Cyber-security Strategy

Will Quince Excerpts

Wednesday 22nd March 2023 Written Statements

[The Minister for Health and Secondary Care (Will Quince)]

My hon. Friend the Parliamentary Under Secretary of State, Lord Markham, has made the following written statement:

I am pleased to announce the publication of the Cyber-security Strategy for Health and Adult Social Care to 2030. The strategy sets out a vision to 2030 for a health and social care sector that is resilient to cyber-attack. It establishes cyber security as a foundational business need to ensuring patient and service user safety. Improved cyber resilience will assure availability of services, protect valuable data, enable quicker response and recovery when attacks do occur, and increase public trust.

The health and social care sector has made good progress in recent years, by making use of the increasing cyber defence and response mechanisms at its disposal, with the sector now much better protected from untargeted attack than it was at the time of the WannaCry cyber-attack in 2017. However, we still have further to go. This strategy will shape a common purpose and an approach that will be applicable across health and social care systems including for adult social care, primary care, and our critical supply chain as well as for secondary care.

Digital transformation offers huge opportunities for the sector and building cyber security into our design will be essential as we put the right technology and controls in place to realise those benefits. The five pillars in our strategy, developed collaboratively across the health and care sector, focus our approach on the most important risks to our most critical systems, while growing our cyber workforce so that we can better tackle threats in the long term. The strategy will be supported by a national implementation plan in summer 2023 which will detail activities and define metrics to build and measure resilience over the next two to three years.

[HCWS662]

Clinical Trials Consultation Response

Will Quince Excerpts

Tuesday 21st March 2023 Written Statements

[The Minister for Health and Secondary Care (Will Quince)]

The Government have announced plans to overhaul the legislation that governs clinical trials, to introduce a series of measures to make it faster and easier to run clinical trials in the UK. These changes will help speed up clinical trials, without compromising on safety, and encourage the development of new and better medicines for patients. They come after the Government announced an extra £10 million of additional funding for the Medicines and Healthcare products Regulatory Agency (MHRA) to accelerate the delivery of cutting-edge treatments, including cancer vaccines.

Leaving the European Union has provided a unique opportunity for the United Kingdom to improve regulatory regimes for healthcare products and exercise our new powers as a sovereign regulator. The Medicines and Medical Devices Act 2021 allows us to update the current legislation for clinical trials, creating a world-leading regime that prioritises patient safety while enabling and encouraging innovation within the clinical research environment.

To deliver this ambition and gather views of patients, industry and academia, we published a consultation on the future of UK regulations for clinical trials—“Consultation on proposals for legislative changes for clinical trials” www.gov.uk'>www.gov.uk on 17 January 2022.

We received 2,138 responses and I am grateful to all those who have taken the time to respond to the consultation.

Officials at the MHRA, in collaboration with the Health Research Authority (HRA), have analysed the consultation responses and have worked with officials within my Department and the Office of Life Sciences to develop the Government response. The response outlines changes that will support innovation within the UK’s life sciences sector and patient access to potentially life-saving medicines, for example through enhancing the transparency of clinical trials; enabling greater proportionality and streamlining the approvals process.

We are removing granular and duplicative regulatory requirements, moving away from ‘one size fits all’ regulation and embedding principles of proportionality. Ensuring that the regulatory requirements expected are more flexible to match the risk that a trial presents, will result in a regulatory framework that is responsive to all kinds of trials and adaptable to innovative research.

The changes also formalise the combined review process in legislation, ensuring research teams receive a single decision from both regulatory and ethical reviews, done in parallel between the MHRA and HRA. This reflects the UK Government’s intention to embrace innovation in clinical trials and accelerate the evaluation and implementation of advances in medical interventions to the benefit of UK patients everywhere.

The legislative changes outlined in the consultation response provide firm foundation for and align with the review of clinical trials led by Lord O’Shaughnessy and work undertaken by Sir Patrick Vallance, to ensure a pro-innovation regulatory environment. Through this collective work we will cement our status as a science superpower by making the UK the best place in the world to conduct fast, efficient and cutting-edge clinical research.

The Government’s response to the consultation will be published on www.gov.uk'>www.gov.uk today.

[HCWS659]

Draft Health Education England (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023

Will Quince Excerpts

Monday 20th March 2023 General Committees

[The Minister for Health and Secondary Care (Will Quince)]

I beg to move,

That the Committee has considered the draft Health Education England (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023.

It is a pleasure to serve under your chairmanship, Sir Edward. I am grateful to be in the Committee today to debate these important regulations, which are intended to transfer all the functions of Health Education England to NHS England and to abolish Health Education England. They use powers under section 103 of the Health and Care Act 2022 that allow regulations to transfer functions between relevant bodies listed in the Act and to abolish a body if that transfer of functions has made it redundant.

The merger is in line with a recommendation from the Public Accounts Committee back in 2020 to review the effectiveness of having a separate body overseeing the planning and supply of the NHS’s future workforce, which the Department of Health and Social Care accepted.

[Theresa Villiers (Chipping Barnet) (Con)]

Regardless of the transition and of who is in charge of education to train the doctors and nurses of the future, we need a lot more of them. Will the Minister assure us that the workforce plan that the Government are going to publish will deliver the doctors and nurses we need to meet rising healthcare need?

[Will Quince]

My right hon. Friend is absolutely right. We need medics across the NHS in various functions: consultants, doctors, surgeons, allied health professionals, nurses, nursing associates, apprentices and so much more. That is exactly why we commissioned NHS England to undertake a long-term workforce plan. She will know that the Chancellor set out in the autumn statement, and reiterated in the recent Budget, that we will publish that plan very shortly—certainly this spring. It will also be independently verified. It will set out our plan and the workforce requirements for the next five, 10 and 15 years. It needs a bit of patience, but it is a hugely important piece of work because, as she rightly says, the NHS needs that workforce to plan for the future.

[Vicky Ford (Chelmsford) (Con)]

Carrying on from what my right hon. Friend the Member for Chipping Barnet said about the doctors and nurses of the future, one of the very successful things that this Government did five years ago was introduce 10 new medical schools. The one in Chelmsford at Anglia Ruskin University is hugely successful and the first new doctors will graduate in just a few weeks. It has some of the lowest drop-out rates anywhere in the country, and the new doctors want to stay locally. Will the Minister press the case for expanding very successful medical schools such as the one in Chelmsford?

[Will Quince]

I thank my right hon. Friend for her question. She is absolutely right. I was due to visit her medical school but, unfortunately, because of illness I could not. I still very much hope to do so. She is right that we need to train more medics domestically, although we have international recruitment. We increased the number of doctors we train by 1,500—a 25% increase to 7,500 per year. I urge her to wait just a little longer for the long-term workforce plan, which will set out our requirements for the future and how we go about ensuring that we fill the places and get medics in training. I am conscious that doctors are one of those groups.

Both of my right hon. Friends talked about planning, which is very much at the heart of the regulations. Their intention is to more closely align workforce planning, which is currently the statutory function of Health Education England, with the service and financial planning responsibilities of NHS England. That will enable service, workforce and finance planning to be properly integrated in one place. Nationally and regionally, it will build on the work that has been done to develop the NHS people plan. It will also help to drive reforms in education and training further and faster so that employers can recruit the health professionals needed to provide the right care to patients in the future.

Merging Health Education England with NHS England will simplify the national system, leading the NHS to end the separate lines of accountability that exist for the two bodies. Currently, Health Education England is responsible for workforce planning, education and training, but NHS England is responsible for culture, retention, international recruitment, workforce and leadership. Uniting those functions will help us ensure a joined-up and long-term view of what our NHS workforce needs for the future.

I pay tribute to Health Education England’s leadership and staff throughout the organisation’s 10-year existence. It has played a hugely effective role in the delivery of growth in the number of health professionals trained in England. It has promoted the creation of new roles, such as nursing associates, and spearheaded reforms to professional training workforce growth; record numbers now work within our NHS. It was hugely flexible and effective during the pandemic, including by supporting the deployment of students to the frontline at critical moments.

I am delighted that as of 1 April this year, Dr Navina Evans will become the chief workforce, training and education officer in the new NHS England. Sir David Behan, the chair of Health Education England, was appointed as a non-exec director of NHS England on 1 July. Those appointments are both important, because they will ensure that there continues to be excellent national leadership of NHS education and training.

