Jonathan Ashworth – 2019 Speech on the NHS Long-Term Plan

Below is the text of the speech made by Jonathan Ashworth, the Shadow Secretary of State for Health, in the House of Commons on 1 July 2019.

I am grateful to the Secretary of State for an advance copy of his statement. I had hoped for a greater sense of urgency from him. He talks about the 100-year anniversary of the Ministry of Health, but this year is the first time in 100 years that the advances in life expectancy have begun to stall, and even go backwards in the poorest areas. Just the other week, we saw that infant mortality rates have risen now for the third year in a row. As this is the first time that they have risen since the second world war, I would have hoped for a greater focus on health inequalities in his statement today, not least because public health services—the services that, in many ways, lead the charge against health inequalities—are being cut by £700 million. Now he says that we should wait for the spending review for the future of public health services, but we do not know when the spending review is. The Chief Secretary to the Treasury has said that it will be delayed, so it could be next year.

In the past, the Secretary of State has talked about a prevention Green Paper. Will that prevention Green Paper be before the spending review or after the spending review? Will he also tell us whether it is still the intention of the Department to insist that local authorities fund their public health obligations through the business rates?

At the time of the publication of the long-term plan last year, the then Secretary of State for Health said that we cannot have one plan for the NHS without a plan for social care, yet we still have no plan for social care. We have been promised a social care Green Paper umpteen times. We are more likely to see the Secretary of State riding Shergar at Newmarket than see the social care Green Paper. Where is it?

The Secretary of State talks about the better care fund revenue increase. May I press him further on that? Is he saying that the clinical commissioning group allocations to the better care fund, which tend to be the bulk of the better care fund, will increase in line with the NHS revenue increase, or is he saying that there will be new money available for the better care fund? Adult social care has been cut by £7 billion since 2010 under this Tory Government, which is why hundreds of thousands of elderly and vulnerable people are going without the social care support that they need. Presumably, we will have to wait for the spending review for proposals on social care.​

The Secretary of State talks about the workforce. We have 100,000 vacancies across the NHS. We have heard about the interim people plan, but of course we have seen the bursary cut, the pay restraint, and the continuing professional development cut. That plan is all good and fine, but when will it be backed up by actual cash?

The Secretary of State talks about IT systems and apps—we know that he is very fond of that—but again he gives us no certainty on capital investment. Hospitals are facing a £6 billion repair bill—ceilings are falling in and pipes are bursting. The repair bill designated as serious risk has doubled to £3 billion. When will we have clarity on NHS capital?

We broadly welcome what the Secretary of State said about mental health, but 100,000 children are currently denied mental health treatment each year because their problems are not designated as serious enough, and over 500 children and young people wait more than a year for specialist mental health treatment. He talks of a fundamental shift, so can he guarantee that clinical commissioning groups will no longer be allowed to raid their child and adolescent mental health services budgets in order to fill wider gaps in health expenditure? On mental health resilience and prevention, only 1.6% of public health budgets is currently spent on mental health, so will he mandate local authorities, when setting their public health budgets, to increase the money they spend on mental health?

On cancer, we broadly welcome what the Secretary of State has said, but patients are waiting longer for treatment because of vacancies and out-of-date equipment. Today we learned that consultant oncologists with shares in private hospitals are referring growing numbers of patients to those hospitals. Is that not a conflict of interest? When will we see tougher regulation of the private healthcare sector?

The Secretary of State talked about the clinical review of standards that is being piloted in 14 hospitals, yet those hospitals are not publishing the data. If he wants to abandon the four-hour A&E target, will he insist that those pilot hospitals publish all the data? He did not mention waiting lists. We have seen CCGs rationing treatment because of the finances. We have seen 3,000 elderly people refused cataract removals. We have seen CCGs refusing applications for hip and knee replacements. We have even seen a hospital that until last week was inviting patients to pay up to £18,000 for a hip or knee replacement—procedures that used to be available on the NHS. When is he going to intervene to stop that rationing of treatment, which we are seeing expand across the country because of the finances?

