PARLIAMENTARY DEBATE
NHS Performance: Darzi Investigation - 7 October 2024 (Commons/Commons Chamber)

I beg to move,

That this House has considered Lord Darzi’s independent investigation into NHS performance.

I am pleased to have the opportunity to open this debate on Lord Darzi’s investigation into the national health service, not just so that we can debate the past and what went so badly wrong, but so that the House can also debate the future of our NHS, how it needs to change and the many reasons to be optimistic about what our health service can be.

We have to start with honesty. For too long, Conservative Governments swept problems under the carpet, more interested in scapegoats than solutions. [Interruption.] I know; it is terrible. That is why I asked Lord Darzi to conduct an independent investigation into our national health service. He is an eminent cancer surgeon, with 30 years’ experience in the NHS, yet what he found shocked even him: some 100,000 toddlers and babies were left waiting for six hours in A&E last year; more than one in 10 hospital beds are taken up by patients who do not need to be there; children are less healthy today than they were a decade ago; adults are living longer but getting sicker sooner; conditions such as diabetes and high blood pressure are rising relentlessly; mortality from preventable causes is far higher than in other advanced countries; almost 3 million people are off work sick; and waiting lists are at record highs while patient satisfaction is at a record low.

The fundamental promise of the NHS—that it will be there for us when we need it—has been broken for a decade. Why? Because of four knock-out blows. First, a decade of under-investment means NHS staff are forced to use pagers and fax machines, with fewer cancer scanners than Greece and buildings literally crumbling. That is not to mention the disgrace that the previous Government’s new hospitals programme was written according to fictitious timetables, with the funding running out this coming March.

Secondly, there was Andrew Lansley’s disastrous 2012 top-down reorganisation that nobody voted for, cost billions and took years. It was an enormous waste of time, talent and money that should have been spent on caring for patients.

Thirdly, there was a failure to reform. The reforms made by the last Labour Government, which delivered the shortest waiting times and highest patient satisfaction in history, were ditched—a golden inheritance squandered.

Fourthly, there was coronavirus. Lord Darzi found that the NHS was hit harder than any other comparable healthcare system because of the damage the Tories had already done. It is not just that they did not fix the roof when the sun was shining; they doused the house in petrol, left the gas on and covid just lit the match. That is why millions are stuck on waiting lists, ambulances do not arrive on time and people cannot see their GP. Never forgive, never forget and never let the Tories do it again.

Lord Darzi’s report was utterly damning about the treatment of children in our health system. He said that too many children were being let down, and pointed out that they account for 24% of the population, but only 11% of NHS expenditure, and that over 100,000 children wait for over a year to be assessed for mental health treatment. He said we must do better, so will the Secretary of State commit to putting children front and centre of the 10-year plan, and to making them a priority, because for a decade, the Tories let our children down?

I strongly agree with the hon. Member. I will talk about the 10-year plan shortly, but I can guarantee that children and paediatric care will be front and centre of that plan. We can do much more to shine a spotlight on paediatric waiting lists, as well as doing much more in practice. She mentioned children and young people’s mental health, on which our parties strongly agree. We will deliver our manifesto commitment to put mental health support in every primary and secondary school in the country, as well as providing walk-in services in every community, so that young people receive the mental health and wellbeing support that they need and do not get to the crisis point reached by far too many of our children.

The hon. Member’s intervention is an example of why I am looking forward to the debate. I hope to listen to contributions and to challenge from all sides of the House. Before I take any interventions from Conservative Members, I advise them that if they want to get a hearing on the NHS ever again, then the first word that should pass their lips is, “Sorry”. Only last week, at the Conservative party conference, we did not see a single shred of remorse or contrition for their appalling record. Indeed, when it comes to the shadow Secretary of State and her party, it seems that sorry is the hardest word.

The NHS is broken. NHS staff do not want to accept that, but it is. According to YouGov, that is what the vast majority of patients say. It is also what staff tell me every time I am on the frontline, but I understand why some people find the word difficult. In the past few weeks, I have met some of the NHS team who happened to be on duty on Monday 29 July. I have listened to paramedics describe the scene they walked into at the community centre in Southport. Children and adults who had been dancing to Taylor Swift were lying bleeding and, in some cases, tragically dying as a result of an unimaginable, senseless, mindless attack. Those paramedics had to make split-second decisions about who to treat and in what order to give the injured the best chance of survival. Security teams cleared busy hospital corridors to shield as many people as possible from the horror. Lab teams mobilised blood supplies. Receptionists fielded calls from panic-stricken patients. Surgical teams across multiple hospitals worked together, fighting to save those young lives. Even now, months later, mental health staff are picking up the pieces for families who are either grieving or going through the unimaginable challenge of supporting their children through what they witnessed.

