PARLIAMENTARY DEBATE
NHS: Winter Preparedness - 15 December 2025 (Commons/Commons Chamber)

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on winter preparedness in the NHS.

The NHS’s national medical director says:

“This unprecedented wave of super flu is leaving the NHS facing a worst-case scenario”.

This is backed up by the data. On any given day last week, an average of 2,500 patients were in hospital beds—a 55% increase on the week before, and almost double the number from 2023. One hundred and six flu patients are in intensive care, compared with 69 the previous week. There are 1,300 more staff off than in the week before, and the number of calls received by NHS 111 last week was 446,000—8% higher than at this time last year.

It is clear from both the NHS and UK Health Security Agency data that there is a real risk for the NHS and for patients, and it is at this moment of maximum danger that the British Medical Association has chosen to go ahead with Christmas strikes, when they will inflict the greatest level of damage on the NHS.

The BMA said this dispute was about pay, but we gave doctors a 28.9% pay rise. Then it said it was also about jobs, so I offered a deal to halve the competition for jobs to less than two applicants per post. It is now clear what these strikes are really about—the BMA’s fantasy demand for another 26% pay rise on top of the 28.9% doctors have already received. I also offered to extend the BMA strike mandate, so it could postpone this action and go ahead once flu has subsided. The fact that it also rejected that offer shows a shocking disregard for patient safety. Since this strike represents a different magnitude of risk from previous industrial action, I am appealing to ordinary resident doctors to ignore the BMA strike and go to work this week. Abandoning patients in their hour of greatest need goes against everything that a career in medicine is meant to be about.

The entire focus of my Department and the NHS team is now on getting the health service through the double whammy of flu and strikes. We have already vaccinated 17 million people, which is 170,000 more than last year, and 60,000 more NHS staff. We have invested in 500 new ambulances, 40 new same-day emergency care and urgent treatment centres, and 15 mental health crisis assessment centres. The NHS will also be recalling resident doctors to work in emergency situations, and we will not tolerate the dangerous attempts to block such requests that we have seen from the BMA in the past.

I am proud of the way that the NHS team has pulled together through strike action in the past, and I know they will move heaven and earth to keep patients as safe as they can this winter. I am just appalled that they are having to do so without the support of their colleagues in the BMA.

This winter, a serious flu wave and rising respiratory syncytial virus infections are pushing the NHS to its limits. Flu admissions, as we have heard, are up 55% in a week, and RSV cases are rising, especially in older people. However, the Government have failed to prepare, as we pointed out earlier in the year.

In July, the Health Secretary accepted Joint Committee on Vaccination and Immunisation advice to expand the RSV vaccine to over-80s, but that expansion seems to have been quietly dropped. Flu vaccine uptake remains dangerously low, with fewer than 30% of some key groups vaccinated. Most worryingly, that includes NHS staff, who are going off sick because of flu, adding to staffing pressures. Delayed discharges are worsening: 19,000 more bed days have been lost this year. Still there is no winter discharge plan, no new funding and no clarity—and today, yes, resident doctors confirmed further strike action this week, which will add pressure to a system already under significant strain. That is why we would ban strike action, but at the same time this Government are literally making it easier for unions through their Employment Rights Bill.

When the NHS is under this level of pressure, families deserve the reassurance that care will be there when they need it, so I ask the Secretary of State: will he now publish the Government’s plan for managing winter pressures, including on delayed discharges and emergency care? Given that he is worried about a double whammy of rising flu cases and a strike, what extra resources is he providing, and if he is not, where is the money coming from? What action will he take to ensure RSV vaccine access for older people, and what will he do to raise flu vaccine uptake in vulnerable groups, particularly in NHS staff? Families are frightened, and some are already grieving. This crisis was not inevitable, but the Government’s failure to prepare has made it much worse.

I will ignore the political nonsense about banning strikes and clamping down on trade unions. I will, however, take on directly the charge that we have not prepared for this winter.

We have delivered over 17 million flu vaccinations this season—hundreds of thousands more than this time last year—and 60,000 more NHS staff than last year are also getting their jab. We are on track to deliver the 5 percentage points increase in flu vaccine uptake in healthcare workers, as set out in our urgent and emergency care plan. On children and young people, half a million two to three-year-olds have been vaccinated, which is the same as last year, and 3.6 million school-age children have been vaccinated, which is up 100,000 on last year. We will be going back to schools to do repeat visits in areas where uptake in schools has not been as high as we would like. For care home residents, flu vaccination uptake is 71%. We are on track to meet the RSV vaccination uptake target for 2025-26 in the published urgent and emergency care plan, so we are doing a lot on the vaccination front to prepare.

In fact, on winter planning more generally, we started earlier and did more than ever to prepare for this winter. We had stress-tested winter plans trust by trust. Local NHS leaders ran scenario-based exercises, including managing surges in demand and responding to virus outbreaks to test and strengthen their winter readiness plans, which are now being put into action. We have strengthened access by boosting GP access to keep people well and out of hospital. Through advertising campaigns, new online access routes and more GP practices open for longer hours over the Christmas period, we are making sure more people can be seen closer to home. That matters, because when people can get help early from their GP, they are less likely to end up in A&E.

