NHS 10-Year Plan
Debate between Wes Streeting and Nusrat Ghani(1 week, 5 days ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
With permission, Madam Deputy Speaker, I shall make a statement to the House on “Fit for the Future”, the Government’s 10-year health plan for England.
There are moments in our national story when our choices define who we are. In 1948, the Attlee Government made a choice founded on fairness: that everyone in our country deserves to receive the care they need, not just the care they can afford. It enshrined in law, and in the service itself, our collective conviction that healthcare is not a privilege to be bought and sold, but a right to be cherished and protected.
Now it falls to our generation to make the same choice: to rebuild our national health service, and to protect in this century what Attlee’s Government built for the last. That is the driving mission of our 10-year plan.
In September, Lord Darzi provided the diagnosis: the NHS was broken by 14 years of Conservative under-investment, and by their catastrophic top-down reorganisation. In the past year, Labour has put the NHS on the road to recovery. We promised 2 million extra appointments; we have delivered more than 4 million. We promised 1,000 new GPs on the frontline; we have recruited 1,900. We have taken almost a quarter of a million people off waiting lists, cutting them to their lowest level in two years. And we have launched an independent commission, chaired by Baroness Casey, to build a national consensus around a new national care service to meet the needs of older and disabled people into the 21st century.
Today, the Prime Minister has set out our prescription to get the NHS back on its feet and make it fit for the future. Our plan will deliver three big shifts. The first is from hospital to community. We will turn our national health service into a neighbourhood health service. The principle is simple: care should happen as locally as it can—digitally by default, in a patient’s home if possible, in a neighbourhood health centre when needed, and in a hospital where necessary.
We will put neighbourhood health centres in every community, so people can see a GP, nurse, physio, care worker, and therapist, and they can get a test, scan or treatment for minor injuries, all under one roof. The NHS will be organised around patients, rather than patients having to organise their lives around the NHS. It will be easier and faster to see a GP. We will train thousands more, end the 8 am scramble, provide same-day consultations, and bring back the family doctor. If you are someone with multiple conditions and complex needs, the NHS will co-create a personal care plan, so your care is done with you, not to you.
Pharmacies will play an expanded role in the neighbourhood health service. They will manage long-term conditions, treat conditions such as obesity and high blood pressure, screen for disease and vaccinate against it. We will also reform the dental contract, to get more dentists doing NHS work, rebuilding NHS dentistry.
Over the course of this plan, the majority of the 135 million out-patient appointments done each year will be moved out of hospitals. The funding will follow, so a greater share of NHS investment is spent in primary and community care.
The second shift is from analogue to digital. No longer will NHS staff have to enter seven passwords to login to their computers, or spend hours writing notes and entering data. Our plan will liberate frontline staff from the parts of the job that they hate, so they can focus on the job that they love—caring for patients. For the first time ever, patients will be given real control over a single, secure and authoritative account of their data. The single patient record will mean that NHS staff can see medical records and know a patient’s medical history, so they can provide them with the best possible care.
Wearable technology will feed in real-time health data, so patients’ health can be monitored while they stay in the comfort of their own home, with clinicians reaching out at the first signs of deterioration. The NHS app will become the front door to the health service, delivering power to the patient. You will be able to: book and rearrange appointments for you, your children or a loved one you care for; get instant advice from an AI doctor in your pocket; leave feedback on your care and see what feedback other patients have left; choose where you are treated; book appointments in urgent care so you do not wait for hours; and refer yourself to a specialist where clinically appropriate. Of course, patients can already do all that, but only if they can afford private healthcare. With Labour’s plan, every patient will receive a first-class service—whatever their background and whatever they earn.
The third shift is from sickness to prevention. Working with the food industry, we will make the healthy choice the easy choice to cut calories. We will roll out obesity jabs on the NHS. We will get Britain moving with our new NHS points scheme, and we will update school foods standards so that kids are fed healthy, nutritious meals. We will tackle the mental health crisis with support in every school to catch problems early, 24/7 support with virtual therapists for those with moderate need, and dedicated emergency departments for patients for when they reach crisis point.
