Oral Answers to Questions Debate
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Main Page: Wes Streeting (Labour - Ilford North)Department Debates - View all Wes Streeting's debates with the Department of Health and Social Care
(4 days, 13 hours ago)
Commons ChamberThe Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), sends her apologies due to a family issue. She is very much in our thoughts today.
Thanks to the decisions taken by my right hon. Friend the Chancellor at the spending review, health capital budgets will increase to £14.6 billion by the end of the spending review period. That will deliver the largest-ever health capital budget in NHS history. Across this settlement, more than £5 billion will be invested to address the most critical building repairs, reducing the most serious and critical infrastructure risks and rebuilding the broken NHS left by the Conservatives.
While I welcome the recent announcement of £12 million of extra funding for Epsom and St Helier university hospitals NHS trust, it is quite frankly a drop in the ocean in comparison with the scale of need, because the current backlog at the trust costs £150 million. Patients and staff deserve safe and modern facilities, not patchwork repairs. I therefore ask the Secretary of State to meet with me and visit Epsom and St Helier hospitals to see at first hand the scale of the challenge and how we can accelerate progress.
I absolutely appreciate the challenges that the hon. Member describes, having met with the trust myself. The Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth) and I have both met with local MPs about the challenges facing Epsom and St Helier. Lord Darzi’s investigation found that the Conservatives left a £37 billion black hole in NHS capital. We are reversing that trend, with the largest-ever capital budget for health. The £12.1 million for Epsom and St Helier trust for estate safety is in addition to the £207 million of capital that the NHS South West London integrated care board is receiving, including for maintenance backlogs. It will take time, but brick by brick Labour is rebuilding our NHS.
The Imperial College healthcare NHS trust has the largest high-risk repair backlog in the country. The support from the Government estates safety fund is very welcome, but to solve this problem we ultimately need a new St Mary’s hospital. Will the Secretary of State join me in praising the work of the new three-year St Mary’s taskforce, which aims to get to full planning consent and explore different financing models so that we can finally get this hospital built?
I thank my hon. Friend for the work that he and my hon. Friend the Member for Cities of London and Westminster (Rachel Blake) are leading in partnership with the trust and Westminster city council to ensure that the people of his constituency have the hospital they deserve. As he knows, this will be the most complicated scheme in the new hospital programme, but that is no excuse for the years of delay that the scheme has faced. The trust now boasts the biggest high-risk repair backlog in the country, so my hon. Friend is right to ensure that this is not allowed to be put in the “too difficult” pile again. We look forward to engaging constructively and doing everything that we can to expedite the progress that is desperately needed for his community and our city.
The Government inherited a ludicrous situation whereby patients could not get a GP appointment and GPs could not get a job, so one of my first acts was to cut red tape to give practices flexibility to hire GPs, along with an extra £82 million investment. Thanks to that combination of investment and reform, this Government have recruited an additional 1,700 GPs to the frontline since July, exceeding our target of 1,000. We have invested an extra £889 million in general practice this year, taking action to bring back the family doctor. We do not pretend to have solved all the problems, but change has begun and the best is still to come.
I welcome the Government’s commitment to restoring the family doctor, and the recruitment of 1,700 additional GPs nationwide, but my constituency has yet to benefit from that. Concern has been expressed to me about the expansion of the additional roles reimbursement scheme to include only newly qualified GPs, which it is feared may be too restrictive. I have met local GP partners who share that concern, so will the Secretary of State meet us to discuss how the scheme can better support areas such as mine?
We are investing an extra £900 million in general practice, and have reformed the GP contract to help bring back the family doctor and end the 8 am scramble. That contract reform included further changes to make it easier to recruit GPs through the scheme. As my hon. Friend will see shortly when we publish the 10-year plan for health, general practice is at the heart of our proposals to build a neighbourhood health service. I am keen to work with her and with GPs to make it even easier to ensure that qualified GPs can get jobs and patients can get GP appointments, and I should be delighted to meet her.
After 14 years of the Conservatives running down the frontline of the NHS, many people in Basingstoke still struggle to gain access to their GPs. One issue that patients and GPs raise time and again is the lack of capital investment in new provision to meet growing housing need. Chineham medical practice, for example, was built to serve just 8,000 patients but now serves more than 18,000, and is set to serve many thousands more in the years to come. What more are the Government doing to enable every patient in Basingstoke to see their GP when they need to?
