Category: Health

Wes Streeting – 2022 Speech on the Women’s Health Strategy for England

The speech made by Wes Streeting, the Labour MP for Ilford North, in the House of Commons on 20 July 2022.

Let me begin by thanking the Secretary of State for advance sight of his statement and adding my thanks to the Minister of State, to his predecessor as Secretary of State, the right hon. Member for Bromsgrove (Sajid Javid), who is sat opposite, and to officials in the Department for the work they have done. I am genuinely glad that this work is out of the door when so much else has been in hiatus because of the wider political change afoot in the Government. I join the Secretary of State in recognising the campaigning efforts of his constituent Kath Sansom, as well as the efforts of my hon. Friend the Member for Swansea East (Carolyn Harris), who has campaigned tirelessly to raise awareness of the menopause and has been a driving force for change on behalf of women everywhere.

For too long, women’s health has been an afterthought, and the voices of women have been at best ignored and at worst silenced. Four out of five women who responded to the Government’s survey could remember a time where they did not feel listened to by a healthcare professional, and that has simply got to change. In recent years, we have seen a string of healthcare scandals primarily affecting women: nearly 2,000 reported cases of avoidable harm and death in maternity services at Shrewsbury and Telford; more than 1,000 women operated on unnecessarily by the rogue breast surgeon Ian Paterson; thousands given faulty PIP— Poly Implant Prothèse—breast implants; and many left with traumatic complications after vaginal mesh surgery. Meanwhile, every woman who needs to use the NHS today faces record high waiting times. The NHS is losing midwives faster than it can recruit them. Gynaecology waiting lists have grown faster than those for any other medical specialty. The number of women having cervical screening is falling. And black women are 40% more likely to experience a miscarriage than white women. That is the cost for women of 12 years of Conservatives mismanagement, so I want to address each part of the strategy in turn.

The strategy promises new research, which is of course important. Studies suggest that gender biases in clinical trials are contributing to worse health outcomes for women. There is evidence that the impact of women-specific health conditions such as heavy menstrual bleeding, endometriosis, pregnancy-related issues and the menopause is overlooked. So of course what the Secretary of State has said today about improving data is so important, but will he also set out how exactly the Government intend to make use of this new data to improve outcomes for women?

Improving the education and training of health professionals is essential, because when we do not do that, there are consequences. Almost one in 10 women has to see their GP 10 times before they get proper help and advice about the menopause, and half of medical schools do not teach doctors about the menopause, even though it affects every woman. I challenge the Secretary of State to go further than the proposal he outlined to train incoming medical students and incoming doctors. What plans do the Government have for clinicians who are already practising? We need to upskill the existing workforce, not just the incoming workforce. However, let us be clear: informing clinicians is no good if we do not also improve access to hormone replacement therapy, so where is the action in the strategy to end the postcode lottery for treatment?

Breast cancer is the most common cancer in the UK, and the NHS offers regular breast cancer screening to women aged between 50 and 70. That can prevent avoidable deaths by identifying cancer early, when it is more treatable and survival is more likely. Yet, fewer women in the most deprived areas than in the most affluent areas receive regular breast screening. Even before the pandemic too many women with suspected breast cancer were waiting more than the recommended two weeks to see a specialist. How will the programme announced today make a difference to outcomes for patients if, once diagnosed, they just end up on a waiting list that is far too long and they cannot access the treatment they need?

I welcome what the Secretary of State said about removing barriers to in vitro fertilisation for women in same-sex couples. For far too long they have faced unnecessary obstacles to accessing IVF, for no other reason than that they love another woman. It is high time that we put that right.

I also want to mention endometriosis. Tens of thousands of women provided testimony to the Government about the issues they face with diagnosis and treatment. Will the Secretary of State give the House an assurance that every woman who is treated for this disease will have equal access to specialist services from day one? Will he make sure that they do not have to fight to get the diagnosis in the first place?

On polycystic ovary syndrome, what will the Secretary of State do to make sure that we equalise access to a range of treatments, not least for women for whom the pill is simply inappropriate? We must make sure we end the division between those who receive a prescription on the NHS and those who go private, receiving better treatment.

I also want to raise some points about what has not been mentioned today. In addition to the appalling figures on black maternity deaths, a quarter of black women surveyed by Five X More felt that they received a poor or very poor standard of care during pregnancy, labour and post-natal care. Women who live in deprived areas are more likely to suffer a stillbirth than their richer counterparts. My hon. Friend the Member for Oxford East (Anneliese Dodds), the shadow Secretary of State for Women and Equalities, has pledged a new race equality Act to tackle the structural inequalities in our society, including in healthcare. However, the Government are more interested in stoking culture wars than in acknowledging that these inequalities even exist. Surely that has to change when there is a new leadership of the Conservative party.

In conclusion, the reality that faces women in this country is this: breast cancer waiting times are through the floor, half a million women are waiting for gynaecology treatment, black women are four times more likely to die in pregnancy and childbirth, and too many women still cannot get HRT when they need it. This strategy simply will not solve the depth of the crisis in women’s healthcare after 12 years of Conservative mismanagement. Every day this Conservative Government remain in office is another day when women will have to wait far too long for the care they desperately need.