Finally, there are many laudable things in the long-term plan that we welcome. Alcohol care teams were a Labour idea. Perinatal mental health services were a Labour idea. Gambling addiction clinics, which the Secretary of State announced last year, were a Labour idea. Today he is talking about bringing catering back in-house, which is also a Labour idea. Why does he not just let me be Heath Secretary, and then he could carry on being the press secretary for the right hon. Member for Uxbridge and South Ruislip (Boris Johnson)?

Jonathan Ashworth – 2019 Speech on Tessa Jowell Brain Cancer Mission

Below is the text of the speech made by Jonathan Ashworth, the Shadow Secretary of State for Health, in the House of Commons on 13 May 2019.

I thank the Secretary of State for an advance copy of his statement. We warmly welcome today’s announcement. His tribute to our much-missed friend and colleague was moving and powerful. It is an extraordinary testament to Tessa’s bravery that in the final harrowing months of her life, faced with a highly aggressive and very-difficult-to-treat cancer, and in full knowledge of the life expectancy associated with such a devastating cancer, Tessa led from the front to campaign for better brain cancer treatment for others. She spoke with extraordinary courage in the Lords, she brought the then Secretary of State and me together, and she convinced Ministers to shift policy, not by garnering sympathy, understandable though that approach would have been, but by persuasion based on facts and policy argument. It was typical Tessa.

Tessa would have been delighted by the Government’s announcement—some 2,000 brain cancer patients a year will now benefit from the “pink drink” solution—but she would be keen to go further still. Almost 11,000 people ​are diagnosed each year with a primary brain tumour, including 500 children and young people, which is 30 people every day, and more than 5,000 people lose their lives to a brain tumour each year. Brain tumours reduce life expectancy by around 20 years, which is the highest of any cancer, and are the largest cause of preventable blindness in children.

We live in hope of dramatic improvements, but further research is needed, given that less than 2% of the £500 million spent on cancer research is dedicated to brain tumours. I welcome the Secretary of State’s commitments on research, but does he agree that we also desperately need more involvement in clinical trials? The number of brain cancer patients taking part in clinical trials is less than half the average across all cancers. How will the Government encourage more trials and data sharing?

Finally, we know that the NHS remains under considerable strain generally. The 93% target for a two-week wait from GP urgent referral to first consultant appointment was not met once last year. Neurosurgery is no exception. In March 2019, the 18-week completion target for referral to treatment pathways stood at 81.3% for neurosurgery— 5% lower than the average for all specialties—which made neurosurgery the worst performing specialty. This is a question of both resourcing and staffing. I know the Secretary of State has his answer on revenue resourcing—we disagree, but we will leave our political arguments for another day—but on workforce there are vacancies for more than 400 specialist cancer nurses, chemotherapy nurses and palliative care nurses, and there are diagnostic workforce vacancies too.

Meanwhile, the staff who are there are reliant on outdated equipment, and we have among the lowest numbers of MRI and CT scanners in the world. Failing to diagnose early is worse for the patient and more costly for the NHS, so will the Secretary of State update us on when we can expect Dido Harding’s workforce plan? Can he reassure us that the cancer workforce will be a key part of that plan? On equipment and MRI scanners, can he guarantee that the NHS will see increased capital investment budgets in the spending review so that it can upgrade existing equipment and increase the number of MRI and CT scanners?

Overall, however, we welcome today’s announcement. It is a fitting tribute to our friend Tessa Jowell, and like Tessa herself will touch the lives of so many.

Jonathan Ashworth – 2018 Speech at Labour Party Conference

Below is the text of the speech made by Jonathan Ashworth, the Shadow Secretary of State for Health, at the Labour Party conference in Liverpool on 26 September 2018.

