Tees, Esk and Wear Valleys NHS Foundation Trust: Statutory Inquiry

Wes Streeting Excerpts

Thursday 11th December 2025 Written Statements

[The Secretary of State for Health and Social Care (Wes Streeting)]

On three occasions this year, I have met with some of the families who lost their loved ones under the care of Tees, Esk and Wear Valleys NHS Foundation Trust. I would like to place on record my deep and sincere condolences to all the families who have taken the time to speak to me. Each one of them has suffered an unimaginable loss, and their courageous and tireless campaigning—not only on behalf of their loved ones, but also on behalf of everyone in urgent need of mental health support—has been inspirational.

I am grateful for their time and for sharing their experiences. What happened to their loved ones is unacceptable. Patients should be safe in mental health services, and their families should be assured that they are safe. Too many people have experienced care that has been well below the high standard that we all deserve when we are at our most vulnerable. I would also like to thank the many local MPs who have campaigned on behalf of their constituents and brought these issues to my attention.

This Government take these concerns extremely seriously. After careful consideration, I have decided to establish a statutory inquiry, under the Inquiries Act 2005, into the deaths of mental health patients at Tees, Esk and Wear Valleys NHS Foundation Trust. I am concerned that services at the trust have not improved to the extent that they should have, and that there has been a lack of transparency around the circumstances of some of these tragic incidents. I believe a statutory inquiry is the only way to get to the bottom of the failings at the trust and to ensure we derive the learning required to prevent such poor outcomes in the future.

Information on the chair and terms of reference will be confirmed as soon as possible.

[HCWS1161]

Resident Doctors: Industrial Action

Wes Streeting Excerpts

Wednesday 10th December 2025 Commons Chamber

[The Secretary of State for Health and Social Care (Wes Streeting)]

With permission, Madam Speaker Deputy, I shall make a statement on industrial action by resident doctors. I thank you, Mr Speaker, business managers and the official Opposition for facilitating this evening’s statement.

As we head into winter, our hospitals are running hot and the pressures on the NHS are enormous. Flu season has come earlier, with a sharp rise in cases and the peak still to come, and this year’s strain is more likely to affect older people more severely. Already, the number of patients in hospital in England with flu is the highest on record at this point in the year. It is 50% higher than this time last year and 10 times higher than in 2023. Some 95% of hospital beds are occupied, growing numbers of staff are off sick and we are already seeing the pressure in our A&E departments. It is against that backdrop that the British Medical Association is threatening to douse the NHS in petrol, light a match and march its members out on strike. This represents a different magnitude of risk to previous industrial action.

The BMA resident doctors committee is in dispute on two issues: pay and jobs. On pay, resident doctors have already received a 28.9% pay rise—the highest in the public sector. For a first-year resident doctor, that is the equivalent of a £9,400 pay rise. I have been consistent, honest and up front with resident doctors that we cannot go further on pay this year. There is a gap between what the BMA is demanding and what the country can afford. Nor would further movement on pay be fair to other NHS staff, for whom I am also responsible and many of whom will never in their careers earn as much as the lowest-paid doctor. As I have made clear to the BMA and other trade unions, I am open to discussing multi-year pay deals with any trade union if we stand a chance of bridging the gap between affordability and expectations.

On jobs, I have much more sympathy with the BMA’s demands. I have heard the very real fears that resident doctors across the country have about their futures; it is a legitimate grievance that I agree with. My Conservative predecessors created training bottlenecks that threatened to leave huge numbers of resident doctors without a job. In 2019, there were around 12,000 applicants for 9,000 specialty training places. This year, that number has soared to nearly 40,000 applications for 10,000 places.

It used to be the case that UK graduates competed among themselves for specialty roles; now, they are competing against the world’s doctors. That is a direct result of the visa and immigration changes made by the previous Conservative Government post-Brexit, and it is compounded by the Conservatives’ decision to increase the number of medical students without also increasing the number of specialty training places.

Taxpayers spend £4 billion training medics every year—we then treat them poorly, and some leave to work abroad or in the private sector. It is time that we protect our investment and give bright, hard-working UK medical graduates a path to becoming the next generation of NHS doctors. Our 10-year plan for health set out our commitment to provide that path. It pledged to introduce 1,000 extra specialty training places and prioritisation of medical graduates from the UK and Ireland.

Today, in an offer to resident doctors, I can announce that I am able to go further. I want to thank Sir Jim Mackey, the chief executive of the NHS, and his team, who have been going trust by trust to see how many extra places can be funded and are needed. Thanks to their hard work, I am in a position today to be able to offer 4,000 specialty places for resident doctors, starting with an additional 1,000 for those applying this year.

In the Department of Health and Social Care, we have been working intensively on UK graduate prioritisation. The barriers have been legal ones, so I have been working intensively with my team to see how quickly we could introduce legislation. Thanks to their efforts, the co-operation of colleagues across Government, and my counterparts in Wales, Scotland and Northern Ireland, I can notify the House tonight that, subject to the agreement of resident doctors, we intend to introduce urgent primary legislation in the form of a Bill to be presented to Parliament in the new year.

The legislation will prioritise graduates from UK medical schools over applicants from overseas during the current application round and in all subsequent years. The reforms will also prioritise doctors who have worked in the NHS for a significant period for specialty training. This will not exclude international talent, who will still be able to apply to roles and continue to bring new and vital skills to our NHS, but it will return us to the fair terms on which home-grown medics competed before Brexit. The impact of these changes is that instead of four doctors competing for every training post, it will now be fewer than two doctors for every place. That is a good deal for doctors.

Following discussions with the BMA, we are also addressing the specific costs faced by resident doctors that do not apply to other NHS staff. Although I cannot go further on pay this year, I am able to offer today to put money back in resident doctors’ pockets by reimbursing royal college portfolio, membership and exam fees, with the latter backdated to April. The allowance for less-than-full-time resident doctors—many of whom are parents and carers—will be increased by 50% to £1,500, helping to close the gender pay gap.

In recent days, I formally made this offer to the BMA resident doctors committee. The BMA will now survey its members in the coming days on whether to accept this offer and end its dispute with the Government. The BMA told us that it will survey its members quickly and give us less than 48 hours’ notice of whether the strikes are going ahead. That presents serious operational challenges for NHS leaders, who need certainty now as to whether they are cancelling patient appointments and cancelling staff annual leave to cover strikes.

In my determination to prevent the havoc that strikes would cause this Christmas, I therefore made one more offer to the BMA, which I will now share with the House, the country and frontline doctors. So that the BMA could run a genuine ballot of its members and call off next week’s strikes while that ballot ran, I offered to extend its strike mandate. This would have allowed enough time for the BMA to reschedule next week’s strikes for the end of January, were the offer to resident doctors rejected in a ballot. It would have avoided the chaos that looming strike action threatens at the most dangerous time of year by removing the spectre of strikes next week. I knew that extending the BMA’s strike mandate would leave me open to attack from political opponents; that was a risk I was willing to take to stop the Christmas strikes going ahead. Madam Deputy Speaker, I must report to the House that the BMA’s leadership said no.

In the coming days, as the NHS prepares for strike action that may or may not happen, there are patients whose operations will be cancelled. There are NHS staff who will have to tell their families that they will not be home for Christmas because they have to cover for their resident doctor colleagues. This was entirely avoidable—no one should be in any doubt that the BMA has chosen to play politics with people’s lives this Christmas, and to continue holding the spectre of strikes over the NHS. I ask resident doctors to bear that in mind when they cast their votes.

The power to end these strikes now lies in the hands of doctors. Resident doctors face a choice: to continue the damaging industrial action in which everyone loses, or to choose more jobs, better career progression, more money in their pockets and an end to strikes. The deal that is on offer would mean emergency legislation to put our own home-grown talent first; to increase the number of extra specialty training places from 1,000 to 4,000, with a quarter of those places delivered now; to reduce the competition for training places from around four to one to less than two to one; to put more money in doctors’ pockets by funding royal college exam fees, portfolio fees and membership fees, with exam fees backdated to April; and to increase the less-than-full-time allowance by 50% to £1,500. It is a chance for a fresh start, to end this dispute and look ahead to the future with hope and optimism—a chance to rebuild resident doctors’ working conditions and rebuild our NHS. I urge every resident doctor to vote for this deal, and I commend this statement to the House.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Health Secretary.

[Stuart Andrew (Daventry) (Con)]

I thank the Secretary of State for advance sight of his statement, and sincerely thank him for making me aware last night of his intention to come to the House today and make a statement. Given that the next set of planned industrial action is due just a few days before Christmas, and at a worrying time when winter pressures are increasing early, with more flu patients needing hospital beds, we all want to see an end to these strikes. We on the Opposition Benches offer our thanks and gratitude to all those in the workforce who have worked so hard to try to minimise the impact of the strikes so far.

In his statement, the Secretary of State talks about the competition for places. This is not new information. He said himself that the figures have soared in the last two years. Why is it only now that he is addressing it, so close to a damaging strike? He could have dealt with this issue back in the previous talks with the unions, but he did not. I have said, though, that I want us to be constructive in opposition, so I welcome the work that he has done to offer more places to UK doctors. Depending on the detail of the legislation, we will help to secure that aim. I make this offer to work with him to ensure that we get there.

On the 4,000 places that the Secretary of State has announced, and the 1,000 specifically announced for this year, can he tell the House in which specialisms those places will be? Can he break it down into GPs, surgery, obstetrics, anaesthetics and so on? Is he confident that there are enough trainers and that there is enough capacity in the training settings he has chosen? GPs are trained in general practice and in hospitals, and there is community training for some specialists, such as paediatrics. When will these places be available for applications? Will he also look at replicating the Australian model of placing any international doctors in areas of the country with the greatest need? We know we need to address those issues.

All of this is dependent on the BMA accepting the offer, but what if it does not? After all, its track record speaks for itself. We warned that giving pay awards with no conditions would encourage the BMA to come back for more, and it has. If its members rejects this offer, what are his plans to manage and deal with the situation? As the Secretary of State has said himself, the NHS is under pressure from combined flu and RSV, so what is he doing to ensure that those who are eligible for the vaccines actually have them? What additional resources has he made available to manage the strikes if they happen, and for winter pressures if they do not?

Does the Secretary of State recognise that if the BMA membership reject this offer and carry on with the strikes, his Government’s own Employment Rights Bill will make things much worse next year? Will he think again about the reductions in the minimum thresholds for strikes and reintroduce the minimum service levels? Does he expect that this new legislation and the announcements he has made today will have any implications for the Equality Act 2010? If so, what are they, and how will he address them? Will he have to disapply the Act?

These strikes must end. The BMA is behaving appallingly, but if the Secretary of State does not deal with those issues around thresholds and minimum service levels, it will only get much worse, with unions like the BMA causing more issues. It is patients—our constituents—and their families and loved ones who will suffer.

[Wes Streeting]

First, I thank the shadow Health Secretary for the constructive terms on which he has agreed to work with the Government. That should give resident doctors across the country who receive their survey the confidence of knowing that, should they vote for this deal, emergency legislation will be introduced in the new year. We will be able to work at pace, because with the majority that the Labour party has in this House, and with cross-party support in the other place, we can make sure that we expedite the legislation and achieve our goal of making the changes for international medical graduates that we have always intended to make, and that we committed to well in advance of today. By expediting those changes, there will be a direct impact on people applying for speciality places now and those who, even in recent weeks, have experienced the disappointment of not receiving the training place they had hoped for. We can keep that hope alive. We can improve the number of specialty places available if resident doctors vote for this deal, so I urge them to do so.

The shadow Health Secretary asked why we had not dealt with this before. I am tempted once again to revert to my usual analogy of the arsonist heckling the fire brigade, but given the constructive terms on which he has offered to work with us on this, I will pull my punches a little. I will say, however, that putting together the 1,000 extra places now, and bringing together the legislation urgently, requires significant operational detail. He is right: we have to ensure that we have enough trainers. Jim Mackey and his team have literally been working trust by trust to ensure that we can give the shadow Health Secretary, the House and resident doctors an assurance that we can facilitate those extra places.

When it comes to the legislation, the shadow Health Secretary will know, and people will appreciate, that this is fiendishly complicated. I have had to secure agreement from business managers, as we have a packed legislative programme. We have had to make sure that the Bill would be legally watertight and consistent with both domestic law and our international treaty obligations, and I have needed support from my counterparts in Wales, Scotland and Northern Ireland. I must thank them sincerely for the spirit in which, regardless of party, they have worked with this Government; we can give resident doctors that assurance.

As for what will happen if the strike goes ahead, let me say first that the shadow Health Secretary was right to say that frontline staff and NHS leaders did a superb job of managing previous rounds of strike action. In fact, during the last round we did indeed maintain 95% of planned care, and I believe—we will see when the waiting list figures are published in January—that the impact on waiting list progress will therefore not have been as severe as it might have been. However, I must be upfront with the shadow Health Secretary and the House and point out that there is a very different degree of risk this time. While we are aiming to maintain 95% of elective activity, I cannot guarantee that. I cannot give that assurance in all good conscience, given the level of pressure that we are under.

I offered to extend the mandate, so that the BMA could reschedule the same amount of strike action for January, if its members reject this offer, and I do not understand why the BMA would not do that. I find it inexplicable. As a Labour MP, I have spent a lot of time in rooms with trade unions and negotiating, and I honestly cannot think of a single other trade union in this country that would behave in this way. I am shocked by it. I am shocked because of the risk that it poses to patients and the pressure that it places on other NHS staff, and shocked because it threatens the recovery of the NHS that we all care about.

I would say this to resident doctors who are following these exchanges: listen to what the Conservative party has said about trade union laws, and about their rejection of the deal that we struck within weeks of coming into office. There is not a more pro-NHS, pro-doctor Government waiting in the wings. There is a Labour Government who are committed to the NHS, and committed to the NHS workforce, who have gone further than any other Government before on pay, on terms and conditions, and on the pace at which we are improving them. These were never grounds for strike action before, and they are certainly not grounds for strike action now. I appeal to resident doctors, over the BMA, to do the right thing, to vote for this deal, and to work with a Government who want to work with them.

