NHS Winter Update

Victoria Atkins Excerpts

Monday 8th January 2024 Commons Chamber

[The Secretary of State for Health and Social Care (Victoria Atkins)]

With permission, Mr Deputy Speaker, I would like to make a statement on the winter pressures facing the national health service and social care, as well as the impact of the ongoing junior doctors’ strikes. The NHS employs 1.3 million people and the social care system a further 1.5 million people. Together, they treat and care for tens of millions of people every day. We all know that winter is the most challenging time of the year for the NHS and social care, as our workforce have to tackle the pressures created by cold weather and seasonal viruses.

To put our health and social care system in a strong position heading into winter, this year we started preparing earlier than ever before. In January last year, we published our recovery plan for urgent and emergency care and provided £1 billion of dedicated funding to boost emergency capacity. The plan committed to delivering 5,000 new permanent staffed beds. I am pleased to update the House that more than 3,000 were already in place in December, and in the coming weeks NHS England will meet the 5,000 pledge and make sure that it has almost 100,000 core beds ready when covid and flu peak.

Our recovery plan also pledged 10,000 virtual ward beds so that more patients can be monitored safely at home, away from hospital. I am pleased to update the House that we have delivered more than 11,000 virtual ward beds, and they have been a vital service for eligible patients over the festive period.

We have boosted our ambulance service with £200 million of additional funding, putting new vehicles on the road, improving response times and getting crews out and about for more hours. In recognition of the importance of patients being discharged promptly from hospital when it is safe to do so, we have made sure that every acute hospital in England has access to a care transfer hub, bringing together teams from the NHS and social care to speed up discharge, backed by an extra £600 million for social care. To help prevent the spread of winter viruses, we brought forward flu and covid vaccinations, protecting the most vulnerable and making them less likely to require hospital treatment.

But no matter how thorough our preparations are, winter will always be the most challenging time of the year for our NHS. That is why it is extremely regrettable that the British Medical Association’s junior doctors committee has chosen to strike not once, but twice at this time of year. It has also chosen to strike for an unprecedented length of time, putting profound pressure on hospitals and GP surgeries throughout the country.

Before Christmas, the BMA’s strike caused the cancellation of almost 90,000 appointments, some of which will have to be rescheduled for a second or even third time. That is in addition to the 1.1 million appointments that have already been affected since strikes began in December 2022. This is not just another statistic; there is a person behind every one of these appointments, who may be in pain or distress and who now must wait longer for the care they deserve.

Last week, a member of the BMA leadership said

“strike action benefits absolutely nobody.”

They were absolutely right on that. The ongoing strikes are causing more appointments to be cancelled and more worry for patients, and are putting a significant strain on staff.

During December’s and this week’s strikes, the NHS’s priority has been to protect patient safety. Resources have been channelled into urgent and emergency care, including vital neonatal and maternity services. Huge efforts were made to make the most of the working days between Christmas and new year, because throughout any strike action, it is crucial that every patient who needs urgent medical care comes forward as normal. We continue to face challenges, and strikes have stretched emergency care, but thanks to the meticulous hard work in local trusts in preparing for strikes, as well as to the huge personal sacrifices that clinicians and staff are making to pick up the slack, emergency care has largely held up and the system has coped under the circumstances.

Staff across the NHS deserve our sincerest thanks for the heroic efforts they have made throughout the unprecedented strikes. I thank the doctors, nurses, paramedics and all frontline staff who have come into work to support each other, deliver care and protect patients; the consultants, including Members of this House, who are working extra hours, cancelling their holidays or even coming out of retirement to safeguard patient safety; the managers, administrators and NHS leaders who are working day and night to make sure that the right staff are in the right place to protect patient safety; and all those working in social care, from local authority staff to care workers and carers, who have rallied round to support hospitals.

I know that work does not stop when the strikes stop. NHS staff will begin turning their attention to recovering from the impact of the industrial action, restarting elective treatment and improving the flow of patients through emergency departments. The junior doctors committee’s choice to strike at this time of year means that that work must now be done under additional pressures, as staff move to catch up from industrial action as well as tackling the impacts of cold weather, covid, flu and norovirus.

I want to find fair and reasonable solutions to industrial action. One of my first acts as Health and Social Care Secretary was to bring in the British Medical Association for talks to end these long-running disputes, as well as meeting representatives for Agenda for Change unions who speak for frontline staff, including nurses. We have reached agreements with unions that represent consultants and specialty doctors on offers to be put to their members. Those offers will modernise contracts, realign pay scales and improve doctors’ career progression, while delivering value for the taxpayer and protecting the hard-won progress we have made to halve inflation. Consultants and specialty doctors are pausing strike action while members vote on the offers, with the results of both ballots expected shortly. The Government and BMA agree that they are the best deals available to us, and I very much hope that members will vote in favour so that those positive changes can be made and we can move the NHS forward.

On junior doctor negotiations, the talks that began in November had been progressing with the BMA junior doctors committee. The talks were constructive, exploring a range of proposals that would improve the working lives of doctors across the NHS. I was therefore extremely disappointed when the BMA turned its back on the negotiations before they had concluded to call the damaging strikes that we face today. The Government will not negotiate with the BMA while strike action is under way and patient safety is at risk. Every strike is hugely disruptive for our NHS. The NHS and patient safety cannot be switched on and off on a whim. I do not believe it right to negotiate with unions while they are being unreasonable and some of their members are walking out of hospitals at the busiest and most challenging time of year for patients.

I remind the House that the junior doctors committee’s headline demand of a 35% pay rise is simply unaffordable for taxpayers. Last summer, we accepted the recommendations of the independent pay review body in full. That meant that junior doctors received average pay rises of almost 9% in their September pay packets—some of the most generous increases across the entire public sector. Meeting the 35% demand would stoke inflation just as we as a country have halved it, burning a hole in the pockets of families up and down the country, and it would be totally out of step with the pay rises awarded to other dedicated public servants and employees throughout the private sector. Staff across the public sector have agreed fair and reasonable deals on pay; only the junior doctors committee has repeatedly walked away from talks.

Let me address the issue of NHS leaders asking some junior doctors to return to work when patient safety is at risk, in what are known as patient safety mitigations or derogations. As of 9.30 this morning, 40 patient safety mitigations have been submitted during the current round of strikes, and two have been accepted by the BMA. NHS leaders, many of whom are themselves members of the BMA, have decades of combined experience. They know their patients and they know their rotas, and they would ask for mitigations only if they were absolutely necessary—in, for example, a children’s emergency department. They are wholly independent of Government: it is for them to make those decisions. I trust them and I trust their judgment. That is the reality, and that is the truth about patient safety mitigations.

One of the reasons why I came into politics was the NHS and what it had done for me and my family. That is also one of the reasons why I am a Conservative. This is a Government who have delivered record NHS funding, the first ever NHS long-term workforce plan, and 50,000 more nurses for our NHS. We are providing the NHS with the doctors it needs for the future by doubling the number of medical school places, opening five new medical schools and pioneering one of the world’s first medical apprenticeships. We have also supported doctors by making changes to pensions for those at the very top of their career path—at that point, that was the BMA’s No. 1 ask, and a policy that the Opposition seemed to oppose.

Those are not the actions of a Government who are turning their back on the NHS, as some have declared. They are the actions of a Government who are building a health and social care system that is sustainable for the long term. To do that, we must put the strikes behind us and move forward together, because the NHS belongs not just to the junior doctors committee: it belongs to us all. It belongs to the millions of people who rely on its being there when they need care, as well as the millions of taxpayers who pay for it. For their benefit, it is time for the members of the junior doctors committee to show that they are serious about doing a deal. They have legitimate concerns about their working lives, and a fair and reasonable deal can be reached, but calling damaging strikes is not the way in which to achieve that. Earlier this week I said that if they called off their damaging strike action, I would get round the table with them in 20 minutes. I am, of course, extremely disappointed that they refused my offer, and continue to refuse it—the strikes are ongoing as we speak—but if they come to the negotiating table with reasonable expectations, I will sit down with them.

This Government have a clear, long-term plan for the NHS. Our recovery plans in elective, emergency and primary care can improve access to treatment, transform services, and give patients more choice in and control over their care. Our long-term workforce plan will give the NHS the staff it needs to thrive for decades to come, our social care reforms will build a better care workforce to support our growing number of older people, and by creating the first smoke-free generation we will reduce long-term pressure on our health service. We have eliminated the longest waits, but we have not yet made a significant enough reduction in waiting lists. To do that, we need the junior doctors committee to come to the table and do a deal that is in the interests of patients, in the interests of our NHS, and in the national interest. Then we can build an NHS that is not only stronger today, but stronger for our children and grandchildren.

I commend this statement to the House.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the shadow Secretary of State.

--- Later in debate ---

[Wes Streeting]

Patients are sick and tired of waiting—waiting for ambulances, waiting for a GP appointment, waiting for their operation and waiting for a general election that cannot come soon enough. Why do the Conservatives not get out of the way and let Labour fix the mess they have made?

[Victoria Atkins]

I welcome the hon. Gentleman back from his world tour promoting his book. It is very nice to meet him for the first time across the Dispatch Box. While he was away in sunnier climes, he may have missed what is actually happening in Wales, which interestingly has been described by the Leader of the Opposition as the “blueprint” for how Labour will run the NHS, were it ever to come into government. Interestingly, in the Labour-run Welsh NHS, people are almost twice as likely to be waiting for treatment, and they are waiting an average of five weeks longer for NHS treatment under Labour in Wales than they do in England. Indeed, the number of patients in Wales seeking treatment in England has increased by 40% in two years because of the experiences that people are having in Wales.

I will just correct the hon. Gentleman on a couple of other things, too. Just to help him understand, we are delivering the 800 new ambulances—those are new ambulances—at pace at the request of the NHS, just as we are putting in 5,000 extra beds in hospitals across England, because we understand the point about capacity and we want to help the NHS look after people in a timely and efficient manner.

I will also just correct him again on the doctors in training point. I am surprised he has come on to that at this point, but had he spoken to his friends in the BMA, he would have understood that that is the phrase that the BMA is using. It has passed a motion to stop using the phrase “junior doctors”. [Interruption.] Yes, the BMA passed a motion. The hon. Gentleman referred to doctors, but he perhaps does not understand the complexities of contractual negotiations. The phrasing is used to denote those professionals who are still on formal training pathways who are not specialty doctors or consultants. That terminology has been agreed with the BMA.

In terms of the strikes themselves, I note—I know that those sat behind me on the Government Benches noted it, too—that the hon. Gentleman did not condemn the strikes. I am happy to give way, if he would like to confirm whether he condemns the strikes. Unfortunately, he has missed his chance to do so, but I suspect that everybody, including the patients at home waiting for appointments, will see the Labour shadow Minister’s failure to condemn these strikes. That is because, in line with public sector strikes more generally, the Labour movement will always prioritise union harmony over patient safety. That is not what we as Conservatives do; we will always put patient safety first.

