A Plan for the NHS and Social Care

Jeremy Hunt Excerpts

Wednesday 19th May 2021 Commons Chamber

[Jeremy Hunt (South West Surrey) (Con)]

Let me start by thanking the NHS and care staff who looked after my constituents in South West Surrey so magnificently in the last year. Every resident of Farnham, Godalming and Haslemere is in their debt and incredibly grateful. As this is Dementia Action Week, I also particularly thank those who looked after people living with dementia, whether care home staff, home visitors or family members.

It is to the quality and safety of NHS care in normal times, as well as during pandemics, that I shall address my comments this afternoon. I will never forget the first members of the public who came to see me when I was Health Secretary to talk about issues of quality and safety. They were a young couple from Devon called Scott and Sue Morrish, who lost their three-year-old son Sam to sepsis. An independent inquiry ultimately decided, in two investigations, that every single NHS organisation that they had dealt with—the GP surgery, the out-of-hours service, NHS Direct, as was, and the hospital—had failed Sam in his care.

Scott and Sue are a modest couple—the last people to kick up a fuss—but they said that when they asked politely for a meeting to discuss Sam’s care a few months after his death, the shutters came down and no one was prepared to talk to them; it was like talking to a brick wall. Ultimately, it took them six years to uncover the truth of what happened to Sam. We should never, ever put a grieving family through that kind of agony.

That is why I focused on safety and quality. It is why I introduced Ofsted-style ratings for hospitals, care homes and GP surgeries, which I think have had some success. Indeed, I am happy to say that they have had particular success at the hospital where Sam was treated, where there has been a big change in culture. However, that is the reason why, with these new reforms, it is absolutely essential that safety and quality is at the heart of what we ask from the new integrated care systems. It is vital that they are outward-looking to the needs of patients and not upward-looking to the requirements of NHS bureaucracy. I am delighted that the Secretary of State wrote to me yesterday confirming that safety and quality would be one of the core requirements being asked of the new integrated care systems. On that basis, I will support the reforms and the Bill, as, I believe, will the Health and Social Care Committee, based on the report that we published last week.

However, there were two omissions from the White Paper that I do need to mention. The first—social care—has been mentioned this afternoon, and I know that the Secretary of State will say that reforms are on the way. I just want to say to him, as the only person here this afternoon who has done his job, that I had four winter crises in a row because we tried to fix the problems of the NHS without trying to fix the problems of the social care system at the same time. If we fix one system and not the other, the social care system will continue to export its most vulnerable patients into hospitals, where they are much more expensive to treat and it is much worse for them, particularly people with dementia. I know that money is a big issue—this is a very expensive thing—but if the NHS really is a priority for this Government, the social care system has to be as well, and I urge him Godspeed and all strength in the battles ahead to secure the reforms for social care that are so urgently needed.

The second omission is around workforce reform. We have a NHS where there are gaps in nearly every medical specialty, as well as in nursing. I was proud to set up five new medical schools and that had a big increase in the number of doctors, nurses and midwives we trained, but even with 50,000 more nurses and 6,000 additional doctors, we need a major overhaul of workforce planning. The obvious reform is to give Health Education England the statutory duty to publish annually long-term workforce requirements to act as a kind of Office for Budget Responsibility-style discipline on the Government to train enough doctors and nurses. I hope that the Secretary of State will consider that.

In conclusion, integration of care—offering joined-up care to patients—is a vital objective, but without enough doctors and nurses to do it, and without a social care system that is able to integrate with the NHS, the worthy objectives that we all have for these reforms will not meet the aspirations that people on both sides of the House rightly have.