I know there will be concern in some quarters that the changes pose a risk of budgets being used for other purposes. However, we have put in place a number of measures, including ministerial oversight, to ensure that that will not be the case. I am happy to elaborate on that later if required. Very briefly, we will include objectives on the workforce within NHS England as part of the NHS England mandate. We will continue to monitor and track expenditure on education and training with, as I said, a ministerial chaired board to provide that important ministerial oversight and governance of the workforce in NHS England.

Health Education England and NHS England already work closely together to ensure that the NHS has the workforce that it needs for the future. As I said in response to the question from my right hon. Friend the Member for Chipping Barnet earlier, we have commissioned NHS England to develop that long-term workforce plan for the next five, 10 and 15 years’ time. In effect, that plan will look at the mix, the number of staff required, and the actions and reforms that will be necessary across our NHS to reduce supply gaps and—importantly—improve retention.

[Sir John Hayes (South Holland and The Deepings) (Con)]

I am sorry to have missed the beginning of the Minister’s remarks, but I want to make a case for dentistry in all this. Given that the aim of the draft regulations is to align the workforce more with local need, and that they are designed to improve care standards and workforce availability, will he look at the dental deserts such as Lincolnshire, where we cannot straight-forwardly access NHS dental care? There are more dentists in London than one could shake a stick at—there are even more than there are barbers—yet in Lincolnshire it is very hard to obtain a dentist. Would he look at that in terms of the strategic change that he has described?

[Will Quince]

I thank my right hon. Friend for his question. He is right to raise dentistry, because, as he rightly points out, there are dental deserts across the country. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), is looking closely at dentistry, including workforce and supply and the use of a skill mix. Of course, it does not have to be a dentist, as others who have similar qualifications can do a lot of work that a dentist does, including on children. My hon. Friend will publish a dental plan in the coming months, and I hope that addresses my right hon. Friend’s point.

In conclusion, the merger will continue to build on Health Education England’s great work, putting education and training at the heart of service planning for the long term. The draft regulations will simplify the architecture of our NHS at national and regional level and ensure it has the workforce that it needs now and in the future. I commend the regulations to the Committee.

--- Later in debate ---

[Will Quince]

I thank the hon. Gentleman for his support and that of the Opposition Front-Bench team. I will go through his questions in reverse order. First, the NHS long-term workforce plan is coming shortly. I know that is a broad term when it comes to the Government. It is a bit like spring—it can stretch all the way to June and July—but it will be published shortly and it is being finalised. I cannot be more precise than that. It will certainly be soon. We commissioned it, and NHS England drafted and produced it, and will be integral in delivering against it.

He mentioned talent and expertise being retained across both Health Education England and NHS England as the two organisations are merged. He is absolutely that all Health Education England staff will automatically transfer to NHS England. The merged organisation will reduce in size by between 30% and 40% by April 2024. However, it is important to stress that both NHS England and Health Education England have already had recruitment controls in place since July 2022. They also launched an initial voluntary redundancy scheme in January 2023. Of course, we keep a watchful eye on that because we want to ensure that we are maintaining the very best talent and expertise in the area, especially given the importance of workforce to the short, medium and long-term future of the NHS.

The hon. Gentleman asked about performance and how we will monitor performance. That is done in a number of ways. First, on performance and what good looks like, the merger is designed to help us ensure that service, workforce and financial planning are integrated into one place, at both a national and a local level. That is what we are trying to achieve through the regulations. We are also trying to ensure that we drive change in education and training much further and faster than we can at the moment through HEE.

That will be monitored in two ways. First, through robust governance, as we will set objectives and place them on the NHS England mandate. We will also have a ministerial chaired board. I suspect that I—or the occupant of my role, at least—will chair that, but that is not confirmed. Also, we will ensure that we have clear governance plans in place to track and monitor performance going forward. That is particularly important in addressing some of the concerns that people have about the NHS England training budget, given the importance of the workforce to the NHS. I think something like 65% of all the funding allocated to the NHS rightly goes on the workforce—the beating heart of the NHS.

I hope that answers all the questions from the Committee. I thank the hon. Member for Denton and Reddish, the representative for His Majesty’s Opposition, and all hon. and right hon. Members for their interventions and contributions. I commend the regulations to the Committee.

Question put and agreed to.

mRNA Covid-19 Booster

Will Quince Excerpts

Friday 17th March 2023 Commons Chamber

[The Minister for Health and Secondary Care (Will Quince)]

As the hon. Member for North West Leicestershire (Andrew Bridgen) says, I am responding on behalf of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield).

Vaccines have underpinned the Government’s strategy for living with covid-19. They have saved tens of thousands of lives, have reduced the pressure on our NHS and were instrumental in allowing our economy and society to reopen. Covid-19 has not gone away. Thousands of people in the United Kingdom continue to be infected each week. Vaccines remain our best line of defence and the most effective way to enable us to live with the virus. Countless studies have shown that vaccinated people are less likely to die or become seriously ill from the virus. Thanks to the huge efforts of NHS staff and the public, as of 5 March, 144 million vaccine doses had been provided in England alone. That includes more than 17 million in the recent autumn booster campaign, which concluded last month.

The hon. Gentleman referred to the efficacy of the mRNA covid-19 boosters. It is important to put on record that all the vaccines used in the UK covid-19 vaccination programme have been through a vigorous approval process. The UK has some of the highest safety standards in the world, and the independent Medicines and Healthcare products Regulatory Agency is globally recognised for requiring high standards of quality, safety and effectiveness. The mRNA covid-19 boosters approved for use in the United Kingdom have also been through similar rigorous approval processes by the European Medicines Agency in Europe and the Food and Drug Administration in the United States.

Each potential covid-19 vaccine is assessed by teams of scientists and clinicians on a case-by-case basis. There are extensive checks and balances required by law at every stage of vaccine development. Only once each potential vaccine has met robust standards of quality, safety and efficacy set by the MHRA will it be approved for use. Both the mRNA and non-mNRA vaccines have already been administered as booster doses, with the majority of doses administered in the recent autumn booster being the mRNA vaccine. Data shows that covid-19 boosters have been highly effective in reducing hospitalisations and deaths. The mortality rate has been significantly lower for people who have had at least a third dose or booster dose, compared with individuals who are unvaccinated, or have received just a first or second dose.

Earlier this month, the Office for National Statistics published its latest covid-19 effectiveness estimates, which showed that, between March ’21 and March ’22, a third booster dose was approximately 93% effective at reducing the risk of mortality from covid-19, compared with 58% for a first dose and 88% for a second dose. It was 77% effective at reducing the risk of hospitalisation, compared with 52% for a first dose and 55% for the second dose. That highlights the effectiveness of all covid-19 vaccinations and shows that protection only increases following a third dose or booster. This is supported by other extensive research such as UK Health Security Agency surveillance reports.

The most recent data from UKHSA on the autumn 2022 booster campaign showed that the mRNA bivalent boosters provided incremental protection against hospitalisations on top of the protection already provided by previous doses in the period following 5 September 2022. It also showed that effectiveness against hospitalisation remained high at 10 or more weeks after vaccination, which was vital in supporting the NHS over a particularly challenging winter period.

The hon. Gentleman raised the matter of ongoing vaccine surveillance. The surveillance of vaccines does not stop at the point of approval. The MHRA and the UK Health Security Agency continuously monitor a wide range of data regarding the safety and effectiveness of the vaccines, including reports, as he pointed out, of adverse reactions from the UK and internationally. As part of this surveillance, the MHRA’s monitoring role includes reviewing all suspected adverse drug reaction reports—known as yellow card reports—relating to covid-19 vaccines. Through the MHRA yellow card scheme, members of the public and healthcare professionals can report any suspected side effects. The nature of yellow card reporting means that reported events are not always proven side effects; some events may have happened anyway, regardless of vaccination. This comprehensive surveillance strategy alerts us to any unforeseen adverse reactions to the vaccines and enables us to act swiftly when required.

The Government are also committed to further research into covid vaccines. Since the start of the pandemic, the National Institute for Health and Care Research has allocated more than £110 million in funding for covid-19 vaccine research. That has included consideration of vaccine safety, including robust monitoring of adverse reactions to covid-19 vaccines.

In summary, we know that the covid vaccine programme has saved tens of thousands of lives and has prevented many more hospitalisations. The Government have recently announced that a targeted seasonal vaccination offer will come in on 17 April in England to top up the protection of those at highest risk. Vaccination of residents in older adult care homes will start ahead of that, from Monday 3 April. The primary aim of the spring programme continues to be the prevention of severe disease, hospitalisations and death. Older persons, residents in care homes for older adults and those who are immunosuppressed continue to be at the highest risk of severe covid-19 and are therefore prioritised for vaccination.

