New Hospital Programme Review
Debate between Wes Streeting and Judith Cummins(3 days, 14 hours ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Wes Streeting)
With permission, Mr Speaker, I would like to make a statement on the new hospital programme.
Of all the damage that the Conservative party did during their time in office—the broken public finances, the broken economy, the broken NHS—perhaps the most egregious was the broken trust between the British people and their Government, not just through their scandals or by breaking the rules they imposed on the rest of the country, but by making promises that they never intended to keep.
In 2019, the Conservatives told the British people that they would build 40 new hospitals over the coming decade, but there were never 40 new schemes and many of them were extensions or refurbishments. Put simply, they were not all new, some of them were not hospitals, and there were not 40 of them. Five years passed, start dates were delayed, spades remained out of the ground, and it became clear the announcement was a work of fiction.
Yet what did the Conservative party manifesto at last year’s general election say on the matter? It said:
“We will invest in more and better facilities, continuing to deliver 40 new hospitals by 2030”.
They repeated the promise even though the Department of Health and Social Care was putting contracts out to tender for hospital building that ran until 2035. They repeated that commitment even after the National Audit Office found that the Government
“will not now deliver 40 new hospitals by 2030.”
They repeated it even though the Government’s own infrastructure watchdog deemed it to be “unachievable.” No one thought that the promise would be met, yet the Conservative party made it anyway time and again.
Despite knowing this, when I walked into the Department of Health and Social Care on 5 July, what I discovered shocked me. The scheme was not just years behind schedule; the money provided by the previous Government was due to run out in March, just weeks from today. On 25 May 2023, the then Health and Social Care Secretary, the right hon. Member for North East Cambridgeshire (Steve Barclay), stood at this Dispatch Box and told the House:
“Today’s announcement confirms more than £20 billion of investment”.—[Official Report, 25 May 2023; Vol. 733, c. 480.]
The truth is that no funding had been set aside for future years; the money simply was not there. This was a programme built on the shaky foundation of false hope.
If I was shocked by what I discovered, patients ought to be furious—not just because the promises made to them were never going to be kept, but because they can see when they go into hospital how badly the health service needs new buildings. The NHS is quite literally crumbling. Lord Darzi’s independent investigation found that the NHS was starved of capital investment by the previous Government. Its outdated estate has hit productivity, with services disrupted at 13 hospitals every day during 2022-23. I have visited hospitals where the roof has fallen in and where pipes regularly leak and even freeze over in winter. The Conservatives literally did not fix the roof when the sun was shining.
On Thursday, the Infrastructure and Projects Authority published its annual report for 2023-24. Its assessment of the new hospital programme read:
“There are major issues with project definition, schedule, budget, quality and/or benefits delivery, which at this stage do not appear to be manageable or resolvable. The project may need re-scoping and/or its overall viability reassessed.”
That is what this Government have done.
Our review of the new hospital programme and the announcement I am making today will do two things: first, it will put the programme on a firm footing with sustainable funding, so that all the projects can be delivered; and, secondly, it will give patients an honest, realistic and deliverable timetable that they can believe in. This Labour Government are rebuilding our NHS, and as we do so, we will also rebuild trust in politics.
The seven hospitals built wholly or mostly from reinforced autoclaved aerated concrete—RAAC—were outside the scope of the review. These will be rebuilt at pace to protect people’s safety. Also out of scope were the hospitals already under construction or with an approved business case, where building works have continued without delay.
Working closely with my right hon. Friend the Chief Secretary to the Treasury, we have secured five-year waves of investment, backed by £15 billion of investment over consecutive waves, averaging £3 billion a year. That funding is in addition to the £1 billion that the Chancellor announced at the Budget to tackle dangerous RAAC and the backlog of critical maintenance, repairs and upgrades across the NHS estate. It is also in addition to the £1.5 billion we are investing in new surgical hubs, diagnostic scanners and beds. Together, it forms part of the £13.6 billion of capital investment announced at the Budget, which is the largest capital investment in our national health service since Labour was last in office.
I will now set out the new timetable. Projects in wave zero are already in the advanced stages of development and will be completed within the next three years. These are: the Bamburgh unit, phase 3 of the care environment development and re-provision, or CEDAR programme; the national rehabilitation centre in Nottinghamshire; Oriel eye hospital; Royal Bournemouth hospital; St Ann’s hospital; Alumhurst Road children’s mental health unit; and Dorset county hospital.