We are also going further to improve our urgent and emergency care performance this winter. That is set out in our urgent and emergency care plan. We are investing almost £450 million into UEC this winter, meaning: 500 new ambulances on the roads; expanding same-day and urgent treatment centres; providing targeted support to the most challenged trusts; creating capacity and keeping flow moving by sharing weekly data with trusts; encouraging the use of alternative community services; and streamlining in-hospital discharge processes to get patients discharged more quickly from hospital when it is safe to do so, including joining up the NHS and social care, where relationships between health and social care have been improving year on year. If I think about where we are this year compared to last year, there has been sustained improvement. A lot done; more to do.

Of course our job is made harder by strike action. That is why the Government are doing everything we possibly can to get the NHS through this winter. I just wish we were doing it with the BMA, rather than against the BMA.

I would like to pay tribute to all the incredible staff at St George’s hospital in Tooting. I did my A&E shift with them this week, together in the trenches.

The Labour Government inherited an NHS that was bursting at the seams. With flu cases on the rise, the NHS feels as though it is working with one arm tied behind its back. Over half a million people this year were treated in corridors in A&E. That is unsafe and undignified. The all-party parliamentary group on emergency care, which I have the privilege of chairing, working very closely with the Royal College of Emergency Medicine, published a report outlining our recommendations to end so-called corridor care. I know this is a matter about which the Secretary of State cares deeply, so will he meet us to discuss the report’s recommendations to provide safe and more dignified care for patients and staff?

I echo my hon. Friend’s thanks to frontline NHS staff for what they are doing against a very challenging backdrop, which will be made all the more difficult this coming week. I also thank her personally for her ongoing frontline service, which she performs in addition to her duties in this House. I am always delighted to meet her and I would be very happy to discuss her report with her.

I call the Liberal Democrat spokesperson.

It is obvious already that this year is going to be very difficult for the NHS, with many A&E departments already overwhelmed, hospital wards full and too many patients looking at spending their Christmas on a corridor. Indeed, corridor care has been common throughout this year and even trusts that have seen improvement in other areas, such as Shrewsbury and Telford in my constituency, are struggling to make real progress in urgent and emergency care. In July this year, one in five people who arrived at an A&E in Shropshire had to wait more than 12 hours, and that was before the double whammy of a record winter flu epidemic and an irresponsible doctors’ strike.

Will the Prime Minister chair regular Cobra meetings to address this emergency? Will the Minister agree to make flu vaccines available to far more people and roll out an emergency vaccination scheme in communities to reach people who have been missed? Finally, will the Government support Liberal Democrat calls for a dedicated winter crisis unit, providing the locum doctors and social care support needed to discharge patients and free up hospital beds?

We are doing much of what the Liberal Democrat spokesperson asks; the hon. Lady is absolutely right that we need to focus on delayed discharge and demand management, and the system is doing all of those things. It is challenging in the NHS. The House will know of our determination to end corridor care. We have certainly ended the nomenclature of “temporary escalation spaces”, which makes corridor care sound like it is both normal and acceptable in the NHS, neither of which is true. I will stop short of asking the Prime Minister to chair Cobra meetings. That would not be the right mechanism or response, but of course he and I meet regularly to discuss winter pressures, and I will keep him apprised of the situation.

I thank the Secretary of State for his statement. Gloucester residents are rightly worried about the rising flu levels. I was struck down a few weeks ago and can attest to how tough the current strain is. Does he agree that in this context it is reckless of the BMA to be taking its members out on strike, and will he call for resident doctors in Gloucester to go to work next week to keep their patients safe?

It is one thing for the BMA to have rejected the offer we made; it is quite something else to have done that following a 28.9% pay rise—but we are where we are. The thing that I find utterly inexplicable and indefensible about the BMA’s position is that we offered it the chance to extend its strike mandate to the beginning of February, in order that strikes could be delayed into January, to give the NHS a clear run at an extremely difficult and challenging winter and the most challenging time of the year for the NHS. The only reason the BMA is choosing this week to strike is that it knows it will inflict maximum damage on the NHS, but in doing so it risks avoidable harm to patients. That is unconscionable, indefensible and unnecessary, and I ask ordinary members of the BMA, whatever their views on the offer or this Government, to bear that in mind when deciding whether or not to leave their patients this week.

Given the pressures from flu and strikes, can the Secretary of State confirm that the evidence he gave to the pay review body remains correct—that any pay rises must be funded from within his Department? If so, given that the Office for Budget Responsibility says that inflation next year will be 3.5% and he has offered 2.5% across the NHS, and said that a 1% increase would cost £1.5 billion, does he intend to give NHS staff a real-terms pay cut, or to take £1.5 billion from headline Government commitments?

It is as if the ghost of Christmas past has come to visit: one of my predecessors is here to remind the BMA of what it used to have to deal with. Perhaps the BMA will be a bit more content with the ghost of Christmas present—and that is before we are threatened by the ghost of Christmas future—[Laughter.] I am being slightly tongue in check, but the right hon. Gentleman asks a serious question, and I will treat it seriously.