On that day, those NHS responders—the whole team involved—were the best of humanity confronting the worst. That is who NHS staff are. That is what they do. Let me be clear: the NHS may be broken, but NHS staff did not break it. I want to be clear about this too: what is broken can be fixed. While the NHS may be in the midst of the worst crisis in its history, the biggest asset that we have is the people who work in it. They are up for the challenge, and up for change. The NHS is broken, but it is not beaten. Together with the 1.5 million people working in the health service, this Government will turn our NHS around, get it back on its feet, and make it fit for the future.

Across my constituency, my constituents are struggling to see the GPs they need; indeed, we see that across the whole nation. On Friday, I visited the Park View surgery, where the GPs do not have the necessary resources and cannot move into the premises that they need to be in to treat their patients. Can the Secretary of State assure me that he will follow Lord Darzi’s recommendations and invest in primary care, so that my constituents get the GPs they need and the Park View surgery can move into the premises that it needs, with the capital expenditure that it requires?

I am grateful to my hon. Friend for his intervention. Of course it is not just in Loughborough that we have a challenge with access to general practice; it is right across the country. I want to be clear, because GPs come in for a lot of criticism: primary care may be broken, and the front door to the NHS may be broken, but GPs did not break it. In fact, there are fewer GPs now than there were in 2015, yet they are providing more appointments. They have worked hard to improve the productivity of general practice, but they are under-resourced. That is why we are committed, as I told the Royal College of GPs just last week, to delivering the shift that we need out of hospitals and into the community—to growing primary care, including general practice, as a proportion of the NHS’s budget, so that we have the GPs needed to treat patients on time.

Saturday was World Meningitis Day, but in the last year we have seen an almost doubling of meningitis cases in the UK. Does the Secretary of State think that the meningitis vaccination take-up rate is where it should be?

I am grateful to the hon. Member for her question. No, I do not think that the take-up rate is where it should be. That is why in the short time we have been in office we have put more effort and energy into vaccine take-up, but there is more to do. I welcome her to the House, and will not have a go at her for the record of the people who sat on the Government Benches just before the general election.

At the end of September, a large GP federation serving patients across Sussex suddenly went bust, causing 130 redundancies; patient care was severely affected. The federation reported that the cause was a failure to obtain long-term contracts from any of its major clients, and the erosion of the real-terms value of contracts with both primary care networks and NHS Sussex. Does the Secretary of State agree that protecting continuity of service is key to public confidence in primary care, and will he meet me to discuss this case?

I am grateful to the hon. Member for her intervention. I wish that this was a challenge only in her constituency; it is a challenge right across the country. As I said to the Royal College of GPs last week, it will take time to rebuild general practice, so that it is back where we want it to be. We would be delighted to hear more from her; I will ensure that my Department makes contact, and that a Minister is in touch about the challenge in her constituency.

I thank the Secretary of State for today’s debate. The whole House, and indeed the whole of the United Kingdom of Great Britain and Northern Ireland, wishes him well in bringing forward the changes that we wish to see. An issue that comes to my attention regularly is research and development. We hear in the press every day about new advances in treating diabetes, heart disease, cancer, Alzheimer’s, dementia and rare diseases. When we look at the bigger picture of the NHS, we see the big problems, but sometimes there are smaller issues. Will he reassure us that research and development will be encouraged?

I strongly agree. Although health is devolved, I look forward to working constructively and closely with Governments right across the United Kingdom of Great Britain and Northern Ireland, because every part of the health system in every part of the UK is going through challenges. We are determined to do that. [Interruption.] I think the hon. Member wants to come in again.

National Institute for Health and Care Excellence recommendations go from here to Northern Ireland, and then we endorse them; if we do not get them from here to start with, we cannot make people better. That is the point that I was trying to make.

The hon. Member’s point is taken.