Wave 1 schemes will begin construction between 2025 and 2030. These include the seven RAAC hospitals: Leighton hospital; West Suffolk hospital; Frimley Park hospital; Hinchingbrooke hospital; Queen Elizabeth hospital; James Paget hospital; and Airedale general hospital. The other wave 1 schemes are: Poole hospital, Milton Keynes hospital; the 3Ts hospital—trauma, tertiary and training—in Brighton; the women and children’s hospital, Cornwall; Derriford emergency care hospital; Cambridge cancer research hospital; Shotley Bridge community hospital; North Manchester general hospital; and Hillingdon hospital.
Wave 2 schemes will now begin main construction between 2030 and 2035. They are: Leicester general hospital and Leicester royal infirmary; Watford general hospital, the specialist and emergency care hospital in Sutton; Kettering general hospital; Leeds general infirmary; Musgrove Park hospital; Princess Alexandra hospital; Torbay hospital; and Whipps Cross hospital, where I should declare an interest, as it serves my constituency.
Wave 3 includes nine schemes that will start construction between 2035 and 2039: St Mary’s hospital in London; Charing Cross hospital and Hammersmith hospital; North Devon district hospital; Eastbourne district general hospital, Conquest hospital and Bexhill hospital; Hampshire hospitals; Royal Berkshire hospital; Royal Preston hospital; the Royal Lancaster infirmary; and the Queen’s medical centre and Nottingham city hospital.
Following this statement, further details of the hospital building programme will be published on my Department’s website and a copy of the report will be placed in the House of Commons Library. In addition, the Minister for Secondary Care will hold meetings tomorrow, to which MPs of all parties are invited, to answer any further questions about these projects.
To ensure that every penny of taxpayers’ money is well spent and every hospital is delivered as quickly as possible, we will shortly launch a new framework for the construction of the new schemes. This will be a different way of contracting by working in partnership with industry to mitigate cost, schedule and delivery risks and saving money through a standardised design approach. That will speed up the process of opening new hospitals and provide a foundation for a collaborative supply-chain partnership. We will also appoint a programme delivery partner in the coming weeks to support the delivery of crucial hospital infrastructure across the country and provide programme, project and commercial expertise.
I know that patients in some parts of the country will be disappointed by this new timetable—they are right to be. They were led up the garden path by three Conservative Prime Ministers, all promising hospitals with no credible plan for funding to deliver them, and by Conservative MPs, who stood on a manifesto promise they knew could never be kept. We will not treat the British people with the same contempt. We will never play fast and loose with the public’s trust.
The plan that we have laid out today is honest, funded and can actually be delivered. It is a serious, credible plan to build the hospitals that our NHS needs. It is part of the biggest capital investment that the NHS has seen since Labour was last in office, delivering not just more hospitals but new surgical hubs, community diagnostic centres, AI-enabled scanners, radiotherapy machines, modern technology, new mental health crisis centres and upgrades to hundreds of GP estates. It will take time, but this Labour Government are determined to rebuild our NHS and rebuild trust in politics. I commend this statement to the House.
Madam Deputy Speaker (Judith Cummins)
I call the shadow Secretary of State.
Wes Streeting
My hon. Friend is absolutely right: I think that will be a unique representation this afternoon. I can already hear the vultures swooping, looking for that capital allocation and slot in the pipeline. She has made the case repeatedly, forcefully and with conviction that these services should remain in a community with high levels of deprivation and high need. I know that the Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth), has already committed to meeting her, and we are very happy to have those conversations with her.
Madam Deputy Speaker (Judith Cummins)
I call the Liberal Democrat spokesperson.
Dr Danny Chambers (Winchester) (LD)
In Hampshire and across the country in 2019 and 2024, Conservative MPs stood on the promise of delivering new hospitals, including one for Hampshire. However, it turned out that there was never any funding for that, and that those were just false promises to try to get votes. I have fought tirelessly to save and improve Winchester’s A&E and consultant-led maternity unit. With the announcement that construction of a proposed new hospital in Hampshire will not even start until between 2037 and 2039, we absolutely need to ensure that the current services are invested in and improved so that they remain fit for purpose.
Given that the new hospital programme is delayed, it is more urgent than ever to increase capacity by fixing social care, so that those who are well enough to leave hospital can be cared for in the community, thus freeing up beds immediately. We cannot endure both insufficient social care packages and crumbling hospitals. Given this delay to the new hospital programme, will the Secretary of State commit to prioritising more social care packages now, rather than waiting three years for a review to be complete?