[Paulette Hamilton (Birmingham Erdington) (Lab)]

I have always been a massive advocate for all medical and nursing staff, and I absolutely understand what a difficult job our healthcare workers do, but given that flu is running rampant across the country and most NHS staff—including resident doctors, but also nurses and other staff—are suffering at this moment, will the Secretary of State join me in urging the leadership of the BMA and the doctors to see sense and put patients first at this difficult time?

[Wes Streeting]

I agree entirely with my hon. Friend. She brings considerable frontline experience to this House, having worked in the NHS and dedicated her life to it. I am pretty sure that as well as speaking for her constituents, she speaks for so many other NHS staff. I do not want to see nurse pitted against doctor, or NHS staff pitted against each other. I do not want to see people resenting each other at a time when we should be pulling together to get the NHS back on its feet, and to make sure that it is well down the road to recovery. That is why, even at this late stage, I urge the BMA to think again. There is nothing to stop me extending the strike mandate tomorrow and giving Jim Mackey and NHS leaders the opportunity to stand down planning for strikes next week, even at this late stage. It would be an extraordinary gesture of good will, and it would be a Christmas present for the country. It would benefit doctors, resident or otherwise, and all NHS staff. Most importantly of all, it would benefit patients. I hope that message is heard in good faith by the BMA, even now.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Dr Danny Chambers (Winchester) (LD)]

I thank the Secretary of State for his statement. People will be hugely alarmed at the threat of more industrial action right before Christmas, and we cannot forget how we got here. We know that the previous Government under-resourced the NHS. It was overburdened, people felt underappreciated, and the whole system was being held together by the good will of the staff.

Having said that, the timing is terrible, because we have the worst winter flu outbreak in decades, right before Christmas. We have to urge the BMA to work constructively to resolve this dispute in a way that is fair for both patients and taxpayers. Given that resident doctors received a 29% pay rise last year, I think most of the public feel that pushing for another 28.9% this year is unaffordable and unreasonable.

The Secretary of State touched on resident doctors’ legitimate concerns. The previous Government increased medical school places without increasing the facilities to deliver the necessary specialist training placements, so this was a predictable bottleneck that we are now up against. Waiting lists are long, we need more doctors, and we have doctors who have been trained largely at the taxpayer’s expense struggling to find work. We very much welcome the extra 4,000 placements that were announced today, which are hugely necessary. Can we ensure that they will address the acute shortages in general practice and psychiatry? To put those 4,000 places in context, 10,000 doctors applied for 500 psychiatric training places last year, and the Secretary of State said that about 40,000 doctors have applied for 10,000 places this year. Is there work to try to increase places as quickly as possible in the next few months and years?

At Winchester hospital, one in five beds is taken up by people who do not have any social care packages. That is not good for them, because they are stuck in the hospital, and we want to get them home for Christmas, but it will also affect the flow through the hospital right now, during a winter flu crisis.

We welcome this action and urge the BMA to call off the strikes, but can we address the legitimate grievances that the Secretary of State has mentioned?

[Wes Streeting]

I thank the Liberal Democrat spokesperson for his support, as well as for the constructive challenge. He is absolutely right to describe the challenge that we inherited, and we are seeking to deal with it. We have taken a number of steps along the way. For example, we promised to recruit an additional 1,000 GPs to the frontline in our first year. We expanded the additional roles reimbursement scheme in order to do that, and we were actually able to recruit an extra 2,500. The international medical graduate dimension of the deal means that the extra speciality training places go even further.

Although I would never pretend that the steps we have taken in our first 18 months in office have solved everything all at once—there is no shortage of things to solve—I say to those BMA members considering how to cast their vote that we have delivered a 28.9% pay rise, have taken action on international medical graduates through urgent legislation, and have expanded speciality training places. This is real progress. It is meaningful change in people’s pockets and to their lives, working conditions, career progression and prospects. 

The BMA should please not let the perfect be the enemy of the good. We have a lot of fires to put out on a lot of fronts as a Government, and that does take time. We are committed—and I am personally committed—to working constructively with the BMA on things like workforce planning to address those issues, if it is willing to work with us. That is all I ask. It is all I ask from any part of the NHS workforce. It should work with us constructively, understand our constraints, work through the challenges with us, and we will all get to a better place and create a rising tide in the NHS that lifts all ships.

[Alex McIntyre (Gloucester) (Lab)]

I thank the Secretary of State for his statement. My residents in Gloucester are rightly worried about strike action in the run-up to Christmas, and the impact that it will have on waiting lists in my patch in Gloucester. I am not surprised that there is no one here from the Reform party to hear about the challenges that our NHS is facing, and I am really shocked that there is nobody from the Green party, but there we go. Can the Secretary of State confirm that there will be resident doctors sitting at home in Gloucester tonight who will want to vote for this deal, who will not want to go on strike next week, and who want to get the NHS back on its feet? The BMA should do the right thing, and call off the strikes next week. It should listen to its members, and let us together get on with the work of repairing our NHS and the damage the Conservative party did.

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. I was about to say that it is always a disappointment when Reform and Green Members do not appear in the Chamber, but I would not want to be accused of misleading the House. I am sure they had a better offer, and there is a Christmas party up the road.

In all seriousness, my hon. Friend is absolutely right. The tragedy of the past couple of rounds of industrial action is that each round costs about a quarter of a billion pounds. Each round, despite the best efforts of NHS leaders and frontline staff, does cause disruption, and we all lose when that happens. One of the things that is really hard for staff is that they are also confronted in a very real way with the impact of the state of the NHS on their patients. They are not in it for themselves, but because they believe in public service and want to improve the health of our nation. We are so much better able to achieve our shared goals if we work together, and we can grasp that opportunity if doctors vote for this deal, we draw a line under this dispute, and we try to reset the relationship between me and this Government on one hand, and the BMA’s leadership on the other.

[Madam Deputy Speaker (Judith Cummins)]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

This is just not the time for a strike. As much as we have huge sympathy with many of the grievances of resident doctors, we understand that the next few weeks will be critical for how the next few months will be for the NHS, so I echo calls for the BMA to listen to reason. However, I spare a thought, and I hope the Secretary of State does, for the overseas doctors we rely on so heavily, because there is an acute workforce shortage. How, through this plan and this legislation, will the Secretary of State avoid creating a two-tier system that risks undervaluing the critical work that overseas doctors do to prop up our NHS?

[Wes Streeting]

I thank the Chair of the Select Committee for that contribution, which is really important on two fronts. First, she is absolutely right that this really is not the time for this kind of disruption, and I think the BMA knows that. I do not think that those I am dealing with are bad people. I think they are frustrated with me and this Government—they do not think we have gone far enough—and I am equally frustrated with them, and the fact that they do not recognise how far we have come, and how fast, but that is the nature of the dispute. With the extended mandate, there is an opportunity for us all to park this and, in the worst-case scenario, revisit it in January. I hope, even now, that the BMA will seize that opportunity. I think it would do it the world of good in the eyes of the public, and in the eyes of its members and the wider NHS family.

I am really glad that the Chair of the Select Committee raised the point about international medical graduates and the overseas workforce. The NHS has always been an international employer. We have been so fortunate as a country that, since 1948, people have come from around the world to help us build and sustain a national health service. Without them, it would collapse, and we never want to be a country that closes the door to international talent.

What is extraordinary is that many of those overseas doctors, when they see the competition ratios and compare our approach to that of their home country and other countries, think we have lost the plot. They cannot believe we do not already do this, so I think they will understand what we are doing and why. I hope they will be reassured that international recruits who have given service to the NHS will also be able to apply for specialty places, because we want to recruit and retain great talent, but they will also recognise how this is a game changer for the ratios for homegrown talent. I think they will understand that. I think they will respect that. Not least, I have been at pains as Health Secretary, given some of the ugly rhetoric that has come from one corner of this Chamber, to emphasise that, while some people in this House might tell those international recruits to go home, as far as we are concerned they are home.

[Jen Craft (Thurrock) (Lab)]

My mum, a former shop steward, always drummed it into me that there are no winners in a strike. Never is that as stark as in the situation we are facing now. There will be healthcare workers in my constituency, already under tremendous pressure, who will be looking at the situation coming up in the next few weeks with dread. That includes resident doctors who will be looking at that uncertainty and wanting some surety as to where they should go. The Secretary of State has been incredibly reasonable and has set out a plan that I plead the leadership of the BMA to get on board with. Call off these strikes to get us through winter and through this difficult period for the benefit of patients and for the whole NHS. Will the Secretary of State join me in echoing that plea?

[Wes Streeting]

I am grateful to my hon. Friend and I hope that point is not lost on the BMA. On the Labour Benches, we are the party of labour. We were created by the trade union movement to represent the interests of working people. That has been our calling for more than a century, since this party was founded. We have shown through our actions, not just our words, that this is a party in government who are committed to defending and extending the rights of working people, to improving pay and conditions, to clamping down on exploitation, and to making sure that this is a Government with and for the people.

The BMA has a willing partner with this Government. I sometimes feel like the Government have changed, the policies have changed and the approach has changed, but the BMA’s tactics towards us have stayed the same. I understand their cynicism about politics and their grievances with the situation they are working in, but I ask them also to recognise the progress we have made when we work together. There is an opportunity confronting them now to make further progress and I urge them to seize it.

[Gregory Stafford (Farnham and Bordon) (Con)]

These strikes will have a massive effect on my constituents in Farnham and Bordon. I am already getting emails from constituents who are concerned about the fact that their operations will be cancelled. The BMA is being entirely irrational and it holds the lion’s share of the blame for this situation, but the Secretary of State also has to take some responsibility for what is going on. If he gives the doctors a 29% pay rise with no strings attached, it is absolutely no surprise that they come back for more. I welcome the 4,000 extra places. I would like to press him on exactly where those 4,000 places will come. Would it not be better to have published that in the workforce plan, which is continually delayed by his Department? When will that workforce plan actually come about?

--- Later in debate ---

[Wes Streeting]

I thank the hon. Gentleman for the first bit. As for the rest of it, let me just say that the NHS workforce plan we inherited came in the 14th year of the Conservative Government. It was so absurd—it was so absurd—that on its trajectories for the increase in staffing numbers, within this century, 100% of the public would have to work for the NHS to sustain that level of workforce growth. And that is against the backdrop of AI, machine learning, genomics and the revolution in life sciences and medical technology that will change the NHS workforce and change the face of medicine.

We are working with the royal colleges, think-tanks and trade unions to make sure that in the new year our workforce plan is more credible. The hon. Gentleman is right to say that we are taking a bit longer with the workforce plan than I had originally intended. We are doing that because I was asked to do so by the partners that we will need, to ensure that the modelling and assumptions underpinning the workforce plan are good. I am always prepared to take a little bit more time to get it right, than to rush something out. That is the spirit in which I have engaged in workforce planning.

[Josh Fenton-Glynn (Calder Valley) (Lab)]

With a 28% pay rise and 4,000 extra specialty training places, it is starting to feel like the BMA resident doctors committee is deeply committed to not taking yes for an answer. It is not just about the services; it is about the parent who wants their kids to have their elective appointment before Christmas. It is real people in my constituency and across the country who are suffering, so I urge the BMA to come to the table and be reasonable. While we are looking at the training crisis, will the Health Secretary look at the specific areas where we have real training crises, such as mental health, GPs, sexual health and palliative care? There are a lot of areas in the NHS where this deal can be a win-win, as we can both open up the extra training places and solve some of the workforce crises that we know about right now.

[Wes Streeting]

My hon. Friend is absolutely right. I do wish the BMA would take yes for an answer sometimes; I would like it even more if the BMA gave yes as an answer to me once a while, but that has not happened in a little while. He is right to talk about the need for workforce planning. The workforce plan, which is in production, is all about making sure we have the right people in the right place at the right time. He mentioned mental health specifically. Our manifesto committed to 8,500 extra mental health workers over the course of this Parliament, and I am happy to report that we have already delivered well over 6,500. There is lots done, but more to do.

[Sir Julian Lewis (New Forest East) (Con)]

I find it rather shocking that when the Secretary of State for Health has offered the BMA leadership an opportunity to strike a few weeks later, they have turned it down, presumably because they prefer to strike at Christmas, when, frankly, lives will be lost as a result. Am I missing something here? Why is it, according to the Secretary of State, that the BMA leaders seem to be so determinedly militant? Does he think that in reality, they simply do not represent the views of their own membership?

[Wes Streeting]

I will say to the right hon. Gentleman that we are doing everything we can to mitigate against harm during the proposed strike dates, but I cannot in all honesty and integrity assure him that no patient will come to harm next week should the strikes go ahead, because the situation is so dire. I really urge the BMA to reflect on that overnight and into tomorrow and to ask themselves—perhaps their members will also ask this of their reps—whether it is really necessary to strike next week, given the offer of an extension to mandate.

To the right hon. Gentleman’s final point, when I was the president of the National Union of Students, I was once asked by a Labour member of a Select Committee that I was appearing before whether I was speaking for my members or for my activists. There is sometimes a difference between the two. I know that lots of people have campaigned hard for pay restoration and that many people are involved in the Doctors Vote campaign in pursuit of that aim. I think there are many doctors, however, who recognise that there has been real progress on pay and that what we are putting forward now is meaningful progress on jobs, too. I say to all members of the BMA: do not let the perfect be the enemy of good, especially when the stakes are so high.

[Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)]

I congratulate our own frontline team, because this is a great deal. I came to Parliament partly to speak up for our NHS, and I have spoken in many debates. I have also trained many surgeons over the years, and I know that my fellow surgeons will be up for this deal. College presidents will support it, and I urge all resident doctors to support it, too. I will just issue a word of caution from my son, a resident doctor, who is up there in the Gallery: if we increase the number of trainees, we will also need to increase the number of consultants and GPs. If we do not do that, we will simply push the bottleneck down the road.

[Wes Streeting]

My hon. Friend is absolutely right about the need to address bottlenecks and to do adequate workforce planning. He draws attention to his son, in the Gallery, who is a resident doctor and no doubt a voter—it is almost tempting to break the rules and start appealing to voters in the Gallery for a yes vote in the survey.

