Summer Health and Resilience
Yvette Cooper Excerpts(4 days, 6 hours ago)
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The Secretary of State for Health and Social Care (Yvette Cooper)
With permission, I would like to provide the House with a brief update on the additional pressures on health this summer as a result of the heat, the action our NHS has taken in response, and some of the next steps the Department is taking on investment and reform to help our NHS improve its resilience and performance in the face of new health challenges.
Before I do that, let me say, as I did last night, what a pleasure and honour it is to be back at this Dispatch Box as Secretary of State for Health and Social Care, 27 years after I first became a Health Minister under the last Labour Government. While there have been many changes in health and healthcare in the last quarter century, the values that underpin our NHS—care and compassion for all of us, based on need and not the ability to pay—are the best of British values, and they have endured through generations.
What has also endured is the incredible dedication of NHS and social care staff. As a result of their work and with the support of this Government, and despite record health demand, we have seen millions of additional appointments; record numbers of patients receiving treatment; waiting lists down by 350,000 in two years; ambulance and A&E waiting times down in the winter; thousands of extra doctors, nurses and mental health workers in place; and patient satisfaction with access to GP services up to 75% from 61% two years ago.
Alongside recognising the dedication of NHS staff, I want to recognise the impact that covid had on staff across our NHS and social care and the pressures they faced. They were there for us then and we should not forget that now. That is one reason why it makes me incredibly angry that the figures show that one in seven NHS workers have faced violence and abuse while doing their job, and the figure is much higher in emergency care. That is a disgrace, and I hope I speak for the whole House when I say to those staff: we are on your side and we will always stand up for you.
Let me pay tribute to my immediate predecessors in this role, my right hon. Friends the Members for Ilford North (Wes Streeting) and for Ealing North (James Murray). I also pay tribute to the work of other Health Ministers over the last two years who together have commissioned the Darzi report, drawn up the NHS 10-year plan and the cancer plan—for which I pay particular tribute to my hon. Friend the Member for West Lancashire (Ashley Dalton)—and driven the additional investment, reforms and improvements in performance we have seen in the last two years.
I want to focus on the immediate pressures on health that our NHS has faced, exacerbated by the summer heat. We have experienced what has officially been registered as the hottest summer on record, with five heatwaves, 40 days of temperatures above 30° and extremes that we now expect to be the new normal because of the impact of climate change. During May and June of this year, it is estimated that there were more than 2,800 excess deaths. To put that in perspective, it is almost twice as many as the 1,500 heat-related deaths during the entire summer of last year. Once the analysis of July and August is complete, it will be clear that the extreme heat we have seen this year has had an unprecedented impact on the health of the nation and represents a new significant threat to the very oldest, the very youngest and the most vulnerable in our society.
Extreme temperatures also pose additional challenges to the normal functioning of the NHS. This July saw the highest number of attendances at A&E of any month in any year in the history of the NHS. Ambulance teams handled over 800,000 incidents that month—the second highest for a month outside winter. This is against a backdrop of continued pressure in A&E. Today’s National Audit Office report recognises that the NHS is beginning to see improvements in A&E performance, but not yet at the scale that we need to see.
The heat has highlighted some of the weaknesses in the NHS estate, including overheated wards and operating theatres. This comes against a backdrop of the damaging under-investment in NHS estates that we inherited. This was highlighted in the Darzi report, which said that the NHS was “starved of capital” after 2009, impacting on productivity and performance as well as letting patients and staff down.
Let me set out the action we are now taking to boost the resilience and performance of our NHS in the face of these new summer and other pressures. First, in the spending review, we allocated for the first time a multi-year £6.75 billion estate safety fund. I can announce the first wave of investment from this fund today, covering 950 hospital projects across England, which will receive a share of a £1.5 billion investment to fix urgent problems with ageing buildings and facilities. The schemes will tackle issues including failing fire safety systems, outdated ventilation and ageing electrical equipment that could put patients and staff at risk. More than £32 million will be spent specifically on projects that include improving cooling and ventilation, and helping hospitals cope with extreme heat as well as winter pressures.
As part of that funding, I can announce 10 major schemes worth £200 million for Wycombe hospital in High Wycombe; the Royal Free hospital in north London; the Linden centre in Essex; the John Howard centre in London; Lister hospital in Hertfordshire; Southend hospital in Essex; the Stepping Hill hospital in Stockport; St George’s hospital in Stafford; the Bristol royal infirmary; and the Queen Elizabeth hospital in Gateshead. I have also asked the NHS to look in particular at extreme weather resilience as part of future waves of capital plans.
The second action is about resilience and planning. For many years, the NHS has run a detailed planning process to ensure that it is prepared for the pressures of the winter months; however, this summer has shown us that seasonal resilience is just as important at other times of year. That is why we have established a new heat taskforce that includes the chief medical officer, NHS England leaders and several NHS chief executives from services that have been most affected. I have requested that the taskforce should examine the impact on vulnerable groups, including the frail, expectant mothers and those with mental health conditions. I will chair its first meeting in the coming weeks.
The taskforce will help to ensure that our summer planning is on the same footing as our winter planning—looking at staffing, expert teams, patient flow, corridor care, links to social care and, crucially, prevention and public health. That comes against a backdrop of a £450 million investment to improve urgent and emergency care, expanding urgent care centres and mental health A&Es, and shifting more care into the community.
The third area is social care. Many of those who are most vulnerable to extreme heat are in social care, so the work that our care system does is vital for people’s health. We also know that the persistent lack of join-up between health and social care continues to be a problem, with frail elderly people who would be better cared for at home being sent to hospital and patients being held in hospital for far too long because care support is not in place.
This feels like groundhog day: we were having the same discussions about co-ordination between health and social care when I was last a Health Minister 25 years ago. The Government are taking action, including through the better care fund, neighbourhood health and an additional £4 billion investment into adult social care by 2028-29, as well as through the planning process to improve co-ordination. However, the problems are structural and will need much more substantial reform. That is why the Prime Minister announced this summer that we are bringing forward Baroness Casey’s commission to report next year and, alongside that, taking forward cross-party talks to see what consensus can be built.
