NHS 10-Year Plan

Roger Gale Excerpts

Thursday 3rd July 2025 Commons Chamber

[Wes Streeting]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Mr Deputy Speaker (Sir Roger Gale)]

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

[Paulette Hamilton (Birmingham Erdington) (Lab)]

As the acting Chair of the Health and Social Care Committee, I am delighted that the 10-year plan was finally launched today. I thank the Secretary of State for Health and Social Care for presenting it to the House.

The plan represents a major opportunity for constructive reform of the health and social care system, and I am delighted that the Secretary of State will come to the Committee on 14 July to be scrutinised on it. Many organisations have waited patiently for the 10-year plan to be published. Will the Secretary of State explain how the plan will help restore the promise of a first-class service in the NHS?

[Wes Streeting]

I thank my hon. Friend for her question and for the leadership she is showing to the Select Committee while the substantive Chair, the hon. Member for Oxford West and Abingdon (Layla Moran), is off on mat leave. What a delight it was to see the Committee Chair on the Terrace this week with her new baby. That was really delightful and we wish her well.

One of the exciting things for me about today’s launch is just how widespread the support has been from across a range of different organisations that we will need to work with to deliver the plan. Whether it is the royal colleges and the trade unions, the organisations that represent patients, the wide range of healthcare charities or, crucially, frontline staff, everyone is up for this change and everyone is desperate for it to succeed.

We will not get everything right and we will make mistakes along the way. We will listen and always learn and reflect. We know in the Government that we cannot do this without effective leadership from Ministers, but nor can Government do this alone. It is now our responsibility to mobilise the more than 1.5 million people who work in the NHS, the more than 1.5 million people who work in social care and our whole country behind a national mission to get our NHS back on its feet, to make sure it is fit for the future and to make sure, fundamentally, that we attack the injustices that lead to ill health, so that we have a fairer Britain where everyone lives well for longer.

[Mr Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

I thank the Secretary of State for early sight of the plan this morning. After years of Conservative failure, a plan for the future of the NHS is welcome and Liberal Democrats support the Secretary of State in his vision to shift the NHS to a community-focused, preventive service. However, I seek his reassurance on some questions.

In the 143 pages of the 10-year plan, there is only a passing reference to social care. Everyone knows that we cannot fix the NHS without fixing social care. With so many people unable to return home from hospital to get the care they need, solving the crisis in social care is a huge part of moving care out of hospital and into the community. Will the Secretary of State bring forward the Casey review, so that it reports in full this year, and reinstate the cross-party talks, so that consensus can be reached on the future of care?

I welcome the idea of a neighbourhood health centre, but how does that interact with the plan for GPs? The 10-year plan implies that GP contracts will encourage them to cover a huge geographic area of 50,000 people. In North Shropshire, that would be two or three market towns combined and would span dozens of miles. Can the Secretary of State reassure me that there will still be a physical health centre, accessible to all, and that in areas with little public transport in particular, people will be able to access care when they need it?

Finally, the plan hinges on the shift to digital solutions, and that is not without risk. The use of the NHS app is critical to what happens. How will the Secretary of State ensure that those without a smartphone—because they cannot afford one, do not feel confident using one or simply do not have adequate broadband or internet—can access the NHS? Many elderly and disabled people in particular who are digitally excluded will feel worried by today’s announcement.

[Several hon. Members rose—]

[Mr Deputy Speaker (Sir Roger Gale)]

Order. Some 60 Members wish to participate. Clearly, the statement will likely impact every constituency in the country, so I understand why so many hon. Members wish to question the Secretary of State. It is our intention to try to call everybody, but there is important business later that has to be reached. May I urge brevity on all Members, and short answers on the Secretary of State? Health Committee member Jen Craft will now set an example.

[Jen Craft (Thurrock) (Lab)]

Thank you, Mr Deputy Speaker. The heart, soul and lifeblood of our NHS are the people who work in it. I doubt there is anyone in this House who does not owe a personal debt of gratitude to a health care worker. Can the Secretary of State reassure me that the fingerprints of NHS workers are all over this 10-year plan, and that it has been designed and produced with all their valuable inputs?

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[Wes Streeting]

I strongly agree with my predecessor on that. It is important that the CQC’s reports and judgments can be understood by the public and the people responsible for carrying out the improvements that it recommends. Via the NHS app, we will have much more transparency for patients about the range of providers, the quality of services and the views of other patients. That will give patients the freedom to choose, in a more data-driven way, where and when they are treated. There is also the importance of data-driven face-to-face inspections by experts. We can also have early warning systems that would alert people who hold his office and mine that something is going seriously wrong, so that we can intervene before more lives are lost unnecessarily.

