NHS Dentistry
Wes Streeting Excerpts(2 years ago)
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Wes Streeting (Ilford North) (Lab)
I beg to move,
That this House recognises that NHS dentistry is in crisis, with eight in 10 dentists in England not taking on new NHS patients and vast parts of the country considered so-called dental deserts, where no dentists are available; regrets that this has led to people resorting to DIY dentistry or attending A&E to access urgent care; is concerned that tooth decay is the most common reason children aged six to 10 are admitted to hospital; and therefore calls on the Government to provide an extra 700,000 urgent appointments a year, introduce an incentive scheme to recruit new dentists to the areas most in need and a targeted supervised toothbrushing scheme for three to five year-olds to promote good oral health and reform the dental contract to rebuild the service in the long-run.
Happy new year, Mr Speaker.
After 14 years of Conservative neglect and mismanagement,
“NHS dentistry in England is at its most perilous point in its 75-year history.”
That is the conclusion of the Nuffield Trust think-thank, and who can blame it? Eight in 10 NHS dentists no longer take new patients. According to the NHS, no dentist is taking on new adult patients in entire constituencies such as Broxtowe, Bolsover, Stoke-on-Trent South and Stroud. Five million patients tried but failed to get an appointment in the past two years. Millions more needed dental care but did not bother trying to book an appointment because they knew it would be impossible. Tooth decay is now the No. 1 reason why children aged six to 10 end up in hospital. We face the moral outrage of one in 10 Brits saying that they have been forced to attempt dentistry themselves because the NHS was not there for them when they needed it. This is Dickensian—DIY dentistry in 21st-century Britain. Is there any greater example of the decline that this country has been subjected to under the Conservatives?
Sarah Champion (Rotherham) (Lab)
May I add Rotherham to the list that my hon. Friend is quoting? To give an example, one of my constituents has been trying for more than a year to register with an NHS dentist. He has now had to go private for the consultation, which said:
“Your teeth are in a very poor condition with most of your remaining teeth decayed and unsaveable. All your teeth except 2 …need extracting.”
He has been living for more than a year on painkillers and soup. I have raised this with the Minister and got no satisfaction. This is what Tory Britain is doing to dentistry.
Wes Streeting
I totally agree with my hon. Friend. We have heard so many heartbreaking stories like the one she mentions from her constituency. A service that once was there for all of us when we needed it is almost gone for good.
Anthony Mangnall
Is there any greater landmine of a Labour legacy than the 2006 contract that it designed, which is pulling us down? Labour Members need look no further than their own designs on the NHS. We are sorting out their mess.
Wes Streeting
The sound you can hear, Mr Speaker, is the scraping of the barrel. How has the hon. Gentleman got the brass neck to stand up, after 14 years of his party in government, and say that a contract agreed in 2006 is the problem? If only the Conservatives had been in government for 14 years to sort it out.
Here is the other rub: we do not pretend that everything was perfect under the last Labour Government. In fact, reform of the NHS dentistry contract was in Labour’s 2010 manifesto, because we recognised that it needed to change. Had we been elected in 2010, we would have delivered. It was also in the Conservatives’ 2010 manifesto and 2015 manifesto. It was probably in the 2017 and 2019 manifestos, too, and they have not delivered. We have 14 years of Conservative failure. How dare the hon. Gentleman have the brass neck to stand up and blame someone else.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
It is of great interest, is it not, that there is not one Member from the governing party in Scotland present for this debate? I can tell the House that dental services in my constituency in remote Scotland have gone backwards in a big way, and I am shocked that none of them are here to hear this.
Wes Streeting
It is deeply disappointing. Let me assure the hon. Gentleman that as with the last Labour Government—13 years that created a rising tide that lifted all ships across the country, when we had an NHS with the shortest waiting times and the highest patient satisfaction in history—the next Labour Government will deliver a rising tide to benefit people across the country.
Alex Cunningham (Stockton North) (Lab)
The British Dental Association highlights that:
“Hormonal changes during pregnancy can make gums more vulnerable to plaque”,
and:
“Changes to dietary habits, and morning sickness”
can also impact on oral health. After being told of the importance of seeing a dentist after suffering multiple miscarriages, a constituent tells me that she has been struggling for three years to see a dentist within a 50-mile radius of her home. Dentists say that they are going private and are helping only with emergencies. Surely that is evidence of a colossal failure of Tory Government dental policy, and even the most vulnerable are suffering.
Wes Streeting
I wholeheartedly agree with my hon. Friend. In fact, he has the ability, as the Labour MP for Stockton North, to speak for his residents. If only other people across the country had MPs standing up for them. Chris Webb, Labour’s candidate in Blackpool South, reported to me that pregnant mothers have been telling him they cannot get an NHS dentist, despite being entitled to free NHS check-ups and treatment. Alice Macdonald, Labour’s candidate in Norwich North, reported similar conversations to me. Expectant mothers have told her that they have been travelling hundreds of miles to see a dentist when we know that pregnant women probably need that support more than many others. What an indictment of 14 years of Conservative Government.
Mr Ben Bradshaw (Exeter) (Lab)
Did my hon. Friend see the report in today’s Times that showed that NHS dentists are performing only 75% of the procedures they are contracted to do? In Devon and Somerset, where the situation is the worst in the country, it is only 26.5% and 30%. Not only have this Government delivered an NHS desert in Devon and Somerset, but they are wasting masses of public money. What is my hon. Friend going to do about it when he is Health Secretary?
Wes Streeting
I strongly agree with my right hon. Friend. Things are so desperate. He mentioned the south-west in particular, and Devon and Cornwall have been particularly poorly served. Jayne Kirkham, Labour’s candidate in Truro and Falmouth for this year’s general election, reported to me that a local dentist handed their contract back before Christmas, meaning that 3,000 people lost their NHS dentist overnight. There are currently no dentists in Truro and Falmouth taking on adult NHS patients. Contract reform is urgent, so where is it? They have had 14 years, so where is the recovery plan that the Health Secretary mentions in her amendment?
Several hon. Members rose—
Wes Streeting
I must make some progress.
Turning to other parts of the country, Keir Cozens, Labour’s candidate in Great Yarmouth, has been running a campaign on the state of dentistry in Great Yarmouth. He has heard heartbreaking stories of broken teeth left for months with people in pain, of children unable to be seen, of at least one person a day going to accident and emergency with dental issues, and of people performing DIY dentistry at home after buying kits from Amazon. No one should be doing that, but people are desperate. DIY dentistry does not work, and before you know it, people are back in A&E waiting for expensive emergency dental treatment. I have heard similar stories from Kevin Bonavia, Labour’s candidate in Stevenage. He tells me that people turning to DIY is shockingly common.
No one voted for this. None of the five Conservative Prime Ministers, the seven Conservative Chancellors or the eight Conservative Health Secretaries told the public that this was what the future held, but this is what they have done to dentistry. It is the way all our public services are going, and it is why the Conservative party cannot be allowed five more years to finish the job.
Jim Shannon (Strangford) (DUP)
I thank the shadow Secretary of State for bringing this debate forward. The stats from the British Dental Association cannot be ignored. In its survey, 41% of practice owners and 38% of associate dentists said that they would like to leave NHS dentistry as soon as possible. This debate will resonate with many people out there. Does he agree with the chair of the Northern Ireland Dental Practice Committee that now is the time for the funding allocation to pay for a better contract and for training more dedicated dentists who will commit to the NHS, rather than private practice?
Wes Streeting
I agree with the hon. Gentleman about the urgency of the situation. There is a different path available to us. We can revive our public services and give our country back what we used to take for granted. Labour’s plan would take immediate steps to rescue NHS dentistry, with 700,000 more urgent appointments and the recruitment of new dentists in the areas most in need. We would also take the necessary steps to rebuild NHS dentistry over the long term, including reforming the dental contract and introducing supervised toothbrushing for three to five-year-olds in primary schools, so that poor oral health is prevented and demands on the service reduced.
In fact, some of my Labour colleagues are not even waiting for the general election to start making a difference. Labour’s candidate in Stroud, Simon Opher—himself a GP—has spearheaded a campaign working with local dentists and the integrated care board. From opposition, he has more than trebled the number of emergency appointments available each day across Gloucestershire, pioneered a new dental stabilisation scheme for people not known to a local practice, opening up more than 130 appointments a week, and introduced supervised toothbrushing in 14 local primary schools. If that is the difference Simon is making in opposition, imagine what he will be able to do as a Labour MP working with a Labour Government. That Government cannot come soon enough.
Catherine West (Hornsey and Wood Green) (Lab)
My hon. Friend is making an excellent speech. Does he agree with me and my constituent in Crouch End who has not had a check-up since 2019 that the link between poor oral health and oral cancer is serious? That could be contributing to the terrible problem we have with cancer waiting times.
Wes Streeting
I totally agree with my hon. Friend. Prevention is better than cure. It is a truism, and it is also the foundation pillar of what would be Labour’s 10-year plan for reform and modernisation of our national health service. A part of that plan is before the House today, and Government Members will have to explain to their constituents, only months, if not weeks away from a general election, why they are refusing to support it.
The Government’s amendment to the motion promises that the dental recovery plan is coming soon, but it was due last summer; now, they cannot put a date on when the plan will arrive, when it will be implemented or even say what it is. Conservative Ministers have taken a look at the state of NHS dentistry, at the millions of people across the country who cannot get an appointment to see a dentist and at children in their own constituencies whose teeth are rotting, and their conclusion is: what is the rush? Let me tell them why they should get their skates on.
A 17-year-old boy in Plymouth had to undergo emergency surgery on an abscess in his mouth last year. He spent two months trying to book an NHS dentist—he said that he was on hold for about three hours per day. According to figures on the NHS website, no dentists are taking on new NHS patients in the Plymouth, Moor View constituency. It was left too late, and when he finally got the healthcare he needed, he required emergency surgery, which has left him scarred for life.