70 years ago Nye Bevan had the vision to build a National Health Service universal in scope, free at the point of use, covering everyone irrespective of their means.

The Tories fought it tooth and nail.

But working men and women refused to give up the struggle.

And so a National Health Service was established not because it was inevitable, it was established because of Labour.

In place of fear, was offered hope.

It was as Bevan said “a real piece of socialism.”

And it has survived because of the men and women who have sustained it through 70 years.

So let us Conference in this the 70th anniversary of the NHS thank the nurses, the midwives, the surgeons, the doctors, the dentists, the junior doctors; thank the paramedics, the patient transport staff, the psychiatrists, the health visitors, school nurses, the OTs, the ODPs; thank the pharmacists, the pathologists, the radiologists, the lab technicians. Thank the porters, the cleaners, the catering staff, the assistants, the clerks and medical secretaries.

Let us thank each and every one of the staff who do us proud every day.

And let us thank those who have come from across the world to care for our sick and elderly whether from the EU, the Indian sub -continent and yes the Windrush generation too.

But instead of hope today there is fear.

The fear of languishing on a trolley in an overcrowded A&E;

The misery of cancelled operations;

The distress at social care snatched away;

The anguish when hip and knee replacements are refused;

Or heartbreak when women are denied a chance to start a family because IVF is restricted.

Eight years of Tory austerity mean waiting lists growing, beds cut, communities losing services, hospitals forced into a fire sale of land.

Eight years of austerity sees hospitals crumbling, equipment breaking down.

Austerity has meant we are so short of midwives that last year half of maternity units shut their doors at some point to women in the throes of labour.

Understaffing has become so chronic, they are now even saying you’ll need to book an appointment to go to A&E. How out of touch. What part of accident and emergency do these Tories not understand?

It doesn’t have to be like this. Austerity was a choice.

In place of fear, it falls to Labour to offer hope again. If a Jeremy Corbyn Labour government had been elected last year, austerity in our NHS would have ended as we’d have invested £7.7 billion extra this year.

We’ll invest in general practice, we’ll invest to prepare our NHS for winter, we’ll establish a National Care Service and to ensure we have the most up to date lifesaving technology and equipment we’ll invest £10 billion extra in infrastructure too.

And when hospital rebuilds are left stalled like here in Liverpool we will step in, take control and ensure hospitals are completed using public money not PFI.

NHS staff care for us in times of most desperate need. It’s time we cared properly for staff.

We will deliver fair pay now and always, based on collective bargaining.

We will safeguard the rights of all NHS and social care staff from the EU and end hostile restrictions on international recruitment.

And, we will expand training places and bring back the bursary too.

Bevan said ‘financial anxiety in time of sickness is a serious hindrance to recovery.’ He was right.

So we will end the tax on the sick that is hospital car parking charges.

And for hospital patients bed bound, sometimes for weeks on end, whose main comfort is the television, it’s a disgrace they can be charged £35.00 a week just to watch TV. We’ll end these rip offs and deliver a fair deal for patients.

Children and young people with cancer often have to travel far for specialist cancer care. But when your child is facing cancer you shouldn’t have to worry about paying for train tickets or petrol just to get to the hospital.

I can announce today a Labour government will cover the costs of travel to and from hospital for cancer treatment for children.

Patients come first and as your Health Secretary I would never abandon my responsibilities to patient care and safety. I certainly wouldn’t be pushing untested private health apps like this new Health Secretary. It’s so irresponsible.

Because we know privatisation puts patient care at risk.

Privatisation means patient transport services run by companies that leave patients stranded.

It means GP out of hours services that aren’t available out of hours.

It means a failing hospital cleaning contract that led to infectious waste flowing through a children’s ward.

And it means Virgin Care suing our NHS.

Now I don’t know if Sir Richard Branson follows the proceedings of the Labour Party Conference.

But I know this. Richard Branson and his shareholders should give that money back to the NHS.