July 27, 2022
Steve Barclay – 2022 Statement on the Women’s Health Strategy for England

The statement made by Steve Barclay, the Secretary of State for Health and Social Care, in the House of Commons on 20 July 2022.

With permission, Mr Speaker, I will make a statement on the women’s health strategy for England.

I know that many hon. and right hon. Members will agree that, for too long, women’s health has been hampered by fragmented services and women being ignored when they raise concerns about their pain. On too many occasions, we have heard of failures in patient safety because women who raised concerns were not heard, as with the Ockenden review into the tragic failings in maternity care and the independent inquiry into the convicted surgeon Ian Paterson. I also remember the outstanding work of my constituent Kath Sansom and her Sling the Mesh campaign where, once again, the response was too slow when women raised issues with their care.

We are embarking on an important mission to improve how the health and care system listens to women’s voices and to boost health outcomes for women and girls, from adolescence all the way through to later life. This is not only important for women and girls; it is important for everyone. This work is already well under way.

Last month we announced the appointment of Professor Dame Lesley Regan, one of the country’s foremost experts in women’s health, as the first ever women’s health ambassador for England. On top of this, we are investing an extra £127 million in the NHS maternity workforce and neonatal care over the next year, and we are creating a network of family hubs in local authorities in England.

Today we are announcing the next step. We are publishing the first ever women’s health strategy for England, which sets out a wide range of commitments to improve the health of women and girls everywhere. I take this opportunity to pay tribute to the almost 100,000 women who took the time to share their stories with us, as painful as it may have been. Your voices have been heard and were vital in shaping this strategy.

I will now set out the key components of the strategy. First, we are putting in place a range of measures to ensure that women are better listened to in the NHS. Indeed, 84% of respondents to our call for evidence recounted instances where they were not listened to by healthcare professionals. We need to do more to tackle the disappointment and disillusionment that many women feel. We are working with NHS England to embed shared decision making where patients are given greater involvement in decisions relating to their care, including when it comes to women’s health.

Secondly, we want to see better access to services for all women and girls. Women and girls have told us that the fragmented commissioning and delivery of health services can impact their ability to access them. That means they have to make multiple appointments to get the care they need, adding to the NHS backlog. There are better ways to deliver women’s health through centres of excellence in the form of women’s health hubs, designed specifically to holistically assess women’s health issues and where specialist practitioners can be more attuned to concerns being raised. We are encouraging the expansion of those hubs, and indeed I visited Homerton University Hospital this morning to see the benefits these local one-stop clinics bring, enabling women to have all their health needs met in one place.

Thirdly, it is essential that we address the lack of research into women’s health conditions and improve the representation of women’s data in all types of research. Currently, not enough is known about conditions that only affect women, as well as about how conditions that affect both men and women impact them in different ways. The strategy sets out how we will tackle the women’s health data gap to make sure that health data is broken down by sex by default.

Fourthly, we will provide better information and education on issues relating to women’s health. Our call for evidence showed that fewer than one in 10 respondents feels they have enough information about conditions in areas such as the menopause and that many people wanted trusted and accessible information about women’s health. The NHS website is currently a trusted source of health information for many people, and we will transform the women’s health content to improve its existing pages and add new pages on conditions that are not currently there. But we know that the NHS will not be everyone’s first port of call for health information, so we will expand our partnerships, such as the one between YouTube and NHS Digital, who are working together to make sure that credible, clinically safe information appears prominently for UK audiences. It is also important that medical professionals have the best possible understanding of women’s health, and I am pleased that the General Medical Council will be introducing specific assessments on women’s health for medical students, including on the menopause and on gynaecology.

Fifthly, our strategy sets out how we will support women at work. In the call for evidence, only one in three respondents felt comfortable talking about health issues with their workplace, and we also know that one in four women has considered leaving their job as a result of the menopause. So we will be focusing our health and wellbeing fund over the next three years on projects to support women’s wellbeing in the workplace, and we will be encouraging businesses across the country to take up best practice such as the menopause workforce pledge, which was recently signed by the NHS and the civil service.

Sixthly, we will place an intense focus on the disparities in women’s health. We know that although women in the UK on average live longer than men, they spend a significantly greater proportion of their lives in ill health and disability than men. Even among women there are marked disparities and our strategy shows our plans to give targeted support to the groups who face barriers accessing the care they need, for example, disabled women and women experiencing homelessness. It also shows how we are putting an extra £10 million of funding towards 25 new mobile breast screening units that will target areas and communities with the greatest challenges on uptake and coverage.

Finally, as well as these cross-cutting priorities, the responses to our call for evidence also highlighted a number of specific areas where targeted action is needed. Those include fertility care, where we will be removing barriers that restrict access that are not health-based but based, for example, on whether someone has had a child from a previous relationship, and making access to fertility services much more transparent. Another of our priority areas is improving care for women and their partners who experience the tragedy of pregnancy loss. At the moment, although parents whose babies are stillborn must legally register the stillbirth, if a pregnancy ends before 24 weeks’ gestation there is no formal process for parents to legally register their baby, which I know can be distressing for many bereaved parents. So we will be accepting the interim update of the independent pregnancy loss review and introducing a voluntary scheme to allow parents who have experienced a loss before 24 weeks of pregnancy to record and receive a certificate to provide recognition of their tragic loss.