We put in evidence to the pay review body process. The pay review body will make its recommendation, which we will consider. We are in active discussions with Agenda for Change unions about whether we can reach an agreement on future years, including exploration of the prospect of a multi-year offer. I have made the same approach to all health unions, including the BMA and resident doctors. The challenge with resident doctors is that their expectations are some way from affordability. They are asking for a 24% pay rise on top of the 28.9% they have already had. That is not acceptable. As the right hon. Gentleman’s question implies, I have a responsibility to the entire NHS workforce, particularly the Agenda for Change staff, who have not done as well as doctors. Addressing that is not only a practical issue for me, but a moral one.

First, I associate myself strongly with the Secretary of State’s comments about today’s regrettable decision by the BMA and its members.

In the light of the pressures of flu and RSV, does my right hon. Friend think it is time to ask the Joint Committee on Vaccination and Immunisation to look again at its recommendations on the ages at which the two vaccines are made available? Specifically on RSV in infants, does he think it is time to ask NHS England to look again at the decision to switch from an infant-based delivery model to a maternal-based delivery model on the ground of cost, without taking into account the lower infant RSV vaccination uptake now?

I thank my hon. Friend for his support and questions. We will indeed reflect on our performance after this winter, just as we did after last winter. He raised interesting points about the way in which we deliver vaccines. As for the questions about eligibility and timing, we rely on the expert advice of the JCVI, which will also look at the data on how this winter has panned out. We look forward to receiving its recommendations in due course.

The Secretary of State says that the strikes come at a time of maximum danger for the NHS and has called on the junior doctors to call off the strikes. I agree with him, but will he accept at least some responsibility for the second round of strikes on his watch? Last year he conceded a bumper pay deal to the same junior doctors with no strings attached. It is hardly surprising that they judge him a soft touch on pay and have come back for more this year.

Regardless of the result today, I think that the BMA is finding that I am not a soft touch and that we will not accede to a completely unreasonable and unaffordable demand. The reason we made that pay award within weeks of coming into government was that we did not think that the BMA’s treatment at the hands of our predecessors had been fair, and we recognised the issues that it was raising on pay. Indeed, the irony of this round of strikes, and previous rounds of strikes under this Government, is that I recognise that whether it is about pay, jobs or working conditions, resident doctors make a whole series of fair and reasonable points, and we are doing our best to address those.

I think that 28.9% is a meaningful step in the right direction on pay. Our offer of emergency legislation, which is unusual in this House, would make a real difference, reducing competition for jobs from 4:1 to less than 2:1—but the BMA has rejected that course of action. In the end, I think that people will judge the BMA’s actions to be unreasonable. Of course the issues that it raises are serious and substantial, but we see similar issues raised not just across the NHS but across the entire public sector.

We cannot fix everything for everyone everywhere all at once. Most reasonable people accept that; for reasons I cannot understand, the BMA does not.

The Secretary of State is rightly proud of the work that has been done to vaccinate people, and he will be acutely aware that we are heading into the super-spreader festive season. There are parents across the country who want to protect their own parents by getting their children vaccinated, but right now there is a gap in the system: 16 and 17-year-olds are not covered. Even if people try to pay for a vaccine at a wholly private provider, they cannot get a vaccine for that cohort, and NHS pharmacists are turning away parents who want to pay for a vaccine. Can I press the Secretary of State to correct that gap, so that families who want to protect their loved ones can do so and 16 and 17-year-olds do not give their grandparents the worst Christmas present ever?

We will review eligibility, distribution and means of accessing the vaccine in the usual way. People should enjoy themselves over the Christmas period. It is a time for family and seeing loved ones and friends, but people should be mindful of the risks posed by this most virulent strain of flu. If people are symptomatic and likely to give someone they love something they would rather not have this Christmas, they may want to hold off for a week until they have recovered.

I strongly endorse the Secretary of State’s emphasis on the importance of vaccination, not least to protect the resilience of frontline NHS staff and face down the anti-vaxxers and vaccine-hesitant. Nevertheless, will he reflect carefully on his emphasis on the shift from hospital to community at this time, given that emergency departments are still in crisis and corridor care is still a norm across much of the country?

I am grateful to the hon. Gentleman for giving me the opportunity to say, for the avoidance of doubt, that accident and emergency is for accidents and emergency situations. It is not an “anything and everything” walk-in service, and A&E departments are already stretched ahead of strikes. For patients who are in need of medical care or attention but are struggling to access their GP or wondering which NHS service local to them would be most suitable, NHS 111 provides a suitable service to triage and point them in the right direction. Of course if someone requires an ambulance, they should dial 999 in emergencies, and if it is an accident or emergency, people should attend emergency departments in the usual way.

Late on Friday, I received notification that the Eastham walk-in centre was to be temporarily closed for four weeks, which appears to be a move in response to the real pressures in the NHS, as I think most of the staff are to be redeployed to the local A&E. Given that previously I and my hon. Friend the Member for Birkenhead (Alison McGovern) campaigned vigorously to keep the centre permanently open, I would be grateful for any assurances the Secretary of State can give that this step is temporary and indeed indicative of the real pressures that the NHS is currently facing.

