Tag: Sajid Javid

The speech made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 21 June 2022.

I welcome this chance to come to the House to discuss primary care and dentistry, but I have to say that the audition by the hon. Member for Ilford North (Wes Streeting) did not go very well. I hope that he can see the irony—some might even say the hypocrisy—of his sudden interest in access to public services, today of all days. It is thanks to the strikes that he has been so vocal in supporting the fact that people right across the country cannot make their appointments, that GPs and dentists cannot get to work and that patients do not have access to the treatments they desperately need.

Several hon. Members rose—

Sajid Javid

I will take some interventions in a moment.

The hon. Gentleman has had every opportunity to do the right thing, to put patients first and to condemn these unjustified and reckless transport strikes, yet at every turn he has chosen to back his union paymasters.

Catherine West rose—

Sajid Javid

I hope the hon. Lady will condemn the strikes.

Catherine West

The Secretary of State speaks about opportunities. In this House, we had a number of opportunities to get workforce reform, workforce numbers and a plan for our health service into the Health and Care Act 2022. Why did he miss those opportunities?

Sajid Javid

We are seeing record investment in the workforce, and we are seeing record increases. For the first time ever, the NHS is also coming up with a 15-year long-term workforce strategy, which I hope the hon. Lady welcomes.

The Government have always been on the side of patients and the people who care for them. I pay tribute to everyone working in primary care and dentistry for the difference they make day in, day out to their patients’ lives. I know that the pandemic has brought some unimaginable pressures, and equally I know that many of those pressures have not gone away now we are living with covid.

The hon. Member for Ilford North talks as though he does not know where the pressures have come from—as though he has had his head under a rock for two years. The NHS has said it believes that between 11 million and 13 million people stayed away from the NHS, including their GPs and dentists. Rightly, many of those people are now coming forward for the treatment they need—and I want them to come forward.

John Redwood

When the Secretary of State does the much-needed manpower review, will he ensure that a fast-growing area such as Wokingham with lots of new houses gets proper provision for that growth? Will the manpower plan also address how we recruit the doctors we have authority to get?

Sajid Javid

I absolutely agree with my right hon. Friend’s important point. In fact, I met my hon. Friend the Member for South West Bedfordshire (Andrew Selous) about that last week, and I agree with them both.

Hilary Benn (Leeds Central) (Lab)

Last month, a constituent contacted me who had developed severe dental pain. He phoned 40 dentists and not one of them could take him on as an NHS patient. It got so bad that he phoned 111 but was told that he was not eligible to see an emergency dentist. What advice would the Secretary of State give to someone in those circumstances? Many other hon. Members on both sides of the House will be able to tell similar stories. In the end, my constituent had to pay to go private, but that should not have happened. Why are our constituents being placed in that position?

Sajid Javid

I am sorry to hear about the right hon. Gentleman’s constituent. If he will allow me, in a moment, I will come on to the pressures that dentistry is facing and, most importantly, what we are doing about them.

Those pressures have come about for two reasons. First, there was a fear of infection, which was understandable in a context where 10 minutes in a dentist’s chair during the pandemic could have meant 10 days in self-isolation or, perhaps, worse. Dental practices were almost uniquely at risk of spreading covid, so their activity was rightly severely constrained across the world—not just here in England and across the UK—by the infection prevention rules that were necessary at the time. Despite all the innovations in dentistry over the last few years, dental surgeries do not have a Zoom option.

Secondly, the British people stayed away because of their innate sense of responsibility during the pandemic. As all hon. Members saw in their constituencies, people understood our critical national mission. Our GPs were doing their duty vaccinating people in care homes and in thousands of vaccination centres up and down the country, protecting the most vulnerable and working hard to keep us all healthy and safe.