[Mr Deputy Speaker (Sir Roger Gale)]

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

[Steve Brine (Winchester) (Con)]

Happy new year. The Secretary of State will know that it is far from all doctors in training who have taken part in this strike. In my trust, Hampshire Hospitals, it was just over 60%, and the average across the south-east was little more than 50%. Many doctors were hard at work this past week caring for their patients. Does my right hon. Friend share the concern of many in the health service that the longer this dispute drags on, the more we lose the good will of the consultants who have been filling in and the more we do serious damage to the career pipeline that sees today’s doctors in training become tomorrow’s consultants?

[Victoria Atkins]

I thank my hon. Friend for asking that question and for noting the enormous efforts that clinicians across the NHS have gone to in order to cover these strikes. We are conscious of the personal impacts that has had for many, and clinicians have had a very tough few Christmases. We were all collectively hoping that this Christmas would be just a little bit easier for them, but sadly these strikes have a real impact on people who are working to pick up the slack from junior doctors not turning up. I am grateful to everyone who has gone into work, who has worked extra shifts and who has cancelled time off with their families. We must find a fair and reasonable solution to this industrial action, which is precisely why I was so very disappointed that the BMA junior doctors committee chose to walk away from these discussions.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the Scottish National party spokesperson.

[Amy Callaghan (East Dunbartonshire) (SNP)]

A very happy new year to you, Mr Deputy Speaker. Our NHS faces an unprecedented winter of pressure, with inflationary costs, increasing viral infections and staff shortages. While the SNP Scottish Government have acted with £300 million to cut waiting lists and negotiated with NHS staff, preventing even a day of strike action, NHS England is undergoing a junior doctors strike—the longest in the history of any NHS in the UK. No one wants strike action, but it works, which is exactly why the Tories want to ban it. In fact, this Tory Government appear to be working to make this winter harder by cutting NHS capital funding, undercutting attempts to recruit new staff and not getting round the table with trade unions, instead blaming the BMA and junior doctors. Is the decision to underpay NHS staff and stoke strikes the policy of this Health Secretary, or is she being forced down that path by a Chancellor who is continuing his decade-long war on junior doctors?

[Victoria Atkins]

I imagine that the hon. Lady has seen that we accepted in full the pay review body’s recommendations last year and, as of September, junior doctors and doctors in training have received on average an 8.8% increase on their basic salaries—they also earn money on top for antisocial hours, working overtime and so on. In addition, they have pension contributions of some 20%, which is a rare employment benefit across both the public and private sectors. In the future, I want to find a fair and reasonable settlement with the junior doctors, as we have been able to reach with consultants and specialty doctors, but we cannot do that if junior doctors are on strike. That is why it is so very disappointing that they walked away from the discussions.

[Mr Deputy Speaker]

I am sure that we all wish to welcome Sir David Evennett back to the House in rude health.

[Sir David Evennett (Bexleyheath and Crayford) (Con)]

Thank you, Mr Deputy Speaker. I welcome my right hon. Friend’s factual statement on the state of the NHS in her winter update. Will she confirm that she would return to the negotiating table immediately were the BMA to call off these very damaging strikes?

[Victoria Atkins]

I welcome my right hon. Friend back. I have said throughout this that I was extremely disappointed that the committee chose to walk away from discussions. I also think that there is a lot more to discuss apart from pay—I have made it clear that I would like to look at other aspects of their working conditions—but, unfortunately, the junior doctors committee walked out. The strike action has had a real-terms impact on patients. We need to find a fair and reasonable solution, but I will not do that while the junior doctors committee maintains strikes. It will have to come to the table with reasonable expectations and change their minds on the validity of strike action.

[Rachael Maskell (York Central) (Lab/Co-op)]

We have had 14 Tory winters. One would have thought that they would learn by now that the real crisis in our NHS is that social care is not up to scratch. A quarter of patients in my local hospital are waiting for social care. As a result of jamming the back door, the front door becomes inaccessible to so many patients. After all these years, when will the Secretary of State publish a proper plan for social care, or will she leave it to my right hon. Friend to take over?

[Victoria Atkins]

I am so sorry, I do not know who the hon. Lady is referring to. On the Conservatives’ plans, at the 2022 autumn statement we announced up to £7.5 billion of additional funding—an historic increase—and we did not stop there. This summer, we announced an additional £600 million, which brings it up to £8.1 billion of additional funding over two years. That will support our care workforce, and the majority of the funding will end up in the pockets of the amazing people who provide care and support to the patients we are all concerned about.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I declare my interest as a member of the BMA and an NHS consultant who has worked during the industrial action. Let us make no mistake that these strikes are causing suffering to patients, both adults and children. The derogation process has not worked because, as the Secretary of State said, the BMA has not returned junior doctors to work when they have been asked to—where there has been a risk of dangerous harm to patients. The first duty of any Government is to protect their citizens, so when will the Secretary of State bring forward the minimum service levels to protect patients from these dangerous strikes?

[Victoria Atkins]

First, I sincerely thank my hon. Friend. I was in contact with her over the weekend when she had come off a very long shift in emergency care, looking after patients locally. I have nothing but admiration for her and the many, many other people who stepped in at short notice to cover urgent and emergency care in our NHS during the strikes. On minimum service levels, she will know that we have already introduced them for ambulance services—something that was opposed by the Labour party—but we have just closed the consultation on minimum service levels in hospitals and we are, of course, carefully analysing the responses. Again, the point that 40—four zero—patient safety mitigations were made by NHS leaders yet only two were granted by the BMA, is very, very worrying when it comes to how seriously the BMA is taking concerns about patient safety.

[Daisy Cooper (St Albans) (LD)]

A few weeks before Christmas, NHS bosses were here in Parliament briefing MPs that, notwithstanding their preparation for the winter crisis, the one thing that would push them to the brink would be a rise in respiratory illness. Now here we are: cases of flu, covid, RSV—respiratory syncytial virus —and whooping cough are all rising rapidly. A strong public health intervention by the Government could have prevented that from happening. When will the Government get serious about public health interventions such as vaccine uptake, air filtration and protecting the immune compromised to stop people getting so ill so often for so long?

[Victoria Atkins]

I thank the hon. Lady for re-emphasising the critical timing of the strike actions and the impact it has on patients. We know that winter is difficult. It is not just difficult for our healthcare system. Around the world, when cold winter strikes, it has physiological impacts on people with underlying health conditions. We also have a rise in infectious conditions, too. As she will appreciate, that is precisely why, on the advice of clinicians, we brought forward the flu and covid vaccination programme to try to protect the most vulnerable in our society. But again, the timing of the strikes is so very cynical, because their impact and tail will, I am sorry to say, have consequences beyond tomorrow’s stop date.

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

I was really concerned when my right hon. Friend mentioned the number of requests made to the BMA for certain duties in hospitals and that only two had been responded to positively. That is really concerning for patients. Contrast that with the behaviour of Nick Hulme, the acting chief executive at Norfolk and Norwich University Hospital, who has transformed its A&E in terms of waiting times. We need to promote such leaders, but we also need to unreservedly condemn the actions of the BMA junior doctors committee and get the strikes over and done with.

[Victoria Atkins]

I thank my right hon. Friend for her work in the Department. She knows only too well the difference an inspirational leader can make to a local NHS trust, and at regional or national level. Managers who are good and committed to their local area, who work with their clinicians and other healthcare staff to try to look after patients all year round, have been put under the most enormous pressure over the last few weeks because of the strikes. I thank every single one of them for doing what they can to safeguard patient safety. As I say, I trust their judgment. If they have put patient safety mitigations in, it is because they consider, in their professional judgment, that they are needed.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

The public health director in Hull published her report recently. She talked about the double jeopardy that my constituents face: from the most disadvantaged communities, they have shorter lives in far poorer health. At the end of last year in A&E, patients were less likely to be treated within the four-hour target than anywhere else in England. Why is that after 14 years of a Conservative Government who are committed, apparently, to levelling up?

[Victoria Atkins]

I am extremely grateful to the right hon. Lady, who will know that our constituencies, albeit not necessarily in the same region, nevertheless share similarities, being relatively close to each other. The work and the progress made on urgent and emergency care is precisely because we were concerned about, for example, ambulance response times and hospital discharges. We worked with NHSE to bring together the urgent and emergency care plan and, for example, bring about 800 new ambulances on to our roads and about 5,000 more core beds into the NHS to try to address those needs. Unfortunately, the strike action that we have seen over recent days has very much militated against those efforts. We all accept that winter is a very difficult time for the NHS, and through the urgent and emergency care plan we have worked with NHSE to try to meet the demands that she so rightly puts forward.

[Mr Robin Walker (Worcester) (Con)]

I welcome the Secretary of State’s commitment to reaching a fair and reasonable solution to the strikes. Worcester went into this winter with the delivery of a new emergency department and was able to deliver 21 beds-worth of extra capacity over the winter, but I have heard from the hospital today that it is still facing intense pressure. Will the Secretary of State join me in paying tribute to the staff who are working around the clock to meet that pressure, and will she support the South Warwickshire University NHS foundation trust as it works to address some of the key transport bottlenecks on its site, in the interests of patients and staff alike?

[Victoria Atkins]

My hon. Friend sets out clearly the many pressures and factors at play in running emergency departments and hospitals at the best of times, when we are not in the middle of winter and facing the pressures that it always brings on the healthcare system. I thank not only staff in his trust, but staff throughout the country for the work they have done over recent weeks to support the NHS and to bring treatment to patients. We are working hand in glove with NHSE regional and local leaders to see whether there are practical measures that can be taken to improve the flow through hospitals.

[Tim Farron (Westmorland and Lonsdale) (LD)]

NHS winter pressures are having a huge impact on cancer surgery and other cancer interventions. In Cumbria, in the south of the county 25% of those with a cancer diagnosis are waiting more than two months for their first intervention, and in the north of the county 47% are waiting more than two months. We know that every month’s delay in treatment means a 10% reduction in people’s chances of surviving. Some 123 cancer operations have been cancelled in the last year in our area. One reason is the lack of investment by this Government, and their predecessors of all colours, in radiotherapy. Will the Secretary of State agree to meet me and Conservative and Labour members of the all-party parliamentary group for radiotherapy, which I chair, to look at solving the problem by investing in the kit that Britain desperately needs to save lives?

[Victoria Atkins]

I hope the hon. Gentleman will be interested to know that we have made cancer treatment waiting times a key focus of our elective recovery plan, which has been backed by an additional £8 billion in revenue funding across the spending review period. We have made progress by delivering record numbers of urgent cancer checks, with more than 2.9 million people seen in the 12 months to October last year. Of course there is more to do, and I would be very happy to meet him and colleagues across the House to discuss the practical ways by which treatment can reach our constituents. He will not be surprised to know that cancer is a priority not just for me personally, but for the Government as a whole.