The shadow health team – Barbara Keeley, Justin Madders, Sharon Hodgson, Paula Sheriff, Glenys Thornton, Julie Cooper and Alex Norris have been campaigning on these issues – we thank them today.

But we have more to do.

Last year, conference, you asked me not to break your heart, well I don’t want to break anyone’s heart. So I can tell you.

In Parliament, we will vote against Tory accountable care proposals that usher in more privatisation and cuts

And the next Labour government will end privatisation, will end PFI, we will repeal the Health and Social Care Act and yes will bring forward reinstatement legislation as we begin the process of renationalising our National Health Service.

And we’ll block transfers of hospital staff to subsidiary companies too.

In the coming days I’ll join those unions like Unison and Unite on a picket line against this backdoor privatisation.

The creation of a National Health Service wasn’t just about the relief of a mother’s anguish who otherwise would have to pay for a doctor to come to the bedside of her sick child.

It was also about something really, really fundamental – equality.

Yet today after years of austerity health inequalities are getting wider.

Advances in life expectancy are stalling. In some of our poorest areas its going backwards.

In our most disadvantaged communities we see the greater prevalence of diabetes, cardiovascular disease, cancers and stroke.

We know a child born into poverty and deprivation is more likely to be admitted to hospital, to leave school obese, to suffer poorer health outcomes throughout life.

Place of birth too often determines length of life.

We shouldn’t settle for that.

So a Labour government will establish a specific target to narrow health inequalities.

Rather than cutting prevention budgets we will fully fund public health provision including sexual health services and drug and alcohol addiction services.

Our ambition is the healthiest children in the world so we’ll start tackling childhood obesity through ending junk food advertising on family TV and introducing universal free school meals.

To support parents and babies we’ll recruit more Health Visitors and invest properly in perinatal mental health services too.

But there is something else we need to do.

I recently met Rachel, she told me her story of trying to get help for her anorexic daughter.

Rachel told me how her daughter was sent ‘out of area’ three times over six years to different hospitals including over 300 miles away to Scotland.

Care was always inconsistent in a mental health system fragmented, understaffed, cut back suffering from years of neglect.

It meant a vulnerable teenage girl, desperately ill, left trapped in an endless cycle of admission, relapse and discharge.

As a father of two girls, I’m not ashamed to admit that I cried listening to her story.

We can’t allow – I won’t allow – families to be let down like that.

So we will fully fund child and adolescent mental health services, we’ll invest in eating disorder services and end the injustice of children treated on adult wards or sent miles from home. As we finally deliver true parity of esteem for mental health services.

So in place of fear, we offer hope again.

And if anyone doubts us, let the message from this Conference be clear.

If it was possible from the rubble, the debris, the austerity of the 1940s to build a National Health Service covering every man, woman and child free at the point of use then it is possible 70 years later to fund our NHS properly and provide the quality of care people deserve.

So let us face the future.

Yes in place of fear, we offer hope.

In place of fear, the hope of a rebuilt National Health Service.

In place of fear, the hope of a Labour government for the many not the few.

Jonathan Ashworth – 2018 Speech to Hospital Caterers Association

Below is the text of the speech made by Jonathan Ashworth, the Shadow Secretary of State for Health, at the Hospital Caterers Association on 12 April 2018.

Can I begin by saying what a pleasure it is to be here, in the 70th anniversary of our National Health Service, but a very special pleasure to be here to congratulate you on your 70th anniversary as the Hospital Caterers Association.

And as we look back over the last 70 years of the NHS and pay tribute to the millions who have cared for the sick, thank those who have helped bring babies into the world and pay tribute to those who attend to us in our final moments, we are reminded that it is the care, dedication and compassion of our NHS staff that always has done and still does make the NHS the pride of Britain.

I was so keen to be here in your 70th anniversary year because I know, just as you do, that quality care is about so much more than medicines, bandages, dressings, treatments and surgical procedures, extraordinary as they all are.