When omicron struck—we all remember that period, which was not that long ago—I stood before this House and asked GPs to stop all non-emergency work once again. I did not take that decision lightly, but we were faced with a stark choice of having more lockdowns or accelerating our vaccine programme. We chose to accelerate, with help from all corners of the NHS and with the backing, at that time, of the hon. Member for Ilford North. I remember him standing at the Dispatch Box pledging his full support for that effort and rightly stating that the Government were acting

“in the best interests of our NHS, our public health, and our nation.”—[Official Report, 13 December 2021; Vol. 705, c. 795.]

He recognised that it was the right thing to do then; he has now conveniently changed his mind. I wonder why.

Mike Amesbury (Weaver Vale) (Lab)

But people like Mark in my constituency cannot find an NHS dentist. This is not about covid; it was happening before covid. The investment just is not there. He is in pain; he is in agony. The Secretary of State needs to step up, step in and get things right.

Sajid Javid

We are putting record amounts of investment into the NHS, including more funding into dentistry—I am about to come on to that right now—which will help with those pressures.

Clive Efford

Covid is just a pathetic excuse, because even if it was the sole reason, the Secretary of State should have been planning for when we came out of it, but nothing he has said explains why we had record numbers of patients on waiting lists even before covid started.

Sajid Javid

I think that many people working across the NHS will be listening to the hon. Gentleman and realising that he has no idea about the pressures that covid has created for everyone working there, especially those on the frontline.

Emma Hardy (Kingston upon Hull West and Hessle) (Lab)

Excuse me for raising this issue, but I want to draw attention to the fact that there has been news released that the Secretary of State’s Government have declined to introduce mandatory reporting of complications resulting from mesh. In the context of problems with waiting lists, and wider issues, if we do not introduce a mandatory reporting scheme to identify problems with a medical product, more people will end up requiring medical intervention and medical treatment, so I urge the Government to look again at their declining to introduce mandatory reporting.

Sajid Javid

The hon. Lady raises an important issue. That is why the Government commissioned an independent report. We have responded to that report. We are still listening to what hon. Members such as herself and others are saying on this important issue, and then we will do a follow-up of the report within a year, so that will be later this year. I know that she will take an interest in that.

Paul Bristow (Peterborough) (Con)

Does my right hon. Friend agree that a lot of the issues with primary care services are about leadership? In my constituency, we have the brilliant Thistlemoor surgery with Dr Neil Modha and Dr Azhar Chaudhry, who serve 29,500 patients, 80% of whom do not have English as a first language. Same-day, face-to-face GP appointments are the norm in that practice. In contrast, a Thorney surgery has just temporarily closed a surgery in my constituency due to a lack of admin staff, which is not the fault of the admin staff themselves. Will he back my campaign to make sure that that GP surgery is open again serving local people as soon as possible?

Sajid Javid

My hon. Friend is campaigning passionately for primary care services in his constituency, and he points to some fantastic practices. I congratulate all the people involved in delivering that and support him in his work with his local commissioners to make sure that they are getting even better local primary care.

Dr Andrew Murrison (South West Wiltshire) (Con)

Does my right hon. Friend recognise that the crisis in NHS dentistry, which affects my constituency as it does his, well predates the pandemic, and indeed goes back to at least 2006 when the then Labour Government changed the way in which dentists are paid? Will he undertake to look at the units of dental activity system, which disincentivises dentists from providing dental work particularly in the most disadvantaged communities?

Sajid Javid

My right hon. Friend is absolutely right in his analysis, and I can give that undertaking. I will say a bit more about that in a moment.

If the hon. Member for Ilford North wants to talk about funding for the NHS, I am happy to oblige. Under the last NHS long-term plan, before the pandemic, we made a historic commitment of an extra £34 billion a year. Because of the pandemic, we then necessarily put in £92 billion of extra funding. At the last spending review, we increased funding still further so that the NHS budget will reach £162.6 billion by 2024-25, supported in part by the new health and social care levy.

We have made sure the NHS has the right level of resourcing to face the future with confidence, but we must also be alive to the consequences. The British people expect every pound spent to be spent well, and they expect us to be honest with them that every extra pound the hon. Gentleman calls for will be a pound less spent on education, infrastructure, housing and perhaps defence. I believe in a fair deal for the British people, and especially for our young people. We will be making plenty of changes alongside this funding.