Covid-19 Update

Jeremy Hunt Excerpts

Monday 17th May 2021 Commons Chamber

[Matt Hancock]

Let me address the hon. Gentleman’s substantive questions. The first was about the surging of vaccines and testing into hotspots. We saw in south London earlier in the month and last month that that sort of surge testing can work. We had an outbreak of the South African variant in south London. We put in more than 200,000 tests, and we effectively managed to contain that outbreak. That is the approach that we are taking in Bolton and Blackburn, and we will also take that approach if we see a further spread in other areas of the country. We have been working very hard on that to ensure we have that capacity and can do that effectively. We do that, of course, hand in glove with the local authorities in question, which know the communities on the ground.

We are also making sure we have the vaccines available, but I want to be absolutely crystal clear about the approach to vaccination. The hon. Gentleman asked about vaccinating all over-18s in Bolton and Blackburn, but that is not our approach. I have looked into it in great detail, and we have taken clinical advice. The approach is to make sure that we get done as many second vaccinations as possible, as many first vaccinations as possible among the vulnerable groups, and then as many vaccinations as possible among those aged under 50 in the eligible groups. We have taken that approach because that is what is likely to save most lives. That second jab is vital. The first jab for anybody over 50 could mean the difference between life and death. The very strong focus is to get the vaccine to all those over 50 who have not yet taken the first jab. I am glad to say that reports from both Bolton and Blackburn suggest that uptake among people who are eligible, but who have not yet taken the jab, has increased since we saw the rise of the B1617.2 variant in those areas. It is effective in proving to people that the jab really does work to protect them. That is what the data shows.

The hon. Gentleman asked about children. I have been closely following the results of the clinical studies from Pfizer that show that the vaccine is safe and effective among children between the ages of 12 and 18. We have procured enough Pfizer to be able to offer that jab to children should that be clinically approved here, but given that we are at the stage of opening tomorrow to people aged 37, there is some time to go before we get to 18-year-olds. We are on track to meet the target of offering the vaccine to all those aged 18 and above by the end of July, so we have a couple of months before we need to make and operationalise a decision. We want to be very, very careful and sensitive about whether and how we offer the vaccine to children.

The hon. Gentleman asked about important wider measures. He mentioned ventilation. We have put in place guidance for businesses in terms of strengthening the rules around ventilation, and that, too, is important. He did a bit of a Captain Hindsight act on the Indian variant. He did not seem to mention that we put India on the red list before this variant was even deemed a variant under investigation, let alone a variant of concern. Indeed, we put India on the red list before countries such as Germany and Canada stopped flights from India. We have a strong policy of restrictions at the border and we will remain vigilant.

The final point to which I wanted to respond was on the global moral responsibility to vaccinate everybody in the world. The hon. Gentleman is absolutely right that we have a global moral responsibility. I argue that, thus far, the United Kingdom has done, and will continue to do, more than any other nation. It is about not just the huge sums that we have put into COVAX, but the way that we delivered the Oxford-AstraZeneca vaccine around the world. As of this morning, 1.47 billion vaccines have been delivered globally, 400 million of which have been the Oxford-AstraZeneca vaccine. AstraZeneca has charged a profit margin and a margin for intellectual property of zero—no charge for intellectual property, no profit for AstraZeneca. Costs, of course, need to be met, but we have taken nothing for the money that we put into the vaccine’s development. This is the biggest gift that this country could give to the world. A total of 65% of those 400 million doses have been delivered into the arms of people in low and middle-income countries, including more than 150 million in India. On the COVAX facility, which is the biggest global effort to vaccinate in low and middle-income countries, it has delivered 54 million vaccines so far, 53 million of which have been done with the Oxford-AstraZeneca vaccine.

This country can be hugely proud of the contribution it has made. It is far bigger so far than that of any other country. We took the view from the start that we do not need to change our IP rules, we do not need to change the law, we just need to get on and get the vaccine out to as many people around the world as possible, at cost. Everybody in this House should be very, very proud of what AstraZeneca and Oxford University have done with the support of the UK Government. That is how we save lives around the world.