I would say one thing to any resident doctors who are watching, and not just the immediate members of my hon. Friend’s family. I do listen carefully to what resident doctors say and how they feel, so I know there will be some who are listening to my hon. Friend and thinking, “It’s all right for you and your generation—you’ve had it easy. We are fed up with these consultants and college presidents telling us what to think and feel.” I hope that they know the extent to which my hon. Friend has fought their corner and spoken up for their concerns—not just on the Floor of the House, but in meetings with Ministers. He keeps us anchored in the sentiment and experiences of all parts of the profession, especially resident doctors. I know that my hon. Friend feels a real commitment to ensuring that resident doctors have a bright future and a bright career. I hope they will heed his advice, just as I do.

[Mr Louie French (Old Bexley and Sidcup) (Con)]

Given the seriousness of the pending strikes, it is understandable that the Secretary has decided to focus his comments today on the BMA and this upcoming strike. I ask the Health Secretary this question constructively: what assessment has he made of the impact of the giveaways he has just announced on the likelihood of future strikes and on other NHS staff, particularly nurses, who are already feeling hard done by following last year’s pay rise?

[Wes Streeting]

That is a very thoughtful and appropriate question. Just to reassure the House, the Minister of State for Health and I have been working with Agenda for Change unions, particularly Unison, the Royal College of Nursing and GMB, to ensure that we are dealing with the structural reform of Agenda for Change that they are seeking. We have been exploring how we can deliver fairer pay for other parts of the NHS workforce and an improvement to the conditions and status of the nursing profession specifically, while maintaining fairness for all NHS workers. That is one of the considerations I have had to bear in mind when it comes to what we can offer the BMA and resident doctors. I have been very clear with the resident doctor reps about that privately, and I am happy to restate that publicly.

Doctors have not had a bad deal from this Government, frankly, and I have a responsibility to all parts of the NHS workforce, especially those who are lowest paid and who often lie awake at night worrying about their bills.

[Dr Simon Opher (Stroud) (Lab)]

On international medical graduates, I commend the Secretary of State. It is something we have discussed in the past, and bringing forward emergency legislation is absolutely crucial here, so I thank him for that. I also want to mention trainers in the NHS. I can reassure the Conservatives that we will make this happen. I have been a GP trainer for 25 years. We will work to make this happen; that is what we do in the NHS.

I have many resident doctor friends who do not like this action. Can we urge those doctors to talk to their fellows and try to call off this strike? It is not generally well supported among resident doctors, and it is something that we can change.

[Wes Streeting]

My hon. Friend makes a really good point. Sometimes during ballots people who are opposed to industrial action choose not to cast a ballot at all because they know that the turnout threshold is material. In the coming days, it is absolutely vital that every resident doctor makes their voice heard. This is their chance to tell me and their reps how they want to proceed on this deal. I respect the fact that the resident doctors committee has chosen today to present the deal in neutral terms to its members so that they can make a choice. I really do respect that. Now I urge resident doctors to make their views known and take the opportunity in front of them so that we can move forward together to make real changes to their lives.

[Several hon. Members rose—]

[Andrew George (St Ives) (LD)]

I welcome the Secretary of State’s statement and the manner in which he has been handling the issue. However, I want to ask him about the way he summarised the position at the end of his statement. He presented it as a choice between striking and having more jobs and the other parts of the offer. I seek clarity on the matter. Is he genuinely saying that he is going to withdraw that? Was that purely for oratorical effect, or is that his negotiating position?

[Wes Streeting]

I regret to say that if the BMA rejects this offer, we will not proceed with it at this time. I wish that we were not in this transactional lock. I wish we could just move forward together in a spirit of partnership, with a bit of give and take. That is not where we are, and I think I would be crucified by the public if I were to take a different approach. It would be the wrong thing to do and it would incentivise people to strike further, and I cannot tolerate that any longer.

[Justin Madders (Ellesmere Port and Bromborough) (Lab)]

Our constituents will consider it absurd that we spend billions of pounds every year on training doctors who will never work in the NHS. I am pleased that we are grappling with this issue, just like the Secretary of State is grappling with many others. He has shown that by working constructively through the issues, we can, hopefully, reduce industrial action. I contrast that with the comments from the shadow Secretary of State, who talked about bringing back the minimum service level laws. Will the Secretary of State remind the House that those laws were so unworkable that no public sector service ever actually used them? In fact, we had the highest levels of industrial action in 40 years under the previous Government.

[Wes Streeting]

My hon. Friend has so much expertise on health and on employment rights and trade union law, and he is right. That is why this Government have chosen a different approach. We want to work with all our trade unions, we want to work with the BMA, and we can still do so if we hit the reset button and each of us commits to building a more constructive relationship.

[Jim Shannon (Strangford) (DUP)]

I congratulate the Secretary of State and I fully support his stance on the resident doctors’ strike action. “Stand firm” is the message that I send to him, and I ask that God bless him and his team.

This will be the 14th strike since March 2023 and it is expected to cause major disruption. With the recent influx of flu, some wards have 70% occupancy. That could put the healthcare system under extreme pressure. Accident and emergency in the Ulster hospital, Belfast city hospital and the Royal Victoria hospital are under intense pressure. If they did not have the doctors from India and Africa, we would be under real pressure. What discussions has the Secretary of State had with the BMA about the impact this strike will have on emergency care and, ultimately, on getting patients back home before Christmas?

[Wes Streeting]

I am grateful to the hon. Gentleman for his support. He is right to raise concerns about the impact on urgent emergency care. We will do our best to keep the show on the road, but I cannot make guarantees in the way that I would want to about the quality or timeliness of care. I place on record my thanks to my counterpart in Northern Ireland, Mike Nesbitt, as well as to my counterparts in Wales and Scotland, for the constructive approach that they have taken in making this possible.

[Laurence Turner (Birmingham Northfield) (Lab)]

I draw attention to my membership of the GMB and my chairship of its parliamentary group. The BMA is currently in dispute with its workforce over an offer of 2% for this year, which is below the inflation rate on the retail prices index and the consumer prices index. Does my right hon. Friend agree that there is a striking inconsistency between the heads of claim that the BMA has advanced and its own record as an employer?

[Wes Streeting]

I should also declare that I am a member of the GMB and Unison. I say to my hon. Friend that there is a striking inconsistency between what the BMA is demanding for its members and what it proposes to pay its own staff. There is a word for that. In the spirit of trying to engage more constructively, I will not use it. However, I urge the BMA to engage constructively with us and with its own staff. It certainly will not want to see me on the picket lines outside BMA House.

[Kim Johnson (Liverpool Riverside) (Lab)]

I am a lifelong trade unionist and a proud member of Unite and Unison. I was proud to stand on the picket line with resident BMA doctors in my Liverpool Riverside constituency recently. They talked about the challenges around fees, and I am sure that they will welcome the fact that more money will be put in their pockets. There was some inconsistency, however. Will the Minister clarify that all resident doctors of all specialisms will be subject to the fee waivers?

[Wes Streeting]

I can give my hon. Friend the assurance that the royal college fees that I outlined in my statement will be covered by us. That will be a material saving in resident doctors’ pockets. Exam fees will also be backdated, recognising that many doctors will have already done those exams and paid the fees. I hope that that gives my hon. Friend and resident doctors in her constituency the confidence that this is a good deal and one that we can move forward on and campaign on together.

[Kevin McKenna (Sittingbourne and Sheppey) (Lab)]

I have worked so many Christmases and new years as a nurse in the NHS, and I know the weary dread with which so many colleagues are facing this threat of strike action, particularly against the background of a spike in respiratory illnesses. It will be devastating. In a good year without strikes, it would be bad enough.

I really commend the Secretary of State for the work he has done to address what have been long-running sores in the experience of resident doctors. Some of this is genuinely transformational, and what I know a lot of clinical colleagues have been after for so long. But healthcare is a collective activity. It is the multidisciplinary team that delivers healthcare, not individual doctors or individual nurses, so can I recommend that the Secretary of State keeps focusing on that collective improvement to the NHS, as I know he has been doing? I implore everyone in the BMA who is listening: let’s just put this to bed now. It is time for everyone to have a healthy Christmas.

--- Later in debate ---

[Wes Streeting]

Of course, my concern is always patients, first and foremost, but it has been playing on my mind and my conscience that, going into this December, a lot of consultants, nurses, allied health professionals and other NHS staff are more tired than they would otherwise have been because they are putting in those extra shifts and extra effort both to cover the previous round of strikes and then to help the NHS to recover in that long tail that follows in the days and weeks afterwards. I really feel for them at the moment because of the conditions they are working in. I think all of us would breathe a sigh of relief—and also, frankly, express a great deal of gratitude, myself included—if the BMA were to take up the offer of postponing strikes until January. It is not too late. I urge it to think about that overnight and to do the right thing.

[Shaun Davies (Telford) (Lab)]

I thank my right hon. Friend for his leadership, and also the NHS bosses up and down this country for theirs. They often do not get the praise that they deserve in this House. This situation is bad for patients and their families and also for NHS staff, but above all it is bad for trust and confidence in our NHS. We know that there are people in this House and across the country who want to attack the very principle of the NHS. Does my right hon. Friend agree that the BMA needs to take into consideration that this is about not just the deal on the table today but the very principle our NHS?

[Wes Streeting]

My hon. Friend is absolutely right. To be honest, the thing that causes me most anxiety is that, although I know that the NHS is on the road to recovery, we are surrounded by an enormous amount of jeopardy. We need, as much as we possibly can, to make sure that we are not inflicting avoidable damage or setbacks on our progress, and it feels like that is what this round of strike action represents. My hon. Friend is right to praise NHS leaders and managers. I know how emotionally invested they are in seeing their patients and their staff through this Christmas, and I urge resident doctors and the BMA to take up not only the deal but the opportunity to at least put off strike action to January.

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

I thank the Secretary of State for all his work on this matter so far, but I know that people in my constituency are going to be really worried about what might happen to them over the Christmas period. I thank all those hard-working NHS staff, be they nurses or doctors, who have continued to look after us and are facing a really difficult situation over this Christmas. Does my right hon. Friend agree that we need to urge the BMA to call off this strike and, in doing so, will he commit to continuing that dialogue with the profession so that it knows that he really understands the challenges it faces, the training opportunities it needs and the job opportunities it deserves?

[Wes Streeting]

I entirely agree with my hon. Friend. This is the point that I have impressed on the chair of the resident doctors committee. This deal is not the end of the conversation about jobs and career development in the NHS, because there are plenty of problems for us to solve. Although we cannot afford to go further on pay this year, what we have done so far—28.9%—is not the extent of what the Government can and are willing to do on pay. It just requires a bit of give and take, and I think we will make much more constructive and meaningful progress if we work together. I have my part to play in that, and from my point of view, we need to reset the relationship. It has hit the buffers somewhat in recent weeks. I am willing to do that. We have people we can work with on the resident doctors committee, but I think we are going to have to grasp the olive branch as it is presented today so that we can make more progress in the new year.

[Mike Reader (Northampton South) (Lab)]

People in Northampton are on a bit of a rollercoaster: they have seen the benefits of a Labour Government in the £16 million that has been secured for our new urgent care centre at Northampton general, but they will now rightly be worried reading the news. Will the Secretary of State send a message to my constituents to assure them that they will be kept safe should the BMA take this disastrous action?

[Wes Streeting]

I congratulate my hon. Friend on all his campaigning to secure investment in his constituency. One thing I can assure everyone in our country is that NHS leaders, frontline staff and I will do everything we can to mitigate harm during these strikes; I am afraid what I cannot do is guarantee that there will be no harm. That is the thing that keeps me awake at night at the moment, and that is the thing that the BMA should keep foremost in their minds when deciding whether or not, even at this late stage, to take up the offer to postpone strikes until January and take the mandate extension.

[Amanda Martin (Portsmouth North) (Lab)]

As a proud trade unionist, I know that trade unions are there to represent their members’ interests and views, yet by pushing ahead with this strike action, the BMA appears set to ignore its members. The offer on the table is real and comes from a Government who are listening and making positive change. Would the Secretary of State urge the BMA to take stock, think again about patients and its colleagues, and pause action while its members are consulted on the new terms? It has nothing to lose from pausing, yet the NHS and the population have so much to lose.

[Wes Streeting]

I completely agree with my hon. Friend. The BMA has put the offer to its members in neutral terms, but the fact is that it is now going to run a hasty survey over the next few days in order to give us what will still be less than 48 hours’ notice of whether or not these strikes will go ahead. If it took up the mandate extension, it could run a referendum properly and give its members more time to consider and discuss the offer in the workplace and with their families and reps. I do not see how more participation in the conversation and in the ballot could possibly be a bad thing.

As I have made clear to resident doctors, there are no downsides for the BMA in this. In fact, the only person who risks having a downside is me if, even after accepting the mandate extension, the deal is rejected and the doctors go out on strike again in January. This is not even a win-win scenario; this is a potential win-lose scenario, so I do not know why the BMA would not take it up.

This is a great offer for doctors. I know there will still be more to do, whether that is the implementation of the 10-point plan that Jim Mackey has come up with, my offer to work with the BMA trust by trust and employer by employer to see progress, or any of the other things we can do together. If we work together, we can get more done together. If we are working as partners rather than adversaries, we will all enjoy it a lot more and we will make more progress, and that is the opportunity that is available.

[Lizzi Collinge (Morecambe and Lunesdale) (Lab)]

I am very concerned that flu has hit hard and hit early this year. Hospital bed occupancy for flu is more than 50% higher than it was this time last year and resident doctors are central to tackling that. I have to admit to being very shocked that the BMA turned down an offer that would allow it to postpone next week’s strike. Does the Secretary of State share my worry that any strike action would make tackling this flu crisis much harder?

[Wes Streeting]

My hon. Friend is absolutely right. It also costs us roughly a quarter of a million pounds each time the BMA does this, and we cannot afford to keep paying that. It may say, “Well, then just do a deal with us and you will not have to fork out,” but then why would the rest of the NHS workforce, or the entire public sector or the entire economy, not go on strike? That is not constructive, and it is not going to get the NHS or Britain out of the enormous hole it was left in by the Conservatives. We are making real progress together, and I thank resident doctors for that. We will make more if we work together.

[Lewis Atkinson (Sunderland Central) (Lab)]

The coming weeks are always the most dangerous time of year for the NHS, and it is important to note that the patient safety risks arising from the strike will be present not just during the strike period but in the weeks following it. Some of my most daunting, and indeed scary, times in the NHS involved working alongside resident doctors, nurses and others in the early hours of the morning in January and late December to try to ensure that ambulances could still be offloaded under the most difficult circumstances. In that spirit of one team working for patient safety, I urge the resident doctors to accept the offer that the Secretary of State has set out. Will he confirm that NHS England and local NHS leaders will have his full support in taking the difficult decisions that they need to take to keep patient flow going and emergency care going during this period if strikes do take place?