The NHS stands at a fork in the road. There is a choice before us, and the parties represented in the House have different opinions on the best way forward. The first option is for the NHS to continue on its current path—to head down the road to ruin, on a mismanaged decline, with a status quo so poor that patients are forced to raid their savings to go private, and with the worst yet to come, because many Opposition Members believe that all patients should have to put their hands in their pockets when they fall ill. Reform UK has openly stated that it wants to change the funding model and replace it with an insurance-based system, and plenty in the Conservative party want to head in the same direction, chasing Reform UK down the hard-right rabbit hole.

That is nonsense.

The shadow Secretary of State says that it is nonsense. She is very upset about it, so let me point out to her that earlier this year, the Conservative former dentistry Minister, who served in her team, under her leadership, proposed a monthly £10 insurance fee to see a dentist. That is what the Conservatives were planning before the election. [Interruption.] If the hon. Member wants to intervene, I will give way.

I will happily intervene. That is simply incorrect. There are a couple of points that the Secretary of State has made that are completely wrong, which I will have to correct in my speech. He is no longer in opposition. He needs to be careful what he says on the record. That is not right.

Honestly, Madam Deputy Speaker, “brass neck” springs to mind. Once again, the hon. Member gets to her feet and fails to say the word “sorry”. If she wants to correct the record, how about she stands up and corrects the abysmal record that she and her predecessors lumbered this country with? They took the NHS from being the very best—that is how it was left in 2010—to being the very worst; that is how she inherited it. If she wants to talk about humility, she might like to start demonstrating some before her time in Parliament comes to an end.

If the hon. Member wants to distance herself from her former dentistry Minister, let us turn to the candidate seeking to lead her party who is head and shoulders above the rest with its membership, the right hon. Member for North West Essex (Mrs Badenoch). She wants to go even further. On whether the NHS should be free at the point of use, she told The Times last month:

“I think we need to have a serious cross-party, national conversation.”

That is what she said about whether the NHS should be free at the point of use. I suspect that she has blamed the journalist for her own words since, but just so that Government Members are clear, that will happen over my dead body. This Labour Government will always defend our NHS as a public service that is free at the point of use, so that whenever someone falls ill, they never have to worry about the bill.

The problem is not, and has never been, the fair, equitable model of funding. It is the same model that we had in 2010, when the last Labour Government delivered the shortest waiting times and highest patient satisfaction in history. A universal, single-payer health service is the fairest, most equitable way to provide healthcare. More than that, in a way that could never have been predicted in 1948 by Attlee and Bevan, it makes the NHS the best placed healthcare system in the world for the revolution taking place in genomics, technology and life sciences. The NHS has the right funding model, but it is not taking advantage of the opportunities in front of it. That is what we need to change.

Under the previous Government, poor investment and a lack of respect for NHS workers, particularly in primary care, resulted in Portsmouth North having over 3,000 patients per GP. That has resulted in over 1,800 people waiting more than a month to see a GP. Despite that, Lord Darzi notes that many of the solutions can be found in parts of the NHS in our constituencies. Will the Secretary of State acknowledge the fantastic initiative and hard work of GPs in Portsmouth North, as they work alongside trainee GPs from King’s College London, and look to push that across the country?

My hon. Friend is right. In Portsmouth and right across the country, there are people who, against the backdrop of the previous Government, have none the less tried to innovate, do things differently and improve services for patients. Especially given that they sent her to represent them here in Parliament, I am sure they are relieved that they now have a Labour Government on their side.

Chapter 5 of Lord Darzi’s report is about where and how the money should be spent. I know from previous experience that there is a lot of money that can be spent in the national health service, but does the Secretary of State agree that we have to invest to save? We cannot simply move about the money that we currently have in the health service. Investment is needed to allow us to go into the greater detail that Lord Darzi talks about in respect of moving from analogue to digital and from primary care back into the community. That needs investment; it cannot be done simply with the budget that is there.

I strongly agree with the former Minister. I will take that as a representation for the forthcoming Budget and spending review, and ensure that his comments are sent straight to my right hon. Friends the Chancellor and the Chief Secretary to the Treasury. Without pre-empting future fiscal events, we have been clear for some time that it is investment and reform that deliver results. That is how the last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history. If people are in any doubt about what investment minus reform does, they need only look at what Darzi says about our hospitals: after 2019, lots of resource was poured in, particularly in relation to staffing, but productivity fell. It is investment and reform that deliver results, and this Labour Government will deliver both.

