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  • Wes Streeting – 2022 Speech on Access to GP Services

    Wes Streeting – 2022 Speech on Access to GP Services

    The speech made by Wes Streeting, the Labour MP for Ilford North, in the House of Commons on 21 June 2022.

    I beg to move,

    That this House notes that primary care is in crisis, with people across the country struggling to access GP services and dental treatment; believes that everyone should be able to get an appointment to see a doctor when they need to and has the right to receive dental treatment when they need it; is concerned by the Government’s failure to remain on track to deliver 6,000 additional GPs by 2024-25; and therefore calls on the Secretary of State for Health and Social Care to urgently bring forward a plan to fix the crisis in primary care, meet the Government’s GP target and ensure everyone who needs an NHS dentist can access one.

    Mr Speaker, thank you for the opportunity to open this debate on the future of primary care, access to GPs and access to dentists. It is a particular delight to see the Secretary of State here. I so enjoyed our exchange of letters last week that I cannot wait to repeat the exchange in real life.

    Primary care is the front door to our NHS—for most of us, the general practitioner is the first port of call when we are worried about our health—but after 12 years of Conservative mismanagement and underfunding of our health service, the front door is jammed. Patients are finding it impossible to book GP appointments, serious conditions are going undiagnosed, patients are waiting longer than is safe for treatment, with backlogs building up and greater pressure placed on the rest of the health service, and millions of people are waiting more than a month to be seen, often in pain and discomfort.

    Catherine West (Hornsey and Wood Green) (Lab)

    My hon. Friend has made an excellent beginning to his speech. What is his view of my local hospital, where, instead of 350 people daily, we have 710 people coming into accident and emergency at the North Middlesex Hospital? What response does he have to that kind of demand? Where is it going to lead if people cannot see a GP? They are going to end up in A&E.

    Wes Streeting

    My hon. Friend is absolutely right to highlight that problem. If the front door of the NHS in primary care is jammed, people end up presenting in A&E. As I shall outline in my speech, this is not only a great inconvenience and burden to patients; it comes at an additional cost to the NHS and we all pay the price for that in every respect.

    Alex Cunningham (Stockton North) (Lab)

    At the GP practice in Norton in my constituency, it is almost impossible to get an appointment on the phone. I have dozens of cases of individuals unable to access vital care. One tried 196 times. The Care Quality Commission has not inspected this practice since 2015. Does my hon. Friend agree that it ought to be doing so now?

    Wes Streeting

    Even in the context of the pressures that we see right across primary care—I think every GP practice would acknowledge they face challenges—the case my hon. Friend has just described sounds extreme. We cannot allow the decade or more of mismanagement we have seen from this Government to excuse that kind of care, or indeed absence of care, for patients, and that brings me on to the next point I want to make.

    We know why patients are forced to wait: Conservative Governments have cut 4,500 GPs over the last decade, they have closed 300 practices since the last election and they have failed to provide any meaningful reform of the system. The public are sick and tired of waiting. Public satisfaction with GP services stands at the lowest level on record as patients become ever more frustrated with not getting an appointment when they need one, or in a manner to suit them.

    It says so much about the NHS at the moment that, while we have the lowest level of patient satisfaction since 1997, when we ask the public whom they trust, nurses and doctors are right up at the top of the list. The public understand that the staff who work in the NHS are trying to grapple with the biggest crisis in its history. Of course, the Government will want to pin that simply on the pandemic, but that does not explain why we went into the pandemic with NHS waiting lists already at record levels, with 100,000 staff vacancies in the NHS and with a decade or more of under-investment, leaving us ill-prepared for the pandemic—or, in the words of the Culture Secretary, “found wanting and inadequate”—but also now struggling to get the recovery from the pandemic that we need to build the health and care service we need for the future.

    John Redwood (Wokingham) (Con)

    The shadow Secretary of State says that we need GP reform. What kind of reform does he have in mind? What does he think should be the right balance between in-person, online and telephone consultations?

    Wes Streeting

    I am grateful to the right hon. Gentleman for that intervention. I will conclude my speech by talking about what a Labour Government will do, but let me answer his direct point about the range of options through which people should be able to access their GP. I value patient choice. Thinking back to my experience of accessing NHS services last year—as many people know, I did quite a lot of mystery shopping on the NHS—I had a range of interactions with GPs. Some were face-to-face. Some interactions at my GP surgery were not with my GP but with a nurse, which was entirely appropriate and much appreciated. Some of my engagements with my GP were over the telephone. I also had a video consultation with a dermatologist. I really valued that flexibility and range of approaches.

    I think that the future for primary care has to be different courses for different horses. Of course, people should have a right to see their GP when they want to see their GP—I am clear about that—but there is also a range of ways in which we can offer more flexible access to GPs, particularly for working people who do not necessarily want to traipse down to the GP surgery in the middle of the afternoon if it is something that could be dealt with over the phone or on a video call.

    Layla Moran (Oxford West and Abingdon) (LD)

    The shadow Secretary of State is making a powerful speech. I commend in particular the point he made that people still trust their doctors. They are desperate to see them, even if it is online. A 74-year-old constituent of mine contacted me and said that he asked for an online appointment but it would take him 30 days to get there. He appreciates that the issue is not with GPs but with the Government’s lack of planning for the number of GPs who can provide that service in Oxfordshire.

    Wes Streeting

    The hon. Lady makes a powerful point. How is it that the NHS can be one of the largest employers in the world—it employs 1.2 million people—but does not have a workforce plan and strategy that says, “This is the workforce need that we have today, this is what the workforce need will be in the foreseeable future and, in the longer term, this is how we need to change the shape of the workforce to take into account advances in medicine and modern technology, and the changing demographics of our society”?

    We gave the Government the opportunity to commission such a report when we debated the Health and Care Bill. It was supported on a cross-party basis, including by the Chair of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt)—sadly, he is not able to be with us at the moment—yet the Government voted against it. What is it about the ostrich mentality of the Secretary of State and his ministerial team—or, I suspect even more, that of the Treasury—that they would rather bury their heads in the sand, pretend there is no problem with workforce and not even count the numbers of doctors and nurses needed because they worry that the Treasury might face up to the reality of what they need to provide?

    Alison McGovern (Wirral South) (Lab)

    Is it not the case that, in the pandemic, the Government fundamentally misunderstood the connection between the health of the nation and its economic success? All the argument the shadow Secretary of State makes about the NHS workforce and what they can achieve for our country shows that the Government are still making the very same mistake.

    Wes Streeting

    I wholeheartedly agree with my hon. Friend, who understands well the link between the health of the nation and the health of the economy. Given the labour market challenges in this country, it is simply not acceptable that we are losing so many people who could be in the labour market to ill health. We are also losing so many people from the labour market who are caring for relatives, because there is a disproportionate burden on families. Who disproportionately bears the burden of that care? It tends to be women, so we are losing a whole tranche of women from the labour market who could be contributing to the growth of the nation and the economy.

    Several hon. Members rose—

    Wes Streeting

    I will give way one more time and then I need to make some progress.

    Jim Shannon (Strangford) (DUP)

    It is not just about GPs and surgeries; it is about dental access as well. In my constituency and across the whole of the United Kingdom of Great Britain and Northern Ireland, dentists are prepared to take private care and monthly care, but they will not take NHS patients. As poverty levels and prices rise, dentistry is at the end of the queue. Does the hon. Gentleman agree that dentistry is at crisis point and that Government intervention is absolutely critical?

    Wes Streeting

    The hon. Gentleman is right to describe the state of dentistry and I will be getting my teeth into that issue very shortly.

    [Hon. Members: “Groan!”] It had to happen at some point. I had to get it in at some point. Let me touch on the other issue he mentions, which is about inequality and inequality of access.

    The system in primary care is entirely unequal. Some areas have twice as many doctors as other parts of the country, with as many as 2,800 patients fighting over one family doctor. Patient safety is being put at risk. Last week, the BBC revealed the scale of the crisis in GP surgeries with its investigation into Operose Health. Patients who can get an appointment are seen by less qualified staff, standing in for GPs without supervision. Patient referrals and test results were left unread for up to six months: private profit placed above patient safety. When the Health Secretary was asked about that last week, he said:

    “we expect local commissioners to take action.”—[Official Report, 14 June 2022; Vol. 716, c. 140.]

