we know from experience that the winter will be a time of intense pressure for urgent and emergency care. The NHS has set out its plans to add the equivalent of 7,000 additional beds this winter, through a combination of extra physical beds and the virtual wards which played such an important role in our fight against covid-19. Another powerful weapon this winter will be our vaccination programmes. Last winter, we saw the impact that booster programmes can have on hospital admissions, if people come forward when they get the call. This year’s programme gives us another chance to protect the most vulnerable and reduce the demand on the NHS. Our autumn booster programmes for covid-19 and flu are now getting under way, and will be offered to a wider cohort of the population, including those over 50, with the first jabs going in arms this week as care home residents, staff and the housebound become the first to receive their covid-19 jabs.

Over the summer, we became the first country in the world to approve a dual-strain covid-19 vaccine that targets both the original strain of the virus and the omicron variant. This weekend, the MHRA approved another dual-strain vaccine, from Pfizer, and I am pleased to confirm that we will deploy it, along with the Moderna dual-strain vaccine, as part of our covid-19 vaccination programme in line with the advice of the independent experts at the JCVI. Whether it is for covid-19 or flu, I would urge anyone who is eligible to get protected as soon as they are invited by the NHS, not just to protect themselves and those around them, but to ease the pressure on the NHS this winter.

Today I have laid before the House a written ministerial statement on further work that we have been doing over the summer, and I want to draw the House’s attention to one particular feature in that statement which has garnered interest in the House in the past. In November 2021, the Government announced it would make £50 million of funding available for research into motor neurone disease over five years. Following work over the summer between my Department and the Department for Business, Energy and Industrial Strategy, through the National Institute for Health and Care Research and UK Research and Innovation, to support researchers to access funding in a streamlined and coordinated way, we are pleased to confirm that this funding has now been ring-fenced. The Departments welcome the opportunity to support the MND scientific community of researchers as they come together through a network and linked through a virtual institute.

I commend this statement to the House.

[Wes Streeting (Ilford North) (Lab)]

I thank the Secretary of State for advance sight of his statement, and wish him and the ministerial team well as the new Prime Minister appoints her first Government. I also welcome what he said towards the end of his statement about the importance of vaccination and funding for motor neurone disease.

Emergency care is in crisis. After 12 years of Conservative Governments, the NHS can no longer reach patients on time. The outgoing president of the Royal College of Emergency Medicine said earlier in the summer that ambulance delays had got so bad that the NHS was now “breaking its promise” to the public that life-saving emergency care will be there when they need it. Twenty-nine thousand patients waited more than 12 hours in A&E in June, more than ever before. Ten thousand urgent cases waited more than eight hours for an ambulance last month. It is estimated that the collapse of emergency care that we are now seeing could be costing 500 lives a week. If the statistics did not paint a stark enough picture, no one can ignore the case of 87-year-old David Wakeley, whose family had to build a shelter around him as he waited outside for an ambulance, with broken bones, for 15 hours. What a shameful indictment on 12 years of Conservative mismanagement of the NHS.

There have been recent reports that the NHS will tell patients to

“avoid A&E as the winter crisis bites early.”

That was in August. The simple fact is that we have gone from no crisis in the system in 2010, to annual winter crises, to the situation we have today where there is a crisis all year round—the worst crisis in the history of the NHS. There is no point in the Secretary of State blaming the pandemic or, indeed, the extreme heat we saw this summer, although they do not help. The reality is that, before the pandemic, the NHS had not hit the 18-minute response time target for emergency incidents since 2017. Will the Secretary of State, on behalf of the Government and his party, finally take some responsibility and admit what his colleague the Culture Secretary was honest enough to say, that the Conservatives left our health service “wanting and inadequate” when the pandemic hit?

The NHS needs Ministers to grip this crisis and work tirelessly to get patients the care they need, so where have the Government been all summer? It is almost as if, the moment the Conservative leadership candidates hit the road, the Cabinet turned on their “out of office” and hit the beach as the NHS slipped into the worst crisis in its history and the Government did diddly-squat on the cost of living crisis, which will also exacerbate people’s health problems.