Quality care is dependent upon good nutrition and hydration.

So today let me thank hospital caterers for your service to the NHS, for your care, compassion and dedication and for your work as part of the healthcare team in caring for the sick, injured and elderly.

Just like all members of the NHS staff, you have played your part in every illness defeated, in every bout of suffering relieved and in every life saved so today I not only thank you but join with you in readily endorsing your mantra that food is indeed the best form of medicine.

I’ve witnessed this myself when earlier this week I spent time with catering staff working out of the in-house central production unit at the Nottingham City Hospital part of University of Nottingham’s Hospital Trust. Chris and his team working closely with Nicola the Chief Dietetic Technician produce 8,000 meals a day cooked on site with food sourced from local farms and suppliers.

Here the catering team work with nursing staff, dieticians, speech and language therapists to put together nutritional fare that helps and supports the recovery of patients.

This is a very real implementation of the Power of Three initiative that the HCA has championed in recent years emphasising that quality healthcare delivery isn’t about fragmentation and silos but about seamless collaboration where catering staff work alongside nursing staff and dietician staff.

But Nottingham has gone even further too in developing a new memory menu following consultation with the local community offering patients the healthy nutritional meals they want.

And because the catering team at Nottingham recognise that the NHS’s responsibility for the health and wellbeing of patients doesn’t simply end when the patient walks out the door, so they ensure the most vulnerable patients leaving to go home are offered a discharge parcel of food basics – bread, a pint of milk, tea, coffee, tinned soup – to help them in the first few days out of hospital.

This is exactly the sort of in-house, high quality service offering nutritional meals to a high standard that I believe is integral to the future of the NHS and one I want to see developed across the service as Labour’s shadow Health Secretary.

I opened my remarks by reminding you this is both the 70th anniversary of the National Health Service and the 70th anniversary of the Association.

In 1948 the overriding endeavour of a National Health Service universal in scope was both to relieve the suffering of those who otherwise would have to pay for a surgeon to come to their bedside but also to wage war on the great infectious diseases that stalked the land and took far too many so early in life such as polio and diphtheria.

70 years later the world is very different and so the challenges facing our National Health Service have changed fundamentally too.

In 1948, life expectancy for men was 66 and for women it was 71.

Today it is 79 and 82 respectively and over the coming years is expected to become 83 and 86 respectively by 2041.

By 2024 the number of over 75s will have increased by around two million compared to 2014.

So today our first big challenge is how the NHS supports those who live longer. And if we are all living longer our second challenge is how the NHS supports living with complex needs, as well as those across all ages living with chronic conditions whether from diabetes, to arthritis to heart conditions.

I think we have a further challenge too.

Health inequalities are widening not narrowing. Sir Michael Marmot, the world-recognised authority on public health, has warned that this country has, since 2010, stalled in the task of improving the life expectancy of our population.

Added to this, he also points out that differences in life expectancy between the poorest areas in the country and the English average has started to widen again.

Just look at what that means for someone born today in the poorest areas. They are likely to live for fewer years than someone born in wealthier areas. Ill health is more likely to blight their childhood. And a child born into poorer areas is more likely to leave school obese than a child growing up in the most affluent area.

Across the population we face an obesity crisis with hospital admissions where obesity is a factor more than doubling in England during the last four years. The UK is spending about £6 billion a year on the medical costs of conditions related to being overweight or obese and a further £10 billion on diabetes. That means British taxpayers are spending more on treating obesity-related conditions than on the police or the fire service

But as just as we face an obesity crisis in society we are on the verge of a malnutrition crisis too.

Child poverty is increasing, with an extra million children predicted to be pushed into poverty by 2022. Across our communities more and more charities and faith groups are forced to open food banks and The Trussell Trust report in the last year they have handed out over 1 million three-day emergency food parcels.