[Mr Deputy Speaker]

I call Select Committee member Josh Fenton-Glynn.

[Josh Fenton-Glynn (Calder Valley) (Lab)]

The shifts announced today, from analogue to digital, and from hospital to community, are exactly the shifts that will make the NHS stable for the future. Will the Secretary of State elaborate on the “analogue to digital” point? A practice manager in Calder Valley recently said to me, “It’s all very well looking at artificial intelligence, but it takes us half an hour to turn on a computer.” What more will he do to ensure that we improve the NHS digital offer for everyone working in the health service?

--- Later in debate ---

[Wes Streeting]

First, I thank the hon. Member for the Green party’s support for so much of the 10-year plan. She is right to highlight the importance of social care to resolving the NHS crisis. Let me reassure her that we are acting urgently as we await the first report of the Casey commission. The Chancellor did that with the Budget and the spending review, providing £4 billion more of investment. We have done that with the biggest increase in carer’s allowance since the 1970s, and with the disabled facilities grant, which does not just mean more ramps and home adaptations but more freedom, more dignity and more independence for disabled people. The Deputy Prime Minister and I will shortly set out how we will deliver fair pay agreements, and social care will absolutely be part of the neighbourhood health team. I hope that that reassures the hon. Member.

Let me also reassure parties across the House that we will wait for the Casey commission to launch. I would like to be able to proceed with the actions we will be taking in this Parliament and, crucially, with the long-term plan for social care in a cross-party way, to build that genuine national consensus—I would be delighted to achieve that.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the Chair of the Housing, Communities and Local Government Committee.

[Florence Eshalomi (Vauxhall and Camberwell Green) (Lab/Co-op)]

I thank the Secretary of State for this really ambitious and bold plan to make sure our NHS is fit for the future. He will be aware that Professor Ian Abbs, the chief executive of St Thomas’ hospital in my constituency, will step down later this year. I want to thank him for his dedication and compassion in leading St Thomas’, especially during the covid crisis, when the hospital cared for so many patients, including the then Prime Minister in his crucial hour.

The Secretary of State may be aware that Royal College of Nursing analysis shows that by 2029, 11,000 nurses may have left the profession after working less than 10 years in the service. Nurses cite exhaustion, mental health and stress as their reasons for leaving the profession. Can he give us an update on how we will ensure we have a workforce that is fit, so that we can achieve our ambitious 10-year plan for the NHS?

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[Mr Deputy Speaker (Sir Roger Gale)]

I call Warinder Juss—not here.

[Anna Dixon (Shipley) (Lab)]

I congratulate my right hon. Friend, his team and the amazing NHS staff on over-delivering on Labour’s promises, and for this amazing, ambitious 10-year plan that will ensure the NHS is fit for the future. I particularly welcome the “My Carer” feature on the NHS app that will allow family and unpaid carers to communicate with the care team for a loved one. Will my right hon. Friend explain how this plan will deliver benefits for disabled people and their carers?

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[Mr Deputy Speaker (Sir Roger Gale)]

Order. Some 20 Members are still seeking to ask questions, and we have an important debate to follow. The questions are getting longer, and so, I fear, Minister, are the answers. Can I urge brevity again, please?

[Jas Athwal (Ilford South) (Lab)]

I also thank my right hon. Friend the Secretary of State for a bold and ambitious plan. Over the past few months, I have had the privilege of connecting with some really inspiring people across my constituency, such as Jagdeep Aujla. His Dopamine Warriors boxing club, which the Secretary of State visited some weeks ago, sets a powerful example. Jagdeep’s boxing club offers a safe, empowering space for people living with Parkinson’s to connect with each other, maintain their fitness, and slow the progression of the condition. Will my right hon. Friend outline how the Government’s 10-year health plan will support the shift from hospital to community, so that more support is available on people’s doorsteps, particularly organisations such as the Dopamine Warriors?

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[Wes Streeting]

My hon. Friend is right that we need to not just treat sickness, but prevent illness. That was a strong message that we got from the public. He will see lots of good stuff on prevention in the plan, and I know that he will welcome it. On the location of the UK Health Security Agency, he may have inadvertently misled the House: he said he did not want to lobby me too much, but that is absolutely not true; he will not leave me alone on this issue. He lobbies me every single day. I can assure him we will make a decision on that issue shortly.