One of the moments before the last general election that I will never forget was turning up at Milton Keynes hospital with my 91-year-old grandmother, who we suspected was having a heart attack, only to be told that the average waiting time at that moment was nine and a half hours. Milton Keynes has some of the longest NHS waiting lists in the country, because of the damage done by the last Tory Government. Does my right hon. Friend agree that we all deserve an apology from the Conservatives, not just for the state they left our NHS in, but for going into the election promising a new hospital for Milton Keynes even though they clearly did not have a plan to deliver it?

I was delighted to visit Milton Keynes hospital with my hon. Friend before the general election. It is doing incredible work in the conditions that he describes; in particular, its innovation in the application of smart, everyday, practical technology to improve patients’ experience is to be commended.

I share my hon. Friend’s anger, his constituents’ anger and the anger of people right across the country in every community—including mine, by the way, where a hospital upgrade was promised. We were told there was a plan and a timetable, and we were told that the programme was fully funded. Then we came into government to find that the timetables were a work of fiction and that the funding runs out in March. That is something else that the shadow Secretary of State should apologise for, and I look forward to hearing her apology. People across the country are owed an apology.

Let me say to every hon. Member who is in the same position that I, my hon. Friend and people across the country are in that we will not play fast and loose with the public’s trust, and we will come forward with a plan for the upgrade of hospitals that is credible, achievable and funded. That is the difference between the way that this Labour Government will behave, in terms of both public trust and public money, and the way that the previous Conservative Government behaved, which was a total disgrace.

On top of coming clean to the public and making a change from the way the previous Government treated the country, will the Secretary of State also assure the House that the Government will establish a proper, effective and honest workforce plan? After the years of Johnsonian bluster, when there was no effective workforce plan, the nurses who are the backbone of the NHS are still being paid £29,000 a year at grade 5. As the Royal College of Nursing says, it is about retention of staff, not just recruitment. They are leaving in droves because they cannot stand the unsafe circumstances in which they are operating.

The hon. Member is right to raise the issues of recruitment and retention. My message to staff who are thinking of leaving the NHS, or who perhaps have left the NHS in recent years because of working conditions and because there was no light at the end of the tunnel, is to stay—or indeed return—and help us to be the generation that takes the NHS from the worst crisis in its history, gets it back on its feet and ensures that it is fit for the future.

On the workforce plan, let me just say that it was regrettable that it was only at 5 minutes to midnight that the previous Government published such a plan. We were highly flattered by the fact that so much that underpinned that plan was Labour party policy commitments, such as doubling the number of medical school places and increasing the number of nursing and midwifery clinical training places. We are committed to those headline commitments. We will inevitably want to update the workforce plan in the light of the 10-year plan and some of the analysis that underpins Darzi. We are clear that that kind of long-term workforce planning is essential, and we are committed—

I must make some progress; I will try to take more interventions shortly.

The public are clear that they do not want the NHS to be sacrificed. They gave Labour our marching orders at the general election to rescue the NHS and turn it around, and that is what we will do. I appreciate that the shadow Health Secretary must be embarrassed by all this, not just by the state that she and her Conservative predecessors left the NHS in, but by what Conservative Members have been saying. I was going to say, “Members who are sat behind her,” but they are actually not—I think they are hiding in shame. [Interruption.] The shadow Health Secretary says from a sedentary position that we have already had this discussion. The Conservatives would rather we just moved on and forgot their abysmal record. Well, I am afraid that we are not ready to do that just yet. At least some of her Back Benchers now say what they refused to say when they were in office: that the NHS is broken. Some of them even admit that only Labour can fix it.

When the shadow Secretary of State stands up, I wonder whether she can tell us whether she agrees with the hon. Member for Mid Norfolk (George Freeman), who said:

“I applaud Wes Streeting for having the political courage. I think only Labour can really say this. The NHS is sort of their thing…I really hope that we can get behind him”.

It is not just Back Benchers. What about the shadow Foreign Secretary, the right hon. Member for Sutton Coldfield (Mr Mitchell)? He said:

“I’m very supportive of what Wes Streeting is saying… The Conservative government put a lot of money into the NHS, the record is there for all to see… I’m not one of those who is seeking to attack…the Labour Party on the NHS.”

He is going for my vote, but sadly—or gladly—I am not qualified to vote in that particular election. Perhaps the shadow Health Secretary can tell us what the shadow Foreign Secretary meant when he said we were not—[Interruption.] She is clearly enjoying this. Was the shadow Foreign Secretary speaking for the shadow Cabinet? [Interruption.] No, he was not.