Although the Health Secretary is not responsible for the state of the NHS or the state of the economy, which the Government inherited, the new hospital programme was seen as part of the solution to the crisis in the NHS, and people across the sector have warned that delaying the programme will only mean more treatments cancelled and more money wasted plugging holes in hospital buildings that are no longer fit for purpose. We are therefore concerned that one of the biggest announcements to affect the NHS over the next few years is coming out right now, during Donald Trump’s inauguration, because it will not get the media attention it deserves. Liberal Democrats therefore urge the Health Secretary to promise to release a full impact assessment on how the delays to the new hospital programme will affect patients and NHS staff.
Wes Streeting
First, I thank my hon. Friend for his strong representations on behalf of his constituents, not just since his election, but before it. Between the by-election and his election to this place, he did not give up; he continued to fight for his community.
I stood outside Hillingdon hospital, having had a good look around at the state of the hospital and the plans for the reconstruction of the site. I am delighted to have kept my promise and this Government’s promise, so that construction at Hillingdon hospital will begin in 2027-28. My hon. Friend is quite right to say that his predecessor and his predecessor’s predecessor made claims about Hillingdon hospital that were not true. This Government will not make those mistakes. We will keep our promise. What we have set out for all schemes in the new hospital programme is a credible, realistic, funded timetable that this Government, for as long as there is a Labour Government, will actually deliver.
Sir Edward Leigh (Gainsborough) (Con)
Will the Secretary of State forgive me if I give the House a few seconds’ respite from the blame game by trying to make a positive suggestion? Everyone accepts that the real problem facing our hospitals is the number of frail and elderly people who do not need to be in hospital and should be in some sort of care facility. Does the Secretary of State agree that while building brand-new, all-singing, all-dancing hospitals is very expensive, there is a future for smaller cottage hospitals such as the one in Gainsborough and a case for opening other facilities so we can move elderly, frail people out of those big hospitals into a caring environment and free up space?
Health and Social Care: Winter Update
Debate between Wes Streeting and Judith Cummins(1 week, 1 day ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Wes Streeting)
With permission, Madam Deputy Speaker, I would like to make a statement on winter pressures.
I start by saying that my thoughts, and I am sure the thoughts of the whole House, are with the nurse who was stabbed in a horrific attack at Royal Oldham hospital on Saturday. Nurses are the backbone of our NHS. They should be able to care for their patients without fear of abuse or violence. As she goes through treatment for her injuries, we pray for her speedy and full recovery and that she will be left to recover in peace.
I want to thank our NHS and social care staff for their remarkable effort, stamina and care in the most challenging of circumstances. Over the past few weeks, I have seen at first hand that staff are doing their level best in hospitals and care homes across our country—in the south-west, Essex, London, South Yorkshire and the north-west. Even when patients are left waiting far longer than they should be, and in conditions they should never be made to endure, they are still at pains to stress that the staff are doing their best.
I said on day one in this job that I would never gloss over problems in the health service and I would not pretend that everything is going well when it is not. The experience of patients this winter is unacceptable. I visited one A&E department over Christmas where I was told on the way in that I was lucky as I had come on a quiet day. Yet, as I walked through the hospital, I saw patients on trolleys lining the corridors where they were being treated, without the dignity or safety they should expect as a minimum. I saw frail elderly people on beds in the emergency department, many with dementia, crying out in pain and confusion because, ultimately, they were in the wrong place for their care needs. That was supposedly a good day.
The King’s Fund has said:
“The NHS is facing a toxic cocktail of pressures this winter”,
and it is right. Fourteen years of under-investment and a lack of effective reform have combined with a tidal wave of rising pressures. This has been the busiest year on record for our ambulance and accident and emergency services. We have had severe cold snaps, with temperatures as low as minus 15° in some parts of England. There are 5,100 patients in hospital beds with flu—more than three times the number at this point last year. Alongside the impact on patients, the rise in respiratory infections saw 53,000 NHS staff forced off work sick in the first week of the year. The result has been patients let down by ambulances that do not arrive on time, A&E departments that leave them waiting 12 hours or more, and the continued normalisation of corridor care. This is not the level of care staff want for their patients, and it is not the level of care this Government will ever accept for patients.
I said coming into this winter that 14 years of failure cannot be turned around in six months. It will take time to fix our broken NHS. Since July, we have done everything we can to prepare the NHS for winter. Following four months of silence from the previous Government, I called the British Medical Association on day one, met it in week one, and within three weeks negotiated a deal to end the junior doctors’ strike with a new deal for resident doctors. For the first winter in three years, staff are on the frontline, not the picket line. The Chancellor made immediate in-year investment in the NHS to fill the black hole we inherited and prevent us from having to cut back on services.