My hon. Friend is absolutely right. Just as this Government are delivering record home building with a huge target to build the homes that Britain needs, we also need to ensure that people get the local services that they deserve. That is exactly why this Government have invested an extra £102 million this year to create additional clinical space in over 1,000 GP practices, which will create new consultation rooms and make better use of existing space to deliver more appointments. I know the Chineham medical practice was one of the practices put forward by its integrated care board for funding, so I hope we will see that practice benefiting from this investment in the near future as we rebuild our NHS.
The Government’s additional roles reimbursement scheme led to just three new GPs for my constituents in Wokingham, which is a drop in the ocean. More needs to be done to deliver GP practices in new developments such as Arborfield in south Wokingham. Why did Ministers not support the Liberal Democrat amendment to the Planning and Infrastructure Bill that would have made commitments to build GP surgeries in all new housing developments legally binding?
Probably because being that prescriptive about every housing development is not sensible, even if the thrust of what the hon. Member describes—that as new housing development is built, we need to ensure that local infrastructure goes alongside it—is the right approach. I take what he says about the number of GPs, and as I have said, we do not pretend to have fixed all the problems in 11 months, but with respect, those are three more GPs than were there before. I know there is more to do, but give me time, and we will rebuild general practice for his constituents and anyone else’s.
Access to GPs in my constituency of Chichester is being undermined by the closure of the Westbourne branch of Emsworth medical practice at the end of this month. Patients will now have to travel to Emsworth, but we are talking about a small rural village, and there is no public transport to get my elderly and vulnerable patients to that medical practice over the border. Will the Secretary of State please meet me to urgently discuss how we can protect this vital service in a rural village in Chichester?
I can well understand the hon. Member’s concern and her constituents’ concern. Practice closures are hard on communities wherever they are, but they disproportionately hit rural communities and those that suffer with poor transport connectivity. I would urge her in the first instance to raise the specific local issues with the ICB. However, I reassure her and other right hon. and hon. Members that the needs of rural, coastal and remote communities are very much in our mind—and, crucially, in the 10-year plan—and our thinking about how we build genuine neighbourhood health services in all types of neighbourhood.
This Government are delivering record investment in our NHS, but that investment is drawn from taxpayers, and we have a responsibility to every taxpayer in the land—as well as to patients—to ensure that every single penny is well spent. That is why that investment is matched with bold reform, so that we get as much value as possible for every penny. The abolition of NHS England will slash duplication and unnecessary bureaucracy, and I am pleased to report to the House that we have slashed spending on agency staff by almost £1 billion compared with last year. All those savings are being reinvested into frontline care.
From speaking to my local NHS trust in Gateshead, I know the value it places on driving costs down, but it still faces financial pressures. Key among those are issues related to the digital capital gap. We are really keen in Gateshead to improve that situation and to allow more people to access the NHS remotely. Will the Secretary of State meet me and Gateshead NHS trust to talk about how we can tackle that?
I would be delighted to do so. My hon. Friend is absolutely right: we have to ensure that the NHS is not only benefiting from, but at the forefront of the revolution taking place in digital services and medical technology. It is key to driving productivity and financial sustainability. That is why, at the spending review, the Chancellor announced that we would invest up to £10 billion in NHS technology and digital transformation; unlike our predecessors, we will not raid tech budgets to plug shortfalls in day-to-day spending. Just this month, we announced the modernisation of the NHS app, so that patients can receive test results and book appointments, saving £200 million in stamps, envelopes and letters.
I thank the Secretary of State for his earlier reply. In Scotland, there are more quangos than MSPs. After four years and £30 million of taxpayers’ cash down the drain, the SNP has scrapped its plans for a national care service—its flagship policy—which was seen as a significant setback for Scottish social care reform, and now we have people going to the pub in chauffeur-driven ministerial cars. Will the Secretary of State advise his Scottish counterpart on how to stop wasting Scottish taxpayers’ money?