Let me move to my favourite comments on the NHS from a Tory MP. This right hon. Member said:

“We were not obsessed with how we can ensure that it actually delivers the experience that patients actually deserve…Out of fear of our opponents mischaracterising our efforts, we shirked the difficult decisions…If Wes Streeting comes forward with genuine reforms I think we should back him.”

Those are the words of the candidate that the shadow Health Secretary is backing to lead her party, so does she agree with the right hon. Member for Newark (Robert Jenrick)? Will she finally apologise for her part in the Tories’ abysmal record and have the humility to admit that when it came to NHS reform their cupboard was bare, and that actually they quite agree with our efforts to clean up the mess that they left behind?

For all the agreement with our diagnosis and praise of our plans, the problem is that there is no apology. Of the four leadership candidates and eight former Health Secretaries, not a single one has apologised for the state they left the NHS in. Would the shadow Health Secretary like to correct that record today and finally say sorry? I expect that we might have to wait a long time. While the Conservatives continue the longest leadership election in history, we are getting on with the job of cleaning up their mess.

The reform that we desperately need includes the so-called “left shift” out of hospitals and into primary care. Yet under the previous Government, the amount of money spent on hospitals went from 47% to 58% of the NHS budget. According to Age UK, every day 2,000 people are admitted to hospital who could be treated elsewhere and earlier. Does my right hon. Friend agree that the only way to fix the NHS is to get more and better care in the community?

My hon. Friend is absolutely right, and that brings me to our reform agenda.

To deliver the Government’s reform agenda, we will have to take on both left and right-wing orthodoxies—for simplicity’s sake, we will call them The Guardian and the Daily Mail. The Daily Mail agrees on the need for health service reform, but attacks proposals for public health reform as “nanny state”. The Guardian loves prevention, but all this talk about health service reform makes it very nervous. The truth is that the Daily Mail and The Guardian are half right and half wrong. We all need to face up to the challenges of today. Our society is getting older and living longer but becoming sicker sooner. Those rising tides of demands and costs are combining to form a perfect storm that threatens to shipwreck the NHS.

Will the Secretary of State give way?

I must make progress.

The right must accept that without reform on public health, we will pay a heavy price, with higher taxes and poorer quality of life—exactly the sort of dependency culture that the right rails against. The left must accept that investment without reform of the health service would be killing the NHS with kindness, with more cash and poor results until the public give up altogether.

I must make more progress.

That is the choice: public health reform or higher taxes; NHS reform or no NHS. The Tories did neither; Labour will do both. It really is reform or die, and we choose reform. That is why this month we will begin formal engagement with NHS staff and patients, who will help to write the 10-year plan for our NHS—a plan that will deliver the change and modernisation that our health service is crying out for—with three big shifts in its focus.

First, a shift from hospital to community will turn the NHS into a neighbourhood health service as much as a national health service, so that patients get more of their tests, scans and healthcare on high streets and in town centres in their own community, and from the comfort of their own home. It will ensure that patients can easily book appointments to see the GP they want to see in the manner that they choose, and it will bring back the family doctor, rebuild NHS dentistry and build a national care service.

Will the Secretary of State give way?

I must make progress. There are lots of speakers and little time.

Secondly, there will be a shift from sickness to prevention. It will mean that we take action to give our children a healthier and happier life, flattening the curve of rising pressures that threaten to overwhelm the NHS by building a healthier society, which will help to build a healthier economy.

Thirdly, there will be a shift from analogue to digital. Upgrading the NHS app will give patients real choice and control over their own healthcare, creating a single patient record owned by the patient and shared across the system so that every part of the NHS has a full picture of the patient that they are treating. Getting the NHS working hand in glove with our country’s leading scientists will put modern technology and equipment in the hands of NHS staff, and patients at the front of the queue for the latest treatments.

I must begin to conclude my remarks, Madam Deputy Speaker, but I see that the Chair of the Select Committee on Health and Social Care is seeking my eye. Given that I will be before her Committee soon and know where my bread is buttered, I give way.