In Worthing West, Labour’s candidate Dr Beccy Cooper told me of an 82-year-old great-grandfather on pension credit who told her that he will not be going back to an NHS dentist before he dies. He tried to get an NHS dentist in Worthing, but no one will take him on the NHS to receive low-cost treatment. Dr Beccy Cooper also tells me that residents who cannot get a dentist are being told to look for one in Hampshire, more than 60 miles away from where they live.
Ian Lavery (Wansbeck) (Lab)
On that important point, a couple who moved into new housing in my constituency tried to get an NHS dentist for over a year without any success whatsoever. They have got two options: they either go private or use their previous dentist, who is 20 miles away. That is wholly unacceptable. Will my hon. Friend simply explain how Labour’s plan will eradicate this unacceptable issue?
Wes Streeting
My hon. Friend is absolutely right. We will have: 700,000 appointments, making a difference straightaway; supervised toothbrushing for three to five-year-olds to reduce future demand on NHS services; and reform of the NHS dentistry contract so that we can rebuild an NHS dentistry service worthy of the name. That change cannot come soon enough.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
My constituent Amy has been in contact with me about the difficulties that she and her five children have had getting NHS dentist appointments. She explained that her husband was in the military and therefore they had to move home frequently, and each time they moved they found it harder to get an NHS dentist. Does my hon. Friend agree that that is a shameful way to treat people who have served and given so much to our country?
Wes Streeting
I agree. I am afraid that when it comes to serving personnel and veterans, there is a gulf between what the Government say and promise and what they do; that is not the only example.
One thing not in the Government’s amendment to Labour’s motion is a pledge to protect the NHS dentistry budget. That is odd, because the Prime Minister promised to do exactly that 18 months ago. The truth is that the Prime Minister broke that pledge in November when he gave the go-ahead for dentistry underspends to be raided, effectively waving the white flag on the future of the service. Can you believe it? Despite everything we have heard, there are dentistry underspends, and the Prime Minister thinks that other things are greater priorities than this crisis. The consequences of that decision are now being felt. The budget in some areas of the country is running out and dentists are having to stop NHS work for the remainder of the year. It is so deeply frustrating.
NHS dentists want to do more NHS work; it is the Government who are standing in their way. The Nuffield Trust’s stark report into the crisis suggested that NHS dentistry may have to be scaled back and made available only to the least well-off. Such an approach would be the end of NHS dentistry as a universal public service, yet that is exactly the approach that the Government are piloting in Cornwall. Children, the over-80s and those with specific health needs are given treatment; everyone else has to go private or go without. They will not admit it, but this is the future under the Tories: further neglect, decline and patients made to go without.
Worse still, NHS dentistry is the ghost of Christmas yet to come under the Tories. That is not partisan overreaction on our part; that is according to the lead author of the Nuffield Trust’s report. He wrote:
“For the wider health system, the lessons are troubling: without political honesty and a clear strategy, the same long-term slide from aspiration to reality could happen in other areas of primary care too.”
What has happened to NHS dentistry under the Tories is coming to the rest of the NHS if they are given another five years. That is not the continuity that the country is looking for—it is looking for change with Labour.
Wera Hobhouse (Bath) (LD)
My Bath constituency is also described as an NHS dental desert. The only option for people is to go private. The hon. Member has already said that it is Dickensian. Does he agree that it is not just a health problem but an equalities issue that the Government fail to recognise?
Wes Streeting
I totally agree. In fact, Claire Hazelgrove, Labour’s candidate in Filton and Bradley Stoke—next-door to the forthcoming by-election—was telling me about problems in her constituency and that exact challenge of people being left without or having to go private. One patient told her that her dental practice was now only seeing private patients. That same patient cares for her 84-year-old dad with dementia, who needed a tooth removal to allow him to eat. His appointment was also cancelled. That is what is happening before our eyes.
What of those who cannot afford it? Anna Dixon, Labour’s candidate in Shipley, told me of a woman in her town who had been turned away as an NHS patient and could not afford to go private. She was struggling with pain, it was affecting her eating, and she was at her wits’ end. With the Tories, if you have not got the money, you have not got the care.
Kerry McCarthy (Bristol East) (Lab)
As a neighbouring MP, I thank my hon. Friend for mentioning Claire Hazelgrove, our candidate in Filton and Bradley Stoke, who is doing tremendous work on this. I have done a survey of my constituency and have found that about 98% of Bristol NHS practices are not taking on new patients. One issue I have also come across is that, even when people do have access to an NHS dentist, they cannot afford even those lower fees, and as a result they are being removed from the active patient list and losing access to that. We can understand how, during the cost of living crisis, people might delay a check-up for a few months because there are so many other pressing demands on their budgets.
Wes Streeting
I totally agree, and I do not think we should be complacent about this as a country. The NHS is already becoming a two-tier healthcare system, where those who can afford to go private are paying and the rest are left with an increasingly poor service for poor people. Government Members protest now, but they admit their goals once they leave the Department for Health and Social Care. The Health Secretary’s predecessors may not have said it when they were in her place at the Dispatch Box, but, as soon as they were out the door of the Department, the right hon. Members for West Suffolk (Matt Hancock) and for Bromsgrove (Sir Sajid Javid) said what they really believe: patients should be charged for GP appointments. Well, why stop there with this Conservative philosophy? Why not go further? That is the future for the health service if the Conservative party is given another five years. That is the risk facing patients across the country, and that is the choice facing voters at the next general election: further neglect, mismanagement and decline under the Conservatives or change with Labour and a decade of national renewal.
On NHS dentistry, the need for change could not be clearer. By the Conservative party’s own admission, it does not have a plan—just the vague promise of one coming in the future. All it does have is a record of 14 years of failure. If we stick to the current path, full universal access to NHS dentistry may be gone for good. The Conservatives may be happy to wave goodbye to this vital public service, but that is not the Labour way. With Labour, there is a clear plan, with immediate steps to tackle the crisis and long-term reform to rebuild dentistry. There will be more appointments, more dentists, more support for children and long-term reform to put the service on a sustainable footing, paid for by abolishing the non-dom tax status. That is because Labour believes that people who live and work in Britain should pay their taxes here, too. It does not matter whether they live on Downing Street or any other street: if they make their money here in Britain, they should pay their taxes here, too.
Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)
My hon. Friend is making an excellent speech. Abby Lane, in my constituency, has contacted over 30 dental practices. Not one is accepting her and her one-year-old child, who desperately needs dental treatment. Is it not the case that we now need to reform the system so that local commissioners can ensure that dental commissioning is happening in local areas where there is need, and not just have this patchwork system where dentists are fleeing because it is not paying well enough?
Wes Streeting
I totally agree. The tragedy is that if we look at the system as a whole and think about the pressure the whole system is under, and if we got NHS dentistry right, we would not only be saving patients untold pain, but saving the NHS money. As Lucy Rigby, Labour’s candidate in Northampton North, reported to me, in 2022 tooth decay forced 625 of her local patients to A&E—worse for them and more expensive for the taxpayer.
If Tory Members disagree with charging non-doms their fair share, maybe they could explain in their own contributions why they disagree. I am sure that their constituents would love to hear their defence of the non-doms, and we would be happy to give them space on Labour leaflets to quote their arguments back at them and let the public decide. I would particularly like to know why the Prime Minister is so wedded to this tax break for the wealthiest.
While Tory Members are set to oppose Labour’s rescue motion today, I understand that our plan on supervised toothbrushing for three to five-year-olds has received an endorsement from an unlikely source. On his podcast, former Conservative Chancellor George Osborne said:
“That really is the nanny-state in action.”
Coming from the Chancellor who introduced a sugar tax, I am sure George meant that as a compliment. Of course, Conservative Members may not see it the same way, just as they do not agree with Labour’s proposal to phase out smoking for children. Don’t worry, we have the Prime Minister’s back on that one; it is, after all, our proposal. But I ask those who attack our plan as nanny-state, what is the alternative? If a child cannot see a dentist and their parents will not do the responsible thing and make sure they clean their teeth, then should we just shrug our shoulders and do nothing while children’s teeth rot?
The problem for the small-statists on the Conservative Benches is this. Too many children today are not cleaning their teeth. Their teeth are rotting and they end up having them pulled out in hospital, which is worse for them and more expensive for the taxpayer. Last year, the NHS spent £80 million on tooth extraction. Toothbrushing in schools would cost a fraction of that, yet the Conservatives choose to waste taxpayers’ money, burning through taxpayers’ cash on the altar of ideological dogma and putting children through unnecessary misery, because it fits their confused ideology.
That is the irony of the Conservative party. Tories say that they believe in a small state and low taxes, yet they have left our country with the highest tax burden since the 1950s. The NHS receives £169 billion a year, yet it is going through the biggest crisis in its history. Because they do not understand that prevention is better than cure. Because they have refused to undertake meaningful reform. Because they treat taxpayers’ money with utter carelessness and contempt. And so they have left us with an NHS that gets to people too late, delivering worse care for patients at greater cost to the taxpayer. We are paying more and getting less. That is Tory Britain. No wonder Tory candidates are so worried.
Before this debate, I happened on a letter on Facebook from the hon. Member for Darlington (Peter Gibson) who is, happily, in his place. First he talks about the state of dentistry in his constituency—we obviously agree with him there—and then he says:
“I was shocked to learn at the end of last year that little to no progress has been made by the Health Board in our region who are responsible for commissioning this service to you.”
Let us assume it was in anticipation of Labour’s motion, which he is going to vote against because the Whip has been cracked. He goes on to say:
“I have today written to the Chief Executive following on from the meetings I had last year, and will be raising this issue in today’s dentistry debate in the House of Commons.”
What that is, and what voters will see it for, is just one of what will no doubt be countless examples of Tory MPs and Tory Ministers, after 14 years of their failure and mismanagement, pointing the finger of blame at someone else, hoping that voters in Darlington and elsewhere will blame local NHS managers and local NHS commissioners for 14 years of failure. If it is really the case that his integrated care board is to blame for why people in Darlington cannot get a dentist, why are people struggling in Newcastle-under-Lyme? Why are they struggling in Northampton North? Why are they struggling in Shipley? Why are they struggling in Filton and Bradley Stoke? Why are they struggling in Worthing West, Stroud, Stevenage, Great Yarmouth, Truro and Falmouth, Blackpool South, Stockton South and every other constituency in the country? Stop blaming other people for your Government’s failures.
