Oral Answers to Questions

Layla Moran Excerpts

Tuesday 21st October 2025 Commons Chamber

[Dr Ahmed]

I thank the hon. Lady for highlighting this issue. The best way to do that is to beef up NHS digital services, as we are doing to the NHS digital app, so that women and all patients can have confidence in the advice that they receive.

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

16. What steps he has taken to support the virtual ward programme.

[The Minister for Care (Stephen Kinnock)]

I welcome the Chair of the Select Committee back from parental leave and greatly look forward to working with her again. Virtual wards allow patients to get hospital-level care in the comfort of their own home, speeding up their recovery while freeing up hospital beds for the patients who need them most. We are rolling out virtual wards further, so that they become the norm for managing many conditions at home.

[Layla Moran]

Earlier this year, I visited the “hospital at home” team at the John Radcliffe hospital, who run an incredible virtual ward. I saw them deliver care to Mavis, who is 91. She was so emotional and grateful for the work they did—we all ended up in tears. Imagine my disappointment that while I was off, we got an email from the team saying that the funding for that incredible service is no longer there and that they face closure. This is an example of the best of the NHS. We want it rolled out to the rest, but if the funding is not there for these nascent services to find their footing, how can we ensure that best practice can be spread across the whole of Oxfordshire and beyond?

Jhoots Pharmacy

Layla Moran Excerpts

Wednesday 15th October 2025 Commons Chamber

[Madam Deputy Speaker]

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

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

The case of Jhoots is clearly hugely unfortunate given the incredible work that community pharmacies do up and down the country for our constituents. I am pleased to hear the Minister say that this case will not negatively affect the funding settlement, but it is set against the backdrop of a very precarious sector where actors who want to do good by our communities and do a high-quality job often find that they simply cannot make ends meet, and bad actors find a way to move in. When the Committee looked last at this issue, the workforce was a key plank to why the sector is not sustainable. What update can the Minister give us on the inclusion of pharmacists in the workforce plan?

[Stephen Kinnock]

I thank the hon. Lady and pay tribute to her work as Chair of the Select Committee. I am very proud of the fact that we delivered a £500 million uplift to pharmacy—19% across the two-year period. It was the highest uplift of any sector, not just of my portfolio but the entire NHS. I am also very proud of the fact that we are taking forward hub-and-spoke legislation to enable pharmacists and pharmacy technicians to operate at the top of their licence. The day before yesterday we signed off on a statutory instrument to improve the ability of technicians to do more in the area of dispensing. We are looking to empower the workforce and enable them to operate at the top of their licence. That is a fundamental part of the shift from hospital to community that is at the heart of our 10-year plan.

Mental Health Bill [Lords]

Layla Moran Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

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

It is a decrease in the proportion of the mental health investment standard for the first time in, I believe, nine years. It is incredibly concerning. It was hard-won, cross-party support that made that proportion go up over time. It was incremental, but it was starting to make a difference to the system. Does the hon. Gentleman agree that it would be helpful if the Government clarified whether that will continue in 2025-26? When Baroness Merron came to our Committee, she could not confirm that. If there is not going to be a continuation, the system needs to know by now, frankly, so that it can prepare adequately for it.

[Dr Evans]

The Chair of the Health and Social Care Committee is absolutely right. A simple answer from the Minister today, on Report, would go a long way to alleviating those fears from the mental health sector. I look forward to his response on that.

Amendment 40 would add a simple but important requirement that each care and treatment plan must include an assessment of the levels of risk to public safety posed by the patient in the community. The purpose of the Bill is right; the Government want to make the system more compassionate, therapeutic, patient-centred and modernised, and we strongly agree with that ambition. However, modernisation must go hand in hand with public confidence, and the public and patients themselves must know that every plan for treatment and discharge is rooted not only in care, but in safety.

In Committee, I argued that the framework still omits one dimension, which is public safety. As far as I can see, there is still no explicit requirement in the Bill for clinicians to assess and record the level of risk posed to the public.

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[Madam Deputy Speaker (Ms Nusrat Ghani)]

To squeeze in a few more Back Benchers, the speaking limit is now three minutes.

[Layla Moran]

This is a long-overdue and very welcome Bill, but frankly it will not even touch the sides of what most of our constituents and communities need when it comes to the wider mental health landscape. I support many of the amendments to improve it, not least those laid by my hon. Friends on the Liberal Democrat Benches. I need to make a couple of quick points, because we want the Bill to succeed.