This is a significant programme of work but we cannot achieve the scale of change we need through central Government alone. We must work across all areas of health and care. We will need the NHS and local authority commissioners to expand the use of women’s health hubs; the medical schools, regulators and Royal Colleges to help us improve education and training for healthcare professionals; the National Institute for Health and Care Research to help make breakthroughs that will drive our future work; and many others to play their part. I would like to finish by thanking everyone involved in the development of this important strategy, including the Minister of State, Department for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), who is on the Front Bench with me today, for the determination she has shown in taking this strategy forward. I would also like to pay tribute to my predecessors, my right hon. Friends the Members for West Suffolk (Matt Hancock) and for Bromsgrove (Sajid Javid), the latter of whom is in his place, for their commitment to this important issue, even during the pressures of the pandemic. This is a landmark strategy, which lays the foundations for change and helps us to tackle the injustices that have persisted for too long. I commend this statement to the House.

July 27, 2022
Gillian Keegan – 2022 Statement on Draft Down Syndrome Act Guidance

The statement made by Gillian Keegan, the Minister for Care and Mental Health, in the House of Commons on 19 July 2022.

Today, I am delighted to announce the launch of a national call for evidence to inform the development of the draft Down Syndrome Act Guidance.

There are around 47,000 people with Down’s syndrome in the UK and we know that people with Down’s syndrome often face significant challenges and can struggle to access appropriate services and support.

I am grateful to the right hon. Dr Liam Fox MP for bringing forward the private Member’s Bill which is now the Down Syndrome Act. This important legislation aims to improve access to services and life outcomes for people with Down’s syndrome. It does this by requiring that relevant authorities when providing certain health, social care, education and housing services take account of guidance issued by the Government—the guidance. The guidance will set out the steps it would be appropriate to take to meet the specific needs of people with Down’s syndrome.

Since the Act received Royal Assent on 28 April 2022, we have been engaging with stakeholders and developing the national call for evidence which will inform the guidance.

This call for evidence is an important stage in the process leading to the publication of the guidance in 2023. It will allow us to collect invaluable information over the next few months, which will then be used to inform and support the production of draft guidance. The draft guidance will in turn be published for full public consultation before final guidance is published next year.

Through the call for evidence, we want to hear about the specific support needs of people with Down’s syndrome and examples of best practice in service delivery from across the country. We want to hear views on other areas that guidance could cover such as employment support and potential linkages with other genetic conditions that we committed to explore during the Act’s passage through Parliament.

We want to hear from all relevant stakeholders including people with Down’s syndrome, their families and carers, organisations that represent them, and professionals such as those working in health, social care, education and housing.

The process must be as accessible as possible and therefore the call for evidence will run for the maximum duration of 16 weeks. Alongside the online questionnaire and an easy read version, we will work with voluntary sector organisations to undertake workshops and focus groups to input into the call for evidence. We want to make sure we gain the views of everyone, including children and young people with Down’s syndrome, their families and carers.

Following this national call for evidence, we will continue to engage with people with Down’s syndrome and other stakeholders to develop the guidance. The draft guidance will also be subject, in due course, to a full public consultation.

The guidance represents a real opportunity to improve the way that services are arranged and delivered but it is essential that it is based on the views and expertise of those it will affect. I therefore strongly encourage everyone to complete the call for evidence and share widely.

I am determined that people with Down’s syndrome should have the opportunity to be fully included in our society and to have access to the services and support that enable that, throughout their lifetime.

July 26, 2022
James Morris – 2022 Statement on Access to NHS Dentistry

The statement made by James Morris, the Parliamentary Under-Secretary of Health and Social Care, in the House of Commons on 19 July 2022.

Access to dentistry was severely impacted by the pandemic. The Government provided unprecedented financial support to the sector during the covid-19 pandemic to ensure that practices remained viable and able to offer treatment during the pandemic and to continue now, as we learn to live with covid-19.

Taking into account the evolving guidance on infection and prevention control NHS England has worked, throughout the pandemic, with the sector to increase levels of dental activity, while keeping dentists, patients and their teams safe. From the beginning of July this year, NHS England has set the expectation that practices will return to delivering treatment at pre-pandemic levels.

With NHS dentists operating at below 100% capacity for over two years, many people have not been able to regularly access a dental professional. We are taking action to address this, in a way which is fair for patients, dentists and the taxpayer.

In April 2021, the Government set out that any changes to NHS dentistry must meet six tests:

Be designed with and enjoy the support of the profession

Improve oral health outcomes (or, where sufficient data are not yet available, credibly be on track to do so)

Reduce perverse incentives for dental care that is not clinically necessary

Demonstrably prevent the loss of NHS commissioned dental activity to private pay

Improve patient access to NHS care, with a specific focus on addressing disparities, particularly those linked to deprivation and ethnicity

Be affordable within available NHS resources made available by Government, including taking account of dental charges

NHSE fully engaged the profession and patient representatives through an advisory board, technical groups and engagement events from May to September 2021 to fully understand the issues and potential solutions. The improvements set out here result from that engagement and have been refined through consultation with the British Dental Association and wider dental sector representatives.