I pay tribute to St John’s Ambulance for the vital work it does, and I am pleased it has now been formally commissioned to provide England’s ambulance auxiliary. Can the Secretary of State confirm that this capacity is being used by the system today? Perhaps he might have a word with his colleague the Secretary of State for Education, or his successor, about recruitment, because the shambles we saw on T-levels and the hand-wringing we saw from the exam boards is unacceptable and risks the pipeline of talent we need to staff the NHS.

Although extra capacity is important, let us be honest that it will not solve the ambulance crisis unless we tackle the delayed discharges that are causing logjams in hospitals. The Secretary of State talked about this, but let me be clear that one in seven hospital beds is occupied by someone who is medically fit to leave but cannot do so because there is no support available—some people are waiting up to nine months longer than needed. What is the answer to this staffing crisis? It has not been to pay care workers a decent wage so that we stop losing them to the likes of Amazon, and it has not been to provide a great career so that people in our country enter this important profession. The answer has been to pull the “immigration lever,” to quote the Government, and to recruit people from overseas on lower pay. How fitting that this Prime Minister’s Government ends with yet another broken promise. One year after promising to fix social care by hiking taxes on working people, where is the plan to tackle the work- force crisis without resorting to immigration every time?

Finally, the Secretary of State barely mentioned the cost of living crisis. The Under-Secretary of State for Health and Social Care, the hon. Member for Erewash (Maggie Throup), has said the Government are worried that if people cannot afford to heat their home, more will lose their life to flu. Has the Secretary of State made an estimate of the number of people who could fall ill as a result of soaring energy bills? As this is rightly a concern, may I point out that there is a plan right in front of him to freeze energy bills, fully costed and ready to go, paid for by a windfall tax on the oil and gas companies? When will the Government stop dithering, delaying and talking to themselves and start acting for the country? Rising energy prices will also push care providers to breaking point, with some facing closure as they are unable to absorb increases of 500% or more. What plans does he have to prevent care home residents from being booted out this winter and to prevent care home doors from closing?

The reality is that this Government are now out of time. A new Prime Minister will be appointed tomorrow who has suggested charging patients to see a doctor. I did not think anything could be worse than fining people for missing appointments, but our new Prime Minister has somehow managed it. Public satisfaction with NHS services is at its lowest recorded level, and patients are struggling to access the care they need. Under Labour, patients could call 999 knowing that an ambulance would come when they needed it, but the longer we give the Conservatives in power, the longer patients will wait.

[Steve Barclay]

Let me start with the areas where the hon. Gentleman and I agree. The David Wakeley case was shocking, and we accept that there have been severe pressures, particularly linked to certain trusts; just 10% of trusts account for 45% of ambulance handover delays. His second charge was about what the Government have been doing on this over the summer. We have had a 100-day sprint with NHS colleagues, a taskforce has been set up and I have met those troubled trusts, particularly Cornwall, to look at how we better support them.

Some of the factors affecting ambulance delays are within the trusts’ control. Those include understanding why delayed discharge is much lower at the weekend, and things that they can do within the emergency department. However, as the hon. Gentleman recognised, some factors are beyond the trusts’ control, whether that is variance in performance on conveyancing by ambulance trusts, differences in hear and treat or see and treat, or the challenges in social care. We recognise that, as I said in my opening remarks, the heatwave and a covid infection rate of one in 25, compared with one in 60 now, created significant pressure on the ambulance system.

In addition to the taskforce, we have enacted a whole range of other measures. NHS England has tasked the system with putting in place an additional 7,000-bed capacity for the winter. We have been expanding emergency department capacity. One thing we funded in spending review 2020, when I was in the Treasury, was additional funding for trusts where there are emergency department constraints.

The hon. Gentleman did not mention mental health, but I know he takes an interest in it, so he will be pleased to know that over the summer we have particularly targeted action that can be taken in emergency departments and across the hospital estate in support of mental health, led by Claire Murdoch in NHS England. We have increased staffing by 16% and there is an extra £2.3 billion going into mental health next year compared with 2016. There is additional funding and workforce, because we recognise the pressures.