Jonathan Edwards

One of the major problems we face in Wales and across the UK is the need to replace retiring GPs and dentists. There has been a welcome increase in the number of international medical graduates training in Wales, but the British Medical Association informs me that very few GP practices and dental practices in Wales are registered as skilled worker visa sponsors. Will the Secretary of State raise this with the Home Office to see what can be done to help GPs and primary care practitioners retain those international graduates to work in Wales and across the UK, if they so decide?

Sajid Javid

We are working with our colleagues in the Home Office on this and other skills and healthcare issues, so I can give the hon. Gentleman that assurance. He talks about the major problem he is facing in Wales, and that major problem is a Labour Government. I hope he agrees—[Interruption.] He is nodding.

Look at the performance of Labour in Wales, whether on health or education: the median waiting time for outpatients in Wales is almost double the median waiting time in England. People in Wales are waiting more than three years, whereas the longest wait in England is more than two years. Thanks to the covid recovery plan we set out in this House a few months ago, the number waiting more than two years has been slashed by more than two thirds in just four months, and it will be almost zero next month.

Thousands of people in Wales are waiting two or three years. In fact, one in four patients in Labour-run Wales are waiting longer than a year. In England it is one in 20, which is far too high and will be lowered, but in Wales it is one in four. It is not surprising the hon. Member for Ilford North had nothing to say about his colleagues in power in Wales.

Kate Hollern (Blackburn) (Lab) rose—

Sajid Javid

I would like to hear what the hon. Lady thinks of the Labour Government in Wales and their abysmal performance when it comes to healthcare.

Kate Hollern

There is much better performance from the Welsh Government than from the UK Government. The Prime Minister promised 6,000 more GPs, which has not happened.

I wrote to the Secretary of State about Blackburn having only 33 GPs per 100,000 people, whereas the south-west has 73. I wrote to him about a young man whose cancer was misdiagnosed, but I have not had a response. I would say Wales is doing much better than the Secretary of State.

Sajid Javid

That is a very strange comment about the hon. Lady’s colleagues in Wales. Either she does not know or she is deliberately saying something she does not quite believe. Perhaps I can make her aware of the facts in Wales, where the number of people waiting more than two years for treatment currently stands at more than 70,000. That is more than three times the figure in England. That is more than three times the figure in England. It is at 70,000, and the hon. Lady seems to be very comfortable with that. I am surprised—it tells us all we need to know about Labour’s ambitions for government if she thinks that is acceptable.

Sarah Champion (Rotherham) (Lab) rose—

Sajid Javid

Maybe the hon. Member for Rotherham (Sarah Champion) can tell us whether she agrees with her hon. Friend the hon. Member for Blackburn (Kate Hollern) on Wales.

Sarah Champion

The Secretary of State knows we are having a debate about the whole UK, but I am asking him specifically about England and his responsibility. Can he answer the original question from my hon. Friend the Member for Blackburn (Kate Hollern), which was about the Prime Minister’s 2019 commitment to 6,000 extra GPs? We know there are 1,000 newly qualified foreign GPs who are about to be deported by his Government, plus students who are unable to complete their studies because this Government are not providing them with the money for the final years. Under the management of the Secretary of State’s Government in the last decade, we have lost 4,500 GPs. Can he talk about what he plans to do to replace them?

Sajid Javid

I am happy to talk about that. Because of the record funding this Government have put in, both pre and post pandemic, we are seeing record increases in the workforce across the NHS. When it comes to GPs, since March 2019 we have seen an increase of some 2,389. On top of that, we have seen a further increase of more than 18,000 full-time equivalent staff working in other important primary care roles. That is in England—I am talking about England numbers.

Of course, we are working hard towards the targets we have set. We are also seeing more GPs in training in our medical schools than ever before, with more medical schools operating than ever before. I hope the hon. Lady will welcome that result and that investment.