Peter Gibson (Darlington) (Con)
I am very grateful to the hon. Gentleman for giving way and I appreciate that he gave me notice that he was going to mention my constituency. What he failed to do in his contribution was read out the letter in full. He has also not anticipated the full content of my speech, which highlights all the work I have been doing in my constituency to tackle the failure by the ICB to deliver the missing contract.
Wes Streeting
I could quote the full letter, but it does not help the hon. Gentleman. He misses the fundamental point. This is not just a failure in Darlington. This is not just a problem in the north-east of England. It is the south-west of England, it is the south-east of England, it is the west midlands, it is the east midlands, it is the north-west, it is Cumbria—it is right across the country. In fact, even in London, my city, which has the best NHS dentistry provision in the country—so much for levelling up—dentistry is still in a poor condition. That is why people in Darlington are looking to Labour and, I hope, Lola McEvoy, to take responsibility, show some leadership, back good Labour policies and rescue NHS dentistry in Darlington. The general election cannot come soon enough.
The choice is clear. Under the Tories, NHS dentistry is dying a slow death. The only chance for survival is change with Labour. Labour’s plan will deliver: 700,000 more dental appointments a year for those most in need; new dentists recruited to dental deserts where there is not a single dentist taking on new patients; toothbrushing in primary school for three to five year-olds to promote good health and prevent demand on the NHS; and reform of the dental contract after 14 years of failure, so that once again every patient who needs a dentist can get one. Politics is about choices. Labour chooses to rescue NHS dentistry, not give the wealthiest a tax break. Labour’s plan is fully costed, fully funded, and will make a real difference to people across the country. The Tories have left our country toothless. Labour will give our country its smile back and give its NHS back, too.
Victoria Atkins
I thank my right hon. Friend, and indeed my friend, my Lincolnshire neighbour, who knows as well as I do the pressures that we face in ensuring that our constituents receive the same quality of care that we expect across England. He was right to draw attention to the—I would argue—badly drafted contract of 2006, but he also touched on the complexity involved in finding systems that would work better.
Victoria Atkins
I cannot wait to reach the part of my speech that will deal with the hon. Gentleman’s suggestions, but first I will allow him to intervene, because I enjoy this back and forth.
Wes Streeting
So do I. The Secretary of State is far more entertaining than her predecessor. Given that she is painting a picture of improvement, how does she explain the story in The Times which revealed that NHS dentistry activity is now falling in 2023-24 compared with 2022-23? Is it not the case that things are going backwards rather than forwards? How does the Secretary of State explain that, and when are we going to see her plan?
Victoria Atkins
I am grateful to the hon. Gentleman for raising that point, because according to the latest statistics available to me, 18.1 million adults were seen by an NHS dentist in the 24 months up to 30 June 2023. That is an increase of 10%, and what does it mean in reality? It means that over 1.7 million more adults were seen than in the previous year. I know that we are all concerned about the health of children; some 6.4 million children were seen by an NHS dentist in the 12 months up to 30 June 2023, an increase of 14%, which means, in real terms, an increase of 800,000 on the previous year.
I accept, of course, that there is more to do, and we will be setting that out in our dental recovery plan shortly, but this is not just about big numbers. [Interruption.] The hon. Gentleman asks when “shortly” will be. As he knows full well, “shortly” is a little shorter than “in due course” and a little longer than “imminently”.
We have introduced several simple and effective measures to improve the nation’s dental health. The Health and Care Act 2022 made it simpler to expand water fluoridation schemes, because raising the fluoride level to 1 mg per litre is a straightforward way to prevent tooth decay. It has proved effective in parts of England as well as Canada, the United States, Ireland and Australia, and the chief medical officer has concluded that there is “strong scientific evidence” that water fluoridation can drive down the “prevalence of tooth decay”.
Victoria Atkins
I am going to plough on, I am afraid.
Earlier, Labour Front Benchers—perhaps not understanding that they were doing so—set out the philosophical difference between our two parties on how to grow the economy. As our economy grows, we on the Conservative side of the House want to attract the best and the brightest from around the world to work in our NHS, in our tech sector, in our life sciences industry, in our movie industry—hon. Members may know that it filmed “Barbie” this year—and in many other thriving industries. Labour, however, apparently wants to shut the door by taxing such people on earnings they make outside the UK. I speak, of course, of non-domiciled tax status.
If I may correct the hon. Member for Ilford North, because I appreciate that he has not spent any time on the Front Bench, last year alone non-domiciled taxpayers paid £8 billion in UK taxes on their UK earnings. That is equivalent to more than 230,000 nurses. Labour wants to put that at risk and put the UK at a disadvantage in the highly paid, highly competitive, highly mobile international labour market. This really is yet another branch of the magic money tree that Labour has always been looking for, to which they apparently want to add £28 billion a year of taxes or increased borrowing and increased inflation.
How they want to spend this money is interesting as well, because in 2022 Labour promised that their non-domiciled taxation would fund a workforce plan. Last September, it became breakfast club meals. Then, by October, it had morphed into 2 million hospital appointments and MRI and CT scanners. Now, apparently, it is funding a dentistry plan. One wonders how all these magic branches on the magic money tree will add up to all the promises made so far.
Victoria Atkins
I will resist, but only because I am going to ask the hon. Gentleman to intervene in a moment—he should be careful what he wishes for. I also notice that he talked about reform of the dental contract but did not give any detail. Government is not as easy as selling a book. It cannot be cut and pasted from Wikipedia, as some on the Labour Front Bench seem to like to do. It is about being clear on what you would do differently. Now, Labour in Wales is of course running the Welsh NHS. They do like to do things differently. People there are almost twice as likely to be waiting for health treatment as in England.
Victoria Atkins
I thank my hon. Friend, who represents a Welsh constituency. The chair of the British Dental Association wrote to the Labour Welsh Government to complain about their plan and, I understand, used words such as “toxic mix of underinvestment” and “untested targets.” The picture in Wales, if it is the Leader of the Opposition’s blueprint, is perhaps not as convincing as the shadow Health Secretary would have us believe.
The fundamental difference between the current systems in England and Labour-run Wales is that Wales has a capitated list system for dentistry. I am willing to give way so that the shadow Health Secretary can clarify whether he wants to bring in that system.
Wes Streeting
I cannot believe that is meant to be the right hon. Lady’s big “Gotcha.” She cannot even tell us when she will bring forward her plan, let alone what is in it. They have had 14 years to come up with a plan. This is absolutely astonishing. As much as I enjoy these partisan knockabouts at the Dispatch Box, the sight of the Health Secretary giggling and laughing at her own jokes will be of small comfort to people who are literally pulling out their own teeth.
Victoria Atkins
Just to cut through all the froth, the hon. Gentleman has not, in fact, answered my invitation. Does he wish to have a capitated list system, as they have in Wales, or does he have other plans? Could he please answer?
Wes Streeting
Like any responsible Government, we would consult the dentistry profession, the BDA, and come up with a serious programme for dentistry reform. If the right hon. Lady wants to ask me questions and have me answer them, the Government should call a general election and I will happily oblige.
Victoria Atkins
Again, cutting through the froth, the hon. Gentleman called this debate and has not set out his plan. He knows full well that this is an Opposition day debate and I am responding to Labour’s motion by moving an amendment. He has no plan on dentistry. When I asked him to clarify whether he will follow the capitated system in Wales, he declined to answer. I assume that is because he knows we tested a prototype system based on the Welsh capitation approach here in England, and the results were clear. It worsened access and widened oral health inequalities.
The hon. Gentleman quoted the Nuffield Trust, placing great emphasis on it, in his opening speech. As he agrees so much with the Nuffield Trust’s report, does he also agree with its former chief executive who said that his ideas on general practice represent
“an out of date view”
and “will cost a fortune”?
It is becoming increasingly clear that the Labour party’s approach to our NHS is empty words about reform followed by the phrase “funded by non-doms.” We are very lucky in this country—on this side of the House we consider ourselves blessed—to have incredible dentists working across the NHS.
Here are some facts for Opposition Members. There are now 1,352 more dentists working in the NHS than 14 years ago, thanks to the stewardship of this Conservative Government. I thank them and their colleagues for everything they do, and we are backing them to build a brighter future for NHS dentistry by taking concrete steps to improve recruitment and retention. That is why our long-term workforce plan, the first in NHS history, will expand dentistry training places by 40%, providing more than 1,100 places by 2031, which will be the highest level on record under any Government.
Over the same period, this Government’s plan will also increase training places for dental therapists and hygiene professionals to more than 500. The importance of the long-term workforce plan to dentistry’s future was recognised across the sector, and Professor Kirsty Hill, who chairs the Dental Schools Council, backed our plan:
“Expansion is a significant and positive development, and we commend the government for recognising the importance of increasing dental hygiene and dental therapist positions. These roles play a vital role in enhancing capacity and improving care.”
NHS Winter Update
Wes Streeting Excerpts(2 years ago)
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Wes Streeting (Ilford North) (Lab)
I thank the Secretary of State for advance site of her statement and wish her and the whole House a happy new year.
Unfortunately, the NHS is beginning 2024 the same way it ended 2022—on strike. This week’s industrial action by junior doctors is the longest strike in the history of the NHS at the worst possible time, because even before the strikes this week the NHS was struggling to stay afloat this winter. Hospitals were declaring critical incidents before the strikes. Patients were waiting dangerously long for ambulances and in A&E before the strikes. Ambulances were queueing up outside hospitals for hours to hand over patients before the strikes. The truth is, before the strikes, and before the pandemic, the NHS has been facing winter crisis after winter crisis as a direct result of the Conservatives’ failure—their failure to train enough staff, their failure to arm the health service with modern technology, and their failure to reform.
In January last year, the Prime Minister published an urgent and emergency care recovery plan, promising
“the largest and fastest-ever improvement in emergency waiting times in the NHS’s history”.