The legislation to create our NHS went through this House 80 years ago this autumn. At its heart was the idea that, as Nye Bevan said on Second Reading, it would
“lift the shadow from millions of homes.”—[Official Report, 30 April 1946; Vol. 422, c. 63.]
It was to ensure that there was a health service to care for all of us whenever we needed it, improving the health of our nation. Ensuring that that shadow stays far from our doors for the next 80 years means not just the modernisation of the NHS, the 10-year plan and the improvements we will debate many times in the House; it means building the level of resilience, be it to changing weather and climate or for a changing world that impacts on our health and healthcare. We will do that only by working together and with the dedicated staff, patients and communities across the country. I commend this statement to the House.
Damian Hinds (East Hampshire) (Con)
I am grateful, Mr Speaker. I thank the Secretary of State for her statement and for advance sight of it. To date, preparedness statements have tended to focus on winter, as she said, but she is right that we now need such an approach for summer.
I welcome the statement today, but we must also ask about this year—the summer just gone. Yes, the intensity and length of high temperatures was new, along with the spikes that it brought in emergency admissions and all the cancelled appointments, but it was also predictable: high temperatures were forecast. What lessons has the Department learned from the UK Health Security Agency reports on adverse weather and health? What preparations had it made in advance of the summer? What guidance was given? Were trusts left to develop protocols themselves? Specifically, what guidance was given to care and nursing homes?
Of course, the high temperatures this summer were not unique to the United Kingdom—nor indeed is the UK, by quite some way, the hottest country in Europe. What conversations have the Secretary of State and her Ministers been having with counterparts in other countries to make sure that each learns from the other?
Right now, the NHS is amid a massive top-down reorganisation. What assessment has the Secretary of State made of the effect of the uncertainty and upheaval that always comes with a major reorganisation on the NHS’s ability to put in place changes at short notice? Given the extreme heat that staff were enduring, what steps is she taking not only on building and ambient temperature, but to ensure that the design of personal protective equipment, for example, reflects the changed needs? What specific consideration is being given to the ambulance service?
There is a connected issue: the cost of energy, for summer as well as winter. What is the right hon. Lady doing across Government to make heating and cooling more affordable for households and individuals? That would bring down admissions. Will the Government now adopt the cheap power plan that we have set out?
Finally, although we are talking about the summer, it is September already; it is reasonable and timely to ask also about winter. We understand that supply of the RSV vaccine is in place, but what guarantees can she give about wider preparedness? When will the Secretary of State come to the House to set out those plans? The number of people waiting more than 12 hours in A&E for admission is up significantly since the change of Government. What is she doing to grip that well ahead of the coming winter pressures?
Yvette Cooper
I thank the shadow Secretary of State for his response. As I did not reply to him yesterday, I did not have the opportunity to welcome him to his post. He referred to my personal links to East Hampshire. I should say that I remember going to see the GP at the health centre on Anstey Road in Alton, because of an earache—not that I am associating the right hon. Gentleman with earache.
The shadow Secretary of State raised the issue of this summer. Despite the record demand on the health service in July, there were actually improvements in performance on waiting lists, waiting times and emergency care as a result of the huge amount of planning and work that had been done on performance, particularly for A&E, emergency care and electives. That is a tribute to the work across the national health service and all the planning work that had been done nationally, including to improve performance.
The right hon. Gentleman rightly raised the issue of preparedness for the coming winter. Health Ministers have meetings about the winter in the summer and we are now increasingly going to have to have meetings about summer in the winter as well, but that planning is already well under way right across the NHS and across NHS England. We will provide updates for the House in due course.
The right hon. Gentleman raised some particular issues to do with heat. The NHS approach should be about seasonal resilience to be ready for what might be extremes of flooding, extremes of hot weather and different kinds of conditions that will impact on the country, so that it is able to respond to changing patterns of health need. That is why things such as capital investment are so important in building that greater resilience, which we do not have at the moment because of what we inherited. It is also why we now have a specific heat taskforce to look through the journey on both prevention and how we modernise, and to ensure that the right response is in place right across the NHS.
I am happy to discuss those details further with the shadow Secretary of State as that work progresses. I hope that he will recognise the investment that has gone in over the last two years, in contrast to what we inherited, and the improvements and reforms that are taking place as a result of the changes we have made. I look forward to discussing those with him further.
Jen Craft (Thurrock) (Lab)
I very much welcome this statement on our preparedness for future extreme heat events. As the Secretary of State mentioned, there were record A&E attendances this summer, and in my constituency, as in many others, this led to ambulances having to queue outside for upwards of eight hours. I have called on my local hospital’s trust—Mid and South Essex NHS foundation trust—to make a room available for paramedics and ambulance crews to rest and recuperate when this happens, because otherwise they have to sit in their ambulance, often with a very sick person, for upwards of eight hours, with nowhere to go for even a cup of tea and a sandwich. I have been unsuccessful thus far, so will she back my call for hospital trusts, and particularly Mid and South Essex, to make a space available so that ambulance crews can take a break when they have to sit outside A&E for prolonged periods of time?
Yvette Cooper
I thank my hon. Friend for recognising the crucial role that ambulance staff and paramedics play in our emergency care, and the importance of the NHS supporting its staff—our NHS is the staff; it is the people who make up the service. I do not know the details of the individual case she raises, but I will ensure that it is passed on to NHS England. I certainly agree that we need to ensure that staff have the support they need.
Helen Morgan (North Shropshire) (LD)
I welcome the Secretary of State and the shadow Secretary of State, the right hon. Member for East Hampshire (Damian Hinds), to their places—I have to say that I was not expecting to be the continuity figure in the health portfolio.