We have introduced the respiratory syncytial virus vaccine, and more than a million people and counting are protected against that virus. In total, 29 million vaccines have been delivered for flu, covid-19 and RSV, and more patients are protected against flu than at this stage last winter. If anyone is yet to get themselves vaccinated, it is not too late to protect themselves, their family and the NHS. They can check if they are eligible and book through their local GP or pharmacy.
We are working hand in hand with NHS England and care leaders, and I continue to meet regularly with senior leaders in social care, NHS England and the UK Health Security Agency. We have an excellent national operations centre running seven days a week. Its data allows us to zoom in—not just on individual hospitals but on individual patient waiting times—to respond in real time to spikes in pressures, and to manage threats as they emerge. The NHS is now using critical incidents proactively to focus minds and get the system responding to de-escalate and steer back to safer waters. I am happy to report that there is currently one live critical incident, down from 24 last week.
However, I do not pretend that that is good enough. It will take time to get back to the standards that patients deserve, but it can be done. That will require a big shift in the focus of healthcare—out of the hospital and into the community—to free up beds for emergency patients and to prevent people from having to call an ambulance or go to A&E in the first place. That is the reform agenda that the Government are enacting.
In recent weeks, we have announced steps to begin rebuilding general practice, and immediate and long-term action in social care. When we came into office, we inherited a situation in which qualified GPs could not get a job, while patients could not get a GP. That is why, within weeks, I found just shy of £100 million to recruit 1,000 more GPs by April. We have recruited hundreds of GPs to the frontline already, and we will recruit hundreds more in the months to come. We have announced an extra £889 million in funding for general practice, which is the biggest funding uplift in years, alongside a package of reforms to bust bureaucracy, slash unnecessary targets and give GPs more time to spend with their patients—our first step towards bringing back the family doctor.
Ten days ago, I visited a care home in Carlisle that was offering intermediate step-down care for NHS hospitals. It was able to give patients en suite bathroom facilities in care homes, with rehab, all at half the price it was costing the taxpayer to keep patients in a hospital bed up the road. That is better for patients and less expensive for taxpayers. Yet there are 12,000 patients in hospital beds today who do not need to be there but cannot be discharged because appropriate care is not available. That is why the Government are making up to £3.7 billion of extra funding available for local authorities that provide social care. It is why we are delivering an extra 7,800 home adaptations through the disabled facilities grant this year and next year. It is why we have delivered the biggest increase in carer’s allowance since the 1970s, worth an extra £2,300 to family carers. It is why are introducing fair-pay agreements to tackle the 131,000 vacancies in social care. And it is why we have appointed Baroness Louise Casey to help build a national consensus on the long-term solutions for social care.
From visiting emergency departments, monitoring the performance of the NHS over this winter and noting the variation in performance across the country, I know that we can clearly get our ambulance and A&E services working better. Before the spring, we will set out the lessons learned from this winter and the improvements that we will put in place ahead of next winter.
Finally, let me be clear on corridor care, which became normalised in NHS hospitals under the previous Government: I will never accept or tolerate patients being treated in corridors. It is unsafe, undignified and a cruel consequence of 14 years of failure on the NHS, and I am determined to consign it to the history books. I cannot and will not promise that patients will not be treated in corridors next year. It will take time to undo the damage that has been done to our NHS, but that is this Government’s ambition.
Annual winter pressures should not automatically lead to an annual winter crisis—indeed, there were no annual winter crises by the end of the previous Labour Government. That is why this Government are investing an extra £26 billion in our health and care services, and undertaking the fundamental reform that both services need. That will take time, but we will deliver an NHS and a national care service that provide people with care where and when they need it. I commend this statement to the House.
Madam Deputy Speaker (Judith Cummins)
I call the shadow Secretary of State.
Wes Streeting
I wholeheartedly agree with my hon. Friend, and thank her for the work she has been doing this winter on the NHS frontline, providing support to her colleagues at her local hospital—literally rolling her sleeves up and looking after people. She is absolutely right that we need an urgent and emergency care plan to make sure we see continued year-on-year improvements. I can reassure my hon. Friend that that plan is already being written; we are learning the lessons from this winter in order to apply them next winter. As I should have said to the shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar), I took the same approach when I was shadow Secretary of State: the very first meetings I held on winter planning were ahead of the general election in access talks with the Department. The first briefing I received on winter preparation was on my first day in office. Throughout the past six months heading into winter, I continued to talk to staff in the Department, NHS England and social care leaders to ensure that we were as well prepared for this winter as we could be. Right now, we are learning the lessons to prepare for next winter.