Instead, heart attack and stroke victims are waiting even longer for an ambulance, and A&E waiting times are the worst they have been all year. The Prime Minister promised 800 more ambulances, but the Government have now admitted that they are just replacing existing ambulances. He promised that 50,000 patients a month would be treated in virtual wards, but in reality it is fewer than 8,000 patients. Is not the truth that the Conservatives have once again sent the NHS naked into the winter, and patients are paying the price?
Given how ill-equipped the Government left the NHS, and given the desperate pleas from NHS leaders for the strikes to be resolved, why on earth did the Government choose to sit back and let this damaging strike action go ahead? Not only did the Health Secretary allow talks with the junior doctors to collapse and refuse to reopen negotiations until tomorrow, when the damage will have been done; at the 11th hour, as junior doctors stood on the edge of this strike action, she chose to push them straight into it. In what way was it helpful for the Secretary of State, in a series of broadcast interviews, to patronise junior doctors by rebranding them as “doctors in training”? A junior doctor can have 10 years’ experience under their belt; they do not expect to be trolled by Ministers who have been in office for barely 10 minutes.
In the Prime Minister’s interview on the BBC yesterday, we saw why he has allowed the strikes to go on for so long without intervening himself: he is using industrial action as an excuse for the state his party has left the NHS in after 14 years. He would rather blame NHS doctors and nurses than take a shred of responsibility himself. Meanwhile, patients cannot get an appointment, cannot get the surgery they need and cannot see a GP, NHS dentistry is decaying, and the NHS itself is on life support. While he was bragging about all the parts of the NHS that are not currently on strike—that is how low he now sets the bar—he seemed to have forgotten that nurses are still in formal dispute. Is he so uninterested in our nation’s health service that he did not know? Was he trying to pull the wool over the voters’ eyes? Or is he just another Tory Prime Minister asleep at the wheel as he drives the country off a cliff?
There was one thing that the Prime Minister got right in his interview with Laura Kuenssberg yesterday. Whether the question was on the NHS, immigration or the economy, his response was the same: ask the Leader of the Opposition. It seems that even this Conservative Prime Minister knows that if we want serious solutions to the problems facing the country today, there is only one place to look, and that is the Labour party.
Mr Deputy Speaker
Order. The hon. Gentleman has been here long enough to know that people do not give way during a statement.
Wes Streeting
Patients are sick and tired of waiting—waiting for ambulances, waiting for a GP appointment, waiting for their operation and waiting for a general election that cannot come soon enough. Why do the Conservatives not get out of the way and let Labour fix the mess they have made?
Victoria Atkins
I welcome the hon. Gentleman back from his world tour promoting his book. It is very nice to meet him for the first time across the Dispatch Box. While he was away in sunnier climes, he may have missed what is actually happening in Wales, which interestingly has been described by the Leader of the Opposition as the “blueprint” for how Labour will run the NHS, were it ever to come into government. Interestingly, in the Labour-run Welsh NHS, people are almost twice as likely to be waiting for treatment, and they are waiting an average of five weeks longer for NHS treatment under Labour in Wales than they do in England. Indeed, the number of patients in Wales seeking treatment in England has increased by 40% in two years because of the experiences that people are having in Wales.
I will just correct the hon. Gentleman on a couple of other things, too. Just to help him understand, we are delivering the 800 new ambulances—those are new ambulances—at pace at the request of the NHS, just as we are putting in 5,000 extra beds in hospitals across England, because we understand the point about capacity and we want to help the NHS look after people in a timely and efficient manner.
I will also just correct him again on the doctors in training point. I am surprised he has come on to that at this point, but had he spoken to his friends in the BMA, he would have understood that that is the phrase that the BMA is using. It has passed a motion to stop using the phrase “junior doctors”. [Interruption.] Yes, the BMA passed a motion. The hon. Gentleman referred to doctors, but he perhaps does not understand the complexities of contractual negotiations. The phrasing is used to denote those professionals who are still on formal training pathways who are not specialty doctors or consultants. That terminology has been agreed with the BMA.
In terms of the strikes themselves, I note—I know that those sat behind me on the Government Benches noted it, too—that the hon. Gentleman did not condemn the strikes. I am happy to give way, if he would like to confirm whether he condemns the strikes. Unfortunately, he has missed his chance to do so, but I suspect that everybody, including the patients at home waiting for appointments, will see the Labour shadow Minister’s failure to condemn these strikes. That is because, in line with public sector strikes more generally, the Labour movement will always prioritise union harmony over patient safety. That is not what we as Conservatives do; we will always put patient safety first.
Building an NHS Fit for the Future
Wes Streeting Excerpts(2 years, 2 months ago)
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Wes Streeting (Ilford North) (Lab)
I congratulate the Minister on being the great survivor of the Department of Health and Social Care. She must surely be due a carriage clock or the long service medal by now. The only long-term decision for a brighter future seems to be that she is still in her place, although she did not offer much of a brighter future.
More positively, I see far more than one nervous face on the Government Benches—I see lots of nervous faces among those contemplating the next general election—but one is undoubtedly that of the hon. Member for Uxbridge and South Ruislip (Steve Tuckwell). I congratulate him on his election and wish him well for his maiden speech, which I can confidently say will be the best speech we hear from those on the Conservative Benches all day.
At a time when patients cannot get a doctor’s appointment, families are struggling to pay the mortgage and major conflicts are having an impact on our economy and security, the Prime Minister has spent the past five days deciding whether to sack his Home Secretary for publicly disobeying him, undermining the police and inflaming tensions on our streets. Finally, having had the sheer poor judgment to have appointed someone to such high office when she had already been forced to resign for a serious national security leak, he has summoned up the guts to sack the worst Home Secretary in history. Yet, as we see, the merry-go-round of the Conservative clown show continues. After 13 years, the Conservatives have run out of names at the bottom of the barrel, so they are starting all over again. May I offer my sympathies to the Conservative Members who did not get the call from No. 10 today? What kind of message does it send to their constituents that their own party leader cannot find a suitable candidate for Foreign Secretary among the 350 Conservative MPs who sit in this House?
The arsonist has today returned to the fire, because when it comes to the national health service, Lord Cameron has quite a lot to answer for as the architect of austerity and the biggest top-down reorganisation in the history of the NHS—a £3 billion disaster that has led straight to the biggest crisis in the history of the NHS. That is before we even begin to take into account his record of ushering in the “golden” age between Britain and China; taking 20,000 police officers off our streets; and having food bank Britain leave more than 1 million people dependent on charity to feed themselves and their families. That is Lord Cameron’s legacy and as the current Prime Minister admits, “some mistakes were made”. Who is he trying to kid when he tells us that this recycled Conservative Government offer the change our country needs?
I would welcome the Secretary of State for Health and Social Care, the hon. Member for Louth and Horncastle (Victoria Atkins) to her position, but of course she is not here this afternoon, having just been appointed earlier today. She is the fifth Secretary of State for Health and Social Care that I have faced in this job in less than two years, although, to be fair, two of those appointments were the right hon. Member for North East Cambridgeshire (Steve Barclay). The Government said they would make
“Long-term decisions for a brighter future”,
but they cannot even deliver a long-term Secretary of State for Health.
We know where the Secretary of State is—she will be in the Department being briefed about the challenges of the job and being brought up to speed. No doubt she and new Ministers will want to review the decisions she is inheriting and to start to think afresh about whether she wants to proceed with those decisions as they have been working through the machine. That is why it is so grossly irresponsible to change Ministers every five minutes and constantly churn from one face to another, when it is clear to everyone but the Prime Minister that it is not just a change of faces around the Cabinet table that we need, but a change of Government.
As the Secretary of State sits in the Department being briefed by her civil servants, I will help them out with the induction by offering her a primer on what she inherits: millions of patients a month unable to get a GP appointment when they need one; 24 hours in A&E—not just a television programme, but a reality for far too many; ambulances not arriving on time, if they arrive at all; the 12th month of the worst strikes in the history of the National Health Service; NHS dentistry in managed decline, to the point where people are forced to pull out their own teeth—DIY dentistry in 21st century Britain; a generation of young people who have paid the price for lockdowns with their mental health, forced to wait years for the support they need; the longest waiting lists and the lowest patient satisfaction in history. That is the record of the Secretary of State’s seven predecessors: failure, upon failure, upon failure, upon failure, upon failure, upon failure, upon failure.
Barbara Keeley (Worsley and Eccles South) (Lab)
My hon. Friend is absolutely right about that list of failures—it is shocking. I would like to add to the list that over 2,000 autistic people or people with learning disabilities are detained in inappropriate units, when this Government promised over 10 years ago to close them all down.
Wes Streeting
I thank my hon. Friend for her intervention. As I make progress through my speech I will come back to the breath-taking complacency about mental health we heard from the Minister a moment ago.
Given the scale of the crisis and given that the Prime Minister has made fixing waiting lists one his five priorities, hon. Members might have expected something in the King’s Speech to deal with it. Instead, we got nothing on the NHS as it heads into its most challenging winter yet and we got nothing on social care, just kicking the can down the road and delaying reforms until after the election. There was nothing on dentistry, despite even Conservative Back Benchers crying out for a rescue plan, and nothing on mental health, despite the Conservative party committing to reform, not just in its last manifesto but in its last two manifestos.
It was the longest King’s Speech in almost a decade, with the fewest Bills. Does that not just sum up the modern Conservative party? Plenty of slogans, but no solutions. What we got was a Bill that will not come into effect until after the general election and a sack-the-nurses Bill. On the tobacco and vapes Bill, the question is not whether Labour will support it, but whether the Conservative party will support it. Government Members will remember that I first proposed that smoking ban back in January. I say they will remember, because they made their feelings known in newspapers at the time. They called it “nanny state” and
“an attack on ordinary people and their culture”.
They accused me of “health fascism”. Well, they can now make their considered and nuanced views known to the new Secretary of State—I am sure she is looking forward to receiving them. It just demonstrates that where Labour leads, the Government follow.
The Prime Minister may be too weak to whip his Back Benchers to vote that crucial measure through, but on the Opposition Benches we will put country first and party second. Labour MPs will go through the voting Lobby and make sure that the legislation is passed, so that young people today are even less likely to smoke than they are to vote Conservative.