The science is on our side. The revolution in artificial intelligence, machine learning and big data offers a golden opportunity to deliver better care at better value. New innovator passports and reform of the National Institute for Health and Care Excellence and the Medicines and Healthcare products Regulatory Agency will see medicines and technology rapidly adopted. Robotic surgery will become the norm in certain procedures, so patients recover from surgery at home rather than in hospital beds. The NHS will usher in a new age of medicine, leapfrogging disease so that we are predicting and preventing, rather than just diagnosing and treating. It is therefore the ambition of the plan to provide a genomic test for every newborn baby by 2035. Thanks to my right hon. Friend the Chancellor, this plan is backed by an extra £29 billion a year by the end of the spending review period, as well as the biggest capital investment in the history of the NHS.
Alongside investment comes reform. This plan slashes unnecessary bureaucracy and devolves power and resource to the frontline. It abolishes more than 200 bodies, because listening to patients, guaranteeing safety and protecting whistleblowers is core business for the NHS and should never have been outsourced. The plan commits to publishing league tables to rank providers. We will intervene to turn around failing providers, and we will reinvent the foundation trust model in a new system of earned autonomy. Pay will be tied to performance, so that excellence is recognised and failure has consequences. Tariffs will be reduced to boost productivity. Block contracts will end, with funding tied to outcomes. The plan gives power to the patient, so hospitals are financially rewarded for better service. It closes health inequalities by investing more in working-class communities, and it establishes a national investigation into maternity and neonatal services to deliver the truth, justice and improvement that bereaved families deserve.
I am sometimes told that NHS staff are resistant to change. On the contrary, they are crying out for it. They suffer the moral injury of seeing their patients treated in unfit conditions. They are ones driving innovation on the frontline, so their fingerprints are all over this plan. The public are desperate for change too. Each of us has our own story about the NHS and the difference it made to our lives. We also know the consequences of failure. To succeed, we need to defeat the cynicism that says that nothing ever changes.
We know that the change in our plan is possible because it is already happening. We have toured the length and breadth of the country and scouted the world for the best examples of reform. If Australia can effectively serve communities living in the outback, we can surely meet the needs of rural England. If community health teams can go door to door to prevent illness in Brazil, we can certainly do the same in Bradford. We know that we can build the neighbourhood health service, because teams in Cornwall, Camden, Northumbria, and Stratford—where I was with the Prime Minister and Chancellor this morning—are already showing us how to do it. We will take the best of the NHS to the rest of the NHS. We will apply to best examples of innovation from around the world to benefit people here at home. Above all else, we will give power to the patient. This plan fulfils Nye Bevan’s commitment in 1948 to put a megaphone to the mouth of every patient. It will restore the founding promise of the NHS to be there for us when we need it.
Of course, we know that there are those on the right who are willing us to fail. They will exploit the crisis in the NHS in order to dismantle it. The hon. Member for Clacton (Nigel Farage) and his cronies argue that universal healthcare could be afforded in the 20th century but not in the 21st. Labour rejects their declinist pessimism and so do the public. But that is the choice—it is change or bust, and we choose change.
We know that the British people are counting on us. It falls to us to ensure that the NHS not only survives but thrives, and we will not let our country down. Of course, if we succeed, we will be able to say with pride that will echo down the decades of the 21st century that we were the generation who built an NHS fit for the future and a fairer Britain where everyone lives well for longer. I commend this statement to the House.
Madam Deputy Speaker (Ms Nusrat Ghani)
I call the shadow Secretary of State.
Health and Adult Social Care Reform
Debate between Wes Streeting and Nusrat Ghani(6 months, 1 week ago)
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Wes Streeting
I am grateful for that thoughtful question. Let me say two things to the right hon. Gentleman. The first relates to the wider fiscal pressures on the Chancellor. I find it difficult enough to manage the different choices and trade-offs to be made between different parts of health and social care and the competing challenges that I hear from Members in all parts of the House, so I am always thankful that I am not the Chancellor of the Exchequer, who has to balance demands from the NHS alongside the demands of education, a rising welfare bill, rising child poverty and the threats to our nation. These are enormous challenges, which is why I am determined to ensure that every penny that goes into the health service is well spent.