We need to be honest: the NHS is now in permacrisis, as outlined by the National Audit Office report. The hallmarks of peak winter pressure in the past—overcrowded A&Es, queuing ambulances and soaring 999 calls—are now a feature year round. This summer was particularly difficult due to record temperatures across the UK, with over 33 NHS trusts reporting temperatures well above the 28° limit set by NHS England, and we can all agree that is not acceptable. It is inhumane not just for patients but for staff—42° is unbearable. A constituent of mine suffered in his final days in a desperately hot setting in Royal Shrewsbury hospital until managers worked with my team to ensure that he was made more comfortable. We do not want to be dealing with cases like that every year. We need hospitals that can withstand the heat, and the Lib Dems have been calling for a new NHS rapid adaptation unit to urgently heatproof the most heat-affected hospitals and care homes.
Turning to corridor care, the percentage of people waiting 12 hours or more in A&E has tripled since before the covid-19 pandemic. Analysis suggests that people waiting this long are twice as likely to die within 30 days of leaving A&E, compared with those who wait just two hours. It is abundantly clear that policies to deal with A&E are not working. Spend is increasing, as outlined in the report, while outcomes are decreasing. We are pumping money into emergency departments with no proportionate improvement.
The Lib Dems have outlined our plan to end 12-hour waits in a year by investing more in step-down care and support for people to leave hospital and go into social care. The Health Bill will reduce co-operation between local authorities and integrated care boards, risking those improvements in social care. Although we welcome the cross-party talks on social care, I hope that the Secretary of State will look at this issue as the Health Bill makes its way through the Lords. Will she listen to our plans, change her approach and commit to ending the ongoing A&E scandal?
Yvette Cooper
I thank the hon. Member for her questions, and for drawing on her expertise and interest in this area. On capital funding, that is exactly why we are allocating £32 million as part of the capital fund that we have set out specifically to deal with repairs and safety issues that have become acute across the NHS estate as a result of more than a decade of capital underfunding of the NHS. Ara Darzi made it clear in his report that this has had a huge impact on patients and staff, but also on the NHS’s productivity, because we have facilities that cannot be used because of that capital underfunding.
That £32 million will be targeted at measures to improve cooling systems, but I have asked the NHS to look further, as part of the second wave of funding, at other areas across the country where there will be particular needs as a result of buildings needing to deal with extreme heat, which they were never designed for. As a result of the announcements I have made today, £1.5 billion is now going into improvements to existing facilities, to upgrade them and ensure that they reach the right quality and standards.
On the hon. Member’s point about corridor care, nobody should have to be seen or treated in a corridor, or have to wait for a long time at one of the most distressing times of all, when they need emergency care and support. I have seen some phenomenal examples and have discussed the work that hospitals such as Watford have done to eliminate their corridor care challenges. We have introduced reporting and publication of those statistics for the first time, exactly to ensure that we have that priority. But I pay tribute to the work done by A&E teams to improve performance, despite the huge increase in demand that they saw in July—they are doing a really important job.
Danny Beales (Uxbridge and South Ruislip) (Lab)
I welcome the new Secretary of State to her place and look forward to working with her. Over the summer I visited a number of GP practices, and they reported frequent instances of racism, abuse and even violence against staff. This summer we also saw a horrific stabbing of a doctor at Hillingdon hospital. I therefore welcome the Secretary of State’s comments about the unacceptable levels of abuse that we are seeing in our health system. The practices think that more could be done, with panic alarms, cameras, increased security staff and speeding up some of the regulatory processes. NHS Property Services can take a long time to make even the simplest improvements, such as a security door or additional CCTV. Will the Secretary of State join me in condemning in no uncertain terms the abuse faced by NHS staff in Hillingdon and across the country, and outline what more action could be taken on this issue?
Yvette Cooper
I thank my hon. Friend for raising this. He is right to stand up for the staff at Hillingdon but also right across the country. These people are doing the most important jobs in the country: caring for all of us at the time when we need them most, at the time when things go wrong in our lives—when we are sick and we need help and support. It is a total disgrace that, while doing that job, they should face abuse, violence, discrimination or racism. It is totally appalling and unacceptable. I am keen to work with staff groups, trade unions and NHS organisations right across the country to uphold strong standards, stand up for our staff and ensure that they have the support they need, and I look forward to working with him on this.
Dr Luke Evans (Hinckley and Bosworth) (Con)
We are talking about resilience, and one of the things that has made resilience worse is Labour’s policy on mandatory advice and guidance, and single point of access. We know that secondary care doctors and GPs are struggling but, more importantly, it is causing actual harm to patients. Those are not my words, but those of the Health Services Safety Investigations Body, the health watchdog, which has asked for a review to be commissioned to look into this specifically. Has the Secretary of State read that report, will she commission that review and, if so, who will do it and by when will it be done?
Yvette Cooper
My hon. Friend the Minister for Secondary Care has been looking in detail at that report. We obviously take all reports immensely seriously. The advice and guidance have been in place for some time and rightly provide huge amounts of support, advice and, actually, improvements in healthcare right across the country. Where there are cases where things go wrong or where cases are raised with us, we will always investigate them and take them immensely seriously. We will also always ensure that the whole regulatory framework is there to ensure that the highest standards are upheld.
Deirdre Costigan (Ealing Southall) (Lab)
I thank the Secretary of State for her statement. Ealing hospital has already had £5.9 million of investment from this Labour Government to install 222 solar panels and a new heating system that stops patients and staff getting too hot or cold. Does she agree that her announcement today will not just help the NHS to beat the heat, but help us to save money that we can spend on patient care?
Yvette Cooper
My hon. Friend is exactly right. What she describes in Ealing is a hugely important example of the way that modernising our basic estate and facilities can ensure that they are fit for different kinds of conditions and circumstances in the future, and that we are able to reduce the energy bills that put other pressures on our NHS, meaning we can get that money back into frontline care. I pay tribute to the work of the NHS in her constituency.
Lisa Smart (Hazel Grove) (LD)
I must confess that I am a little frustrated, because I think this is the third time that the ventilation system at Stepping Hill hospital has been announced by a Minister—and it is not new money. There is a £138 million repairs backlog, so may I invite the Secretary of State to join me on a tour to see the remarkable work done by some of the remarkable people working at Stepping Hill, as well as the state of repair of buildings that in many cases are older than the NHS itself?