I am afraid to disappoint the Government, but we will not be supporting the other Bill in the King’s Speech that relates to health. Most people look at the crisis in the NHS and think it needs more doctors and nurses. The Conservative party looks at the health service and concludes that we need to sack more doctors and nurses. The Government are saying that public servants should be sacked for failing to provide minimum standards on strike days, but the Government have not met the four-hour A&E standard since 2015; they have not met the standard for treatment within 18 weeks since 2016; and they were doing so badly on meeting cancer waiting time standards that they have simply got rid of the standards altogether. If the Conservatives are proposing to sack doctors and nurses for failing to provide minimum service levels, can we now sack Ministers for failing to meet minimum standards on non-strike days?
The new Health and Social Care Secretary has an opportunity to break with the past year. Strikes are crippling the NHS and they are putting patients in harm’s way. Her predecessor may have thought that they were a useful excuse for his failure, but they were, and are, a misery for patients and staff alike. The Government must stop the scapegoating of NHS staff, go into these negotiations with good faith, work at finding a solution, and, finally, bring these strikes to an end. There will be no progress on turning around our national health service until the Government make some progress.
When summing up I hope the Minister will explain why action was not taken on the Mental Health Act 2007, because, I am afraid, the Minister’s opening remarks were entirely unsatisfactory. The Bill has gone through Committee. It has cross-party support. It is ready to go, so where is it? The treatment of people with learning disabilities and autism under the current Act shames our society. The disproportionate impact on black people, who are four times more likely to be sectioned than white people, is appalling. Prisons and police cells are no place for people with mental ill-health. Surely that is not controversial in 2023. It is, as the former Prime Minister, the right hon. Member for Maidenhead (Mrs May), said, “a burning injustice”. I cannot understand why the Government have broken their promise to address that matter finally.
It is long past time that mental health was treated with the same seriousness as physical health. Labour will not only reform the Mental Health Act in our first King’s Speech, but recruit thousands more mental health professionals, provide hubs in every community, and set up mental health support in every school, so that young people can get the help they need when they need it. [Interruption.] The Minister says that they have done that. What planet is she living on? This is the problem with these Ministers. Even when the faces change, the lines remain the same. The Minister has not changed, but she is still reading from the same failed script. This is the problem with the Conservative party. Its message to the country is simple: “You have never had it so good. Everything is going really well. The reason we are churning all the Ministers in our Cabinet is that they are doing such a good job. It is job done and time to give someone else a chance.” I am afraid that that is why these Conservatives are so out of touch and will struggle at the next general election if their message to the country is that it has never had it so good.
Furthermore, unlike this Government, who crashed the economy in the most reckless way, we will pay for our policies, making sure that they are fully costed and fully funded—in this case, by ending tax breaks for private schools and private equity fund managers. Politics is about choices: Labour chooses the wellbeing of the many, not the interests of the few, and we will fight the election on those lines any time. I say call the election tomorrow, because we are ready.
When it comes to dentistry, I should also say farewell to two former Ministers, the hon. Members for Colchester (Will Quince) and for Harborough (Neil O’Brien). As the hon. Member for Harborough departs Government, I hope that he does not take with him his pledge to bring forward a recovery plan for NHS dental services. It has been seven months since he announced that such a plan would be forthcoming, yet it is now nowhere to be seen. Indeed, last week, integrated care systems were given permission to raid their dentistry budget underspends and to remove the ringfence. That follows a pilot in Cornwall, trialling making NHS dentistry available only to children and the most vulnerable. It is the managed decline of NHS dentistry before our eyes. If people want to know what the future of the NHS would look like with five more years of the Conservative Government, they need only look at the ghost of Christmas past in NHS dentistry. The Conservatives blame the previous Labour Government, but they have been in power for 13 years. In 2010, we stood on a manifesto committed to reforming the NHS dental contract. They have had 13 years to do it, and they have failed again and again, leaving us in the situation that we are in today, with Dickensian stories of desperate people performing DIY dentistry and tooth decay being the most common cause of children aged six to 10 being admitted to hospital. It did not need to be this way.
I say to the new Secretary of State and her team that she may not have a plan, but Labour does, and she is more than welcome to nick it. We will deliver 700,000 more urgent appointments a year, recruit dentists to the areas most in need, introduce supervised toothbrushing in schools to prevent children’s teeth from rotting, and reform the NHS dental contract so that everyone who needs an NHS dentist can get one—
Wes Streeting
The Minister says, “Is that it?”. It is 700,000 more NHS dentistry appointments than her Government are providing. It is ridiculous. The extent to which Ministers continue to parrot these ridiculous lines is embarrassing. If they want to intervene, make my day. I am perfectly prepared to confront any Member with their own Government’s record. Of course, they do not want to defend the Government’s record; they have a hard enough time doing that on the doorstep.
Turning back to His Majesty’s Gracious Speech, there may not have been any Bills for the health service last week, but we did see the white flag being waved on the Prime Minister’s pledge to cut waiting lists. Hospitals received a letter telling them to cut the number of operations and appointments they are aiming to offer this year. At the same time, an extra funding pot was announced, so we are literally paying more and getting less. No wonder the NHS is in such a state. No wonder waiting lists have trebled since 2010. No wonder hundreds of thousands more patients are waiting for treatment today than when the Prime Minister first made his pledge.
Jim Shannon (Strangford) (DUP)
I want to make a plea for those 10,000 young people with cystic fibrosis, who have to take multiple medications and endure daily physiotherapy, blood tests, X-rays, and hospital visits—waiting on many occasions—as part of their normal routine just to stay well. The shadow Secretary of State and the Labour Opposition have given a commitment to endeavour to do better for the NHS. Will he do better for those 10,000 young people who have cystic fibrosis?
Wes Streeting
I am very grateful to the hon. Member for his intervention. I am deeply concerned about the situation facing children with cystic fibrosis in particular, given that there is radically life-extending treatment available that offers the hope to those young people not just of longer, happier, healthier lives, but of reduced admissions to hospital. It is right that the National Institute for Health and Care Excellence makes those judgments in a rigorous way, looking at the evidence. I hope that it will be successful in bringing down the price of those drugs by negotiating with the pharmaceutical companies to make sure that we can get affordable drugs to families who desperately need them and are desperately anxious that the announcement they have read about means shorter lives for their children. No family should go through that agony, and I hope that a resolution can be found.
The Government and the previous Health Secretary got into the habit of stealing Labour’s policies—I say that not as a complaint, but as an invitation. It is clear that the Government do not have a plan to cut NHS waiting lists, but we do: £1.1 billion will be paid straight into the pockets of hard-pressed NHS staff to deliver 2 million more appointments a year at evenings and weekends, paid for by abolishing the non-dom tax status, because patients need treatment more than the wealthiest need a tax break—[Interruption.] Conservative Members groan when we mention charging non-doms their fair share, they groan when we talk about closing private equity loopholes and they groan when we talk about taxing private schools fairly. They did not groan when taxes went up on working people. They did not groan when benefits were cut for the poorest people.
We know who the Conservatives are in it for. They are in it for the few; we champion the interests of the many. That is the Labour difference. We believe strongly that people who live or work in Britain should pay their taxes here too. There is still time for the new Secretary of State to lobby the Chancellor ahead of the autumn statement. This genuinely is an oven-ready plan, unlike some of the plans we have heard from the Conservatives, and I encourage the new Secretary of State to nick it.
After 13 years, we have an NHS that gets to people too late. We have a hospital-based system geared towards late-stage diagnosis and treatment, which delivers poorer outcomes at greater cost. We have an analogue system in a digital age. We have a sickness service, not a health service, with too many lives hampered by preventable illness and too many lives lost to the biggest killers. It could not be clearer: the longer we give the Conservatives in power, the longer patients will wait. This was an empty King’s Speech from a Government who have run out of road, run out of steam and run out of ideas; a Conservative party too busy tearing itself apart to govern the country; a Prime Minister who cannot decide whether it is time for a change or to go back to year zero.
The future of the NHS after another five years of the Tories is emerging before our eyes: a two-tier health service, where those who can afford it go private, and those who cannot are left waiting behind—our NHS reduced to a poor service for poor people; our country viewed as the sick man of Europe. It does not have to be that way. The Prime Minister was right when he said,
“It’s time for a change”,
but only Labour can deliver it.
Labour has a different vision for our country in which no one fears ill health or old age; people have power, choice and control over their own health and care; the place people are born, or the wealth they are born into, does not determine how long they will live or how happy their lives will be; patients benefit from the brightest minds developing cutting-edge treatments and technology; and children born in Britain today become the healthiest generation that ever lived.
Only Labour has a plan to get the NHS back on its feet and make that vision a reality: a plan to cut waiting lists, delivering 2 million more appointments a year; a rescue plan for NHS dentistry, delivering 700,000 more appointments, recruiting dentists to the areas most in need, introducing toothbrushing for three to five-year-olds in schools and having an NHS dentist for all who need one; a plan to double the number of scanners so that patients are diagnosed earlier; a plan to recover our nation’s mental health from the damage of lockdowns; a plan to cut red tape that ties up GPs’ time, so that we can bring back the family doctor; a plan for the biggest expansion of NHS staff in history—a plan so good that the Government adopted it and gave us a head start; and a plan to reform the NHS to make it fit for the future. To those who say that that cannot be done and that things cannot be better, I say this: the last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history. We did it before and we will do it again.
It is not a change of faces we need but a change of Government. It is time to call a general election and give the British people the choice: more of the same with the Conservatives or a fresh start with Labour. Call a general election now, so that Labour can give Britain its future back.
Mr Speaker
We come now to a maiden speech, so there will be no interruptions. I call Steve Tuckwell.