My second responsibility, in addition to ensuring that patients are treated at the right time, in the right place and in the right way, is ensuring that we have a sustainable healthcare system in which there is reduced demand. That means doing more on the prevention side, so that we can keep people out of hospital and not needing to knock on the door of their GP surgery, so that they do not achieve the frequent flier status in the NHS that so many people do achieve—the one frequent flier status to which they do not aspire. We can deal with this only through both health service reform and public health reform, and I want very much to build cross-party consensus on the latter.
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. That was a very lengthy answer.
Nesil Caliskan (Barking) (Lab)
Just before Christmas, I met care workers in my constituency, who told me about the day-to-day work that they do supporting the most vulnerable people in our community. Does the Secretary of State agree that just as access to GPs helps to relieve pressure on hospitals and A&E departments, an adequate number of adult social care workers will help to relieve the pressure on our GP services, which also have to deal with huge demand?
Government Policy on Health
Debate between Wes Streeting and Nusrat Ghani(10 months ago)
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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Wes Streeting
I wholeheartedly agree with my hon. Friend. Frankly, every single contribution from the Opposition Dispatch Box should begin with a grovelling apology for the way they conducted themselves in government, but they will not apologise: they have learnt nothing and they show no humility. To my hon. Friend’s point, when it comes to covid corruption and crony contracts, the message from the Chancellor is clear. We want our money back and the covid commissioner is coming to get it.
Madam Deputy Speaker (Ms Nusrat Ghani)
I call the Liberal Democrat Front-Bench spokesperson, Sarah Olney.
Sarah Olney (Richmond Park) (LD)
The Liberal Democrats find it deeply ironic that the shadow Health Secretary has raised this question on the involvement of people with no formal appointment in the development of Government policy. Are they forgetting their record in government? Perhaps we should remind everyone that, under the Conservatives, it was their friends that benefited from large contracts to supply the Government during the covid pandemic. The result is that, just today, as the hon. Member for Eltham and Chislehurst (Clive Efford) has already highlighted, Transparency International UK has revealed multiple red flags in more than 130 covid contracts totalling over £15.3 billion. With the Conservatives out of power, we have the opportunity to clean up our politics, so will the Secretary of State update the House on whether the Prime Minister plans to appoint his own ethics adviser or whether Sir Laurie Magnus will remain in the post? Will the ethics adviser be empowered to initiate their own investigations and publish their own reports?
Wes Streeting
I strongly agree with the hon. Member. In the short time that I have been in post, I have been delighted to have had virtual meetings with the current Northern Ireland Minister of Health, as well as with his predecessor, the hon. Member for South Antrim (Robin Swann), who now sits over there on the Opposition Benches—I am delighted to see him in his place.
Ministerial meetings attended by third parties are declared in our quarterly transparency publication. People will want to lobby and influence Government, and Members of Parliament, all the time. Members of Parliament regularly receive correspondence—let alone the deluge of advice that we receive in government. The important thing is that Ministers take decisions on the basis of the best possible advice available, that they weigh up carefully the evidence and arguments in a fair and proper way, and that advisers may advise but Ministers ultimately decide.
This Government are aware of the deep crisis in trust in our politics. That is why, on his very first day, the Prime Minister talked outside Downing Street about restoring Government to service. It is why it should be no surprise whatsoever that many people who have given outstanding public service to this country, such as my right honourable friend Alan Milburn—and the same is true of Patricia Hewitt, Alan Johnson, my noble Friend Lord Reed, the Mayor of Greater Manchester and many more—want to roll up their sleeves and help the Government. They can see the state that the Conservative party left our country in, and are willing once again to roll their sleeves up to get our country back on its feet, turn the situation around and ensure that everyone in our country can look forward to the future with optimism and hope after 14 years of abysmal failure.
Madam Deputy Speaker (Ms Nusrat Ghani)
That is the end of the urgent question. I thank all Members who participated. In reference to the Secretary of State earlier, the privilege of choosing UQs is down to the Chair and is based on merit and the urgency of the point being raised.