[Jeremy Hunt (South West Surrey) (Con)]

Many of the new variants come from abroad, so clarity on borders policy is essential. We now know that the first wave was largely seeded by people coming back from their spring holiday break in Italy, France and Spain, so will my right hon. Friend provide absolute clarity on the amber list? Should my constituents in Farnham, Godalming and Haslemere—indeed, all our constituents—go on holiday to countries on the amber list even when it is no longer illegal?

[Matt Hancock]

The answer is no. The official Government advice is very clear that people should not travel to amber or red-list countries or territories. People should not travel to amber-list countries for a holiday. What is on the amber, red and green lists is kept under review, based on the data assessed by the Joint Biosecurity Centre. Our priority is protecting the progress we have made at home. We will assess whether any new countries might go on to the green list every three weeks and, of course, we constantly monitor to check that the countries on the green list remain safe. If a country is not on the green list, people should not travel there unless they have an exceptional reason.

Covid-19 Update

Jeremy Hunt Excerpts

Monday 19th April 2021 Commons Chamber

[Matt Hancock]

Let me address the final point first. As I said to the House last week, my approach was and is that local NHS employers are best placed to decide whether to take up offers of pay flexibilities, and Ministers are not involved in decision taking in NHS Shared Business Services. When it comes to the other matter that the right hon. Gentleman raised in terms of my declarations—which are known to him and to everybody else only because I have followed the rules in letter and spirit and made that declaration—I agree with the Leader of the Opposition, rather than him, who said that he was not suggesting that any rules were broken.

I turn to the covid-related matters. I welcome the right hon. Gentleman’s support of the decision to put India on the red list, which is not one that we take lightly. He is right to ask about surge testing, to make sure that we limit the spread as much as possible of the variant first found in India, and I can confirm that we will be doing that.

I welcome the right hon. Gentleman’s support for vaccinations, which he has demonstrated at all turns. It is partly because of the unanimity across the House among all parties on the importance of vaccination that we have this absolutely spectacular level of uptake. He says that every attempt at mandatory vaccination is counterproductive. I gently point him to the fact that surgeons needs to have a vaccine against hepatitis B. Vaccination that is tied to work in fact has a longstanding precedent in this country.

The right hon. Gentleman asks many questions about certification, but he knows that a review of it is under way at the moment, being led by my right hon. Friend the Chancellor of the Duchy of Lancaster, who I am sure will have heard his representations and questions, and will be able to address them in the review.

Finally, the right hon. Gentleman says that we must avoid a third wave by sticking to the rules, and he is right. We should avoid a third wave if we can, and the way that we can do it is by sticking to the rules and getting the jab. That is why the vaccination programme is so important. It is why the road map is cautious and, we hope, irreversible. That is the plan, and with the 10 million second vaccines and the progress in the vaccination programme that we have seen in the last few days, weeks and months, I am very pleased to say that we are on track.

[Jeremy Hunt (South West Surrey) (Con)]

It is a pleasure to see you face to face, Mr Speaker, after some time.

The Health Secretary is absolutely right to put India on the red list and to explore mandatory vaccination of certain frontline workers, however difficult and sensitive that decision may be, but he will know that in the last week NHS waiting lists have risen to nearly 5 million people, which is nearly one in 12 of the population of England—the true cost of the pandemic. It is equally true that we have had capacity problems in the NHS for some time. That is partly why we have opened five new medical schools.

Does my right hon. Friend agree with the letter that he recently received from the three main health think-tanks, which says that Health Education England should be given a statutory duty to publish regular, transparent, independent, objective workforce projections, so that we can ensure that we really are training enough doctors and nurses? That approach is strongly supported by the Health and Social Care Committee and the Academy of Medical Royal Colleges. I hope that he will support it too.

Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 13th April 2021 Commons Chamber

[Matt Hancock]

I wholeheartedly agree with the hon. Gentleman. I am very proud of how, across this House, people have united to support the vaccination effort and to get those messages out there as he says so clearly. It is very important that we have trusted confidants working in and with communities to explain the benefits of vaccination to those who may be hesitant. For instance, in Leicester we have ensured that within the Somali community, Somali clinicians are administering the vaccine. Having a vaccination centre that is staffed by the Somali community near where they live, even though there is another vaccination centre round the corner, has proved successful in driving up vaccination rates in that community. I pick on that as one excellent example of the national and local systems working together, listening to the data, and working with local communities. and I very much look forward to working with the hon. Gentleman to make that happen.

[Jeremy Hunt (South West Surrey) (Con) [V]]

At the Liaison Committee three weeks ago, the Prime Minister confirmed that there would be a 10-year plan for the social care sector, like that of the NHS, to fix the crisis in social care. Will the Secretary of State tell the House what he thinks that 10-year plan needs to contain, and whether external organisations such as Age UK, the Alzheimer’s Society, Care England, and the Health and Social Care Committee, will be able to contribute to the Government’s thinking on that plan? Will they be able to do so before the plan is published later this year?

[Matt Hancock]

I warmly welcome my right hon. Friend’s enthusiasm and support for that project, which the Prime Minister set out at a high level to the Liaison Committee. We are working hard, including with stakeholders, and the Minister for Care has held a number of roundtables on the subject. We want this to be an open and broad programme, to ensure that we get the right answers to these long-standing questions.

Social Care Reform

Jeremy Hunt Excerpts

Thursday 18th March 2021 Westminster Hall

[Jeremy Hunt (South West Surrey) (Con) [V]]

It is a pleasure to serve under your chairmanship, Dr Huq, and to follow such excellent contributions from the hon. Member for Worsley and Eccles South (Barbara Keeley), my hon. Friend the Member for Northampton South (Andrew Lewer) and the hon. Member for West Lancashire (Rosie Cooper). I completely agree with the comment just made by the hon. Member for West Lancashire: it is now or never.

Over the last two decades, we have had 12 White Papers, Green Papers and consultations, and four independent reviews and commissions. I am ashamed to say that a number of them happened when I was Health Secretary for nearly six years, and we were unable to make the progress that I wanted. In the last decade, we have had five Select Committee reports from both the Commons and the Lords.

This time is different, however, because we have just had a pandemic that has shown the whole country how amazing our care staff are and how dependent we are on a group of people who do extraordinary work on very low wages. If we are not going to fix it now, I do not think we ever will. At the same time, the ageing population has continued to age, and last year was the first in human history with more over-65s in the global population than under-fives.

The Health and Social Care Committee undertook a report on this subject last autumn. We are clear that there are three core elements to the reforms. We have to address the catastrophic care costs that see one in 10 people pay more than £100,000 and the terrible dilemma people face of losing their entire life savings to pay for their care home, when they want to leave those savings for their loved ones after they have gone. We should not be forcing people to make those choices in modern Britain.

We have to do more for the workforce, where turnover is about a third. A third of social care staff leave their jobs every year—up to 40% in domiciliary care. Many of them do not get the minimum wage because they are not paid for the time between appointments, yet we know how amazing they are.

We need more funding; we cannot duck that now. The Select Committee thinks a minimum of £7 billion is needed to deal with the catastrophic care issue, the growth in the demography and the minimum wage. We should look at models in Germany and Japan, as my hon. Friend the Member for Northampton South rightly said, when thinking about the best way to fund that.

This is a big ask, but the country was bankrupt after the second world war in 1948 when, with cross-party support, we had the vision to set up the NHS. This is the equivalent challenge for today. It is in tune with the values of the British people. We are a kind country, but our social care system is not kind to the older people who depend on it and get 15-minute slots. It is not kind to the people who work in it.

My message to the Minister is that I know that she cares about this and that behind the scenes she is doing everything that she can, but what is the point of being in Government if not to grasp the nettle on difficult decisions that can transform the lives of ordinary people? Now is the moment to rise to that challenge.