A recent All Party Parliamentary Group Report into Hunger estimated there around 1.3 million elderly people suffering from or at risk from malnutrition in society.

We have seen a 122 per cent rise in admissions to hospital for malnutrition since 2010. There has been a 20 per cent increase in the number of pregnant women admitted to hospital with primary or secondary cases of Vitamin D deficiency over the past year

Not only should it offend our sense of decency, indeed I would even go further because I believe these rates of malnutrition shame us a society for a nation that is the sixth biggest economy in the world.

And it makes no economic sense either. Rising malnutrition is predicted to cost our health and social care services £13 billion by 2020. For example an increase in malnutrition amongst the elderly means an increase in hospital admissions, longer recovery times with longer hospital stays.

So the reason I highlight all of this is because my burning ambition as hopefully the next Labour Health Secretary is to lead an all-out assault on unacceptable heath inequalities in society by beginning to tackle some of these wider determinants of ill health.

That means a strong commitment to investment in public health provision in the wider community; it means investment in social care provision with an extra £8 billion across a Parliament, as well as supporting elderly people to live independently in their communities.

It means prioritising child health and focusing support to improve the health and wellbeing of every child.

It means improving the quality of air that we breathe, the fabric of the housing we live in and the economic conditions in which our society is ordered, to encourage the eating of a healthy diet.

Because we know a healthy diet means healthy body weight and reduces the risk of developing major health problems like high blood pressure, heart disease, diabetes, certain cancers and osteoporosis.

And we also know eating a healthy diet positively impacts our mental health. Following a healthy balanced diet reduces the risk of developing specific mental illnesses such as depression, schizophrenia, Alzheimer’s disease and Parkinson’s disease.

So yes we must take much bolder action to fight obesity.

So while we welcome the sugar tax we would want to see it extended to milk based sweet drinks, we want to end the advertising of junk food on family TV viewing and we would ban the sale of high energy drinks to under 18s.

And so when we focus on improving the quality of care across our NHS we must also focus relentlessly on improving the quality of food we offer patients, visitors and staff as well.

Because what sense does it make to offer patients the very best medicines, treatments by the very best clinicians and surgeons, to offer patients access to some of the very best cutting edge technology and yet deny them the best quality nutritional food that will help them make a full recovery.

And when we know that poor diet is a major driver of ill health across the nation then surely it should be our obligation to support patients with their diet when in hospital.

Indeed all of us who are passionate about securing the future sustainability of the NHS have a responsibility to ensure the NHS promotes healthy eating in order to reduce the chronic conditions that poor diet is contributing to in wider society which in turn are increasing the pressures on the NHS.

In the last year across the NHS in England 144 million inpatient meals were made at a cost of £560 million.

Some hospital trusts according to the Estates Return Information Collection – and I appreciate not everyone accepts this data, believing it puts a rosier tint on the reality on the ground, but nonetheless it is the only official data set we have – suggests that some hospitals are spending as little as around £3 per meal per patient.

Of course cost does not necessarily equate to quality but I was shocked to learn from Jeremy Hunt’s own data that nearly half of hospitals failed to meet the food expectations as outlined in the NHS Standard Contract.

Nearly half of hospitals did not meet dietician guidelines outlined by the British Dietetic Association. And despite one third of people aged 65 years or over being at risk of malnutrition on admission to hospital, yet only half of hospitals screened every patient for signs that they were struggling to get enough to eat.

It is quite simply unacceptable that the standards in the contract are not enforced and I believe this fails patients and NHS staff alike.

Given we all accept that good food is important to our health, it’s time to apply the very highest standards to hospital food across the board.

So today I can announce that the next Labour Government will put hospital meals on the same legal basis as school food standards, and ensure hospitals mandatorily meet minimum standards for the food served to patients, staff and visitors.

We will be setting new, higher quality standards for hospital food so it is nutritious and made with care by highly trained staff using the best sustainable ingredients

I can also confirm these standards will be independently monitored and enforced.