My hon. Friend can rest assured that he has my support as he keeps his eye on the temporary nature of this closure. I share his desire for it to be temporary.

I would make this point, too. There is a view among some in the BMA that somehow these strikes are consequence-free for patients and the NHS on the basis that we can just cancel some operations and it is okay because consultants will be covering. That is quite a cavalier attitude to take to fellow frontline staff who will be having their annual leave cancelled and finding themselves recalled right now. It also really minimises how patients feel when they cannot access a walk-in service, such as my hon. Friend’s, or indeed have waited, often for far too long, for a diagnostic test, scan or operation. They will have psyched themselves up and be ready for that appointment, but then find it cancelled because of strikes. The BMA might try to kid everyone else that the strikes are consequence-free for patients, but BMA members really ought not to kid themselves.

Will the Health Secretary ensure we have clarity on advice regarding the use of face masks, particularly where they are mandated? He will be aware that conflicting advice is issued by various agencies, which confuses people and reduces confidence. Will he ensure that advice is rigorously evidence-based?

The right hon. Gentleman is right to call for an evidence-based approach. That is why the Government are not mandating mask use across the NHS or social care. We are supporting leaders in providers to make their own judgments based on the situations in their trusts as to whether wearing of masks by patients and visitors is necessary, given the pressures they are under. Even in those cases, there is an understanding that people may not wish to comply, but I hope that, if asked to do so, they would comply.

Does my right hon. Friend share my concern that, in the run-up to Christmas, NHS staff will be having to change their Christmas plans to cover emergency shifts as a result of this ridiculous strike, and patients will have emergency operations, and indeed scheduled operations, cancelled?

My hon. Friend is right to raise the issue of disruption. Although we have carefully laid plans to manage industrial action this week, the thing I am really worried about as we look towards the end of this week is the long tail that takes us into next week, the following week and the new year. That is for a few reasons. First, in our experience, there is always a need to recover the service following such disruption; ironically, sometimes the worst disruption is seen in the weeks that follow and not just during strike days. Secondly, this is normally the busiest time of the year, and we normally get through it because we have experienced consultants who are willing to put in extra shifts over the Christmas and new year period, recognising those pressures. Those same people are now going to be absolutely knackered because of the toil of covering for their resident doctor colleagues over the five-day period. I really think that, in choosing the timing of these strikes, the BMA has been highly inconsiderate of colleagues, and I do not think it has even thought about patients.

My constituent Fred is eligible for a flu vaccination, but has had his appointment cancelled three times due to a lack of vaccines in the local area. Pharmacies and GPs are asked to guess what their need will be, sometimes a year in advance and without sight of the JCVI’s eligibility criteria, and this naturally results in conservative estimates, so that they do not have waste. What emergency measures are the Government taking to get additional vaccines to rural and coastal areas like mine, in order to slow down the crisis in our A&E?

There is no shortage of the vaccine, which makes things even more frustrating for our constituents, and for the hon. Member; they know that there are flu vaccines available, but they are not in the right place at the right time. I am extremely sorry that her constituent has suffered that inconvenience and setback three times. She has placed her concerns on record, and we will look at what has happened in her constituency. We will look at the supplies, and I will make sure that my Department works with her to resolve that situation. More generally, where we have seen reports of shortages, or of suppliers being caught short, we have acted rapidly to remedy the situation.

I refer the House to my entry in the Register of Members’ Financial Interests as a former leader on healthcare in a trade union, and also as a clinician in respiratory medicine. I am deeply concerned about patients right now. I recognise that the Health Secretary shared a lot of information with the House on Wednesday evening about how he wants to take things forward. Could he set out the process of engagement, not least with ACAS? Could ACAS sit down with the BMA, and work through the proposals to see if they could be enhanced or tweaked, so that we achieve the right resolution for patients and the NHS, and abate these forthcoming strikes?

I have lost count of the number of times I have met the BMA personally, or spoken on the telephone, including as recently as this afternoon, with the chair of the resident doctors committee and his predecessors. Of course, we are always willing to consider bringing in people who can help to close the gap between those on either side of the table. In the past, the BMA has not been too fond of ACAS. We will let this round of strikes pass. Our first priority now has to be managing our way through this period and recovering the NHS into the new year. There will then, by my reckoning, be at least six weeks without strikes, and of course we will do our best to resolve the situation with the BMA.

I would just say to my hon. Friend, to the House and to the BMA that there really is not much further for the Government to go. We have given a 28.9% pay rise already. The BMA wants to talk about future years’ pay, but we have not even had a recommendation from the Doctors and Dentists Review Body. I think it is extraordinary that BMA members are out on strike on pay after the 28.9% pay rise. On jobs, the BMA peddles to its members the idea that there were just 4,000 extra specialty training places up for grabs; it seems to completely sideline the point about emergency legislation to deal with UK graduate prioritisation, which is exactly what it asked from us, in all the meetings that I had with it. Since it has rejected that offer, it should not expect to see the legislation. If BMA members want to see the Government move forward constructively with them, they really need to stop striking, stop harming the NHS and maybe start thinking about patients while they are at it.