The Minister will know that since December the Health and Social Care Committee has been conducting an inquiry into community mental health services, because we recognise that unless we start tackling these matters upstream, we will not achieve the Bill’s aims. For so many, it feels like they are walking through an NHS desert: they simply cannot get the appointments they need; they do not feel supported; and no one can navigate this complex system.

Just a few weeks ago, while still on maternity leave, I decided to have a keeping-in-touch day and the Committee decided to visit an oasis in this desert—the incredible Barnsley Street neighbourhood mental health centre in Tower Hamlets. Unfortunately, the centre is one of only six pilots set up to this level across the country, but we heard some amazing stories of how people had been diverted away from in-patient mental health units by an approach that truly puts the patient at its centre. It was inspiring. However, we heard from the centre that its funding will not continue beyond April. It is only just starting to gather the data it needs; system change is desperately needed in this space, but the concern is that the system will change without robust data behind it. My question to the Minister is, will the centres be funded beyond April? If not, how can the Department make decisions about the system based on data that does not represent a full calendar year?

I also want to speak in support of amendment 9. I pay tribute to Cyril and Dianne whose son Leon suffered from schizophrenia for many years and sadly completed suicide in January 2019. He was let down by community mental health services. Leon’s mother, Dianne, saw the illness get worse and worse, and when she tried to re-refer him into the system after he had been detained, she was told, “Computer says no.” This Bill will improve the lives of families like Dianne and Leon’s, because Dianne’s pleas would have been heard under the new nominated persons provisions. Amendment 9 would be an extra step, ensuring that the plan is shared with parents and carers—with the nominated person. I pay tribute to those who have campaigned so doggedly for the inclusion of nominated persons in the Bill.

[Anna Dixon (Shipley) (Lab)]

I am no expert on mental health law, but I do have decades of experience in the health and care sector, and my sister is a psychiatrist. I know that the decision to detain someone with severe mental illness is never taken lightly, and that psychiatrists must weigh up a range of factors and information to come to a final decision. I tabled amendments 43, 44 and 45 and new clause 34 after a number of conversations with the Royal College of Psychiatrists, which has expressed concern about the wording used in the detention criteria.

Taken together, the purpose of my amendments is to ensure that the detention criteria are aligned with good clinical practice. It is important that they are reflected in the primary legislation, rather than simply relying on a code of practice. They would remove from the detention criteria mention of the terms “likelihood” or “may be caused” to allow psychiatrists to make a straightforward, holistic assessment of individual risk in the context of significant mental disorder. The risk is that “likelihood” suggests that it is possible for clinicians to predict serious harms such as violence or suicide when it is not possible to do so, while the idea of causation neglects the fact that complex background conditions can be the genesis of a harm. There is a risk, too, that the language may lead to preventive detention—more detention, not less. It is always easier with hindsight, when unexpected harms have happened, to oversimplify causation and ask, “Why was this person not detained?

Hospitals

Layla Moran Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Stephen Kinnock]

If hon. Members will bear with me, I will make a little bit more progress and then come back to them.

Many Liberal Democrat colleagues have made the argument that with hospitals in the state they are in, it is more important than ever to have a robust social care system in place. As the Minister for Care, I agree with them wholeheartedly, but it is simply not true to portray the Government as sitting on their hands while Baroness Casey gets cracking on her vital work. In fact, we have hit the ground running through a plethora of measures. We have legislated for the first ever fair pay agreement for social care in order to tackle the 130,000 vacancies we see today. We have delivered an extra 7,800 home adaptations through the disabled facilities grant to change the lives of thousands more disabled people for the better. In the Budget, the Chancellor provided the biggest increase in carer’s allowance since the 1970s, worth £2,000 a year to family carers and with an extra £3.7 billion for local authorities.

We are not hanging around on more structural reforms, either. We are introducing new standards to help people who use care, their families and providers to choose the most effective new technology as it comes on the market. We are joining up care and medical records, so that NHS and care staff have the full picture they need to provide the best possible care, and we are training more care workers to perform more health interventions, helping people to stay well and at home. Just two weeks ago, we announced a new qualification for social care staff, training them in artificial intelligence to automate routine tasks and motion sensors to detect falls. We are seizing the opportunities of care tech and harnessing it for the benefit of thousands who draw on care across our country.