The covid vaccine programme is something of which this country can be very proud. I reiterate my thanks to the scientists, clinical staff, volunteers and others who have helped to make it happen.

Question put and agreed to.

Brain Tumour Research Funding

Will Quince Excerpts

Thursday 9th March 2023 Commons Chamber

[The Minister for Health and Secondary Care (Will Quince)]

First, let me congratulate my hon. Friend the Member for St Ives (Derek Thomas) on securing this debate on a very important topic and for his personal commitment to making progress on this devastating condition. Like him, I pay tribute to the life and work of Tessa Jowell, who, after a long and distinguished career on these Benches, left a legacy that lives on in the numerous initiatives that the Government are supporting.

I also thank hon. Members from across the House for their valuable interventions and comments today— I will come to them in turn—especially in regard to NIHR support for cancer research, the Tessa Jowell Brain Cancer Mission and our commitment across Government to cancer research funding.

Before I turn to the contributions of individual Members, I want to touch on Government commitments, particularly the Baroness Tessa Jowell Brain Cancer Mission. As my hon. Friend the Member for St Ives said, in 2018 the Government announced funding through the NIHR of £40 million over five years for brain tumour research as part of the brain cancer mission. I would like to draw on Tessa’s words. She said that this

“is not about politics but about patients and the community of carers who love and support them. It is…about the NHS but it is not just about money. It is about the power of kindness”.—[Official Report, House of Lords, 25 January 2018; Vol. 788, c. 1169.]

We are grateful to all those who have provided care and support and who have campaigned for better funding for research, and to those involved in brain tumour research for keeping this nation at the forefront of scientific progress. Research, as many Members have set out this afternoon, remains key to progress. There are many challenges with brain tumour research, some of which have been set out today, but as Tessa implored us, we must not leave this in the “too difficult” box. I will now try to address the comments made by hon. Members in turn.

My hon. Friend the Member for St Ives rightly praised the work of the Realf family, whose petition led to significant funding and focus on brain tumour research. He rightly pushes us to ensure that we are spending the allocated funding on brain tumour research, and he asks us to look at the NIHR’s processes to make them more user-friendly. He followed the report in calling for a brain cancer champion, as did the right hon. Member for Hayes and Harlington (John McDonnell). I want us to be world leading in this sphere, so I will take that point away and ask the Secretary of State. Indeed, my hon. Friend the Member for St Ives might pick this up and run with it himself, given how he runs the APPG and given this superb report.

I will come back to research more generally a little later, but my hon. Friend talked about applications and the application process. As part of the £40 million fund, all the applications assessed as fundable in that open competition have been funded—in total, that is 13 of 95 applications, and a further three are under consideration. I very much encourage researchers to make those applications. We have to get it right, and I will come back to this later.

My hon. Friend touched on funding committees, which play a hugely important role. We have a diverse range of applications for funding and, as a result, there is a broad range of expertise sitting on the panels. The panels may or may not include people who specialise in brain tumour research. I understand the frustration of applicants, and work is already being done by the Tessa Jowell Brain Cancer Mission, through customised workshops and the work of researchers, to enable people to resubmit their funding applications after understanding why they were not successful.

The right hon. Member for Leeds Central (Hilary Benn) rightly praised the work of Brain Tumour Research. I understand his point about not only patients but consultants hearing the phrase, “There is nothing more I can offer or do for you.” We have to do what we can to change that. He rightly says the brain is a very complex organ, which is why treatment and research are so complicated—I will come back to this point if I have time.

My hon. Friend the Member for Scunthorpe (Holly Mumby-Croft) talked about the heartbreaking experience of David. She asked us simply to get the money into the hands of researchers, and I wish it were that simple. Understandably, this does not sit in the hands of Ministers—it would be totally inappropriate if it did. It sits in the hands of clinicians and experts in this field, but I completely understand the sense of urgency with which she makes the point. We spend around £1.3 billion a year on research, and we have to ensure that it is well spent and leads to research that gets treatments and drugs to patients in this country and around the globe.

The hon. Member for Mitcham and Morden (Siobhain McDonagh) gave the most powerful testimony, sharing her sister Margaret’s experience. I am so very sorry to hear of her experience, which must have been very difficult to share. She spoke about cancer diagnosis and treatment, and we have come on so much, but I recognise that this is not universal across all cancer types and that we have much more to do.

The hon. Lady made a very strong case for clinical trials, and she spoke about the need to travel abroad. We cannot do every clinical trial in the UK, although I sometimes wish we could. There is global competition, but I give her my personal assurance that clinical trials are high on my agenda. I want to make sure that our United Kingdom has the best environment for clinical trials. We have launched the O’Shaughnessy review, and we are working with the NHS, the MHRA and NICE. We are trying to encourage patients through the NHS app to sign up to clinical trials. Of course, raising awareness of clinical trials is a huge area of interest and importance for me.

[Siobhain McDonagh]

I completely understand all the work that the Minister and everybody else is doing, but can he explain why it is not happening?

[Will Quince]

I will specifically address brain tumour research, but clinical trials are taking place in acute trusts across the country. There are fewer clinical trials in this area than I would want, and I will explain why a little later. Finally, I pass on my very best wishes to Margaret.

My hon. Friend the Member for Buckingham (Greg Smith) urges us to act on the report’s recommendations, and he is right to do so. I will look at those recommendations very carefully. He touched on the £40 million, and I will come on to that a little later. He also mentioned childhood brain tumours. There is insufficient time to go into the level of detail I would want to on that subject, and I would be happy to meet him and members of the all-party group to discuss what more we can do on childhood brain tumours and the treatment thereof.

The right hon. Member for Hayes and Harlington talked about the courage and fortitude of families. He shared Sonya’s experience and talked about the importance of support for loved ones, and I will raise those issues with my counterparts at the Department for Work and Pensions. My hon. Friend the Member for Meon Valley (Mrs Drummond) shared the impact on the Fearn family, which outlines why it is so important that we get this right. She touched on the importance of awareness, and how in this area there is a high prevalence of late presentation and late diagnosis, and the impact that has on prognosis.

The hon. Member for Luton North (Sarah Owen) told Amani’s story and how the family had to fundraise to travel to take part in an international clinical trial. Of course, I send my condolences to Amani’s family, and I would be happy to meet Khuram and Yasmin to discuss this further. The hon. Lady asked where the money allocated is. It sits within NIHR and remains there; funding is allocated and it awaits suitable, fundable applications, so that is where we need to focus our efforts.

My hon. Friend the Member for Great Grimsby (Lia Nici) rightly praised the work of the all-party group, which probably makes this the right time to turn to the report, “Pathway to a Cure”. I very much welcome the group’s investigation and report. I acknowledge the problems and issues that have been identified. Let me be clear: we want to fund more high-quality research to accelerate the field and help patients. The report makes a number of recommendations for actions by research funding agencies, such as the MRC and NIHR, on co-ordinating action and making funding available. Crucially, the report is clear that to make advances in brain tumour research we must bring together diverse disciplines. There are detailed recommendations here, with potentially far-reaching consequences, and the MRC, NIHR and I will consider responses and come back to colleagues.

Members from across the House will understand that this debate is not necessarily the place for a detailed response to the report and every recommendation. Notwithstanding the strong case made today on the importance of research, we have to tread carefully. This is not the first condition into which I have probed and asked lots of questions about why we have not been funding all the research, and why funding is sitting unallocated, given the bids that have come in. We have to tread carefully because the clinicians and scientists rightly push back, saying that lowering the scientific quality bar for access to scarce public research funds, which would not be won in open competition, is unlikely ultimately to be a good solution. We must get this right, and at the heart of that is ensuring that we support applicants to make high-quality bids, which will then translate into funding awards. Of course, we want to fund the best science to help patients and ensure that our country remains at the forefront of scientific progress.

All Members, from across the House, rightly mentioned the crucial importance of research in tackling cancer. A theme of the report and the debate has been that of co-ordinating action along the translational pathway; that starts with the fundamental science and early translation, typically supported by the MRC, and goes through to the applied health and care research, which is funded by the NIHR. Working with the NIHR, the MRC has developed guidance and toolkits for teams to help them to navigate the scheme that is best suited to their proposal. However, I have heard today that we are not giving the right support to those making applications, and where applications are rejected we need to look into that further.