These initial changes are aimed at improving information for patients; improving the incentives in the contract to deliver more complex care; and enabling the NHS to better work with the sector to ensure that dental care is delivered.

Improve care for high-needs patients

We have responded to the call from dentists to improve the remuneration system to incentivise complex preventive and restorative treatment. We will make changes to the way dentists are remunerated for the range of treatments that are currently covered in band 2 treatments. Dentists will be paid more when they need to do three or more fillings or extractions and provide endodontic care.

To provide the capacity to deliver the additional care required by higher-needs patients, we will support practices to adhere more closely to the National Institute of Clinical Excellence guidance on recall intervals which indicate that a healthy adult with good oral health need only see a dentist every two years and a child every one year. We want to decrease the volume of any low-value clinical care provided through NHS dentistry, for the NHS and patients themselves.

These changes will support dentists and patients in getting the care they need as we start to tackle the pandemic backlogs in care.

Promote more effective use of skill mix

Dental care can be provided by a wide range of dental professionals including dental nurses, dental hygienists, and dental therapists. We will make clear that there is no legal barrier to the increased use of these professionals in the provision of NHS care and seek to increase their use in the provision of NHS care, as is already the case in private practice. NHS England will issue clear guidance on how to utilise these team members to provide NHS care that is within their scope of practice and which they have the skills, competence and experience to deliver safely and effectively in the best interests of patients. We will also work with the NHS Business Services Authority to make sure there are no administrative barriers to more effective use of this skill mix in practices providing NHS care.

This will help improve access to NHS care and make dental care professional roles including dentists more fulfilling and rewarding, and help to tackle workforce challenges in underserved areas.

Maximise patient access from available dental resources

NHS England will work with local commissioners to help ensure that dentists are able to deliver high-quality care to patients. Most dental practices consistently deliver their contracted amount of dental activity, but there are some that do not, and some that want to deliver more NHS dentistry.

We want to enable high-performing practices to expand to deliver more NHS care, particularly in those areas where NHS dentistry is less prevalent. To incentivise this, we will enable, subject to commissioner agreement, practices to deliver up to 110% contracted activity.

Where contractors are unable to deliver their contracted activity in-year or persistently across years, commissioners are currently limited in their ability to recommission that activity to contractors better able to do so. In 2019-20,13% of contractors had consistently failed to deliver. This lost activity represents around 4.6 million units of dental activity per annum.

As an initial step NHSE will encourage commissioners and contractors to work together so that where a practice has not delivered 30% of contracted activity by mid-year, 10% of annual activity will be rebased with agreement of the contractor. For contractors that consistently do not meet their targets over a number of years, we will enable NHSE to rebase contracts to achievable levels and release unused funding to commission care from other providers.

Improve communication with patients

Patients told us that they have difficulty finding an NHS dentist, in part because of the limited information on the NHS website. We will make the updating of the NHS website and directory of services a contractual requirement for dental practices. This will make it easier for patients to find a dentist who can deliver the care they need and for the system to refer patients to practices with capacity.

Recruitment of dentists

International professionals form a large proportion of joiners to the General Dental Council (GDC) register—indeed, in 2020, 35% of new GDC dentist registrants qualified outside the UK. They are a vital part of the UK’s dentistry workforce, ensuring that there is more capacity for dental treatment than UK graduates can provide alone

As part of the ongoing reforms to healthcare professional regulation, officials have identified prescriptive detail which restricts the GDC from modernising its international registration processes. This may in turn deter safe and competent professionals from seeking registration to practise in the UK. The Department is therefore taking forward a legislative change which will:

support flexibility for the GDC to ensure that international processes are proportionate and streamlined, while continuing to robustly protect patient safety;

enable the GDC to increase the number of overseas registration exam (ORE) seats it offers by charging a fee which covers the cost of the exam, explore alternative ORE providers, and make changes to the structure of exam and applicant information which will support an increased pass rate; and

allow the GDC to explore alternative pathways to international registration, such as recognition of programmes of education delivered outside the UK, or registration based on recognition of the qualification held by an applicant, as it considers appropriate.

Current arrangements ensure that UK regulators continue to automatically recognise relevant European economic area (EEA) qualifications of healthcare professionals, including dentists. This enables qualified dentists from other EEA countries to continue to practise in the UK and we want to continue to facilitate their vital contribution to the dentistry workforce. EU exit legislation places a duty on the Secretary of State to carry out a review of the operation of these provisions at the start of 2023. The system of automatic recognition will not terminate unless further legislation is made to bring the current system to an end.

Next steps

These changes are the first steps in our work to support NHS dentistry and patients in areas where they continue to struggle with access. We are committed to working with the sector to consider any further changes which meet the six tests set out above, in particular regarding improved access to urgent care and further workforce and payment reform.

July 26, 2022
Steve Barclay – 2022 Statement on Doctors’ and Dentists’ Remuneration

The statement made by Steve Barclay, the Secretary of State for Health and Social Care, in the House of Commons on 19 July 2022.

