PARLIAMENTARY DEBATE
Topical Questions - 19 November 2024 (Commons/Commons Chamber)

This weekend, we launched the first in-person consultation as part of change.nhs.uk, the biggest national conversation about the future of the NHS we have ever seen. We know that the Leader of the Opposition wants a conversation about whether the NHS is free at the point of use, and I can tell her, from that first conversation, that no one agreed with her.

Earlier this month, I visited Barnet hospital to see the way in which it is changing the emergency care department so that more patients can be seen more quickly, freeing up capacity in accident and emergency. What steps are the Government taking to ensure that trusts such as the Royal Free and others across the country get the support they need, through investment and reform, to improve patient care?

I am grateful to my hon. Friend for his question. The Royal Free hospital saved my life when I went through kidney cancer, so it holds a special place in my heart. Thanks to the Chancellor’s decision and the investment she put into the NHS at the Budget, and the reform my Department is delivering, we will deliver the change and improvement that his constituents and mine, and the rest of the country, deserve.

I call the shadow Secretary of State.

The Secretary of State knows that every year, irrespective of which party is in government, winter is challenging for the NHS. Possibly, it will be all the more so this year with the potential impact on older people’s health of the loss of the winter fuel allowance by many. What winter preparedness steps has he taken, like previous Governments, to increase A&E capacity and to increase the number of beds this winter, and can he say by how many?

It is thanks to this Government and the action we have taken that, for the first time in three years, we go into winter without the spectre of national strikes looming over the NHS, and with NHS staff on the frontline not the picket line. It is thanks to the priority this Government have given to prevention that we have already delivered almost 15 million covid-19 and flu vaccinations, alongside the new RSV—respiratory syncytial virus—vaccination to help vulnerable groups for the first time. The shadow Secretary of State mentions the winter fuel allowance. This Government are protecting support for the poorest pensioners to protect them not just this winter, but every winter, and over the coming years the value of the pension will of course rise with the cost of living.

I am grateful for that response but, just as my hon. Friends have highlighted in respect of the damaging impact of increases in employer national insurance contributions on GPs, hospices and care providers, I fear it was another example of the Government simply not answering the question and not having a plan yet. Either the Government have not done their homework and, as with the impact of NICs increases, they have not thought this through and do not know, or worse, they do not care—which is it?

This Government are prepared for winter and we are already standing up the operational response to winter pressures. On funding, the right hon. Gentleman was in government just before the general election. Is he saying that his Government did not provide enough funding for the NHS this winter? If not, why not? If he does accept that it is enough money, he will surely welcome the extra investment that the Chancellor is putting into the NHS from next year.

I call the Liberal Democrat spokesperson.

The Conservatives’ disastrous legacy on dentistry means that more than 4.4 million children have not seen a dentist in the past year. In Shropshire, dentists continue to hand back their contracts, including one in Wem in recent weeks. Will the Minister outline his plan to reverse that terrible decline and ensure that the issue is addressed in rural areas where there are dental deserts?

There will be 700,000 extra urgent appointments, golden hellos, and a prevention and supervised toothbrushing scheme for three to five-year-olds.

We all know that general practice is under enormous pressure, and that will be a big part of this Government’s agenda. I reassure my hon. Friend that our view is that there should be patient choice, patient control and different courses for different horses. I value online and over-the-phone appointments, but they will not be right for everyone on every occasion. Patients should have a voice and a say.

I would say to GPs who are thinking about staffing for the next financial year that they should hold tight and wait for funding allocations shortly, so that they can make informed decisions about staffing and care for patients.

We have pledged to bring back the family doctor, and we have already invested an additional £82 million in the additional roles reimbursement scheme to recruit 1,000 more newly qualified GPs in 2024-25. We are also committed to fixing the front door of the NHS, for example through £100 million of capital funding that was announced in the Budget. We are fully aware of the pressures, and we will set out further details on funding allocations for next year in due course.

I might resist the invitation to give a specific date today, but the hon. Gentleman makes a valuable point about the ease of use of the NHS app, and I will write to him further on that point.

The UK rare diseases framework aims to improve the lives of people living with all rare diseases. I am more than prepared to meet my hon. Friend to look at the adequacy of support available to people with Usher syndrome.

We have not yet announced allocations for general practice for the year ahead, and we are taking into account all the pressures that general practice is under.

We will confirm the 2025-26 local authority public health grant allocations in due course. Local government plays a critical role in delivering the Government’s health mission and driving action on the prevention of ill health. We are committed to working in partnership with local government to tackle the wider determinants of ill health.

I am in no doubt about the state that general practice was left in by our Conservative predecessors. That is why, in making decisions about funding allocations for the year ahead, we are taking into account all the pressures that general practice is under, as we clean up the mess left by the Conservatives.

In summer 2023, I spoke to Rachel, who suffers from endometriosis. She was told that she might have to wait 18 months for urgent surgery. She is still waiting. In fact, she has had the menopause induced to help tackle her symptoms. Can the Minister tell me what the Government are doing to improve the diagnosis and treatment of women, including Rachel, who have had to wait far too long?

Respiratory health conditions are one of the main drivers of NHS winter pressures, yet only 32% of asthma sufferers in Bath and across the country can access the most basic level of care. What will the Government do to improve access to basic levels of care for the 68% of asthma sufferers who are currently missing out?

NICE is reviewing its guidelines for the diagnosis, monitoring and management of chronic asthma, and an updated version is due to be published in late November 2024. I am happy to meet the hon. Lady to discuss it further.