The Secretary of State is very kind indeed. I can take no credit for what I am about to say, which comes from reports on prevention and digital transformation published by the previous Select Committee, which he would do very well to look at. What those reports say is very much echoed in Lord Darzi’s report—particularly that the place-based narratives about embedding the NHS into our communities are key, as is reform of Government as a whole, and embedding health in every Department. Will he say a bit more about reform in Government, and not just reform in the NHS?

I strongly agree with the Chair of the Select Committee and commend the work of the previous Committee, to which she refers. She has certainly given me some revision for the first meeting that I will attend. To answer her question, she is absolutely right that digital transformation and place-based healthcare planning are key. This Government will have a much sharper focus on health inequalities than the previous Government did. In fact, if we consider the NHS over the past 30 or 40 years, even when it has performed well overall, and patients in every part of the country have received access to timely care, some health systems have still been more challenged than others. We need to be honest about the structural challenges in those areas. Secondly, she is absolutely right that, if we are serious about health and prevention, we need a serious cross-Government approach. That is why I am delighted that the Prime Minister’s mission-driven approach has already seen Departments coming together with a focus on prevention. That will deliver fruit.

This is the major surgery that our national health service needs over the next decade to make it fit for the future. There is no time to waste, so we have hit the ground running. We inherited a Care Quality Commission that is not fit for purpose. I was genuinely stunned to learn that one in five health and care providers has never been inspected; some hospitals have been left uninspected for a decade; and inspectors were sent to care homes when they had never met someone with dementia. The Conservatives did not think that patients would like the answers, so they stopped asking the questions. This Labour Government are different: we will be honest about the problems facing the health service, and serious about solving them. Our policy is radical candour.

Today I am delighted to announce that Sir Julian Hartley has been appointed the new chief executive of the CQC. He is a proven reformer with a track record of turning around large organisations, and I am confident that he will provide the leadership that staff in the CQC need to address this crisis, improve patient safety and restore confidence in the regulator. Sunlight is the best disinfectant, so this Government are taking action to turn the regulator around. That is the difference a Labour Government make.

We inherited the farce of newly qualified GPs facing unemployment. Patients could not get a GP appointment, while GPs could not get a job, so we cut red tape, found the funding and are recruiting an extra 1,000 GPs. That is the difference a Labour Government make. We have tabled a motion to ban junk food ads targeted at children —our first step towards making our country’s children the healthiest generation that has ever lived. That is the difference a Labour Government make. Just this week, the Secretary of State for Science and Technology and I announced funding to produce new cutting-edge cancer treatments: a new blood test that can detect 12 different cancers. We are backing Britain’s scientists to save lives. That is the difference a Labour Government make.

Of course, strikes in the NHS have cost taxpayers billions. Patients saw 1.5 million operations and appointments cancelled. The Conservatives saw strikes as an opportunity to scapegoat NHS staff, so they let the strikes rage on. In fact, the shadow Health Secretary had not even bothered to meet the junior doctors since March. This Government do not exploit problems; we solve them. I called the junior doctors on day one and met them in week one, and in just three weeks, we had negotiated a deal to end the strikes. That is the difference a Labour Government make.

Those are just our first steps. Rebuilding the NHS will not be easy and it will take time, but we have done it before and we will do it again. Along with the millions of dedicated staff in health and social care across our country, this can be the generation that takes the NHS from the worst crisis in its history to build an NHS fit for the future—an NHS that is there for us when we need it, with world-class care for the many, not just the few. That is the change that Britain voted for; that is the change we will deliver together; and that change has already begun.

Before I bring in the Opposition Front Benchers, the House should be aware that over 50 Members wish to speak in the debate, so I ask you to help each other. On this occasion, I will impose a three-minute limit on Back-Bench speeches, with the exception of maiden speeches and that of the Chair of the Health and Social Care Committee. I call the shadow Secretary of State.

On this, the first anniversary of Hamas’s horrific attack on Israel, our thoughts are with Israel, the victims of that horrific attack and their loved ones, and with all those who are trying to rescue the hostages, get aid where it is needed and bring peace to the region.

Day 95 of this fumbling Labour Government, and yet another general debate to talk about a report that we talked about three weeks ago. That seems to be the golden—or Gray—thread running through this Government: lots of talk, but where is the action? If the Secretary of State for Health and Social Care wanted to make a meaningful contribution to the nation’s health, why did he not bring forward the Second Reading of the Tobacco And Vapes Bill this evening, to help our children and bring about the first smokefree generation? That Bill is ready to go; why are the Government not?