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

We are desperate to help the Minister in this endeavour, and look forward to receiving our invitations to the cross-party talks, which have yet to be issued. However, the Health and Social Care Committee heard today from an organisation called Think Ahead, which is the only organisation in the country that trains mental health social care workers. I have just heard that the Department of Health and Social Care is not refunding that organisation. Can the Minister explain why?

[Stephen Kinnock]

I thank the hon. Lady for that intervention. Baroness Casey is working at pace to get the commission up and running, and that will be launched this month. On her point about Think Ahead, the fundamental challenge we had with that programme was its relatively high unit costs. We are aiming to ensure that we deliver value for money for the taxpayer—I am sure that the hon. Lady shares that objective. We have to ensure that we deliver a programme for mental health social care work that delivers not only the best possible outcomes for our communities, but the best possible value for taxpayer money.

A lot has been done in the nine months since the election, but there is a huge amount more to do, and this Government are getting on with the job. Alongside the work I have described, the Government are putting record levels of investment into healthcare, with capital spending rising to £13.6 billion over this year and the next. That includes £1.5 billion for new surgical hubs, diagnostic scanners and beds across the NHS estate, as well as new radiotherapy machines to improve cancer treatment; over £1 billion to tackle RAAC and make inroads into the backlog of critical maintenance, repairs and upgrades across the NHS estate; and over £2 billion to be invested in NHS technology and digital. We are also taking the pressure off our hospitals through care in the community, and I am sure the whole House will welcome the fact that we have recruited 1,500 extra GPs on to the frontline.

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

Lord Darzi’s independent investigation clearly set out the impact that “capital starvation” has had on the NHS in recent years, and the importance of capital spending to fixing the health service. The report highlighted substantial shortfalls in capital investment, combined with a tendency to raid capital budgets to cover in-year spending deficits, so I welcome today’s Liberal Democrat motion, which allows Parliament to highlight how important these issues are to the public. This is the second Liberal Democrat Opposition day, and it is the second time we have debated health and social care. It is because it is a priority for the country that it is a priority for us.

The Health and Social Care Committee has taken a keen interest in the new hospital programme. We have challenged the Government to maintain their capital spending and not fall into the traps of the past, when capital spending was redirected to fund day-to-day spending, so I was pleased to receive confirmation from the Department, and now from the Dispatch Box, that the Chancellor’s changes to the fiscal rules will stop future raids on the capital budget, or CDEL, to fund the day-to-day spending budget, or RDEL. That is hugely welcome. However, although the protection of capital budgets is reassuring, I remain concerned about the lack of transparency around how the funding is allocated by the Treasury.

The charge levelled at the Government is that funding is being funnelled into acute care to tackle waiting lists, at the expense of funding primary care, infrastructure and care in the community. Clearly, on current commitments, we will not see capital funding that is sufficient to meet anything close to the unfunded promises made by the Tories in 2020. Nevertheless, the principle of investing in our hospital infrastructure is good; money will be saved in the long run on maintenance and emergency repairs, as well as providing a better quality of care.

In the policy paper on the plan for implementing the new hospital programme, the Government stated that funding will reach only £3 billion in the early 2030s due to

“other key priorities in health spending, such as funding to enable the Secretary of State’s 3 shifts”.

That is good, but we need transparency around how decisions were made and which projects were chosen. In January, the Secretary of State provided the criteria by which the schemes were scored and funding was allocated, such as site constraints and maturity of planning permission, but it is disappointing that, as I understand it—I am willing to be corrected—the review was conducted without the involvement of the trust teams responsible for delivering the rebuilding programmes. As of last month, no trust with a new hospital programme scheme has been provided with the full details of how it scored specifically against the criteria.

The Health and Social Care Committee has asked how the Department is prioritising schemes and has not received a clear answer, so my question is very simple: in the interests of transparency, will the Secretary of State publish, for every single new hospital programme scheme that was subject to last year’s review, the details and findings of the Department’s assessment of them against each of the criteria that were published alongside his statement in the House of Commons on 20 January 2025? It is the very least that the schemes that felt deprioritised deserve, and we are hearing many examples of those from Members of different parties. I choose to believe that this outcome is inadvertent but, frankly, it just looks a bit shady. We have seen it happen before with the levelling-up money under the previous Government. The Public Accounts Committee, on which I know many Members have served, as have I, has a motto: sunlight is the best disinfectant. If the Government will not publish the detailed assessment, the Minister needs to explain why.