The 50th report of the Review Body on Doctors’ and Dentists’ Remuneration (DDRB), the 35th report of the NHS Pay Review Body (NHSPRB) and the 44th report of the Senior Salaries Review Body (SSRB) are being published today. The reports will be presented to Parliament and published on gov.uk.

I am grateful to all the chairs and members of the review bodies for their reports, and I welcome their robust, independent recommendations and observations. I am accepting the pay bodies’ recommendations in full, recognising the vital contributions NHS workers make to our country.

This pay award comes on top of the 3% last year for staff under the remits of NHSPRB and DDRB, when pay uplifts were paused in the wider public sector. This year, most overall pay awards in the public sector are similar to those in the private sector. Survey data suggests median private sector pay settlement, which is the metric most comparable to these pay review body decisions, was 4% in the 3 months to May.

The NHSPRB has recommended a £1,400 consolidated uplift to the full-time equivalent salary for all Agenda for Change (AfC) staff. This will be enhanced for pay points at the top of band 6 and all pay points in band 7 so it is equal to a 4% uplift.

The DDRB has recommended a 4.5% increase to national salary pay scales, pay ranges or the pay elements of contracts for all groups included in their remit this year (consultants, speciality and associate specialist (SAS) doctors on the closed 2008 contracts, salaried general medical practitioners (GMPs) and general dental practitioners).

The SSRB has recommended a 3% increase for all very senior managers (VSMs) and executive senior managers (ESMs), with a further 0.5% to ameliorate the erosion of differentials and facilitate the introduction of the new VSM pay framework.

After careful consideration of the pay review body reports, we have decided to accept the pay review bodies’ recommendations in full. In doing so, we have committed to:

uplifting the full-time equivalent salaries of staff on Agenda for Change contracts—over 1 million NHS staff—by £1,400 on a consolidated basis, and enhanced for staff in bands 6 and 7, those with full-time equivalent basic pay up to £45,839, so it is equal to a 4% pay uplift. This means the lowest paid will receive a 9.3% increase compared to 2021-22;

uplifting the salaries of consultants (c.55,000 doctors) by 4.5% on a consolidated basis;

uplifting the minimum and maximum pay range for Salaried GMPs (c.15,000 doctors) by 4.5% on a consolidated basis;

uplifting the GMP trainers grant and GMP appraisers grant by 4.5%;

uplifting the pay element of the general dental practitioners contract (c.24,000 dentists) by 4.5% on a consolidated basis;

increasing the overall investment in the SAS workforce (c.12,000 doctors) on average, by 4.5%. The detailed arrangements for implementing this increase alongside the reformed 2021 SAS contract will be set out in due course; and

uplifting the salaries of all very senior managers and executive senior managers (c.2,500 staff) by 3% and providing NHS organisations with additional flexibility to provide a further 0.5% to ameliorate the erosion of differentials and facilitate the introduction of the new VSM pay framework. Further information will be shared with NHS employers in due course.

All pay awards will be backdated to 1 April 2022. This pay award is only applicable to NHS staff in England. The 2022-23 pay uplift for NHS staff directly employed by NHS providers will be funded by NHSE through system allocations.

The DDRB was not asked to make recommendations for staff groups in multi-year deals (contractor GMPs, doctors and dentists in training or SAS doctors on the 2021 contracts). However, we note the wider comments made by the DDRB regarding these groups.

This is an annual process and as is always the case, decisions are considered in light of the fiscal and economic context and ensuring awards recognise the value of NHS staff whilst delivering value for the taxpayer.

While it is right that we reward our hard-working NHS staff with a pay rise, this needs to be proportionate and balanced with the need to deliver NHS services and manage the country’s long term economic health and public sector finances, along with inflationary pressures. Sustained higher levels of inflation would have a worse impact on people’s real incomes in the long run, which is why we need proportionate and balanced pay increases recommended by the independent pay review bodies.

In written and oral evidence to the pay review bodies, the Government set out what was affordable within the NHS’s spending review settlement. The pay review bodies have recommended pay awards above this level. This Government are committed to living within its means and delivering value for the taxpayer, and therefore we are reprioritising within existing departmental funding whilst minimising the impact on frontline services.

The pay awards should be viewed in parallel with the £37 billion package of support the Government have provided for the cost of living, targeted to those most in need.

Salaried general medical practitioners

For salaried GMPs the minimum and maximum pay range set out in the model terms and conditions will be uplifted. As independent contractors to the NHS, it is for GMP practices to determine uplifts in pay for their employees.

Clinical excellence awards and clinical impact awards

The Government have recently reformed the national awards in England, now named national clinical impact awards. The reforms aim to address issues with inequality previously raised by the DDRB.

Government acknowledges the DDRB’s comments on local clinical excellence awards and their reasons for not recommending an increase in their value this year.

July 26, 2022
Rosena Allin-Khan – 2022 Speech on Ambulance Pressures

The speech made by Rosena Allin-Khan, the Labour MP for Tooting, in the House of Commons on 18 July 2022.