[Wes Streeting]

I thank my hon. Friend for what he says and for the experience he brings to bear. I hope his urging is heeded by the BMA. I can give him that assurance. I think its operational leaders will face some fiendish choices in the coming days and weeks if strike action goes ahead. They will have my full backing. Myself, the Minister for Health and the Minister for Care are working closely with both the NHS and the social care sector, but this will be extremely challenging, and that is why I urge the BMA to adopt that “one team, one NHS” approach that he urges them to adopt.

[Josh Newbury (Cannock Chase) (Lab)]

I too thank the Secretary of State for the lengths he is going to for resident doctors. As somebody who worked in our NHS before coming to this place, I know what a pressured time winter is for staff and patients alike. With strikes at this time of year, NHS staff will this week be taking calls from harried managers and cancelling plans to be with their families at Christmas to cover shifts, and of course patients will have their operations cancelled. Does he share my concern about the human impact of this planned strike?

[Wes Streeting]

That is the only thing I have been thinking about in recent days, and it is why I have offered to extend a strike mandate for the first time, even though the BMA has asked me to do that on previous occasions in different contexts. I think it is a sensible compromise, and it avoids that dreaded phone call to the NHS staff member who has to cancel their holiday plans for Christmas and go back to work. Most importantly of all, it avoids that dreaded phone call to the patient who has been gearing themselves up for that test or scan that they are worried about, or that operation or procedure that they have waited far too long for. Indeed, it avoids the dreaded situation of someone having to call 999 in an emergency uncertain about whether the ambulance is going to arrive on time and anxious about whether they will be waiting in a car park, in a queue, in the back of an ambulance or, indeed, on a trolley in a corridor.

It gives me no pleasure at all to acknowledge that the bleak situations I have described are in play today in the NHS. Activity is already being stood down, but even if this strike action were not looming, the NHS is not in a state that I would want myself, the people I love, the people I represent or anyone in our country to be treated in, because of the enormous pressures that it is under.

With that in mind, and after listening to the contributions we have heard from across the House from Members on both sides who are not anti-doctor or even anti-BMA, I urge the BMA to do the right thing—not just to adopt this deal, but even at this late stage to adopt the offer of mandate extension in order to put off till January the spectre of strike action, and to give their members time to think, vote and make a decision on whether to accept a deal that would make a meaningful material difference to their job prospects, to their careers and to the future of our national health service. It is not too late to change course. It is not too late for the BMA to change its mind, and there is never any shame in doing so for those who think that is right.

I thank all hon. Members for their contributions, and you, Madam Deputy Speaker, for giving us so much time on such an important issue.

National Maternity and Neonatal Investigation: Progress Update

Wes Streeting Excerpts

Tuesday 9th December 2025 Written Statements

[The Secretary of State for Health and Social Care (Wes Streeting)]

This statement updates Members on the national maternity and neonatal investigation. In June 2025, I launched a rapid national investigation into NHS maternity and neonatal services. Baroness Amos was appointed to lead this investigation to examine the systemic causes of unacceptable care affecting women, babies, and families.

She and her team have made significant progress since then, having met with over 170 individual family members, including site visits where they have met further families and NHS staff to gather evidence and hear about their experiences of maternity and neonatal care. These local visits have included in Barking, Oxford, East Kent, Kings Lynn, Somerset and Bradford, and Gloucestershire.

Today is the first of three publications that are expected from the investigation. Baroness Amos’ update today sets out reflections and initial impressions since the investigation was launched of the work done and the picture that is starting to emerge. I want to recognise the extraordinary courage that bereaved and harmed families have shown in coming forward to share their experiences. What they have described is deeply distressing, and I cannot imagine how difficult it must be for them to relive these moments.

Baroness Amos highlights the significant challenges faced by women and families within maternity and neonatal care. She has also heard how fathers and non-birthing partners frequently feel unsupported, and how discrimination against women of colour, younger parents, and those with mental health challenges leads to poorer outcomes. Her reflections provide a valuable perspective of the issues and barriers that prevent the delivery of high-quality maternity and neonatal care.

We know that there is a diversity of views among families on the immediate action that needs to be taken. Families do not all agree, and we have a responsibility to listen to all of them. For example, some families want a full statutory public inquiry. Others are focused on systemic change that will prevent future harm. Some want individual case reviews and accountability. Others prioritise learning lessons quickly. I am absolutely committed to recognising this diversity of views and finding a way forward that delivers both accountability and urgent action.

As the investigation progresses, an eight-week call for evidence will begin in January 2026, and engagement will continue with national organisations and seldom-heard voices from communities facing health inequalities. This will be brought together by the investigation to build one set of national recommendations to improve the safety and experience of maternity and neonatal care.

Baroness Amos will deliver two further publications next year. The initial findings will come in February 2026, and a final report and recommendations are expected in spring 2026.

While there is still much to be done, today’s update is a key step forward in improving maternity and neonatal care, and families’ experiences. We are setting up the national maternity and neonatal taskforce early next year, which I will chair. It will develop and oversee the implementation of a new national action plan, based on the recommendations made in the national investigation’s final report. In the meantime, we are pressing on with important improvements to maternity safety, including a new early warning system to spot and tackle emerging safety concerns, and the roll-out of a programme to avoid brain injury in childbirth.

I would like to express my gratitude to Baroness Amos and her team for their dedication to the investigation and their work to date. The Government recognise the urgency of the concerns raised, and I would like to thank the bereaved and harmed families for their courage and bravery in sharing their experiences with the investigation.

[HCWS1148]

Mental Health Conditions, Autism and ADHD

Wes Streeting Excerpts

Thursday 4th December 2025 Written Statements

[The Secretary of State for Health and Social Care (Wes Streeting)]

I am announcing today the launch of an independent review into the prevalence of, and support for, mental health conditions, attention deficit hyperactivity disorder, and autism.

Over the past decade there has been progress in reducing stigma and an increase in public awareness of mental health conditions, ADHD and autism, and the importance of psychological wellbeing. Yet the prevalence of common mental health conditions for adults has increased to one in five, and many people who are autistic or have ADHD are struggling to access the right support. This Government have already taken significant steps to stabilise and improve NHS services, but there is much more to do.

I am deeply concerned that many adults, young people and children with mental health conditions, ADHD and autism have been let down by services and are not receiving tailored, personalised or timely support and treatment.

That is why I am announcing this independent review to understand the rises in prevalence and demand on services to ensure that people receive the right support, at the right time and in the right place.

The review will look to understand the similarities and differences between mental health conditions, ADHD and autism, regarding prevalence, prevention and treatment, the current challenges facing clinical services, and the extent to which diagnosis, medicalisation and treatment improves outcomes for individuals. This will include exploring the evidence around clinical practice and the risks and benefits of medicalisation. The review will also look at different models of support and pathways, within and beyond the NHS, that promote prevention and early intervention, supplementing clinical support.

I have asked Professor Peter Fonagy to chair this review with the support of two vice chairs, Professor Sir Simon Wessely and Professor Gillian Baird. They each have specific expertise on mental health and neurodevelopmental conditions and extensive clinical and academic experience.

The review will appoint an advisory working group, which involves a multidisciplinary group of leading academics, clinicians, epidemiological experts, charities and people with lived experience, to directly shape the recommendations and scrutinise the evidence.

I have asked the chairs to provide a short report within six months setting out conclusions and recommendations for responding to the rising need, both within Government and across the health system and wider public services.

The terms of reference will be published on gov.uk.

[HCWS1132]

Budget Resolutions

Wes Streeting Excerpts

Tuesday 2nd December 2025 Commons Chamber

[The Secretary of State for Health and Social Care (Wes Streeting)]

I begin by addressing the British Medical Association’s reckless call for resident doctors to strike in the run-up to Christmas. That is a cynical choice, coming as flu cases surge and we enter the most dangerous time of year for hospitals, and it is completely unjustified. After a 28.9% pay rise, the Government offered to create more jobs and put money back in resident doctors’ pockets. The BMA rejected that out of hand. My door has always been open, I have never walked away from the table and I stand ready to do a deal that puts patients first. We will prepare for this round of strike action.

I am extremely proud of the hard work and performance of NHS leaders and frontline staff who did so well to minimise costs and disruption during recent rounds of strike action. In fact, during the most recent round, we were able to maintain planned elective activity to cut waiting lists at 95%. Yet I must be honest with the House and with the country: if this strike goes ahead, this time will be different. Our hospitals are running hot and the pressures are enormous. That is why I urge the BMA not to go ahead. Not only does it put the progress we are making together in the NHS at risk; it threatens to do so in the worst way and at the worst time possible.

[Florence Eshalomi (Vauxhall and Camberwell Green) (Lab/Co-op)]

Does the Secretary of State agree that the hard-working staff at St Thomas’ hospital across the bridge, who deal with patients from right across the country, including many who have had surgeries and operations booked for many months, still kept the show going during the last rounds of strikes? Will he please do everything in his power to make sure that the strike does not go ahead?

[Wes Streeting]

I can certainly give my hon. Friend that assurance, and I absolutely endorse what she says about our local hospital, which I know very well. I genuinely thank frontline NHS staff, without whom the performance and improvements we are seeing simply would not be possible.

Let me turn to the substance of this debate. There was once a time, not long ago, when this place was bound in consensus on a number of issues addressed by this Budget. We used to be united on the need for a national health service as a publicly funded, public service, free at the point of use. The last Labour Government built a shared conviction that in 21st-century Britain, no child should grow up shackled by the scourge of poverty. We could go back as far as the Government of Benjamin Disraeli and find a Conservative Prime Minister committed to public health in a way that Labour and Conservative Prime Ministers have been in my lifetime. We did not always agree on how to get there, but there was at least agreement on the destination. However, as the opposition parties lurch to the right, consensus after consensus is breaking. [Interruption.] Admittedly, the Liberal Democrats have moved further to the left since their days in coalition; that is true. Maybe do not lead with your chins on that one, comrades.

Regardless of our friends on the centre left, old battles that were won must now be fought all over again, so it falls to Labour not just to cut waiting lists, improve the health of the nation and lift children out of poverty, but to win the argument, as well as hearts and minds. It falls to Labour to persuade people that we can and must help people lead healthier, longer lives, free from preventable disease; rebuild our national health service as a public service, free at the point of need; and give every child the best possible start in life, free from the scourge of poverty. Labour has won those fights before, and we will win them again.

[Calum Miller (Bicester and Woodstock) (LD)]

The Secretary of State knows, because his Department shares responsibility for special educational needs and disabilities education, that that is a major challenge facing the young people whose opportunity he so rightly champions. How will the announcement that the Government will take responsibility for that from 2028 alleviate the growing deficits facing many county councils across this country, which it is estimated will grow to nearly £17 billion by the time the national Government take over?

[Wes Streeting]

That is a good question, and I give the hon. Gentleman the assurance that my Department is working closely with the Secretary of State for Education and colleagues right across Government to make sure that we get that right. We have growing levels of need for provision for children with special educational needs and disabilities. We can all see in our casework, let alone through debates in the House, the unmet need, and its impact on children’s education, health and life chances. We are committed to modernising and reforming the system so that it meets needs and sets children up to not only survive but thrive. That is the ambition of this Government.

On Sunday, the Leader of the Opposition said that she would reinstate the two-child benefit limit. At the stroke of a pen, she would plunge half a million children back into destitution, shame and hunger. Gone are the days when David Cameron attempted to ape Gordon Brown on issues of inequality and poverty; in fact, the 2010 Conservative party manifesto included the word “poverty” 20 times and committed to an anti-poverty strategy. The 2024 Conservative manifesto mentioned the word once, in a chapter on foreign affairs. Was that because, after 14 years of Conservative rule, the stain of child poverty had been removed from our nation? No, of course it was not. The Conservatives plunged 900,000 children into poverty, more than a million children relied on food banks last year, and children are being admitted to hospital for malnutrition in 21st-century Britain—but now, this Conservative party does not even pretend to care.

On public health, remember it was George Osborne who introduced the sugar tax, and Boris Johnson who introduced legislation to ban certain “buy one, get one free” deals and free refills of fizzy drinks, yet today their successors dismiss these policies as nanny state. Their party is more apologetic about their record on public health than it is about Liz Truss’s catastrophic mini-Budget.

We are seeing the NHS’s founding principles contested for the first time in generations. The Leader of the Opposition says,

“we need to have a serious, cross-party national conversation”

about charging for healthcare. Well, if she wants one, she’s got it, and it will be a short conversation. The answer from this side is “No, over our dead body.” We will always defend the NHS as a publicly funded public service, free at the point of use, owned by us, and there for all of us. Of course, it is not just the Leader of the Opposition saying these things; the leader of Reform wants to replace the NHS with an insurance-style system. [Hon. Members: “Where are they?”] They are obviously not here to advocate for their policies. They find it increasingly hard to defend them. They want a system that checks your pockets before your pulse, and asks for your credit card before providing your care.

Where is the hon. Member for Clacton (Nigel Farage)? He is not normally the shy, retiring type—unless, of course, he is being asked challenging questions, like whether paracetamol is safe, whether he believes in science or whether he racially abused schoolchildren. In fact, it is reported that he told a Jewish contemporary at school that “Hitler was right”. Admittedly, he was at school a lot longer ago than me, but had I grown up in the aftermath of the second world war, I think I would remember if I had supported the losing side. His politics are a disgrace. He cannot stand by his record, and that is why he is not here to defend it, and why he is regularly referred to in his constituency as “Never-here Nigel”. But as we are in a debate on these issues, let me take on the Opposition parties’ arguments, whether they are here or not.

The Conservatives say that the route out of poverty is work, not welfare. I do not disagree that those who can work should work, but six in 10 households impacted by the two-child limit have at least one parent in work, and they are still in poverty because of low wages and a high cost of living. The Conservatives say that it is the responsibility of families, not the state, to ensure that children are well fed. I agree that parents have a responsibility to look after their own children, but life is a bit more complicated than that. It is far too easy for others who have never walked in the shoes of parents like mine to pass judgment on people whose lives they will never understand.