Health and Social Care Update

Jeremy Hunt Excerpts

Thursday 18th March 2021 Commons Chamber

[Matt Hancock]

I welcome the right hon. Gentleman’s support for the vaccines, the vaccine roll-out and the clinically-led approach that we have taken in this country, and I mean that as more than simply a polite gesture. It is vital in this country that we have such a strong cross-party consensus, which includes all parties represented in this House, behind the vaccine programme and behind the science. The science means, of course, that we should and we do publish any side-effects, and we are open and transparent about that, but also that we make an assessment as to the benefits and how those benefits weigh against any side-effects. It is absolutely clear from the data we have seen so far that the vaccines are safe and that they make us safer than not getting vaccinated. That is an absolutely critical fact, and the MHRA will shortly set out more details; it is properly for the independent regulator to set out those details.

The right hon. Gentleman asked about supplies from Moderna. We expect supplies from Moderna in the coming weeks, and I am grateful to Moderna for the work that it has done. Of course, we have always been cautious about setting out future supply details, and the experience of the last 24 hours makes me even clearer that it is far better for us to set out clear commitments to the public in terms of when people can be vaccinated. This means that all over-50s now can come forward and that we are committed to and on target to offer to all over-50s and groups 1 to 9 by 15 April.

However, we know that supply figures move up and down. We have seen that throughout the roll-out, and it is part of the normal management of this roll-out. The commitment I can give the right hon. Gentleman is that, for those who are coming forward for second doses, those appointments will not be delayed because of these supply issues. Also, appointments that are already made will not be cancelled because of supply issues. I therefore say clearly to any member of the public who is watching: the vaccination programme is on track to meet the targets we have set out, and if you get the call from the NHS—whether you get it through a letter, a text, a telephone call or even, these days, an email—take up the offer and get the jab.

The right hon. Gentleman rightly asked about the road map. We are on track for the dates in the road map, and there is no impact on the road map from the changes to vaccine supply that we have been detailing in the last 24 hours.

The right hon. Gentleman asks about the vaccination of children and the autumn vaccination programme. Neither of these is certain. The vaccination of children is currently being assessed in a number of different clinical trials and it is very important that we consider the results of those before making any decision. It is likely that we will need a vaccination booster programme in the autumn, not least to deal with new variants, but that is again not yet certain.

Finally, I am very glad that the right hon. Gentleman welcomed the extra funding that we are putting into the NHS. He asks whether, after six months, there will be more funding if needed for covid purposes. The Chancellor has been absolutely clear from the start of this crisis that the NHS will get what it needs to deal with covid. That is very important, as is the work to restart the NHS in areas where it has had to be paused and, critically, the work that colleagues across the NHS will be doing to recover the backlog of elective work and make sure that everybody can get their appointments and operations in a timely way on the NHS once more. That is the work of the months ahead and I look forward to supporting NHS colleagues in delivering on it.

[Jeremy Hunt (South West Surrey) (Con) [V]]

Was the Health Secretary as concerned as I was by the comments by former Finnish Prime Minister, Alexander Stubb, on the “Today” programme this morning about the threat by the EU Commission President to block exports to countries that were ahead in their vaccination programme? He said that that was a “political reality”, irrespective of any breach of legal contracts that it might involve. Does my right hon. Friend not agree that it is incredibly dangerous to make threats to the supplies of vaccines and components, alongside casting aspersions on their safety at the very moment when vaccines are the only way the world is going to get out of our covid straitjacket?

[Matt Hancock]

I agree with every word that my right hon. Friend said. It is vital that we all work together. The supply chains for the manufacture of these vaccines cross borders. They are often global supply chains and it is vital that we work together to deliver them. There is a need for that co-operation and there is, of course, a need for all countries to respect contract law. That is the basis of international trade, and I am sure that the European Union will live up to the commitments and statements that it has made, including President von der Leyen herself, who has said that there should not be restrictions on companies when they are fulfilling contractual responsibilities. Of course there should not, and we fully expect those contracts to be delivered on, because there are very significant consequences to breaking contract law.