[Mr Deputy Speaker (Sir Roger Gale)]

I am sure that the hon. Member for Harlow will wish to correct the record.

[Matt Turmaine (Watford) (Lab)]

I welcome the 10-year plan, and I thank the Secretary of State for giving my constituents in Watford the opportunity to feed into it through the consultation. Does he agree that the Tories accepted decline in the NHS as inevitable, but it takes a Labour Government to get the NHS back on its feet?

--- Later in debate ---

[Wes Streeting]

I knew exactly where that question was going, because my hon. Friend has been such a strong champion of his constituency since he arrived in this place. I am committed to rolling out neighbourhood health across the country, and to making sure that we particularly benefit the communities with the greatest need that are the most poorly served. This is in no small part possible thanks to the leadership of the Chancellor of the Exchequer and the wise decisions that she has taken. Not only have we delivered investment in the NHS, but interest rates have fallen four times, wages are finally rising at a higher rate than the cost of living, and we have the fastest-growing economy in the G7. That is the leadership that we need from the Chancellor, and it is here to stay.

[Mr Deputy Speaker (Sir Roger Gale)]

Finally, and with thanks for his patience, I call Richard Baker.

[Richard Baker (Glenrothes and Mid Fife) (Lab)]

Thank you very much, Mr Deputy Speaker—persistence pays off.

Will my right hon. Friend assure me that he will report regularly to this House on progress against this excellent plan? I hope that will help us to evidence the case for investment in community health facilities in Scotland, which have long been promised but not been delivered by the SNP, including the much-needed new health centre in Lochgelly in my constituency.

[Wes Streeting]

I can absolutely give my hon. Friend that assurance. I just feel so sorry for him, because he comes here to stand up for his constituents, knowing full well that while they have a Labour Government who are delivering the biggest increase in investment to the devolved Administrations since devolution began, the SNP, which has been in government for almost two decades, is squandering the money and the opportunity. People will not get change in his constituency, or across the rest of Scotland, if they face more of the same from the SNP. Scotland needs an alternative, and Scotland’s NHS needs an alternative. That alternative is Scottish Labour and the leadership of Anas Sarwar and Jackie Baillie, and it cannot come soon enough.

[Mr Deputy Speaker (Sir Roger Gale)]

May I thank the Secretary of State for answering in excess of 65 questions, and the shadow Secretary of State for being in attendance throughout the entire proceedings?

Haemochromatosis Screening

Roger Gale Excerpts

Wednesday 25th June 2025 Commons Chamber

[Torcuil Crichton]

I will.

[Mr Deputy Speaker (Sir Roger Gale)]

Briefly, Mr Shannon.

[Jim Shannon]

I will be brief, Mr Deputy Speaker. I am descended from the Stewarts of the lowlands of Scotland, and I am probably the hon. Gentleman’s Gaelic cousin. This screening needs to be carried out in Northern Ireland as well as Scotland.

Department of Health and Social Care

Roger Gale Excerpts

Tuesday 24th June 2025 Commons Chamber

(3) a further sum, not exceeding £116,089,479,000, be granted to His Majesty to be issued by the Treasury out of the Consolidated Fund and applied for expenditure on the use of resources authorised by Parliament.—(Keir Mather.)

[Mr Deputy Speaker (Sir Roger Gale)]

The debate will be opened by a member of the Health and Social Care Committee, Paulette Hamilton.

--- Later in debate ---

[Several hon. Members rose—]

[Mr Deputy Speaker (Sir Roger Gale)]

Order. It will not have escaped Members’ notice that we are playing “beat the clock” this afternoon. There is another debate to follow, with a very large number of speakers, and we are going to have to try and split the time between two debates. That means two things. First, after the next speaker I will impose a limit of three minutes on every speaker. The Liberal Democrat Front Bencher has agreed to cut her speech to six minutes and the other two Front Benchers have agreed to cut theirs to eight minutes, with no interventions. Secondly, it is up to Members, but if they intervene, we will not get through this, or else some Members will not be called—and it may be that Members who have spoken in earlier debates will not be called at all.

Incontinence

Roger Gale Excerpts

Thursday 19th June 2025 Commons Chamber

[Several hon. Members rose—]

[Mr Deputy Speaker (Sir Roger Gale)]

Order. A significant number of Members want to take part in the following debate, so we are playing “beat the clock”. I will not introduce a rigid time limit at this stage, but if Members could confine their speeches to no more than six minutes, we should get everybody in, get the Front Benchers in and give adequate time for the next debate.