There is also bespoke action with NHS colleagues. Sometimes, relatively low numbers of patients—for example, patients needing palliative care, patients with dementia and patients with Parkinson’s—are particularly challenging in terms of delayed discharge, and their discharge may be delayed for an extended period of time. Although the quantum of patients may be modest, that leads to delay.

The hon. Gentleman recognised other things we have been doing over the summer, such as the St John Ambulance contract that has been put in place to help with auxiliary ambulances, the work on international recruitment—I do not accept that people are being paid less; that is bringing people in to work in important roles in our care sector—and the consultation on retire and return.

Finally, the hon. Gentleman mentioned the cost of living. He will know that the new Prime Minister has made it clear that she will have further things to say on that over the next week, and I know there will be ample opportunity to debate that further in the House.

Women’s Health Strategy for England

Wes Streeting Excerpts

Wednesday 20th July 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

Let me begin by thanking the Secretary of State for advance sight of his statement and adding my thanks to the Minister of State, to his predecessor as Secretary of State, the right hon. Member for Bromsgrove (Sajid Javid), who is sat opposite, and to officials in the Department for the work they have done. I am genuinely glad that this work is out of the door when so much else has been in hiatus because of the wider political change afoot in the Government. I join the Secretary of State in recognising the campaigning efforts of his constituent Kath Sansom, as well as the efforts of my hon. Friend the Member for Swansea East (Carolyn Harris), who has campaigned tirelessly to raise awareness of the menopause and has been a driving force for change on behalf of women everywhere.

For too long, women's health has been an afterthought, and the voices of women have been at best ignored and at worst silenced. Four out of five women who responded to the Government’s survey could remember a time where they did not feel listened to by a healthcare professional, and that has simply got to change. In recent years, we have seen a string of healthcare scandals primarily affecting women: nearly 2,000 reported cases of avoidable harm and death in maternity services at Shrewsbury and Telford; more than 1,000 women operated on unnecessarily by the rogue breast surgeon Ian Paterson; thousands given faulty PIP— Poly Implant Prothèse—breast implants; and many left with traumatic complications after vaginal mesh surgery. Meanwhile, every woman who needs to use the NHS today faces record high waiting times. The NHS is losing midwives faster than it can recruit them. Gynaecology waiting lists have grown faster than those for any other medical specialty. The number of women having cervical screening is falling. And black women are 40% more likely to experience a miscarriage than white women. That is the cost for women of 12 years of Conservatives mismanagement, so I want to address each part of the strategy in turn.

The strategy promises new research, which is of course important. Studies suggest that gender biases in clinical trials are contributing to worse health outcomes for women. There is evidence that the impact of women-specific health conditions such as heavy menstrual bleeding, endometriosis, pregnancy-related issues and the menopause is overlooked. So of course what the Secretary of State has said today about improving data is so important, but will he also set out how exactly the Government intend to make use of this new data to improve outcomes for women?

Improving the education and training of health professionals is essential, because when we do not do that, there are consequences. Almost one in 10 women has to see their GP 10 times before they get proper help and advice about the menopause, and half of medical schools do not teach doctors about the menopause, even though it affects every woman. I challenge the Secretary of State to go further than the proposal he outlined to train incoming medical students and incoming doctors. What plans do the Government have for clinicians who are already practising? We need to upskill the existing workforce, not just the incoming workforce. However, let us be clear: informing clinicians is no good if we do not also improve access to hormone replacement therapy, so where is the action in the strategy to end the postcode lottery for treatment?

Breast cancer is the most common cancer in the UK, and the NHS offers regular breast cancer screening to women aged between 50 and 70. That can prevent avoidable deaths by identifying cancer early, when it is more treatable and survival is more likely. Yet, fewer women in the most deprived areas than in the most affluent areas receive regular breast screening. Even before the pandemic too many women with suspected breast cancer were waiting more than the recommended two weeks to see a specialist. How will the programme announced today make a difference to outcomes for patients if, once diagnosed, they just end up on a waiting list that is far too long and they cannot access the treatment they need?

I welcome what the Secretary of State said about removing barriers to in vitro fertilisation for women in same-sex couples. For far too long they have faced unnecessary obstacles to accessing IVF, for no other reason than that they love another woman. It is high time that we put that right.