Yvette Cooper
The hon. Member talks about Stepping Hill hospital in Stockport, so I hope that she welcomes the fact that the hospital is one of 10 major schemes included in funding worth £200 million, which is part of the £1.5 billion investment that we are putting into improving our NHS estate. I gently remind her that some of the problems in the capital estate go back to austerity and what happened in the reduction in capital funding after 2010.
Rachael Maskell (York Central) (Lab/Co-op)
I welcome today’s statement and I welcome the Secretary of State to her place. York hospital was heralded as a cheap build, but we are paying a heavy price today. We know that heat in that hospital will have an impact on clinical outcomes as well as on staffing. Will she look at York’s desire to have a new hospital, co-located with the university, that is fit for modern healthcare? Will she recognise the work being done in York to prevent frail and elderly people from entering hospital through the incredible primary care work that is leading the way?
Yvette Cooper
My hon. Friend is exactly right about the importance of preventing people who do not need to go to hospital from having to go there. Frankly, it would be better for those people to be treated and supported either in their own homes or in care homes. The overall approach to improving our health through the service and care that is supported needs to include primary care, acute care and social care. The integrated care board needs to work with York hospital on the improvements to the facilities that are needed. I look forward to hearing more from her about what professionals working in the health system in York want to see, to ensure that they have the facilities they need.
Layla Moran (Oxford West and Abingdon) (LD)
May I welcome the Secretary of State to her place? I look forward to working with her as I have done with her predecessors. May I draw her attention to our Committee’s work on corridor care, and the correspondence between the Committee and the Minister for Secondary Care, who is in her place? I thought it was a constructive session. In our correspondence with the Department, we raised the issue of staff fatigue. Staff will understandably have questions, such as whether summer is the new winter, what now happens to the leave they were planning to take and the training they must attend, which they often cannot attend during the winter, so can she be clear with staff about that? In the letter responding to the Committee, the Department said that there are new NHS staff standards and new occupational health and wellbeing support, which is all fine, but it then says that there will be
“a continued focus on workforce sustainability through the upcoming NHS Workforce Plan.”
Where is that workforce plan?
Yvette Cooper
I thank the hon. Lady for her work and that of her Committee. The Committee, as a result of its extensive work, has highlighted many of the issues that the Government have needed to look at and have then responded to, so I welcome its work. I look forward to giving evidence to the Committee and responding to the inquiries it has under way. One of the issues that I have asked the taskforce looking at summer pressures to consider is staffing resilience. While there were all sorts of extremely good preparations in place for summer, meaning that many areas responded well, including in July, she is right to raise the issue of staff resilience and the impact of the pattern of staff holidays—all our holidays—on planning. I take that immensely seriously.
The hon. Lady is right to raise the workforce plan. We are continuing to work to complete the workforce plan, because it is needed. We are looking at how we ensure that we have a proper workforce plan around social care and what the links should be. One key area that we want to prioritise in response to Baroness Casey’s work is to develop a proper workforce strategy for social care, alongside the work being done for the NHS.
Lewis Atkinson (Sunderland Central) (Lab)
I welcome the Secretary of State to her place and look forward to engaging regularly with her and the ministerial team. International evidence makes the link between extreme heat and poorer mental health across the population increasingly clear. The Office for National Statistics estimates that one in every 32 suicides in recent years in the UK has been attributable to extreme heat. Will the Secretary of State give her assessment of the impact of extreme heat on mental health? As she goes about her role, will she ensure that she pays as much attention to NHS mental health waiting lists as she does to physical health waiting lists?
Yvette Cooper
I thank my hon. Friend not only for his question but for his considerable work in this field, both before he came to this place and through the issues he has been raising here. Our intention is to bring forward a new mental health strategy before Christmas, and I completely agree with him that we need to look at waiting times and where we can make early interventions around mental health. Earlier this summer, we announced new mental health A&E provision. As part of the work led by the chief medical officer, we have asked for work to be done looking at the impact of extreme heat, including on mental health and the most vulnerable populations. My hon. Friend is right to raise the health inequalities here.
Sir Ashley Fox (Bridgwater) (Con)
I welcome the Secretary of State to her place and thank her for her statement. The Government’s reorganisation of the NHS will see the abolition of Healthwatch England and all the other local watchdogs, including Healthwatch Somerset. At a time when NHS services in Somerset are in great need of improvement, how confident is the Secretary of State that she will be aware of patients’ views without Healthwatch Somerset?
Yvette Cooper
I take very seriously the importance of patient voice in local health services, and in ensuring that that local patient voice can be heard. That is why I have said that we will look further at the provisions around Healthwatch and what happens in local areas to ensure that there is proper accountability and strong patient voice. We will do that before those issues are discussed in the House of Lords, because I take them seriously. On the overall reforms, we know that the current system has not been working, that there has been too much duplication and that there is a legacy from the damaging 2012 reforms. What we want to see now is a much more streamlined and effective system that gets support to the frontline.
Chris Vince (Harlow) (Lab/Co-op)
I put on record my thanks to NHS and care staff across Harlow for their work during a very difficult summer, particularly those at the Princess Alexandra hospital. The Secretary of State will know from talking to my right hon. Friend the Member for Ilford North (Wes Streeting) how much I lobby on behalf of the Princess Alexandra. I am delighted that it is in wave 2 of the new hospital programme, but may I emphasise the hospital’s ageing estate and the need for emergency funding moving forward, before we complete the new hospital project?