One further point is that the Oxford-AstraZeneca vaccine was developed because of UK taxpayers putting the funding into the science, development and clinical trials and because of AstraZeneca, with an incredibly bold and generous decision, which we fully support—but it was their decision—to offer this vaccine around the world at cost. Working with institutes such as the Serum Institute of India, Oxford and AstraZeneca are providing a vaccine for the whole world. They are not taking a profit from it. We are very proud of that fact, and that makes this materially different from other vaccines that have been developed for commercial advantage. I am not against that at all, but let us celebrate what AstraZeneca has done, and it only underlines how important it is for everybody to work together to keep their populations safe.

NHS Staff Pay

Jeremy Hunt Excerpts

Monday 8th March 2021 Commons Chamber

[Helen Whately]

My apologies, Mr Speaker.

I do not think that we should play politics with these very serious questions as we come through a pandemic that has hit us and the world so hard, when people have lost their lives, people have lost their jobs, and we as a Government have had to spend so much to support the economy, individuals and, indeed, the NHS. I have been speaking to staff on the frontline of health and social care throughout this pandemic, and I and the Government are grateful to them and thank them from the bottom of our hearts for what they have done and are still doing. While so much of the public sector is having a pay freeze, NHS staff will get a pay rise.

In these difficult times, the Government have submitted their evidence to the pay review bodies and, as I said in my opening statement, they will report back to us. They will look at a wide range of evidence, including, for instance, evidence from trade unions, inflation, and the wider situation with the economy and pay levels, and we will of course look at their recommendations carefully.

The right hon. Gentleman talked about the vote that we had on the NHS Funding Act and, yes, we absolutely did vote for it. We are fulfilling our commitment to record investment in the NHS—£34 billion more. He also referred to the long-term plan and, although not something we voted on, the 2.1% increase within it will be invested in the NHS workforce this year. That will include not only these pay rises, but pay progression and further investment in the NHS workforce.

We will continue to invest in more doctors and more nurses for the NHS, and I wish that the right hon. Gentleman would welcome that. We will continue to support the recovery of our economy and restore our public finances, so that we can fund our NHS not just through the pandemic, but into the future.

[Jeremy Hunt (South West Surrey) (Con) [V]]

The long-term plan budgeted for a 2.1% increase in salaries, which has now gone down to 1%, but an even bigger gap in last week’s Budget was identified by the Office for Budget Responsibility as a lack of funding from next year for annual covid vaccinations, for Test and Trace, for long covid and for millions of catch-up operations delayed by the pandemic. What discussions has the Health Secretary had with the Chancellor about that gap in funding, and where will that money come from?

[Helen Whately]

I thank my right hon. Friend for his question. He mentions the 2.1% increase within the long-term plan. That figure covers not only this pay rise for the NHS workforce, but the pay deals that have been agreed for staff in other multi-year pay deals, pay progression, and other investment in the workforce. As for his question on funding for the broader extra covid costs, that is not in the main NHS budget. Just as we had £63 billion invested in those costs throughout this year, there is an extra £22 billion set aside for covid costs outside the NHS budget and also £3 billion specifically for recovery and bringing down waiting lists.

Covid-19 Update

Jeremy Hunt Excerpts

Tuesday 2nd March 2021 Commons Chamber

[Matt Hancock]

The right hon. Gentleman says he likes it. We always knew that he was misplaced over there. His problem is that sometimes his rhetoric is aimed more at his Back Benchers than what he thinks is right. I urge him to listen to his conscience and to back us and the businesses that are making this vaccination roll-out happen, and to put that support into practice.