Madam Deputy Speaker (Judith Cummins)
I call the Liberal Democrat spokesperson.
Helen Morgan (North Shropshire) (LD)
I associate myself with the comments of the Secretary of State and the shadow Secretary of State regarding the abhorrent attack in Oldham.
The pressure on our hospitals this winter brutally demonstrates the scale of action needed after years of Conservative neglect of the NHS. Across England last month, 71% of A&E patients were seen within four hours, but that statistic varies wildly depending on where one happens to live. At Shrewsbury and Telford emergency departments last month, ambulances had to wait an average of over two hours to hand over their patients. Just 50% of patients were seen within four hours, and nearly 1,500 patients were left stuck on a trolley for more than 12 hours.
Statistics like these often fail to have much impact now, because we have heard them so regularly—particularly since winter crises have become normalised—but it is very important that we consider who is behind them. It is patients such as my constituent Emma, who having been diagnosed with sepsis spent 48 hours in a fit-to-sit area and then 12 hours on a trolley in an X-ray corridor before finally being admitted, alongside a horrifying delay in the medication required to deal with her life-threatening condition. Yet we often have to wait weeks for data that fully explains what is happening in our hospitals, and no official data is collected about the number of critical incidents. This leaves patients potentially ill-informed, and it makes scrutiny and support in this place, in particular, difficult to provide.
Will the Secretary of State commit to introducing faster and more detailed reporting about the live state of play in our emergency departments, including the number of critical incidents and the temporary escalation spaces, and give a timeline for reporting that information? Will he publish information that shows the impact that delays are having—for example, by looking at the number of deaths in emergency departments—and will he act on the long-term Liberal Democrat request to publish localised data on ambulance delays so that support is provided in areas, such as Shropshire, where it is most needed?
Wes Streeting
I thank my hon. Friend for that question. The conditions she describes at her local hospital are truly shocking. As I have said, and this is often quoted by the SNP, all roads lead to Westminster, and I am happy to report that up that road from Westminster to Holyrood lies a record uplift in funding for the Scottish Government. They have no excuses for inaction. They need to grip the crisis in the NHS in Scotland, as we are here. The difference, as my hon. Friend states, is that they have a record of 18 years that they cannot defend, and I hope people will consider that record very carefully when they decide who should govern in Scotland at the next set of Scottish elections.
Madam Deputy Speaker (Judith Cummins)
I call the Chair of the Health and Social Care Committee.
Layla Moran (Oxford West and Abingdon) (LD)
May I press the Secretary of State on that data point? It is not just the Liberal Democrats making these representations; the Royal College of Nursing, the Royal College of Physicians, the Royal College of Emergency Medicine, HealthWatch, the British Medical Association, Age UK and many others also want the data. This matters, because the situation causes moral injury to staff and compromises patient safety—and the problem is not just corridor care; it encroaches on to other wards. Will the Secretary of State commit to releasing that data before the NHS England board meeting on 4 February? In addition, what assessment has he made of the impact of this winter on less urgent care, and on elective waiting lists?
Puberty-suppressing Hormones
Debate between Wes Streeting and Judith Cummins(1 month, 1 week ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Wes Streeting)
With permission, Madam Deputy Speaker, I shall make a statement on puberty blockers.
At the outset, I wish to make clear the principles that drive the Government’s approach to this issue. First, children’s healthcare must always be led by evidence. Medicines prescribed to young people should always be proven to be safe and effective. Secondly, evidence-led, effective and safe healthcare must be provided to all who need it, when they need it. Thirdly, this Government believe in the dignity, worth and equality of every citizen, and recognise that trans people too often feel unsafe, unrecognised and unheard, and that must change. None of these simple ambitions has been achieved in recent years. Medicine has been provided with insufficient evidence, and young people have been left to go without the support and care that they need. This Government are determined to change that.
The Cass review made it clear that there is not enough evidence about the long-term effects of using puberty blockers to treat gender incongruence to know whether they are safe or beneficial. That evidence should have been established before they were ever prescribed for that purpose. It is a scandal that medicine was given to vulnerable young children, without proof that it was safe or effective, or that it had gone through the rigorous safeguards of a clinical trial.