Oral Answers to Questions
Wes Streeting Excerpts(2 years, 3 months ago)
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Wes Streeting (Ilford North) (Lab)
To listen to the Secretary of State, you would think it was all going so well, so let me give him a reality check. In Tamworth last year, only a third of patients said it was easy to get through to their doctor on the phone, one in three GP appointments were not conducted face to face and fewer than half of patients were offered a choice of appointment. The Government are not listening to the people of Tamworth. Perhaps the Secretary of State would like to explain to the people of Tamworth why, after 13 years of Conservative Government, this is the case, and better still, adopt Labour’s plan to cut red tape, incentivise continuity of care and bring back the family doctor.
Steve Barclay
I am glad that the hon. Gentleman raised GPs in Tamworth. The GP lead for the Doctors Association said that his plans for general practice filled them with despair, and his proposal for GP nationalisation was mocked by the Nuffield Trust, one of the respected think-tanks. The reality is that this Government are investing in more tech in primary care, have recruited 31,000 additional roles into primary care and have over 2,000 more doctors working in primary care than before the pandemic. Those are the facts. His plans have been mocked by respected think-tanks because he talks a good game on reform but we know that he will never stand up to the trade unions.
Wes Streeting (Ilford North) (Lab)
In Mid Bedfordshire last year, 165 children—[Interruption.] I do not know why Government Members are laughing; perhaps they should listen, as it is not our party that has let down the people of Mid Bedfordshire. Last year, 165 children in Mid Bedfordshire had teeth removed due to tooth decay. Some 800 patients were forced into A&E for the same reason and 100,000 people across the region cannot get access to an NHS dentist. Instead of laughing, the Government might like to adopt Labour’s plan to provide 700,000 extra dentistry appointments every year.
Steve Barclay
Since 2010, we have had 6.5% more dentists, a quarter more appointments and, as we have just touched on, increasing flexibility in regulation and boosting overseas recruitment. It is striking that one area of the country that the shadow Secretary of State does not want to talk about is Wales, which has a record of what a Labour Government will deliver. Indeed, the Leader of the Opposition says that he wants Wales to be the “blueprint” for what the NHS would be in England. There, this week, we have seen a fiddling of the figures on health. Even without that fiddling, we know people are twice as likely to be on a waiting list in Wales as in England—
Mr Speaker
Order. One of us has got to sit down and it is not going to be me. I let you have a good crack at the beginning, Secretary of State. Your opening statement took quite a long time, which I do not mind. I do not mind your having a go about Wales, but I am certainly not going to open up a debate between the Government and Opposition Front Benches. Topical questions are for Back Benchers and about short questions with short answers. I want it to be kept that way, so please understand that. There must be too many by-elections, because Members are getting carried away.
Wes Streeting
It is not just Mid Bedfordshire. Across the country, the No.1 reason children aged six to 10 are admitted to hospital is tooth decay. Given that, will the Secretary of State at least adopt the modest measure that Labour has proposed to introduce national supervised tooth brushing for small children—low cost, high impact—to keep their teeth clean and keep children out of hospital?
Steve Barclay
We are reforming the NHS workforce more fundamentally, looking at how we expand the roles that dental hygienists and dental therapists can perform. We are looking at how we can boost training, which is why we have made the commitment for more dentists in the long-term workforce plan, backed by £2.4 billion. How does that help? It increases the number of dentists being trained and we have a quarter more activity compared with last year.
Countess of Chester Hospital Inquiry
Wes Streeting Excerpts(2 years, 4 months ago)
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Wes Streeting (Ilford North) (Lab)
I strongly echo the sentiments of the Secretary of State and thank him for advance sight of his statement. I welcome the appointment of Lady Justice Thirlwall to lead the inquiry into the crimes committed by Lucy Letby, and I strongly welcome his appointment today of Baroness Lampard to lead the statutory review in Essex. I look forward to receiving further updates from the Secretary of State as soon as possible.
Turning to the case of Lucy Letby, there are simply no words to describe the evil of the crimes that she committed. They are impossible to fathom. Although she has now been convicted and sentenced to a whole-life order, the truth is that no punishment could possibly fit the severity of the crimes she committed. With Cheshire police’s investigation having expanded to cover her entire clinical career, we may not yet know the extent of her crimes. What we do know is that her victims should be starting a new school term today. Our thoughts are with the families who have suffered the worst of traumas, whose pain and suffering we could not possibly imagine, and who will never forget the children cruelly taken from them. We hope that the sentencing helped to bring them some closure, even though the cowardly killer dared not face them in court.
I wish to pay tribute to the heroes of this story: the doctors who fought to sound the alarm in the face of hard-headed, stubborn refusal. This murderer should have been stopped months before she was finally suspended. Were it not for the persistent courage of the staff who finally forced the hospital to call in Cheshire police, more babies would have been put at risk. I am sure the whole House will want to join me in recognising Dr Stephen Brearey and Dr Ravi Jayaram, whose bravery has almost certainly saved lives.
Blowing the whistle on wrongdoing is never easy, which is why it should not be taken lightly. Indeed, we can judge the health of an institution by the way that it treats its whistleblowers. The refusal to listen, to approach the unexplained deaths of infants with an open mind and to properly investigate the matter when the evidence appeared to be so clear is simply unforgivable. The insult of ordering concerned medics to write letters of apology to this serial killer demonstrates the total lack of seriousness with which their allegations were treated.
I welcome the fact that the Secretary of State has changed the terms of the inquiry and put it on a statutory footing. There must be no hiding place for those responsible for such serious shortcomings. It is welcome that the inquiry will have the full force of the law behind it, as it seeks to paint the full picture of what went wrong at the Countess of Chester Hospital, and it is right that the wishes of the families affected have been listened to. I welcome the fact that they will be involved in the drawing up of the terms of reference.
I ask the Secretary of State, people right across Government and people who hope to be in government to make sure that, in future, in awful cases such as this, families and victims are consulted at the outset. Can he assure the House that the families will continue to be involved in decisions as the inquiry undertakes its work?
Mr Speaker, no stone can be left unturned in the search for the lessons that must be learned, but it is already clear that there were deep issues with the culture and leadership at the Countess of Chester Hospital. This is not the first time that whistleblowers working in the NHS have been ignored, when listening to their warnings could have saved lives. Despite several reviews, there is no one who thinks that the system of accountability, of professional standards and of regulation of NHS managers and leaders is good enough.
Why were senior leaders at the Countess of Chester Hospital still employed in senior positions in the NHS right up to the point that Lucy Letby was found guilty of murder? The absence of serious regulation means that a revolving door of individuals with a record of poor performance or misconduct can continue to work in the health service. Does the Secretary of State agree that that is simply unacceptable in a public service that takes people’s lives into its hands?
The lack of consistent standards is also hampering efforts to improve the quality of management. I am sure the Secretary of State will agree that good management is absolutely vital for staff wellbeing, clinical outcomes, efficient services and, most of all, patient safety. The case for change has been made previously. Sir Robert Francis, who led the inquiry into the deaths at Mid Staffs, argued in 2017 that NHS managers should be subject to professional regulation. In 2019, the Kark review, commissioned by the Secretary of State, called for a regulator to maintain a register of NHS executives, with
“the power to disbar managers for serious misconduct”.
In 2022, the Messenger review commissioned by the right hon. Member for Bromsgrove (Sajid Javid) recommended a single set of core leadership and management standards for managers, with training and development provided to help them meet these standards. We must act to prevent further tragedies, so I welcome the Secretary of State’s announcement that his Department is reconsidering Kark’s recommendation 5. Labour is calling for the disbarring of senior managers found guilty of serious misconduct, so I can guarantee him our support if he brings that proposal forward.
The Secretary of State should go further. Will he now begin the process of bringing in a regulatory system for NHS management, alongside standards and quality training? Surely we owe it to the families and the staff who were let down by a leadership team at the Countess of Chester Hospital that was simply not fit for purpose.
Finally, I know that I speak for the whole House when I say that the parents of Child A, Child C, Child D, Child E, Child G, Child I, Child O and Child P are constantly in our thoughts, as are the many other families who worry whether their children have also been victims of Lucy Letby. We owe it to them to do what we can to prevent anything like this from ever happening again. As the Government seek to do that, they will have our full support.
Steve Barclay
I thank the hon. Gentleman for the content of his response and the manner in which he delivered it. I think it underscores the unity of this House in our condemnation of these crimes, and our focus on putting the families at the centre of getting answers to the questions that arise from this case. I join him in paying tribute to those consultants who spoke up to trigger the police investigation and to prevent further harm to babies. I note the further work that the police are doing in this case, and also pay tribute to the police team, which I had the privilege of meeting. They have worked incredibly hard in very difficult circumstances in the course of this investigation.
As the hon. Gentleman said, the families are absolutely central to the approach that we are taking. That is why I felt that it was very important to discuss with them the relative merits of different types of inquiry, but their response was very clear in terms of their preference for a statutory inquiry. I have certainly surfaced to Lady Justice Thirlwall some of the comments from the families in terms of the potential to phase it. Of course, those will be issues for the judge to determine.
On the hon. Gentleman’s concerns around the revolving door, clearly a number of measures have already been taken, but I share his desire to ensure that there is accountability for decisions. As Members will know, I have been vocal about that in previous roles, and it is central to many of the families’ questions on wider regulation within the NHS.
The hon. Gentleman mentioned the importance of good management. I am extremely interested in how, through this review and the steps we can take ahead of it, we give further support to managers within the NHS and to non-exec directors. The Government accepted in full the seven recommendations of the Messenger review. The Kark review was largely accepted. There was the issue of recommendation 5, which is why it is right that we look again at that in the light of the further evidence.
It is clear that a significant amount of work has already gone in. A number of figures, including Aidan Fowler and Henrietta Hughes, have focused on safeguarding patient safety, but in the wake of this case we need to look again at where we can go further, which the statutory inquiry will do with the full weight of the law. I am keen, however, that we also consider what further, quicker measures can be taken. Indeed, I have been in regular contact with NHS England to take that work forward.