Yvette Cooper
I welcome my hon. Friend’s determination and enthusiasm. While he managed to refer to the hospital twice, I think he only managed to refer to Harlow once, so he may be slipping. I am delighted that the hospital is included in wave 2 of the new hospital programme. Obviously, there is considerable work under way to ensure that the project stays on track and that the planning is in place. This is part of our commitment to upgrade, to increase the capital investment in our NHS and to ensure that there are facilities for the staff who work in the NHS and, most of all, for patients in Harlow. I thank, through him, the NHS staff who work in his constituency,
Andrew George (St Ives) (LD)
The Secretary of State mentioned the 10-year plan, and central to that plan is the shift from hospital to community. One of the things she will have no doubt noticed in the quarter of a century since she was last a Minister in the Department of Health and Social Care is the dramatic cut in acute hospital beds, and the resulting pressure that that is putting on frontline services. As summer pressures become winter pressures—in Cornwall, at least, the pressures are all year round, with 98% bed occupancy most of the time—the result is dysfunctionality and crisis on the frontline. Will she look again at this issue and ensure that hospitals are stabilised before that shift? Otherwise, further dysfunctionality and crisis will occur. I recommend that she comes to Cornwall and sees what it is like on the frontline in order to understand what I am talking about.
Yvette Cooper
I too take very seriously the pressures on acute hospitals across the country, including the pressures around beds and services. It is really important that we have the right kinds of facilities. I believe that the prevention work for people who do not need to be in hospital and who would be better cared for in the community has to start straight away, because that is the right thing to do.
We want to take further measures around neighbourhood health, and we are building plans right across the country that we want to see more of, but none of that is an alternative to having good acute care and strong hospitals that perform well; we all need those to be there whenever we need them. However, we are not serving patients and communities in the best possible way if we are not also doing more to prevent people needing to go into hospital—certainly for long stays—in the first place.
John Slinger (Rugby) (Lab)
I warmly welcome the Secretary of State to her place. She rightly said that the NHS is its staff, so I pay tribute to the NHS staff in my constituency. Obviously, there are the doctors and nurses, but there are some people who do not always get mentioned, such as the allied health professionals, the caterers, the cleaners, the administrators, the managers and, may I say, the porters, since I was one in my 20s. They all do a fantastic job, and we owe them a debt of gratitude. I use those services in my constituency, and they are improving thanks to the work of this Government since July 2024. However, there is obviously much further to go, particularly in urgent care services.
In my constituency of Rugby, like in many towns, there are urgent treatment centres that do a very good job, and I am very grateful to the Government for their investment in those. May I make a plea for some of the £450 million that the Secretary of State mentioned in her statement? Will she take a look at the urgent care centre in Rugby, where my constituents feel that more could be provided? I fully agree with them, so I hope that she can at least take a look at that.
Yvette Cooper
I join my hon. Friend in thanking the NHS and social care staff in Rugby. He is absolutely right to refer to the allied health professionals, support staff, catering staff and, crucially, the porters. He has raised that last point with me before; as some of the staff who spend the most time in direct contact with patients, they are hugely important. We must never underestimate the importance of every role in our health service, so I welcome his point. We have provided £450 million to transform urgent and emergency care, and we are already seeing improvements taking place, despite the very strong pressures on emergency care. I pay tribute to all those involved.
Adam Dance (Yeovil) (LD)
I have been contacted by families in Yeovil with disabled relatives who are unable to leave their flat and rely on carers. During the recent heatwaves, one family reported indoor temperatures of over 49°C, with no air con. Public transport and lots of other public spaces do not have air con either. What steps will the Secretary of State take to protect housebound individuals and their carers from the public health risk of heatwaves?
Yvette Cooper
That is exactly one of the issues I have asked the chief medical officer to look at. If we are going to face more extreme heat conditions, what is the impact on those who are the most vulnerable? That includes those who are housebound and those who are the most disabled. Those are issues for local authorities to look at in local areas, but I have asked the chief medical officer to look at them nationally.
Alison Hume (Scarborough and Whitby) (Lab)
I welcome the Secretary of State to her place, and I welcome her statement. Last year, a wildfire raged across the North Yorkshire moors near Whitby, releasing 25,000 tonnes of carbon into the atmosphere. Wildfire smoke is a health risk and exacerbates symptoms for those with pre-existing health conditions. With the frequency and severity of wildfires increasing, may I ask what assessment my right hon. Friend has made of the health risks posed by wildfire smoke? How is her Department preparing for these growing public health challenges?
Yvette Cooper
I thank my hon. Friend for the work that I know she is doing in her constituency and for recognising the impact that this issue has. The chief medical officer attended a meeting chaired by the Prime Minister to look at the wildfires over the summer. We are already looking at how we ensure rapid advice is given to people who suffer from asthma or other conditions that might be exacerbated by wildfire smoke so that public health messages can go out and reach them in those areas. We can do that prevention work, but that is part of ensuring that our NHS is resilient enough to respond to whatever healthcare issues are raised by different extreme events.
Adrian Ramsay (Waveney Valley) (Green)
During one of the summer heatwaves, a hospital serving my constituency—the Norfolk and Norwich university hospital—had to switch off its MRI scanners, resulting in hundreds of people losing their appointments. Does the Secretary of State agree that that shows the range of challenges facing the NHS? Will the Government’s investment plans look at how to keep equipment working and how to keep patients and NHS staff safe in extreme heat?
Yvette Cooper
The hon. Member makes an important point. There are two issues here. The first issue is that there is a legacy of a lack of capital investment in the resilience of our NHS estates, and that includes capital investment around equipment. That goes back over many years and was highlighted in the Darzi report. That is why we are turning that around with the safety fund, which can start to respond to and put money into looking at exactly these issues, including £32 million dedicated around heating issues as part of this wave of funding. The second issue is that, if we are honest with ourselves, many of our NHS buildings were not designed with climate change in mind or to anticipate weather that we do not expect to see in this country. That means that we all have to start rethinking ways of working to ensure that we respond to that challenge.
James Naish (Rushcliffe) (Lab)
I welcome the Government’s approach. The Secretary of State is right to highlight how the NHS has been starved of capital over many years, and that is nowhere more obvious in my constituency than at East Leake health centre—a poorly ventilated 1960s class building, which currently has holes in the roof of one of the treatment rooms. Will she commit today to ensuring that older, rural areas are prioritised and that her team look at East Leake health centre?
Yvette Cooper
I welcome my hon. Friend standing up for healthcare in his constituency. We are asking ICBs to look at the priority needs at different locations in each area, and it is vital that they look at pressures around rural areas and for every community in each area to ensure that all areas have the services they need.