These strikes, at a time of peak seasonal pressure on the NHS, are reprehensible, and the BMA should be thoroughly ashamed of itself. Does the Health Secretary agree that we should use this opportunity to reassert our collective societal trust in vaccines, and encourage anyone who is vulnerable or eligible to get a vaccine, to mitigate the effects on themselves and on wider society? Given his comment that there is not much more that the Government can offer, does he at least acknowledge that the Government’s unconditional inflation-busting offer last year, just weeks after they came into office, must surely have emboldened the BMA?

I thank the hon. Member for being helpful in two ways. First, it is always good to hear voices from the right making the case for vaccine uptake. That contrasts the Conservative party starkly with Reform UK, which we hear peddle anti-science nonsense. Secondly, I thank him for reminding resident doctors and the BMA of what they used to have when the Conservative party was in government. Maybe I do not look so unreasonable after all.

I want to place on the record my immense thanks to staff at Derriford hospital in Plymouth, who are working tirelessly to keep people safe during the busiest winter yet. I am sure that the Secretary of State will want to join me in giving those thanks. The south-west has seen a 93% increase on last year in the number of beds taken up by those with flu. Does the Secretary of State agree that the run-up to Christmas is a dangerous and reckless time for doctors to go on strike? What would he say to all the other staff at Derriford, who will have to take up that work on the frontline as we approach Christmas?

First, I thank the staff of Derriford hospital. I have visited it a number of times over the years, and have seen them coping with pressures at the height of summer, during peak tourist season, and in the depths of winter; I was there this time last year. They do a really good job in very difficult circumstances, and my hon. Friend champions them regularly and consistently, publicly and privately.

My hon. Friend is absolutely right about the challenges that we face in our urgent and emergency departments. Our urgent and emergency care plan addresses the underlying issues that he raises, but of course, we have more to do in the coming weeks to help manage the NHS through this winter, and we are already reflecting on how we will plan for next winter, too.

This afternoon, I am hearing of resident doctors who are not BMA members, and who plan to go to work, as we would urge them to, being pressured and bullied by the BMA not to go to work. They are being told that locum doctors have been booked in their place, at huge extra cost to the NHS. Does the Secretary of State join me in absolutely condemning this pressure and bullying by the BMA?

No member of staff should be bullied for going to work this week and doing the right thing by patients. I am grateful to resident doctors who have been at work during previous strike actions, and I hope that we will see resident doctors do the same this week.

I ask resident doctors, regardless of their views on the offer that this Government have made, to think really carefully about the risks that the BMA is playing with, and I use that term advisedly, by choosing to schedule strikes this week. The most reasonable thing would have been for the BMA to accept the offer of an extension to its strike mandate, and to have simply postponed its strikes to January. It would have reflected well on the BMA. It would have shown that the BMA cared and had consideration for its colleagues who are under pressure this week. It would have shown that it cared and had consideration for patients who risk suffering this week because of its action. It is for the BMA to say why it rejected that perfectly reasonable offer, and why it has chosen the most dangerous time to be out on strike. I think this is probably the most shameful episode in the BMA’s history since it marched against the foundation of the NHS.

I thank the Secretary of State and his whole team for all that they are doing to fix the NHS, including boosting the number of appointments by more than was in our manifesto last year. In Southwark, there is particular NHS pressure on GP access. Southwark council is helping to expand and improve provision, but how do the Government ensure that GP practices’ self-reported access times—four in five people can see a GP within two weeks—are accurate and heading in the right direction?

That is part of GPs’ contractual obligations. Accurate reporting is absolutely central, both from an ethics and integrity perspective, and because it helps to inform us about the state of the service, and how we can improve care for patients. I am happy to look at the situation in my hon. Friend’s constituency with the integrated care board, to ensure that data and information are being collected and provided accurately for him and for public consumption.

I hope that the Secretary of State will give a little more consideration to the rather important point raised by the hon. Member for Walthamstow (Ms Creasy) about 16 and 17-year-olds not being able to be vaccinated.

If any junior doctor—whether or not a member of the BMA, but particularly if a member of the BMA—decides on ethical grounds to go into work during the period of the strike, and then faces sanctions from the BMA, will the Government protect them?

Two things: first, we will certainly give serious consideration to the point made by my hon. Friend the Member for Walthamstow (Ms Creasy)—the JCVI will do that in the usual way, and we follow its advice —and secondly, resident doctors have been to work in previous rounds of strikes, and I have not been made aware of bullying or intimidation of them. Of course, that should not be happening, and if it does, my priority will be protecting doctors who are doing the right thing. My expectation is that no one will be intimidated for making the moral and ethical judgment that going to work is the right thing to do by patients, by their colleagues and by the NHS this Christmas.

The Government were elected to pick the NHS up off its knees, and that is exactly what we are doing by putting tens of billions extra into the NHS—that includes giving a 28.9% pay rise to doctors. That money is delivering a 20% reduction in NHS waiting lists in my area. However, despite that progress, families are worried by the spectre of these strikes and a surge in super flu. I know that the Secretary of State is working flat-out to support the NHS. Families in Sandwell can support the NHS at this time by taking up a vaccine, but what more can they do to support it?