--- Later in debate ---

[Dr Sullivan]

I agree. The community toilet scheme in Gravesham has been a good success. However, the issue of course comes down to vandalism. Councils cannot see this as an easy way to cut money. It needs to be a statutory duty, so I support the bid of my hon. Friend the Member for Penrith and Solway to make it a statutory duty to provide public toilets in those spaces.

No one deserves to be lonely or locked in at home, so I hope that this debate is the first step to opening the door. I again thank my hon. Friend the Member for Dudley for bringing this issue to the attention of the world.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

It is a pleasure to see you back in the Chair, Mr Deputy Speaker. I thank the hon. Member for Dudley (Sonia Kumar) for securing this important debate and for outlining the issues so well in her opening speech, particularly the importance of breaking down the taboos surrounding incontinence and the social isolation that can result from it. I have carefully scribbled out the term “incontinence” all the way through my speech and hopefully replaced it with “bladder and bowel control issues”—forgive me if I have missed one.

I recognise the importance of prevention and specialist treatment. The hon. Member for Dudley highlighted the benefit to both individuals and taxpayers from investing in women’s health up front, and I echo that call. There have been lots of excellent contributions, but I thank the hon. Member for Wolverhampton West (Warinder Juss) for raising the scandal of pelvic mesh implants. I thank him for highlighting that issue and the need for redress there.

Incontinence, or bladder and bowel control issues, can have a hugely detrimental impact on a person’s wellbeing and sense of dignity, as we have heard. Despite affecting millions of people across the UK, it is the subject of stigma, and the needs of those with bladder and bowel control issues are not properly considered in many aspects of life. All too often, people suffering from these issues are left without the right support, whether that is the uncomfortable bladder pressure tests that the hon. Member for Gravesham (Dr Sullivan) referred to, or the lack of access to sanitary bins in public and workplace toilets.

It has been widely assumed for many years that sanitary bins for men are not required in public toilet facilities. As we have heard, many millions of men are affected by bladder and bowel control issues. The absence of sanitary bins has a wholly unnecessary and damaging impact on their self-esteem, causing embarrassment and stress and, as we have heard, withdrawal from public places and the workplace. The cost is tiny but the benefits for those affected can be significant.

There has been progress in this area, thanks to the work of campaigns such as Boys Need Bins by Prostate Cancer UK, but there is much further to go. That is why it is crucial that we support all individuals with the condition by ensuring access to services such as public toilets and sanitary bins, as unfortunately that is not the case. Under the last Government, 19% of public toilet facilities—nearly 600—lost their local authority maintenance and funding between 2015 and 2021 alone. Liberal Democrat research from 45 councils found that the number of public toilets had fallen by 14% from 2018-19 to 2023.

Many local authorities are on the verge of bankruptcy and do not have the spare capacity for these vital services. Proper funding of local authorities to provide services such as public toilets and sanitary bins could make a truly meaningful difference for people with bladder and bowel control issues, and I hope the whole House will agree that these individuals deserve access to basic facilities.

There is also a clear need for more research into developing better treatments and mitigations for people suffering from bladder and bowel control issues. Crucially, these should avoid unnecessary discomfort or invasive procedures. As such, I support what the hon. Member for Gravesham has said. The University of Aberdeen has found that women with ongoing urinary incontinence can avoid invasive bladder pressure tests, and that non-invasive assessments work just as well in guiding treatment. An emphasis on respecting people’s dignity and reducing discomfort should be at the heart of how we approach the testing, treatment and mitigation of these issues.

We also know that these issues—particularly bowel incontinence—can place a significant strain on family carers carrying out personal care, who are often under-supported and suffer from ill health themselves. Many care requests go unmet; last year, the King’s Fund estimated that nearly a third of requests for local government funding result in no support for care at home. This means that there are many thousands of families struggling with the realities of caring for a loved one with bladder and bowel control issues, which can include not only feelings of shame and embarrassment —both for them and for their loved one—but difficulty with lifting and moving a family member to clean them, and in accessing the equipment necessary to cope. That is why dealing with the crisis in social care should be a top priority for the Government.