[Will Quince (Colchester) (Con)]

I welcome my right hon. Friend’s statement; there is a lot in it to welcome, but I particularly welcome the additional 11,000 virtual ward beds. Hospital at home is hugely popular and we know it takes pressure off our hospital. I thank all of the clinicians who helped to make that possible. Can she confirm that it is her intention now to go further and roll it out to more hospitals and more specialties, so that more patients can recover at home?

[Victoria Atkins]

I thank my hon. Friend for all his work in making that happen. He worked very hard on virtual wards when he was a Health Minister, and they represent a real step change in how we treat people with long-term conditions who can be monitored safely at home. They mean that people do not have to spend time in hospital, with all the pressures that can mean for us as individuals. Importantly, that also frees up beds for other patients who need them. I am keen to roll the scheme out further. Indeed, we have not just met but exceeded our initial ambition, which is why I can confirm that we have delivered 11,000 places in the virtual bed ward category.

[Clive Efford (Eltham) (Lab)]

The BMA says that junior doctors’ pay has been cut in real terms by 26% through consistent below-inflation increases. If the Tories really cared about this strike and about the NHS, would they not have avoided creating the circumstances that made junior doctors so angry that they felt the need to go on strike? Does that not just show that you cannot trust the Tories with the NHS?

[Victoria Atkins]

The figure that the BMA relies on is in fact from 2008, when the Labour party was in government for the first two years. The BMA cites a 35% pay rise. Just to clarify, independent organisations such as Full Fact and the Institute for Government rely on the consumer prices index measure, which shows a difference of 11% to 16%. I am sure that the hon. Gentleman will take into account the fact that we have already given graduate doctors, in their first year out of medical school, a rise of 10.3%, and I was willing to negotiate further and consider additional settlements that are fair and reasonable to the taxpayer.

[Steve Double (St Austell and Newquay) (Con)]

Is the Health Secretary aware that the impact of these strikes on the Royal Cornwall Hospitals NHS Trust has seen more than 7,000 appointments and operations cancelled and several million pounds in extra costs to the trust—and that is before the most recent strikes. Does she share my concern that the junior doctors are pursuing an unreasonable pay demand and causing lasting damage to patients and the finances of the NHS?

[Victoria Atkins]

My hon. Friend is a brilliant advocate on the challenges facing his rural and coastal community. We all know that geography is a factor in the difficulties of delivering healthcare in his corner of England, but everything the trust and clinicians do is about trying to improve healthcare for his constituents. I cannot be the only one who felt uncomfortable at the image of some on the picket lines last week singing while our constituents were struggling with cancelled appointments and worried about urgent and emergency care times. I am very keen that we should reach fair and reasonable settlements with junior doctors, but in order for that to happen they must act reasonably, change their minds and call off the strikes.

[Sarah Edwards (Tamworth) (Lab)]

Recently, Tamworth had clarification that mental health provision at the George Bryan Centre would not be invested in. From now on, patients must travel to Stafford for crisis care. Labour has pledged to recruit 8,500 more staff for community-based talking therapies in order to reduce waiting times and crises. Why have the Government not put in place a plan to recruit more NHS mental health staff?

[Victoria Atkins]

We have—in the NHS long-term plan. We have set an ambition to grow the mental health workforce by an additional 27,000 staff between 2019-20 and 2023-24. That is in addition to the at least £2.3 billion of additional funding a year by March this year.

[Holly Mumby-Croft (Scunthorpe) (Con)]

We are delighted to have our new community diagnostic centre, and of course our new A&E, under way in Scunthorpe. However, my right hon. Friend will know that we are fighting incredibly hard to prevent the loss of some of our hospital services. Of the hundreds of local residents who responded to my survey, over 98% agreed with me that we must not lose those services. Does my right hon. Friend agree that, in order for the NHS to provide resilience during the winter and the services that it wishes to provide to patients, hospital bosses need to listen carefully to what patients think?

[Victoria Atkins]

Indeed. I thank my hon. Friend for all the hard work and advocacy she puts in on behalf of her constituents. If I may, I will ask the Minister for Health and Secondary Care to visit my hon. Friend’s hospital to discuss with her the concerns of local residents and to ensure that the trust is aware of them.

[Richard Foord (Tiverton and Honiton) (LD)]

Two GPs from Seatown, in my part of Devon, moved to Australia to practise a little over two years ago. Both are working as full-time GPs, with no gaps in their career, and they now wish to return to east Devon to help ease winter pressures. Retesting someone who returns to England is lengthy, costly and bureaucratic, and it does not take into account practice in similar primary care settings. Can NHS England not make it easier for UK-trained GPs working in Australia, New Zealand or Canada to return to general practice in England?

[Victoria Atkins]

That is a very fair challenge, and I will look into it, given that the hon. Gentleman has raised it.

[Alun Cairns (Vale of Glamorgan) (Con)]

The Labour party has been running the NHS in Wales for the last 27 years. The shadow Secretary of State, the hon. Member for Ilford North (Wes Streeting), highlighted that he was frustrated with waits for ambulances, GPs and operations. I politely point out to him, and to other Members, that my constituents in the Vale of Glamorgan, and people across the whole of Wales, are waiting much longer for ambulances, GPs and operations. In fact, a quarter of my constituents, and a quarter of people across the whole of Wales, are on an NHS waiting list. I advise my right hon. Friend the Secretary of State that junior doctors and GPs are also in disputes in Wales, despite the claims made by Opposition Members. I therefore ask her to show some caution before taking advice from her shadow.

[Victoria Atkins]

I will follow that advice with great enthusiasm. I have another statistic for my right hon. Friend: the Labour-run Welsh Government were hiding 45,000 patients from their A&E waiting figures in the first half of 2023, and falsely claiming that they perform better than England. If that is the blueprint for how it runs things, we should all be very worried if Labour ever again forms a UK Government.

[Alison McGovern (Wirral South) (Lab)]

Further to the question from my hon. Friend the Member for Tamworth (Sarah Edwards), it was disappointing that the Secretary of State did not mention mental health in her statement. Given the rising levels of destitution and chronic bad housing in our country, mental health services have winter crises too these days. What progress is she making in developing proper waiting times for people in need of mental health services?

[Victoria Atkins]

I reassure the hon. Lady that the impact of mental health patients remaining in A&E for any length of time, let alone beyond 72 hours, is genuinely a metric and factor that we look at very carefully, as we have done throughout the strikes. We appreciate that A&E is not the right environment for most people who are suffering from a mental health illness or a psychotic episode, and we want to move them into appropriate care as quickly and safely as we can. With that in mind, I hope that she will welcome the fact that we are spending some £7 million for up to 100 mental health ambulances over the next two years, to try to ensure that people get the right care they need, when they need it. More than 160 projects are being allocated funding in the community, including crisis cafés and safe havens, so that hopefully people are caught before the crisis happens and they end up in A&E.

[Alberto Costa (South Leicestershire) (Con)]

I welcome the winter update from the Secretary of State. There is actually a winter update going on in South Leicestershire. Will she join local NHS stakeholders there, and me, in encouraging South Leicestershire’s constituents to respond to the consultation on the future of the Feilding Palmer Hospital? The deadline is 14 January.

[Victoria Atkins]

I would be happy to do so. I am pleased to hear of local NHS leaders actively seeking the views of the patients and communities they serve, in order to ensure that their services are what the public expect from their local hospitals, and from primary and secondary care services.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I remember a former Conservative Prime Minister promising to fix social care, yet I am still hearing of too many patients who are medically fit for discharge being stuck in hospital. This time last year we had a record high of about 14,000 patients stuck in hospital who were fit for discharge. Will the Secretary of State tell us what the figure is at the moment, and whether she expects it to go up or down before the end of the month?

[Victoria Atkins]

We are making progress. The hon. Gentleman will appreciate that that figure alters not just day by day, but hour by hour. We have been investing in social care packages precisely because we understand the importance of being able to discharge people promptly and safely into the appropriate social care setting, which can have a huge impact on flow through the hospital.

Other factors can also have an impact on flow, such as practical measures for people who perhaps do not need social care help when they leave hospital. We are looking at what we can do to improve those local factors as well. The hon. Gentleman is right to make the point that the social care system goes hand in hand with our NHS and hospital care. That is why we have been so keen this year to inject extra investment into social care—to try to alleviate some of the issues that he rightly raises.

[Andrew Percy (Brigg and Goole) (Con)]

The shadow Secretary of State seemed to forget the 50,000 hospital beds that Labour closed when they were in government—the thousands of mental health beds and the large number of wards they closed, including at Goole and District Hospital. But I digress.

I spent Christmas on duty as a first responder at the Yorkshire Ambulance Service—as the Secretary of State knows, the Minister for Health and Secondary Care performs the same role at the North West Ambulance Service—so I can attest to the professionalism and dedication of our ambulance services and of our 999 dispatch centres and the clinical hub that supports us at scene. Ambulance crews bear the strain not only of winter pressures year in, year out, but of this doctors’ strike. I urge the Secretary of State to pay tribute once again to their work and, as I have said before in this place, to consider what we can do to expand community paramedicine, so that, as demography changes and more older people are cared for at home, more people can be treated at scene rather than being taken to A&E.

[Victoria Atkins]

I pay tribute to both my hon. Friend and my right hon. Friend the Minister for Health and Secondary Care for their work as first responders. I would get into a lot of trouble in my own constituency if I did not mention the wonderful LIVES—our community first responders, who get to the scene of road accidents or emergency calls before ambulances and conduct the most extraordinary and complex procedures very safely on patients when they need it.

Recently, I was pleased to visit the London Ambulance Service to see for myself what team work can achieve across an ambulance service and how these highly qualified and experienced individuals can make a real difference to people’s lives and health after recovery. I send my sincere thanks to everyone who has been working in those capacities in recent weeks and over the festive period.

[Janet Daby (Lewisham East) (Lab)]

We have gone from no winter crisis when Labour left office to an annual winter crisis—and now a crisis all year round under this Conservative Government. Patient satisfaction with the NHS is at a record low. Instead of there being a blame culture, when will the Secretary of State accept responsibility for that appalling record?

[Victoria Atkins]

I think the hon. Lady was claiming that there was no winter under Labour, but perhaps that is yet another thing that does not quite stack up. I fully endorse her call for an end to blame culture, but point her to the real and practical measures that we have taken to improve urgent and emergency NHS care. I assume that she joins those on the Government side in condemning the unprecedented strike actions that the junior doctors committee has called at this particular time of year.