My local area, like so many others, has been affected by this issue. Last year I visited the John Radcliffe hospital, which serves much of Oxfordshire, and I saw at first hand how its capacity to deliver care is being severely constrained by the size and condition of the physical estate. We went to visit the old site of the neonatal intensive care unit, which had to be moved because the staff were worried about the ceiling literally coming down on sick children and on incubators. It was atrocious.

The John Radcliffe hospital wants to be world-leading. It is a specialist tertiary care hospital, which means it is able to perform very specialist surgery, and it wants a new building to do that in. When it put to the Government a bid for £28 million, it was rejected. Instead, it has gone out to seek private financing, and it will now cost the trust £46 million to deliver the exact same building. Would it not have made sense for the Government to allow the trust to borrow from the Government to build it, and then to pay the money back from its own reserves over time? Think what it could have done with that £18 million.

[Sean Woodcock (Banbury) (Lab)]

I know the John Radcliffe hospital, which serves some of my constituents. The hon. Lady has made a powerful case about the amount of money that has potentially been lost through this process. Would she, however, reflect on the role played by her party, particularly the right hon. Member for Kingston and Surbiton (Ed Davey), and the amount of money wasted on the disastrous top-down reorganisation of the NHS under the coalition Government?

[Layla Moran]

I have to say that that was quite a segue. We are focusing on the capital estate. We all know that there were problems with the Lansley reform. In fact, I welcome the fact that it is being unravelled, and I was pretty vocal about it at the time.

The savings the John Radcliffe could have realised might have been spent on hospital at home services and other ways to divert people away from coming into A&E in the first place.

Across the wider Oxford university hospitals NHS foundation trust, £100 million of backlog is deemed as high or significant risk. Pausing or delaying plans to rebuild hospitals is a false economy, and hospitals around the country, including the John Radcliffe, are overspending on maintenance as a result. That is not limited to our hospitals; we are also seeing it in GP practices, many of which date from well before 1948. I will declare an interest in that my own surgery—the Summertown health centre—is one of those practices. It is doing incredibly well, despite working out of a very old Victorian building. It is desperate for a new site, and it was deemed one of the top priorities for the ICB. I note that the Minister mentioned a figure of £102 million, but, frankly, that does not touch the sides.

As in the case of the John Radcliffe, the Summertown health centre is now going out to seek private finance, which it will find a way to pay back slowly over time. The Exchequer would not even have to lay out this money in advance, and even with inflation, the amount it would get back is less than what the health centre has to pay to do this with private finance. I ask the Government to think about this innovatively. It is not the same as the PFI. It is the Government using their own borrowing rules to allow investment in vital public services, and it makes no sense that they cannot do it.

When it comes to mental health services, we have the incredible Warneford hospital in Oxfordshire, and Warneford Park in Oxford will provide a new cutting-edge mental health hospital surrounded by a research and innovation hub. Groundbreaking research is planned on understanding brain health and discovering new drug therapies and new forms of treatment. This is a great vision, but it will cost £500 million. We do have private benefactors, including local businesses, willing to feed into it, but where is the funding pot for mental health trusts? They were excluded from the new hospital programme, and it is not at all clear where that kind of money may be found.

[Monica Harding (Esher and Walton) (LD)]

I would like to share a story from a constituent who called me last night. Her daughter had psychosis and was locked in a room at the local hospital, with a mattress on the floor and two security guards outside. She was there for a week waiting for mental health provision in a setting outside the hospital. I would like the Minister to tell me what mental health provision will be in place.

[Layla Moran]

I am so sorry to hear about the experience of my hon. Friend’s constituent. In Lord Darzi’s report, there are some stark pictures of him sitting in substandard accommodation for the very sickest in our society. The Health and Social Care Committee is currently undertaking an inquiry into severe mental ill health, because we know that mental health is so often forgotten in the NHS. It is good that the mental health investment standard has been continued, but it is sad that the overall spend as a proportion of NHS spend is going down this year for the first time in the last few years. We very much hope that this is not a trend, but a one-off, and that it will continue to rise from next year.

For the Warneford, we need to understand what new innovative funding pots we can put together. We understand that the Government are working across Departments, and this project would be as much of an advantage to the Department for Science, Innovation and Technology as to the Department of Health and Social Care. Where are these pots of money, because they are important?