Following the Cass review, the NHS ceased the routine use of puberty blockers to treat gender incongruence in children. In May, the previous Government issued an emergency order to extend these restrictions to the private sector. In Opposition, my party and I, as shadow Health and Social Care Secretary, supported those decisions. Since coming into office, I have renewed this order twice, continuing restrictions until the end of this year. That was done jointly with the Health Minister in Northern Ireland, and I updated the House via a written statement.
While the temporary ban was in place, I asked the Commission on Human Medicines to look at the current environment for prescribing puberty blockers, and we launched a targeted consultation. The commission is an independent body, made up of leading clinicians and epidemiologists, that advises on medicine safety. It took evidence directly from clinical experts, consultant paediatric endocrinologists and patient representatives, including representatives of trans people, young people and their families. After thoroughly examining all the available evidence, it has concluded that prescribing puberty blockers to children for the purposes of treating gender dysphoria, in the current prescribing environment, represents “an unacceptable safety risk”. Of particular concern to the commission was whether these children and their families were provided with enough time and information to give their full and informed consent. The commission found that children had received prescriptions after filling out online questionnaires and having one brief Zoom call with prescribers from outside the UK.
Consequently, the commission has recommended that the Government extend the banning order indefinitely, until a safe prescribing environment can be established for these medicines. On the basis of those findings, I am acting on the commission’s advice and putting in place an indefinite order to restrict the sale or supply of puberty blockers to under-18s through a prescription issued by either a private UK prescriber, or a prescriber registered outside the UK. This is on the advice of expert clinicians, the independent Commission on Human Medicines—advice based on the best available evidence—and follows the cautionary and careful approach recommended by Dr Cass. The legislation will be updated today, and will be reviewed in 2027, when there will be an updated assessment of the safety of the prescribing environment for these medicines.
We are working to grow a thorough evidence base for puberty blockers. The National Institute for Health and Care Research is working closely with NHS England to establish a clinical trial on puberty-supressing hormones. The NIHR is now contracting the team that will deliver the study and is working tirelessly towards recruiting the first patients by spring. The trial is the first of its kind the world over. It will help us better understand the effects of puberty-suppressing hormones on young people, providing the robust evidence required.
The Cass review also made clear recommendations to the Government and NHS England on improving healthcare services for children with gender dysphoria. I will now provide an update on the progress made. NHS England has published its implementation plan, which will transform its services. It has also published a new services specification, to ensure that children and young people experiencing gender incongruence have an appointment with a paediatrician or mental health professional before being referred to specialist services. Dr Cass was clear on the need for the model of care to change and take account of children and young people’s holistic needs.
Since April, NHS England has opened three new gender identity services—in the north-west, in London and in Bristol—with a fourth expected in the east of England by the spring. That puts us on track to open services in every region by 2026. These services offer a fundamentally different clinical model. They bring together clinical experts in paediatrics, neurodiversity and mental health, so that care can be tailored to patients’ needs. At first, the new services were prioritising patients registered with the old Gender Identity Development Service, but I am delighted to report that the north-west and Bristol services are now taking patients off the general waiting list.
On the waiting list, Dr Cass’s review painted a picture of a service unable to cope with demand. Children and young people face unacceptably long waits for care, with some children passing into adulthood before their first appointment, leaving them facing a dangerous cliff edge. I am pleased to tell the House that NHS England is working with potential partner organisations to explore establishing a much-needed follow through service for 17 to 25-year-olds, as Dr Cass recommended. Young people’s distress or needs do not vanish when they turn 18, and neither should their healthcare.
We do not yet know the risks of stopping pubertal hormones at this critical life stage. That is the basis on which I am making decisions. I am treading cautiously in this area because the safety of children must come first. There are some who have called on the Government not to go ahead with the clinical trial recommended by Dr Cass. Others on the opposite side of the debate want the Government to ignore the recommendations of the independent expert Commission on Human Medicines. We are taking a different approach. The decisions that we take will always be based on the evidence and the advice of clinicians, not on politics or political pressure.
Finally, there are many young people in this country who are desperately worried and frightened by the toxicity of this debate. This has not been helped by some highly irresponsible public statements, which threatened to put vulnerable young people at risk. In the past few months, I have met young trans people, who either have been, may be, or will be affected by the decisions that I and my predecessor have taken. I have listened to their concerns, fears and anxieties, and I want to talk directly to them. I know it is not easy being a trans kid in our country today. The trans community is at the wrong end of all the statistics for mental ill health, self-harm and suicide. I cannot pretend to know what that is like, but I do know what it is like to feel that you have to bury a secret about yourself, to be afraid of who you are, to be bullied for it, and then to have the liberating experience of coming out. I know it will not feel like it, based on the decisions that I am taking today, but I really do care about this, and so does this Government.