Given the state of the NHS in Scotland, I suspect my counterpart needed to go and drown his sorrows. The truth is that the longer the SNP is in government, the longer the NHS in Scotland is on the road to nowhere. The SNP is now on its fifth health plan in four years. Thanks to the decisions taken by the Chancellor, it is not just the NHS in England that is receiving record investment, but the Scottish Government. I have used that investment to cut waiting lists by almost a quarter of a million people; the same could be true in Scotland, if the Scottish people boot out the SNP and elect Anas Sarwar and Jackie Baillie to deliver the change that Scotland’s NHS needs.
A good way to save money in the NHS is to invest in palliative and end-of-life care, because it averts costs that would otherwise go into the acute sector, including into ambulances. However, this Government are taking money from that sector through their national insurance rises. Given that integrated care boards are supposed to commission palliative care, will the Secretary of State commit in the 10-year health plan to a proper revenue funding model for hospices, and for a minimum service specification for palliative care?
I can reassure the hon. Member that end-of-life care is featured in the 10-year plan for health. I also recognise the pressure on our hospice sector, which is why this Government, as well as delivering £26 million through the children’s hospice grant, committed £100 million of capital investment— the biggest in a generation for our hospices. None the less, hospices do rely on the generosity of donors and I am keen to work in partnership with the sector to look at what more we can do to encourage investment. The final thing I would say is that the Opposition parties welcomed the investment in the national health service while opposing the means of raising it. They cannot have it both ways; either they support the investment and the revenue raisers or they have to be honest with the public that they would be cutting the NHS.
One of the most egregious examples of waste in recent years was the almost £10 billion spent on useless personal protective equipment during the pandemic. When the Treasury eventually recovers some of that money, will the Secretary of State assure me that Scottish taxpayers will benefit in the usual way through the usual channels?
Fiscal decisions and spending are matters for my right hon. Friend the Chancellor, but let me reassure the hon. Gentleman of two things. First, the way in which the taxpayers of this country were ripped off during a national emergency was a total disgrace, and this Government are determined to get our money back and reinvest it in frontline services, where it should always have been. Secondly, I can reassure him that, so long as there is a Labour Government here in Westminster, Scotland will continue to benefit from the investment it needs to sort out its public services. Now it just needs a Labour Government in Scotland to spend that money wisely.
This Government are committed to fixing the NHS and reducing A&E waiting times. Our new urgent and emergency care plan is backed by nearly £400 million of investment to deliver new urgent treatment centres, mental health assessment centres and almost 400 new ambulances. Alongside that investment, we are reforming urgent and emergency care so that more patients are treated at the scene or in their homes where appropriate, which is better for them and will help to unclog A&E departments. Lots has been done, but there is much more to do.
The Minister for Secondary Care recently visited my constituency and saw the pressures that Newham hospital A&E was under. That is partly due to the pressures left by the previous Conservative Government, and partly due to capacity issues resulting from a massive growth in population in the borough. Further pressures will come as we regenerate the massive areas of brownfield site in the Royal Docks. Can the Secretary of State reassure my constituents that, as well as the excellent work being done on day-to-day capacity, we will be looking at infrastructure over the longer term to make sure that we are not only dealing with the growth that we have had, but future-proofing for the population growth to come?
I know that my hon. Friend the Minister for Secondary Care enjoyed her visit, and I thank the staff at Newham hospital for the work they do, which also benefits my constituents. We need to make sure that we are supporting hospitals across our country to meet need, because we are part of a wider ecosystem—I noticed that that point was also powerfully made by the hon. Member for Romford (Andrew Rosindell) in his question. My hon. Friend the Member for West Ham and Beckton (James Asser) is right to raise increasing demand and pressures, which is why we will shortly publish our 10-year plan for health. I am happy to report that Whipps Cross and Newham hospitals have also been provisionally allocated £28 million this year to improve buildings and estates.
The Government continue to claim that they wish to expand community diagnostic centres to speed up scanning and treatment of patients and therefore reduce demand on the likes of A&E. If that is the case, why are they cutting the revenue tariffs that were available to the community diagnostic centres under the previous Conservative Government, which has already impacted the financial viability of the CDCs and access for patients?
I think the hon. Gentleman will find that, since this Government came to power, we have reduced the size of NHS waiting lists by a quarter of a million. NHS waiting lists are coming down—latest figures show that this is the first time in 17 years that waiting lists have fallen in the month of April—so we are making progress, not least thanks to the investment that we are putting into community diagnostic centres. The hon. Gentleman has some brass neck to complain about NHS services under this Government, when we are cleaning up the mess that the previous Government left behind.