I thank the Secretary of State for advance sight of the statement and welcome him to his new role. It would have been helpful if, ahead of the current temperatures, he had responded to our urgent question last week, but I am glad that he is here now.

The Secretary of State claims that everything is in hand, but I know from my own experience and that of colleagues across the country that that is far from the truth. We have already seen ambulance wait times soar and pressure on staff spiral, all while the NHS struggles to find the essential staff needed to deliver patient care. I am sure that everyone across the House will agree that our frontline workers are truly amazing. But if nurses and doctors are so overworked and do not have the time and resources to take care of themselves in this heat, the care that they can give patients will be impacted. The Government must step up and show the urgency that this crisis demands.

The Secretary of State talks of creating additional space for new patients in hospitals. How will that happen—with what money, what resources and what staff? Will the Government try to call those new hospitals, too? Is not the reality that creating capacity elsewhere in hospital really means patients being left in corridors on trolleys or in car parks? Can he assure us today that that will not be the case?

Under the Conservatives, the NHS is simply struggling to cope. A record 6.6 million people are waiting for NHS treatment—and they are waiting longer than ever before, often in pain and discomfort. The people in our thoughts this afternoon are those waiting in queues outside hospitals in ambulances, with soaring temperatures and no air conditioning. If it were dogs or cattle, it would be against the law, but these are people in tropical heat unable to enter hospitals. People with conditions triggered by excessive heat are unable to get an ambulance, because ambulances are logjammed outside A&E. Will the Secretary of State apologise to them and their families?

This situation is impacting mental health, too. People attending A&E experiencing a mental health crisis cannot get a bed in a psychiatric hospital, so they wait in A&E, some of them for more than three days. Why? Because the Government have spent the past decade cutting a quarter of mental health beds.

I worked in A&E over this weekend and saw the amazing work being done by staff to prepare for the record heat. The heatwave and surge in covid cases are putting additional pressures on the NHS. I am glad that the Secretary of State recognised that in his statement. Without doubt, 12 years of Conservative mismanagement and underfunding have left our health service unable to cope, which not only has an impact on patients but hurts staff. Staff morale is at rock bottom. Is it any wonder that 5.7 million days were lost to mental ill health in the NHS last year?

Last week, the Minister of State claimed that the Government had procured a £30 million contract for an auxiliary ambulance service, but, moments later, it was revealed that it was yet to be awarded. Can the Health Secretary confirm whether the Minister of State has issued a correction yet?

On Wednesday, ambulance trusts were placed on their highest possible alert level. A national emergency was declared on Friday and, over the weekend, hospitals were scrambling to increase capacity. Why then has it taken until today for the Health Secretary to step up and show leadership? Can he tell us who he met over the weekend? I do not mean at Chequers; I mean from the NHS. Can he also tell us why the Prime Minister did not think it necessary to chair Cobra today? Just when we thought irony had reached a peak, the Prime Minister spent the weekend partying when he should have been dealing with a health emergency. Has the Secretary of State spoken to the Prime Minister today? The Health Secretary has been too slow. The Prime Minister has not even bothered to turn up and the Government have gone AWOL.

If the Government will not step up now, then Labour will. As temperatures reach a record high, all we are getting from the Government is more hot air. This is a crisis. The country has one message for Ministers: stop squabbling and plotting, do your jobs and get a grip.

July 20, 2022
Steve Barclay – 2022 Statement on Ambulance Pressures

The statement made by Steve Barclay, the Secretary of State for Health and Social Care, in the House of Commons on 18 July 2022.

Following the announcement by the Met Office on Friday of a red warning for extreme heat, I would like to update the House on the impact of extreme weather on health and care, the current covid infection situation and our plans for covid and flu vaccines this autumn.

This is the first time in its history that the Met Office has issued a red warning for extreme heat. The warning covers today and tomorrow. In addition, the UK Health Security Agency has issued its highest heat alert. Its level 4 alert, issued to health and care bodies, means that the heat poses a danger to all of us, not just high-risk groups. Although for many the risk from this heat can be mitigated by simple, common-sense steps, the extreme temperature poses a particular risk in respect of cardiovascular conditions, including heart attacks and strokes. Level 4 does not change the contingency plans in place across the health system, only their likelihood.

We have taken a number of steps in response. Cobra has convened several times, including over the weekend and earlier today, to co-ordinate every part of the Government’s response to this emergency, and I have held a series of meetings with the chief executives of ambulance trusts to discuss the specific measures that they are taking. Steps include increasing the numbers of call handlers; extra capacity for ambulances; and extra support for fleets, including the buddy system, so that calls can be diverted to another trust if there are delays in the area people are calling from. We have held numerous meetings with NHS leaders, including the chief executive of the NHS and her senior team, to continue to implement their long-standing heatwave plans. We had a further meeting again this morning. Meanwhile, ministerial colleagues have continued to liaise with our local resilience forums to co-ordinate across both health and social care.

Even before this heatwave, ambulance services in England have been under significant pressure from increased demand, just as they have across the United Kingdom. The additional pressure on our healthcare system from covid-19, especially on accident and emergency services, has increased the workload of ambulance trusts; increased the average length of hospital stays; and contributed to a record number of calls. Taken together, that has caused significant pressures, which are now being compounded by this extreme heat.