Steve Brine (Winchester) (Con)

We are talking about GP and dentistry services today, but the wider primary care family includes community pharmacy and ophthalmology, the vast majority of which are not NHS providers but operate under contract providing NHS services. In my excellent right hon. Friend’s second year in the Health Secretary job, will there be a ruthless focus on the wider primary care landscape? When it comes to prevention, surely those people must be the front door of the NHS to ensure that the system is sustainable in the long term.

Sajid Javid

Yes, absolutely. I know my hon. Friend speaks with great experience in this area. I am just about to come on to some of the changes we will be making to primary care, which I am sure he will welcome.

Andrew Selous

When the Secretary of State goes back to the Department, will he have a quick look at how it is that, in Leeds, north-east Lincolnshire, Fylde and Wyre and Stockport in the past six-and-a-half years, we have increased the number of GPs by between 18% and 22%? I am curious to know whether there are any lessons we can draw from those areas for the rest of the country. Will he ask his officials to look into that to see whether there are useful points for us?

Sajid Javid

I will, and I will get back to my hon. Friend on that issue with more detail. I hope he welcomes the investment we are seeing and the record numbers of doctors and GPs in training.

Richard Fuller

I know my right hon. Friend is coming on with some more ideas, but from talking to GPs across my constituency, one of the issues I have found is that, as we have diversified primary care staff beyond GPs to paramedics and others, the role of what might be called receptionists and telephonists has moved far more into triage. It is now a more complicated role. Is he attracted to the idea in the Policy Exchange document of creating an NHS gateway to provide more medically qualified staff at that first point of entry to GPs, but on a nationalised basis, available via internet, telephony and the cloud?

Sajid Javid

Yes, I am. I have seen the report my hon. Friend refers to and have discussed aspects of it with its authors, so the short answer is yes.

Imran Hussain (Bradford East) (Lab)

Will the Secretary of State give way?

Sajid Javid

I will later.

In terms of the changes we are making, let me first turn to primary care. The hon. Member for Ilford North, in his motion today, is calling on me to

“urgently bring forward a plan to fix the crisis in primary care”,

as he puts it. That is his motion. He is probably too busy supporting the strikers to have read my speech to the NHS Confederation last week. Had he bothered to listen to or read what I said in that speech, or the similar words from Amanda Pritchard, the chief executive officer of NHS England, he would have heard me acknowledge that our current model of primary care simply is not working. I have made no secret of that, or of my desire for change.

We are now working on a plan for change and, based on today’s motion, I will be glad to count on the hon. Gentleman’s support when we bring those plans forward, because what he has asked for, we are already doing. Our plans, for example, include a much bigger expansion in what our fantastic pharmacists can do. In fact, on the very day that I made that speech in Liverpool, we also announced a new pilot scheme to allow people with signs of cancer to be assessed and referred by pharmacists. That is yet another example of how we are working hard to enhance the role of our brilliant pharmacists and thereby freeing GPs to spend more time with their patients.

Imran Hussain

Thus far, if I have got this right, the Secretary of State has told us that there have been record levels of investment across our NHS services, including GPs and hospitals, and that any minor concerns that have arisen are because of the covid years. Does he think that the British public have been asleep for the last 12 years? Does he think that the British public will buy this? The stark reality on our streets—the Secretary of State may want to go and have a look—is as dire as it has ever been.

Sajid Javid

As I said—I am glad that the hon. Gentleman was listening—there have been record levels of funding in the NHS, and, as we set out in our spending plans, that will continue. But that is no thanks to the hon. Member for Ilford North and his colleagues, who all voted against that record funding. They wanted to deny those resources to their constituents. He should reflect on the impact of that had their wish gone through the House.

On the changes that we are making, we are going further, from improving telephone services to letting others such as nurses and pharmacists complete fit notes. Appointment numbers are already exceeding pre-pandemic levels—for example, in April, GPs and their teams were delivering 1.26 million appointments per working day. That is a phenomenal achievement, which the hon. Gentleman should be commending, not castigating.