Waiting lists are at their lowest level for two years, we have taken almost a quarter of a million patients off waiting lists and for the first time in 17 years waiting lists were cut in April. There is a long way to go, but this Government are finally putting the NHS on the road to recovery. Through our plan for change, I have announced that the NHS will also be at the forefront of the revolution in life sciences. Through the NHS app, patients will be linked up with relevant trials to boost our life sciences sector, generate investment for the NHS and develop the medicines of the future.
It is nearly four years since Professor Sir Chris Whitty published his striking report on health in coastal communities. Covid inevitably delayed implementation, so will the Secretary of State look again at that report, deliver on the chief medical officer’s recommendations and ensure that my constituents in Bridlington and The Wolds can access the health services that they need?
The hon. Gentleman is right to commend Sir Chris Whitty’s report. We have taken that into consideration, as well as the wider consultation we did in preparation for our 10-year plan for health, which will commit to tackling the gross health inequalities that affect our country, particularly in rural and coastal communities.
I absolutely agree with my hon. Friend. It is thanks to the fact that his constituents sent him to this House of Commons that we have a Labour Government able to deliver, with him, for his community.
May I, through the Secretary of State, pass on my best wishes to the Under-Secretary of State for Health and Social Care, the hon. Member for West Lancashire (Ashley Dalton)? In front of the Health and Social Care Committee in January, NHS England’s then chief financial officer set out that pretty much all the additional funding to the NHS last year would be absorbed by pay rises, national insurance contributions and inflation. What proportion of the latest additional funding will be absorbed in the same way?
First, I just do not buy the argument that investing in our staff is somehow not investing in the NHS. Who on earth do the Opposition think provides the treatment, delivers the care, organises the clinics and delivers the services? Even in this great new world of technology, the NHS will always be a people-based service and I am proud that this is a Government who deliver for staff. We are also waging war on waste, and that is how we can deliver fair pay for staff and improve care for patients. If only the Conservatives had done that when they had the chance.
The right hon. Gentleman could not answer that question, but hopefully we will get a more positive response to this one. I recently had the privilege of meeting Dr Susan Michaelis and her husband Tristan, who have set up the Lobular Moon Shot Project, which large numbers of Members of all parties across the House have backed. They are seeking £20 million over five years—a tiny sum in the context of the overall NHS budget—to research lobular breast cancer, which Susan is currently battling, to help improve outcomes. Her immediate ask is even simpler: it is for the Secretary of State to meet her in person to discuss the campaign and its aims. He is a decent man. Will he agree to do that?
I thank the shadow Secretary of State for his question and, even more importantly, I thank the amazing campaigners for what they are doing. This is probably the easiest question he is ever going to ask me. The answer is, of course, an emphatic yes.
Can I first thank my hon. Friend the Minister for Care for the considerable amount of work he has done to support the House as it makes its deliberations on this important issue? Of course, the Government are neutral; it is for the House to decide. There is not money allocated to set up the service in the Bill at present, but it is for Members of this House and the other place, should the Bill proceed, to decide whether to proceed. That is a decision that this Government will respect either way.
I should just say for the record that it is thanks to my friends at the Treasury that we are able to do so much to invest in our health service. It is important to put that on record ahead of the Budget. The hon. Lady raises a really serious issue, and we are looking carefully at what we can do to ensure that we get great people into our health service and that they can look forward to a great career. We are not in the right place as a country now; we need to be in a better place. The 10-year plan will set out our ambitions on workforce and we will publish a new workforce plan later this year.
My constituency, in Scotland, has a significant shortage of health and social care workers, despite extensive efforts to advertise recruitment to get people in, as replicated in parts of England, Wales and Northern Ireland. The rug has been pulled out from under that by the changes to immigration policy and visas for that sector. Will the Secretary of State commit to pushing this harder in Cabinet to ensure that we can have more geographic and sectoral visas?