I also want to mention endometriosis. Tens of thousands of women provided testimony to the Government about the issues they face with diagnosis and treatment. Will the Secretary of State give the House an assurance that every woman who is treated for this disease will have equal access to specialist services from day one? Will he make sure that they do not have to fight to get the diagnosis in the first place?

On polycystic ovary syndrome, what will the Secretary of State do to make sure that we equalise access to a range of treatments, not least for women for whom the pill is simply inappropriate? We must make sure we end the division between those who receive a prescription on the NHS and those who go private, receiving better treatment.

I also want to raise some points about what has not been mentioned today. In addition to the appalling figures on black maternity deaths, a quarter of black women surveyed by Five X More felt that they received a poor or very poor standard of care during pregnancy, labour and post-natal care. Women who live in deprived areas are more likely to suffer a stillbirth than their richer counterparts. My hon. Friend the Member for Oxford East (Anneliese Dodds), the shadow Secretary of State for Women and Equalities, has pledged a new race equality Act to tackle the structural inequalities in our society, including in healthcare. However, the Government are more interested in stoking culture wars than in acknowledging that these inequalities even exist. Surely that has to change when there is a new leadership of the Conservative party.

In conclusion, the reality that faces women in this country is this: breast cancer waiting times are through the floor, half a million women are waiting for gynaecology treatment, black women are four times more likely to die in pregnancy and childbirth, and too many women still cannot get HRT when they need it. This strategy simply will not solve the depth of the crisis in women’s healthcare after 12 years of Conservative mismanagement. Every day this Conservative Government remain in office is another day when women will have to wait far too long for the care they desperately need.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call Sajid Javid.

Oral Answers to Questions

Wes Streeting Excerpts

Tuesday 19th July 2022 Commons Chamber

[Mr Speaker]

I call shadow Secretary of State, Wes Streeting.

[Wes Streeting (Ilford North) (Lab)]

I welcome the Secretary of State to his first oral questions and, as this is likely to be his last oral questions, also wish him the best for the future. I associate myself with his remarks about his predecessor, who of course resigned from the Government on a point of principle as others chose to remain loyal; on that note, I also pay tribute to the former Minister, the hon. Member for Charnwood (Edward Argar), for the diligent approach he took to his work and the spirit in which he engaged with the Opposition. One of the contenders for the Conservative leadership says that public services are in a state of disrepair. Another describes the NHS backlog as frightening. A third called ambulance waiting times appalling, and of course the Secretary of State for Culture, Media and Sport said that the former Health Secretary’s preparation for a pandemic was “found wanting and inadequate”. They are right, aren’t they?

[Steve Barclay]

The Government are committed to putting increased funding into our NHS. I set out yesterday the position on the resource departmental expenditure limit. Just to remind the House of the capital departmental expenditure limit, capital investment in the spending review was £32.2 billion between this year and 2024-25. The Government are committed to putting record funding into our NHS. We are also committed to funding 40 new hospitals and have allocated £3.7 billion to that programme.

[Wes Streeting]

I cannot believe that the Government are still talking about 40 new hospitals with a straight face. Nobody believes that it is true. As for capital investment, we have the lowest in the OECD and we lag significantly behind.

We have the longest waiting lists in NHS history and record waits for ambulances. People are finding it impossible to book a GP appointment. There are 400,000 delayed discharges each month because the social care support is not there. The Government are finally acknowledging that covid is still a challenge, and that the hot weather is a challenge, but they do not want to talk about their record, which is, I am afraid, at the heart of the challenge. Does the Secretary of State really believe that it is reasonable to expect NHS employers to meet the pay rise for NHS staff from existing budgets?

[Steve Barclay]

We will respond shortly to the independent pay review body, which, as part of its recommendations, weighs up the pressures on the cost of living and the other factors within its remit. The Government are delivering more doctors, more nurses, more appointments and more treatments, investing in our estate and planning for the future. That includes investment in research and development, and in future technology through our life sciences. That not only delivered the vaccine that allowed us to lift the covid restrictions that the Opposition wanted to retain, but will unlock the technologies of the future.