[Hilary Benn]

I am listening carefully to the Minister. What does he say to the argument that we heard during the inquiry that the people who sit in judgment, quite properly, on bids might not have a sufficient degree of expertise in this area to be able to judge whether the research proposals are suitable to be funded? I do not expect an answer now, but will he undertake to go away and look at that point?

[Will Quince]

I thank the right hon. Gentleman for his question, and I shall try my best to answer it. It is a question that I listened to very carefully when he posed it in his contribution, and it is one that I have posed myself when looking at the NIHR and what it does. The committees for NIHR and the programmes that come forward receive a diverse range of applications, which is understandable. Their make-up, therefore, is that of a broad range of expertise. As I said a few moments ago, they may or may not contain experts in the field of brain tumour research. However, having said that, the NIHR committees then use peer review from appropriate experts, which would include brain tumour expertise as relevant to the brain tumour proposal that is under review in each individual case. That is there deliberately to inform their decision-making. They co-opt particular expertise on to the committee, which is an option always available to NIHR if the committee needs that particular input. If clinicians and scientists are telling the right hon. Gentleman that that is not happening, or is not happening to the degree that we would want and expect it to, I would want to take that away and look at that further.

I wish to come back to a comment that the right hon. Gentleman made about brain tumours and why they remain a challenging area for research. There is the complexity of the brain itself as an organ, and the way that perception, memory, and emotion— everything the brain does—can be affected differently by different types of tumour. Brain tumours are different diseases that can differ in terms of histology, molecular characteristics, and clinical behaviour, meaning that many different treatments must be developed. Brain tissue is precious and obtaining it for research purposes can be difficult. Obtaining biopsy samples is risky and invasive, and animal models are of limited applicability. Additionally, the community of active clinical researchers is relatively small—it is certainly small in relation to the scale of need. This all makes research on brain tumours challenging, as has been well articulated today, and progress, if we are to make it—and I am determined that we will—requires a collaborative effort between researchers, clinicians, and funding agencies.

How do we grow the field of brain tumour research? This was a challenge from the shadow Minister. We have been taking action to grow the field by supporting researchers to submit high-quality research bid proposals. That has been supported by working with the Tessa Jowell Brain Cancer Mission, which hosts workshops for researchers, and provides research training specifically for clinicians.

Since the initial Government announcement of £40 million over five years ago, we have spent £33.9 million on brain cancer research across Government. I am conscious that there is a difference in the two figures, but that is because we are combining spending from UK Research and Innovation with the spending of NIHR. However, as I have made clear already, we want to spend more and the NIHR welcomes funding applications for research into brain tumours, and the Department of Health and Social Care priority call on brain tumours remains open. Critically, all applications that have been assessed as “fundable” in open competition have been funded, and that will continue.

As I have said, brain tumour research is one of the most difficult scientific challenges of our age. We need to invest across the translational pipeline, from fundamental science through to effective treatments. These are long-term challenges and we are committed to them for the long term. To be clear, the £40 million announcement was a signal to the research community that we are serious about funding research in this space. It is not a ceiling. If we can spend more on the best quality science, let me assure the House that we will do so. I understand and share the frustrations that only a proportion of the £40 million on brain tumour research has been allocated so far, but this funding will remain available. I genuinely believe that the funding for brain tumour research is promising and we look forward to considering the all-party group recommendations with colleagues across Government. I am confident that the Government’s continued commitment to funding will help us make progress towards effective treatment.

[Liz Kendall]

As the Minister may be about to close, I would like to ask him whether he would respond to a request to meet Professor Mulholland about the other issues that he raised around training and clinical trials, because that would make a hugely useful contribution to the debate.

[Will Quince]

The hon. Lady pre-empts not only that I am coming to a close, but my final response. I have a little more time than I would ordinarily, but in closing such debates, one never quite gets the opportunity to answer every single question. I have never turned down a meeting with a colleague, and I do not intend to start doing so today—it is important that we consider some of the issues that have been raised this afternoon, including the report’s recommendations—and, of course, I would be very happy to meet senior clinicians and scientists in the field as well.

In closing, I want to say how much I appreciate the vital work of my hon. Friend the Member for St Ives as chair of the all-party parliamentary group on brain tumours, of all those who have spoken so powerfully today, and of the powerful advocacy for more research on brain tumours and better treatments and care for patients, not least in last week’s report and in this important debate. It has been my pleasure to respond to the powerful points that everyone has made.

[Mr Deputy Speaker (Mr Nigel Evans)]

I call Mr Derek Thomas for the final word.

Draft Medical Devices and Blood Safety and Quality (Fees Amendment) Regulations 2023

Will Quince Excerpts

Monday 6th March 2023 General Committees

[The Minister for Health and Secondary Care (Will Quince)]

I beg to move,

That the Committee has considered the draft Medical Devices and Blood Safety and Quality (Fees Amendment) Regulations 2023.

It is a pleasure to serve under your chairmanship, Sir George. I am grateful to be here to debate these important regulations. The purpose of the provisions is to update the fees payable to the Medicines and Healthcare products Regulatory Agency in relation to its regulation of medical devices and blood components for transfusion.

As is standard practice for Government bodies that charge fees, the MHRA’s fees have been updated several times in the past to ensure they remain appropriate. However, to provide certainty and stability to the sector throughout the EU exit transition period and, of course, the covid-19 pandemic, the MHRA has not updated its fees since the financial year 2017-18 for medical devices and the financial year 2010-11 for blood components for transfusion. It is not sustainable for the MHRA to continue charging fees at their current level, as they do not adequately recover the costs involved in delivering those crucial regulatory services.

This statutory instrument therefore introduces amendments that fall into three categories. First, there is a 10% indexation increase on all fees. The indexation is simply linked to MHRA staff costs, which, in line with the wider civil service pay award, have risen by 10% since the last substantial MHRA fee increases in 2016. Secondly, there is a further uplift for a specific number of activities identified as significantly under-recovering via their fees to ensure cost recovery. Thirdly, there is the introduction of new fees for services that require cost recovery since the last fee changes in 2018 for medical devices.

The SI also introduces two new optional services related to clinical investigations of medical devices that industry may take advantage of. These services relate to obtaining expert regulatory advice or statistical reviews from the MHRA in relation to clinical investigation of a medical device. The changes are necessary because the MHRA is obliged to recover the costs of its regulatory activities in accordance with the Treasury’s “Managing Public Money” guidelines.

The SI amends a range of fees for the MHRA’s medical devices and blood components regulatory work to ensure that the MHRA recovers its costs associated with delivering those crucial services. This full cost recovery approach means that the regulated bear the cost of regulation and the MHRA does not profit from fees at the expense of industry—nor, importantly, does the MHRA make a loss that would fall on UK taxpayers and patients to subsidise.

The fees updates are important to ensure that the MHRA has the resources it needs to deliver a reliable service. The updates will in turn contribute to operating modernised systems and processes, to the recruitment and retention of skilled staff, and to keeping pace with technological advancements. They will support the delivery of a responsive and efficient regulatory service that protects and improves public health.

The MHRA is committed to regularly reviewing its fees, ensuring that they remain fair and reasonable and continue to reflect the true cost of providing regulatory services. By supporting the regulations, we help to ensure that the agency is financially sustainable and sufficiently resourced to provide its essential services more consistently, and so to provide patients, the public and industry with the level of service they expect. I commend the regulations to the Committee.

--- Later in debate ---

[Will Quince]

I thank the hon. Member for Enfield North for her broad support and for her comments regarding the fees. The fee updates are important to ensure that the MHRA has the resources it needs to deliver a reliable service. The extra £1.9 million that we anticipate being raised will go directly to support the MHRA’s ability to operate modernised systems and processes, to recruit and retain skilled staff, and to keep pace with technological advancements. That £1.9 million is to support the MHRA in cost recovery; it is not to go to the broader NHS.

My hon. Friend the Member for South Cambridgeshire rightly touched on whether this is a temporary measure. It is not; we intend now to get back to business as usual. There was a temporary measure in place because of EU exit and covid, and the pressures on the MHRA and industry. We removed that. This is catch-up, and the plan will be to get back to business as usual.

On scrutiny of the MHRA, I meet regularly with its chief executive—and others, because, as my hon. Friend knows, it is a holistic environment. We have to ensure that the MHRA is working closely with the National Institute for Health and Care Excellence, industry, charities and, of course, the NHS and the Department of Health and Social Care, to ensure that we create a competitive environment in which businesses want to conduct clinical trials and to invest and bring forward innovation in medtech here in the United Kingdom.