Oral Answers to Questions
Wes Streeting Excerpts(2 years, 6 months ago)
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Wes Streeting (Ilford North) (Lab)
The Minister is aware, I know, of the outstanding campaigning work that my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) is doing, not least because of the experience of her sister—our late great friend Margaret McDonagh—with glioblastomas. Over decades now, we have seen no improvements in outcomes, no drug trials of any seriousness and no mandatory training of oncologists. I have learned through experience that, when the McDonaghs come knocking, it is best to say yes, and if anyone says no, they will be hit by this unstoppable steamroller. With that cautionary note in mind, might the Minister be prepared to meet me, my hon. Friend and relevant stakeholders across the Department, NHS England and the National Institute for Health and Care Excellence to see what more can be done? There are challenges, I know, but what more can be done to make sure that, for families such as my hon. Friend’s and Margaret’s, and for thousands of others each year, glioblastomas are not simply a death sentence?
Will Quince
I thank the hon. Member for that question and join him in paying tribute to the hon. Member for Mitcham and Morden (Siobhain McDonagh), especially after the tragic loss of her sister, for all the work that she has done in campaigning on this issue. I have spent significant time on the issue and I have met her, the hon. Member for Leicester West (Liz Kendall), campaigners, charities and other hon. Members from across the House. Funding for research is available and, having spoken with the Secretary of State, I know that he is as keen as I am to work with colleagues from across the House. There are issues that transcend party politics and this is certainly one of them. I would be very happy to meet the shadow Secretary of State, the National Institute for Health and Care Research, NHS England, the Tessa Jowell Brain Cancer Mission and clinical specialists to find a way forward.
Wes Streeting (Ilford North) (Lab)
Last week, the Health Secretary said that he was willing to offer doctors a higher pay rise. Last night, the Chancellor slapped him down, saying that any increased offer will have to be paid for by cuts. How can the Health Secretary negotiate an end to the NHS strikes when he cannot even negotiate with his own Chancellor?
Steve Barclay
We have been clear throughout that Government decisions on the pay review bodies’ recommendations are taken on a cross-Government basis. The agreement that we reached with the largest group of NHS staff, those on “Agenda for Change”, has demonstrated that we are willing to work constructively with trade union colleagues, but the demand from junior doctors for a 35% increase is not affordable—indeed, the hon. Gentleman himself has said that he does not support it.
Wes Streeting
But the worst strikes in the history of the NHS are still to come. The impact of the junior doctors’ strikes and the consultants’ strikes will be devastating for patients. The Secretary of State has failed to stop these strikes for seven months. He has lost the confidence of nurses, radiologists, junior doctors and consultants, and he cannot even successfully negotiate with his Chancellor, so what is his plan to stop these strikes going ahead?
Steve Barclay
The hon. Gentleman’s message is not even consistent with what he said at the weekend in the media: that he was not in a position to offer more money to the NHS, and that the shadow Chancellor had made that clear—in a vain attempt to demonstrate some sort of fiscal responsibility. The hon. Gentleman has been clear that he does not support the 35% demand from doctors in training. We are demonstrating that we are working constructively with groups such as the “Agenda for Change” group—the largest staff group, made up of over 1 million staff—with which we have reached a deal. We have also been responding constructively to the British Medical Association’s principal demand for consultants, which was for changes to pension taxation. We are willing to engage constructively with trade union colleagues, but the 35% demand is not affordable. He needs to decide on his position. Which is it: his position at the weekend that the Opposition are not offering more money, or his position today, which seems to be that they will?
Electronic Cigarettes
Wes Streeting Excerpts(2 years, 6 months ago)
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Wes Streeting (Ilford North) (Lab)
It is a pleasure to serve under your chairmanship, Mrs Latham, and to respond to the points made in the course of this afternoon’s debate on behalf of the official Opposition. I thank the hon. Member for Sleaford and North Hykeham (Dr Johnson) not just for securing the debate, but for the enormous amount of campaigning work that she is doing on this issue and for the wide-ranging and detailed scene-setting speech she gave at the beginning, which highlighted the extent of the challenge and the severity of the risk to children’s health.
Sadly, I think the hon. Lady has more work to do on her colleagues in the Government when it comes to her proposal to ban disposable vapes. The Secretary of State for Health and Social Care gave a speech this week on
“recasting prevention from a Conservative perspective”—
whatever that means—in which he argued that bans are left wing and an affront to personal freedom. I look forward to finding out what that means for the Government’s drugs policy, but let me be the first to welcome the hon. Lady—our new comrade—to the left. The lyrics to “The Red Flag” are in the post.
I will address the point raised by the right hon. Member for Calder Valley (Craig Whittaker). The central argument put forward by the vaping industry is that, at their most effective, e-cigarettes are a useful tool for driving down smoking rates. As Dr Javed Khan highlighted in his 2030 smokefree review, if we want to create a smokefree Britain, using vapes and other smoking cessation aids will be essential in reaching that ambition, but we should be under no illusion: although vapes are unquestionably less harmful than cigarettes, they are none the less harmful products.
I share the deep concerns that Members have expressed about the impact that the vaping industry is having on children, because it is not targeting children to get them off cigarettes, but to get them on nicotine. I do not care what the industry leaders told the Health and Social Care Committee yesterday; frankly, they are insulting the public’s intelligence. If someone walks down pretty much any high street in our country today, they will be able to buy brightly coloured vapes and e-liquids with names such as Vimto Breeze, Mango Ice, or indeed Unicorns. There is no doubt that these products are being designed, packaged, marketed and sold deliberately to children.
It is no wonder that there has been an explosion of under-age vaping in recent years. Action on Smoking and Health estimates that in just the last three years, under-age vaping has increased by 50%, which shows that the vast majority of kids are being exposed to e-cigarette promotions. In this debate today, we have heard about the impact of illicit goods and the harmful substances that many of these products, which are often sold to children, contain. I personally have heard horrifying stories about the extent of their promotion on popular social media platforms, where children are able to buy them with ease, although, frankly, they can also chance their arm quite successfully on our high streets.
The effects of these products should seriously trouble us all. Teachers have to monitor toilets in schools where children congregate to vape; children make up excuses to leave their classroom in order to satisfy their nicotine cravings; and children in primary school, aged nine or younger, end up in hospital because of the impact of vaping. Paediatric chest physicians report that children are being put in intensive care units for conditions such as lung bleeding, lung collapse and lungs filling up with fat. One girl who started vaping while she was at school told the BBC last week that she has:
“no control over it. I start to get shaky and it’s almost all I can think of.”
I have seen some people warning of a “moral panic” about under-age vaping, but children who are addicted to a drug are unable to focus in the classroom, and it affects their behaviour in other ways, too. We cannot sit back and allow a new generation of kids to get hooked on nicotine.
I recognise that this concern is shared by Members across the House, but I have to say that it is hard to swallow the comments of Ministers, including the Prime Minister, who try to grab headlines today by promising a crackdown on under-age vaping at some time in the future, because they had a chance to vote for such a crackdown two years ago. Labour tabled an amendment to the Health and Care Act 2022 to ban the marketing of vapes to under-18s, and it was Conservative Members who voted it down. I hope that Ministers have had a genuine change of heart, but either way there will be action on this issue after the general election. The next Labour Government will come down like a ton of bricks on companies pushing nicotine to children and we will ban the branding and advertising of vapes to children.
I want to press the Minister on the Government’s progress towards their Smokefree 2030 target, which Cancer Research UK estimates they are set to miss by nine years. That will result in thousands of additional deaths due to the health impacts of tobacco and pile more and more pressure on an already overburdened national health service. Cancer Research UK also estimates that, on current trends, smoking will cause one million cancer cases by 2040. What are the Government planning to do to get us back on track?
What has happened to the Government’s tobacco control plan, which was promised in December 2021? Prevention is better than cure, so the next Labour Government will shift the NHS from being a service focused only on treating sickness to one that prevents ill health in the first place, because that approach is better for patients and less expensive for the taxpayer. We would make all hospital trusts integrate smoking cessation interventions into routine care and we would expect every trust to have a named lead on smoking cessation. This would come alongside work with councils to improve access to e-cigarettes as a stop-smoking aid, and a clamp- down on the pervasive myths peddled by the tobacco industry that smoking reduces stress and anxiety.
That is Labour’s plan to build a healthier society; that is Labour putting the vaping industry on notice that we will not sit idly by and allow a generation of young people to become addicted to nicotine. Where is the Government’s plan?
Lung Cancer Screening
Wes Streeting Excerpts(2 years, 7 months ago)
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Wes Streeting (Ilford North) (Lab)
Before I begin, I would like to take this opportunity to pay tribute to the life of Margaret McDonagh, Baroness McDonagh of Mitcham and Morden. Margaret was the first women general secretary of the Labour party and the best: a political organiser second to none; kind, compassionate and made of steel. I am one of so many people throughout the Labour party and the Labour movement who benefited from Margaret’s kindness, generosity and wisdom. She was a friend, a mentor and a political hero. It breaks my heart that so many glioblastoma victims like Margaret have no hope of treatment and that a diagnosis means a death sentence. So, in sending, I am sure, condolences from across the House to Margaret’s sister, my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh), the best tribute we could make to Margaret and the best condolences we could offer her sister and family, is to unite across the House and resolve to do everything we can to make the breakthrough discoveries we need so that other people like Margaret do not receive this devastating death sentence.
I also join the Secretary of State in paying tribute to the late James Brokenshire, who was unbelievably kind to me when I went through my own cancer diagnosis—even more generous given what he was going through, which was so much worse.
I thank the Secretary of State for advance sight of the statement.
Lung cancer patients in this country are less likely to survive than patients in most European countries. Why? Because patients today find it impossible to get a GP appointment. On receiving an urgent referral, they wait too long for a scan. On receiving a cancer diagnosis, they wait months for treatment. And before the Government blame covid, the target for patients to start treatment within 62 days of referral has not been hit
since 2015.
The Secretary of State was not joking when he said that he is not announcing anything new today. The programme announced today will not be fully rolled out until 2030. So, after 13 years in Government, they are not announcing action today and not even for the next Parliament, but for the one after that. I thank the Health Secretary for making commitments for a second-term Starmer Government to deliver.