We are taking action in a range of areas. In May, NHS England published a tender for auxiliary ambulances to provide national surge capacity to support ambulance responses during the period of increased pressure. Alongside measures in ambulance trusts to assist with call handling and capacity, NHS hospital trusts are taking steps to address handover delays, in the interests of patient safety. On Friday, the NHS medical director, Steve Powis, and the chief nursing officer, Ruth May, wrote to the chief executives of NHS trusts, ambulance trusts and integrated care boards setting out some of the urgent interventions we need to make; most significantly the focus was on improved ambulance handovers and increased hospital bed capacity.

On ambulance handovers, we are asking health leaders to look again at the balance of risks across the system. We know that leaving vulnerable people in the community would have serious implications for patient safety. Equally, we know that keeping people in ambulances for too long carries other risks, especially from heat. NHS leaders are therefore asking hospital trusts to create additional space for new patients in their units. That may involve the creation of observation areas or exploring ways to add additional beds elsewhere in hospitals, including by adjusting staffing ratios where necessary, as we did during covid, and working to identify areas to mitigate additional workload, such as through greater support on wards with pharmacy and administration.

The NHS is executing its urgent and emergency care recovery 10-point action plan, which includes action across urgent, primary and community care to better manage emergency care demand and capacity. The NHS medical director and chief nursing officer both recognise that this will place an additional burden on some staff, so they are asking trusts to increase efforts on staff wellbeing and support. Alongside the measures being taken by the ambulance services and NHS trusts, the UK Health Security Agency is leading on public health comms to reduce the burden on NHS staff by making sure that we do not create unnecessary demand. We can do that by following the common-sense public health guidance and by looking out for others, in particular the elderly and the vulnerable.

With services under so much pressure, we must make sure that 999 calls are reserved for life-threatening emergencies. We must also consider what advice we can get through other services such as NHS 111, NHS online resources and local pharmacists. In addition to the immediate steps to mitigate the pressures on 999 calls, ambulance services and adult social care, we will keep building on our operational response, with particular attention to discharge and expanding on our pockets of best practice.

That is particularly pertinent, given the current levels of covid, which continue to rise. The latest data from the Office for National Statistics shows that the percentage of people testing positive for covid continued to increase across the UK. In England, an estimated one in 19 people tested positive in the week to 6 July, compared with an estimated one in 25 during the previous week, with more than 13,000 patients admitted to hospitals with covid-19.

Given those pressures and the expected pressures this autumn and winter from respiratory viruses, we are taking important steps to further align our offers on covid and flu. On Friday, I accepted the Joint Committee on Vaccination and Immunisation’s recommendations for a covid-19 autumn booster programme, focusing on vulnerable cohorts, including everyone aged over 50. At the same time, I took the decision that we should keep offering flu jabs to more cohorts than we did before the pandemic. Taken together, this will reduce the number of people getting seriously ill this autumn and winter, easing pressure on the NHS at a critical time. Vaccines have always been, and continue to be, one of the best protections we have, both for ourselves and for the NHS.

From this heatwave to the foreseeable pressures in autumn and winter, I will continue to work closely with colleagues across health and social care, as well as with Members across the House, to ensure that we can address the challenges ahead. I commend this statement to the House.

July 20, 2022
Wes Streeting – 2022 Speech on Ambulance Services and National Heatwave

The speech made by Wes Streeting, the Shadow Secretary of State for Health and Social Care, in the House of Commons on 13 July 2022.

Thank you, Mr Speaker, for granting this urgent question, but what a disgrace that the Secretary of State is not here. Our NHS is going through the biggest crisis in its history, every ambulance service is on the highest level of alert, patients are forced to wait hours in pain and discomfort, and he is yet to say a word about any of it. The Home Secretary was not at the Home Affairs Committee this morning, and the Health and Social Care Secretary is not here this afternoon. This is not even a Government in office, let alone in power.

One person who is still in office, however, is the Minister. Her boss resigned saying he could not put loyalty above integrity any longer. Well, the Minister obviously made a different choice. Can she say whether any further meetings of Cobra are scheduled beyond the meeting held on Monday? As we saw during the pandemic, public health emergencies require clear communication from Government. Can she tell the House what the consequences of a national heatwave emergency would be for schools, public transport services and other public services, and what guidance will be provided to the general public? What assessment has she made of the suitability of care homes to protect residents from the extreme heat, and what contingencies are in place should further measures be necessary?

Every ambulance service is now on the highest level of alert, so what is the Secretary of State doing about it? The Minister talks about targeted help for ambulance services—she is going to be hitting the phones this week; presumably the Secretary of State is too busy—but, as I think she acknowledged, this is a crisis across the health service. Last month, a crew in the west midlands waited 26 hours outside A&E because clinical staff were not available to hand over to. What are the Government doing to provide additional support to A&Es during this heatwave? These pressures are not new. Average waiting times for stroke and heart attack victims are one hour. Patients in the north-east were told to phone a friend or call a cab rather than rely on emergency services. Is it not the case that, although extreme weather is of course putting further pressure on our emergency services, it is 12 years of Conservative underfunding that has left them unable to cope?