    Well, it is not good enough to sit back and wait for others to act. Is an investigation happening? Can he tell us? If not, why on earth has he not launched one? [Interruption.] The Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield), from a sedentary position, talks about the last Labour Government. When are the Conservatives going to wake up to the fact that they have been in government for 12 years? Twelve years! It is remarkable. Twelve years they have been in government.

    Felicity Buchan (Kensington) (Con) rose—

    Wes Streeting

    Perhaps the hon. Lady could tell us why they want to run away from their record of 12 years.

    Felicity Buchan

    I thank the hon. Gentleman for giving way. He makes grand statements in support of the NHS, but I am afraid his actions do not support the NHS. He has backed these train and tube strikes today, which have meant that in my constituency patients cannot get to hospital, and nurses and doctors cannot get to their places of work. Can we have better action, rather than words?

    Wes Streeting

    I am very, very grateful to the hon. Lady for that intervention. Our party has been clear: we did not want to see the strikes go ahead. We believe the strikes could have been averted if the Government had shown responsible action. The absolute brass neck of the Secretary of State! It is one thing pretending they have not been in government for the last 12 years; now they are pretending they are not in government today and that, somehow, it is down to me, the shadow Health Secretary. Somehow, if I had uttered the magic words, “Don’t go ahead,” the RMT would have said, “Oh no, the shadow Secretary of State for Health has spoken now. We better put a stop to it.” [Interruption.]

    Mr Speaker

    Order. I want to help a little bit. We do not want to open up a debate that is not down for today. We have got a little bit carried away. The hon. Member for Kensington (Felicity Buchan) got in, and I was quite right to allow a response, but I think we have heard enough now.

    Wes Streeting

    Thank you, Mr Speaker.

    I was about to quote the great political philosopher, Jonn Elledge, who, in response to what the Secretary of State said, commented on Twitter that we are

    “all as ants before the might of the all powerful shadow health secretary”.

    When is the Health Secretary going to wake up to the fact that he is in government, he has responsibilities, he is discharging the greatest crisis in the history of the NHS and he is doing nothing about it? Instead of lecturing the Opposition, when is he going to show some leadership and get on with governing?

    Clive Efford (Eltham) (Lab)

    The “Panorama” programme also exposed the fact that GP practices are being hoovered up by the private sector. Operose Health now owns 70 practices, with more than 600,000 patients. That exposes the fact that there is now a value to GP patients lists and that they are being sold on. They are collected by GPs, free of charge and then, as they are amassed in great number, they are sold to the private sector. Is my hon. Friend, like me, concerned about that practice?

    Wes Streeting

    I wholeheartedly agree with the point my hon. Friend makes. It is simply not good enough for the Minister to keep on talking about what the last Labour Government did. If she does not agree with the situation described by my hon. Friend, which is happening on her watch, why does she not legislate? If she is incapable of governing, she should make way for people who can govern.

    Catherine McKinnell (Newcastle upon Tyne North) (Lab)

    I commend my hon. Friend for the tone of the speech that he is making, because it is vital that we stand up for our NHS, which the Government are failing to do. They seem happy to let everybody be angry with their GPs and about their inability to seek the medical help they need, but very unwilling to do something about it. Is this argument not really one to be had with the Government entirely? They should be making sure that we have sufficient GPs to treat the people in this country.

    Wes Streeting

    I wholeheartedly agree with my hon. Friend; it is the trend with this Government to seek division, sow division, pass the buck, devolve the blame and not take responsibility for anything. What Opposition Members would not give for just one day of being able to govern in the interests of the people in this country! This Government want to give the appearance of being in office but not governing at all. That is what is happening on their watch. If that is not bad enough, against a difficult economic backdrop, with scarce resources, not only is the way in which they manage and govern bad for patients, but it is squandering taxpayers’ money.

    Dr Caroline Johnson (Sleaford and North Hykeham) (Con) rose—

    Wes Streeting

    I will give way in just a moment. The problems in general practice are storing up problems for the rest of the NHS; as we have heard, people are presenting in accident and emergency because they cannot see a GP. That failure is costing the taxpayer dearly. A GP appointment costs the NHS £39, but a visit to an urgent care centre costs it £77 and a visit to the emergency department costs it £359. The Government’s failure to invest in new GPs may be penny-wise but it is pound-foolish. It is wasting money and inconveniencing patients, and it is not the way to manage the NHS. One of my constituents wrote to me yesterday to say that if she wants a same-day appointment for her baby, her GP sends her to A&E. She wrote:

    “I was sent to A&E to check a newborn baby’s suspected ingrown toenail that had no sign of infection. How is going to A&E for a non-urgent matter a good thing for anyone.”

    Yet that is what our constituents are forced to do, because they cannot get a GP appointment. I hope the hon. Member for Sleaford and North Hykeham can give us some insight as to why.

    Dr Johnson

    As part of that, I suggest that the hon. Gentleman remembers that GPs take 10 years to train. He is right to say that we have been in government for 12 years, but most of the current GP shortage is because the previous Labour Government did not train those GPs at the time. One of the first things the Conservative Government did was to set in train the opening of five medical schools to increase the number of medical students. We had enough doctors but they do take 10 years to train. The reason I stood up to intervene on the hon. Gentleman was to say that one of the challenges that doctors—I refer to my entry in the Register of Members’ Financial Interests, as a doctor—and members of staff face is being abused in a surgery. I wonder whether he would like to apologise for some of the comments he has made on social media—

    Mr Speaker

    Order. Interventions are meant to be questions. I know that the hon. Member is down to speak. I would not want you to use up your speech now; I want you to save something for later.

    Wes Streeting

    Let me first say in response to the final point the hon. Lady made that there is absolutely no excuse for abusing NHS staff whatsoever. Most people in this country do not blame NHS staff for the state of the NHS; they place the blame squarely where it belongs, with the Government who have been in power for the past 12 years. Her first point would be more powerful if we did not have 1,500 fewer full-time equivalent GPs now than we did when her party came to power. Her point would have been more powerful if her party had not whipped its MPs to vote against having a workforce plan for the NHS, but I am afraid that that is what it did. Conservative Members cannot run way from their choices and decisions, and from the fact that they have now been in government for 12 years and there is no one else to blame but themselves. In communities right across the country, we now see the consequences of their mismanagement.

    Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)

    I regret to inform the hon. Gentleman that the situation in Wales is not much better, but I do not want to make a party political point. Will he commend the potential role that pharmacists can play in alleviating pressure on GPs? I have an excellent pharmacist in my home village of Pen-y-Groes, which provides an invaluable service for the communities in my area.

    Wes Streeting

    I wholeheartedly agree with the hon. Gentleman’s point about the importance of looking at primary care as a whole and the really powerful and valuable contribution that community pharmacies can make, alleviating pressures on other parts of the primary care system, particularly general practice.

    Communities across the country are experiencing those problems; let me take one place at random to illustrate the scale of the challenge. Today, after a decade of Conservative mismanagement, the city of Wakefield has 16 fewer GPs than in 2013. In fact, Wakefield has not seen a single additional GP since the Prime Minister promised 6,000 more at the last election, and since Wakefield has been served by a Conservative MP—albeit, thankfully, no longer—it has seen three GP practices close, with some surgeries so short-staffed that 2,600 patients are left to fight over one family doctor. Last month, patients in Wakefield were able to book 25,000 fewer GP appointments than in November 2019, the last month in which they were served by a Labour MP. The only good news for general practice in Wakefield in recent years has been that Simon Lightwood, an NHS worker and brilliant candidate in Thursday’s by-election, has successfully campaigned to save the King Street walk-in centre. [Interruption.] They don’t like it. Conservative Members shout in protest and point the finger at us, but they have been in government for 12 years.

    Richard Fuller (North East Bedfordshire) (Con)

    The hon. Gentleman is talking about problems, but his motion does not include one solution. He has now been speaking for 20 minutes, and he has not outlined one solution. If he wishes to be taken seriously as a politician, will he now turn to some solutions to the problems he has outlined?

    Wes Streeting

    It is certainly true that I am saving the best until last in my speech, but the hon. Gentleman may have missed the point I have made repeatedly, which is that the NHS—an organisation that employs more than 1.2 million people—needs a workforce strategy. It needs a proper analysis of what its workforce needs are today, the workforce needs of tomorrow, and the future shape of the workforce. We gave Government Members the opportunity to vote for that; the hon. Gentleman voted against it, and he wants to lecture me about being taken seriously as a politician. Who is he trying to kid? I do not know how the hon. Gentleman voted, because it was a secret ballot, but the fact that a majority of Government Members voted to keep the current Prime Minister in office means that they are not in any position at all to lecture anyone else on who is and is not a serious politician.