On the workforce, the problem with the plan is that the NHS simply does not have the staff to deliver it. The Prime Minister and the Health Secretary have been all over the media setting out the upcoming workforce plan, although they have not yet said a word to the House. Is this why it will take seven years to roll out the screening programme, because they have no plan to bring down NHS waiting lists today? We have been waiting almost as long as we have been waiting for the right hon. Member for Mid Bedfordshire (Ms Dorries) to hand in her resignation and call a by-election.
While the Health Secretary writes the Labour party’s 2028 manifesto, junior doctors who treat lung cancer patients are due to walk out on strike for five days. More than 650,000 operations and appointments have already been cancelled due to NHS strike action. Is it not time for the Health Secretary to accept he has failed, step aside and call in the Prime Minister to finally meet junior doctors? If the Prime Minister has time to negotiate gongs for Conservative cronies with Boris Johnson, he has time to meet junior doctors.
Today we learnt that the National Cancer Research Institute announced it will be closing after 22 years, due to
“uncertainty in the wider economic and research environment.”
There is still so much we do not know about cancers and so many treatments still to be discovered and developed, yet clinical trials have fallen off a cliff in recent years.
What impact does the Health Secretary expect the closure to have on cancer clinical trials?
After 13 years of Conservative rule, the verdict is in. A report published today by the King’s Fund reveals that the NHS has fewer CT and MRI scanners than other advanced countries, and
“strikingly low numbers of…clinical staff”.
That explains why the King’s Fund also found that the NHS was hit harder during the pandemic than other healthcare systems. It is not just that the Government did not fix the roof when the sun was shining; they dismantled the roof and ripped up the floorboards. It also helps to explain why patients in this country are less likely to survive treatable conditions, such as breast cancer and stroke, than those in comparable nations, and why we have one of the lowest levels of life expectancy. The King’s Fund summed it up with something of an understatement, saying that the NHS had “seen better days.” Is it not the case that the longer the Conservatives are in office, the longer patients will wait?
Madam Deputy Speaker (Dame Eleanor Laing)
Order. Before I call the Secretary of State, let me say to the hon. Member for Ilford North (Wes Streeting) that I think the whole House will join him, and me, in sending condolences to the hon. Member for Mitcham and Morden (Siobhain McDonagh).
Oral Answers to Questions
Wes Streeting Excerpts(2 years, 7 months ago)
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Wes Streeting (Ilford North) (Lab)
First, I congratulate the Health Secretary on his recent write-up as the next Leader of the Opposition. According to the i newspaper, his supporters are calling him “Mr Consistent”. Is that because of the consistent rise in waiting lists since he became Health Secretary, the consistently longer waiting times that patients are facing, or the consistent delay to the NHS workforce plan?
Steve Barclay
The point of consistency is that we gave a manifesto commitment to have 26,000 additional roles in primary care, and we have delivered that. We made a commitment to the largest ever hospital building programme, and we have announced over £20 billion of investment in it. The Government are standing by their manifesto commitments—that is what we are delivering.
Wes Streeting
I am sure that will do it.
I want to turn to the most recent reports about the NHS workforce plan, because apparently not only is that plan delayed, but we now read in the media that it is unfunded. Labour will pay for our workforce plan by abolishing the non-dom tax status. [Interruption.] Conservative Members do not like it, Mr Speaker, but it is the only tax they have been unwilling to put up. We have a plan, and we have said how we will pay for it. How will the Health Secretary fund his plan when it eventually arrives? Will it be cuts to the NHS, more borrowing, or even more broken promises?
Steve Barclay
The hon. Gentleman is recycling this question almost as often as he recycles the non-dom funding. As I said at the last Health and Social Care Question Time, it is like the 1p on income tax that the Lib Dems used to promise, which was applied to every scheme going.
We touched on this issue at the last Question Time, and indeed at the one before: we have a commitment to a long-term workforce plan. The Chancellor made that commitment in the autumn statement, but it is a complex piece of work that NHS England is working on. It is important that we get the reforms in that plan right, and that is what we are committed to doing.
Patient Choice
Wes Streeting Excerpts(2 years, 8 months ago)
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Wes Streeting (Ilford North) (Lab)
I thank the Secretary of State for advance sight of his statement. I also join him in paying tribute to the late Karen Lumley and, even more important, extending condolences to her family and her many friends on both sides of the House —but particularly on the Conservative Benches—for their loss. I know that the sadness is felt very deeply throughout the Chamber.
Let me now turn to the first of today’s two statements from the Health Secretary. It seems that quantity is not matched by quality. In a week in which the Leader of the Opposition announced Labour’s plans to give patients more choice, with regional waiting lists for care and more power through the NHS App, the Conservatives’ big idea to cut waiting times is to give patients a choice that they already have. It is thanks to the last Labour Government that patients waiting for planned treatment already have a right to choose an alternative provider if they have been waiting too long.
Beneath the spin, the Health Secretary’s announcement is actually a watering down of the measures that are already in place. He says that patients will have the right to choose an alternative provider if they have been waiting longer than 40 weeks, but in 2019 the Conservatives said that they should have that right after 26 weeks—which, even then, was worse than the 18-week standard to which patients were already entitled thanks to the last Labour Government. Is it not the case that he is once again shifting the goalposts because he cannot even meet his own standards, let alone those that patients expect?
The Health Secretary concluded his statement by talking about his Government’s record. That was a bold move, because 7.3 million people— the highest number on record—are currently waiting for planned treatment in England. As usual, the Health Secretary said that that was because of the pandemic, but the figure was already at a record high before the pandemic. Behind this shocking statistic are real people, waiting, waiting, waiting in agony. It does not matter how often the Health Secretary says that the Government are committed to reducing the waiting lists; people can see with their own eyes the numbers that do not lie, which show that waiting lists are getting higher and things are getting worse, not better.
The Health Secretary’s total incompetence when it comes to preventing strike action in the NHS has inflicted untold misery on patients. So far the total number of appointments affected by NHS strikes in recent months is more than half a million, a figure that the Health Secretary called “deeply disappointing”. Well, that is something on which he and I can agree, for once, but with another round of strike action planned by junior doctors, he must surely see the risk to patient choice and waiting lists. What is his plan? Ministers blame strikes as if they were mere bystanders, but it was their refusal to speak to nurses, paramedics and junior doctors that forced them out on strike in the first place. I am afraid the Health Secretary’s warm words today are not going to cut it, when all he is doing is giving more patients more choice over where their next appointment or operation is to be cancelled because of the strikes that he and the Prime Minister have failed to prevent.
Finally, let me turn to the supermassive black hole that is at the heart of today’s announcement. I will keep on reminding the Health Secretary of this until the penny drops. It does not matter which hospital patients choose; they can only receive care on time if there are enough staff to treat them—so why are we still waiting for the NHS workforce plan that the system is crying out for? Why do we have net migration at the highest level ever, with the Government over-reliant on recruiting staff from overseas because they cannot be bothered to train home-grown talent? Where is the plan to train the doctors and nurses whom the NHS is so desperately short of? Labour has set out our plan to double medical school places and train 7,500 more doctors and 10,000 more nurses a year, which we would pay for by abolishing non-dom tax status. [Interruption.] I am afraid that Conservative Members like non-doms more than they like nurses, but the public are not with them on that. Let me once again, in the spirit of generosity, before we break for the recess, offer the Secretary of State our fully costed, fully funded plan. It is available to him—[Interruption.] Conservative Members should not laugh too much now. I wager that, before we break for the summer, the Government will finally swallow their pride and announce the doubling of medical school places. We will wait and see.
After 13 years of Conservative Government, people can see for themselves where it has landed this country and compare it with 13 years of Labour Government, which delivered the shortest waiting times and the highest patient satisfaction in history. We will offer real choice and cut waiting times, so that the NHS is there when people need it. We did it before; we will do it again. We have the ideas and we have the plan. That is why only Labour can build an NHS that is fit for the future.
Steve Barclay
Not since the famous 1p on income tax from the Lib Dems, which was to be spent on every issue going past like a passing bus, have we heard of money being spent in as many different ways as the non-dom money. No wonder the hon. Member for Ilford North (Wes Streeting) said it with a smile; the whole House could see how credible that proposal is.
The theme of the hon. Gentleman’s response was comparison, so I think we should compare the substance of the announcement on patient choice with the situation where Labour is in office. In Wales, patients do not have the ability to choose where they receive treatment; that right is not offered to patients. In NHS Wales, patients registered with a GP in Wales do not have a statutory right to choose at which hospital they receive treatment. We can compare what a Government in England are doing—empowering patients, giving them that choice as well as the information and technology they need to make it—with NHS Wales, run by the Labour party, which deprives patients of their choice.
I hesitate to draw the comparison with Wales, however, because another Labour Front Bencher, the hon. Member for Denton and Reddish (Andrew Gwynne), says that he does not want Labour to be judged on its record in Wales. That is slightly confusing because the leader of the Labour party, no less, says that he wants Labour in Wales to be
“a blueprint for what Labour can do across the UK”.
So they cannot even compare among themselves, never mind compare between England and Wales.
The hon. Member for Ilford North talked about strike action but seemed to skirt around the fact that the Government have reached a deal with the NHS Staff Council in relation to Agenda for Change staff—a deal that his own union, Unison, voted 74% in favour of. His own union—the union that gives him money—supported the deal. He chides us about junior doctors, but those of us who were present in the Chamber the last time heard him say that he did not support the junior doctors’ demand for 35%. When we did negotiate with them, they even increased their demand to 49%, when next year is added in, further confusing the position.
It will come as no surprise to the House to discover that people in Wales are almost twice as likely to be waiting for treatment as people in England. That is the true comparison that we are addressing. We can see that situation play through to people waiting more than 18 months. In England, we have virtually eliminated 78-week waits—at the end of March, it was under 11,000—but in Wales, it will come as no surprise to Members, the number was closer to 75,000, and of course Wales has a smaller population. So we can compare waiting times, which we in England are bringing down. We have an electives plan, we cleared virtually all the two-year waits in the summer and over 90% of the 18-month waits at the end of March, which contrasts with the situation in Wales. We are giving patients choice, enabling them to move if they want to in order to get quicker treatment elsewhere. We are on the side of patients. We can see what the Labour party is doing by its disastrous performance in Wales.