I am determined to improve the quality of care and access to healthcare for all trans people. I am convinced that the full implementation of the Cass review will deliver material improvements in the wellbeing, safety and dignity of trans people of all ages, and the Government will work with them to help them live freely, equally and with the dignity that everyone in our country deserves. I commend this statement to the House.
Madam Deputy Speaker (Judith Cummins)
I call the shadow Secretary of State.
Wes Streeting
I can certainly give my hon. Friend that assurance. Better-quality evidence is critical if the NHS is to provide reliable and transparent information and advice to support children and young people, and their parents and carers, in making potentially life-changing decisions. That is why we support the setting up of the study into the potential benefits and harms of puberty-supressing hormones as a treatment option. The study team’s application for funding is going through all the usual review and approval stages ahead of set-up—including peer review, consideration by the National Institute for Health and Care Research funding committee, and ethical approval processes. We want the trial to begin recruiting participants in spring 2025. I am confident in the robust, appropriate and ethical way in which the trial is being established.
Madam Deputy Speaker (Judith Cummins)
I call the Liberal Democrat spokesperson.
Helen Morgan (North Shropshire) (LD)
I thank the Secretary of State not only for the content of his statement, but for its tone and his recognition of the importance of such a tone in this place. For too long, children and young people who are struggling with their gender identity have been badly let down by low standards of care, exceptionally long waiting lists and an increasingly toxic public debate.
Before GIDS closed, more than 5,000 young people were stuck on the list for an appointment and waited, on average, almost three years for their first appointment. For teenagers going through what is often an incredibly difficult experience, three years must feel like an eternity, so change is desperately needed.
The Liberal Democrats have long pushed to ensure that children and young people can access the high-quality healthcare that they deserve. We welcome the NHS move to create multiple new regional centres, but those centres must get up and running as quickly as possible. Will the Secretary of State outline what steps the Government are taking to ensure that happens in every region, and will he give a timetable for that work? Tackling waiting lists and improving access to care must be priorities.
I understand why today’s news is causing fear and anxiety for some young trans people and their families, who have been badly let down for so many years—not least those I have met in my constituency, who have highlighted the catastrophic mental health impacts of the situation. It is crucial that these sorts of decisions are made by expert clinicians based on the best possible evidence. Will the Secretary of State publish all the evidence behind his decision, including the results of the consultation, to give those families confidence that this is the right move for them?
We welcome the announcement of a clinical trial. We need the NHS to build up the evidence base as quickly as possible, and the Government to provide certainty that they will follow evidence and expert advice on behalf of those children.
NHS Performance: Darzi Investigation
Debate between Wes Streeting and Judith Cummins(3 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Wes Streeting
I strongly agree with the Chair of the Select Committee and commend the work of the previous Committee, to which she refers. She has certainly given me some revision for the first meeting that I will attend. To answer her question, she is absolutely right that digital transformation and place-based healthcare planning are key. This Government will have a much sharper focus on health inequalities than the previous Government did. In fact, if we consider the NHS over the past 30 or 40 years, even when it has performed well overall, and patients in every part of the country have received access to timely care, some health systems have still been more challenged than others. We need to be honest about the structural challenges in those areas. Secondly, she is absolutely right that, if we are serious about health and prevention, we need a serious cross-Government approach. That is why I am delighted that the Prime Minister’s mission-driven approach has already seen Departments coming together with a focus on prevention. That will deliver fruit.
This is the major surgery that our national health service needs over the next decade to make it fit for the future. There is no time to waste, so we have hit the ground running. We inherited a Care Quality Commission that is not fit for purpose. I was genuinely stunned to learn that one in five health and care providers has never been inspected; some hospitals have been left uninspected for a decade; and inspectors were sent to care homes when they had never met someone with dementia. The Conservatives did not think that patients would like the answers, so they stopped asking the questions. This Labour Government are different: we will be honest about the problems facing the health service, and serious about solving them. Our policy is radical candour.
Today I am delighted to announce that Sir Julian Hartley has been appointed the new chief executive of the CQC. He is a proven reformer with a track record of turning around large organisations, and I am confident that he will provide the leadership that staff in the CQC need to address this crisis, improve patient safety and restore confidence in the regulator. Sunlight is the best disinfectant, so this Government are taking action to turn the regulator around. That is the difference a Labour Government make.