The Conservatives sneer about “Benefits Street”. They have never been there. They have not got the first clue what life is like for people living on welfare. They say that lifting the two-child limit helps only the feckless and irresponsible, so let me tell them about the mum who came to see me at my advice surgery one Friday afternoon with her three children in tow. She had fled domestic violence and had been rehoused on the other side of London in a bed and breakfast. That remarkable woman was hand-washing her girls’ uniforms, doing a three-hour round trip every day to get her kids to school and holding down three separate jobs. Please do not tell me that women like her are feckless or irresponsible, or on the take. She is facing down hardships and challenges that would break many of us. I will tell Conservative Members who is feckless and irresponsible. It is the people who exploited the covid pandemic, ripped off Britain and lined the pockets of the Conservative party.

Conservative Members say that abolishing the two-child limit is not affordable, but the policy is fully funded. It is paid for by cracking down on tax avoidance and evasion, and a tax on online gambling. What they really mean is that they would make different choices. They would put the interests of gambling firms over the wellbeing of children. By labelling it as unaffordable, they betray their view that the prosperity of our country has nothing to do with the talent of its people, but we know that by investing in our people, we are investing in a more prosperous future. Growing up in poverty is not an inconvenience; it is a trap. On average, the poorest children start school already behind, get worse exam results, are less likely to make it to university, earn less, are more likely to develop long-term illness, end up paying less tax, and are more likely to need welfare support and the NHS.

Investing in our children is a moral mission; morally, we do not believe it is right to punish children for the circumstances of their birth, or the choices of their parents. This is also a down payment on a better future. It is far better and more cost-effective to invest in children now than pay the price for social failure later. I stand here today as the product of the wise investment of the British taxpayer. It was taxpayers’ contributions that clothed me, housed me, fed me and educated me when I was growing up. As a result, I am now in a position to pay back that debt to society—and to pay it forward to the next generation, too.

We should all be proud that this Budget funds the biggest reduction of child poverty of any Budget this century. My right hon. Friend the Chancellor takes that prize from Gordon Brown, who took it from Denis Healey, because lifting children out of poverty is what Labour Governments do. And why is it that every time Labour enters office, there is the moral emergency of child poverty? It is because, since records began, every single Tory Government left child poverty higher than they found it. That is why they must never be allowed back in power.

[Paul Holmes (Hamble Valley) (Con)]

Will the Secretary of State give way?

[Wes Streeting]

Gladly. Please do defend keeping children in poverty.

[Paul Holmes]

I am grateful to the Secretary of State for intervening, but this is my intervention, not his. Why was he part of a Cabinet that stood by and punished his colleagues for voting against the two-child benefit cap? Why do we now see this sudden conversion and revisionism? Why does he think that most people in this country who were polled are against the removal of the child benefit cap?

[Wes Streeting]

Let me say two things in response. I am almost certain that my hon. Friends will be delighted that he has intervened in defence of their plight at the hands of the Labour Whips, but he knows as well as I do that the Whip was removed from some of my hon. Friends not because of the substance of the issue they were raising but because we never, ever accept people voting against a King’s or Queen’s Speech. [Interruption.] That was the issue. He asked me a fair question, and he has got an honest answer. He should take it on the chin.

The hon. Member also asked why many people in our country believe that the two-child cap was right. It is because our Conservative predecessors peddled the myth and the lie that people in receipt of welfare are on the take, and are just looking for handouts, rather than help. We Labour Members take a different view; we recognise, as I have set out, that so many people affected by the two-child cap are in work and in poverty. That is one of the many scandals of the damage that more than a decade of Conservative rule did. The Conservatives broke the link between a hard day’s work and a fair day’s pay. In addition to the measures that we are taking on child poverty to remove the two-child limit, we are also increasing the national minimum wage. We are increasing it even higher for young people. We are doing this because this is the party of work, the party that wants to make work pay, and the party that is genuinely committed to waging war on poverty.

Just as we must win the argument for lifting children out of poverty, we must win the argument for the founding principles of our NHS. Having left the NHS in the worst crisis in its history, the right now argues that it is unaffordable and should be abandoned. The NHS was broken, but it is not beaten, and Labour is already breathing new life into our health service. Waiting lists are falling for the first time in 15 years. Ambulances are arriving 10 minutes faster in stroke, sepsis and heart attack cases.

Patient satisfaction with GPs is up from 60% to 74%, and nearly 200,000 more patients were given a cancer diagnosis or the all-clear on time.

With Labour, the NHS is on the road to recovery. That is in no small part because the Chancellor is reversing 14 years of austerity and investing in our NHS. We promised an extra 2 million appointments; we have delivered 5 million. We promised to recruit an extra 1,000 GPs; we have recruited 2,500. We promised to end the 8 am scramble; we have widened the window that patients have to request appointments and have made booking available online. A lot done and a lot more to do.

At this Budget, we announced the next steps on the road to recovery: 250 new neighbourhood health centres with the first ones in Birmingham, Barrow, Truro and Southall, and £300 million more to invest in technology to modernise healthcare. Next year, we will receive recommendations from Baroness Casey on laying the foundations to build a national care service.

The NHS does not just face an existential political challenge from the Conservatives and Reform UK; it faces a sustainability challenge.

[James Naish (Rushcliffe) (Lab)]

I appreciate the announcement about the 250 new neighbourhood health centres, but I am concerned for my constituency—a more affluent constituency that has health centres that were built in the ’60s. They are genuinely falling apart and need significant investment to ensure that GPs can continue to deliver outstanding service to my constituents. Could the Secretary of State provide some reassurance, or agree to meet me to discuss how we can ensure that deprivation is not the only aspect considered in that excellent initiative?

[Wes Streeting]

My hon. Friend is absolutely right. Of course, we want to ensure that investment is deprivation linked. We want to reverse the damage the Conservatives did when they pursued what I would characterise as the Royal Tunbridge Wells strategy, when our former Prime Minister, the right hon. Member for Richmond and Northallerton (Rishi Sunak), declared with pride to Conservative party activists that he had taken funding from the poorest communities in the country and funnelled it to the richest. There could be no shorter or clearer exposition of Conservative party values and politics in action than that claim.

To my hon. Friend’s point, he is absolutely right that within many affluent communities there are also pockets of deprivation, and we have to ensure that the NHS is there for everyone in every part of the country. We are dealing with enormous undercapitalisation in the NHS, totalling some £37 billion as identified by the noble Lord Darzi. It will take time to address that challenge, but I think my hon. Friend’s constituents know from his assiduous hard work and visible campaigning as a constituency MP that he will ensure that their needs and interests are not forgotten or overlooked by this Government.

Of course, as we improve the health of our health service, we also need to address the health of our nation. Children in England face some of the poorest health outcomes in Europe. Obesity in four and five-year-olds is reaching record levels—a health time bomb that leaves them at greater risk from cancer and heart disease later in life. What kind of start in life are we giving our children, and if we allow it to continue, what kind of future are we leaving to them? Our children will lead shorter, less healthy lives; our NHS will buckle under a tidal wave of chronic conditions; and our economy will suffer because businesses will be denied the potential of the next generation.

This Labour Government are tackling the sickness in our society. Whether it is the extension of the soft drinks industry levy, free school meals, a warm home discount that reaches millions more, the generational ban on smoking, Awaab’s law, cutting pollution and cleaning up the air that our children breathe, we are combating the drivers of ill health in children’s lives: poor diets, damp homes, dirty air and a lack of opportunity. In short, we are tackling poverty, because every child deserves a healthy start in life, and prevention is better than cure.

The leader of Reform, the hon. Member for Clacton, says we should instead be educating people to make healthier choices—I assume that he will not be leading from the front on that campaign. But we know that Reform and the Conservatives oppose our agenda to improve public health. They oppose our investment in the NHS. They should just be honest and admit that they now oppose the NHS itself. [Interruption.] Conservative Members do not like it, but I challenge them to dispute a single claim I just read. Let me repeat the charge sheet for their benefit: they oppose our investment in the NHS. Have they not opposed every budget spending review since Labour came to office? [Interruption.] Honestly, from a sedentary position, the hon. Member for Kingswinford and South Staffordshire (Mike Wood), who does not want to intervene because I think he knows he is leading with his chin on this, wants to suggest that somehow the Conservative party left a legacy that they could be proud of. They inherited the shortest waiting times and the highest patient satisfaction in history. They left us the longest waiting lists and lowest patient satisfaction on record. No wonder so few of them have turned up to defend that shoddy record.

The Conservatives oppose our public health agenda, do they not? I thought this was an area where we had built consensus, but not under their present leadership. I have already quoted what their leader, the right hon. Member for North West Essex (Mrs Badenoch), has said. Maybe they were not listening—the country certainly is not. I would have thought, though, that their own side would at least listen to what she said. She says she wants a debate about charging for healthcare. I do not know whether they have heard that or whether they stand by it. Maybe we could just see a simple show of hands—how many of her own side want to see charging for healthcare in the NHS? Not a single hand has gone up. That does not bode well for the future of the Leader of the Opposition, but let’s leave the Conservative party to revel in its irrelevance.

In fact, I was probably one of the few people who paid any attention to what the shadow Health Secretary, the right hon. Member for Daventry (Stuart Andrew), said at the Conservative party conference. I noticed that he did not mention a single policy. I say to the Conservatives: if we are doing such a bad job, why would they not do anything differently? Would they cut the £26 billion this Labour Government are investing in the NHS, and if not, if they oppose this Budget, how would they pay for it? The Conservatives seem to think that the British people are so stupid that they will forget which party wrecked the NHS and led it to the worst crisis in its history.

To conclude, this is a Government who are cutting waiting lists, giving children a healthier start in life and lifting 500,000 children out of poverty. In doing so, we are restating the case for universal healthcare that is publicly owned, publicly funded and free at the point of use. We are showing that progress is possible after 14 years of decline, that things can get better. Abolishing the two-child limit is not a handout, it is a hand up. Our country cannot prosper while 6 million people languish on waiting lists, 4.5 million children grow up in poverty and 1 million young people are not in education, employment or training. But if we protect people’s health, give them the opportunities to put their talents to use and give them a strong foundation, they will build a good life for themselves and a better Britain for all, and we can fulfil the lost promise that tomorrow will be better than today.

[Madam Deputy Speaker (Judith Cummins)]

I remind all Members that the courtesies of this House require Members to inform other Members if they intend to name them in the Chamber.

I call the shadow Secretary of State.

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[Stuart Andrew]

Well, we did not spend tens of billions of pounds in pay rises just for the same old problem to come back. There should have been proper reform, and conditions for those pay rises, but the Government did not make that happen, and here we are again.

The NHS Confederation has also warned that local services cannot continue to absorb the costs of ongoing strikes by the BMA without consequences for patient care. I pay tribute to frontline staff, who have been trying to keep everything going. I remind the Secretary of State that we have the answer: ban doctors from striking, like the Army and the police, and introduce minimum service levels, using the legislation that our Government passed. That would protect patients and taxpayers, so why won’t he do it? Labour’s Employment Rights Bill will make things much worse, because it reduces the vote threshold for calling a strike, and there will be no minimal service levels.

In addition, the Government have shown that they cannot stand up to the unions. By pushing up inflation, the Budget will make it harder to reach pay settlements across the rest of the NHS workforce. Even an additional rise in NHS pay of just 1% of what the Secretary of State included in his pay review body evidence would create another £1.5 billion hole in his budget. Is he confident that he can head off wider industrial action with a 2.5% offer, especially given that benefits are rising much faster under this Government?

The OBR has also raised the unknown risk of increasing drug prices. My understanding is that the spending review assumed that spending on branded medicines would rise by 25%—or £3.3 billion—between 2025-26 and 2028-29. In winding up, will the Minister clarify what happens when the negotiated price costs more than what was assumed in the spending review? The rest of the money is surely intended to be used to deliver more care and to cut waiting lists, so are frontline services at risk?

[Wes Streeting]

I am grateful to the shadow Health Secretary for giving way. We should be clear that the deal struck with the United States is the first and only deal with the United States that secures 0% tariffs and mitigations against most-favoured-nation pricing. It will ensure that patients get access to good drugs. For the avoidance of doubt, although some costs are unpredictable because of the complexity of medicine pricing, of course we will not cut NHS budgets to fund the pharma deal.

[Stuart Andrew]

We will see what happens. It would be interesting to know exactly where the money will come from. [Interruption.] The Secretary of State just said that if the prices go up, there will be no cuts to the NHS budget, but where will the money come from? Which other part of the national health service and social care will the money come from? We will have to wait and see.

The Budget last week made no mention of social care. After all, Labour’s only plan is to delay coming up with a plan for a few more years, despite the urgency and the scale of the challenge. Many of us entered the cross-party talks in really good faith, and they were encouraging, but we have only met once. Surely we should be getting on with it. The message was loud and clear that we want to work together, but we want to get on with it. Please can we have another meeting, so that we can get on with tackling this really important issue?

It is not quite true to say that social care is unaffected by what was announced. The increase in the national living wage will be welcomed by those on the lowest incomes, but the Nuffield Trust estimates that it will cost the social care sector £1.2 billion. The sector is already struggling with last year’s national insurance contributions hike, so who will pay for this? Will there be funding cuts to other parts of the health budget? Will self-funders have to fork out yet more again, or will it be passed on to local authorities, inevitably leading to council tax rises? What impact will this national living wage increase have on wider pay in the sector?

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Bill read the First time; to be read a Second time tomorrow, and to be printed (Bill 342) with explanatory notes (Bill 342-EN).

[Wes Streeting]

On a point of order, Madam Deputy Speaker. I have to confess a sin. Earlier today, in the debate on the Budget, I referenced the hon. Member for Clacton (Nigel Farage) and did not notify him in advance. This was particularly egregious because I was not very nice about him. With that in mind, and out of respect for the customs and conventions of this House, I would like to apologise to the hon. Member and put this note on the record. I have, of course, written to him in similar terms.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I am grateful to the right hon. Member for giving me advance notice of his putting this point on the record. I am not sure that it is a sin, or whether he will be absolved of it, but it has been noted.