In conclusion, if people such as the Home Secretary and the Health Secretary cannot be bothered to turn up to do their jobs and are not interested in the business of running this country because they are too busy making endorsements for fantasy candidates with far-fetched promises, perhaps it is time they step aside so that Labour can give Britain the fresh start it needs.

Maria Caulfield

Can I say how disappointed I am at the shadow Secretary of State’s response? If he is not happy that a female Minister with over 20 years’ experience in the NHS is able to answer a question on NHS waiting times, I find that very disappointing.

As I said in the debate a few weeks ago, I do not want to bring politics into health because I think it is too important, but if the shadow Secretary of State wants to play politics, I will give him politics. If we look at Wales, where Labour runs the NHS service, we see that the ambulance service and A&E departments are facing exactly the same pressures. Only 51% of red calls in Wales are being seen in eight minutes; the target is 65%. If he looks at the call time for strokes, he will see that only 17% of those people are being seen in time. Those numbers are falling month on month, whereas in England our responses are improving month on month. On the four-hour wait in A&E in Wales, 34.9% of people have been seen within four hours.

Wes Streeting indicated dissent.

Maria Caulfield

The hon. Gentleman shakes his head, but he stood at the Dispatch Box just now and said that Labour would do better. It is not doing better in Labour-run Wales; it actually has either similar response times or worse response times.

I have set out a plan. It is clear that the hon. Gentleman has not read the heatwave plan for England, which was published earlier this year, because he would have the answers there. We are making sure that all NHS trusts are prepared. I am happy to work with each and every Member across this House to make sure that the ambulance service, our A&Es and hospital trusts have the support that they need, but if all he wants to do is play politics, I think that is extremely sad.

July 14, 2022
Maria Caulfield – 2022 Statement on Ambulance Services and National Heatwave

The statement made by Maria Caulfield, the Minister of State at the Department for Health and Social Care, in the House of Commons on 13 July 2022.

Our ambulance service performs heroics every single day, and I put on the record my thanks to every single one of its staff for their dedication and hard work. We have a duty to support this vital service and give it the resources it needs.

The latest figures from the NHS in England show that ambulance service response time performance has improved month on month, and that ambulance hours lost are also improving month on month. However, we fully acknowledge the rising pressures facing the service, and there are three significant factors influencing the situation. First, bed occupancy is currently around 93%, which we would normally see during winter. Secondly, there are high rates of hospital covid admissions—whether “with covid” or “because of covid”—and that puts pressure on A&Es’ ability to admit patients. Thirdly, void beds are running at roughly 1,200, partly due to a 16% increase in the length of stays. Delayed discharges are another significant influence, but they remain flat. We also have record numbers of calls to the ambulance service—100,000 more compared with May last year. There is therefore significant pressure on the system.

We also have to be mindful of the weather in the coming days. We do have a heatwave plan for England, which was published earlier this year—I am sure the hon. Gentleman has read it—and we also have the hot weather plans that NHS trusts have put in place. In addition, we are providing sector-specific guidance setting out the best way to protect people who may be at risk. We are also supporting the service more widely to make sure it has the resilience it needs. We have allocated £150 million of extra funding for the ambulance service this year, and we are boosting the workforce too. The number of national 999 call handlers had risen to nearly 2,300 at the start of June, which is a considerable increase on the previous September, and we are on track to train 3,000 paramedic graduates a year nationally every year until 2024. On top of this, we have invested £50 million in NHS 111 to help give extra capacity to the service.

I will be meeting all 11 ambulance trusts over the coming days to make sure that they have the capacity and the resilience they need not just to deal with the pressures now, including with the warm weather, but to prepare for the forthcoming winter pressures that we know are inevitable. This is an important issue that I take extremely seriously, and I will keep the House updated as the situation develops.

July 14, 2022
James Morris – 2022 Statement on the Patient Safety Commissioner for England

The statement made by James Morris, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 12 July 2022.

In July 2021, the Government published their formal response to the recommendations by the Independent Medicines and Medical Devices Safety review led by Baroness Cumberlege setting out an ambitious programme of change. As part of our response, we committed to appoint a Patient Safety Commissioner with a remit covering medicines and medical devices.

I am pleased to announce the appointment of Dr Henrietta Hughes OBE FRCGP SFFMLM as the first ever Patient Safety Commissioner for England. This appointment was made following an open competition, in line with the Governance Code for Public Appointments, and following a pre-appointment scrutiny hearing with the Health and Social Care Committee. Dr Hughes will continue working as a GP and remain Chair of Childhood First.

The First Do No Harm report, led by Baroness Cumberlege highlighted the need to avoid harm and protect patients. The Patient Safety Commissioner will add to and enhance existing work to improve patient safety in relation to medicines and medical devices by being a champion for patients and helping us to learn more about what we can do to put patients first. The Commissioner’s core duties are to promote the safety of patients, and promote the importance of the views of patients and other members of the public. The Commissioner will act independently, and a memorandum of understanding will be agreed to ensure the Commissioner’s independence is safeguarded.

July 13, 2022