Alison Bennett (Mid Sussex) (LD)
On social care, the Secretary of State pointed to the better care fund in her statement. I am glad that she recognises its importance, but why is she weakening provisions for pooled budgets, including the better care fund, in the Health Bill? Will she reconsider that?
Yvette Cooper
The better care fund is hugely important—I think it has £9 billion that is being jointly allocated. It is for the NHS and local authorities to work together on ensuring that we help to prevent people from entering hospital when they do not need to and that we have the proper services and co-ordination in place. We are also looking at the neighbourhood health programme, as that is another area in which we should look place by place at better co-ordination and ways of working. Those things are really important and will continue. As part of the response to Louise Casey’s review, we also want to look at how we can better bring together all these different approaches, because there is the same fundamental, core issue: whatever we have tried at different times, we are still not effectively co-ordinating health and social care, and we have to do that.
Rosie Wrighting (Kettering) (Lab)
I welcome the Secretary of State to her place. I also thank all staff across the NHS, particularly those at Kettering general hospital, who worked throughout the summer in very tough conditions. Under this Government, we have seen investment in Kettering general hospital, with new solar panels and construction starting on a new energy centre, but we still await construction on the main building, particularly the maternity ward. One local midwife told me:
“The building is deteriorating badly, we are worried about the safety of everyone who relies on this service. As midwives we come to work every day to provide safe, compassionate care but it is becoming difficult to do so in a building falling into disrepair.”
Will the Secretary of State meet me and my constituent to discuss the building’s urgent challenges?
Yvette Cooper
I am very happy to talk to my hon. Friend further about this issue, as I know other Health Ministers will be. She is rightly standing up for the patients—particularly new mums—and staff in her constituency who are affected by the facilities. It is hugely welcome that we managed to include Kettering hospital in wave 2 of the new hospital programme, given the new facilities it needs. Obviously, there is a lot of work to be done, and there will need to be discussions about prioritisation locally—about what can be done and when. I also welcome my hon. Friend prioritising maternity issues, which are an important personal priority for me; I think we have not taken them seriously enough, across the health service, for too long.
Mr Adnan Hussain (Blackburn) (Ind)
When I bumped into the Secretary of State yesterday, I made clear the urgent need for investment in the Royal Blackburn hospital. I have seen shocking and undignified scenes in the corridors throughout the year. Having spoken to the hospital’s executive team, it is abundantly clear that the hospital is serving a population far, far beyond the capacity for which it was originally built. I welcome the building of new homes across east Lancashire, but does the Secretary of State accept that, unless we extend the hospital’s estate and workforce, this crisis will get worse? Health inequalities across Blackburn are already among the worst in England—
Madam Deputy Speaker (Caroline Nokes)
Order. I am sure the Secretary of State has the gist of the hon. Gentleman’s question.
Yvette Cooper
I thank the hon. Member for raising this issue. We have invested an additional £29 billion in the national health service this year, and we have also recruited thousands more doctors, nurses, midwives and mental health workers. It is important that investment goes in. Alongside that, we also now have the major new hospitals programme. In addition, the £1.5 billion I announced today is part of a £6.75 billion fund to improve existing facilities where there are safety issues, in order to ensure that the NHS has the facilities it needs.
Dr Lauren Sullivan (Gravesham) (Lab)
I welcome the Secretary of State to her place. I know she will share my concern about the ongoing water supply issues at Darent Valley hospital. An internal heating system fault was identified on 28 April, leading to the contamination of the hot and cold water network, which resulted in bottled water being used on many wards in the hospital. Will she outline the capital funding support available to help modernise the hospital in North Kent and for the renewal of outdated buildings, such as the Gravesend hospital known as “M Block”, so that local patients and staff have a good, fit place to work?
Yvette Cooper
My hon. Friend is right to raise this issue. It is an example of the way in which the under-investment over more than a decade—since 2009—has had an impact on both safety and performance, because it has meant that facilities cannot be effectively used. That is why we have the estate safety fund in place, and why we encourage local areas to prioritise what further capital improvements and other improvements they can make. I look forward to discussing this further with my hon. Friend.
Max Wilkinson (Cheltenham) (LD)
The Secretary of State’s mention of prevention was welcome: that means keeping people cool in their own homes. For those who live in a conservation area or a listed building, however, that is extremely difficult. So many people in my Cheltenham constituency and many other places like it have experienced temperatures way in excess of 35°C on their upper floors this summer, which is a particular problem for older people and for parents with young babies. Is it not time for the Secretary of State to get involved with Historic England and the Ministry of Housing, Communities and Local Government, and to lead a big conversation about sensible reform of conservation and listing rules so that the planning system does not stop people cooling their own homes?
Yvette Cooper
I can assure the hon. Member that the chief medical officer looks very seriously at all the broader issues around prevention. We deal with health inequalities, and we know that issues around housing, buildings and communities have a big impact on our health. Some areas have traditionally provided community centres for cold weather, so that there is somewhere for people to go—somewhere they can stay warm and see other people in the community—when the weather gets cold, if they are worried about heating their homes. Some areas have now started to do the same thing to ensure that there are cooler places for people to go. That is an example of communities coming together to respond to challenges, so it is actually local communities that we need to empower.
Shockat Adam (Leicester South) (Ind)
Analysis from Ordnance Survey has highlighted that my great city of Leicester is now projected to show the biggest rise in Britain’s heat vulnerability ranking, climbing from 10th to fourth. This is deeply concerning, considering the record-setting heatwave we have just had. In the absence of a full and speedy green transition, what reassurance can the Secretary of State give my Leicester South constituents that their health facilities will be able to cope with the inevitable increase in heat?
Yvette Cooper
I draw the hon. Member’s attention to the work we have set out, including the new planning processes for summer pressures. As part of the heat taskforce’s work, we are setting out the framework for local areas to do their resilience planning. Local NHS managers need to ensure that their systems are resilient to extreme heat, just as they do for winter pressures. Our NHS needs to be resilient at all times of year, and it is important that also happens in Leicester.