[Richard Graham]

Having chaired more than 150 meetings between Gloucestershire MPs and our NHS leaders, this week I am handing over the baton to my neighbour, my hon. Friend the Member for Tewkesbury (Mr Robertson). My two thoughts are, first, to share the Secretary of State’s immense gratitude to everyone in the Gloucestershire Royal Hospital and our other services for all their continuing, amazing work; and secondly, to highlight that the biggest single impediment to reducing the elective surgery backlog—the hips, knees and much more of many of our constituents—is this continued strike by doctors in training. I am sorry, but the continued failure of the shadow Secretary of State to highlight whether he supports patients or strikers shows an absence of leadership. Will my right hon. Friend confirm that the doctors in training, the doctors on strike, have already received, in 2023, a pay rise of between 8.1% and 10.3%?

[Victoria Atkins]

I most certainly can confirm that—those doctors have already received the rise. As I said, I wanted to continue discussions on more fair and reasonable settlements for junior doctors, recognising as I do how tough their job is and the conditions under which they work. May I thank my hon. Friend for the leadership he has shown with his local trusts and clinicians? I agree with him that the one thing we have not heard from the Opposition is that they condemn the strikes. They seem to prioritise union harmony over patient safety.

[Helen Morgan (North Shropshire) (LD)]

Shrewsbury and Telford Hospital Trust has one of the most challenged A&E departments in England, for a number of reasons. In August last year, the Government awarded a grant of £21 million to provide extra beds to ease some of the issues in A&E, but those beds are not online and operational yet. What assurances can the Secretary of State give us that the measures that have been taken to ease winter pressures will be in place to help people before the winter is over?

[Victoria Atkins]

I will ask the Minister for Health and Secondary Care, my right hon. Friend the Member for Pendle (Andrew Stephenson), to liaise with the hon. Lady directly. As I say, the latest figures I have from NHS England, working with local trusts, is that more than 3,000 of the extra 5,000 beds were in situ in December, and we expect the 5,000 deadline to be met very shortly. I hope she will see that at local level in her hospital very soon.

[James Wild (North West Norfolk) (Con)]

Is not the rejection by the BMA of derogation requests made on the basis of patient safety dangerously irresponsible? Rather than Dr Laurenson, co-chairman of the junior doctors committee, saying that the NHS hates doctors, it is past time that they called off this damaging strike action and put patients first.

[Victoria Atkins]

Very much so—the NHS belongs to us all, as I say repeatedly. It goes without saying that doctors are a critical part of our workforce. That is why, since becoming Secretary of State, I have wanted to have a good, constructive working relationship with all of the representatives of doctors and the wider workforce. That was why I called in the BMA and “Agenda for Change” as soon as I possibly could, and I am pleased that I have been able to find fair and reasonable settlements with consultants and specialty doctors. I very much hope that junior doctors will call off their strikes and come back around the table so that we can find solutions for them too.

[Samantha Dixon (City of Chester) (Lab)]

The latest period of strike action by junior doctors has been the longest in the NHS’s history. We have seen trusts declaring critical incidents and A&E departments telling patients not to come in unless their lives are under threat. Can the Secretary of State tell me why the Prime Minister has not stepped in to resolve the dispute? Does he think it is not serious enough?

[Victoria Atkins]

As I said earlier, strikes have very serious consequences for the NHS. We cannot pretend that the NHS can be switched on and off at whim. My one ask of the junior doctors committee was that it stop the strikes so that we can return to the table. As the number of patient safety mitigations has revealed—by the way, it is the highest number of patient safety mitigations that local NHS leaders have ever asked for, because of the unprecedented length and timing of the strike—and because the BMA has refused even those derogations, with the exception of two, we have to get to a place where it returns to a more reasonable frame of mind and comes back to the table with more reasonable expectations, so that we can try to find a solution. I will not put patients’ safety at risk: I have to enable NHS England to make preparations and continue the work it is doing day by day, hour by hour, to safeguard hospitals and patients during this very damaging strike action.

[Mr Philip Hollobone (Kettering) (Con)]

My right hon. Friend the Secretary of State will be as concerned as my constituents in Kettering that, for every three days of junior doctor strikes, the cost to Kettering General Hospital is a staggering quarter of a million pounds, with hundreds of operations cancelled or delayed for patients in pain. In confirming that the 35% pay demand is both unrealistic and unaffordable, will she call for junior doctors to return to their posts so that that money can be better spent on reducing waiting lists and improving patient outcomes?

[Victoria Atkins]

My hon. Friend puts it eloquently; there is a real human cost to these strike actions. It is why I did everything I could when we were in negotiations to try to find fair and reasonable settlements for junior doctors. I was very disappointed when they walked out, but we have to find solutions for the sake of our patients and of all 1.3 million people working in our NHS across England. There have been some brilliant examples of local trusts, local clinicians and other members of staff working really hard and pulling together to cover these damaging strikes, but all we ask of junior doctors is to come back to work, do their jobs and look after our patients.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

NHS waiting lists have trebled since the Conservatives came to power almost 14 years ago. The Prime Minister’s pledge to cut waiting lists has effectively been abandoned, with the Government choosing to blame NHS staff instead of fixing the problems. Is it not the case that the longer we give the Conservative Government in power, the longer patients in Slough and across our country will, sadly, have to wait?

[Victoria Atkins]

Waiting lists are coming down, but they are still too high. Towards the end of last year, we had a period without any strikes in the NHS. We saw the waiting lists fall by tens of thousands—indeed, by 65,000—over the period of October, which shows the impact of the industrial action. Sadly, we know that more than 1.1 million appointments have been rescheduled in the last 12 months. It is having an impact on waiting lists and, for the sake of patients, we ask the junior doctors to come back to work.

[Jack Brereton (Stoke-on-Trent South) (Con)]

May I first thank Tracy Bullock, the chief executive of University Hospitals of North Midlands NHS Trust, who has announced her retirement today due to ill health.

We have been making significant progress in north Staffordshire with improvements to health services. Nursing vacancies have declined significantly over the last year and £13.4 million has been invested in improving urgent and emergency care services, freeing up some beds, but what puts all that at risk are these reckless strikes. Some 867 appointments at the Royal Stoke have been cancelled, as have 38 operations. Does my right hon. Friend agree that all the progress we are making is put at risk by these reckless and unprofessional strikes?

[Victoria Atkins]

First of all, I join my hon. Friend in thanking Ms Bullock for her work and public service, and I wish her a speedy recovery.

On the progress made in my hon. Friend’s local area, he is right: there are some really encouraging signs for the future of the NHS. All the work that we have been doing across all the recovery plans—whether it is for urgent and emergency care, primary care or elective recovery plans—is about embedding progress in the future of our NHS in this year of all years, as we celebrate 75 years of its establishment.

On the impact of the junior doctors’ strikes, my hon. Friend is right to refer to the number of new nurses and the progress that has been made locally. In fact, this year we have been able to announce that we have met a manifesto commitment to recruit 50,000 more nurses. We made that promise in 2019. We have met it early, as well as the commitment to have 50 million more GP appointments than in 2019—two manifesto commitments made, and two manifesto commitments kept.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

Happy new year, Mr Deputy Speaker.

More and more of my constituents are waiting longer and longer for emergency care. In 2010, the target for emergency care was 95% of patients within four hours. The Government watered down that target to 76%, and are not meeting that. When will they meet their own target, and when can we expect to see 95% of my constituents being seen within four hours?

[Victoria Atkins]

I hope the hon. Gentleman is injecting the same anguish into the conversations that I imagine he is having with his local junior doctors, asking them to come back to work. Of course, having junior doctors not working in hospitals across the NHS has an impact—of course it does; they are a vital part of our NHS. The attention of NHS leaders, medical directors and clinicians over past weeks has had to be diverted towards covering the strike action rather than making the sorts of improvements and progress we all want to see across urgent and emergency care, in line with our recovery plan.

[Anna Firth (Southend West) (Con)]

Happy new year, Mr Deputy Speaker. The majority of NHS staff at Southend Hospital are working incredibly hard. Despite winter pressures and industrial action, they have used winter money to open a new ward, adding extra bed spaces. However, the chief executive has written to tell me he is extremely concerned that approaching 40,000 out-patient and in-patient appointments across the Mid and South Essex NHS Foundation Trust have been postponed since this industrial action started. This afternoon, we learned from the Secretary of State that doctors in training have received above inflation average pay rises of 9%, so is it not time that they simply got back to work, delivering the care my constituents deserve and pay for?

[Victoria Atkins]

I thank my hon. Friend. We know the figures for previous strike actions, but sadly we will hear the true extent and impact of the strike action over the last six days later this week, and I suspect we will have even more missed and cancelled appointments to add to the list she rightly sets out.

On the point about pay, the basic pay of a foundation year one doctor has risen by 10.3%. Once one takes into account factors such as overtime and unsocial hours payments, that means the average salary is £40,800, a figure that I hope begins to reflect the importance we put on doctors and their role in the NHS. As doctors progress with their careers, there is a good package of development and progress, culminating in the pay settlement, currently out to ballot with the BMA, that I hope consultants, who are at the end of their career and do so much to help train younger doctors, will vote for. There is much work to be done, but progress has already been made on pay. That is why the decision by the BMA junior doctors committee to call strikes of such length at this time of year was so disappointing.

[Mr Deputy Speaker (Sir Roger Gale)]

I thank the Secretary of State for her statement and for responding to questions, and my thanks also go to those on the Opposition Front Bench.

Government Offer to NHS Specialist, Associate Specialist and Specialty Doctors

Victoria Atkins Excerpts

Tuesday 19th December 2023 Written Statements

[The Secretary of State for Health and Social Care (Victoria Atkins)]

After seven weeks of constructive negotiations with the British Medical Association specialist, associate specialist and specialty doctors committee, I am pleased to inform the House that on 16 December, I made a formal reform-based offer that the BMA SAS committee has agreed to put to its members for a vote.

No strikes will be called by these doctors while the deal is being put to members.

SAS doctors are a vital part of the NHS. They focus predominantly on providing direct patient care by providing clinical expertise in their specialist area and taking responsibility for a full range of patients within their area of practice, making them essential to our efforts to cut waiting lists and deliver the highest quality service to patients.

In 2021, the Government agreed a multi-year deal with the BMA SAS committee. If accepted, this offer will: address the unintended imbalances in the pay scales for these doctors on the 2021 contract and pre-2021 contracts to ensure consistency and fairness across the workforce; speed up the delivery of some of the key objectives of the 2021 deal, such as the roll-out of the new specialist grade; and encourage more existing doctors to take up the new contracts, which offer modernised terms and conditions.

The offer includes plans to set up a £5 million funding pot to encourage and support NHS employers to create more permanent specialist roles where there is a need. This will fund a significant increase in the number of specialist doctors, improving patient care and access, and will create further opportunities for doctors to progress in their careers.