Oral Answers to Questions

Wes Streeting Excerpts

Tuesday 25th November 2025 Commons Chamber

[Laura Kyrke-Smith (Aylesbury) (Lab)]

4. What steps his Department is taking to improve patient access to GPs.

[The Secretary of State for Health and Social Care (Wes Streeting)]

I am pleased to report that both access to general practice and patient satisfaction with general practice have improved since Labour came to office. Over 75% of patients find it easy to contact their practice —an improvement of 14 percentage points since the general election. Not only have we recruited an extra 2,500 GPs; crucially, more patients are receiving continuity of care, backed by an additional £1.1 billion. Lots done, lots to do, and certainly a long way to go, but general practice is on the road to recovery.

[Alex Baker]

I am proud to see this Government’s improvements to GP services making a real difference locally, with over 2,000 more GPs hired and new investment already reaching practices like Jenner House surgery in Farnborough. However, many of my older and more vulnerable constituents tell me they are still struggling to get through on GP phone lines, especially as more practices move online. What steps is the Secretary of State taking to ensure that phone lines remain accessible for those who rely on them, so that everyone benefits from our NHS health plan? [Interruption.]

[Wes Streeting]

Well, Mr Speaker, you couldn’t script this! We have a doctor in the House—my hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley)—whose phone was alive as this very issue was raised by my hon. Friend, such is the commitment of doctors in our NHS to be available to patients wherever and whenever they are needed.

This Labour Government were elected on a pledge to end the 8 am scramble, and that is exactly what we are doing. We know that not everyone wants to contact their practice online. That is why practices must offer patients the option to telephone or visit in person in addition to online access. I thank GPs up and down the country for the work they are doing and the progress we are making in improving online access, access generally and patient satisfaction—lots done, lots to do.

[Laura Kyrke-Smith]

The number of qualified GPs in Buckinghamshire has risen by 8% in the last year thanks to this Government’s determination to recruit and retain more GPs. It is a great start, but I still hear from too many people in Aylesbury who cannot get through to their GP surgery or cannot get a quick enough appointment when they do. My constituent Jane, whose husband had suffered a stroke, was advised that he needed a GP appointment the next day, but it took a month to get one. I know my right hon. Friend is determined to keep improving access to primary care for people in Aylesbury and across the country, so can he set out his next steps?

[Wes Streeting]

I certainly can, and I am sorry that my hon. Friend’s constituent was let down. Everyone who needs a same-day appointment should be able to book one, and that is what we are working towards. As she says, we are recruiting more GPs. We are also investing £102 million to create additional space for appointments, including in 21 GP practices in my hon. Friend’s local integrated care board system. Nowhere is the state of the NHS, and the crumbling legacy we inherited, more evident than in the NHS estate, and that is why I am proud that in her Budget, the Chancellor will be setting out plans to roll out a new generation of neighbourhood health centres to deal with the crumbling NHS we inherited and to build an NHS that is fit for the future.

[Mr Speaker]

Can’t be possible—we have not had the Budget yet!

[Dr Kieran Mullan (Bexhill and Battle) (Con)]

There are a number of exciting opportunities for extended GP premises in my constituency—in places like Martins Oak in Battle, Little Common and Old Town, and Oldwood in Robertsbridge. One major challenge is the rates that the NHS district valuer is willing to offer for construction sites; they have just not kept up with the inflation we have seen across all sectors of construction. I did have a meeting with the Minister for Care and it was helpful to start those discussions, but we have not made the progress that we need to. Can we have a further meeting, and will the Secretary of State outline what he will do to ensure that district valuers are offering rates that can allow construction to go ahead?

[Wes Streeting]

I thank the hon. Gentleman for raising some of the practical challenges that stand in our way to improving and expanding the primary care estate. We are looking into the issues that he raises. We want to ensure that we can modernise the estate as effectively and quickly as possible. When there is progress to report, I have no doubt that the Minister for Care will be in touch.

[Lisa Smart (Hazel Grove) (LD)]

Over the summer, my team and I conducted a health survey across my constituency, and 40% of those living in the most deprived and most urban parts of my patch—Heaviley, Little Moor and Great Moor—were struggling to access GPs. What more can the Secretary of State do to ensure that urban and deprived communities get their fair share of GP access?

[Wes Streeting]

I am sure that the hon. Member’s constituents will have noticed what an assiduous and active Member of Parliament she has been in actively soliciting their views. I hope that they and she will find it reassuring to know that we are taking action to deal with the very inequalities that she mentions. The Royal College of General Practitioners found that in the poorest parts of the country, there are an extra 300 patients per GP. It cannot be right that the poorest parts of the country receive the poorest service too. That is why we are reforming the Carr-Hill formula so that deprivation is the driver of funding and prioritisation. That will help us to improve services for everyone and to tackle the gross health inequalities that blight our society.

[Liz Twist (Blaydon and Consett) (Lab)]

2. What steps he is taking to ensure parity of esteem between mental and physical health services.

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[Elaine Stewart (Ayr, Carrick and Cumnock) (Lab)]

5. What steps his Department is taking to reduce the number of people waiting for NHS treatment.

[The Secretary of State for Health and Social Care (Wes Streeting)]

In England, for the first time in 15 years, waiting lists are falling. Through record investment and modernisation, we have cut backlogs by more than 230,000, and we smashed our target for additional appointments in our first year, delivering more than 5 million. There is a long way to go, but the NHS in England is on the road to recovery. Unfortunately, in Scotland the SNP cannot seem to get the car started.

[Elaine Stewart]

While the NHS is on the road to recovery in England thanks to the investment of this Labour Government, there are 61,000 patients in NHS Ayrshire and Arran on a waiting list for treatment, almost 11,000 of them for over one year. Does the Minister agree that after record levels of funding for Scotland in the last Budget, people in my constituency should be asking the First Minister and his Government, “Where’s the money gone, John?”

[Wes Streeting]

My hon. Friend is absolutely right. More patients are waiting a year for treatment in Ayrshire and Arran than in the entire south-west of England—that is shocking. Thanks to the investment the Chancellor has made, Scotland is receiving an extra £1.5 billion this year and £3.4 billion next year—the biggest funding increase since devolution. Labour is cutting waiting lists in England. Labour is cutting waiting lists in Wales. Why is the SNP failing where Labour is succeeding?

[Joe Robertson (Isle of Wight East) (Con)]

The Secretary of State has failed to end industrial action like he said he would. How is that helping to reduce waiting lists?

[Wes Streeting]

Industrial action sets back our progress on waiting lists, but frankly, the Conservatives presided over an absolute mess—not just over the course of 14 years, when waiting lists rose every single year during the Conservatives’ time in power, but in their catastrophic mishandling of industrial relations. We came in, and we settled with the British Medical Association—[Interruption.]

[Mr Speaker]

Order. Mr Fox, you were the last voice I heard. I want to hear what the Secretary of State has to say. If you do not want to, you can go and get a cup of tea.

[Wes Streeting]

We came in, and we settled with the resident doctors with a 28.9% pay rise. It should be clear to them from the questions that Opposition Members have asked and the extent to which they have opposed a pay rise for not just resident doctors but NHS staff more generally that there is not a more pro-NHS, pro-doctor Health Secretary or Government waiting in the wings. It is either the Conservative party, which lumbered the NHS in this crisis in the first place, or the Reform party, which does not believe in the NHS at all.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I would first like to say I am sorry that the Minister for Public Health and Prevention is unwell and convey to her the best wishes of the Opposition.

I would like the Secretary of State to consider a patient who has waited a year for a procedure and then, after three waiting list validation calls, finally sees the consultant to check that the procedure is still necessary. If the consultant agrees that it is, do the Government figures show that patient as waiting for a year or a much shorter period?

[Wes Streeting]

A clock stop would be in place from the moment the patient saw the consultant. The reason we have had to do waiting list validation is that, in addition to driving waiting lists up, the Conservative party presided over a total shambles where patients were often waiting in duplicate slots on the waiting list, removed from waiting lists unnecessarily or waiting far too long. That is the mess we inherited from the Conservative party.

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

What’s the answer?

[Wes Streeting]

It is no use shadow Ministers heckling from the sidelines. When they had the chance, they drove waiting lists up, and they drove the NHS into the abyss.

[Dr Johnson]

The Secretary of State does not seem entirely sure, so perhaps he can write to us with an answer—

[Wes Streeting]

I said that there is a clock stop.

[Dr Johnson]

As someone who is on the waiting list myself, I do hope that the Secretary of State is correct. Waiting lists for procedures and operations requiring day care or overnight admission are both rising and higher than they were a year ago. Orthopaedic surgery waiting lists are up, yet this Government scrapped our major conditions strategy and say that they have no plans for a musculoskeletal conditions framework. Gynaecology surgery waiting lists are up, yet the Government scrapped and are now reviewing the women’s health strategy. Waits for procedures and operations in ophthalmology, general surgery, neurology and gastroenterology are going up too. When is the Secretary of State going to get a grip of the surgical waiting lists?

[Wes Streeting]

I honestly cannot believe the brass neck of Conservative Members; their time in government led to the longest waiting times and lowest patient satisfaction in the history of the national health service. The best news I can offer the shadow Minister, and others like her who are on a waiting list, is that we have a Labour Government who are reducing waiting lists for the first time in more than 15 years.

[Sally Jameson (Doncaster Central) (Lab/Co-op)]

6. What steps he is taking to help reduce the repair backlog at Doncaster Royal infirmary.

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[Josh Newbury (Cannock Chase) (Lab)]

8. What assessment he has made of the adequacy of the provision of health services for men.

[The Secretary of State for Health and Social Care (Wes Streeting)]

May I first commend my hon. Friend not just on leading the recent International Men’s Day debate, but on his courage in speaking so openly about his own experience of sexual assault and the need to tackle the stigma surrounding it? [Hon. Members: “Hear, hear.”] For too long, men’s health has been overlooked, with a reluctance to accept that men suffer specific inequalities and hardships as men and boys. We know that men are less likely to come forward for healthcare. From partnering with the Premier League to rolling out health support in the workplace, we are meeting men and boys where they are and supporting them to live longer, healthier lives.

[Josh Newbury]

The publication of the first ever men’s health strategy for England was a historic step forward, including the drive to improve care for men with prostate cancer, the most common form of cancer in men under 50. I place on record my admiration for the right hon. Lord Cameron for speaking publicly about his diagnosis and successful treatment. The commitment to expanding home-based testing and remote monitoring is welcome, but can the Secretary of State tell the House what the Department will do to increase awareness and access to testing among the men most at risk, including those under 50?

[Wes Streeting]

I join my hon. Friend in commending Lord Cameron on his openness. Raising awareness, as we know, encourages men to come forward and leads to more diagnosis. He has done a great public service in talking about his own experience. We are improving care for men diagnosed with prostate cancer and undergoing active monitoring or treatment. We will be introducing support for individuals who are on prostate cancer active monitoring pathways to enable them to order and complete prostate-specific antigen blood tests at home from 2027. As for screening and the case being made for targeted screening, I await the recommendations of the National Screening Committee. We will study those carefully. We know that this is contested within the sector, so it is important that we have an evidence-based discussion, thrash out the arguments and reach the right way forward.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I welcome the Secretary of State’s indication that he is awaiting the outcome of that report on screening for prostate cancer. If that report recommends what many of us hope it will recommend, will he act quickly to develop the report’s recommendations, whatever they are?

[Wes Streeting]

We are expecting the draft recommendations, and then a three-month consultation period will follow, but I want to act quickly on the evidence and what the recommendations contain, not least because we know that as well as it being a prevalent form of cancer, some groups—particularly black men, men with a family history of prostate cancer and men with BRCA gene mutations—are at higher risk. Black men are twice as likely to die with prostate cancer than white men. There is therefore an imperative to act. Whatever the recommendation, we need to do much better on diagnosis and treatment of this terrible condition.

[Ben Goldsborough (South Norfolk) (Lab)]

9. What steps his Department is taking to improve access to NHS dental services in Norfolk.

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[The Secretary of State for Health and Social Care (Wes Streeting)]

Women’s health is a priority for me, for my Department and for the Government. Since I last answered questions in the House we have extended the NHS health check to include the menopause for the first time, following the brilliant campaigning of Menopause Mandate and others. We have also made the morning-after pill free in pharmacies. The Prime Minister is co-ordinating work across Government to tackle violence against women and girls, and in the health and care services we will play our part in protecting and supporting victims. I have also asked the Government’s women’s health ambassador to renew the women’s health strategy that was introduced by the last Government, so we can ensure that it is driving the right progress in the future.

[Josh Dean]

When my constituent Rachel attended numerous A&E departments with severe abdominal pain, swelling, fever and nausea, her fears of a ruptured ovarian cyst were repeatedly dismissed. In her day-to-day life Rachel is a professional advising on antimicrobial resistance around the world, but as a patient she felt that her concerns were being ignored and that she was being pushed aside. She is determined to use her experience to challenge the unacceptable medical misogyny that she and other women across the UK still face too often. What action are the Government taking to ensure that women are not left to endure painful reproductive health conditions, and will the Secretary of State agree to meet Rachel to hear her story at first hand?

[Wes Streeting]

I thank my hon. Friend for describing Rachel’s experience. We have introduced Jess’s rule and we are rolling out Martha’s rule, so that, whether in primary or acute care, patients’ voices will be heard and they will be given the power to ensure that health professionals are listening and responding appropriately. However, my hon. Friend is right to acknowledge that much of this arises from medical misogyny. It is not just a case of changing rules and regulations; it is a case of changing culture and practice, so that women are not just seen but heard and listened to. That is a fundamental problem that we determined to address—and of course I should be delighted to meet Rachel to hear about her experience at first hand.

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

Diethylstilbestrol, or DES, was prescribed to women until the 1980s to treat miscarriage. Those who took it were themselves at greater risk of breast cancer, and their daughters have a higher risk of rare cervical cancers. It is estimated that a whopping 300,000 women have been affected. Two weeks ago the Secretary of State made an apology to victims, but they rightly want more than “sorry”, and they have pointed out that the current screening regime is insufficient. Will the Secretary of State meet me, and campaigners and victims, in order to understand how this was allowed to happen, who will be held accountable, and how those women can go about securing compensation for this egregious scandal?

