Asked by: John McDonnell (Labour - Hayes and Harlington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what are the findings of the department’s business case on new private finance in the NHS.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
As set out in the 10 Year Infrastructure Strategy (the Strategy) and the 10-Year Health Plan, in addition to significant capital investment, the Government would explore the feasibility of using new Public Private Partnership (PPP) models for taxpayer-funded projects in very limited circumstances, where they could represent value for money. This included the potential use of PPPs to deliver Neighbourhood Health Centres (NHCs).
A business case was developed by the Department and supported by National Infrastructure and Service Transformation Authority (NISTA). The business case was considered by ministers and has resulted in the announcement in the Budget published on 26 November 2025.
The Budget builds on the Strategy and the 10-Year Health Plan by confirming that the NHS Neighbourhood Rebuild Programme will deliver new NHCs through upgrading and repurposing existing buildings and building new facilities through a combination of public sector investment and a new model of PPPs.
This new PPP model is being developed by NISTA, and is supported by the Department, and will ensure private sector expertise is harnessed to deliver these assets on time and on budget.
The new model will build on lessons from the past and other models currently in use, and will draw on lessons learnt, including the National Audit Office’s 2025 report on private finance.
To ensure the NHC PPPs are managed transparently and are fiscally sustainable, these partnerships will be budgeted for as if they are on a balance sheet.
Delivering new NHCs through a combination of public investment and PPPs will also allow, for the first time, for evidence to be built and compared between different delivery models.
Asked by: John McDonnell (Labour - Hayes and Harlington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what estimate he has made of how much the NHS budget will need to grow to keep pace with patient need, drug prices, inflation and private finance debt in each of the next five years.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The financial pressures and the cost of new commitments for the National Health Service are analysed as part of the Spending Review process. The outcome of the most recent Spending Review is given in the policy paper Spending Review 2025, which is available at the following link:
https://www.gov.uk/government/publications/spending-review-2025-document/spending-review-2025-html
As set out in the document, this level of funding growth will support the NHS to deliver on the Government's priorities, including delivery of the Government’s Plan for Change commitment, meaning that by the end of this Parliament, 92% of patients will start consultant led treatment for nonurgent conditions within 18 weeks of referral.
At the 2025 Autumn Budget, the Government protected the NHS envelope announced at the 2025 Spending Review. This will see the NHS in England receive an over £15 billion real terms increase in annual resource budgets by the end of the period, between 2025/26 and 2028/29.
Asked by: John McDonnell (Labour - Hayes and Harlington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential merits of renegotiating current private finance debt to fund neighbourhood health centres with any potential savings.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Private finance initiative contracts are not held by the Department. Contracts are held between the local National Health Service trust and their respective private finance company.
The Department’s Private Finance Centre of Best Practice (CoBP) team, together with the National Infrastructure and Service Transformation Authority, provides expert support and advice to public authorities with private finance initiative contracts, to improve the performance of existing contracts and manage their expiry.
The Department focuses on supporting trusts to assess the costs and performance of their contracts, to help maximise support for frontline services and make every penny of our NHS funding count. The Department supports trusts on a case-by-case basis considering all options available whilst maintaining contractual compliance. The contracts were let for a prescribed period of time, with the terms set at the outset with limited areas for renegotiation. The CoPB team, however, continues to assess opportunities to refinance debt where possible and where it would provide value for money.
As set out in the 10 Year Infrastructure Strategy (the Strategy) and the 10-Year Health Plan, in addition to significant capital investment, the Government would explore the feasibility of using new Public Private Partnership (PPP) Neighbourhood Health Centres (NHCs).
The Budget, published on 26 November 2025, builds on the Strategy and the 10-Year Health Plan by confirming that the NHS Neighbourhood Rebuild Programme will deliver new NHCs through upgrading and repurposing existing buildings and building new facilities through a combination of public sector investment and a new model of PPPs.
To ensure the NHC PPPs are managed transparently and are fiscally sustainable, these partnerships will be budgeted for as if they are on a balance sheet.
Delivering new NHCs through a combination of public investment and PPPs will also allow, for the first time, for evidence to be built and compared between different delivery models.
Asked by: John McDonnell (Labour - Hayes and Harlington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what estimate his Department has made of the potential impact of the changes to income thresholds in the Statement of Changes in Immigration Rules, HC 997, published on 1 July 2025, on the number of people employed on Skilled Worker Visas who no longer have leave to remain.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Immigration Rules, published on 1 July 2025, set out the wider salary changes across the Skilled Worker route. This increased salary requirement does not apply to the Health and Care Worker visa.
From 9 April 2025, the minimum salary for the Health and Care Worker visa, which is part of the Skilled Worker route, increased to £25,000 per year. For healthcare roles that are eligible for the Health and Care Worker visa, the salary threshold is linked to national pay scales for the specific job, or the minimum of £25,000, whichever is higher.
Entry level National Health Service Agenda for Change band 3 roles do not meet the new minimum salary threshold for a Health and Care Worker visa. However, Agenda for Change NHS pay band 3 staff currently on the Health and Care Worker visa are not required to meet the new minimum salary threshold until the point at which they need to renew their visa. At this point, we expect the majority of staff to have accrued two or more years’ experience and therefore be at the top of pay band 3, which is above the new minimum salary threshold.