A joint piece of work will also be undertaken to consider how locally employed doctors—doctors who are employed on local terms and conditions as opposed to national—can be better supported to progress in their careers, including the development of a potential process whereby such doctors operating at specialty level for 24 months could be transferred to a specialty contract.

The Government have made further commitments on career development, including the promotion of job planning for all such doctors; the development of guidance to support the career development of SAS doctors; the development of guidance for employers to encourage, establish and embed specialist roles in their organisation; and a research project to understand why specialist roles are not being created.

Both the Government and the BMA SAS committee engaged constructively and in good faith to identify fixes and reforms that address important concerns for SAS doctors. This offer is independent of the headline pay uplift that SAS doctors have already been awarded in 2023-24 through the Government’s acceptance of the independent pay review body’s recommendations.

The BMA SAS committee will now make arrangements to put this offer to a vote of its members in the coming weeks. I encourage them to accept this offer, and I will update the House in due course.

[HCWS162]

Oral Answers to Questions

Victoria Atkins Excerpts

Tuesday 5th December 2023 Commons Chamber

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

16. What recent assessment she has made of the potential impact of levels of availability of dentistry appointments on other NHS services.

[The Secretary of State for Health and Social Care (Victoria Atkins)]

May I, through you, Madam Deputy Speaker, wish Mr Speaker a very speedy recovery?

As Secretary of State for Health and Social Care, I want to reform our NHS and social care system to make it faster, simpler and fairer. Dentistry is a critical part of that. Integrated care boards are responsible for identifying areas of local need and determining the priorities for investment. NHS England published guidance in October this year to help ICBs use their commissioning flexibilities within the national dental contractual framework, and I will be looking carefully at how the boards are identifying need and investment across England, including for vulnerable people.

[Kim Johnson]

I am glad that the Minister mentioned ICBs. Liverpool has a very high percentage of children with dental decay, and tooth extraction is the most common hospital procedure for five to nine-year-olds at Alder Hey Children’s Hospital, yet there was a £10 million underspend for primary care dentistry, and instead of investing it in preventive care, NHS England gave permission to all ICBs, including NHS Cheshire and Merseyside, to use the balance to balance their budgets. Will the Minister agree, here and now, to reinstate the ringfenced funding to commission extra capacity for the most vulnerable patients?

[Victoria Atkins]

I am delighted to be able to inform the hon. Member that NHS England has provided guidance for ICBs that requires dental funding to be ringfenced, with any unused resources redirected to improve NHS dental access in the first instance. Interestingly, ICBs will report their expenditure against the dental ringfence to NHS England as part of their in-year financial planning, which will happen at the end of this financial year.

[Kim Johnson]

But the underspend is not being used on dentistry—

[Steve Brine (Winchester) (Con)]

The Government previously committed to publishing a dental recovery plan, which the former dental Minister, my hon. Friend the Member for Harborough (Neil O’Brien), said that the Government would publish shortly. He also told my Committee:

“We do want everyone who needs one to be able to access an NHS dentist”.

We were surprised, but he said it. We were told that the plan would be published during the summer or before the summer recess. When will the plan be published, if that is still the intention? Presumably it will come alongside the response to our “Dental Services” report, which was due on 14 September.

[Victoria Atkins]

I thank my hon. Friend and I look forward to being grilled by him and his Committee in due course—at least, I think I do. Perhaps I can assist him, first, on the very important dental report that his Committee published. I am looking through it myself this afternoon and I will be publishing the response and sending it to the Committee imminently. In relation to the dental plan, both the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), and I are looking carefully into the needs of communities in rural and coastal areas, as well as in more urban areas, to understand not just the need but the answers that we can provide to help with urgent care and, importantly, preventive care, particularly for our children and vulnerable people in our society.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

Last week another dentist in my constituency told my constituents that they were no longer able to provide NHS services. These people have literally nowhere else to go nearby. I want to come back to what my hon. Friend the Member for Liverpool, Riverside (Kim Johnson) asked about the underspend, because we had a meeting with the ICB and it was specifically told that the ringfence was being disapplied. Does the Secretary of State agree that that money should be spent on dental services and that that instruction should be given by her today?

[Victoria Atkins]

I agree, and that is why NHS England has provided guidance, as I set out earlier.

[Derek Thomas (St Ives) (Con)]

I welcome the guidance that ICBs have received. Cornwall ICB has committed to ringfencing money for dentistry next year, but the truth is that, before it took on that commitment, £4.5 million for unmet units of dental activity was returned to NHS England. What can the Secretary of State do to ensure that Cornwall gets the money that was intended for Cornwall to deliver NHS dentistry?

[Victoria Atkins]

A theme is emerging of underspend in dental work, which is one of the things that the ministerial team and I are looking at. NHS England emphasised in its guidance to ICBs that the funding should be ringfenced. I very much understand the pressures that my hon. Friend and other south-west Members have been raising over many months on the care that their constituents are getting. To ease pressures in the south-west, NHS England has commissioned additional urgent dental care appointments that people can access through NHS 111.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the shadow Minister.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I begin by welcoming the Secretary of State and her Ministers to their posts.

Last year, the Prime Minister pledged to restore NHS dentistry, including a specific promise to protect its budget, yet last month we learned that he will break that promise and allow ICBs to raid dentistry budgets to fill the gaps. Labour has a plan for 700,000 extra appointments, supervised toothbrushing in schools and a targeted dentistry recruitment scheme in left-behind areas. It is all fully funded by abolishing non-dom tax status. We have a plan, but the Government’s plan is four months overdue. Where is it?

[Victoria Atkins]

I thank the hon. Lady for her warm welcome. I look forward to discussing these matters with her over the Dispatch Box.

Over the weekend, I was rather pleased to see the Leader of the Opposition’s damascene conversion to the Conservative cause. As the shadow Secretary of State is on his world tour investigating what other health systems are doing, the Labour party may wish to bear in mind the words of wisdom from the great lady herself: “The problem with socialism is that at some point you run out of other people’s money.”

[Michael Fabricant (Lichfield) (Con)]

2. What recent steps she has taken to help prepare for a future pandemic.

--- Later in debate ---

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

9. What steps she is taking to help reduce health inequalities.

[The Secretary of State for Health and Social Care (Victoria Atkins)]

I am pleased to reiterate to my right hon. Friend the Member for Witham (Priti Patel) that Essex is receiving funding from the National Institute for Health and Care Research, which is funded by the Department of Health and Social Care, to promote research into health inequalities and support better health outcomes for her constituents and all residents in Essex.

[Priti Patel]

I thank the Secretary of State for her response and welcome her to her new role; it is a real pleasure to see her in her position today. My Witham constituents have one of the highest patient-GP ratios in the country. That brings many challenges in accessing the NHS, from primary care to dentistry, social care and hospital appointments, some of which have been exacerbated by industrial action. Will she give an update on the work she is leading to address some of those issues and will she support my work and campaign locally to get a new primary health centre in Witham town?

[Victoria Atkins]

I thank my right hon. Friend very much for her kind words. She will remember how much I enjoyed sitting on the Front Bench alongside her when we were in the Home Office. In terms of her work in Essex, she is a formidable campaigner and she will know that the decision on such a healthcare centre lies with her integrated care board, to which the Government have given some £183 million of capital funding between 2022 and 2025. I am sure she will make a compelling case to the ICB for such a centre in her constituency. Interestingly, the Mid and South Essex integrated care board is one of seven sites receiving additional support and funding from NHS England to address health inequalities, and I know she will pay close attention to how that is spent.

[Debbie Abrahams]

There were multiple warnings from experts such as Professor Sir Michael Marmot of the widening health inequalities that started in 2015. Covid just exposed and amplified those inequalities, so that in the north there were 17% more deaths, or more than 2,500 avoidable deaths. While I welcome the new Health Secretary to her post and I welcome her announcement this morning, what else is she going to do to address in particular the socioeconomic inequalities that drive those health inequalities?

[Victoria Atkins]

I thank the hon. Lady for her welcome. Having grown up in Lancashire myself, I very much understand why she is speaking up on behalf of her constituents. There are many different ways that we deal with this, but let me use a couple of headline points. First, we are increasing the public health grant to local authorities, providing more than £3.5 billion this year, so per capita public health grant allocations for the most deprived local authorities are nearly two and a half times greater than for the least deprived.

There is also interesting work going on with family hubs. Indeed, the Under-Secretary of State for Health and Social Care, my right hon. Friend for South Northamptonshire (Dame Andrea Leadsom), who has responsibility for start for life, is leading on that. The family hubs and start for life programme will deliver a step change in outcomes for babies, children and parents in 75 local authorities in England with high deprivation. We believe strongly that if we can give the best start in life to our babies and children, it will bode extremely well for their future years.

[Maggie Throup (Erewash) (Con)]

A report that is to be published shortly by the all-party parliamentary group for diagnostics, which I chair, has highlighted that community diagnostic centres are essential for tackling health inequalities. I welcome my right hon. Friend to her new role. Will she honour her predecessor’s commitment to meet the all-party group to discuss the benefits of diagnostics in general and the preventive role that they can play in reducing health inequalities across the country?

[Victoria Atkins]

Not only am I delighted to accept my hon. Friend’s kind invitation, but I am also extremely grateful for her work in that area. Of course, we think that community diagnostic centres are an important and exciting part of healthcare in this country. We have 136 centres operational at the moment, and we know that they have provided 5 million additional tests since July 2021. That is the future and we very much support it.

[Kirsten Oswald (East Renfrewshire) (SNP)]

We know that socioeconomic inequalities drive health inequalities and that poverty increases adverse health effects. Research by the Trussell Trust shows that one in seven people faces hunger across the UK because they simply do not have enough money. Will the Secretary of State raise with her Cabinet colleagues the Trussell Trust joint campaign with the Joseph Rowntree Foundation calling for an essentials guarantee in universal credit to ensure that the basic rate at least covers life’s essentials so as to ensure that people can afford essentials such as food and heating and to mitigate against health inequalities?

[Victoria Atkins]

Of course, conversations continue between Ministers across Government in terms of helping not just with health inequalities but with inequality of opportunity. That is why I very much hope that the hon. Lady and her colleagues will welcome the thoughtful focus that both the Chancellor and the Secretary of State for Work and Pensions have put into the back to work plan. We know that getting people into work can have enormous benefits, not just financially but, importantly, for their wellbeing. The idea behind the back to work plan is that we do it by working with people to draw out their full potential and help them to lead healthy lives.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

8. If she will review the provision of health services for people living with (a) Ehlers-Danlos syndromes and (b) hypermobility spectrum disorder.

--- Later in debate ---

[Marion Fellows (Motherwell and Wishaw) (SNP)]

T1. If she will make a statement on her departmental responsibilities.