The right hon. Gentleman asked about sequencing—again, done by a brilliant combination of academics, Government and private businesses. We are now sequencing a third of the positive tests in this country. That is not yet a full survey of all the positives, although we are working towards that, but it does mean that we are able to spot the variants much more than anywhere else in the world. We currently provide around 40% of the total global sequences of this disease—this virus—and we are driving up that sequencing capacity.

The right hon. Gentleman asked about increasing the uptake of vaccination. He was quite right to, and we are working with faith groups and local directors of public health and others. Councils have a very important role to play alongside pharmacists and, of course, GPs in increasing the vaccination uptake. However, the vaccination uptake has been very, very high—higher than I expected—and I am really thrilled about that.

Finally, the right hon. Gentleman asked about making sure that the road map follows data, not dates. We have rigorously set out the gap between the steps to ensure that we can see the effect of one step before we take the other. That is with the goal of having this road map as a one-way route out of restrictions so that we can all get back to the freedom that we crave.

[Jeremy Hunt (South West Surrey) (Con) [V]]

I congratulate the Health Secretary on the brilliant progress of the vaccine roll-out, which is a personal achievement for him as well as a collective achievement for the Government. I also thank him for transparency in that programme and the transparency on the risks of the new Brazilian variant.

I would like to ask about transparency in another area, which is the new integrated care systems that he is planning in his White Paper and the concerns expressed by the Nuffield Trust, the King’s Fund, the Health Foundation and NHS providers at this morning’s Health and Social Care Committee about the lack of detail on how the public will know how well their local ICS is doing. Sir Robert Francis told the Committee that he favoured asking the CQC to Ofsted-rate the new ICSs and I wonder whether my right hon. Friend thinks that that might be a solution to the accountability issue.

[Matt Hancock]

Transparency has played a vital role in our approach to responding to this virus, and I think that is an important lesson from it that should be heeded globally. In terms of the future of the NHS arranged around the ICSs, that transparency will be important, too. There will be a crucial role for the Care Quality Commission, which currently rates hospitals according to, as my right hon. Friend put it, an Ofsted-style rating. It is vital that the CQC has a similar role when it comes to ICSs, and I look forward to working with him and other members of his Committee to make sure that we get the details of that right.

Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 23rd February 2021 Commons Chamber

[Matt Hancock]

The hon. Lady is a long-standing and passionate campaigner for Kuvan, and I pay tribute to the work that she has done. The NICE methods review looks at the question she raises. It is important that we have a clinically-led process for approval of medicines, and I know she agrees with that. The question is ensuring that the details live up to that principle. The methods review will make sure that we take advantage of advances in medical technology, which will, I hope, allow us to bring drugs and treatments to patients of rare diseases who need them more quickly than in the past.

[Jeremy Hunt (South West Surrey) (Con) [V]]

Can I add my support to the previous question about the urgent need to sort out the issue of Kuvan, because I too have constituents suffering very badly from the long wait that they have had?

I wanted to talk to the Secretary of State about support for NHS frontline staff, who have done such a magnificent job this year but worry that, even now, we are not training enough doctors and nurses for the long-term needs of the NHS, and that is the crucial way that we will reduce the pressure on them. So could I ask him: will he be publishing a workforce plan this year, will that have independent projections as to the number of doctors and nurses the NHS will need in every specialty over the next couple of decades and will he commit to funding the number of training places that we need to make sure that we meet those needs of the future?

[Matt Hancock]

The good news is that, thanks in part to the work that my right hon. Friend did when he was in my shoes, we now have a record number of doctors in the NHS and he will have been as pleased as I was to see the record number of applicants to nursing places as well, because we need both more doctors and more nurses. I am delighted that, during the pandemic, we have increased numbers very substantially. On nurses, we are on track to meet our manifesto commitment to 50,000 more nurses, and we have seen a significant increase—just under 10,000—in the number of doctors too, so there is significant progress. Of course there is more to be done, and of course we will need to set out the route to that, as he suggests. The time is not quite right now, because right now there are still very urgent needs and pressures, thanks to the pandemic—I am sure that he and the Select Committee understand that—but this is undoubtedly a question that we will return to.