People can check their eligibility for a vaccine online or via the NHS app. They can and should seek to protect themselves. If people need healthcare, they should seek to access it. I do not want people to be deterred unnecessarily by strike action. It is important that people get the right care in the right place. Unless it is an accident or an emergency, the best thing to do is to call 111; from there, patients will be directed to the most appropriate service.

My hon. Friend is right about the progress that we are making with the NHS since coming into office. That is one of the many reasons I am so disappointed by the BMA’s action. This is lose-lose: it is bad for the NHS, and therefore for patients, and it leaves doctors working in poorer conditions for longer than I, they and the country would want.

We are told that the NHS is adequately funded, but in Birmingham and my constituency, the ambulance service does not respond. People dialling 999 are informed that they ought to catch a taxi to the hospital, because there are no ambulances. There is not just corridor care; ambulances are also being used as facilities in which to care for vulnerable people. What can the Government do to ensure that ambulances are ready and available to pick up those who need that service?

This Labour Government are investing more in the NHS—£26 billion, rising to £29 billion over the spending review period. Urgent and emergency care is improving. Ambulance response times are improving year on year. I recognise that there are particular challenges with the West Midlands ambulance service. We are going as hard and fast as we can to repair the damage done by 14 years of Conservative Government. We are able to do that only because people chose to vote Labour at the last general election.

At a Hanukkah event in Nottingham last night, I spoke to a medical undergraduate who welcomes the Government’s commitment to halving competition, and the offer that was put to the BMA. Lots of medical professionals, be they hospital doctors, GPs or allied health professionals, are struggling to find work. Will the Secretary of State outline how this offer, and the Government’s other work, would have helped those individuals?

This is the futility of the BMA’s position. The steps that we were proposing to take—both increasing the number of specialty places and bringing forward emergency legislation to deal with UK prioritisation—would have reduced the competition ratio from around 4:1 today to less than 2:1. That would have kicked in during the current round. We would have been able to bring forward emergency legislation and a new application round in the spring. The BMA has rejected that approach, and we will not proceed on that basis.

It is for the BMA to explain what its dispute is all about. We were told that it was all about jobs. What it seems to be about in substance is that the BMA wants a 26% pay rise, in addition to a 28.9% pay rise. I think the BMA is missing a degree of perspective about not just the state of the public finances but the pressures on other parts of the NHS and the public sector. The Government are committed to improving, consistently and year on year, the pay, terms and conditions of staff, and, crucially, the conditions in which patients are seen and treated. We cannot fix it all at once.

In fact, when this and previous Governments have floated the idea of raising extra money, BMA committees have sometimes been among the first to complain about the prospect of higher taxes, including on pensions, and other issues. It seems that their view is that everybody else should pay higher taxes for their higher salaries, and no one else matters. For me, those Agenda for Change staff who have been left behind are the first priority.

Everybody knows that South Shropshire is the most beautiful rural constituency, but that rurality brings remoteness, which brings challenges with an ageing population, and with additional strikes there is concern about whether adequate healthcare will be provided this winter. Will the Secretary of State set out how that will be done, so that residents of South Shropshire will not go without?

The hon. Gentleman is absolutely right to raise the interests not just of our cities and towns but of rural communities. I was proud of the emphasis that we placed on rural services and coastal communities in our 10-year plan for health, and we take that into account with our urgent and emergency care plan. I have been encouraged by the way that some of our ambulance services that are dealing with remote and rural constituencies are responding this year compared with last year, but there is still much more for us to do, particularly across the midlands. We want consistent year-on-year improvement so that whoever someone is and wherever they live, the NHS is always there when they need it.

I thank the Secretary of State for his statement and for his hard work in trying to bring an end to these unacceptable strikes. When such strikes happen, particularly at this time of year, it draws attention away from the hard work that staff across our national health service are constantly putting in during these difficult times. That is why later this week I will visit Milton Keynes hospital to thank staff for what they are doing over Christmas, particularly given the important work that they have put into supporting my family through what has been a difficult year. Will the Secretary of State please join me in thanking staff, particularly at Milton Keynes hospital, for working hard during a difficult time when we are tucking into our Christmas dinners next week?

Through my hon. Friend I thank staff at Milton Keynes hospital for all their hard work—I have had the privilege of visiting recently—and I thank all NHS staff for what they are doing throughout this week and throughout a very challenging winter. We know that staff are working under pressure and that their pay, terms and conditions need to improve. Most importantly, we know that conditions for patients need to improve, and we are far better able to do that if we work together, and if the BMA is more reasonable not just about the scale of the asks, but about the pace with which it is demanding change, recognising our responsibility to all staff, not just doctors, and crucially to patients.

More than 34,000 residents of Dorset are over the age of 80 and therefore excluded from the RSV vaccine. They have been told that it is too dangerous for them to take, but they are now extremely worried because cases are going up. Will the Secretary of State sit back round with the Joint Committee on Vaccination and Immunisation and review the decision to exclude them, so that residents such as Joan in Wimborne, who has to care for her even older and more disabled husband, can get reassurance this winter that she can protect herself and him?