    Andrew Selous (South West Bedfordshire) (Con)

    I am very grateful to the shadow Secretary of State for giving way. I have in front of me figures from the House of Commons Library on the increase in GPs per 100,000 population between September 2015 and April 2022, which show an 8% increase for Wakefield.

    Wes Streeting

    I notice that the hon. Gentleman has played the old trick of selecting figures from a specific set of years, but nothing he has said contradicts the facts that I have outlined. In any case, the people of Wakefield will draw their own conclusions on Thursday when they go to vote. The fact is that the Government have had more than enough time to reform general practice in this country, and they have no one other than themselves to blame for the crisis we are in.

    Since the Conservative party has been in government for the past 12 years, I thought I would take a trip down memory lane to remind us, the House and the British people exactly what they have been promising since they were first elected in 2010. The 2010 Conservative party manifesto promised that GP surgeries would be open 12 hours a day, seven days a week. The Government failed to deliver that—maybe they blame their coalition partners, although I do not think the Liberal Democrats would have disagreed with GP surgeries being open for that long—so they promised the same again in 2015. That time, they set themselves a deadline of 2020, and guess what? They missed that, too.

    In 2015, they promised that everyone over the age of 75 would get a same-day appointment—another promise broken. They said they would hire 5,000 more GPs by 2020—another promise broken. In 2019, they promised 6,000 more GPs, but the Health Secretary has already admitted that he is on course to break that promise, too. They promised 50 million more GP appointments a year, but as the British people know from their experience, appointments are down. That is today’s Conservative party: over-promise and under-deliver, never take responsibility, and leave patients paying the price.

    Lilian Greenwood (Nottingham South) (Lab)

    This morning, one of my constituents contacted me to say she was standing outside her GP practice at 7.15 am in order to secure an appointment. She said that she was successful in securing an appointment, but a number of people who were also standing outside did not. Does my hon. Friend remember the Health Secretary promising that people would have to do that in order to secure a GP appointment?

    Wes Streeting

    I wholeheartedly agree with my hon. Friend. This is the problem: they overpromise and underdeliver. If they will not hear it from me, Mr Speaker, let us remind ourselves of what some of the Secretary of State’s colleagues have said. The hon. Member for South West Bedfordshire (Andrew Selous), who is in the Chamber, said in Prime Minister’s questions only last week:

    “At one of my surgeries, which has double the recommended number of patients per GP, the bowel cancer diagnosis of a 51-year-old father of four was missed and is now terminal.”—[Official Report, 15 June 2022; Vol. 716, c. 283-4.]

    Earlier this month, the hon. Member for Telford (Lucy Allan) read a letter from a constituent to the Health Secretary. It said:

    “Trying to get basic healthcare is a joke in Telford. Maybe I would be better off in…a third-world country”.

    If the Secretary of State is not going to listen to us, he should at least listen to his own side. Before Conservative Members leap to the defence of their Government’s record, they should probably go back and check the record to make sure that they had not agreed with us in the first place.

    As for dentistry, 2,000 dentists quit the NHS last year, around 10% of all dentists employed in England. It is an exodus under the Government’s watch. Four million people cannot access NHS dental care and cannot afford to go private either.

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

    My hon. Friend is making an excellent speech. My constituent, Ellie Cokeley, wrote to me. She works as a receptionist in a local dental practice and gets hundreds of calls a week from upset members of the public who are unable to find an NHS dentist. She said that it feels greatly unjust that the poorest in our society are being forced to pay huge amounts for vital dental care or, worse still, having to continue without any at all. Are the Government not failing people in this country when it comes to the care of their teeth? It is vital that we get more dentists in the system.

    Wes Streeting

    My hon. Friend is absolutely right. Some places, such as Somerset, are dentistry deserts because the remaining NHS dentists are not taking on new patients.

    Several hon. Members rose—

    Wes Streeting

    I will give way first to my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), then to my hon. Friend the Member for Hackney South and Shoreditch (Dame Meg Hillier) and then to the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone).

    Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

    My hon. Friend mentioned Somerset, but can I also mention Sunderland, to keep up the alliteration? In Sunderland, we cannot find an NHS dentist and the few good ones we have are now turning to private practice to make it work. It is an existential crisis in dentistry—it really is at breaking point. Does my hon. Friend agree that the blame lies squarely with the Conservative Government, with backlog Britain, and that this is the effect on our constituents?

    Wes Streeting

    My hon. Friend is absolutely right about the state of dentistry. It is not alliterative, but I suspect that my hon. Friend the Member for Hackney South and Shoreditch has similar points to make.

    Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)

    A constituent of mine told me that she had a terrible toothache, rang 111 and was assigned to an emergency dentist. The system worked, but does my hon. Friend agree that that that costs the taxpayer so much more money? My hon. Friend talks about overpromising and underdelivering, but with dentistry the Government have not even promised anything and they are underdelivering.

    Wes Streeting

    My hon. Friend knows exactly what she is talking about. Of course, there is no one better in this House to make the point about the waste of public money. That is the outrageous thing about all of this. People are paying more and getting less. Their taxes have been put up, justified in the name of the NHS, but the money is not being directed in the right way to deliver better care. In fact, the Government admit that even with the investment they are putting in, people will be waiting longer for care and that is a disgrace.

    Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)

    I thank the shadow Secretary of State for giving way. He is very civil. Can I also go down memory lane? We have had a Government of a rather different colour in Scotland since 2007, and today I have constituents coming to me and saying, “I cannot get on an NHS dentist’s list”. That echoes the point made by the hon. Member for Strangford (Jim Shannon). Does the shadow Secretary of State agree that in the event of the present Government sorting this situation out, they would do well to share what they did with the Scottish Government? And in the event of a change of Government after the next general election, will the shadow Secretary of State commit to giving advice to the Scottish Government?

    Wes Streeting

    This is the thing that the First Minister of Scotland does not want to acknowledge, but for all her noise, bluff and bluster she knows full well that a Labour Government here in Westminster would be good for the people of Scotland. The investment and reform that we would put into the NHS to deliver the same kind of results as the previous Labour Government did would be good for the people of Scotland. I look forward to the day when I can phone the Scottish Government to give them some advice and I look forward to the day when the Governments in Westminster and Edinburgh are Labour Governments delivering for people across the United Kingdom.

    The hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) mentioned the trip down memory lane. The Under-Secretary of State for Health and Social Care, the hon. Member for Lewes, regularly blames Labour for what is happening in dentistry. That is because of something that happened 16 years ago: it was a contract that was put in place by the last Labour Government, which we committed to reform in our 2010 manifesto. Unfortunately, that manifesto was never implemented. The tragedy is that the Conservative manifesto that promised reform of the dentistry contract was not implemented either.

    In 2010, the Conservatives promised to introduce a new dentistry contract. In 2017, they also promised to introduce a new dentistry contract. What is the Minister’s policy today? She promises to introduce a new dentistry contract. She must make up her mind: either, the current contract is so good that every time she tries to change it, she cannot find a way of improving it, or, the Minister’s Department, her Secretary of State and her Government are so incompetent, so distracted, or so indifferent, that they simply cannot get the job done. It is no good their blaming the Labour party for the problems in NHS dentistry. They have been asleep at the wheel for 12 years. They have failed to do anything to improve the service, and now 4 million people cannot access a dentist. The consequences are severe.

    Let me tell the Health Secretary about a constituent of my right hon. Friend the Member for Normanton, Pontefract and Castleford (Yvette Cooper). She tells me that this constituent cannot get a dentist appointment anywhere for an unbearable toothache, and that they are in too much pain to sleep through the night. When they contacted a dentist, they were told that they would have to wait two years for an appointment. They wrote in an email:

    “I am in such agony that I took Ibuprofen, drank whisky and tried to pull it out myself with plyers, but they kept slipping off and it was agony.”