When the Secretary of State phoned me—and, presumably, the other national party health spokespeople —over the Christmas break to let me know that he was instigating the Casey review and cross-party talks to find a long-term solution to that crisis, I was hugely encouraged. Since then, the Casey review has been delayed, and the cross-party talks have apparently been cancelled. I must stress that each party giving its view to Baroness Casey is not the same as sitting in the same room and agreeing a long-term funding plan. The review’s terms of reference will not deliver meaningful reform until the next Parliament, and there is a huge risk that, again, nothing will be done by the Government of the day—in this case, despite them having a huge majority to achieve whatever they want. Meanwhile, the number of people needing care increases every year, and the step change required to transform the sector becomes larger and less politically palatable. As such, I urge the Minister to speak to the Secretary of State and help him to recover the enthusiasm for change that he showed over Christmas, because he will have my full support.

However, there are simple steps that can make a difference now, such as hospitals working with family carers ahead of discharge to ensure that they are equipped to carry out heightened personal care needs. In many places, that support is not delivered, let alone ongoing support and meaningful respite care. Wait times for a continence assessment vary across the country—it can take weeks and weeks. Improving those wait times would ensure that the right care and equipment is available much sooner. There is also a chronic shortage of speech and language therapists, who can make a real difference in helping people with limited or no speech to more easily communicate when they need the toilet or want to be changed or washed. That is particularly essential in cases in which those people suffer from bladder and bowel control issues.

Incontinence is not properly reflected in how we organise paid social care. For instance, too often the pay for domiciliary carers and the time they are expected to care for any one person do not reflect the fact that someone’s need for care might vary hugely from day to day. Any embarrassment, frustration and discomfort for the person being cared for will only be made worse if their carers are rushed, stressed and overworked, and if spending longer at one house could mean that those carers are effectively having to work for free.

I also want to highlight the importance of good care in hospital settings. NHS England’s 2018 “Excellence in Continence Care” guidance states that

“pathways of care should be commissioned that ensure early assessment, effective management of incontinence, along with other bladder and bowel problems such as constipation and urinary tract infections and their impact on social, physical and mental well-being”.

I highlight this because my constituent Trevor Collins died on 21 May 2022 as a result of aspiration pneumonia and small bowel ileus, due to a small bowel obstruction caused by constipation. The coroner concluded that neglect at Royal Shrewsbury hospital and a failure to manage Mr Collins’ constipation contributed to his avoidable death. It is essential that healthcare settings follow the NICE guidelines that are in place, not only to preserve dignity but to prevent serious harm and—in the worst cases—even death.

Liberal Democrats recognise the seriousness of the issues surrounding all types of incontinence and bladder and bowel control issues, and the critical importance of ensuring that people with those conditions can live in dignity. The Minister will have heard the calls in my speech. I hope she will commit to repairing our broken social care system, reinstating cross-party talks and wrapping up the Casey review this year, so that we can make the reforms that are necessary for long-term stability in the sector and the dignity of all those receiving and providing care.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the Opposition Front Bencher.

Oral Answers to Questions

Roger Gale Excerpts

Tuesday 25th March 2025 Commons Chamber

[Stephen Kinnock]

As my hon. Friend says, we are delivering 700,000 additional urgent appointments. Patients are not limited to a registered practice in England, and practices are required to keep their status up to date on the NHS website. Anyone struggling to find a dentist should go to nhs.uk or call 111. It is also clear that while NHS England is not mandating an approach to the purchasing of these additional appointments, ICBs could consider either buying more appointments through new or recommissioned contracts or modifying existing contracts, and/or using flexible commissioning.

[Sir Roger Gale (Herne Bay and Sandwich) (Con)]

The Minister is aware of my concern about the inability of some 200 fully qualified Ukrainian dentists to practise because of the restrictions placed on them by the General Dental Council. I know that the Minister has written to the GDC about this, but has he received a reply?

[Stephen Kinnock]

I thank the right hon. Gentleman for the constructive meeting and discussion that we had on this matter. As he will know, we are exploring the use of provisional registration for overseas dentists, and we are urging the GDC to arrange more examinations for dentists. I have a meeting set up in short order with the head of the GDC, and I will keep the right hon. Gentleman posted on that conversation.

New Hospital Programme Review

Roger Gale Excerpts

Monday 20th January 2025 Commons Chamber

[Wes Streeting]

We keep a regular eye on the capital needs of the NHS across the board. Subject to the usual constraints on resources, supply chain construction industry capacity and so on, we will continue to do so. We are determined not to repeat the mistakes of our predecessors, but to ensure that the promises we make are promises we can keep.

[Sir Roger Gale (Herne Bay and Sandwich) (Con)]

Before the general election was called, there was a clear indication from the Government that they intended to fund the—only—£25 million reconstruction of the maternity unit at the QEQM hospital in Margate, which emerged from the Bill Kirkup report. I will be grateful if the Secretary of State can tell me whether it is his intention to ensure that that funding is made available.