To my hon. Friend’s direct point, beyond this measure, the MHRA has delivered an ambitious transformation programme and put in place a new organisational structure with a clear mission for oversight of healthcare products. That goes all the way from first discovery through to deployment. Work is under way on optimising the services offered and developing new services. That is very much supported by a substantial technology investment programme, which includes upgrading support systems—replacing things such as the legacy system that the MHRA had before—and investing in new technology.

I hope that answers the questions asked by the hon. Member for Enfield North—I will call her my hon. Friend—and my hon. Friend the Member for South Cambridgeshire. The MHRA provides essential services and plays a crucial public health role. It is absolutely right that it is able to cover its costs to do that, and these fee increases are now necessary. By supporting the regulations, we will ensure that patients, the public and industry are provided with the service that they rightly expect and, in so doing, protect public health and encourage innovation.

Question put and agreed to.

New Hospital Programme

Will Quince Excerpts

Friday 24th February 2023 Commons Chamber

[The Minister for Health and Secondary Care (Will Quince)]

I congratulate my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) on securing the debate. He campaigns tirelessly for his constituents, and I know he recently met Lord Markham to discuss plans for the new hospital scheme. Although responsibility for this area sits with our Minister in the Lords, I am happy to respond to some of the points he has raised today.

We are working closely with Epsom and St Helier University Hospitals NHS Trust on its plans for a new specialist emergency care hospital in Sutton, with general acute services to remain at the current Epsom and St Helier hospitals. All schemes within the programme have been grouped into cohorts on the basis of readiness to progress and the extent to which the schemes can realise the benefits of the national programme approach.

Epsom and St Helier is a cohort 3 pathfinder scheme, as my hon. Friend said. This means it will be one of the first of the larger and more complex schemes to be taken forward, in line with the national programme approach. The trust is currently at outline business case stage, and we are working closely with it to incorporate the national standardised approach.

We have always been clear that, after entering the new hospital programme in 2020, any planned timescales for delivery will change to align with the national programme approach. As my hon. Friend said, the trust has received £20.5 million in public dividends to date to progress its scheme. This includes fees for design work and a contribution towards the cost of a new electronic patient record system. Further allocations for the scheme, including the total individual allocation, will be decided through the proper business case process. This will ensure deliverability, alignment with the national programme standards and, of course, value for money.

The programme has developed an integrated systems approach known as “hospital 2.0”, which spans the whole hospital lifecycle from business case and design through to construction, commissioning and handover. Hospital 2.0 is the vehicle through which the national programme approach can ensure we get the maximum value for taxpayers’ money and deliver more efficient designs. Our hospital 2.0 process will drive efficiencies by up to 25% compared with traditional methods of delivering infrastructure.

Lord Markham recently visited the manufacturing technology centre in Coventry, where he saw at first hand how this work is advancing. This includes prototypes of the standardised hospital rooms that will be part of the designs for the new hospital scheme. The Department is planning a range of events, communication pieces and milestone moments to show the progress being made on delivering these new hospitals. This will, of course, include a parliamentary event in the coming weeks to demonstrate what these new hospitals will look like, including standardised rooms, as well as roadshows at each of the new hospital locations. I hope my hon. Friend will be able to attend.

Lord Markham, our Lords Minister, has also agreed to visit the hospital when his diary allows—I can certainly agree to that request—to see at first hand how the new hospital scheme will benefit the staff and patients of Epsom and St Helier University Hospitals NHS Trust.

My hon. Friend asked about maintenance, and we certainly recognise that backlog maintenance can pose challenges to the efficiency, safety and quality of NHS services. Although individual NHS organisations are legally responsible for maintaining their estates, the Government have been clear that they expect NHS organisations to use existing capital budgets and assets to maximum effect. I am pleased to see that the level of backlog maintenance in the trust has decreased every year since 2016-17.

At the spending review we backed the NHS with substantial operational capital investment for trusts to prioritise and deliver locally to maintain and refurbish their premises. The Government are investing record sums to upgrade and modernise NHS buildings so that staff have the facilities needed to provide world-class care for patients, including £4.2 billion this year and £8.4 billion over the next two years.

While this major scheme got under way over the 2020-21 and 2021-22 period, we supported Epsom and St Helier University Hospitals NHS Trust with other capital investment, including £6.1 million to expand the emergency department and the same-day emergency care unit at St Helier Hospital, and to extend waiting room space and mental health cubicles at Epsom Hospital. We have invested £11.6 million to eradicate backlog maintenance across the trust’s estate.

The new hospital programme has been undertaking ambitious work. Two hospitals, the Northern Centre for Cancer Care and the Royal Liverpool Hospital, are now open to patients. Five schemes are in construction, with one due to complete shortly, and 22 schemes have received either full or outline permission, which is a vital step on the road to delivery. This programme will deliver facilities that are at the cutting edge of modern technology and will engage with clinical staff to ensure that we are providing them with a better working environment, enabling increased efficiency, promoting staff wellbeing and, importantly, improving staff retention.

Again, I thank my hon. Friend for his continued engagement on the new hospital scheme. I appreciate and recognise how tirelessly he campaigns for his constituents, and I assure him that we are committed to the delivery of a new hospital for Epsom and St Helier University Hospitals NHS Trust.

Question put and agreed to.

NHS Strikes

Will Quince Excerpts

Monday 6th February 2023 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the NHS strikes.

[The Minister for Health and Secondary Care (Will Quince)]

I am grateful to the hon. Member for his question, which I am taking on behalf of the Department as the Secretary of State is attending a COBRA meeting focused on minimising the disruption experienced by patients because of today’s walkouts.

In preparation for today’s industrial action, we have again drawn on extra support from a range of places, including military service personnel, volunteers and the private sector. People should continue to use NHS 111 if they need medical help and to dial 999 in the event of an emergency. Yet even such strong contingencies, including more people trained to drive ambulances and doctors redeployed to other parts of the system, are no replacement for having the right people doing the right jobs.

Any strike inevitably means that some patients will have their treatment delayed, and I know that people are being contacted if their appointments need to be changed. About 88,000 procedures or outpatient appointments have been postponed as a result of industrial action over the last eight weeks, so I am disappointed and concerned that patients are facing disruption once again, especially because strikes by Royal College of Nursing members have now come together with action by GMB and Unite members in eight ambulance trusts.

I recognise that there have been efforts on behalf of unions to ensure that derogations are in place to keep people safe, and I acknowledge that some aspects of that can indeed be challenging, but it is essential that all unions adhere to a set of derogations at a national level so that we can plan and act with certainty. I have also been heartened to hear that on previous strike days, some devoted ambulance workers and nurses who received calls while on the picket line returned to work where derogations were not going to be met. That is a real tribute to the care and dedication we see on the frontline day in, day out.

Ultimately, both staff and the public should no longer be in this situation, because we all know that industrial action is in nobody’s best interests, especially given the collective challenges we face to help the NHS recover from the pandemic. Despite what the hon. Member for Ilford North (Wes Streeting) might imply, there is much common ground, not least our shared desire to improve the NHS and deliver better care. Last week we announced our plan to recover urgent and emergency care—the second of three plans to cut waiting times in the NHS, including our elective recovery plan and our primary care recovery plan, which will be published in the next few weeks. With such important missions ahead of us, and fewer than two months left of this financial year, it is time to move forward, to look ahead and to come together in the interests of the patients we all serve.

[Wes Streeting]

This week will see the biggest strike in the history of the NHS, with nurses, ambulance workers and physiotherapists all driven to walk out. Some 88,000 appointments, including 10,000 operations, have already been cancelled, with much more disruption to patients expected this week, yet Government Ministers still speak as if they are mere observers or commentators, not leaders key to solving this dispute. This is the cost of the Prime Minister’s failure to sit down and negotiate with nurses, paramedics and other NHS staff.

Let us be clear about this fact: there has not been a single minute of negotiation on pay. NHS leaders are asking the Government to negotiate. Chief nurses are desperate for the Government to negotiate. The unions have offered to call off the strikes if the Government are willing to negotiate. The public cannot understand why, even now, they will not get around the table to sort this out. What on earth are they playing at?