    What kind of country have we become when the most common reason for children to go to hospital is to have their teeth extracted? We have 78 children going to hospital every day to have their teeth extracted. [Interruption.] There is no point Members arguing from a sedentary position that it is because of fizzy drinks. That is their approach all the time. The system is broken, so let us blame the patients. It is absolutely outrageous. DIY dentistry in one of the richest countries on the planet, and their answer is to blame the patients. They should get real. This is so far from that original promise of the NHS, where care is provided to all who need it, when they need it.

    To be fair to the Health Secretary, he has been in the role for just under a year, and, on that note, I would like to wish him a happy anniversary this Sunday for one year in the job. But I am afraid that that is where the niceties end, because I will now run through what he has said and done in his year in charge. He had a big media splash on “league tables for practices” to pressure them into doing more face-to-face appointments and then he backed down. He achieved great headlines on “nationalising GPs” in January—imagine the excitement—but there has been no action since. He talks about bringing the NHS into the Netflix age. Has he ever actually used the NHS app? I cannot even book a GP appointment through the app because my GP is not on it. Why is it still not available to every patient as a way to book appointments? I visited Israel recently—I refer to my entry in the Register of Members’ Financial Interests—where it has embraced the technological advances in medicine over recent years to massively improve access to healthcare for patients.

    I was talking to a start-up, which is developing an app that tracks the recovery of stroke victims, and notifies them when they need to see a physio. I then showed the staff what the NHS app can do and what it cannot do and they laughed. In some senses, the Health Secretary had a point: the NHS is not as modernised as it needs to be to deliver for patients, and nowhere is that more true than in primary care. It is an analogue service in a digital age. Patients should not have to wake up at 8 in the morning and wait on the phone for an hour for an appointment. They should not be told to expect a call back, but given no indication as to what time that will be, and then be considered a missed appointment if they do not pick up because they are at work, or are busy, or are picking up the kids and doing everything else that people do between nine and five.

    People have never been so well-informed about their own health. We carry around with us devices that can measure our exercise, our heart rate, how well we sleep, and so much more. Yet our healthcare system puts none of this to use and keeps all the pressure on GPs.

    Let me conclude by outlining some of what a Labour Government would do to address this crisis—[Interruption.] I am not surprised that Conservative Members are excited; they must be as fed up as we are. First, we would take immediate practical steps to boost the number of GPs available. Why have the Government sat idly by while doctors are forced to retire early, for no other reason than that the cap on their pension contributions means they pay a financial penalty for staying on? Let us change the rules to keep the good doctors we have. Why is it that, at the last count, 800 medicine graduates had not been able to find junior doctor posts? Let us get them to work immediately—

    The Secretary of State for Health and Social Care (Sajid Javid)

    That is rubbish!

    Wes Streeting

    It is rubbish, but it is his record.

    Why is it that so many people are accessing NHS services because of a failure to invest in social care, where staff can be recruited and deployed a lot faster? On the dentistry contract, the last Labour Government acknowledged that the 2006 contract was not good enough, which is why we put the reform of that contract in our 2010 manifesto. The difference is that we will not wait 12 years to deliver the promise after the election of the next Labour Government. Those are just some of the practical steps that we would take immediately and that the Government could take immediately.

    Let me tell the House about some of the fundamental issues we would fix. First, mental health services in this country are in such a state that GPs are seeing more and more of their own cases present with mental ill-health. A Labour Government would recognise that there has been a surge in mental ill-health following the pandemic and we would not leave it to overwhelmed GPs to see them. That is why we have committed to recruiting 8,500 new mental health professionals, including specialist support in every school and mental health hubs in every community. We would pay for that by ending the charitable status of private schools and closing the tax loopholes enjoyed by private equity fund managers—and do not tell me the Health Secretary does not know where they are; he was using them before he became a Member of Parliament.

    That policy—[Interruption.] Conservative Members are funny. They ask for our policies but they do not like it when we provide the answers, because we have them and they do not. That policy, which would put mental health hubs in every community and support in every school and speed up access to treatment for everyone in our country, would help to reduce pressure on GPs and to deliver better mental health treatment in every community and faster access to a GP for everyone else who needs to see them. It also tells you something about the choices we would make and the priorities we would have as a Labour Government: better public services enjoyed by the many, paid for by closing tax perks for the few.

    I know that there is lots of cynicism about politics. We have a Prime Minister who wants people to believe that we are all the same, that things cannot change and that his shambles of a Government are the best that Britain can do. All I would say to the people of Britain is this: judge them on their record and judge Labour on ours. They have been in power now for 12 years. They delivered the highest NHS waiting lists in history, before the pandemic. They delivered record staffing shortages in the NHS with 100,000 vacancies, before the pandemic. They delivered cancer care that worsened in every year since they came to office, before the pandemic. Now they tell us that patients will be paying more and waiting longer.

    The last Labour Government were in power for 13 years, and we delivered the highest patient satisfaction in the history of the NHS, the lowest waiting times on record and more doctors, nurses and new hospitals. There were no threats of strikes in the NHS when we were in government because staff could see the difference we were making and so could the patients. We did not get everything right—nobody is perfect—but Labour’s record on the NHS is one that this Government could not even begin to touch. The longer we give the Conservatives in power, the longer patients will wait. Well, people are sick, and they are tired of waiting. This Government’s time is up.

  • Maria Caulfield – 2022 Statement on the Appointment of Professor Dame Lesley Regan as Women’s Health Ambassador

    Maria Caulfield – 2022 Statement on the Appointment of Professor Dame Lesley Regan as Women’s Health Ambassador

    The statement made by Maria Caulfield, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 20 June 2022.

    In December 2021 when we published “Our Vision for the Women’s Health Strategy for England”, we announced that we would be appointing a Women’s Health Ambassador.

    I am pleased to announce the appointment of Professor Dame Lesley Regan DBE MD DSc FRCOG as the first ever Women’s Health Ambassador for England.

    The Ambassador will focus on raising the profile of women’s health, increasing awareness of taboo topics and bringing a range of collaborative voices to implement the Women’s Health Strategy. The Ambassador will develop networks across and outside Government to champion women’s health and break down stigmas which surround particular areas of women’s health, such as the menopause, endometriosis and PCOS, and mental health and wellbeing.

    We will also appoint a deputy Women’s Health Ambassador to maximise the positive impacts of the role. The deputy ambassador will work collaboratively with the Women’s Health Ambassador to help increase awareness and build relationships with community groups and women and girls across the country.

    Dame Lesley Regan is Professor of Obstetrics and Gynaecology at Imperial College’s St Mary’s Hospital Campus, and Honorary Consultant in Gynaecology at the Imperial College NHS Trust. She is also Honorary Secretary of the International Federation of Gynaecology and Obstetrics (FIGO) and the Immediate Past President (2016-2019) of the Royal College of Obstetricians and Gynaecologists (RCOG), only the second woman to ever hold this role and the first in 64 years. As President of the RCOG, she oversaw the publication of the ground-breaking Better For Women report, the findings and recommendations of which have informed the development of our Women’s Health Strategy.

    When we set about recruiting the Women’s Health Ambassador, we heard from many highly qualified candidates who were interested in the role. I am very grateful for their interest in the role.

    Next steps on the Women’s Health Strategy

    The Women’s Health Strategy will set out an ambitious and positive new agenda to improve the health and wellbeing of women across England and reduce disparities, focusing both on the priority healthcare issues for women and key thematic priorities across the life course. I look forward to announcing the publication of the new Women’s Health Strategy shortly and to working with the new Women’s Health Ambassador to deliver real change for women in England.

  • Sajid Javid – 2022 Statement on Reducing the Need for Anti-Biotics

    Sajid Javid – 2022 Statement on Reducing the Need for Anti-Biotics

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 20 June 2022.

    The ability of bacteria—and other types of pathogen—to develop and propagate resistance to the available therapeutic drugs and medicines, such as antibiotics, used to treat them is a significant and growing threat. Alongside extensive efforts to tackle this threat, as set out in the Government’s five-year National Action Plan, we have sought to reduce the need for antibiotics. This is being achieved through both effective infection prevention and control, and through careful stewardship of the antibiotics that we have at our disposal, by reducing inappropriate prescribing. It is also essential that we incentivise the development—by pharmaceutical companies—of new antimicrobials, which has historically been challenging. To address this challenge, we committed to develop and test a new purchasing model for antimicrobials that de-links payments for antibiotics from the volumes used.