[Wes Streeting]

I thank the Chair of the Select Committee for raising that extremely serious issue. I am glad that she has drawn it to the House’s attention. I have apologised, on behalf of the state, for the failure that occurred and for the harm that has arisen as a result. My hon. Friend the Member for Bournemouth West (Jessica Toale) has been campaigning diligently, and the DES Justice UK campaigners have done a magnificent job in raising public awareness. I am always delighted to meet the Chair of the Select Committee because I know which side my bread is buttered on, but I should be particularly delighted to meet her to discuss this specific issue.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

The impact of health inequalities on women’s health are starkest when it comes to maternity care, with many NHS trusts requiring improvement. Black and Asian women, and those from the most deprived communities, are far more likely to suffer the worst outcomes or even lose their babies. The Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives have vocally opposed the removal of the ringfence from the service delivery fund, saying that funding provided to drive change following the Ockenden review has disappeared at the stroke of a pen. Will the Secretary of State commit himself to reinstating that ringfence, and to ensuring that all the immediate and essential actions arising from that review of the failings at Shrewsbury and Telford hospital NHS trust are taken as soon as possible?

[Wes Streeting]

I thank the Liberal Democrat spokesperson for her question. She is right to raise the inequalities at the heart of poor maternity care, as well as failures in services overall. We are taking a number of actions, but on the issue of funding specifically—I think this will become a recurrent theme across a range of issues during this Parliament—the approach that we are taking as a Government is to try to devolve more power, responsibility and resources to the frontline. As we do so, we are removing national ringfences.

I appreciate what the hon. Lady says about the risk. It is important that we, and no doubt Parliament, scrutinise the situation to make sure that outcomes across the board improve and that the focus that this House wants to bring to issues like maternity safety is delivered in practice, but I think we are right to drive at the issue of devolution. Decisions are better taken within communities, close to communities and at a local-system level, but she is right to be vigilant about this issue, and we on this side of the House are absolutely open to challenge. If systems are not acting in the way that we want and it is having an adverse impact, we will reconsider.

[Cat Smith (Lancaster and Wyre) (Lab)]

11. If he will set out a timeline for responding to the Hughes report, published on 7 February 2024.

--- Later in debate ---

[Alison Griffiths (Bognor Regis and Littlehampton) (Con)]

12. What steps he is taking to help prevent industrial action in the NHS.

[The Secretary of State for Health and Social Care (Wes Streeting)]

Trade unions, representing the majority of NHS staff, are engaged in constructive dialogue with the Government, particularly around reform of Agenda for Change. All NHS staff have received above-inflation pay rises. No other staff in the public sector have received a pay rise as high as that of resident doctors. We offered extra jobs, prioritisation for UK graduates and help with out-of-pocket expenses. Against that backdrop, it is simply appalling that British Medical Association leaders led their members out on strike, even though a majority of resident doctors supported the Government’s offer.

I am pleased to report to the House that, thanks to NHS leaders and frontline staff, including the resident doctors who turned up, the NHS met its ambitious goal and 95% of planned elective activity went ahead, meaning that 850,000 patients got the procedures and operations they needed, despite the BMA’s reckless action. None the less, the time and money that this has cost us is detrimental, and I hope the BMA will come back to the table constructively.

[Alison Griffiths]

After warnings from the NHS Confederation and NHS Providers, my constituents are still rightly concerned that services may yet be cut, appointments lost and operations delayed as a direct result of the BMA’s industrial action. These strikes did not need to happen. What will the Secretary of State do to reassure patients in Bognor Regis and Littlehampton that their safety and wellbeing is a priority for this Government, who have no timetable and no plan, and who have made no progress towards ending these damaging rolling strikes?

[Wes Streeting]

I must say that a bout of collective amnesia has swept the Opposition Benches, because the Conservatives seem to have forgotten the absolute calamity of bad industrial relations over which they presided. The difference between Members on this side of the House and the Conservatives is that we have never closed the door to talks; we have always been willing to engage with resident doctors in good faith. Unlike under that party, resident doctors have received a 28.9% pay rise from this Labour Government. It is a reminder to resident doctors across the land that the grass is not greener on the other side, and that they should work with a Labour Government who want to work with them.

[Gregory Stafford (Farnham and Bordon) (Con)]

13. If he will publish a national strategy for palliative care.

--- Later in debate ---

[Sarah Olney (Richmond Park) (LD)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Wes Streeting)]

Obesity robs children of the best possible start in life, hits the poorest hardest, sets them up for a lifetime of health problems and costs the NHS billions, so I can announce to the House that we are expanding the soft drinks industry levy to include bottles and cartons of milkshakes, flavoured milk and milk substitute drinks. [Interruption.] We are also reducing the threshold to 4.5 grams of sugar per 100 ml. This Government will not look away as children get unhealthier and our political opponents urge us to leave them behind.

[Mr Speaker]

The only thing I will say is that at least we are hearing it first in this House and not on Sky.

[Sarah Olney]

I congratulate the Secretary of State and the Department of Health and Social Care on the launch last week of the men’s health strategy. My constituent Philip Pirie, who sadly lost his son to suicide, has been calling on the Government to launch a public health campaign to reduce the stigma of suicide. Nearly 75% of those who lose their lives to suicide have not been in contact with mental health services, and that is why we need to reach out. Will the Secretary of State meet me and my constituent to discuss such a campaign?

[Wes Streeting]

I am sure that my hon. Friend the Minister for Care would be delighted to meet. The men’s health strategy sets out precisely the challenge in those terms. Through the partnerships that we have already announced, such as with the Premier League, as well as the people who have been knocking on our doors to get involved in such a campaign, I am absolutely confident that together, collectively across the House and across the country, we can tackle this terrible stigma.

--- Later in debate ---

[Stuart Andrew (Daventry) (Con)]

Thank you, Mr Speaker. Can I ask the Secretary of State why he has not sorted out the strikes and disputes?

[Wes Streeting]

I wish the shadow Health Secretary a very happy birthday—21 again! It is good to see him here.

We continue to hold the door open to the British Medical Association. If it wants to engage constructively, we are ready and willing. What we will not do is be held to ransom. What we cannot afford to do is pay more than we already have. What we are able and willing to do is go further to improve their career progression and job prospects, and to work with them to rebuild the NHS, which the Conservative party broke.

[Mr Speaker]

Order. I have a lot of topical questions to get through.

[Stuart Andrew]

But, Mr Speaker:

“The power to stop these strikes is in the Government’s hands.”—[Official Report, 6 February 2023; Vol. 727, c. 660.]

“They need to sit down and negotiate to end the strikes, but Ministers are too busy briefing against each other.” Those are not my words, but the Secretary of State’s words when he was standing here on the Opposition side. He said it was so simple. The Secretary of State is embroiled in a leadership battle that is taking over the need to focus on averting walkouts, and the Employment Rights Bill reduces voting thresholds on strikes and scrapping minimum service levels. Does the Secretary of State accept that things are only going to get worse as a result of the Bill? And in his words, does he agree that patients have suffered enough?

[Wes Streeting]

I was very clear in opposition about the Government’s responsibility to sit down and negotiate, and that is exactly what I have been doing. It takes two to tango. As for the other trivial nonsense the right hon. Gentleman mentions, I have been very clear that I am a faithful. Of course, if he were a gameshow, he would be “Pointless”.

[Katrina Murray (Cumbernauld and Kirkintilloch) (Lab)]

T4.   There is a higher prevalence of multiple sclerosis in Scotland than in any other part of the UK. What steps is the Department taking to ensure that people living with MS can access both a timely diagnosis and equitable specialist care, regardless of where they live in the UK?

--- Later in debate ---

[Helen Morgan (North Shropshire) (LD)]

Every MP will be aware of the huge value that unpaid carers add to the NHS, taking the pressure off paid carers while often under intolerable pressure themselves. We were therefore really pleased to hear the news this morning that thousands of unpaid carers will have their cases reviewed, after they had been left with huge debts as a result of a failure of Government over a long period of time. However, it has been reported that debts will continue to accrue and overpayments will continue to be pursued for as long as a year from now. Given his responsibility to unpaid carers, will the Secretary of State raise the issue with colleagues, urging them to suspend repayments until the recommendations are enforced, and ensure that those people propping up the care system are treated fairly from today, not from in a year’s time?

[Wes Streeting]

I am grateful to the hon. Member for that question, as this is a terrible situation and one of the many messes that this Government are now working to clean up. I will certainly ensure that the issue she raises is taken up with my right hon. Friend the Work and Pensions Secretary.

[Tristan Osborne (Chatham and Aylesford) (Lab)]

T5. The Public Accounts Committee has recently scrutinised the state of clinical negligence in the UK. At £60 billion, the Government liability for clinical negligence significantly increased under the last Government. The Government have commissioned David Lock to review the issue. Does the Secretary of State agree that reform is desperately needed in this space?

--- Later in debate ---

[Wes Streeting]

I am happy to report to the hon. Gentleman that we are well on the way towards delivering the 8,500 more mental health staff we promised in our manifesto, with over 6,500 already there. Digital tools can play a role, and I am pleased to report that, given the evolution of our online tools via the NHS app, ensuring that we have high-quality and clinically verified apps will be part of our approach, so that people have access to high-quality digital tools, not ones they have googled on the internet.

[Kenneth Stevenson (Airdrie and Shotts) (Lab)]

T6. As a faithful, I commend the Secretary of State for reaffirming his commitment to driving forward digital innovation in the NHS. Does he agree that Scotland should mirror the UK so that we do not fall behind the pace with developments that could be game changing in terms of outcomes for patients and staff alike?

--- Later in debate ---

[Wes Streeting]

Yes, Mr Speaker. [Interruption.] Opposition Members do not like to hear it, but we are bringing waiting lists down for the first time in 15 years, patient satisfaction with general practice is rising, and we are delivering the investment, modernisation and change the country voted for.

[Pippa Heylings (South Cambridgeshire) (LD)]

T9. Two weeks ago, when I asked the Government whether they had had discussions with the Cambridgeshire integrated care board on the 16,000-strong petition to save beds at the Arthur Rank hospice, I was informed that it would not be possible to provide a response within the usual time period. I have a simpler request today: will the Minister meet me and the new Central East integrated care board to discuss how to identify need and strategically commission beds?

--- Later in debate ---

[Sarah Smith (Hyndburn) (Lab)]

About 38% of children in my constituency are sadly growing up in poverty. This Government are committed to ensuring the best start in life for all children, so in addition to the increase in mental health support teams in schools, does the NHS workforce plan currently address the vital need for trained specialist community public health nurses in schools?

[Wes Streeting]

My hon. Friend is absolutely right about the need to improve the quality of the paediatric workforce. We are considering that as we revise the workforce plan. I am proud that already, with just one decision that we took in the first year of this Labour Government to expand free school meals, we are lifting 100,000 more children out of the poverty they were left in by the Opposition.

[Seamus Logan (Aberdeenshire North and Moray East) (SNP)]

In 2024-25, the NHS trust in the Secretary of State’s constituency collected £2.4 million from patient and visitor parking and a further £1 million from staff parking. Given that those costs fall hardest on the poor and the most seriously ill, will the Secretary of State consider abolishing this inequitable burden on the sick, their relatives and those who care for them?

[Wes Streeting]

If I were the hon. Gentleman, I would be more worried about the situation close to home and the SNP’s abysmal record of failure: while waiting lists are falling in Labour-led England and Labour-led Wales, in SNP-led Scotland they are rising, despite the biggest funding settlement since devolution began. It is a record that should make him and his party blush.

[Stuart Andrew]

On a point of order, Mr Speaker. I know that you have been incensed by the unprecedented briefings we have seen by the Government in the run-up to the Budget. It beggars belief that, despite your clear statements on this issue, they have done it again today by announcing that the Chancellor will announce £300 million for NHS tech in her Budget tomorrow—not through a briefing to journalists but with an article on the gov.uk website. This happened just today, after a Minister stood at the Dispatch Box yesterday and said:

“I can assure the hon. Member, given the respect that the Government pay to this House and to their obligations in it, that if there is an important policy announcement to be made, it will be made to this House.”—[Official Report, 24 November 2025; Vol. 776, c. 32.]

Given that that was clearly not the case in this instance, despite your statements, can you advise us as to what we as Members of this House can do?

Cass Review Implementation

Wes Streeting Excerpts

Monday 24th November 2025 Written Statements

[The Secretary of State for Health and Social Care (Wes Streeting)]

I am today updating the House on the Government’s efforts to provide better outcomes for children and young people with gender incongruence, in line with the recommendations of the Cass review.

Children’s healthcare must always be led by evidence, and medicines prescribed to young people should be proven to be safe and effective.

The Cass review was clear that there is not enough evidence about the long-term effects of using puberty-suppressing hormones to treat gender incongruence to know whether they are safe or beneficial. It is a scandal that medicine was given to vulnerable young children without proof that it was safe or effective, and outside the rigorous safeguards of a clinical trial.

The review recommended that a clinical trial be commissioned within a full programme of research, which is being taken forward. This is the safest and most effective way of building an evidence base and charting a course through this challenging issue, where there are understandable concerns around safety, efficacy and consent. The Commission on Human Medicines —a statutory, expert body made up of clinicians and academics that provides independent advice to Ministers on the safety, efficacy and quality of medicines—considered information on the proposed trial and made recommendations, which have been adopted

On Saturday, following the receipt of full ethical approvals from the Medicines and Healthcare products Regulatory Agency and the Health Research Authority, King’s College London launched two new studies funded by NHS England to provide better evidence for how the NHS can support and treat young people with gender incongruence.

This includes the pathways trial—a carefully designed, randomised controlled clinical trial of puberty suppressing hormones for gender incongruence. This trial will involve young people being treated in NHS children and young people’s gender services with a formal diagnosis of gender incongruence. It will measure the impacts of these hormones on their cognitive, physical, social and emotional wellbeing. For their own wellbeing, there are strict eligibility criteria in place, including clinical review and parental consent. Young people will undergo comprehensive physical and mental health checks before and during the study, and will continue to receive psychosocial and other non-medical care while participating. If a young person meets the eligibility criteria, they will then be offered the opportunity to participate in the trial. The study team are now working to open sites for recruitment.

The trial has received comprehensive scientific, ethical and regulatory approval from the MHRA and from the Health Research Authority, including review by an independent research ethics committee. It follows the initiation of the observational pathways horizon study, and has been approved alongside the pathways connect study. The health and wellbeing of the children involved will always be our primary consideration.