Productivity: Rural Areas
Debate between Wes Streeting and Nusrat Ghani(4 years, 9 months ago)
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Wes Streeting (Ilford North) (Lab)
It is a pleasure to be here for your debut in the Chair, Ms Ghani. I congratulate the hon. Member for North Cornwall (Scott Mann) on securing this very good debate. I also congratulate all those Members who were elected for the first time at the most recent general election—not for the election victory, I hasten to add; we would rather that had not happened—on having already learned the fine parliamentary art form of squeezing a five-minute speech into two minutes. As a result, we heard a wide range of important points.
When I read the room, I was not sure about whether I should have more trepidation about addressing this gathering as a Labour MP or as a London MP. I want to explain why both of those things are complementary to what we have just heard. First, the regional imbalance in the UK economy is not working for London and the south-east, either. This city—one where I am a suburban MP—is overheating and overcrowded. It is in the interests of London and the south-east that we are rebalancing the economy across England and the rest of the UK. The concentration of power, wealth and opportunity in London and the south-east does not work for London, for the rest of England or for the rest of the UK. I hope we can achieve genuine consensus about how we redistribute power, wealth and opportunity from London and the south-east to the rest of the UK to create a genuinely balanced economy that benefits everyone and strengthens our country as a whole.
The Opposition not only not disagree with so much of what we heard in the debate but strongly support it. We understand the diversity of the rural economy in this country. Jobs and businesses in farming, forestry and fishing are important for the people who work in them, the communities who benefit from them and, of course, the consumers who enjoy them too. However, they are not the grand total of rural businesses; in fact, 85% of rural businesses are unrelated to farming, forestry and fishing. It is really important that public policy makers, whether in Government or around the Westminster village, understand that point and think about the diversity of the rural economy and how we support those businesses to succeed.
It is also a really important point that, in the context of the productivity challenge we have in the economy as a whole, rural economies in the UK are less productive. The hon. Member for North Cornwall made the point well that that reflects not on the workforce but on the conditions in which those businesses operate. It is also true that employment is generally higher in rural areas but pay is lower. We heard some illustrations of why that was, with people holding down a number of jobs—in fact, running a number of businesses—to make ends meet. That point was made powerfully during the debate.
What are the conditions in the wider environment that are causing some of these challenges? Of course, some challenges arise out of business size and density, and there are not the same conglomeration effects as in urban areas.
We have heard contributions on the challenges of accessing finance and the closure of bank branches. We ought to think, in the context of the connectivity that we have had to create during the course of covid, about how to better connect rural businesses with each other. We need to make sure that we are investing in our people, which is about access to skills and making sure that people do not need to leave the places where they grew up in order to have a successful career or to build a successful business. It is important that we invest in infrastructure, whether that is buses, rail or other forms of public transport. There are also ongoing issues of digital connectivity—this country is a digital laggard. We only have to look at the report of the Environment, Food and Rural Affairs Committee to see that we are so far behind other European countries on digital connectivity.
Notwithstanding all the other challenges that our country faces at the moment, I really hope that, as we think about how to break the back of this covid crisis, we think about how we build a better, stronger, more resilient economy beyond the crisis, making sure that we invest in rural communities and their people, businesses and infrastructure. I hope we can build a cross-party consensus in this area to generate good ideas for the next Labour Government to take forward.
Ms Nusrat Ghani (in the Chair)
If the Minister can conclude by 5.43 pm, that will give enough time for the hon. Member for North Cornwall (Scott Mann) to wind up the debate.
Oral Answers to Questions
Debate between Wes Streeting and Nusrat Ghani(5 years, 5 months ago)
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Wes Streeting (Ilford North) (Lab)
Ms Ghani
I know that the hon. Member has been working incredibly hard, along with members of the Transport Committee. We put together a task and finish group to ensure that taxi services up and down the country are far more equal in their service, while providing security and safety for passengers. We will be issuing statutory taxi and private hire standards shortly. Having had many conversations with the hon. Member, I think he can be quite confident that most of the issues raised will be addressed.