The Department continues to monitor trends in the size of the care workforce using a range of intelligence, including monthly tracking based on data collections from independent providers.
Asked by: John McDonnell (Labour - Hayes and Harlington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, which companies have expressed an interest in investing in Public Private Partnerships.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government announced in the 10 Year Infrastructure Strategy document, published on 19 June, and its 10 Year Health Plan, published on 3 July, that it will explore the feasibility of using new Public Private Partnerships (PPPs) to deliver certain types of primary and community health infrastructure.
A decision whether to use PPPs in these circumstances will be taken in the Autumn Budget 2025, based on co-development of a model and business case between the Department and the National Infrastructure and Service Transformation Authority.
Any new model will be market-tested and informed by past lessons and recent Government reviews to ensure better outcomes and value for money.
To better understand market appetite and lessons learned from previous PPPs, the Department conducted a successful preliminary market engagement exercise over the course of the summer. We had in excess of 320 interested parties who registered an interest, including advisors, construction, equity, debt, facilities management, and managed service providers. This preliminary market engagement exercise was not inviting expression of interest to invest, instead, it was focused on testing market appetite for a new PPP model and discussing lessons learnt.
Asked by: John McDonnell (Labour - Hayes and Harlington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will provide information on the (a) new Public Private Partnerships and (b) in what way they differ from Private Finance Initiatives.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government announced, in the 10 Year Infrastructure Strategy document on the 19 June 2025 and the 10-Year Health plan published on 3 July 2025, that it will explore the feasibility of using new Public Private Partnerships (PPPs) to deliver certain types of primary and community health infrastructure.
A decision whether to use PPPs in these circumstances will be taken by the 2025 Autumn Budget, based on the co-development of a model and business case between the National Infrastructure and Service Transformation Authority and the Department.
The Department conducted a successful preliminary market engagement exercise over the summer, and this is feeding into the business case, which is still in development.
Any new PPP models will be subject to further market-testing and will build on lessons learned from past experience, models currently in use, and the March 2025 National Audit Office report Lessons Learned: private finance for infrastructure.
Asked by: John McDonnell (Labour - Hayes and Harlington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the 10 year health plan, what steps his taking to provide (a) palliative and (b) end of life care in the community.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life.
Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. ICBs, including the Staffordshire and Stoke-on-Trent ICB, which covers the Stafford constituency, are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.
As set out in the Government’s recently published 10-Year Health Plan, we are determined to shift more care out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting. Palliative care and end of life care services, including hospices, will have a big role to play in that shift, and were highlighted in the plan as being an integral part of neighbourhood teams.
The Government and the National Health Service will closely monitor the shift towards the strategic commissioning of palliative and end of life care services to ensure that, in future, services reduce variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.
Officials will present further proposals to ministers over the coming months, outlining how to operationalise the required shifts in palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.
Asked by: John McDonnell (Labour - Hayes and Harlington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to help ensure that the 10 year health plan enables equitable access to (a) palliative and (b) end of life care.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.
One of the three shifts that the 10-Year Health Plan will deliver is the shift of healthcare from the hospital into the community, to ensure patients and their families receive personalised care in the most appropriate setting. Palliative care and end of life care services will have a big role to play in that shift and were highlighted in the plan as being an integral part of neighbourhood teams.
I have tasked officials to look at how to improve the access, quality, and sustainability of all- age palliative and end of life care, in line with the 10-Year Health Plan.
Asked by: John McDonnell (Labour - Hayes and Harlington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will take steps to introduce a 24/7 single point of access for (a) palliative and (b) end of life care (i) advice, (ii) guidance and (iii) support.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The guidance makes specific reference to commissioners defining how their services will meet population needs 24 hour a day, seven day a week, and includes a priority action for ensuring that staff, patients, and carers can access the care and advice they need, whatever time of day.
NICE guidance on the service delivery of end of life care for adults also includes recommendations about 24 hour a day, seven day a week access to care. Although NICE guidance is not mandatory, there is an expectation that commissioners and service providers take the guidelines into account when making decisions about how to best meet the needs of their local communities.
I have tasked officials to look at how to improve the access, quality, and sustainability of all- age palliative care and end of life care in line with the 10-Year Health Plan.
Asked by: John McDonnell (Labour - Hayes and Harlington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential impact of the proposed abolition of NHS England on (a) Genomics England and (b) the provision of whole genome sequencing to patients with rare cancers by the NHS Genomics Medicine Service.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
Genomics is a powerful healthcare technology, aiding diagnosis and informing treatment for rare diseases and certain cancers.
Ministers and senior Department officials will work with the new Executive Team at the top of NHS England, led by Sir Jim Mackey, to jointly lead this transformation. As we work to return many of NHS England’s current functions to the Department, we will ensure that we continue to evaluate impacts of all kinds. Throughout the transition, we will retain our focus on patient care, ensuring continuity of care and that there are no risks to patient safety.
In addition, the National Cancer Plan for England will be published in the second half of this year, and will not be adversely affected by the work to bring the two organisations together. The plan will seek to improve every aspect of cancer care to better the experiences and outcomes for people with cancer, including outcomes for people with rare cancers.