    As a result, NHS England and Improvement (NHSEI), the National Institute for Health and Care Excellence (NICE) and the Department of Health and Social Care (DHSC) launched a joint project in July 2019 to test a “subscription-style” payment for two antibiotics, basing the annual payment on a NICE-led assessment of the value of the medicines, rather than on the volumes of drugs used. On 12 April 2022, NICE published guidance estimating the value of the two antibiotics to the NHS. This guidance informed negotiations between NHSEI and the two companies to agree payment levels in the “subscription-style” contracts.

    I would like to inform the House that the contracts between NHSEI and the two pharmaceutical companies have now been signed. Payments to the companies for their antibiotics, Cefiderocol—manufactured by Shionogi —and Ceftazidime with Avibactum—manufactured by Pfizer—will start on 1 July 2022.

    This world-leading project represents an important development in our approach to incentivising innovation in antimicrobial drugs and in our efforts to tackle antimicrobial resistance (AMR). We will continue to build on this work to develop routine arrangements for the evaluation and purchase of new antimicrobials as they are developed. I will be writing to my counterparts in Scotland, Wales and Northern Ireland to formally invite them to participate in these next steps, to ensure that the project can be adapted and scaled across the UK.

    Maintaining momentum on our international advocacy and action on market incentives is crucial. We hope other countries will offer similar incentives in their own domestic markets, so that collectively we can achieve a meaningful incentive for global investment in antimicrobials. This project is representative of our leading role in this area, aligning with the Government’s vision for a Global Britain.

  • Sajid Javid – 2022 Speech at the NHS ConfedExpo

    Sajid Javid – 2022 Speech at the NHS ConfedExpo

    The speech made by Sajid Javid, the Secretary of State for Health and Social Care, in Liverpool on 15 June 2022.

    Thank you, Victor [Adebowale]. It’s great to be with you all in person – and to be part of the new format. The NHS Confederation has always had an awesome ability to bring people together and this Expo is an incredible example of just that.

    The last time I saw a crowd this size was at the Platinum Jubilee. We came together that week to celebrate an institution we’ve all grown up with. And I think these kinds of moments matter because they make us look forward, as well as back. Few can match the Her Majesty the Queen’s record of sacrifice and service – but the NHS can make a very fair claim. Like the monarchy, its success stems from continually reinventing itself for the times we live in.

    In nearly 74 years, the NHS has reigned over the greatest uplift in health in British history. And 50 of those years were spent safely in Conservative hands. I’m so proud to be the latest custodian of our health and social care system, working in partnership with Amanda, who – I think you’ll agree – has been a real force for good.

    Later this month, I’ll mark my first year in the job. It’s just the blink of an eye when you consider our history. But it’s been a remarkable year. Our Roadmap to Recovery. Omicron, and our fightback against it. And our Covid-19 Elective Recovery Plan. There have been so many unprecedented achievements of which you should be fiercely proud.

    In just a short time, I’ve experienced more highs and lows than in any other job – and I’ve had a few! Highs – like how we rose to meet the challenge of Omicron. Highs – like the way so many of you moved mountains to run a remarkable booster campaign. Highs – like how the social care workforce helped to safely open care homes so family members could visit again.

    But the lows have been profound too. Like receiving Donna Ockenden’s report on maternity failings in Shrewsbury and Telford. Like meeting heartbroken families, bereaved by painfully similar tragedies in Nottingham. Or learning of the allegations about the North East Ambulance Service.

    My experiences of health and care are so many people across the country. We’ve all borne witness to phenomenal bravery and dedication, all while knowing, things still need to get much much better.

    It is possible to love the NHS and still demand change. There’s no contradiction there.

    Like most of us, I watched that recent video from the A&E at Princess Alexandra Hospital in Harlow with a mixture of emotions. Horror – at the thought: how would I feel if it was me in that room? Or one of my children? But also respect. Respect for the colleague who had to deliver that difficult message and her poise in the face of unimaginable pressure.

    We all know that people working in health and care have one of the most difficult jobs in Britain today. So to her, and to everyone else working in health and care: I want to thank you for everything you’re doing in such difficult circumstances.

    And I’m under no illusion about the challenges we face.

    Our Covid-19 Recovery Plan is ramping up to deliver a huge increase in activity, embedding new ways of working. Our new Community Diagnostics Centres are bringing life-saving tests, checks and scans closer to people’s home. It’s a vast effort, of which we should all be enormously proud.

    Yet the scale of the challenge is equally vast. We know that some 11 to 13 million people stayed away from the NHS because of the pandemic. Many of those people are now righty coming forward – and many of them to A&E.

    Omicron was also set-back, with an additional 16,000 Covid positive people in hospitals. And we know the number of people on waiting lists is continuing to rise.

    Not only that, but the Covid-19 backlog sits atop a broader set of generational challenges.

    Improved life-expectancy is one of the great triumphs of the modern age, and in so many ways, an NHS triumph. But it also comes with its own challenges.

    The Resolution Foundation has projected that this decade is likely to see the fastest pace of ageing in any decade from the 1960s to the 2040s. As our population gets older, more and more people are living with increasingly complex long-term conditions. Treating an 80-year-old is around four times more expensive than treating a 50-year-old.

    At the start of this century, in 2000, health spending represented around 27 percent of day-to-day public service spending. By 2024, that figure it is set to rise to 44 percent.

    This government will always make sure our health and care system has what it needs to face the future with confidence. We’ve put in record levels of funding in recent years, including raising billions more through the new Health and Social Care Levy.

    But funding will only ever be part of the answer. Growing health spending at double the rate of economic growth over the next decade, as I’ve heard some propose, is neither sustainable, desirable, nor necessary.

    I don’t want anyone’s children to grow up in a country where more than half of our national budget is taken up by healthcare, at the expense of everything from housing to education. That’s not a fair deal for the British people – particularly young people.

    Obviously, we face many structural challenges, from an ageing population and multiple long-term conditions. But demanding spending growth of this kind suggests that we will fail to reduce demand through prevention, early diagnosis and more effective care – as well as a fail to increase health and care productivity with improved use of capital, skills, management, data and innovative models of care. I refuse to countenance such failures.

    I know that – when it comes to improving productivity and quality over the next decade – there’s no one more ambitious than you. Indeed, it’s one of the four key objectives which Matthew set out for this conference, which I very much welcome.

    When reports came out of Cabinet last week that I’d described the NHS as like “Blockbuster in the age of Netflix”, it caused a bit of a stir. But it’s because I believe in the NHS and its founding principles that I want to focus minds on why some organisations keep pace, while others get left behind.

    Before entering Parliament, I had the privilege to live and work around the world. I can tell you: the NHS is unique. It’s not there to make a profit – and it never will be.

    But it’s also not immune to the same basic choices that face organisations right across the world. We need to be smarter with our capital, digitise and transform our use of data. We need to grow the workforce, improve leadership and management and prevent problems from escalating in the first place. We need to accelerate the development of new, innovative models of care and build a more personalised service in a way that people now come to expect.

    Can you imagine any multinational without access to levers like workforce planning? Or any big supermarket chain without a consistent leadership and management programme? Or any FTSE 100 company with its digital functions outside of its own organisation? I believe there are a great many things still to do before we even think about turning to taxpayers again. And it was great to hear what Amanda said just now about making the best use of taxpayers’ money.

    What we’ve done

    Together with all of you here today, a lot of this work is already under way. Let’s just take a quick look at some of the things we’ve worked on in the last year alone.

    We’ve built new institutions, like UKHSA and OHID to redefine how we do public health in this country.

    We’ve strengthened existing institutions, like NHSE by bringing workforce and digital transformation into the heart of the NHS.

    We’ve announced how we’ll improve the provision of social care, something successive governments have ducked for far too long.

    We’ve set out ambitious public targets to slash long waits in the coming years through the Covid-19 Elective Recovery Plan, and we’re projected to meet the first of these targets by next month.

    We’ve published our Integration White Paper, a blueprint for how we provide better care for patients and better value for taxpayers.

    In March, in a speech at the RCP, I laid out the building blocks for our future around Prevention, Personalisation, Performance and People. I did note Amanda’s ‘4 Rs’ earlier, which I also very much agree with.

    On Monday, I announced our new data strategy, called ‘Data Saves Lives’, to bridge the digital divides between health and social care and ensure we use people’s data safely and responsibly so we can take the public with us on this exciting journey.

    And next month, the bulk of the new Health and Care Act comes into force, including our statutory ICSs. It’s certainly not been a quiet first year in the job!