Future of Health and Care

Jeremy Hunt Excerpts

Thursday 11th February 2021 Commons Chamber

[Matt Hancock]

I will take that as cautious support. I know that the hon. Gentleman sometimes has to say these things, but I am very glad that he leaves the door open for yet more enthusiastic support in the future, not least because of all the questions that he just asked. The proposals on the table—the proposals in the White Paper—are addressed directly to make the improvements that he calls for.

The hon. Gentleman raised an important point about the vaccination programme. The vaccination programme is one of the largest and also one of the most successful civilian operations that has happened in this country, and that is because of the teamwork among the NHS, local authorities, the Department and the brilliant civil servants who work in the vaccine taskforce. It is that combination, that teamwork and that integration which is making the programme the great success that it is.

The hon. Gentleman asked about timing, and I say to him: why argue for delay? Why stop work to integrate? Why stop work to ensure the NHS is more accountable? When people are working so hard in the NHS for us, why should we not work hard in this Parliament to give them the legislative support that they need and have asked for? That is the question he needs to answer if he wants to continue an argument for delay. If not now, when? There is no better time than immediately, so I hope that he will, on reflection and on reading the White Paper, come forward with enthusiastic support.

I absolutely look forward to debates about the details and the implementation. I look forward to the parliamentary passage of a significant piece of legislation in the future, and I look forward to the hon. Gentleman’s engagement on that, but the removal of bureaucratic barriers cannot wait. The increase in the integration of the system should not have to wait, and accountability for this enormous amount of taxpayers’ money to this House, and through this House to the citizens whom we serve, is something that should be welcomed right across this Parliament, and I hope that it will be.

[Jeremy Hunt (South West Surrey) (Con) [V]]

May I start my comments by thanking the brilliant staff at the Royal Surrey County Hospital for the wonderful care they gave me—this morning, as it happens, when I unfortunately slipped over and broke my arm on a morning run. I have just come from the hospital.

It is a very big deal to do a structural reorganisation of the NHS, and I know from my time as Health Secretary how distracting it can be, but it is none the less the right thing to do and a brave thing to do, because NHS staff want nothing more than to be able to give joined-up care—joined up between hospitals, GP surgeries, the social care system and community care—and the current structures make that more difficult than it should be.

I also welcome the public health measures, particularly on obesity, given the high mortality rates that obese people have had during the pandemic. However, these integrated care systems are going to be very powerful, so my question to the Health Secretary is this: how will the public know in their area about the quality and safety of care, and whether waiting lists are being properly managed? How will they know how good all that is? Is he planning to ask the CQC to do Ofsted ratings, as it successfully does for hospitals and GP surgeries?

[Matt Hancock]

I pay tribute to my predecessor’s work setting up integrated care systems in the first place. In a way, this legislation builds on the foundations that he laid when he was in my job, and I look forward to working with the Health and Social Care Committee on the legislation as it proceeds. We have already had discussions, and I am grateful for the Select Committee’s work so far and the insights it has provided.

The question my right hon. Friend raises about the accountability of ICSs is absolutely central, not just to accountability for the use of taxpayers’ money, but to driving up both the quality of care for patients and the health of the population the ICSs serve. It is critical that we ensure the correct combination of high levels of transparency, the role of the CQC as inspector, and accountability up from the ICS, through NHS England, to Ministers and therefore Parliament, and through our democratic processes to taxpayers. The White Paper sets out at high levels how that accountability will work. The details will be a matter for the Bill. The combination of transparency and clear lines of accountability are vital to make sure that while we use the integration provided for in the Bill to empower frontline staff to deliver care better, they are held to account for the delivery of that care and, critically, the outcomes for the population as a whole whom we serve.