Developments in Wales show that there is a deal to be done. The general secretary of the Royal College of Nursing has written to the Prime Minister, but she has not heard anything from the Government for weeks. It looks to the country like the Prime Minister and the Health Secretary are the ones on strike. Where is the Prime Minister? Where is the Health Secretary? In the week of the biggest strikes in the history of the NHS, during the biggest crisis the NHS has ever faced, the Health Secretary was not available for interviews this morning and he is not available to MPs today. Are we meant to believe that at 4 o’clock in the afternoon he is talking about how to avert disruption that has been taking place all day? Don’t make me laugh. Perhaps the Health Secretary is busy briefing against the Chancellor, just as the Chancellor is busy briefing against him. All the while, the Prime Minister is too weak to do anything about it.

The power to stop these strikes is in the Government’s hands. Patients have suffered enough disruption as it is. Is it not time for the Prime Minister to swallow his pride, sit down with NHS staff and negotiate an end to these strikes by paying NHS staff fairly?

[Will Quince]

I am not going to engage in the playing of party politics on this. The hon. Gentleman already knows that the Secretary of State is due to attend a Cobra meeting, which he and I rotate, and the hon. Gentleman may have missed it, but this morning the Secretary of State did do a media clip, and Members will have seen that across multiple outlets.

Where I do agree with the hon. Gentleman is that he is right to talk about the amazing job that our NHS colleagues do on the frontline. I know he does that, and I thank him for that, but that is even more reason why we must find a fair resolution, and NHS colleagues certainly will not get one from those on the Opposition Benches. The Opposition say that they back the independent pay review process, while disagreeing with the body’s decision when it does not suit them. They say they would not increase public spending, while failing to set out any plans for how they might pay for unaffordable pay increases. They say they believe in public safety, too, while criticising the common-sense steps we are taking to ensure safe minimum staffing levels, just as they do in many other European countries. We have got a plan—they do not.

More than 1 million NHS staff have been given at least a £1,400 increase in their pay, representing a 9.3% rise for those on the lowest salaries. NHS staff also received a 3% pay rise last year—even when pay was frozen across the rest of the public sector. We have done this because we know how hard NHS colleagues work and we recognise that there are cost of living pressures on NHS staff.

Our goal has always been a resolution that is fair for colleagues and for the country: to find a way forward that ensures we are spending money where it is needed most, and helping the NHS to recover from the pandemic, but not on pay hikes that would stoke inflation and ultimately make us all poorer. I met GMB members last week, and—together with my ministerial colleagues—I remain fully committed to working together with the unions, the NHS and others to find a responsible and fair way forward.

[Mr Speaker]

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

[Steve Brine (Winchester) (Con)]

The NHS Pay Review Body was in front of my Select Committee last week, but it will not produce its report for 2023-24 until the end of April. Surely the longer this process goes on, the slower the resolution will be for those on Agenda for Change. Does the Minister agree that a much earlier remit letter would have been helpful, and when does he expect the Department to produce its evidence to this year’s pay review body round?

[Will Quince]

I thank the Chair of the Select Committee for his question. He is right that we are committed to the independent PRB process, which is the right way to set public sector pay and has operated successfully for over four decades. We are not changing that process, but we decided to take the step to engage with the unions on our respective evidence so that it can be as informed as possible, and we very much thank the trade unions for working with us in that spirit. We need to wait for discussions with unions to finish across Government, so I hope I can use the word “shortly”; I am mindful that we want to get this done as quickly as possible.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

What does the Minister think when he looks across the border to Scotland and sees that Unison, Unite and other unions representing the majority of NHS Agenda for Change staff have accepted the 7.5% pay rise offer? There are no planned strikes in Scotland while pay deals are being considered, which clearly illustrates that negotiating with the unions is a better way of ending strikes than picking fights with them. The UK Government are unique among the four Governments of the UK in that they are the only ones who have full financial powers, and therefore the only Government who are not acting with a hand tied behind their back in offering pay uplifts to their NHS staff. Why is it, then, that the UK Government are facing the greatest number of strikes and have failed to settle any pay disputes?

[Will Quince]

I remember another Scottish National party Member making a similar comment in a previous urgent question, crowing about how Nicola Sturgeon, the First Minister of Scotland, was directly negotiating with the unions and that they had paused their industrial action, but only a handful of weeks later that industrial action was renewed. Pay is of course a devolved matter for Scotland and for Wales.

I will not make unfunded promises or pledges from this Dispatch Box. I want to have an honest and open dialogue with the unions about what is affordable for the NHS, where we recognise and reward NHS staff—who do the most incredible job day in, day out—with one eye to recruitment and retention, but it also has to be fair to taxpayers; and that is the spirit in which I approach this matter.

[John Redwood (Wokingham) (Con)]

Can senior managers of NHS England and its various trusts make more use of pay gradings, job evaluations, promotions and increments, using pay flexibilities so that staff who are doing a good job feel valued and can be paid more?

[Will Quince]

That certainly is an option. My right hon. Friend talks about NHS managers. Understandably, the Opposition focus on nurses and paramedics, but let us not forget exactly who we are talking about: the entire Agenda for Change workforce, which is 1.245 million people. That is exactly why every 1% equates to £700 million. My right hon. Friend is right that pay is a factor, but it is not the only factor, which is why we also focus on working conditions and environment.

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

Taxpayers want NHS staff to be there when they need them, but as more and more staff leave the service, flipping over to work for agencies because they simply cannot afford to work for the service on their salaries, their money is being spent in the wrong way. On Friday, when I met NHS staff who came in on their day off, they said that the thing that is breaking them is the Government’s contempt for them. They simply want the Government to negotiate—so why will they not?

[Will Quince]

I thank the hon. Lady for her question, but she could not be more wrong. I was in Darent Valley hospital today and I was in Watford hospital last week, and I have the utmost respect for all those who work in our NHS. Everybody in this Chamber wants those who work in our NHS—in fact, all public sector workers—to be paid more, but the independent pay review process is a tried and tested process that has been used for more than 40 years, and it is important that the unions engage with it so that we get this right from April.

[Mr Philip Hollobone (Kettering) (Con)]

Due to the covid pandemic, the NHS has a large care backlog, which my constituents in Kettering are keen to see addressed. Will the Health Minister confirm that spending on the NHS is at record levels and that the Government have a plan to reduce NHS backlogs, which the strikes are disrupting? For every day of NHS strike action, how many NHS operations and procedures are lost?

[Will Quince]

I will gladly write to my hon. Friend on the specifics, but he is right to point out that NHS spending in England this year is about 11.4% higher in real terms than it was in 2019-20. He is right to point to his constituents on the waiting lists, and I want to get the numbers down as quickly as possible, particularly for those who have been waiting the longest. On top of a £2 billion recovery fund, we have invested £8 billion over three years; we have already opened 92 community diagnostic centres, and we will open 160 by March 2025; and we have opened 89 surgical hubs, with an aim to open 140. Our aim is 9 million more treatments and diagnostic appointments by 2024, so that constituents of my hon. Friend who have been waiting too long get that service.

[Paul Blomfield (Sheffield Central) (Lab)]

Ministers are hiding behind the independent pay review process. The Minister knows that recommendations have been ignored when it suited the Government in the past. NHS employers want negotiations, the unions want negotiations and the public want negotiations. The Minister says it is time to come together in the interests of patients. He is right, so why do the Secretary of State and the Prime Minister not come together with the unions and sort it out?

[Will Quince]

I have met employers, and I believe in open and honest dialogue. What the hon. Gentleman has not accepted—and I appreciate that being in opposition is the easiest job in the world—is that, as I have pointed out, every 1% is £700 million. I have a budget this year of £153 billion and, yes, that is rising, but I have some huge challenges. We have huge challenges to tackle within our NHS. The hon. Gentleman the shadow Secretary of State just says, “Negotiate, negotiate”—

[Wes Streeting]

Yes, yes!

[Will Quince]

Yes, yes—but where exactly is the funding coming from? The hon. Gentleman rightly pushes me on the elective backlog and he rightly pushes me on urgent and emergency care, but every 1% is £700 million that I would have to find from our NHS budget. That is exactly why we have to ensure that the pay review body makes the recommendation from April that is affordable to the NHS and recognises and rewards NHS staff, taking account of recruitment and retention and some of the challenges that we face, but that is fair to taxpayers too. That is why I would encourage the unions to get involved and take part in that pay review body process, so we can get it right.