Women with spinal cord injuries face significant challenges in accessing core health services, including breast screening, cervical screening and gynaecological care. Research shows that women with disabilities, including spinal cord issues, are 30% less likely to attend routine breast screening appointments, in significant part due to the physical inaccessibility of the screening equipment. Will the Minister meet me and representatives of the all-party parliamentary group on spinal cord injury to discuss these unacceptable disparities and ensure that women receive the equitable and accessible care they deserve?

Ludlow community hospital in my constituency provides a great service for the local community, but it is restricted by its location and its building. There is a business model that would be more cost-effective in the long term that involves moving the facility to the eco park. Will the Secretary of State meet me, healthcare stakeholders and the league of friends in Ludlow to take that forward?

The hon. Member is welcome to make representations to the Department for the capital investment that he is calling for, but he should welcome the means of providing it, which was the Chancellor’s decision in the Budget.

I welcome Ministers’ leadership in attacking the record waiting times inherited from the Tories. Will they in turn recognise Guy’s and St Thomas’ efforts to reduce delays, especially in the ear, nose and throat and paediatric spinal surgery teams? Will the Secretary of State outline measures to protect our NHS from cyber-attacks, which was another issue neglected by the last Government but is affecting patients in Southwark?

I am grateful to my hon. Friend for the question and pay tribute to the work being done by Guy’s and St Thomas’. He is right to raise cyber-security. That is why the capital investment announced by the Chancellor is welcome and necessary, and joint working across Government, including with security colleagues and my right hon. Friend the Secretary of State for Science, Innovation and Technology, is vital to keep patients’ data and information safe and to keep critical systems running.

When the Secretary of State reviews GP funding, will he also consider the burden that sits on GP practices when they have to hold the lease for their surgeries and what role integrated care boards could have in holding that risk, which is stopping the recruitment of GPs to join practices as partners?

NHS England currently accepts ICBs holding leases only as a last resort or by exception due to the significant capital required. While we know that is not the most effective use of ICB resources, it is an important safeguard. We are committed to fixing the front door of the NHS by supporting GPs and ICBs through, for example, the £100 million of capital funding announced at the Budget for GP estate upgrades.

My constituent Ollie Horobin’s life has been completely transformed after contracting covid, leaving him wheelchair-bound with a feeding tube and battling debilitating symptoms every single day. His story is a stark reminder of the devastating impact that long covid can have. Will the Minister commit to meeting Ollie and me to hear about his experience at first hand, and prioritise further research into the causes, treatments and long-term impacts of extreme long covid?

As somebody who still suffers from long covid, I know how debilitating and complex it can be, and I am committed to improving support for people affected by it. There are now more than 100 long covid services across England, and £57 million is being invested in long covid research. I recently co-chaired a roundtable on strategies to stimulate further research into treatments. I am more than happy to meet my hon. Friend and Ollie for further discussion.

Opt-out testing for HIV at A&E has been a great success since it was announced last year, particularly in identifying those who were not aware they had the disease and among difficult-to-reach communities. Can the Health Secretary confirm whether the programme will continue?

Opt-out HIV testing has been a great success so far. Of course, we will make further announcements on its future in due course. I would like to say, as a former member of the HIV commission that made the representations to the previous Government, that he has me at a real advantage—or disadvantage, depending on the side of the spending fence. I very much welcomed the approach taken by the previous Government, which this Government plan to continue.

Will the Secretary of State explain what plans he has—if any—to limit the scope of practice of anaesthetic associates and physician associates, about whom there has been such publicity lately?

Indeed there has. Medical associate roles can and do play a valuable role in freeing up other clinicians’ time to do the things that only they can do, but there are legitimate concerns within the professions about scope of practice, doctor substitution and transparency for patients. We need to grip that and address it. We will have a further announcement to make about that shortly.

South Green surgery in my constituency has been given notice by its landlord that it has to move by the end of March next year. Will the Secretary of State meet me to see what we can do to ensure that other facilities can be provided if available, or to do the best for those local patients?

That would be a matter for the right hon. Gentleman’s ICB. I know that he is new to the area, so I am happy to make some introductions.

My constituent Craig Eskrett was diagnosed with motor neurone disease 12 months ago. He says that the services are there in the local NHS trust, but there is a distinct lack of co-ordination. Will the Minister meet me to discuss what improvements can be made to co-ordinate those services for sufferers of MND?

My hon. Friend raises a real issue about how we join up the whole of the patient journey. Once diagnosed, patients need appropriate treatment and wraparound care. I am more than happy to meet him and his constituent.

At the weekend in Devon, I met a psychiatric nurse who previously worked in London and has been recruited to the south-west. She does not have a start date, and is still subject to routine checks after waiting months. Can the Secretary of State expedite these routine checks, given waiting lists for mental health?

Absolutely. That is a good example of why investment needs to be matched with reform to speed things up, improve productivity and get staff to the frontline, where they want to be.

Last week, the chief executive of Forget Me Not children’s hospice visited Parliament with local dad Steve, whose son is supported by the hospice. The hospice provides vital services to families such as Steve’s, but its services are at risk in the longer term without sustainable funding, including the NHS England children’s hospice grant. Can the Health Secretary take urgent steps to improve funding for hospices?

I am grateful for the steps that my hon. Friend is taking to make representations on behalf of her local children’s hospice, both on the Floor of the House and outside the Chamber. I recognise the pressure she describes. We are determined to help hospices to overcome them.

Can the Secretary of State confirm what assessment has been made of the number of women waiting for endometriosis surgery across the United Kingdom? What has been done to reduce waiting lists?

As my hon. Friend the Minister for Secondary Care said, the wait for women with common conditions such as endometriosis is far too long. That is why we are taking steps to cut waiting times and stop the merry-go-round of repeat visits to the same clinician to get the same answer, until someone finally listens to what a woman has to say.