I am not a clinician or a scientist, but the JCVI is full of them and we follow its expert advice. It will, in the normal way, review how this winter has gone and look ahead to future pressures, but it is important that we are guided by the evidence, whatever the political pressure.

I am so angry. I am sorry to say this, but I feel that by its actions today, the BMA is killing our NHS, and quite possibly my constituents and patients over the Christmas period, and it has become almost the midwife for privatisation under Reform. The Secretary of State has been robust in his role as patient advocate in chief, and more power to him in that, but will he go a step further and join me in appealing to resident doctors in my constituency and elsewhere, and say, “Go back into work and look after my constituents.”?

I certainly hope that when making the decision about whether to go to work this week, resident doctors bear in mind the pressures that the NHS is under, the consequences of their actions on their colleagues not just this week but in the coming weeks, and—crucially —the impact that risks having on patients, which is the most important consideration. I ask resident doctors to bear in mind that we offered the BMA the chance to postpone the strike action into January. I think that is a reasonable offer, and the BMA’s rejection of it shows how thoroughly unreasonable it is. I follow what resident doctors say, and I worry that too many seem to think that these strikes are consequence free for everyone but the Government. If only that were true, and if only the strike was not placing intolerable pressure on other NHS staff, and an intolerable risk to patients, which I think is unconscionable.

Coroners have warned that without change, unsafe pressures and delayed care at Royal Blackburn hospital risk further deaths. Blackburn also has one of the worst GP-patient ratios in the country, with over 3,000 patients per GP, leaving many of my constituents unable to access early care and pushed into A&E out of desperation, not misuse, only to face fear and delay. With winter admissions rising, what targeted support for staffing, bed capacity and GP access will be provided to places such as Blackburn? Does the Secretary of State accept that winter resilience is impossible without fixing primary care in the hardest hit communities, such as Blackburn?

Thanks to the decisions taken by this Labour Government, we have increased funding for general practice by £1.1 billion, we deployed not just 1,000 more GPs to the frontline in our first year as promised but 2,500 and, through reforms to the Carr-Hill formula, we are restoring the deprivation link to health funding. As a result, the poorest communities with the greatest needs are receiving greater care, support and investment. All this is undoing the damage left by 14 years of Conservative government and it is only possible because people chose to elect Labour MPs.

Last week, I met leaders from Darent Valley hospital in my constituency. Apart from discussing progress made on the new intensive care unit that the Government are investing in at the hospital, which is a sure sign that the Government are starting to turn the NHS around, it was clear from the conversation that the rise in flu admissions is already having a big impact on A&E waiting times and that care is having to be administered in corridors. Does the Secretary of State agree with the message that the hospital leadership team wanted to amplify: anyone who wants to help the NHS should go to their GP or their local pharmacy and get a vaccination as soon as possible, if they have not already done so?

That is very good advice on vaccination. If people require health services and it not an accident or an emergency, they should call 111, visit the website or use the NHS app. There are plenty of services available to help people, but as people will have seen on their television screens and social media feeds, the current pressures mean that the emergency department is not a place to be, unless they have had an accident or it is a genuine emergency.

We do flex beds depending on needs. For example, there were just over 101,000 beds open on average per day in the past week, which was up on the previous week and broadly the same as it was this time last year. We are investing in the NHS, and we have to ensure that people get the right care, in the right place at the right time. That means not just investing in secondary care; if anything, it means investing in the front and back doors of the hospital—primary care, community services and social care—to deal with the flow of patients through hospitals.

I do not pretend that these are easy issues or that everything is going swimmingly in the NHS—quite the opposite. I have seen conditions on our screens in the past week or two that I would not want to be treated in, someone I love to be treated in, or anyone to be treated in. It is a reflection of that fact that we inherited an NHS that was in enormous crisis. It will take time to recover. The key for me is achieving year-on-year improvements to get the NHS back on its feet and to ensure it is fit for the future.

I put on record my thanks to the staff at Princess Alexandra hospital in Harlow for their work to support residents in my constituency not just at Christmas but all year round.

Clearly, the BMA’s decision to take strike action over Christmas is hugely disappointing. As a former teacher, I remember that if we took industrial action, we always tried to avoid taking it over exam season, for similar reasons. Will the Secretary of State reiterate his point about the deal he put forward to the BMA? In particular, reducing the number of applicants per job is hugely important and should be welcomed by resident doctors, or potential resident doctors.

My hon. Friend is absolutely right. Responsible trade unions think about the wider workforce and the impact on service users, whether they are children or other users of public services. Crucially, for most trade unions in this country strike action is a last resort. It is astonishing that the BMA chose to go on strike after a 28.9% pay rise, well ahead of the Government making any decisions on future years’ pay and with the Government willing to discuss future years’ pay with the BMA.