[The Secretary of State for Health and Social Care (Victoria Atkins)]

My priority as Secretary of State is to reform our NHS and social care system to make it faster, simpler and fairer. Since my appointment, we are making progress. To make our system faster, we have hit our manifesto target to recruit and retain 50,000 more nurses for our NHS, and to deliver 50 million more GP appointments, achieving both commitments months ahead of time. We have made an offer to health unions that I hope will end the consultants’ strike, which has disrupted care for the public and put a strain on staff. To make our system simpler, we have announced Pharmacy First, which will make it quicker and easier for millions of people to access healthcare on the high street. To make our system fairer, we have agreed a deal with pharmaceutical companies that will save the NHS £14 billion in medicine costs and give patients access to more life-saving treatment. The NHS is one of the reasons I came into politics—[Interruption.] I know Labour Members do not like to hear that, but I look forward to working with patients and staff across the country—[Interruption.]

[Madam Deputy Speaker]

Order. I do not need any help, thank you. The Secretary of State has answered the first question at length. I am sure that means she will answer the other questions much more briefly.

[Marion Fellows]

People with disabilities and serious health conditions already have higher living costs, and the proposals in the work capability assessment activities and descriptors consultation will mean that if they are reassessed they will lose £390 a month. I appreciate that the Secretary of State is new to her role, but will she commit as a priority to taking this up and consulting Cabinet colleagues, to ensure that people who are disabled and have serious health conditions are not pushed even further into dire poverty?

[Victoria Atkins]

As I said earlier, careful thought has gone into the announcements that were made in the autumn statement, and of course I will work with the Secretary of State and the Chancellor to ensure that the commitments we already have to people living with disabilities are maintained, and that we have their wellbeing at the heart of all our policy making.

[Priti Patel (Witham) (Con)]

T4. The Secretary of State’s predecessor took a strong interest in the deaths that took place in the Essex mental health trusts, and a statutory inquiry is now taking place. Will she meet me and our Essex colleagues, and the families, to discuss that important inquiry, so that they can have justice for the loved ones they have lost?

[Victoria Atkins]

I would be very pleased to meet my right hon. Friend, the families and other Essex MPs to discuss that important inquiry.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the shadow spokesman.

[Ashley Dalton (West Lancashire) (Lab)]

With your indulgence, Madam Deputy Speaker, I welcome the Secretary of State and the new members of her Front-Bench team to their roles. I am honoured myself to stand at the Dispatch Box today for the first time on behalf of the shadow Secretary of State for Health, my hon. Friend the Member for Ilford North (Wes Streeting), who is currently in Australia exploring international best practice in healthcare.

Talking of best practice, on this Government’s watch, people with suspected breast cancer are not getting it. The two-week target from GP referral to a first consultant appointment for breast cancer has not been met since March 2020. I know from my own experience of breast cancer that the waiting is terrifying, wondering whether it has been left too late and the cancer has become incurable. How much longer will patients have to wait before the Government can meet their own targets and deliver the timely care that patients need and deserve?

[Victoria Atkins]

I genuinely thank the hon. Lady for her warm welcome, and indeed I welcome her to her first outing at the Dispatch Box. As she was describing where the hon. Member for Ilford North (Wes Streeting) is, I had images of “I’m a Celebrity… Get Me Out of Here!” Sadly for citizens in Wales, they are experiencing what it is like to live under a healthcare system run by Labour, and they might fully agree with that sentiment.

The hon. Lady raises the important issue of breast cancer, and the NHS has an ambition to diagnose 75% of cancers as stages 1 or 2 by 2028. In January last year we provided £10 million of funding for 28 new breast screening units and nearly 60 life-saving upgrades to services in the areas where they are most needed, because we understand our constituents’ concerns and also their determination that we continue to improve cancer survival rates.

[Ashley Dalton]

Unfortunately, the reality is that cancer referrals have only got worse with the Conservatives in government. In September 2023, only 74% of urgent cancer referrals to a consultant met that two-week target. That is the second-lowest rate for two-week referrals since 2009. When can the public expect this performance to improve?

[Victoria Atkins]

We have in fact made progress by delivering record numbers of urgent cancer checks, and levels of first treatments following an urgent cancer referral have been consistently above pre-pandemic levels, with activity in September standing at 108% of pre-pandemic levels on a per working day basis.

[Peter Gibson (Darlington) (Con)]

T6. Some six months ago, the dentist based at Firthmoor community centre, serving 8,000 of my constituents, handed back its contract to the integrated care board. I was shocked last week to learn that the ICB has still not commenced the tender process to replace that provision. What advice can the Minister give me to ensure that our ICB is doing what it needs to do?

--- Later in debate ---

[Dr Luke Evans (Bosworth) (Con)]

T9. My local practice, on Heath Lane in Earl Shilton, released its “did not attend” figures. Between 20 November and 24 November, 69 appointments—including 36 GP appointments and 28 nursing appointments—were missed. That was 12 hours lost in five days. If that is happening up and down Hinckley and Bosworth and across the country, that is thousands of hours being missed. I know that the Government are keen to see more on data, so will they consider statementing patients on how much missed appointments cost, because clinically that would make a big difference to the awareness of what people are cashing out on?

[Victoria Atkins]

May I thank my hon. Friend for bringing his professional expertise to the Chamber? Of course, minimising “did not attends” is a critical part of ensuring that clinical time is optimised, and I will take his suggestion away and mull it over.

[Kate Hollern (Blackburn) (Lab)]

T2. I understand that pathology staffing levels at Royal Blackburn Hospital have not been reviewed for 15 years and the workload is up 300%. The national deficit in pathology is a ticking time bomb, as hospitals are unable to offer surgical and emergency services. What steps is the Minister taking to address recruitment and ensure that staff and patients are safe?

--- Later in debate ---

[Imran Hussain (Bradford East) (Lab)]

T5. The Health Secretary declared at the weekend that the Government will miss their target to cut NHS waiting times if doctors strike to defend their pay and conditions, but she seems to forget that since the Tories took power in 2010, waiting lists for hospital treatments are up, A&E waiting times are up, cancer referral times are up and ambulance response times are up. The only thing that has fallen is not waiting times; it is public confidence in the Government. Will the Minister finally admit that the threat to waiting time targets is not striking doctors, but her party being in government?

[Victoria Atkins]

I assume from the hon. Gentleman’s question that he fully supports our efforts to get consultants back into hospitals as well as junior doctors and doctors in training. It is all very well to sit there commenting, but we on the Government side of the House are working with doctors to try to help them look after the NHS for us all.

[Selaine Saxby (North Devon) (Con)]

While I recognise that money does not grow on trees, neither do teeth. Can my right hon. Friend advise me of how quickly my North Devon constituents will be able to see the NHS dentists they so desperately need?

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

T7. Last week, the former Health Secretary admitted at the covid inquiry that sick pay across the UK is “far too low”. It is far lower than the European average and encourages people to go to work when they should be getting better. Does the Secretary of State agree with her predecessor? What discussions will she have with her Cabinet colleagues to improve the inadequate sick pay system?

[Victoria Atkins]

I will not comment on evidence from the covid inquiry, given that it is an independent inquiry. However, on the general principle of encouraging people back into work, we have the plans set out by the Secretary of State for Work and Pensions and the Chancellor at the autumn statement. We want to encourage people back into work and to support them when they fall ill and need help from the state.

[Anna Firth (Southend West) (Con)]

Last year, I asked the Government to show me the money with respect to £118 million of long-awaited capital funding for south Essex hospitals. With £8 million now delivered and the other £110 million now confirmed to be on its way, will the Secretary of State please come with me to Southend Hospital and see how that vital money will transform care in Southend and Leigh-on-Sea?

[Victoria Atkins]

I will be delighted to visit that hospital with my hon. Friend—I suspect that I will be visiting a lot of hospitals.

[Paul Blomfield (Sheffield Central) (Lab)]

T8. Was the Secretary of State consulted about yesterday’s announcement by the Home Secretary? If she was, did she agree with him that it will have no impact on overseas recruitment, or does she hear the fear of care providers about its consequences?

[Victoria Atkins]

Yes, I was. What is more, we looked carefully at the figures in relation to overseas care workers. We are grateful to all international people who work in our NHS and our care system, but we need to tackle the migration rate, which is too high. The package presented yesterday by the Government is a thoughtful and careful one to tackle legal migration.

[Siobhan Baillie (Stroud) (Con)]

Stroud Maternity Hospital is doing a great job, but the post-natal beds are still not open. We have been chasing a ministerial meeting about that for some time. Will my hon. Friend meet me and the Gloucestershire NHS scrutiny chair, Andrew Gravells, to discuss the issue? We think that we need some help with the Care Quality Commission.

--- Later in debate ---

[James Sunderland (Bracknell) (Con)]

Would the Health Secretary please agree to meet me to discuss improved access to GPs and dentists in Bracknell Forest and Wokingham boroughs?

[Victoria Atkins]

I will; it would be a pleasure.

[Pete Wishart (Perth and North Perthshire) (SNP)]

My constituent Air Marshal Dr David Walker, an inspirational leader and academic, sadly died of glioblastoma in June. When diagnosed, he and his wife Catherine were shocked to learn of the woefully low funding for brain and other less survivable cancers and established the charity the Right to Hope with Cancer. Will the Minister show the courage and leadership so epitomised by the life of Air Marshal Walker, and properly resource and fund less survivable cancers, so that everyone living with cancer has some sort of hope?

Public Health: Opt-out HIV Testing

Victoria Atkins Excerpts

Wednesday 29th November 2023 Written Statements

[The Secretary of State for Health and Social Care (Victoria Atkins)]

The Government remain committed to ending new HIV transmissions within England by 2030. In order to do this successfully, we must identify and treat more of those who are unknowingly living with HIV.

As part of our HIV action plan, NHS England is currently operating a bloodborne virus emergency department opt-out testing programme for HIV and for hepatitis B and C for 34 emergency departments across London, Manchester, Salford, Brighton and Blackpool, focusing on areas with extremely high HIV prevalence (five or more HIV cases per 1,000 residents aged 15 to 59), in line with National Institute for Health and Care Excellence HIV testing guidance.

This means that anyone aged 16 years and over attending an emergency department in these areas and having a routine blood test will automatically be tested for HIV and for hepatitis B and C, unless they opt-out. Accessible public-facing information about testing, its benefits and how they can opt out allows individuals to make informed choices.

Through their recently published evaluation report, the data from NHS England and the UK Health Security Agency (UKHSA) indicate that the existing opt-out testing programme has been highly successful in areas of extremely high HIV prevalence, helping identify over 2,000 cases of bloodborne viruses, including 550 cases of people living with undiagnosed or untreated HIV.