Dr Danny Chambers (Winchester) (LD)
I welcome the Secretary of State to her place. I heard from many patients and staff that Winchester hospital was horrendously hot this summer, and I pay tribute to all the staff who are delivering care in those conditions. When we are looking at how we can address the repairs backlog and ensure that the entire NHS estate is fit for the hotter summers we are expecting, can we ensure that clinical staff and infection control experts are also consulted? For example, installing air conditioning is also a way of improving ventilation, air filtration and infection control, as well as reducing the antimicrobial resistance in hospital-acquired infections.
Yvette Cooper
I welcome the hon. Member’s point. The £1.5 billion that I announced today covers 950 projects across England, right across the NHS, to deal with some of the safety issues and to improve facilities. Each area needs to ensure that it has looked at issues around infection control and building repairs so that they are making best use of the funding they will get.
Richard Foord (Honiton and Sidmouth) (LD)
I welcome the announcement of £32 million for cooling and ventilation in hospitals. I received letters from seven children over the summer about the closure of Littletown primary school for two days in June, because it acted like a greenhouse and was deemed unsafe. Likewise, Ottery St Mary primary school is fundraising for air conditioning. Will the Secretary of State talk to her counterparts at the Department for Education about adapting the school estate to climate change, so that children do not end up with heatstroke?
Yvette Cooper
I know this is an issue that my right hon. Friend the Secretary of State for Education already takes very seriously. She recognises the importance of keeping children in school. Just as we are ensuring that the NHS is sufficiently resilient, public buildings across the country need to take seriously how we deal with the changing weather and climate that we face.
Steve Darling (Torbay) (LD)
The tower block at Torbay hospital was like an oven this summer; it is no longer fit for purpose, and it is even seen to be a fire risk for staff and patients alike. On 5 February, myself and my hon. Friends the Members for South Devon (Caroline Voaden) and for Newton Abbot (Martin Wrigley) wrote to the Government backing the foundation hospital’s bid for funding for a new ward tower block. Secretary of State, is the cheque in the post?
Yvette Cooper
As the hon. Member knows, we have different waves of work as part of the new hospital programme—which depends on prioritisation being done within ICBs and regions—and for the first time, this Government have set up a dedicated fund for safety improvements, the estates safety fund, which is worth £6.75 billion. The first wave of £1.5 billion in funding will deal with the 950 projects I have announced. We are turning around the substantial under-investment we inherited from the previous Government, but I would again gently point out to the hon. Member that Ara Darzi’s report identified that the big drop in capital investment in our national health service that has led to many of these problems started after 2009, as part of austerity under the coalition Government.
Ayoub Khan (Birmingham Perry Barr) (Ind)
I thank the Secretary of State for her statement and welcome the additional funding, which will help the infrastructure of our hospitals up and down the country. I also thank our NHS staff for their valiant efforts throughout challenging times. My question is about the numerous complaints I receive because the bodies of patients who were treated in hospital and unfortunately passed away there are not being released rapidly in order for burial to take place. Will the Secretary of State meet me, or get a relevant Minister to meet me, to see how we can improve the release of bodies from hospitals?
Yvette Cooper
I take the point that the hon. Member has made very seriously, and will ensure that one of the Health Ministers talks to him further about the details. It is immensely important that families who have lost a loved one have the respect and support they need to be able to bid farewell to their loved one, and it is also immensely important that we treat those who are deceased with the utmost respect. That has not always happened, which is why we are proposing the regulation of services in this area, but it is also why we need to make sure that existing facilities work properly.
Claire Young (Thornbury and Yate) (LD)
The Secretary of State mentioned social care. There have been a number of distressing reports in the media about care home deaths from heatstroke, and I have written to her about a case where a resident was left in direct sun for a period of time. Does the Secretary of State have plans to improve knowledge and understanding of heatstroke among the care home workforce, and how will the CQC assess whether they are taking appropriate steps?
Yvette Cooper
The hon. Member is absolutely right to raise this issue. It is one of the first issues I raised with the Department of Health and Social Care teams during some of the first meetings I had after being appointed; at the height of some of the heatwaves, we were looking at what could be done to ensure that the right advice and requirements were going out to social care across the country. Many care homes did a phenomenal job, sometimes in difficult circumstances because of old buildings, but the hon. Member is absolutely right to point out areas where things did not happen in the way they needed to. We are looking further at this issue as part of the heat taskforce.
Jim Shannon (Strangford) (DUP)
I thank the Secretary of State very much for her statement, and welcome the commitment she has made. Strangford’s ageing population rely heavily on robust community care and swift access to their GPs, so can the Secretary of State outline what specific discussions she is having with her counterparts in the devolved Administrations—particularly in Northern Ireland—to ensure a UK-wide co-ordinated approach to summer resilience? What targeted support has been made available for community pharmacy networks, which so often act as the frontline of defence when GPs’ surgeries are stretched to capacity, as we prepare for the cold and flu season?
Yvette Cooper
I can reassure the hon. Member that regular meetings and discussions take place, involving not just Ministers but chief medical officers across the devolved Administrations, to ensure there is co-ordination. There are areas where we can learn from each other, but there are also areas where we need proper co-ordination, particularly on some of the public health and information issues and—as the hon. Member rightly says—some of the issues that link into our economic supply chains, including community pharmacies.
Health Bill
Yvette Cooper ExcerptsTuesday 8th September 2026
(5 days, 6 hours ago)
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The Secretary of State for Health and Social Care (Yvette Cooper)
I beg to move, That the Bill be now read the Third time.
Let me thank all those who have been involved in bringing this Bill to this point, including all those involved in Committee. I thank the parliamentary staff, the departmental staff and the legal staff, and the Members on both sides of the House, who have debated so many different issues during the passage of the Bill. In particular, I pay huge thanks to the Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth), who has not only chaperoned this Bill through every stage from beginning to end—with some different Health Secretaries along the way—but has done today’s Report stage on her birthday; I wish her a hugely happy birthday.