I will end simply by saying that I completely agree with the thrust of the motion—and, indeed, with what the Government have themselves said—which is that if we invest in capital expenditure, we need to take an invest to save approach. We know that this matters to our constituents, and we know that they cannot get the services they so desperately need. If we are to achieve the three shifts, we should not be pitting them against each other. Investing in capital will help the three shifts to succeed, and we do will the Government and the NHS to succeed.

[Madam Deputy Speaker (Judith Cummins)]

With an immediate four-minute time limit, I call Emily Darlington.

NHS Pensions

Layla Moran Excerpts

Tuesday 1st April 2025 Commons Chamber

[Madam Deputy Speaker (Caroline Nokes)]

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

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

I have to say that I am none the wiser about what exactly has happened. If we are to ensure that this will not happen again—that these deadlines will be met—we need to know how we got into this position. It may well be the fault of the previous Government. Will this Government commit to a full review of exactly how we got here, so that we can ensure that the published deadlines are met this time?

[Karin Smyth]

The Chair of the Health and Social Care Committee makes a good point, as she so often does, about what went on previously. This is an issue from the McCloud judgment that runs across many Departments. It was a problem under previous Governments, starting with the coalition Government. I know that the Public Accounts Committee, on which I served, and the Treasury Committee have looked at the matter over time. The Department will certainly co-operate with any inquiry and investigate what happened across Government. I am happy to get back to the hon. Lady on that point.

NHS England Update

Layla Moran Excerpts

Thursday 13th March 2025 Commons Chamber

[Madam Deputy Speaker]

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

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

This is a bold change indeed. The job of my Committee is to help the Secretary of State to do it, so let me start by asking him to come in front of the Committee as quickly as possible—certainly before Easter—because there is a lot of detail that we need to drill down into.

On a more substantive point, the right hon. Member mentioned the financial reset that Sir Jim Mackey announced to integrated care boards just yesterday, which means that they need to cut their running costs by 50%. I am concerned that when my Buckinghamshire, Oxfordshire and Berkshire West ICB struggled with money, the first thing it cut were the place-based teams. If we are to deliver the neighbourhood NHS that the Secretary of State and I both want, those are not the teams to cut. Will he send a signal to ICBs that cost savings should not be at the expense of the broader shifts in the 10-year plan?

[Wes Streeting]

First, I give the Chair of the Select Committee my assurance that I would be delighted to appear in front of her Committee at the earliest opportunity —that means soon. I appreciate that it will want to scrutinise these changes in more detail, and I would welcome the constructive challenge that it offers. I also reassure her that the direction that we are giving to frontline leaders is to deliver the three big shifts in our 10-year plan, and to ensure that as we take immediate steps to bring the finances under control, we do so in a way that lays the firm foundations for the future of the NHS that we need to build.

My cautionary note to Members across the House is that when we ask frontline leaders to reform and to change ways of working, sometimes that requires not just changes to the bureaucracy as it were—the easier and lower hanging fruit—but service reconfiguration in the interests of patient outcomes and better use of taxpayers’ money. Sometimes, they get those changes wrong. I have successfully campaigned against closures of services such as the King George accident and emergency department, which should not have closed and where we won the case on clinical grounds.

Sometimes, let us be honest, the public can get anxious, and Members of Parliament feel duty bound to act as megaphones and amplifiers for public concerns. It is important that we support and engage with local NHS leaders. By all means, we should scrutinise, challenge and ask questions, but we must give local leaders the support to do the task that we are asking of them on behalf of patients and taxpayers. The powers that I have to intervene in those frontline service reconfigurations are ones that I will use only in the most exceptional and necessary cases, and that is why I have not used them once in the past eight months.

Department of Health and Social Care

Layla Moran Excerpts

Wednesday 5th March 2025 Commons Chamber

[Sir Geoffrey Clifton-Brown (North Cotswolds) (Con)]

Thank you, Madam Deputy Speaker, for granting us the opportunity to debate this supplementary estimate, which provides an opportunity for all Members of this House to look at the Public Accounts Committee’s report on health and discuss how the money might be spent on different priorities.

As the Chair of the Public Accounts Committee, I am honoured to introduce the first estimates debate on the supplementary estimate of the Department of Health and Social Care. I made this application jointly with the hon. Member for Oxford West and Abingdon (Layla Moran), the Chair of the Health and Social Care Committee, and my right hon. Friend the Member for Salisbury (John Glen).