It is extraordinary that the BMA has chosen to go on strike after we proposed to take action on jobs, including by bringing forward legislation at an expedited pace. By the way, that involved ensuring that the legal advice was watertight and that, operationally, we could deliver a new application round. It involved working trust by trust to secure the extra training places, and working with my counterparts in Scotland, Wales and Northern Ireland. Even after all that effort was strained to bring forward something quickly for this application round, the BMA rejected it. It is unreasonable, and to have rejected the offer of postponing strikes until the new year on the grounds of patient safety and doing the decent thing by their colleagues was unconscionable.

Next week, families such as mine will be coming together across the generations to celebrate Christmas, and there will be a mix of people who have been vaccinated and those who have not, whether by choice or by default. Teenagers and young adults are struggling to access vaccinations, and they cannot walk into a pharmacy like an adult can. Is the Secretary of State content that everything is being done to ensure that if families want to get their young people vaccinated, they will be vaccinated in time for Christmas?

Yes. The JCVI makes evidence-based recommendations, and we follow its evidence. With the best will in the world, we of course give out practical, common-sense advice, but we should not infantilise our constituents. They are perfectly capable of working out who can get together this Christmas. They really do not need Government Ministers to start issuing directions about who can get round the table for Christmas dinner and who can get together in the days after. In the exchanges we have in this House there is sometimes a degree of patronising of the British people. They really, really do not need us. They really do not need our advice on the seating plan at Christmas dinner; what they need is for NHS services to be there when they need them, and that is what the Government are focused on.

I commend the Secretary of State for his action to try to prevent industrial action. Nye Bevan had his own challenges with the BMA.

The covid inquiry made a number of recommendations with regard to co-ordination and preparedness across all four nations. What interaction has the Secretary of State had with the devolved nations in respect of this wave of flu, RSV and access to vaccinations?

I speak regularly with my counterparts, and the Ministers who are either side of me this afternoon have been engaging with our counterparts in recent weeks on these issues. We have a good relationship with devolved Administrations, regardless of party or where they sit across the United Kingdom, and that is a good thing.

As for the history of Labour Governments’ interactions with the NHS, that is not lost on me. The BMA marched against the NHS. It may be the case that the BMA does not really feel it needs the NHS—the BMA will be all right regardless—but my constituents cannot afford private healthcare, let alone earn money working in it. We will do everything we can to save the NHS, get it back on its feet and ensure that it is fit for the future. It is the only NHS our country has ever had and, compared with all the alternatives, I would not give up on a publicly funded public service—owned by us and there for all of us—for anything.

Vaccination rates among the over-65s are not where we would like them to be, so will the Secretary of State adopt an emergency vaccination scheme in village halls, supermarkets and—if needed—jab vans to get to the people who have been missed?

There are many examples of great community-based vaccination initiatives. Many of those initiatives are supported by faith-based organisations, which is really important given the vaccine hesitancy in some of those groups. I do not believe that people are hard to reach; I believe that public services often do not try hard enough, and our approach is to do so. We will reflect on our success this year and seek to build on it for future years.

I thank the Secretary of State very much for his answers—the BMA is losing public support, and clearly the Secretary of State is gaining it. I wish him well in his role.

Official figures show that flu cases in Northern Ireland nearly doubled to 954 in recent weeks, and flu-related admissions also doubled, with hundreds being treated in hospitals. There are issues with the supply of the flu vaccine, to the extent that people are unable to get their jabs in pharmacies and GPs are only offering them to select groups. I know that the Secretary of State is in regular contact with the Minister in Northern Ireland, Mike Nesbitt. What discussions have taken place to increase the supply of the flu vaccine and ensure it is accessible to those who need it?

I thank the hon. Gentleman for his question. Given that politicians are somewhere below traffic wardens and estate agents in terms of public popularity at the moment, it is quite an achievement for the BMA to have found itself even less popular with the public, but I think it has made very clear through its actions and rhetoric this week that it does not care about public opinion. In fact, the BMA does not seem to care much about the public at all.

The hon. Gentleman is quite right that we need to make sure we have a good supply of vaccine available across the whole of the United Kingdom. We work closely with the devolved Administrations, and I speak regularly with my Northern Ireland counterpart. Should the Northern Ireland Executive ever need support or assistance, we are always willing to provide it wherever we can.

On a point of order, Madam Deputy Speaker. During the urgent question, the Health Secretary suggested that Reform UK were vaccine sceptics—that is not the case. I have had all my vaccines since being born, and I will continue to have vaccinations, including the flu jab. Is there anything you can do to encourage the Health Secretary to be a little bit more accurate with the facts?

Unfortunately, I am not responsible for the content of speeches made by Front Benchers or by Back Benchers. That is not a matter for the Chair, but the hon. Member has most definitely got his point on the record.

Does the Secretary of State wish to respond? Hopefully, we are not going to prolong the debate.

Further to that point of order, Madam Deputy Speaker. I just wanted to welcome the hon. Gentleman’s endorsement of vaccination. It is by far the most sensible thing he has ever said—that is a low bar, but he has cleared it, and I am very grateful to him. He might want to have a closer look at who his party platforms at its conferences, but that is not a matter for this urgent question.

We do not wish to prolong the urgent question.