After careful consideration of the available evidence, I am pleased to announce that the Government are committing to new research, commissioned through the National Institute for Health and Care Research, to evaluate the expansion of HIV opt-out testing to a further 46 emergency departments, in areas across England where there is high HIV prevalence (two or more HIV cases per 1,000 residents). Funding will support 12 months of testing for each emergency department, to begin during the next financial year.

We anticipate that this will be an effective way to reach a substantial proportion of the estimated 4,500 people England who are living with HIV but unaware of their status.

We will continue to keep Parliament updated on our progress to meet our 2030 ambitions as set out in our HIV action plan. We also want to thank our partners across the NHS, in NHS England, UKHSA, local government, and the community and voluntary sector, for their work towards ending HIV transmission in England.

[HCWS79]

NHS Consultants: Pay Offer

Victoria Atkins Excerpts

Tuesday 28th November 2023 Written Statements

[The Secretary of State for Health and Social Care (Victoria Atkins)]

After several weeks of constructive negotiation with the British Medical Association and Hospital Consultants and Specialists Association committees, I am pleased to inform the House that, on 27 November, I made a formal offer to both unions, which includes a package of reforms to be applied from January 2024. If accepted by their members, this would end damaging strike action, benefit patients and deliver for consultants by reforming outdated aspects of their contracts.

The Government’s position is that the headline pay uplift for 2023-24 was settled through the pay review body process. This offer builds on that and focuses on reform. All parties strived to find a fair deal for NHS consultants that acknowledges the wider economic pressures facing the UK and the need to continue to bring down inflation. We have heard the concerns consultants have raised about outdated pay scales that have poor equalities outcomes. This offer would invest in modernising the consultant pay scale to reduce the number of pay points and the time it takes to reach the top.

As part of this reform, we would also be introducing more consistent performance gateways so that there is a clearer link between pay progression and evidence of skills, competencies and experience. This would make it faster for consultants to progress and help mitigate the gender pay gap, which was expressly highlighted in the independent review into gender pay gaps in medicine in England. To enable these reforms, unions have agreed to end local clinical excellence awards—an employer-level bonus scheme that has been seen to contribute to pay inequalities.

In addition, the Government will work with the unions to review the operation of the Review Body on Doctors’ and Dentists’ Remuneration. This work will extend to looking at the process for the appointment of members to the DDRB, the timing of the round, the data provided to the DDRB, and changes to remit letters and the panel’s terms of reference.

The Government have listened carefully to the concerns of consultants, their representatives and employers, particularly around retention, motivation and morale. This offer has been carefully balanced to meet those concerns while also ensuring value for the taxpayer. Together, this represents the biggest transformation in the consultant contract in 20 years. This offer, should it be accepted, will improve the working lives of consultants while ending damaging strike action that has had a detrimental impact on patients and the NHS.

The BMA and HCSA will put this offer to their members for a vote in the coming weeks. No further industrial action will be called while this happens.

[HCWS75]

NHS Federated Data Platform: Contract Award

Victoria Atkins Excerpts

Tuesday 21st November 2023 Written Statements

[The Secretary of State for Health and Social Care (Victoria Atkins)]

Today, NHS England announced that, following an open and competitive procurement, it has awarded a group led by Palantir Technologies UK, with support from Accenture, PwC, NECS and Carnall Farrar, the contract to provide the new NHS Federated Data Platform (FDP).

The NHS manages data in different systems that do not connect effectively or efficiently. Every day, clinicians and other hospital staff spend time on the phone and in meetings, trying to join this information up themselves—to manage their theatre lists, waiting lists and information on patients ready to be discharged. This time could be better spent caring for patients.

The FDP is software that will sit across NHS trusts and integrated care systems (ICSs), allowing them to connect data they already hold, such as health records, waiting lists, and theatre and staff rosters, in a safe and secure environment, to better manage patient care. The FDP will support key priorities of the NHS, including recovery of elective care and the improvement of discharge processes to get medically fit patients treated and home quicker.

The safety and security of patient data is front and centre of this new system. As happens currently, there will be clear rules and auditability covering who can access this data, what they can see, and what they can do. Only authorised users will be granted access to data for approved purposes—for example, NHS staff and those supporting them, such as administrators, bed managers or care co-ordinators, and staff in social care supporting the move from hospital care. The provider of the software will not hold or have access to NHS data for any purpose, other than as directed by the NHS; they will not control the data in the platform, nor will they be permitted to access, use or share it for their own purposes. The contract makes strict stipulations about confidentiality. No new data will be collected, and GP data will not be part of the national platform.

In addition, NHS England has awarded a contract to a separate provider, IQVIA, for privacy enhancing technology, as an additional safeguard to enhance the security of data used in the FDP. The FDP will not go live at trusts or ICSs until this privacy enhancing technology is in place.

Across England, 26 trusts have been piloting what the FDP will provide. Clinicians have described the results as “game-changing”. It has helped them to better organise their clinics and waiting lists by integrating and consolidating data from different hospital systems or by creating a single list of information used by everyone working in health and care on discharge of patients from hospital. Patients in these vanguard trusts have seen falls in waiting times, discharge delays reduce, and diagnoses speed up. Theatre utilisation has increased by more than 6%, meaning an average of 120 additional patients per month are being treated at each trust. A new discharge tool has allowed one trust to reduce unnecessary days in hospital for long-stayers by 36% and halve the number of patients occupying a hospital bed for 21 days or more, compared with the England average.

It is these real benefits that an FDP will bring for patients and clinicians that have seen the chief executives of all 42 integrated care boards sign up to an open statement of support for the procurement.

Every hospital and integrated care board will have its own version of the platform which can connect and collaborate with other data platforms as a “federation”. In the first contract year, investment is expected to be at least £25.6 million and over the total contractual period of seven years, there will be up to £330 million investment in the Federated Data Platform and associated services. Learning about how to make the roll-out to trusts as efficient as possible will be built in overtime to reduce costs.

Additional funding has been set aside for other organisations to bid in separate, future procurements to build new products on to the platform that are interoperable and provide the opportunity for the NHS to benefit from new innovations from a range of suppliers. This makes it easier for health and care organisations to work together, compare data, analyse it at different geographic, demographic and organisational levels, and share and spread new effective digital solutions.

The contract will not only benefit users of the NHS; it will see investment in the UK-based data industry: the contract includes the creation by the supplier of a hub in the north-west. Data will not leave the UK.

Contract award for the FDP is the first stage of the process. An advisory group made up of expert health and care stakeholders, as well as patients and regional system representatives, will help to shape how the FDP is implemented. NHS England has already carried out engagement on the FDP requirements, including with patient and professional representative bodies. Ongoing public engagement is planned throughout the period of the contract, including as part of a recently announced circa £2 million national programme of engagement on the use of health data.

Further information on the FDP can be found on NHS England’s webpages at:

https://www.england.nhs.uk/digitaltechnology/digitising-connecting-and-transforming-health-and-care/fdp-faqs.

[HCWS57]

Voluntary Scheme for Branded Medicines Pricing, Access and Growth

Victoria Atkins Excerpts

Monday 20th November 2023 Written Statements

[The Secretary of State for Health and Social Care (Victoria Atkins)]

I am pleased to inform Parliament that agreement has been reached on a Heads of Agreement for the 2024 Voluntary Scheme for Branded Medicines Pricing, Access, and Growth (VPAG). This is an agreement between the Department of Health and Social Care—representing the UK Government, the Governments of Scotland and Wales and the Northern Ireland Department of Health—NHS England and the pharmaceutical industry, represented by the Association of the British Pharmaceutical Industry (ABPI).

This is an important milestone in the agreement of a new scheme. Once the Heads of Agreement has been formalised in a full scheme document, the 2024 VPAG will operate for five years starting from 1 January 2024, when the current scheme ends.

The 2024 VPAG stands to deliver savings to the NHS across the next five years, rapid patient access to new clinically and cost-effective medicines, and a sustainable approach to medicines provision.

The proposals also demonstrate the Government’s commitment to supporting a strong UK life sciences industry to drive economic growth, including through the establishment of a £400 million fund to support investment in the UK life sciences ecosystem, including improved clinical trial capacity.

[HCWS52]

Mental Health Units (Use of Force) Bill

Victoria Atkins Excerpts

2nd reading: House of Commons
Friday 3rd November 2017 Commons Chamber

[Victoria Prentis]

Rather than get too party political, I think it is appropriate to talk about other difficulties that have led to reductions in staffing in real terms in the Prison Service, because we on this side of the House can give lots of facts and figures about how much more is being spent. The difficulty that I know about personally now in my Banbury constituency is in recruiting and retraining staff—not with the money to pay for them, but with finding the right people. I pay tribute to all who choose to work in the very difficult mental health sphere, with patients who suffer from dreadful illnesses; the House should pay tribute to the work they do day in, day out with people who are often very difficult to deal with while they are ill.

One matter on which I am sure we can agree is the importance of reducing further the number of black, Asian and minority ethnic people detained for mental health reasons in police cells. The figures are disproportionately high. It simply cannot be right that black people are four times more likely to be detained under the 1983 Act than white people. The hon. Member for Croydon North mentioned the Angiolini review and the importance of standardised data recording. I apologise for again referring to my Prison Service experience, as the mental health system is completely different from the criminal justice system, but there are themes that run through the way BAME people are treated in both systems which we increasingly find utterly unacceptable.

[Victoria Atkins (Louth and Horncastle) (Con)]

I pay tribute to the hon. Member for Croydon North (Mr Reed) for bringing the Bill to the House. Does my hon. Friend join me in welcoming clauses 8 and 9 requiring mental health units to record the relevant characteristics of the patient on every occasion in which force is used, and to submit an annual report to the Secretary of State, so that health units and also the Secretary of State can review and understand where there are patterns of behaviour?

[Victoria Prentis]

I could not agree more. The provision of statistics and retention of figures and then the crunching of them is vital. It might not sound exciting, but it is the only way to deal with the big problem of racial imbalance in both the mental health and the criminal justice system. It sounds absurd to say that figures are what will push through action on racial imbalances, but I truly believe that facts and figures—such as those provided recently in the report on the Prison Service, where we learned that 277 black women are in prison for every 100 white women—will help achieve that. Such figures are unacceptable on any level. The more we can talk about such figures, backed up by good evidence, the better. A civilised society cannot put up with such things.

I have strayed far from my brief. I am proud that the Government have committed to addressing the disproportionately high rates of BAME people detained for mental health reasons, and I am proud of the work the Government have done generally on mental health.

We all know that the 1983 Act is outdated, and it will be reformed to make it fit for the modern era. In October 2017, the Prime Minister announced a comprehensive review of the Act, with a planned end date for the report of autumn 2018. I am pleased that the review is being led by Professor Simon Wessely, former president of the Royal College of Psychiatrists. I worked closely with him in my previous role. We were working on a case concerning the pardoning of first world war prisoners who had been shot for cowardice, and he was able to recreate their mental health states from the limited records we had available and give invaluable evidence to the court. He is a great man and I am sure he is the right person to lead this review. He has said that he expects some of the solutions to the difficulties in the mental health system to lie in practice, leadership and culture, as well as in potential legislative change.