I am really proud of the contribution that overseas workers make to health and social care services across our country. If they all left tomorrow, the services would simply collapse. But I think there is an overreliance on overseas staff in health and care services, and that is contributing to levels of net migration that are simply unsustainable. I have a responsibility to help the Home Secretary bring those numbers down and to give opportunities, through better pay and career progression, to home-grown talent, and that is what we will do.
The Secretary of State may well be aware of the greater awareness among young people of nicotine pouches. That seems to be a gap in the Tobacco and Vapes Bill currently going through Parliament. Will he commit to look at this issue to ensure that it is covered and that we bar this alongside other forms of tobacco and nicotine?
As the hon. Gentleman knows through bitter experience, that rotten industry always finds a way, and we have to keep on top of it and tackle the scourge of nicotine addiction. He knows about this issue better than most, he having campaigned so assiduously on it, and he is right to raise it, so let us look at what we can do to strengthen the Bill, if we can, as it goes through Parliament.
In Prime Minister’s questions last week, I raised the need for a universal national screening programme for type 1 diabetes. Will the Secretary of State agree to meet me to discuss this, so that it could form part of the 10-year plan, given that it fits so neatly into prevention of issues such as diabetic ketoacidosis over treatment?
I was in the Chamber to hear the hon. Member’s question. Obviously we are led by clinical advice when it comes to decisions on screening programmes, but I understand the case she makes. I would be delighted to ensure that she gets a meeting with the relevant Minister.
I have raised with Ministers before my concerns about the closure of St Mark’s walk-in urgent care centre in Maidenhead. Frimley ICB has confirmed yet again that it will not reopen the centre, against the will of the majority of Maidenhead residents. Will the Secretary of State meet me and local campaigners to see how we can finally get St Mark’s walk-in centre back open after five years of closure?
I know that the hon. Gentleman’s constituents will have noted, through his representations as a constituency MP, that he could not have fought harder to save that service. We devolve these sorts of decisions to ICBs, in order that they make decisions closer to the communities that they serve, with the conviction that those sorts of decisions are better taken locally than centralised in Whitehall. I understand the case that he makes, but having given ICBs a challenge, resources and freedom, we Ministers must resist the temptation to meddle every time they make decisions that they believe are right for the community, even if those decisions are controversial.
Will the Minister look into minimising the pain of patients going through hysteroscopy and biopsy procedures by requesting that medical professionals fully brief them on anaesthetics and pain relief in advance of procedures to ensure that they can plan accordingly?
Absolutely: the NHS always does better under a Labour Government.
Barking community hospital in my constituency has been providing antenatal services to mothers in Barking for many years, and women also use its services to give birth. I was therefore really disappointed when I heard last week that the maternity birthing unit is likely to close. Many in my community are deeply concerned. They are being redirected to Newham hospital, which the Care Quality Commission has rated as “requires improvement”. Women deserve to give birth in a safe clinical environment. Will Ministers ensure that additional attention and resources are provided to Newham hospital, so that it improves its standards and my constituents who are being redirected to give birth there can do so in a safe clinical space?
Making sure that women are giving birth safely is the ultimate priority and the least that women deserve. I understand my hon. Friend’s anxiety about this reconfiguration, and she is right to raise that with the ICB in the first instance. We are happy to meet her as Ministers, too. The crucial thing is that the services are configured and delivered in a way that prioritises the safety of women and their babies.
In March, the Minister for Care told me that no decision could be taken on a new dental school at the University of East Anglia until the spending review settlement was known. Now that we know it, will he instruct the Office for Students to allocate new training places at the UEA from 2026?
Between 2001 and 2011, the 15% health inequalities weighting in NHS allocations made a positive, measurable difference to the health of deprived people. Unfortunately, it was cut to 10% in 2015. With the spending review’s increase in funding to the NHS, when will the health inequalities weighting reach 15%?
I am really grateful to my hon. Friend for her question. She is right to highlight the importance of funding following inequalities to redress that imbalance. I think she will be pleased with where we are with the 10-year plan for health, and I would be delighted to meet her to discuss it.
People in East Devon have been told that they must now travel to Exeter for audiology services that they previously received at their local community hospital. What steps are the Government taking to encourage new providers to restore accessible audiology services?
That has been a running theme this morning, which will not be lost on Ministers. We will ensure, as we deliver neighbourhood health services, that people can receive care closer to home, wherever they live. We have heard that message loud and clear today, and I think the hon. Member will see that priority reflected in our 10-year plan for health.