The right hon. Gentleman referred to the number of houses that the Secretary of State for Housing, Communities and Local Government is determined to see built. Could he explain, for the sake of East Kent, how the primary and secondary healthcare services will be provided to meet the needs of the people who will live in those houses?

[Wes Streeting]

I am very aware of the challenges in East Kent and the challenges of providing good-quality care and the facilities that people need. I am sure that Ministers will be happy to receive representations from the right hon. Gentleman.

The right hon. Gentleman asks about the Government’s commitment to building 1.5 million more homes. Let me reassure him and the House that the Deputy Prime Minister and I, as well as other members of the Cabinet, are discussing very carefully how we can make sure that alongside the new homes that our country needs, we have the infrastructure and the public services that people deserve.

National Insurance Contributions: Healthcare

Roger Gale Excerpts

Thursday 14th November 2024 Commons Chamber

[Karin Smyth]

My hon. Friend is right: getting away from short-term fixes and sticking plasters is exactly what we are attempting to do. That is why we put in the extra security of extra GPs over the summer, committed to extra funding in the Budget, and launched our 10-year plan. I encourage all hon. Members and their constituents to submit their views to that exercise at change.nhs.uk.

[Sir Roger Gale (Herne Bay and Sandwich) (Con)]

Dr Aleksandra Fox of the Ash surgery in my constituency is one of a number of GPs who have pointed out to me the deleterious effects of an ill-thought-through Budget. In addition, charities such as Shooting Star and Demelza children’s hospices are facing problems now. They cannot wait for discussions through the normal channels while this cock-up is put right. When will something be done about it, please?

[Karin Smyth]

The right hon. Gentleman says that it is an ill-thought-through Budget. I do not know whether he agrees or disagrees with the extra funding that the Government have committed to the NHS after the disaster of the last 14 years.

Cancer Strategy for England

Roger Gale Excerpts

Thursday 31st October 2024 Westminster Hall

[Sir Roger Gale (Herne Bay and Sandwich) (Con)]

I do not want to go down the road of party politics. The previous Government poured shedloads of money into the national health service, but throwing money at the problem is not the answer. I am not saying that there is not any demand for more capital expenditure—there is—but that is not the point. Unless we get the structure right, we will go on wasting more and more money. We need to be grown up about this; we must all understand that.

In the few minutes I have, I want to concentrate on an issue that the hon. Member for Wokingham (Clive Jones) touched on, but only briefly: the incidence of cancer in young people. It is many years since my eldest son used his wedding—and probably his bride too—to raise money for the Teenage Cancer Trust. In the time between then and now, sadly not a very great deal has changed. That is lamentable. The point was made that, every day, seven young people between their teenage years and their mid-20s are diagnosed with cancer. By the end of this decade, that figure is likely to have risen to 10 per day.

Most of us in the Chamber probably have family members who have had experience of cancer—or even have personal experience, as the hon. Member for Wokingham clearly has. We all know somebody who has had cancer, and sadly some of us know, only too well, people who have died of cancer. But the instances of cancer among young people are widely disregarded and neglected within the health service and beyond. It is not infrequent for a young person, subsequently diagnosed, to have to make at least three visits to a general practitioner before even being referred, because it is assumed, completely wrongly, that cancer is something that affects old people—people like me. I am expected to get cancer, but young people do not get it, do they? Well, sadly, yes they do, at a rate of seven a day, rising to 10 a day by the end of the decade.

My plea is for the Minister to take away this message: however much money is being pumped into the health service and being made available for investment in diagnostic kit, there is a real need to address one area of the population that has been neglected. That area is teenage cancer victims. It is the largest single killer of young people in this country—bar none—yet young people are overlooked when it comes to clinical trials that could be lifesaving. There is a real reason why young people as a proportion of the population should be included in clinical trials, but they are not—they are overlooked. Why? Because there is the assumption that it is not a disease that affects young people. But it does.

I make my plea on behalf of those in my family who support the Teenage Cancer Trust, and those in the Teenage Cancer Trust who have taken the trouble to brief Members of Parliament. I ram home this message to the Minister and ask him to take it away to the Secretary of State: when we set up, as I am sure we will, a national cancer strategy, the Government must make certain that the 13-to-25 age group is given the recognition it deserves, so that they get the diagnoses in time, before they die, and the treatment they need, and so they are included in clinical trials.

[Mr Clive Betts (in the Chair)]

I call Noah Law.