We believe over time this will increase the numbers of freshly cooked meals served, reduce the amount of hospital food uneaten and wasted and most fundamentally of all help us start the addressing malnutrition in our hospitals helping staff nurse patients to recovery quicker.

And because the NHS is and must continue to be the trusted authority on health and well-being, I strongly believe all food served on NHS premises should be healthy food.

As far as I am concerned hospital is no place for junk food, super-sized confectionery and sugary drinks. So I praise those hospitals like Tameside and Glossop Care Trust who have taken all sugary drinks and fizzy drinks off their menus in Tameside General.

But when we have junk food burger bars in the forecourts of Addenbrooke’s Hospital I believe we still have a long way to go. So if trusts don’t move speedily in implementing national guidelines then the next Labour government will look at mandatory legal requirements on the sales of junk food and supersized confectionery products as well.

But of course I don’t want to be a Health Secretary who keeps expecting those who work across the service to deliver more and more on less and less.

I’m not going to place upon our NHS staff unrealistic demands while refusing the NHS the investment it needs.

We are now in the eighth year of severe underfunding alongside deep cuts to social care budgets in England.

Today the impact of this sustained underfunding has been revealed. Across England we’ve seen the worst A&E figures for March on record and the impact of a blanket cancellation of elective operations has seen waiting list rise by nearly 5 per cent compared to last year.

With more patients turning to private sector provision through ‘self-pay’ arrangements, the old fears of a middle class flight of people who can no longer tolerate waits for treatments from the NHS is returning, leaving a two tier service for the rest of us.

It’s now clearer than ever that we face a year-round crisis in our NHS, which places the very future of our NHS at risk and requires a sustainable long term investment plan.

At the last General Election my party offered the country a new approach.

We said we were prepared to increase taxation for the wealthiest in society, the top five per cent and allocate the yield from that tax change to the NHS.

It would have meant this year spending an extra £5 billion on the NHS itself plus around an extra £1 billion to invest in staffing such as bringing back the training bursary and an extra £1 billion as the first stage of our plans to stabilise social care.

And because too many of our hospitals are crumbling, because too often our IT systems are slow and vulnerable and in too many places equipment is out dated we would allocate an extra £10 billion across a Parliament for infrastructure investment too.

This is the sort of financial package our NHS in its 70th year needs and the challenge for Theresa May as we approach the NHS’s July birthday is as to whether she will offer the NHS this level of support.

But we know a funding package is desperately needed. The ongoing underfunding has in many areas forced trusts to outsource in the belief a better deal can be found by not delivering in-house. It’s often a false economy.

I can tell you we are opposed as a Party to the current moves towards wholly owned subsidiaries which many trusts are currently pursuing in order to gain a VAT advantage.

We fear this will create a two-tier workforce amongst facilities management staff and we are calling on the government to close down this loophole and block this practise.

And I was struck by the quality offered when I visited Nottingham this week. That’s a service that has been brought back in-house when previously Carillion ran the contract. I’m told since coming back in-house staff morale as improved.

The current Government has too often left valuable public services like hospital catering exposed to the risk of failing companies like Carillion.

The Labour Party has said it will introduce a new presumption that public sector contracts will come back in house across the public sector. So today I want to begin a dialogue with you about what that means for your sector and how a Labour government could meet its ambitions on out-sourcing.

Where catering managers and hospital management want to bring services back in house because it serves the best interests of patients and taxpayers then a Labour Government will want to give them the support and the resources to do so.

So in closing let me reiterate under a Labour Government high quality hospital catering will be at the heart of our vision for the NHS with legally enforced standards for hospitals meals, fully resourced and given the support from government to be delivered in-house.

And as we celebrate 70 years of the NHS this July and as you celebrate 70 years as an Association you can be proud of all you have achieved and you have my commitment to working together in the coming years to improve and support the high quality care every patient deserves.

Thank you.