I declare an interest, as my brother is a GP. When my residents are able to get a GP appointment, they are frustrated when they are sent halfway across the borough to a different surgery from the one they are registered with by their primary care network. Can we address that, and is it part of our proposals in the new GP contract?
We do want to put GPs at the heart of neighbourhood health services, and we want people to have care close to home. There are benefits to primary care working at scale, so I would not want to criticise them for doing that. The important thing is different courses for different horses. Some of us are much more mobile, more active and more online and would welcome that flexibility. For others, continuity of care that is close to home, or indeed in their home, is important. It is important that people get the right care, in the right place, at the right time, wherever they live, and that is what we will deliver.
I am grateful for the consideration the Secretary of State has already given to finding a fairer and more effective way of compensating those injured by a covid vaccination, but he knows that those who are profoundly affected by such injuries are anxious for news. Can he give me, and indeed them, a progress report?
I reassure the right hon. and learned Gentleman, the constituents of his I have met and other campaigners that I am having discussions with the Cabinet Office about how we deal with that and other issues that have been raised this morning, including the sodium valproate scandal. He knows the complexities involved, and I have been grateful for his advice as a former Attorney General. I do not have specific progress to report now, but I reassure him and campaigners that this issue has not gone off the boil and we are working to find a resolution.
The challenge of finding and keeping an NHS dentist is raised with me time and again across the Filton and Bradley Stoke constituency, and I welcome the early action that this Labour Government have taken to introduce more than 19,000 urgent care appointments across our integrated care board area. What will be the next steps to help ensure that NHS dentistry is opened up again to everybody?
The Secretary of State will know that my local ICB in Bedfordshire, Luton and Milton Keynes is set to merge with Hertfordshire, Cambridgeshire and Peterborough. The new ICB will cover a population of about 3 million people. Given the difficulties we have had securing a GP surgery in Wixams, will the Secretary of State set out how supersizing that quango will help rural mid-Beds to get the local healthcare it needs?
May I respectfully say that that was part of the problem with Conservative thinking? They thought that the answer to the NHS crisis was more quangos, and they measured success in the number of ICBs, not the number of appointments and the size of the waiting list. We are taking a different approach, slashing bureaucracy and reinvesting in the front line. We are not centralising but decentralising, and cutting waiting lists—a record that the Conservative party cannot begin to touch.
A couple of weeks ago at my constituency surgery, though tears my constituent Amy explained how, following a hip operation in 2008, she suffered progressive nerve damage due to repeated failures in diagnosis, referral and treatment. Despite raising concerns for years, she was told that her pain was common. A nerve test in 2015 confirmed damage, and further tests last year showed a significant deterioration. After 17 years she has only now been offered surgery. All Amy wants to know is what steps are being taken to ensure that no other patient is left permanently disabled due to such prolonged and systemic failure—
Order. That is very important, but why does the hon. Member not want others to get in?
First, on behalf of the NHS I apologise to my hon. Friend’s constituent. That is an intolerable situation, but sadly not rare or exceptional. There is too much of that happening, and a culture of cover-up and covering reputations, rather than being honest with patients about failures. We are changing the culture. Safety is at the heart of the 10-year plan, and I would be delighted to talk to my hon. Friend further about his constituent’s case.
This morning I attended an event about bladder cancer. Bladder cancer is the fifth highest killer in the United Kingdom, and people were anxious to meet the Minister and discuss those matters. Will he agree to meet bladder cancer organisations to take forward their four objectives to make things better for people in the United Kingdom?
I am sure my hon. Friend the Under-Secretary of State for Health and Social Care (Ashley Dalton), who is the Minister responsible for cancer, would be delighted to meet campaigners, particularly as we put together the national cancer plan. We want to ensure that we capture every type of cancer, and genuinely improve cancer care for everyone in our country.
The Minister may have seen my constituent Mollie Mulheron recently featured on “Newsnight”. Our local ICB recently refused her access to fertility treatment after recovery from an aggressive cancer with a high likelihood that her illness will return. Will the Minister meet me and Mollie to discuss that issue, and access to fertility treatment for cancer survivors and patients?
Yes, I will make sure that my hon. Friend gets that meeting.