The hon. Gentleman raised Wakefield and primary care. He was using dodgy numbers, so he was corrected by my hon. Friend the Member for South West Bedfordshire. He also gave out further dodgy information by somehow claiming that the King Street walk-in centre was under threat. I do not know if you have seen this in the by-elections, Mr Deputy Speaker, but the Labour party has a history of just making things up and creating fake news to scare local people. That is the respect that they show for local people. The walk-in centre has never been under threat. The local clinical commissioning group has confirmed that it has never been under threat. If he had any decency, he would stand up and withdraw his remarks. I give him that chance.

Wes Streeting

I would have thought that the Secretary of State would have learned by now that it is silly to give way to me when he makes these facile points. It is absolutely the case that the walk-in centre’s future was in jeopardy. It is absolutely the case that Simon Lightwood campaigned to save it. If that is what Simon Lightwood can achieve as a candidate, imagine what he will do as Wakefield’s next Labour MP.

Sajid Javid

The hon. Gentleman is now using the past tense. A moment ago, he claimed that it was under threat. He clearly has no issues with giving false information in this House. The truth is that, if Wakefield wants a better future, as everyone in Wakefield deserves, only one by-election candidate can provide that, and that is Nadeem Ahmed.

We intend to go much further to build a truly 21st-century offer in primary care. That includes Dr Claire Fuller’s independent review, which I found to be extremely valuable, and the changes that will stem from that as well as the many others that we will bring forward shortly. We will work with the population and the profession alike. The hon. Gentleman was right to focus on the importance of the profession, but he did forget to mention, as I referred to earlier, that since March 2019 we have more than 2,380 additional GPs in primary care, record numbers of doctors in training and more than 18,000 additional primary care professionals.

Let me turn briefly to the important steps we are taking in dentistry. Urgent care has been back at pre-pandemic levels since December 2020, and the 700 centres for urgent care that we set up to provide treatment for patients during this difficult period have helped thousands of patients across the country. At the start of this year we put an additional £50 million into NHS dental services, which boosted dental capacity by creating 350,000 extra appointments. Dentists are currently required to deliver 95% of pre-covid activity, and we are planning to return to 100% shortly. I commend all the dentists who are already achieving that.

Paul Blomfield (Sheffield Central) (Lab)

The Secretary of State referred to an additional £50 million. As he knows, the way in which that was framed made it difficult for dentists to draw down the money. Will he tell the House how much of it has been drawn down and used?

Sajid Javid

I do not have the exact figures to hand, but I know that millions of pounds were drawn down and used to deliver tens of thousands of appointments across the country. That made a huge difference to a great many people.

Greg Clark (Tunbridge Wells) (Con)

The urgent care centres are an important innovation, but it is also important for them to be accessible throughout the country. There are seven in Kent, but the one nearest to my constituents is 33 miles away. Could my right hon. Friend intervene with the NHS in the south-east to bring about a more even distribution?

Sajid Javid

My right hon. Friend’s point is important and well made, and I will look at the issue closely and get back to him, if I may.

As we have already heard today—but it is such an important point—the challenge for NHS dentistry predated the pandemic. It is not just about the number of dentists in England, but about the completely outdated contracts under which they are working, which were signed under a Labour Government. [Interruption.] Labour Members do not like it, but it is true. These contracts mean that we are operating almost with one hand tied behind our backs. They do not incentivise prevention, they hold back innovation, and they mean that hard-working families cannot get the dental services that they deserve. However, we will now be changing that; our work with the sector, along with the work of Health Education England on recruitment and retention, will be vital for the future.

Lilian Greenwood

Will the Secretary of State give way?

Sajid Javid

I will in a moment.

If there is one thing that unites all our work on primary care and dentistry, it is this. We are shifting to a new mode of operating—one that is about helping the whole population to stay healthy, not just about treating those who ask for help. We need to get to a place where we are healthier for longer, because freedom is hollow without our health.

