NHS 10-Year Plan

Edward Argar Excerpts

Thursday 3rd July 2025 Commons Chamber

[Edward Argar (Melton and Syston) (Con)]

I thank the Secretary of State for his typical courtesy in providing advance sight not only of his statement but of his plan. I am grateful, and others on the Government Front Bench might learn a thing or two from him. I am pleased to see the plan published. This Secretary of State is a rare thing these days: one whose announcements do tend to survive largely intact for more than a week. In the case of the plan, it is vital that it does stick.

The Secretary of State is not known to be short on ambition, and to be fair that is reflected in his plan; it is ambitious. I believe that his long-term goals are right and that the reforms he has set out build on the reforms that the Conservatives set out and carried out. The desire to shift care from hospital to community, to better use technology and to move to prevention is not new at all, but it remains vital.

The NHS undoubtedly needs reform, not just more cash—it is not fiscally sustainable in the long term to have 38% of day-to-day Government spending going on the NHS—so we need to focus on outcomes, not just inputs. But the plan, while welcome, is still sketchy on some of the details of delivery and how it will be paid for without the funds that the Secretary of State mentioned being eaten by pay rises and by inflation, as well as how that shift will be staffed. Greater use of the app is right, and builds on the amazing work done on the app by my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay) when he was Secretary of State. Greater use of technology and of genomics is right, and the Secretary of State’s big five tech bets are largely right, but, as he knows, tech alone will not deliver this; people will, so a workforce plan that is clearly aligned with his strategy is vital.

Neighbourhood health centres are one of the measures at the heart of the Secretary of State’s plan. The concept is an interesting one, but it does throw up a number of questions that I hope he can answer in the spirit in which they are asked. Will the providers of those new centres be NHS public sector organisations, private sector organisations or a mixture? How will the centres fit with GP provision and other services without duplication or fishing in the same pool for staff? What assessment has he made of the cost of new buildings and technology to go in them? How many centres does he envisage, and by when? Crucially, how will he ensure that a public-private partnership model will avoid the downsides of the Blair- Brown private finance initiative model?

I ask those questions from a desire not to see this fail but to succeed, because it is in all our interests that the Secretary of State does succeed, but that will take time. Given that, on page 71 of his plan he talks about the need for “immediate opportunities” to be seized. Although there will be others, may I take the opportunity to suggest just one? He should deliver on the pre-election commitment for fracture liaison services to be delivered in all communities, as campaigned for by the Royal Osteoporosis Society, The Mail on Sunday, the Express and many others. That policy would deliver savings within the comprehensive spending review period. Similarly, Melton Mowbray in my constituency has a fantastic community hospital—there will be many up and down the country—and I hope that such hospitals will be a part of delivering more services in the community.

On maternity care, I welcome the Secretary of State’s commitment to a national investigation into maternity scandals, but I hope that will not stop him from delivering on the work done by the hon. Member for Canterbury (Rosie Duffield) and Theo Clarke, which included measures that can be implemented now to help improve maternity safety.

On systems reform, may I offer the Secretary of State a couple of words of caution? One is on folding the Health Services Safety Investigations Body into the Care Quality Commission, even as a discrete entity within it. HSSIB is not a regulator and is not designed as such, and it is important that those distinctions are not blurred in making that change. Similarly, may I urge him to be wary of further moving integrated care boards to larger geographies—they are at risk of becoming again the old regional health authorities—as that will move them further away from the local communities they serve and the entities providing social care in those communities with whom they must interact?

That brings me finally to a significant question hanging over the plan. Unless we move faster to adjust to the challenges of social care and put it on a sustainable footing, these reforms risk failing to seize the genuine opportunity presented. In the move from cross-party talks to an independent commission, we risk losing that opportunity. Crucially, I ask the Secretary of State again to consider bringing forward the end date of that commission so that we can go further and faster on social care.

I have often said to the Secretary of State that where he is wrong we will rightly hold him to account and challenge him, but where he is right we will offer constructive support. The plan, by and large, does say the right things. We must shift to outcomes and not focus continually on inputs, and we must do that through real and genuine reform. The challenges he faces will be in the detail, much of which is still to be confirmed, and crucially for the Government, in the actual delivery. He should not underestimate those challenges. I will work with him to improve the plan where it needs it, but I will support him where he pledges and brings genuine reform to our healthcare system. His plan will have a key test: will patients see the difference, and when will they see the difference? In all that we do, it is vital, as we reform our NHS, that patients are at the heart of our deliberations and our plans.

[Wes Streeting]

I thank the shadow Secretary of State for his constructive approach to what does need to be a successful plan for the next decade, to get our NHS back on its feet, to make it fit for the future and to make sure we improve the health of the nation. Aside from the lines that he was no doubt given to trot out at the beginning—he almost said them with conviction—we know that we can count on him to be rather more serious and sensible than the display we saw from the Opposition yesterday.

I turn to the shadow Secretary of State’s points. He was right to say that investment needs to go alongside reform. That is why the spending review only a matter of weeks ago set out the Chancellor’s commitment to the NHS and NHS reform. The Government are providing a £29 billion real-terms increase—a £53 billion cash increase—in annual NHS day-to-day spending by 2028-29. That funding will support the first steps towards delivering the reforms, the service improvements and the new technology set out in the plan.