As Members of this House will know, the Public Accounts Committee is one of the oldest Committees of this House. It exists to protect taxpayers’ money and ensure that their pound is being used effectively. It goes back, I think, to about 1867. Unlike other Committees, we do not take evidence from Ministers; instead, we take evidence directly from permanent secretaries and the most senior civil servants and public sector officials. The National Audit Office provides us with audited accounts and value for money reports, and we produce reports of our own with recommendations to Government to which they must formally respond as part of the Treasury minute.

At this point, I pay tribute to Amanda Pritchard, who has recently announced that she will be stepping down as chief executive of NHS England this summer. She oversaw the NHS at a time when it was under so much pressure post pandemic, and I wish her well in her future endeavours. I also congratulate Chris Wormald on his promotion to Cabinet Secretary. These vacancies at the head of NHS England and the Cabinet Office provide an opportunity for completely fresh thinking within the NHS.

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

I echo the hon. Gentleman’s thanks to Amanda Pritchard for her time at the head of NHS England. While I also welcome the appointment of Dr Penny Dash as its new chair, the hon. Gentleman is right to say this is a really important moment in the future of the national health service.

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

We are proving that estimates are not dull, although they have a terrible reputation for being so. Everything comes from the money, and if we do not follow the money, we do our constituents a disservice. The Government have announced an incredibly welcome £22.6 billion increase in day-to-day spend on health and social care, in addition to the further £3 billion in capital expenditure. It sounds like, and is, a huge amount of money. The only thing bigger than the uplift will be the disappointment of our constituents if the money is not spent wisely and does not lead to the change that they desperately want and need.

I will start with an example. My constituent was referred to her GP for an NHS-funded assessment for autism spectrum disorder. She took tests, and exceeded the threshold in all of them, and was told that she would be put on a waiting list, with an expected wait of 16 years to 18 years—yes, years. She is 34 with young children, and will be waiting for an appointment until she is 51. That is clearly ridiculous.

We welcome the three shifts, the 10-year plan and the long-term thinking, which hopefully will end stories like the one that I just told; I know Members from across the House will have similar stories. I was interested to hear the Secretary of State choose technology as his top pick when I pressed him to pick a favourite priority at our Committee hearing on 18 December. In recent correspondence with the Committee, which is now online, the Department credited technology with a 0.7% productivity contribution this year alone. I am concerned, though, that we do not have much detail about how exactly technology will achieve that, and we will press the Department on that figure.

Prevention is also incredibly important, and it is always in danger of being overlooked. I assure the Minister—I know she is responsible for prevention—that if the Government do not pursue it, we will press them to, as will the electorate, I am sure, because is a no-brainer.

[Gregory Stafford]

If we want prevention, we have to invest in social care, but the Government are putting almost all the investment that the hon. Member talks about into the NHS, rather than social care. Surely there needs to be a rebalancing.

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[Layla Moran]

In our Committee hearing just this morning, we heard that all parts of the system want this. Acute care trusts recognise that they have the bulk of the investment, but they realise that unless they start pooling budgets and working in an integrated way, we will not achieve the productivity gains that we desperately need.

[Mike Martin (Tunbridge Wells) (LD)]

The Government’s policy is actually achieving the opposite for social care of what the hon. Member for Farnham and Bordon (Gregory Stafford) suggests. Peter runs a small domiciliary service in my constituency that is going bust. That means 35 people without a job, a loss of £100,000 in taxes every year, and all those patients now blocking beds in hospitals. Does my hon. Friend the Member for Oxford West and Abingdon (Layla Moran) agree that the Government’s policies are downgrading and trashing social care, rather than boosting it?

[Layla Moran]

I share my hon. Friend’s frustration that we are not doing more faster. Indeed, the first inquiry that our Committee has launched is on social care and the cost of inaction, because there is a cost to doing nothing, and we need to quantify that as best we can.

On the three shifts, the shift to the community is incredibly important, not least because successive Secretaries of State have said that they want that shift, yet the money has flowed in the opposite direction.

[Steff Aquarone (North Norfolk) (LD)]

In Cromer in my constituency, about 18 months ago, the Conservative-controlled county council closed down Benjamin Court reablement centre. That is exactly the sort of facility that we need to help bridge the gap between acute hospitals and community and primary care. Does my hon. Friend agree that we must work to reopen those facilities, which do not stand a chance until there is proper integration of NHS budgets and the budgets of adult social care providers?