    But I’ve been determined we keep moving forward, because this moment in time we dare not lose. It’s a moment when we can combine valuable lessons from the pandemic, with incredible new technology and innovative ways of working which when taken together, help us face the challenges of the future.

    It’s a small window of time where we can make a big difference.

    Leadership Review

    For me, an important recent moment was when General Sir Gordon Messenger and Dame Linda Pollard published their landmark review into health and social care leadership.

    I remember Gordon saying: “For a report like this to really have an impact… it has to be supportive and honest”. I think we can all agree, that’s what we got. And I’m pleased it has been welcomed by the NHS Confederation, NHS Providers and many more.

    I’m so grateful to Gordon and Linda for their work, and I’m pleased to accept their recommendations in full. They found countless examples of great leadership, not just at the top but at all levels. More than that, they found great leadership under considerable stress.

    They found that where there’s better leaders, there’s better teams. And where there’s better teams, there’s better outcomes. I’ve seen this for myself, in countless visits around the country including this morning, on my visit to the Royal Liverpool University Hospital.

    But this kind of exceptional leadership isn’t embedded everywhere. The review had some really important insights.

    First, on collaboration. We know that, for years, people have worked tirelessly to do the right things for patients – doing their best to work across the walls that have kept us apart. The walls between health and care. The walls between neighbouring trusts. The walls between one organisation and another.

    We’ve chipped away at these walls for a while now. And through the pandemic, we sent whole sections crumbling down, for instance, the incredible way that we rolled out the vaccine – the incredible job the NHS did. No one wants the walls to go back up, so now we’re bringing more and more walls down. From the changes to NHSE to the new ICBs, colleagues can collaborate as never before.

    Implementing the recommendations of the review will support more collaborative leadership: one where we’re working across the divides where the walls once stood, and embracing a ‘connection culture’.

    I was also moved by the insights on culture in the workplace. They found “too many reports to ignore” of poor behaviour – and that we’ve reached a point where – in some parts of the system bullying and discrimination are – and I quote – “almost normalised”. All of us know, from our own careers, just how toxic that can be. Because when even just a tiny minority behave that way it can be contagious for behaviour and morale.

    We will have zero-tolerance on discrimination, bullying and blame cultures. And that of course includes racism – which was highlighted by the BMA’s report yesterday.

    We know that, if we tolerate it, it doesn’t just make health and care a worse place to work, it makes this country a worse place to live. The examples of Shrewsbury and Telford and Mid Staffs shows the extremes where this behaviour can take us. Standards not met. Complaints ignored. Lives, needlessly lost.

    Let me be clear: the actions of the few should take nothing away from the values of the many. In fact, it’s because of the incredible professionalism of the overwhelming majority of colleagues in health and care that we should be even more determined to get it right.

    And the good news is this: just as Gordon and Linda found that bad behaviour was contagious, they found that great leadership was contagious too. It works best when everyone – even those without the word ‘leader’ in their job title – feels like a leader.

    Other recommendations around training, standards and management will support this effort, helping the workforce at all levels, by creating the conditions for everyone to thrive.

    And when I say everyone, I mean everyone everywhere. Not just those in leafy pockets of England, but where people need it most.

    We know that in some regions, poor leadership is a constant challenge. That’s an injustice we’re just not prepared to tolerate. We need the best people doing the hardest jobs – and getting the right leaders in the right places takes the right incentives.

    One of the first things I did in this job was to read Sir Chris Whitty’s report on the serious health and social challenges in coastal communities. And I’ve seen them first-hand. I did my first speech in Blackpool, on health disparities. And I was recently in Clacton as part of my Road to Recovery tour, where they have the second highest mental health need of anywhere in the country. So I’ll make no apologies for encouraging top talent to areas facing the biggest problems, especially some of our most deprived communities.

    I’m committed to making these changes: To supporting the leadership our colleagues in the NHS and social care deserve – and the leadership everyone everywhere deserves.

    What’s to come

    The year ahead promises to be no less busy. We’ll shortly be publishing: our Digital Health and Care Plan; our Health Disparities White Paper; our 10-year plans on cancer, dementia, and mental health; our update of the NHS long-term plan after Covid; the HEE workforce framework, which, later in the year, will be followed by the NHS’s first-ever 15-year workforce strategy.

    I also recognise that Primary Care is going to be a crucial part of the puzzle. It’s the front door to health and care – and I’m grateful to all the primary care staff who make a difference every single day.

    But I don’t think our current model of primary care is working. That won’t be a surprise to you. I know. You know. Patients know. And everyone working in primary care knows: we need a plan for change.

    We are starting with pharmacy – and I will be setting out my plans shortly.

    I’m grateful to Dr Claire Fuller for her recent review on how we can improve patient access to primary care. I’m confident her recommendations will improve access, including for those with the most complex needs, and, ultimately, help us tackle the Covid backlog and help people live healthier lives for longer.

    I’m determined that when we look back on these years – on this window of change we have right now – that we can say we did all we could to secure the future of health and care for the generations that come after as.

    Reform Partnerships

    So today, I want to focus on one more thing our new Health and Care Act can help us achieve.

    The pressure of the pandemic produced some powerful partnerships. With the ingenuity of people on the front line, including so many of you, walls that had seemed so rigid came crumbling down. As we face the challenges of recovery, those ways of working can work again.

    Back at the RCP in March, I talked about the potential power of ‘partnerships for reform’. Now, we have a legislative framework that encourages it. For ICSs to fulfil their full potential – and make the changes truly worthwhile – I want to see the creation of many more of these reform partnerships.

    This is already happening. We’ve already taken forward the Provider Collaborative model where are group of providers of acute or mental health services agree to work together to improve the care pathway of their local population.

    For example, there are currently 47 NHS-led Provider Collaboratives for mental health, learning disabilities and autism. We’ve seen the success of this approach in London, where the South London Health and Community Partnership has been able to bring out of area patients down by a third, and readmissions down by two-thirds.

    There are also some 50 acute trust collaboratives and mixed collaboratives, bringing together acute, specialist, mental health and community providers. It’s about listening to the innovators already doing incredible things within the system – then giving them a platform to do it.

    They’ve already shown that when we partner like this, challenges that appear intractable in one place can be resolved in another. These partnerships work. They deliver for patients. And they’re helping us to tackle the Covid backlog.

    So for me, the logical next step is to think about how we can use these kinds of partnerships to support underperforming trusts.

    Earlier, I talked about using incentives to get the right leaders in the right places – places that have been let down for too long.

    Reform Partnerships will be a central way we can spread good leadership to those places. So as part of the work on Reform Partnerships, I want to explore whether we make being part of a Reform Partnership a requirement for underperforming trusts.

    I believe this could be powerful way to ensure that the leadership we need doesn’t stay in the walled gardens of England’s best performing trusts, but is there to help turn trusts round and with it, the health and happiness of those who live there.

    So I’m looking forward to working with all of you on these plans.

    I know you’ve faced – and continue to face – the most unimaginable kinds of pressures. And you continue to do so with passion and innovation.

    You have, not just my admiration, but my full support.

    I’m proud to work with you and call you my colleagues.

    Because if there’s a theme that unites all of this work, it’s this: that the ideas and the ways working we need are already here – with so many of you in the room today.

    I believe we can continue to reinvent ourselves for the times we live in; for this institution we’ve all grown up with to be the one we grow old with – with dignity and with good health.

    And the moment to do it is now. We have no time to lose. We have a small window of time to make a very big difference.

    Let’s keep breaking down the walls between us. To meet the challenges before us. So that, together, we can deliver better health and care for everyone everywhere.

    Thank you all very much.

  • Sajid Javid – 2022 Statement on Health and Social Care

    Sajid Javid – 2022 Statement on Health and Social Care

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 13 June 2022.

    I would like to inform the House that the final version of “Data saves lives: reshaping health and social care with data” has been published today. It builds on the groundbreaking use of data during the pandemic and sets out ambitious plans to harness the potential of data in health and care, while maintaining the highest standards of privacy and ethics.

    When facing this country’s greatest public health emergency for generations, one of the most effective tools at our disposal has been the power of data. Now, as we look to live with covid, we must apply those same tools as we tackle the most pressing challenges facing the country including elective recovery and integration of health and social care.