But investment alone is not enough. One of the reasons we are paying more and more for worse and poorer outcomes is that we have the wrong care in the wrong place at the wrong time. Contrary to what we read in some newspaper columns—on the radio this morning I heard the hon. Member for Clacton once again attacking the NHS’s equitable principles and funding model—the problem is not the model of funding; it is the model of care. That is why the shift to neighbourhood health is essential for delivering better outcomes for patients and better value for taxpayers.

The technology coming down the track, and indeed the technology we already have, will drive the big productivity gains in the system that have eluded us. In recent years, the previous Government invested in more staff, but they put all those staff in hospitals to work in an undercapitalised NHS. If there are more inputs but not the enablers to deliver the service, we do not see the responding improvements in output and impact. That drives poorer productivity, poorer value for money and poor outcomes for patients, and that is the approach that we are changing.

If, for example, we roll out, as we will, ambient AI to all GPs, and we make sure that in their interactions with patients we liberate them from being glued to the screen, filling out the forms and drafting the letters, because that is all done automatically before the GP spends a few moments checking over to make sure it is right—if we can just save 90 seconds in every GP appointment—we will save the equivalent time of 2,000 more GPs. That is how we get more bang for the buck, that is how we drive productivity improvements and that is how we deliver better care and better value.

That is why the previous Government’s workforce plan was not right. It assumed that the NHS just needed growth at the same rates and in the same way as always. In fact, so implausible were the assumptions in that plan that if we had continued with the rate of growth that they had set out, by the end of the century 100% of our entire country would be working in the NHS. I know we love the NHS and we love the people who work in it, but I do not think that everyone in our country can or should be working in the national health service. To reassure the right hon. Gentleman, we will, this autumn, set out a new workforce plan that aligns with this 10-year plan.

The shadow Secretary of State asked about neighbourhood health centres. We aim to go for 250 to 300 new neighbourhood health centres by the end of this plan and 40 to 50 over the course of this Parliament. They will be NHS providers and we will have a combination of new builds and the refurbishment and rejuvenation of underutilised existing estate, both in the NHS and in the public sector. Therefore, the cost of each neighbourhood health centre will vary, from the low millions to around £20 million, depending on whether it is an upgrade, a refurb and expansion or a new build.

Given the undercapitalisation of the NHS that we inherited, even the record investment from public sources that the Chancellor has provided will not be enough to deal with the capital backlog. That is why, as set out in the Government’s infrastructure plan, with care and caution, and keeping in mind the mistakes that were made by the private finance initiative, we are looking at alternative private sources of investment to make sure that we can go further and faster on capital improvement, particularly in the neighbourhood health service.

The right hon. Gentleman asked me to commit again to fracture liaison services. Those services have a demonstrable impact on keeping people well and providing both better outcomes for patients and better value for taxpayers. That is why we want to see them rolled out across the country.

On maternity, I welcome his support for the investigation. NHS England is in the third year of the three-year plan put in place by the previous Government and we have sought to support that progress and not to interfere. Yet as we have seen, even with the most recent CQC report into the trust in Nottingham, we have so much more to do and an entire change in approach and culture is needed, let alone a change in practice and behaviour. I am committed to working with all parliamentary party groups across this House and to making sure that the expertise and insight that we have right across these Benches, on both sides of the Chamber, help us to drive maternity improvements.

He asked about us rolling HSSIB into the CQC. Let me provide him with this reassurance. HSSIB has been a really effective body, but we cannot justify the duplication of back-office functions and the inefficiency that comes with that. However, the CQC, when we came into office, was in such a dire state that we had to replace the leadership and we have in place an improvement plan. The House therefore has my assurance that we will not roll HSSIB into the Care Quality Commission until we are assured that the CQC is back to the standards that we expect for it to perform its core duties today, let alone the work it will do with HSSIB housed within the CQC.

On ICBs, I will not measure success through the number of bodies in the NHS; I think that has led us to where we are. However, I am committed to making sure that as we devolve more power, more responsibility and more resource closer to the frontline, to system leaders and to provider leaders, we also make sure that we have in place democratic accountability, so that Members of Parliament, local councils and metro mayors can influence and shape healthcare where they live.

The right hon. Gentleman also asked about social care. We are not waiting for Casey. The spending review gave an additional £4 billion to social care. We are delivering the biggest expansion of carer’s allowance since the 1970s and a significant increase in the disabled facilities grant. The Deputy Prime Minister and I will also shortly set out how we will deliver the first every fair pay agreements for the care workforce, building real social care progression.

On neighbourhood health, social care has to be part of it. In the context of this plan, social care features because it has a role to play on admission avoidance and speeding up delayed discharges. However, we know that social care is important in its own right and that is why it is important that it has its own commission.

Finally, the shadow Secretary of State asked about whether people will see and feel these improvements. We know on the Government Benches that we will be judged by results and by whether people can feel the change that we are delivering. All I would say to people watching our proceedings today is this: in our first year, we promised 2 million more appointments to cut waiting lists—we doubled that; we promised to deliver 1,000 more GPs—we have almost doubled that; and we promised that people would see the NHS moving in the right direction—waiting lists are at the lowest point for two years. We know that there is more to do, but I hope that the progress people have seen under this Labour Government reassures them that, when it comes to our national health service, if anything, we under-promise and over-deliver. We know that people will see and feel the change. I say respectfully, given the shadow Secretary of State’s constructive tone, that that will be the difference between a Labour Government and a Conservative one.