[John McDonnell (Hayes and Harlington) (Lab)]

The Minister says that opposition is the easiest job. Well, we are hoping he is soon performing it. When he opened his response this afternoon, he said that the Secretary of State was at a Cobra meeting, but would it not be more worthwhile if he negotiated and met the unions themselves? In advance of the next meeting for discussions of wages, maybe he could visit a picket line, because if Conservative Members visit the picket lines, they will find groups of staff—nurses and ambulance workers—who are extremely distressed. I have met many of them who were in tears—tears because they are worried about the patients whom they want to support, but also tears because many of them cannot survive doing the service they want to provide due to their low wages. Unless negotiations are started soon, the Government could do irreparable damage to the national health service, so the Secretary of State needs urgently to leave the Cobra meeting, sit down with the unions and start negotiating.

[Will Quince]

The right hon. Gentleman says that many who work in the NHS are worried about patients: I spend every single day worrying about patients; I spend every single day ensuring the NHS has the resources it needs to provide the level of care and service our constituents rightly expect. I have a budget, and that budget has already taken into consideration a 4.75% on average pay award, with more than 9% for some of the lowest earners. There is an independent pay review body process for a reason; it is only two months away, in April, and I encourage the unions to take part in it. Of course I meet with unions, and of course I do and will meet with nurses and those who work in our NHS. I believe some of the points the right hon. Gentleman makes are correct, and I know those who work in the NHS genuinely want to ensure we are attracting and retaining the very best; that is all the more reason for us to get it right, and the way to get it right is the independent pay review body process.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

There were no strikes in the NHS over 13 years of the last Labour Government, and the cavalry is coming to rescue our health service with the next Labour Government. The Minister just asked where the funding is coming from to pay for NHS staff: we will train a new generation of NHS staff paid for by abolishing non-dom tax status so that the NHS has the workforce it desperately needs. Why will the Government not do as the Chancellor has suggested and adopt this policy now?

[Will Quince]

The hon. Lady says the cavalry is coming; how many more unfunded pledges—[Interruption.] Labour Members say they are fully funded: absolute tosh. I have heard the Opposition spend that non-dom money more times—

[Wes Streeting]

Once.

[Will Quince]

Once? The shadow Home Secretary, the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper), has spent it twice over already. And that is if indeed it would raise any money; I know I look very young, Mr Speaker, but I am old enough to remember a former Chancellor, one Ed Balls, say he did not believe taxing non-doms would raise any money whatsoever.

[Dr Luke Evans (Bosworth) (Con)]

I declare my interest, Mr Speaker.

We have spent a lot of time talking about pay, but making working conditions for frontline staff much better is key, so what are the Government doing to focus on improving the simple things in a clinician’s life such as joining up testing, improving prescribing, and making sure that 10% to 15% of a GP’s workload is not spent chasing admin? These are simple things that would make a huge difference and improve outcomes for both patients and staff.

[Will Quince]

I completely agree with my hon. Friend. Ensuring that we support the mental health and wellbeing of NHS staff and that working conditions and working environments are the best they can possibly be is how we can attract and retain the best. Measures such as wellbeing champions, training for line managers, occupational health services and flexible working are very important, but the key to this is having conversations with the unions, because they are the representatives, ambassadors and advocates. That is why I very much hope they will engage in the pay review body process and continue to have those conversations with me, not just about pay, but about how we can improve working conditions and working environments and reduce the bureaucracy that makes the job so difficult.

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

It is now clearly established that the workforce crisis in the NHS is mirrored by vacancies in adult social care. There are more than 165,000 vacancies in social care, up by 52% in a year. The Liberal Democrats are calling for a carers’ minimum wage of £12.42 per hour from April; will the Minister support a £2 per hour uplift in that minimum wage for care workers by doubling the tax on the profits of online gambling companies?

[Will Quince]

The hon. Gentleman got a plug in for his policy there, but I am not entirely sure how relevant it is to this statement. On NHS staffing, we have 10,500 more nurses and 4,800 more doctors than last year. But I know adult social care represents one of the biggest challenges for our NHS, and it puts pressure on the rest of the system. That is why in the autumn statement the Chancellor put in place £7.5 billion, the largest ever investment in adult social care.

[Valerie Vaz (Walsall South) (Lab)]

The Minister will know about the ministerial code and about keeping the House updated, so will he tell us when the Secretary of State for Health met Pat Cullen of the RCN? If cannot tell us now, will he write to us and put that letter in the library, please?

[Will Quince]

Of course I am happy to do that, and I think these things are put on the public record in any event. I do not know when the Secretary of State met specifically with the RCN, but I can tell the House that I have met the unions, I believe, on 9, 12, 25 and 31 January.

[Zarah Sultana (Coventry South) (Lab)]

I have just come from the nurses’ picket outside St Thomas’s Hospital, on the other side of Westminster bridge, where nurses made the point that they were not striking against the NHS but to save the NHS. They have been underpaid and overworked for too long; their pay is down 20% on what it was when the Tories came into power, and now there are a record 50,000 nursing vacancies in England. That is not just unfair but incredibly unsafe. As one nurse said, “Patients aren’t dying because nurses are striking. Nurses are striking because patients are dying.” Will the Minister finally listen to NHS staff, get around the table to talk about pay and give them the pay rise they deserve?

[Will Quince]

Despite what the hon. Lady says, there are 47,100 more nurses this year than there were in 2010 and 10,500 more than last year, and we have 72,000 nurses in training. The Government hugely value the work not just of nurses—I remind the hon. Lady that she is also talking about the 1.245 million people who work on the Agenda for Change contract. She is right that we have to get pay and other matters right, and that is why we have an independent pay review body process where we look at affordability, reward and recognition, and pay, alongside recruitment and retention and achieving a package that is fair to taxpayers. That independent pay review body will make a recommendation, and it is then for the Government to look at it and accept it or reject it.

[Margaret Greenwood (Wirral West) (Lab)]

I stand in solidarity with nurses and other NHS workers who are taking action in their fight for fair pay and improved patient safety. Miriam Deakin, the director of policy and strategy at NHS Providers, has said that its key ask is that

“the Government does sit down around the table with the unions for formal negotiations on pay, and for that to be applied to pay this year.”

She has described the absence of formal negotiations as “very worrying”. Does the Minister accept that responsibility for the continuation of strike action by NHS staff lies firmly with the Government? Does he agree with Pat Cullen, the general secretary of the RCN, that

“this government has chosen to punish the nurses of England instead of getting round a table and talking…about pay”?

[Will Quince]

I thank the hon. Lady for her question, but nothing could be further from the truth. We accepted the independent pay review body’s recommendation of an average of 4.75% in full. That is over and above a 3% pay award last year, when the rest of the public sector saw a freeze. The hon. Lady, like me, will have lots of other public sector workers, and indeed private sector workers, in her constituency who will also earn between £30,000 and £50,000 a year. They will also have seen pay awards this year of between 4% and 6%, but they will not have 20% pension contributions or up to 33 days of annual leave a year. We have to keep these things in context, and any award also has to be fair to taxpayers more broadly, which is why we have an independent pay review body process. I want to address many of the issues that the hon. Lady has raised. We have that process; it is important that we use it, and I hope that the unions and others, including providers, will engage with it.

[Liz Twist (Blaydon) (Lab)]

Our NHS staff—all of them—saw us through the pandemic, many without proper protective equipment. They have now seen us through the catch-up exercise, and they are working hard, but they are at the end of their tether. Meanwhile, the Minister says there is no money, but the Government wasted £15 billion on personal protective equipment—money that could have given everyone a 20% pay rise. Is it not time that the Government understood the issues in this strike, got around the table and talked about pay to the nursing unions?

[Will Quince]

First, let me correct what the hon. Lady said about PPE. I was not a Health Minister at the time, but let us not forget that 97% of all PPE was usable. Despite being a Minister in another Department, I remember that those on the Opposition Front Bench rightly agitated on this issue, saying, “Do anything, strain every sinew and take a risk, but make sure you get PPE as quickly as possible.” It was the most desired global commodity, and Governments around the world were fighting for it.

Nevertheless, the hon. Lady raised a good point, and of course NHS staff got us through the pandemic. That is exactly why we accepted the independent pay review body recommendation in full. It is exactly why we accepted the recommendation last year of a 3% award when the wider public sector was frozen. Of course we value all those who work in our NHS, and that is exactly why have to get this right for the next independent pay review body. That is why we have to ensure that not just the Government but the unions, providers and others give evidence to that body.