    Earlier this year, I made a speech setting out my four priorities for reform in health; prevention, personalisation, performance and people. We cannot deliver the change we need to see, and our 10 year plans for cancer, dementia and mental health, unless we embrace the opportunities from data-driven technologies. Last week, Sir Gordon Messenger and Dame Linda Pollard published their review into leadership of health and social care, and I accepted their recommendations in full. Today’s data strategy is the next step in our plans to modernise the NHS.

    This strategy shows how we will use data to bring benefits to all parts of health and social care; from patients and care users, to staff on the front line, to the pioneers driving the most cutting-edge research.

    It is backed by a series of concrete commitments, including investing in secure data environments to power research into new treatments, using technology to allow staff to spend more quality time with patients, and giving people better access to their own data through shared care records and the NHS app. The strategy will support NHS providers to tackle the covid backlog, providing them with the means to monitor and optimise capacity through improved data sharing and the development of advanced analytics. This is all on top of the huge investment that we have already made; for instance investing £200 million in our data for research and development programme.

    It is vital that, as we deliver these benefits, we work in a way that maintains the high level of public trust in how the NHS uses health and care data. That means maintaining the highest standards of privacy and ethics, investing in secure data environments and cyber security, involving the public in decisions about how data is used in the future, listening and responding to their views and concerns.

    We published a draft of this strategy in June 2021, and I would like to thank the hundreds of people and organisations who provided feedback which was invaluable in shaping this final version of our strategy for the future.

    I would also like to thank Dr Ben Goldacre for his work on the Goldacre Report, which was published in April, and made a compelling case for how data can drive innovation and improve healthcare. I fully support his recommendations and this strategy shows how we will take them forward.

    I will deposit a copy of the draft strategy in both Libraries.

  • Sajid Javid – 2022 Statement on a Smokefree 2030

    Sajid Javid – 2022 Statement on a Smokefree 2030

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 9 June 2022.

    In 2019, this Government set the bold ambition for England to be smokefree by 2030—reducing smoking rates to 5% or less.

    Today, Dr Javed Khan OBE published his independent review on Smokefree 2030, providing this Government with a wide range of recommendations for how we can achieve this ambition.

    Tragically, smoking remains the single biggest cause of preventable illness and death across the country. There are still almost 6 million smokers in England—and two out of three will die from smoking unless they quit.

    Although smoking rates have fallen, we know that they are currently not falling fast enough.

    The Government are committed to levelling up society and extending the same chances in life to all people and all parts of our country. However, smoking is one of the largest drivers of health disparities and rates vary substantially across different parts of the country. As stated by Dr Khan in his independent review, at its most extreme, smoking prevalence is 4.5 times higher in Burnley than in Exeter.

    Smoking is a significant drain on the household finances of our most disadvantaged families. In Halton in Cheshire, smokers spend an estimated £3,551 a year on tobacco, nearly 15% of their income. Reducing smoking presents a huge economic opportunity in higher disposable income and higher labour productivity.

    Smoking is particularly high amongst certain populations, and one third of all cigarettes smoked in England are smoked by people with a mental health condition. Nearly 10% of mothers smoke at the time of giving birth, increasing the risk of sudden infant death syndrome by over three times compared to mothers who do not smoke. Further, the risk of stillbirth is increased by at least 60% if the father smokes. Smoking is also known to increase the risk of miscarriage.

    Behind all of these statistics are individuals, families and communities who are suffering from the harms of tobacco. This Government are committed to doing more to help smokers to quit and stop people from taking up this deadly addiction. We also know that most smokers want to quit.

    For these reasons, we asked Dr Khan to undertake this independent review to help the Government reduce the devastation that smoking causes in our communities. There are a number of recommendations in Dr Khan’s independent review. The Government will now consider their response.

    There is a call for greater investment—from local authority-led stop smoking services, through to improved data and evidence. The Government are already investing funding through the public health grant, but we will examine where we can go further.

    There is a call to offer vaping as a substitute for smoking. Vaping is far less harmful than smoking and is an effective quitting device. It is recognised that there is much more Government can do to tackle the myths and misconceptions that surround vaping. We have worked with the MHRA to provide guidance to support bringing e-cigarettes to market as licensed therapies and this Government will take forward a range of work on vaping as a substitute for smoking in due course.

    Dr Khan also calls for the NHS to prioritise further action to stop people from smoking. Smoking costs the NHS £2.5 billion every year. The benefits of focusing on preventing smoking-related illnesses, rather than treating them, are clear for patients and the NHS themselves.

    This Government are determined to address the challenges raised in the independent review and to meet the Smokefree 2030 target. We know that more action needs to be taken to protect our people from this dangerous addiction.

    The Department will now carefully consider the recommendations set out in this independent review. The independent review will help to inform our upcoming White Paper on health disparities, which we plan to publish this summer. To complement this, the Department will also be publishing a new tobacco control plan in due course.

    We would like to thank Dr Khan for his far-reaching work on the independent review, and for his clear and challenging recommendations.

    A copy of the independent Khan review will be deposited in the Libraries of both Houses.

  • Sajid Javid – 2022 Statement on Monkeypox

    Sajid Javid – 2022 Statement on Monkeypox

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 8 June 2022.

    Following the increased prevalence of cases of monkeypox in England, and transmission within the community for the first time, I would like to inform the House that as of Wednesday 8 June 2022, the following amendments have been laid and come into force:

    The Health Protection (Notification) Regulations 2010 have been amended to include monkeypox as a notifiable disease in Schedule 1 and monkeypox virus as a notifiable causative agent in Schedule 2.

    The National Health Service (Charges to Overseas Visitors) Regulations 2015 have been amended to include monkeypox in Schedule 1.

    The public health assessment remains that the threat to the public is low. These amendments will support the UK Health Security Agency, or UKHSA, and our health partners to swiftly identify, treat and control the disease, and reduce potential financial barriers to overseas visitors in England who require NHS-funded secondary care services in relation to monkeypox.

    Health Protection (Notification) Regulations 2010

    From today, 8 June 2022, monkeypox is a notifiable disease and there is now an explicit legal duty on doctors to notify the “proper officer” of the relevant local authority if they see a patient they suspect of having the monkeypox virus in England. While we believe cases have been reliably notified to date, this amendment puts beyond doubt the legal obligation of doctors to report cases of suspected monkeypox. Placing a legal duty on doctors to report suspected monkeypox cases, and provide the relevant patient information, will strengthen our understanding of the virus and its transmission within the UK and, if required, support the implementation of timely prevention and control measures.

    We have also placed a legal duty on laboratories to notify the UKHSA if they identify monkeypox virus when they test a sample in England, by listing the virus as a notifiable causative agent. Positive laboratory samples will be an important core dataset, strengthening surveillance and helping to inform our understanding of outbreak progression and trends to underpin action. Laboratory notification will also help to identify the links between cases and act as an important contingency if case notification by doctors has not occurred.

    National Health Service (Charges to Overseas Visitors) Regulations 2015 (“the charging regulations”)

    The charging regulations require providers of NHS-funded secondary care to make charges to people not ordinarily resident in the UK (“overseas visitors”) except where an exemption category applies.

    We have taken swift action to ensure that, should an overseas visitor in England need NHS- funded secondary care services in respect of monkeypox, they will not face any charge for them. Providing such services without charge removes a potential financial barrier to overseas visitors presenting for NHS-funded secondary care, therefore ensuring that the risk to the public’s health from infected visitors is minimised. This brings monkeypox into line with most other infectious diseases, such as tuberculosis and covid-19.

    The inclusion today of monkeypox in Schedule 1 of the charging regulations will mean that overseas visitors will not be charged for the diagnosis and treatment of monkeypox. The charging regulations have also been amended so that if any charges have already been incurred during this outbreak, they must be cancelled, or, if paid, they must be refunded.

  • Wes Streeting – 2022 Speech on the Health and Social Care Leadership Review

    Wes Streeting – 2022 Speech on the Health and Social Care Leadership Review

    The speech made by Wes Streeting, the Labour MP for Ilford North, in the House of Commons on 8 June 2022.

    The Secretary of State has picked quite the week to talk about standards in leadership.

    I give a huge thanks to NHS staff and leaders for the work they are doing against the most extraordinarily difficult backdrop. I also thank General Sir Gordon Messenger and Dame Linda Pollard for carrying out the review. Its seven recommendations are sensible, and I am pleased the Secretary of State has already committed to implementing them.