We inherited the farce of newly qualified GPs facing unemployment. Patients could not get a GP appointment, while GPs could not get a job, so we cut red tape, found the funding and are recruiting an extra 1,000 GPs. That is the difference a Labour Government make. We have tabled a motion to ban junk food ads targeted at children —our first step towards making our country’s children the healthiest generation that has ever lived. That is the difference a Labour Government make. Just this week, the Secretary of State for Science and Technology and I announced funding to produce new cutting-edge cancer treatments: a new blood test that can detect 12 different cancers. We are backing Britain’s scientists to save lives. That is the difference a Labour Government make.
Of course, strikes in the NHS have cost taxpayers billions. Patients saw 1.5 million operations and appointments cancelled. The Conservatives saw strikes as an opportunity to scapegoat NHS staff, so they let the strikes rage on. In fact, the shadow Health Secretary had not even bothered to meet the junior doctors since March. This Government do not exploit problems; we solve them. I called the junior doctors on day one and met them in week one, and in just three weeks, we had negotiated a deal to end the strikes. That is the difference a Labour Government make.
Those are just our first steps. Rebuilding the NHS will not be easy and it will take time, but we have done it before and we will do it again. Along with the millions of dedicated staff in health and social care across our country, this can be the generation that takes the NHS from the worst crisis in its history to build an NHS fit for the future—an NHS that is there for us when we need it, with world-class care for the many, not just the few. That is the change that Britain voted for; that is the change we will deliver together; and that change has already begun.
Madam Deputy Speaker (Judith Cummins)
Before I bring in the Opposition Front Benchers, the House should be aware that over 50 Members wish to speak in the debate, so I ask you to help each other. On this occasion, I will impose a three-minute limit on Back-Bench speeches, with the exception of maiden speeches and that of the Chair of the Health and Social Care Committee. I call the shadow Secretary of State.
NHS: Independent Investigation
Debate between Wes Streeting and Judith Cummins(4 months, 1 week ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Wes Streeting
I thank my hon. Friend for her question and congratulate her warmly on her election to the Chair of the Work and Pensions Committee. I am looking forward to sharing, through the Secretary of State for Work and Pensions, the work that our Departments are doing together, particularly on the link between mental health and unemployment and on integrating pathways. She is right about the social determinants of ill health. That is why I am genuinely excited that, through the mission-driven approach that the Prime Minister has set out, we are already bringing together Whitehall Departments, traditionally siloed, to work together on attacking those social determinants. The real game changer is genuine cross-departmental working, alongside business, civil society and all of us as active citizens, to mobilise the whole country in pursuit of that national mission, in which we will be tough on ill health, and tough on the causes of ill health, as someone might have said.
Sir Edward Leigh (Gainsborough) (Con)
I greatly respect the Secretary of State, and, as an older person who relies on the NHS, I support his radical zeal. I repeat what he said in his statement: cancer is more likely to be a death sentence for NHS patients than for patients in other countries. We have had this conversation previously, but can he at least look at the health systems in other countries, particularly those in the Netherlands, Australia, France and Germany? Those countries, which have wonderful health systems protecting the vulnerable, use a mixture of social insurance and public and private funds to maximise inputs into their health services.
Wes Streeting
My hon. Friend is absolutely right: the health of the nation and the health of the economy are inextricably linked. Under this Government, the Department of Health and Social Care is a Department for growth as well as a Department for health and care, and the Chancellor understands those linkages too. I can say to my hon. Friend and all of her friends at the King’s Fund—we were delighted to see them host the Prime Minister this morning—that unlike our predecessors, this Government cannot get enough of experts.
Madam Deputy Speaker (Judith Cummins)
That concludes the statement. We have had more than 45 contributions from Back Benchers, so I thank you for your patience.
Points of Order
Debate between Wes Streeting and Judith Cummins(4 months, 1 week ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Wes Streeting)
Further to that point of order, Madam Deputy Speaker. I like the hon. Lady very much, and I will just say two things in response: first, she has been around in this Chamber a long time. Conservative Members cannot sit and heckle, then get cross when Ministers respond robustly. Secondly, I think that was a perfectly legitimate analogy; indeed, I might say that the arsonists should not complain about the fire brigade.
Madam Deputy Speaker (Judith Cummins)
I remind all hon. Members that good temper and moderation are the characteristics of a good debate.