[Layla Moran]

We should be celebrating examples of where this works well, not shutting them down.

In Oxford, the Hospital at Home programme, run by Oxford University hospital ambulatory team, does incredible work. I visited 91-years-young Mavis the other day, who was receiving top-notch ultrasounds in her home—ultrasounds of better quality than those that she would have got in the hospital. That saves hundreds of pounds for the NHS and means no long trip for her and her family. That is definitely something that we should do more of.

Let me turn to the estimates, because they are why we are here. The supplementary estimates have been published. I will not hit anyone over the head with them—they are incredibly heavy. They are worth a read. They talk about a £198.5 billion day-to-day spending budget. At face value, that is an increase of £10.9 billion on the estimate from July, but £9.2 billion is for staff pay increases. Let us be clear: staff deserve that pay rise. It is long overdue. Retention and mental health are important, and we must invest in our workforce, but that does leave just £1.7 billion.

[Jen Craft]

Will the hon. Member give way?

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[Layla Moran]

I will make progress, if I may, because the clock is ticking down. As for that £1.7 billion, once we add in national insurance contribution increases and inflationary costs, the NHS has had to ask for an additional £812 million on top, so it is already running a little behind. Next year, the increase is due to be £10.6 billion, but as the Committee heard in a hearing, the expected pressures are £11.7 billion. We can all do the maths. There is a problem. The way it will get solved, at least on paper, is through an enormous 4% productivity increase, combined with cost reduction. We need more detail about how exactly that will be done.

I echo the point made by my fellow Committee member, the hon. Member for Uxbridge and South Ruislip (Danny Beales), about capital expenditure. In these estimates, we see that there has already been a decrease in capital spend of £1 billion from the 2024-25 main estimate. It is explained away as a transfer to day-to-day spending, due to a reclassification of spending on technology and new hospitals as day-to-day spending. I do not know how others feel, but that does not sound quite right to me. I am concerned that the Government are falling into the same trap as previous Governments—perhaps understandably, because they have to pay for the day-to-day somehow. The Government gave an assurance to the Public Accounts Committee that they would stop making those sorts of changes. Is that still the case?

Finally, I want to do more of this; I want to undertake more scrutiny of the estimates, but it is quite hard to do, because there is a lack of detail. For example, in the document, £120 billion comes under the sub-heading, “NHS providers”, and there is absolutely no detail under that. Will the Minister commit to working with the Committee and the House of Commons scrutiny unit to provide Parliament with a meaningful breakdown, so we can have more wonderful debates just like these?

[Several hon. Members rose—]

--- Later in debate ---

[Ben Coleman]

Will my hon. Friend give way?

[Layla Moran]

Will the Minister give way?

[Ashley Dalton]

I will give way very briefly.

--- Later in debate ---

[Layla Moran]

The Minister will have noted, on page 53 of the estimates, a £1 billion decrease in capital spending in the departmental accounts. Will that be explained, and can the Minister explain now how new hospitals constitute day-to-day spending?

[Ashley Dalton]

I will be coming to that, but I thank the hon. Lady for raising it.

We have talked about productivity, an issue that has been raised by many Members including the Chair of the Public Accounts Committee. I am delighted that Members on both sides of the House, including Conservative Members, have now recognised and accepted the value of the Darzi report, which this Government commissioned.

We are committed to meeting a 2% productivity target by 2025-26. To help us to achieve that, there is a £2 billion investment in NHS technology, allocated to freeing up staff time, ensuring that trusts adopt electronic patient records—we have heard a great deal about old-fashioned paper today—and enhancing cyber-security measures, while also improving patient access to services via the NHS. The current measures of health productivity data do not capture all the outputs and outcomes adequately, and NHS England is working with the Office for National Statistics and the University of York to refine those metrics. Reform is at the heart of our 10-year plan.

We are rebuilding our capital-starved NHS through £1.6 billion of national capital funding in 2025-26, which will help us to achieve constitutional standards. The money will help to deliver more than 30,000 additional procedures and more than 1.25 million diagnostic tests as they come online through investment in new surgical hubs and diagnostic scanners, new beds across the estate, and a £70 million investment in new radiotherapy machines to improve cancer treatment. Questions have been asked about the shift from capital to revenue. Some of investment has met historic need, including capital funding for technology and new hospitals programmes, but because of the nature of the funding it needed to be defined as revenue. It is still being spent on those programmes. The autumn Budget included a commitment to ban shifting from capital to revenue, and I can confirm that no shifts of that nature have taken place since then. I will now give way.