[Mike Amesbury (Weaver Vale) (Lab)]

Just over two hours ago, I joined Lorraine and other colleagues from the Royal College of Nursing over the bridge at St Thomas’s Hospital. They do not want to be on strike and they do not want to be on a picket line, but they want a fair day’s pay for a fair day’s work. A key message from them to the Minister is to get round the negotiating table and give them a fair deal.

[Will Quince]

Opposition Members keep saying, “Get round the table and negotiate.” I encourage the next one who says that to tell me exactly where each block of 1%, each £700 million, will come from out of our NHS budget. [Interruption.] They point at me, but I remind the hon. Gentleman that we accepted the independent pay review body’s recommendations in full. We stand ready to look at the independent pay review body’s recommendations for next year, which of course is only two months away, because it starts in April. It is really important that we all engage with that process, so we can get it right and address many of the issues the hon. Gentleman and others raise.

[Mr Ben Bradshaw (Exeter) (Lab)]

What is the Minister’s estimate of the number of people in England who have had their appointments or operations cancelled today, compared with Wales and Scotland where there are no strikes? Why are the Conservative Government so indifferent to the suffering of patients in England that they refuse to do what the Governments in Scotland and Wales have done, which is to get round and negotiate a settlement?

[Will Quince]

We do not, as yet, have the details of today’s and tomorrow’s industrial action, but we will certainly be able to publish that information in due course. I can tell the right hon. Gentleman, as I mentioned in my opening response to the urgent question, that over 88,000 appointments have been rescheduled so far and over 58,000 shifts have been missed. Of course I deeply regret that and wish that there was no strike action. [Interruption.] Of course I do.

If we had not accepted in full the independent pay review body’s recommendations, the right hon. Gentleman and others would have an argument to make to say that we had not, but we did accept them in full. We accepted them in full last year, too, despite them being over and above the evidence submitted by the Government in respect of affordability. That is why I look forward to the next independent pay review body process, and why it is so important that the unions and others engage with that process so that we get it right.

[Andy McDonald (Middlesbrough) (Lab)]

I have more than enough cause to thank my local NHS for the lifesaving treatment it has given me, but so has every single family in this country. Why do the Government not get it, as the public clearly do, that our health workers, like all public sector workers, are at the end of their tether? Get round the table to resolve these disputes and give them the proper wage rise they so desperately need and deserve.

--- Later in debate ---

[Will Quince]

First, let me agree entirely with what the hon. Gentleman said about NHS staff and how we all owe them a debt of gratitude for the service they have given, not just to us but to all our families. Again, he may have missed it when I asked that if any Opposition Member was going to raise the same question, they might also stand up and say exactly where each block of £700 million would come from, out of my £150 billion budget. [Interruption.] The hon. Member for Brent Central (Dawn Butler) says, “Show us the books.” She knows exactly where the NHS funding goes. I want to ensure that we have an open and honest dialogue. I have been having those conversations with the unions and I have set out exactly the challenges we face. Any pay has to be affordable not just to the NHS but to the wider budget. It has to recognise and reward those who work in the NHS. Of course I want to retain and attract the very best, but it also has to be fair to taxpayers, and that is the point I think the hon. Gentleman and others are missing.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his answers. For nurses and many others in the NHS, striking is not what they want to do: all they want is dialogue and to try to move forward with an agreed wage structure. They have been left vulnerable by understaffing on the wards, and the pressure that adds is repugnant to them. The Government must move from their entrenched position to find a workable solution. Will the Minister commit to reopening dialogue and looking at the situation, not from the angle of enshrined principle but from a safety angle, which concerns us all?

[Will Quince]

I thank my hon. Friend for his question. We accepted in full the independent pay review body’s recommendation this year of 4.75%, which was over and above last year’s figure of 3% when the rest of the wider public sector was frozen. He asks about dialogue. Of course I am happy to have dialogue with the unions; my door has always been open and it will continue to be so. What I am not going to do is reopen this year’s pay review. We have the independent pay review body process and we accepted that recommendation in full. What I am willing and happy to do is to have that dialogue about next year’s independent pay review body recommendation. Let us not forget that it is in only two months’ time that the new financial year starts, and we have to get that right. I hope that he will encourage unions and others to take part in that process so that we can get it right, because we all want to ensure that NHS staff get the right pay rise that recognises the huge service they give.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

Half of the successful revised offer by the Welsh Government is in the format of a one-off payment. Will the British Government confirm that that element of the pay settlement will be recognised as cost of living support and not as income, and treat it as such for tax and benefit purposes?

[Will Quince]

Pay is a devolved matter and I understand that the full details of the Welsh offer are yet to be finalised. They will include a number of non-pay commitments, and I understand that the cost of those measures could be substantial. I will look carefully at what the hon. Gentleman says. In any event, it would not be a matter for me as a Health Minister but for the Treasury.

Transfer of NHS Digital into NHS England

Will Quince Excerpts

Wednesday 1st February 2023 Written Statements

[The Minister for Health and Secondary Care (Will Quince)]

My noble Friend the Under-Secretary of State for Health and Social Care (Lord Markham) has made the following written statement:

Today, NHS Digital legally becomes part of NHS England, to create a single, central authority responsible for all elements of digital technology, data and transformation for the NHS.

Laura Wade-Gery was commissioned by the Government to lead an independent review of how we can ensure digital technology and the effective use of data is at the heart of transforming the NHS.

Her report “Putting data, digital and tech at the heart of transforming the NHS”, published in November 2021, recommended merging the functions of NHS Digital into NHS England, to provide a single statutory body for data, digital and technology to provide the right leadership and support to integrated care systems.

NHS Digital, since its creation as the Health and Social Care Information Centre, has been a powerful force for change in the NHS and guardian of its key data IT and data systems. These will be transferring to NHS England, together with its expert staff.

All the protections of people’s data which existed in NHS Digital will apply in NHS England. Rigorous internal controls will continue to ensure that data is used and shared safely, securely and appropriately to deliver high-quality care, understand and protect the health of the population, effectively plan and improve services, and research and develop innovative treatments, vaccines and diagnostics.

This is an important step in bringing together in a single place, the essential systems and programmes to digitally transform the NHS, and to harness the full potential of data. This will enable health and social care services to use digital and data more effectively to deliver improved patient outcomes and address the key challenges we face.

[HCWS539]

Draft Mental Health Bill 2022

Will Quince Excerpts

Thursday 26th January 2023 Commons Chamber

[Dr Poulter]

On behalf of the Committee, I thank the hon. Lady for all her work. We were lucky that we had her professional expertise as a frontline clinician, which added to our important scrutiny work. Given that it has been 40 years since there were any changes to the Mental Health Act, I certainly agree that the time has come to make those changes through a Bill. We urge the Government to take on board our well-intentioned recommendations and concerns to strengthen the Bill, and I hope we will continue to see a cross-party, collaborative process to improve mental health care for the patients who most need it.

[The Minister of State, Department of Health and Social Care (Will Quince)]

I sincerely thank my hon. Friend and the Committee for all the work that has been put into this constructive and important report, and I also thank all those who gave evidence to the Committee. The Government are now considering the Committee’s recommendations on how we can further improve the Bill and modernise the Mental Health Act. The Minister for mental health, my hon. Friend the Member for Lewes (Maria Caulfield), gave evidence to the Committee in November, alongside the Minister for prisons, parole and probation, my right hon. Friend the Member for East Hampshire (Damian Hinds).

I am grateful to see that the final report reflects the support that these reforms have on both sides of the House. The Committee has clearly engaged fully with the complexities involved in this work. It is the Government’s intention to take the next steps in getting this legislation right, so that people with severe mental health needs get the help and support when they need it, with their rights and dignity better respected. It is vital that we continue to progress the work we have started with NHS England and others to address the racial disparities that have for too long been associated with the use of the Act. Does my hon. Friend agree that the reforms proposed in the Mental Health Bill provide for an improved framework in which people experiencing the most serious mental health conditions will have far more choice and influence over their treatment?

[Dr Poulter]

I agree with the Minister. He is right to suggest that this is an important step forward and this piece of legislation will make a significant difference to patients, but it is part of a process, not the end of the journey. In particular, I draw the Government’s attention to the potential unintended consequences of some of the well-meaning changes being proposed in relation to patients with learning disabilities and autism and to changing the grounds for detention; for example, it might be harder to detain patients who are the most unwell, with chronic and enduring mental illness and psychotic conditions. I hope the Government will take on board those concerns and ensure that what comes back to this place is a stronger Bill that works in the best interests of patients.