    As this is a rare example of decisiveness from the Health Secretary, can he tell us when he intends to publish his implementation plan? All too often, the senior leadership of the NHS still does not represent the diversity of the population it serves. Instead of throwing red meat to his Back Benchers, for reasons that will probably be obvious to everyone, I would like to hear how, in particular, he intends to ensure that equality, diversity and inclusion will be improved, so that the best leaders are incentivised into the most challenging roles and are able to provide inclusive healthcare for the breadth of diversity in our great country. Can he explain why the review has not covered leadership in primary care or social care in any detail? Surely this is a missed opportunity. Let us face it: although he is trying to dress this up as the biggest shake-up in history, I am not sure that giving staff an induction on joining the NHS is a revolutionary development, and it hardly meets the scale of the challenge.

    The NHS faces the biggest crisis in its history. NHS staff are in a system under pressure like never before, and there are simply not enough of them. There are currently 106,000 vacancies across the NHS, and staff are leaving in droves. In some specialties, such as midwifery, they are leaving faster than we can recruit them. I do not know how the Health Secretary expects NHS managers to demonstrate good leadership and deliver the best outcomes for patients when there are no staff to lead. For an organisation the size of the NHS, one of the biggest employers in the world, not to have a plan for its workforce is unbelievably negligent. What is the NHS meant to do until he eventually delivers his long-term workforce strategy, which he has been promising for some time? How are managers meant to lead effectively when instead of thinking about patient care as their primary driver, they have become buildings and facilities managers, because the ceilings are falling in? The only place where more than 40 new hospitals really exist is in the Prime Minister’s imagination.

    The Health Secretary said that we should accept only the highest standards in NHS management, so let me ask him not about the generalities, but about the specifics. Last month, it was reported that North East Ambulance Service bosses oversaw cover-ups of negligence, leaving about 90 families not knowing how their loved ones died. He said yesterday that he is still considering whether to launch a review. Is he seriously considering protecting managers who cover up bad practice, instead of standing up for grieving families? Staff in that service were reportedly paid to sign gagging clauses, and I understand that attempts to get them to sign such clauses are still under way. In a written question, I asked how many non-disclosure agreements had been signed in the NHS since the Government said that they would be banned in 2014. He does not know and he is refusing to investigate the use of gaging clauses in the NHS. So how can he claim to be shaking up NHS culture and dealing with bullying when he has no interest in what is going on under his nose?

    Of course the NHS needs good leaders, but when it comes to examples of poor leadership in the NHS, the Health Secretary did not need the Messenger review; he just needed to look in the mirror. This is the man who described the NHS as Blockbuster Video

    “in the age of Netflix”,

    as if it was the greatest revelation since Moses received the 10 commandments. Who has been in government for the past 12 years? On his watch, on this Government’s watch, we have the highest waiting times in the NHS’s history; the lowest patient satisfaction since 1997; longer waiting times for cancer in every year since 2010; heart attack and stroke victims left waiting for about an hour, on average, for ambulances; and patients at risk of serious injury because the hospital is crumbling around them. He kicked off his own Health Week expecting applause for the fact that, despite his best efforts, there are still 9,000 people waiting for more than two years for treatment. He knows, I know, NHS staff know and the public know that with this Government, NHS staff are lions led by donkeys, wanting and inadequate.

  • Sajid Javid – 2022 Statement on the Health and Social Care Leadership Review

    Sajid Javid – 2022 Statement on the Health and Social Care Leadership Review

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 8 June 2022.

    With permission, Mr Speaker, I will make a statement on the independent leadership review of health and social care.

    This is an important report that comes at a critical time. This Government are embarking on a huge programme of reform to tackle the covid backlogs, to improve people’s experience of the NHS and social care, and to place this system on a sustainable footing for the future. But we cannot seize this opportunity and deliver the change that is so urgently needed without the best possible health and care leadership in place, because great leaders create successful teams, and successful teams get better results. So a focus on strong and consistent leadership at all levels, not just on those who have the word “leader” in their job title, will help us in our mission to transform health and care and to level up disparities and patient experiences.

    This review, which I have deposited in the Libraries of both Houses, was tasked with proposing how to deliver a radical improvement in health and social care leadership across England. It sets out a once in a generation shake-up of management, leadership and training, as well as how we can make sure that health and care is a welcoming environment for people from all backgrounds, free from bullying, harassment and discrimination.

    The review was led by General Sir Gordon Messenger, former Vice-Chief of the Defence Staff, and Dame Linda Pollard, the chair of Leeds Teaching Hospitals NHS Trust. I thank them both for taking on this role and providing their varied experience of leadership, along with everyone in their review team who has contributed to this important review.

    Before I turn to the recommendations of the review, I shall update the House on its findings. The review found that, although there are many examples of inspirational leadership within health and social care, from ward to board, these qualities are not universal. The report states that

    “there has developed over time an institutional inadequacy in the way that leadership and management is trained, developed and valued.”

    As a result, careers in management are not viewed with the same respect and prestige as clinical careers. The review also found

    “too many reports to ignore”

    of poor behaviour, and that the acceptance of bad behaviours like discrimination, bullying and responsibility avoidance has become “almost normalised” in certain parts of the system.

    We must only accept the highest standards in health and care, where failures in culture and leadership can make the difference between life and death. So we must do everything in our power to share and promote brilliant, innovative management and to act firmly where standards fall short. This means culture change from the top of the system to the frontline. The review identifies a number of areas where improvement is needed, and it makes seven transformative recommendations. I will quickly update the House on each of them in turn.

    First, the review recommends new measures to promote collaborative leadership and to set a unified set of values across health and care. This includes a new national entry-level induction for new joiners to health and care, and a new national mid-career programme for managers.

    Secondly, the review recommends that we should agree and set uniform standards for equal opportunities and fairness, with more training to ensure that the very best leadership approaches become ingrained. The Care Quality Commission must support this work by measuring progress through regular assessments. This does not mean more people working in diversity but fewer. In my view, there are already too many of these roles and, at a time when our constituents are facing real pressures on the cost of living, we must spend every penny with care. Instead of farming out this important work to a specific group of managers, it must be seen as everyone’s responsibility, with everyone being accountable for extending fairness and equal opportunities at work.

    Thirdly, the review recommends a single set of unified leadership and management standards for NHS managers. These standards will apply to everyone, including those who work part time and flexibly, with a curriculum of training and development to help people meet them. This modernisation is well overdue, and completing the training should be a prerequisite for advancing to more senior roles.

    Fourthly, the review recommends a more simplified, standardised appraisal system for the NHS, moving away from variation in how performance and career aspirations are managed towards a more consistent system that takes into account how people have behaved, not just what they have achieved.

    Fifthly, the review identifies a lack of structure around careers in NHS management. It proposes a new career and talent management function for managers at a regional level, to oversee and support careers in NHS management and to provide clear routes to promotion, along with training and development.

    Sixthly, the review recommends that the recruitment and development of non-executive directors needs to be given greater priority due to their vital role in providing scrutiny and assurance. It proposes an expanded specialist appointments team in the NHS, tasked with encouraging a diverse pipeline of talent.

    Finally, there is currently little or no incentive for leaders and managers to move into the most challenging roles, as the barriers are often seen as simply too high. I want leaders in the NHS to seek out those roles, not shy away from them. It is essential that we address that and get great leaders into areas that feel left behind. The review proposes an improved offer, with stronger support and incentives to recruit top talent into those positions.

    We will be accepting these comprehensive, common-sense recommendations in full. The recommendations have been welcomed by groups representing people who work throughout the NHS, including by the NHS Confederation and NHS Providers. By taking the review forward, we can finally bring how we do health and care leadership into the 21st century, so that we have the kind of leadership that patients and staff deserve, right across the country, and so that we make sure that some of our country’s most cherished institutions can thrive in the years ahead.

    I commend this statement to the House.

  • Sajid Javid – 2022 Comments on the Innovative Medicines Fund

    Sajid Javid – 2022 Comments on the Innovative Medicines Fund

    The comments made by Sajid Javid, the Secretary of State for Health and Social Care, on 7 June 2022.

    I want NHS patients to be the first in the world to access the most promising and revolutionary treatments that could extend or save their lives.

    The launch of the Innovative Medicines Fund delivers another manifesto pledge and will fast-track cutting-edge medicines to adults and children to give people renewed hope for a better future.