I have been encouraged by the work on mental health in my constituency, including in the veterans support group. It meets at Behind the Wire in Heyford Park, next to my constituency office, about once a month. It is a former military establishment and the veterans who access it feel very comfortable in that environment. It is well known that veterans as a group are more prone to experience mental health issues. This particular group offers drop-ins for veterans living in the local area so they can meet organisations including the Support, Empower, Advocate, Promote service, Help for Heroes, the Royal British Legion, Veterans UK and Rethink Mental Illness, which the hon. Member for Croydon North mentioned, and which does a great deal of good work across the country.

I have other local organisations who are doing great things in supporting my constituents, including Restore in Banbury, which I was also lucky enough to meet recently. I visited the local branch of Mind in September, which has contacted me in recent days urging me to support the Bill. Its letter said that

“the proposals in this Bill are crucial to protecting people experiencing a mental health crisis...With your support this Bill would lead to better training for staff, better data, improving transparency and highlighting problem areas”.

It therefore gives me great pleasure not only to support the hon. Member for Croydon North, but to stand up for those of my constituents who have asked me to attend this debate and to speak in it.

As a former civil servant, I cannot emphasise enough how important it is that we have a joined-up approach across Departments. It is very much not just a matter for the Department of Health; the Ministry of Justice is also involved. I speak to it frequently about mental health and prisoners and the use of restraint in the criminal justice system, and I hope that the Minister will reaffirm the importance of cross-governmental co-operation, including work with NHS England, on the delivery of reforms to detention.

--- Later in debate ---

[Oliver Dowden]

I quite agree that we need to have the right levels of staff, and that is why I am so pleased that the Government have protected police funding. I was going to come on to this point, but I will raise it now. In the health service, we are moving towards achieving parity between mental and physical health. Some of the stats on this are very welcome. We are now spending £11.6 billion a year on mental health, for example. I believe that that is more than we have ever spent before. Also, the Health and Social Care Act 2012 is giving parity of esteem.

[Victoria Atkins]

Does my hon. Friend agree that this is not just about the numbers of staff but about how well they are trained to work in the particularly difficult circumstances of a mental health unit? The pressure on members of staff is particularly acute in such an environment. Clause 5 requires training in the appropriate use of force, which will provide positive benefits for members of staff.

[Oliver Dowden]

My hon. Friend is absolutely right. I do not think anyone is suggesting that police officers are actively seeking to treat mental health patients in an incorrect fashion, but there is a need for training so that they understand the correct way to behave.

--- Later in debate ---

[Mrs Trevelyan]

My hon. Friend is exactly right. It is incumbent on us as we go forward with this Bill to set these new markers to ensure that we get a cultural change; we need that understanding that mental ill health is part of our life experience and most of us may well suffer from it in one form or another. For those who are the most vulnerable we absolutely need to ensure that the practices are the best they can be, so that dignity and respect is afforded to every person who needs that support.

Transparency and accountability will also allow health professionals and emergency staff to manage the risks, protecting not only the patient, but our public servants. This can protect them from false allegations and allow us to have that evidence should things go wrong. Body-worn cameras are so important in this regard. The prison in my constituency, HMP Northumberland, was one of the prisons where body-worn cameras were trialled. This has been running for nearly two years now and there has been a dramatic drop not only in the reported cases of argy-bargy between prison officers and inmates, but in poor behaviour, because inmates who might have decided to have a go cannot be bothered anymore because they know it is going to be filmed; the relationship has improved so much as a result. This has created the same thing as we see where a teacher has good discipline in the classroom, understanding that if we provide a framework everyone within it works in a more conciliatory and more constructive fashion.

[Victoria Atkins]

I am a huge supporter of body-worn cameras on police officers and on prison officers, because I believe it protects not only them, but members of the public. Does my hon. Friend agree that just as—I hope—body-worn cameras will help victims of domestic violence who perhaps do not have the confidence to give evidence against their assailants, or cannot face the consequences of doing so, the same thing may apply in respect of prisons?

[Mrs Trevelyan]

My hon. Friend is absolutely right. Interestingly, even in the social media world we all live in, a storm of anonymity allows a level of poor behaviour. If the body-worn camera empowers people to remember that anything from good manners and good behaviour to constructive dialogue rather than more violent interventions is the way forward, this must be a tool we should be encouraging across the board. One hopes that behaviour can improve once people remember how these things can be done more constructively and with less violent interventions.

Surgical Mesh Implants

Victoria Atkins Excerpts

Wednesday 18th October 2017 Westminster Hall

[Emma Hardy]

I absolutely agree and thank the hon. Gentleman for raising that.

Currently in the UK, there are about 100 types of vaginal mesh implants. Carl Heneghan, professor of evidence-based medicine at the University of Oxford, has raised concerns about the evidence that mesh manufacturers need to provide before their products are approved and made available on the NHS. It is extremely worrying that the Pelvic Floor Society, which is associated with the surgeon Mr Dixon and was set up as a world expert group, is partly sponsored by mesh manufacturers. The BBC spoke to the Pelvic Floor Society on camera during the “Inside Out West” documentary and was told that it had discovered complications only in 2014. However, minutes of a joint meeting of the southern, midland and northern groups of the Pelvic Floor Society in October 2012 say:

“We need to ensure that all individuals are appropriately consented for the risks of mesh placement; Long term Shrinkage, Mesh erosion, Mesh failure. We need to have a prospective registry for”

laparoscopic ventral mesh. Why, if the industry knew about these problems in 2012, are they only coming to light now? That is further proof that the Government must do something about this.

One thing that could be done is to follow the recommendations of the all-party parliamentary group and bring forward publication of the NICE guidelines on mesh for stress-related urinary incontinence. Currently, NICE says that it plans to publish revised guidelines in 2019, but we think that is too long to wait. We want NICE to urgently prioritise them. Mesh as a first-line treatment for incontinence and prolapse should be suspended until the NICE guidelines are revisited.

In May this year, the Scottish Cabinet Secretary for Health and Sport, Shona Robison, confirmed that the Scottish Government had suspended the treatment for people with pelvic organ prolapse. Until we have a proper understanding of just how many women are suffering from mesh injury, we think the surgery should be suspended, but in all cases, not just for pelvic organ prolapse.

Professor Carl Heneghan says that some of the devices used in mesh treatment have not been clinically tested or trialled and that the number of people affected by mesh injury means that this could be one of the biggest medical scandals of our time. Suzy Elneil, consultant urologist at University College London, has also warned about the number of women affected by mesh injury. She is one of the few qualified surgeons in the UK who can remove mesh once it has been fitted and she tells me that she sees about 15 women a week who are suffering following mesh surgery. Consultant gynaecologist Dr Wael Agur from the University of Glasgow was once an advocate of mesh surgery, but has changed his mind since seeing at first hand the evidence of mesh risks. He agrees that there is significant under-reporting of mesh complications and says that, as a result, the MHRA has only a fraction of the knowledge of adverse events associated with mesh.

[Victoria Atkins (Louth and Horncastle) (Con)]

I apologise for arriving late to the debate, Mr Owen. I congratulate the hon. Lady on holding this important debate. The point that she makes about long-term complications is just as important as that about the short-term complications. My constituent developed fibromyalgia as a result of the complications arising from her mesh surgery for stress urinary incontinence. Does the hon. Lady agree that long-term conditions such as that must be taken into account?

[Emma Hardy]

Absolutely. Studies need to go far beyond the two years.

I am delighted that Labour has called for a public inquiry into the use of mesh. As my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) rightly said, it is extremely worrying that mesh surgery has been introduced so widely, with so little evidence and with limited trials to support it.

I call on the Government to do four things. First, they must commit to a full retrospective and mandatory audit of all interventions that involved mesh, followed by a full public inquiry. Secondly, they must suspend prolapse and incontinence mesh operations while the audit is being carried out. Thirdly, they must bring the NICE guidelines for mesh in stress-related urinary incontinence forward from 2019 to 2018. Fourthly, they must raise awareness among the general public and GPs.

Mesh implants have affected thousands of people all over the country. For some, the consequences of operations will be life-changing and devastating. A Government commitment to taking these actions will not undo the suffering and pain that these people have endured, but would go a long way to making sure that nothing like this happens again.

Contaminated Blood

Victoria Atkins Excerpts

Tuesday 11th July 2017 Commons Chamber

[Victoria Atkins (Louth and Horncastle) (Con)]

I welcome you to your place, Madam Deputy Speaker.

I join other Members in paying tribute to all those affected by this terrible tragedy, to the families of those affected and to hon. Friends and hon. Members, including the hon. Member for Kingston upon Hull North (Diana Johnson) and my hon. Friends the Members for Worthing West (Sir Peter Bottomley) and for Stratford-on-Avon (Nadhim Zahawi). I also pay tribute to the new hon. Member for Oxford East (Anneliese Dodds) for delivering her maiden speech in this important debate.

I speak today to give a voice to a constituent, who understandably wishes to remain anonymous. He was born with haemophilia and has had to endure that terrible chronic condition, the treatment for which has poisoned him—he has been infected with both HIV and hepatitis C. Those infusions have condemned him to a life of pain, of serious medication, which has its own side-effects, of major surgery and of worry. “Worry” seems an inadequate word to describe the constant weight that must be on his mind, and on the minds of those who love him, each and every day of his life.

This tragedy has affected every single day and every single aspect of his life, from his marriage to his ability to work and his family. He told me recently that he and his wife have told their grown-up child of his condition and his infections because, as he told me, “when is the right time to tell your child that you have HIV and hepatitis C?” So my constituent welcomes today’s announcement. He asks for a Hillsborough-style inquiry because, as others have said, people affected by this do not have time on their side.

I must declare an interest as a barrister. I hope the public inquiry will ensure that public money is directed towards those who need it most, namely the victims and their families, not towards massively expensive tribunal costs. I state that warning to any of my former colleagues in the legal profession.

I am conscious that some of my colleagues wish to speak in this debate, so I will finish by talking about a school photograph that my constituent brought into a surgery. It was like any other school photograph—children smiling, and with teachers on either end of the row—but this photograph was different. It showed my constituent’s class at the special school he had to attend because of his medical condition. Eight of his school friends had haemophilia. Four of those eight are now dead as a result of contaminated blood infections, and another is so ill that, in his early 50s, he is forced to live in a specialist care home because of how his body has been left.

My constituent and the thousands of others we have heard about today are the victims of a terrible episode in our national life. They have fought for justice for 30 years, and I thank this Prime Minister and this Government for listening and acting. I hope this inquiry delivers answers for those affected.