I am grateful to everybody for their engagement, including those who, as well as debating the issues covered by the Bill, have taken the opportunity of these debates to raise so many issues that are so important to patient care right across the country, and to the improvements we need to make to patient and family care. I include in those thanks the parents of little Hugh Menai-Davis, who were in the House today.
Members in all parts of the House have been raising issues from special educational needs and disabilities to funeral regulation and health inequalities, and it is important that our NHS and health systems continue to improve.
Jim Dickson (Dartford) (Lab)
I thank the Secretary of State very much for giving way, because I know time is short. She is talking about the various issues that have come up while the Bill has been debated. One of them is the most common cause of death in the UK: dementia. An amendment that I tabled with the Alzheimer’s Society suggested that we bring the data on dementia, which is scattered right across the health system at the moment, into a single place to drive progress on early diagnosis and treatment. Does she agree that that is an important priority for the Government?
Yvette Cooper
My hon. Friend is exactly right to raise this vital issue. So many of us will have families and constituents who are affected by dementia. We are committed to introducing a dementia tsar as part of our response to Louise Casey’s commission, and we will be looking at data issues and evidence as part of that.
As this legislation completes its passage through this House, I thank my predecessor Health Secretaries for the work that they have done in bringing down waiting lists, improving treatment and getting more appointments than ever before. There are thousands more doctors, nurses, midwives and mental health workers in place than ever before, and we thank our national health service staff across the country. They also recognised that we inherited a system that was still badly held back by the failed 2012 Lansley reforms, including the huge administrative issue and unaccountable bureaucracy, with lots of duplication, poor communication and no proper accountability. This legislation is about strengthening democratic accountability and the focus on patient care. To be clear, I pay tribute to the work done by many people across NHS England—including in particular the recent work of the current chief executive, Jim Mackey, to substantially improve patient care and to reduce that duplication—but the systems and structures have been holding people back. That is why we have brought this reform forward, part of which will not just end the wasteful duplication, but ensure that our NHS system is better able to deliver.
I will update the House and the NHS shortly on the future operating arrangements. Let me say now that that means returning to some of the arrangements that applied before 2012, when we had strong national NHS leadership, but with much greater partnership and accountability and far less duplication than we have today. I have been frank with both the Department and NHS England that the focus needs to be on patients.
We are making some further reforms in response to the discussions in this House. I have made a commitment that we will bring forward amendments in the House of Lords to establish England’s first statutory maternity commissioner, implementing the Amos review’s recommendation, but also directly reflecting the work and determination of my hon. Friend the Member for Sherwood Forest (Michelle Welsh), the Government’s national maternity adviser. I thank her for the work that she has done. We have also amended the Bill to ensure that local government is represented on ICBs. That was raised by the Select Committee. I am also clear that we need to ensure that patients’ voices are properly embedded in decision making. Members have all debated the importance of the single patient record to improve care.
It is great to be back at this Dispatch Box as a Health Minister, 24 years since I last spoke at the Dispatch Box as a Health Minister. I am surprised by how little has changed in many ways, but one thing that has not changed, but which is so immensely important to all of us, is the dedication of NHS staff and the people who work right across the country to support patients and communities. This Bill is about helping them to ensure they can do their jobs in the most effective way. I commend this Bill to the House.
Funeral Industry Regulation
Yvette Cooper Excerpts(1 week, 5 days ago)
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The Secretary of State for Health and Social Care (Yvette Cooper)
I wish to update the House on the Government’s proposals for formal regulation of the funeral sector, announced this summer following the sentencing of criminal funeral director Robert Bush. These proposals will seek to crack down on rogue operators in the funeral sector and ensure better protection for bereaved families.
On 31 July, Bush, of Legacy Independent Funeral Directors in Hull, was sentenced to 20 years in prison for a total of 67 charges, including the prevention of a lawful and decent burial, fraud, fraudulent trading and theft.
His actions were utterly abhorrent, and my thoughts remain with all the bereaved families in Hull who were so badly let down. Every person in every situation deserves dignity in death, and every bereaved family deserves certainty that their loved ones are being treated with care and respect.
For those families, there can be few things more painful than knowing a loved one was not treated properly after they died. The deceased cannot speak for themselves, which is why clear safeguards, stronger oversight and consistent standards are needed to protect their dignity and give families the reassurance they deserve.
Sadly, this case was just the latest horrendous example in our country of the deceased not being treated with the care and respect they deserved.
Sir Jonathan Michael’s independent inquiry into the horrific crimes of David Fuller in the mortuary of Maidstone and Tunbridge Wells NHS Trust showed the need to ensure better standards across all settings that look after our loved ones after they die, including those where some level of regulation is already in place.
Building on the progress already made in responding to the Fuller inquiry—see HCWS26, 15 July 2026—and in the wake of the Robert Bush case, the Government will bring forward comprehensive proposals to ensure respect and dignity for the deceased in every setting, to drive rogue operators out of the funeral industry, and to protect other families from suffering this same heartache.
The Department of Health and Social Care is leading this work alongside the Ministry of Justice and other Government Departments, and will draw up detailed proposals to drive up standards, including proper regulation of the funeral sector. As part of this work, the Law Commission will also undertake a review of the criminal law in relation to the deceased, consider any gaps in existing legal protections and make recommendations on the creation of new offences, if they are needed.
The Government will work closely with bereaved families, funeral providers, faith groups, local authorities and other stakeholders to ensure that future policy in this area is proportionate, effective and informed by those with relevant experience. This will ensure families can have confidence that funeral providers are meeting clear, consistent standards, no matter where they live or which provider they choose.
These changes will also reinforce the profound responsibility placed on anyone entrusted with caring for someone after death. The majority of funeral providers live up to that responsibility, and offer compassionate and professional care every day. Nevertheless, stronger oversight, including proper regulation of the sector, will protect families from rogue operators, support good providers and restore confidence in a sector that people must be able to trust in moments of profound grief and loss.
We will keep the House updated as this work progresses, and set out our detailed plans and timetables for the implementation of these new proposals in due course.
[HCWS295]