Department of Health and Social Care

Caroline Johnson Excerpts

Tuesday 24th June 2025 Commons Chamber

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

I congratulate the acting chair of the Health and Social Care Committee, the hon. Member for Birmingham Erdington (Paulette Hamilton), on securing this important debate. It is almost one year since the Labour Government took office. They came to power promising that they had a plan to improve our NHS. However, what they actually had was a plan to get a plan by launching a consultation asking professionals and the public for ideas. The consultation was launched in October last year, and I understand that more than 220,000 people have contributed, but despite it being promised for spring, there is still no sign of it. Will the Minister commit to publishing a plan before the summer recess?

While the Secretary of State considers what the plan should say, over in No. 11 we have seen the Chancellor follow the usual Labour playbook: higher spending, higher borrowing and higher taxes. There will be more funding for the NHS, yet as the chief executive of NHS England noted, the NHS budget is now equivalent to the entire GDP of Portugal, reaching £226 billion in 2028-29. That is around 50% of public spending. It is said that 18th-century Prussia was an army with a state attached to it; 21st-century Britain is at risk of becoming a health service with a country attached to it. This is not the Government’s money; it is taxpayers’ hard-earned cash, yet the Government have provided no clarity—no meaningful detail and no credible plan—on how such vast sums will be used.

In the autumn Budget, an additional £10.6 billion in extra funding was promised for 2025-26. However, Julian Kelly, NHS England’s former chief financial officer, told the Health and Social Care Committee that most of it will be consumed by pay settlements, the national insurance hikes and non-pay inflation. Today, 64% of NHS spending goes towards personnel wages and pensions, which is a far higher proportion than in other comparable systems, but the NHS still faces staff shortages and expensive agency costs. Will the Minister confirm how much of the overall funding will go to salary increases? How much will be diverted into covering the national insurance increases for hospitals, social care, pharmacies, GPS, NHS contractors and social care providers?

As we speak in this Chamber, resident doctors and nurses are balloting for industrial action. Strikes would only add to the disruption and delay in care for sick and vulnerable people. Do the Government have a plan to minimise the impact of strikes, should they occur?

Let us look at one proposal that the Government have announced: the scrapping of NHS England. This Government by press release announced NHSE abolition without adequate planning. Ministers have dodged basic questions about costs, staffing changes and structural reform. There is, once again, no plan. The details that we know about do not inspire confidence. NHS England has asked the ICBs to reduce their costs by up to 50% by October 2025. ICBs will have to cluster, with the number expected to fall from 42 to 27 in two years. Many have warned that services will be cut, and redundancy payments linked to those restructurings could reach £1 billion in 2025-26. Has the Minister costed that in the Department of Health and Social Care revenue settlement?

The Government promised to restore the 18-week hospital waiting time within this Parliament. However, their departmental modelling shows that only 80% of patients may meet that standard for routine operations. Will the Minister confirm that the Government will deliver that promise?

Moving on to capital spending, the Minister says that she wants to continue the new hospitals programme, albeit more slowly than we would have done, and invest in technology, but capital budgets remain flat in real terms. The chief executive of the NHS Confederation says that this leaves

“a major shortfall in capital funding”.

The Nuffield Trust said that

“it will be difficult for the NHS to invest in the technology and facility upgrades it needs to meet the government’s…targets.”

Will the Minister explain how they will prioritise, and what will be delivered?

The Government have said that they want to shift funding from hospitals to primary and community care. Will the Minister confirm or deny reports that the NHS 10-year plan will delay the planned increase in spending on primary community care until 2035, instead of 2029, as was originally promised? A key part of community care is social care, but as Daniel Elkeles, the chief executive of NHS Providers, noted,

“social care…hasn’t been given the focus it needs”,

and that is

“a significant blocker on progress for the NHS.”

Cross-party talks on reform have quietly been abandoned in favour of an independent commission led by Baroness Casey, but that process is not due to complete until 2028. Yet again, we see headline-grabbing announcements from the Government, with no delivery plan and no real reform, leaving patients, staff and families waiting for the care they desperately need. The Government aim to deliver £13.8 billion in efficiency savings by ’28-29, with more than £9 billion of that total expected to come from DHSC alone. Will the Minister clarify where, within the Department, those savings will be found, and what impact assessments have supported those decisions?

The Government say that prevention is better than cure, and I agree. A good example is the “Act FAST: face, arms, speech, time” campaign, which we will all be familiar with, but just last week, in an answer to a written parliamentary question, the Minister admitted that

“the Government have made reductions in the Department and NHS England’s communications and campaigns.”

Can the Minister tell us which public health campaigns are to be affected?

Finally, the dental contract requires reform. The Government started negotiations a year ago, yet the Public Accounts Committee has noted:

“NHSE and DHSC do not yet know what reform might look like or to what timescales it can be delivered”.

Will the Minister tell us when the Government expect to conclude negotiations and get on with dental reform? In summary, the Government need to stop governing by headline. They need to publish a robust evidence-based plan, and start delivering.