NHS England has significantly increased both capacity and investment since April last year, with the opening of three new children and young people’s gender services in London, the north-west and the south-west. I am pleased to say a fourth service will open in the new year, with the ambition of service provision in every region of England by 2026-27.

Last year, NHS England reformed the referral pathway in these services. A referral can only be made by an NHS-commissioned, secondary care level paediatric service or a children and young people’s mental health service. This will ensure that healthcare professionals with the relevant expertise conduct the assessment and help to determine any co-existing mental health or other health needs of these children and their onward care.

I am determined to improve the quality of, and access to, care for all trans people. The full implementation of the Cass review will deliver material improvements in the wellbeing, safety and dignity of trans people of all ages. I will continue to work to help trans people to live freely, equally, and with the dignity that everyone in our country deserves.

[HCWS1088]

International Men’s Day

Wes Streeting Excerpts

Thursday 20th November 2025 Commons Chamber

[The Secretary of State for Health and Social Care (Wes Streeting)]

What a pleasure to follow the spokespeople for the Conservative party and the Liberal Democrats, the hon. Members for East Grinstead and Uckfield (Mims Davies) and for Mid Dunbartonshire (Susan Murray), whose contributions were very much in the spirit of what we have heard this afternoon. I can reassure both of them that the suicide prevention funding is not gone; it is devolved. This will be a challenge that we have to work through during this Parliament as we embrace devolution and set local authorities and health trusts free to spend as they choose. We will need to keep a focus to ensure that the emphasis on suicide prevention is not lost. I really welcome the challenge the hon. Members have brought and the spirit of it. I can confirm that we will be appointing a new men’s health ambassador, and I will keep the hon. Member for East Grinstead and Uckfield updated on that.

It is customary when beginning these debates to thank the Backbench Business Committee, as well as the hon. Member who opened the debate for their outstanding contribution, whether the speech was any good or not. I can honestly say, though, having been in this House for 10 years, that it is a rare moment to hear such a courageous speech as the one we heard opening this debate. We can be truly proud of my hon. Friend the Member for Cannock Chase (Josh Newbury). I hope his constituents know how diligently he fights for them every single day here. He is a conviction politician; he is prepared to speak truth to power and use his influence to get things done for his community. Just through his words today, he will have had such an impact on so many people he will never meet, but who will none the less draw strength from his courage.

I do not think anyone listening to the powerful contributions from right hon. and hon. Members today could fail to be moved by what we have heard—nor could they be anything but truly appalled by all the terrible dad jokes. I think the contribution from my hon. Friend the Member for Edinburgh South West (Dr Arthur) was truly the worst. I would like to get involved, Madam Deputy Speaker, but as is well known, I have absolutely no sense of humour—less sense of humour than Downing Street has for tolerating my jokes. I am not a fan of political jokes anyway, as too many end up getting elected. However, I did once hear of a Canadian politician who was popular with everyone—it’s probably not Trudeau. [Laughter.]

As I listened to the debate, two broad themes emerged. The first is how every day, many boys and men make wonderful contributions to our families, schools, communities and workplaces, and not just in jobs, roles and behaviours that are associated traditionally with masculinity and men, but in roles such as nurses, carers and primary school teachers. They have embraced a genuine commitment to equality—that no matter who someone is and where they are from, and whatever their background, sex or gender, they can grow up to be whoever they want to be.

As my hon. Friend the Member for Bolsover (Natalie Fleet) said so powerfully, the role of men and boys as allies, advocates, mentors and role models and their capacity for love, laughter and empathy inspire others, lift up our society, change lives and bring joy to those around them. I pay tribute particularly to two of the most important men in my life: my dad and his father, my grandad. For those who follow my family history, that is not the armed robber; it is the working-class east end Tory. I have to say that I have that in common with my hon. Friend the Member for Redditch (Chris Bloore), with his family heritage and political leanings.

Without those two men, I would not be standing here today. They have been a rock of stability and inspiration in life. My grandad was my closest friend and moral compass; my dad has been the rock of stability I needed, particularly when things were hardest in my childhood. I am lucky that both of my parents have always been in my life, but I must say that when I talk about being brought up by a single parent, the shorthand too often used in newspapers is “single mum”. As my dad often points out, he was the one who got the terrible teenage years and had to move out of the area to get me to move out before I hit the age of 30. I am very grateful to my dad, whom I love and admire very much.

We have heard powerful contributions today. I could not help but notice that almost everyone endorsed the Dad Shift campaign for greater paternity rights and leave. This Government are legislating for day one rights, but I know that the advocacy and representation that we have heard across the House will have been heard by my colleagues in Government. There will be a consultation, and I am sure that we have not heard the last of that.

None the less, for all the positivity, the second theme we have heard about today is an altogether less positive one. It is a startling reality that being and growing up as a man in today’s society can be very tough, especially for those from working-class backgrounds such as mine. My hon. Friend the Member for Loughborough (Dr Sandher) spoke powerfully about the economic injustice in our society, the poverty and inequality that add up to the pressures and strains, the educational disadvantage and the lack of security and opportunity that too often hold back people, and especially men and boys from backgrounds such as mine. Though I am proud to stand here today, proud of my working-class roots and proud of having beaten the odds that were stacked against me, the object of this Government—the object of the Labour party—has always been to change the odds for everyone and not just to have the exceptional few beat the odds. That is at the heart of this Government’s agenda.

I want to pay tribute to those who have brought this agenda to the mainstream. This debate is 10 years old, but I must remember and recall, back when it started, an awful lot of eye-rolling about whether it was necessary—including, I suspect, by me and others who wondered whether this was truly relevant. How wrong that sentiment was and how much of a brilliant riposte we have heard.

I pay particular tribute to my hon. Friend the Member for York Outer (Mr Charters) who spoke so powerfully at Prime Minister’s questions about the “dark cloud” that hung over him following the difficult birth of his and his wife’s first child. As he said, the strength of a man is about being open about his emotions. Sometimes, as we have heard so painfully today, those struggles become so overwhelming that men feel that the only way out is to take their own lives. When that happens, it is not just an individual, personal tragedy; it is like a nuclear bomb and the fallout hits everyone around them, as my hon. Friend the Member for Southend West and Leigh (David Burton-Sampson) spoke of so powerfully.

We know that that impacts men in different ways, from different backgrounds and in different sectors. During an interview on Fix Radio: The Builders Station yesterday, I was told that men in the construction industry are four times more likely to die by suicide. One of the biggest causes of stress and anxiety for tradesmen is tool theft. That is why I thank my hon. Friend the Member for Portsmouth North (Amanda Martin), who has been like a dog with a bone on that issue, with her campaign already delivering tougher punishments for the perpetrators of tool theft. Indeed, I promised Clive Holland, the host of Fix Radio, that I would pass on this message to the House. He said:

“I would love to stand up at that Dispatch Box and speak to all the people in Parliament…and I would grab them by the lapels and say, ‘Get it through…Just get it through. It’s crucial. We all need this industry. We’d still be living in caves without the skills of our industry’.”

He is absolutely right and that is why we are lucky to have my hon. Friend championing that issue on behalf of that industry.

The Government’s response to many of the issues raised in today’s debate is the country’s first ever men’s health strategy. It covers physical and mental health, and I am most proud that it was drawn up in partnership with men themselves, experts, men’s groups, charities and campaigners. We are all aware that politicians today are about as popular as tax collectors and traffic wardens, so we need wider allies and advocates, groups such as Movember, Men’s Sheds and Everton in the Community, which I had the pleasure of visiting last week. There are also campaigners such as Stephen Manderson, better known as Professor Green, and Clarke Carlisle, the premier league footballer, who use their own experiences with suicide and mental ill health to spread awareness and prevent that from happening to others. I also pay tribute to the journalists, such as the LBC philosopher king Tom Swarbrick, for talking about modern masculinity, the importance of male friendship and keeping the ties that bind us.

There are a number of ways in which we will act. First, by expanding access to support services; secondly, by helping men to take better care of ourselves; and thirdly, by ensuring that stigma is challenged and every man feels empowered to reach out for help. This is not just a plan; it is a call to action. It is not just about changing services and laws; it is about changing hearts and minds and culture, particularly in an online world of harms and radicalisation, as pointed out by my hon. Friend the Member for Watford (Matt Turmaine), as well as many positives, as identified by my hon. Friend the Member for Ribble Valley (Maya Ellis).

Half the battle for men and boys is to have the conversation in the first place, opening up the space to utter what are often the most challenging words: “I need help.” That is why our strategy meets men on their own terms and their own turf—partnering with the Premier League’s “Together Against Suicide” initiative; investing £3 million in community-based men’s health programmes; workplace pilots with EDF to support workers in male-dominated industries; support for minors; and new research to help us tackle the biggest killers of men, including rising cocaine and alcohol-related deaths, as well as taking action on gambling, as my hon. Friend the Member for Dartford (Jim Dickson) exhorted us to. On prostate cancer, I will keep the House updated as we await the recommendations of the National Screening Committee. I heard the representations today, particularly from the hon. Member for Wokingham (Clive Jones) and my hon. Friend the Member for Leyton and Wanstead (Mr Bailey).

Our aim is to create a society where men and boys are supported to live longer, healthier and happier lives, where stigma is replaced by understanding and where every man knows that his health matters. As we heard so powerfully, including from some of this House’s most outstanding feminist campaigners, like my hon. Friend the Member for Walthamstow (Ms Creasy), this is not an either/or. This is not a choice between men and women; it is the recognition that while women’s health inequalities have sexism and misogyny layered on top of them—something that we as men must take responsibility for tackling, too—men and boys do face challenges when it comes to our education, employment, health, wellbeing, life chances and opportunities.

As we heard so powerfully, especially from my hon. Friend the Member for Portsmouth North, it is not as if the women out there do not care about their sons, dads or brothers—quite the opposite. Similarly, we care about our mums, sisters, daughters, nieces, friends and colleagues. There are differences between the sexes—there are differences in how we are impacted by and contribute to the society around us—but we are born equal, and we have a responsibility to stand together to make sure that we create a rising tide that lifts all ships. A healthier, happier, more equal and more just society is what this strategy will help to bring about, and it is why this debate has been so wonderfully powerful.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

As the Secretary of State mentioned brothers, it would be remiss of me not to mention my five brothers—this will give Hansard a run for its money—Basharat, Nasim, Rasalat, Nazir and Imran, and obviously my husband David. Those wonderful men in my life have enabled me to be in this Chair today. I call Josh Newbury to wind up.

Transforming the Health Service

Wes Streeting Excerpts

Wednesday 12th November 2025 Written Statements

[The Secretary of State for Health and Social Care (Wes Streeting)]

I am today updating the House on the Government’s plans to reform the health system in England, in line with our commitment to deliver a more accountable, productive and patient-focused national health service.

The Government intend to abolish NHS England by March 2027, subject to the will of Parliament. And as we have set out, the role of integrated care boards is also changing. ICBs now have a clear purpose as strategic commissioners, tasked with building a neighbourhood health service focused on preventing illness.

We are doing this to deliver a more streamlined, efficient and strategic centre. The size of the centre has more than doubled since 2010. The 2012 reorganisation of the NHS led to worse care for patients, at soaring costs, leaving taxpayers paying more but getting less. That is why the Government’s ambition remains to reduce staff numbers by up to 50% across the Department of Health and Social Care, NHS England and ICBs. These reductions will be made by March 2028.

Patients will experience better care as we end duplication and slash bureaucracy across the NHS, with around 18,000 posts abolished and more than £1 billion per annum saved by the end of the Parliament. These reforms will also give more power and autonomy to local leaders and systems—stripping away red tape and bureaucracy, and providing more freedom to better deliver health services for their local communities. Today’s announcement comes ahead of next week’s Budget, which will focus on cutting waiting lists, cutting the national debt and cutting the cost of living, and driving more productive and efficient use of taxpayers’ money by rooting out waste in public services.

As set out in our 10-year health plan, we are revitalising the foundation trust model that drove previous improvements in performance, but with the shift from treatment to prevention at its heart. And as our next step in delivering this commitment, I can today update Parliament that eight high-performing trusts will be assessed by NHS England to become the first advanced foundation trusts, based on their record of delivering quality care, strong finances and effective partnerships with staff and local services:

https://www.england.nhs.uk/advanced-foundation-trusts/

Further waves will follow over the coming years, driving up standards in every community.

This new designation will reward excellence with greater freedom for providers and clinicians to make decisions locally—from how services are organised to how money is spent—so that care can be designed around what works best for local people, not dictated from Whitehall.

On top of this, the best foundation trusts—those embracing the three shifts and demonstrating the strongest partnerships—will also be given the opportunity to hold integrated health organisation contracts. As an IHO, they will hold the whole health budget for a local population, alongside responsibility for improving health outcomes.

From the first wave of advanced foundation trusts, two will go forward as candidates for first wave IHO designation. We will work with these designates to further develop the IHO model, and over time we expect IHOs to become the norm.

All of this adds up to a very different kind of NHS. It marks a fundamental shift: from command and control to collaboration and confidence. It will not happen overnight, but with our investment and modernisation, this Government will rebuild our NHS so that it is there for you when you need it once again.

[HCWS1051]

Points of Order

Wes Streeting Excerpts

Tuesday 21st October 2025 Commons Chamber

[Mr Speaker]

We all remember Oliver Colvile very fondly. He really was a good MP and a nice kind of guy to meet. I knew Oliver way before he came to this House. We are all saddened to hear the news.

[Wes Streeting]

Further to that point of order, Mr Speaker. On behalf of the Government and Labour Members, I associate myself fully with the remarks of the shadow Secretary of State, the right hon. Member for Daventry (Stuart Andrew). Oliver Colvile was a decent man and a wonderful public servant—we all share that view. I am sure that my hon. Friends on the Labour Benches will absolutely follow his example when it comes to following the Whip.

[Graham Stuart (Beverley and Holderness) (Con)]

Further to that point of order, Mr Speaker. Oliver Colvile was loved by Members from across this House. As it will soon be the 175th anniversary dinner of the Lords and Commons cricket team, it is worth remembering one of the most famous wickets ever taken, when Oliver Colvile bowled and took that wicket in India, on live television, watched by tens of millions. I had never seen a triumph like it. He will be much missed. He was always loved and respected in this House.