Oral Answers to Questions

Layla Moran Excerpts

Tuesday 11th February 2025 Commons Chamber

[Mr Speaker]

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

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

I welcome the Under-Secretary of State for Health and Social Care, the hon. Member for West Lancashire (Ashley Dalton), to her place. I look forward to working with her, as I do with other Ministers.

As the Minister for Care will know, 20% of the burden on the NHS is due to mental health, yet only 10% of the budget is allocated towards it. The mental health investment standard has been a welcome maintenance under this Government. However, the Select Committee heard from Amanda Pritchard the other day that the standard is guaranteed for only the next two years. Does the Minister agree that the standard has had a positive effect on mental health community services, and would he commit to protecting it?

[Stephen Kinnock]

The Chair of the Committee will have seen that we have made an explicit commitment to the mental health investment standard—we are absolutely committed to that. In addition, we have to drive reform in the system so that it is about not just the amount of investment going in, but how we ensure that it is working properly. I am absolutely confident that the commitment to 8,500 new specialists, the Young Futures hubs and having a mental health specialist in every school will facilitate the delivery of services in a far more effective way than is currently the case.

Health and Social Care: Winter Update

Layla Moran Excerpts

Wednesday 15th January 2025 Commons Chamber

[Madam Deputy Speaker (Judith Cummins)]

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

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

May I press the Secretary of State on that data point? It is not just the Liberal Democrats making these representations; the Royal College of Nursing, the Royal College of Physicians, the Royal College of Emergency Medicine, HealthWatch, the British Medical Association, Age UK and many others also want the data. This matters, because the situation causes moral injury to staff and compromises patient safety—and the problem is not just corridor care; it encroaches on to other wards. Will the Secretary of State commit to releasing that data before the NHS England board meeting on 4 February? In addition, what assessment has he made of the impact of this winter on less urgent care, and on elective waiting lists?

[Wes Streeting]

I am grateful to the Chair of the Select Committee for her questions. I cannot give her a commitment to publish those statistics ahead of the next NHS England board, but I can give her an undertaking to go away and look carefully at the rhythm and pace at which we publish performance data, to make sure that we are being as transparent as we can, as fast as we can. That, I think, should be the principle that underpins our approach to the publication of data. She is right to talk about wider system pressures as a result of what we see in emergency departments. We will wait to review the performance of the NHS overall until we exit winter. I think we have seen some effective protection of elective activity throughout this winter, but that will of course vary from provider to provider.

The hon. Member mentioned a whole number of organisations calling for more data transparency. I, too, welcome the very public representations that we have heard from the Royal College of Emergency Medicine and others about the need to tackle corridor care. Let me assure her and all those who have made representations that we are absolutely determined to turn this situation around, and not just improve the performance of urgent and emergency care, but get a better system working. Ultimately, it is through ensuring better patient flows, and ensuring that people get the right care in the right place at the right time, that we will finally get this country out of the cycle, created by our Conservative predecessors, of winter crises.

Oral Answers to Questions

Layla Moran Excerpts

Tuesday 7th January 2025 Commons Chamber

[Mr Speaker]

I call the Chair of the Select Committee.

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

Following the theme raised by my hon. Friend and neighbour, the hon. Member for Bicester and Woodstock (Calum Miller), may I make a plea for Summertown health centre? They are my doctors, by the way, so I declare an interest. They operate in an old Victorian building and are desperate to move to new premises. That health centre was at the top of the priority list, but the ICB says that there is no money, and the doctors say that there is no pot that they can bid into in order to get this seen to. Will the Secretary of State meet me as well? Clearly, £102 million spread across 50 projects in the country is not going to be sufficient. Can we get creative about how we can get new premises built for Summertown health centre?

[Wes Streeting]

Of course I will meet the hon. Lady. It would be daft of me to say no to the Chair of the Select Committee; otherwise, she will see me in less pleasant circumstances. In all seriousness, we are looking creatively at this issue. There are enormous capital pressures right across the NHS estate. We are regularly lobbied on new hospitals, for example, but we are also lobbied on general practice, the mental health estate and the rest. We will do as much as we can as fast as we can, thinking creatively about how we can get more capital investment in, and I would be happy to discuss that further with the hon. Lady.