Our new Health and Social Care Act 2022 is an important step in that ambition. Statutory integrated care systems will be responsible for the funding to support the health of their respective areas—not just treating people, but helping people to stay healthy in the first place. The Act also allows us to make safe and effective public health interventions such as water fluoridation, and we will set out further plans for that shortly.

Prevention, personalisation, people and performance: those will be our watchwords for modernising NHS services. They will sit at the heart of everything to come, from the health disparities White Paper to the update of the NHS long-term plan. While the Opposition continue to go off the rails, we remain firmly on track, laying down our plans to deliver a truly 21st-century offer for the profession and, most of all, for patients.

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.

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.

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.

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.

The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 23 May 2022.

Following announcements made by the UK Health Security Agency on 7,14,18 and 20 May, I am writing to inform the House that—as of 12 pm on Monday 23 May 2022—a total of 56 monkeypox cases, in three unlinked incidents, have now been confirmed in the UK. Further cases have been identified worldwide, outside the endemic regions of west and central Africa.

Monkeypox virus in the UK is extremely rare and the detection of monkeypox in unlinked cases indicates community transmission. Prior to May 2022, there were three previous domestically acquired cases—two household transmissions related to an imported case and one healthcare worker related to a separate imported case.

In the coming days, I expect that further cases will be detected by the UK Health Security Agency’s expert diagnostic capabilities, working with NHS services to ensure heightened vigilance among healthcare professionals.

The UK was the first country in the world to identify and report this recent emergence of non-endemic cases to the World Health Organisation, which continues to receive reports of further cases in other countries across the globe.

The infection can be passed on through direct contact with monkeypox skin lesions or scabs; contact with clothing or linens—such as bedding or towels—used by an infected person; and potentially by close respiratory contact via coughing/sneezing by an individual with a monkeypox rash. Monkeypox has not previously been described as a sexually transmitted infection, though it can be passed on by direct contact during sex. A notable proportion of cases have been among gay, bisexual and other men who have sex with men.

The virus does not usually spread easily between people without close contact and the risk to the UK population remains low.

World-leading experts at the UK Health Security Agency, working in partnership with health protection agencies in Scotland, Wales, and Northern Ireland, are providing the latest scientific, clinical and public health advice. They are also providing testing capability at the Rare and Imported Pathogens Laboratory at UKHSA Porton Down and have stood up additional capacity at UKHSA Colindale. They continue to contact trace, rapidly investigate the source of these infections, and raise awareness among healthcare professionals. Any close contacts of the cases are being identified and provided with health information and advice.

UKHSA, and its partner public health agencies in the devolved Administrations, will continue to keep the scientific and clinical evidence under review to ensure that decisions are made on the best available evidence despite the fast-moving situation.

Individuals, especially gay, bisexual and other men who have sex with men, who develop an unusual rash or lesions—such as scabs—on any part of their body, but particularly their genitalia, should contact NHS 111 or a sexual health service. Individuals should notify clinics ahead of attendance and avoid close contact with others until they have been seen by a clinician. They can be assured that discussion will be treated sensitively and confidentially.

UKHSA has set up a dedicated helpline to support clinicians dealing with monkeypox cases.

Vaccination and treatment

The smallpox vaccine, Imvanex (MVA-Bavarian Nordic), although not specifically licensed for the prevention of monkeypox in Europe, has been used in the UK in response to previous incidents. This vaccine has a good safety record; it is made from a smallpox-related virus that cannot replicate and has been demonstrated to be highly effective at preventing infection—when given within four days of exposure—and reducing severe illness, if given between four and 14 days of exposure.

The vaccination of named close contacts of cases is under way, with vaccine eligibility being kept under close review. As of 10 am on 23 May 2022, over 1,000 doses of Imvanex have been issued or are in the process of being issued, to NHS trusts. There remain over 3,500 doses of Imvanex in the UK.

We are also exploring procurement options in case any specific antiviral treatment is shown to be effective against this virus; further details will be provided in due course.

I can confirm to the House that it will be kept abreast of updates as the situation evolves.