The right hon. Gentleman could have provided an update to the House on the 40,000 more appointments that he promised many times during the campaign, which the latest answer from his Minister to a written parliamentary question suggests is nowhere near happening. It is perhaps about as likely as the Prime Minister paying for his own glasses. The right hon. Gentleman could have set out the steps that his Department is taking to prepare the NHS for winter. In the spring, I asked the system to start planning for this winter. How many beds, ambulances and care packages has he put into the system to prepare it for winter? He could have set out the terms of the royal commission on social care. We in the Conservative party stand ready to help on that royal commission, because we believe in constructive opposition, yet we have heard nothing from this Government. The right hon. Gentleman could have launched the much-hyped 10-year plan, which he promised before the election was “oven-ready”, but appears to be in the deep freeze. How many more Government resets will there be before that 10-year plan is launched?

Instead, in their first 95 days, this Labour Government have talked down the economy and the NHS, stopped new hospitals from being built, scrapped NHS productivity improvements, overseen GPs entering industrial action, been exposed in a health cronyism scandal, and opened a dispute with hundreds of thousands of nurses and midwives. They seek to justify all of that with the Darzi report. That report, from a former Labour Health Minister, has sunk as quickly as it was briefed out. It looks backwards, but not far enough to mark the last Labour Government’s policy and operational failures. If this Government are serious about reforming the NHS—and I genuinely hope they are—they and the Secretary of State need to transition quickly from opposing to governing.

Will the right hon. Lady give way?

I will finish this point. That transition must begin with the language that the Secretary of State is choosing to use about the NHS. Interestingly, we have heard a little bit of nuance for the first time tonight, perhaps because health leaders are raising concerns that his “broken” narrative is damaging public confidence and will lead to people not coming forward for care, as was reported on the day that the right hon. Gentleman gave his speech to conference. That narrative is hurting the morale of staff who are working tirelessly for their patients. As the confected doom and gloom of the new Chancellor damages business confidence, so too does the Health Secretary’s relentlessly negative language risk consequences in real life.

Let me say what the Health Secretary refuses to acknowledge: the NHS is here for us and is ready to help. Its dedicated staff look after 1.6 million people per day, a 25% increase from the days of the last Labour Government. That is why I am always a little concerned whenever the right hon. Gentleman harks back so far; I do not think he has quite understood the change in capacity and scale of the national health service since we inherited it from the last Labour Government. The majority of those 1.6 million people will receive good care. [Interruption.] These are just facts, but I know the Health Secretary finds them difficult to receive.

Will my right hon. Friend give way?

In one moment.

Of course, it is important that we focus relentlessly on those patients who do not receive good care, but that will not be achieved by writing off the 1.5 million people who work in the NHS. In fact, the NHS has more doctors, nurses and investment than at any point in its history. It is delivering millions more outpatient appointments and diagnostic tests and procedures for patients than in 2010, and NHS mental health services are supporting 3.6 million people a year, a 10% increase in one year alone.

I will give way to the doctor behind me, and then I will give way again.

It is interesting that Lord Darzi chose 2010, because there were some good points in what the Labour Government put in place, but there was also the problem of Mid Staffs. We had the Medical Training Application Service fiasco around medical careers, for which Patricia Hewitt had to apologise, and we had the £11 billion IT project that was put in place and has now failed as well. These things shape the NHS, and when we are trying to come up with solutions, they impact on the way that doctors, leaders and politicians come together. Does my right hon. Friend have suggestions for how we can take the politics out of this debate, enabling us to have a sensible debate on reform, which I think both sides of this House would like to see?

I thank my hon. Friend, who brings his clinical experience and expertise to this debate. I say frankly to the Secretary of State that I wish he had taken the approach of the Defence Secretary, who has set up a cross-party commission on defence spending. Indeed, he has invited my former colleagues to sit on that review, because he understands that we bring an enormous amount of knowledge, experience, and—dare I say it?—some hard knocks from working in those massively complex Departments.

The right hon. Gentleman knows me. We have done good-humoured battle over the Dispatch Boxes for a long time now, and had he come to me and asked me to help him, I genuinely would have. [Interruption.] The public are hearing this. They want politicians to cut all the flim-flam and the bluster and work together, and had the right hon. Gentleman been serious about the Darzi report, he would have done exactly as his colleague around the Cabinet table has done and conducted a cross-party review of the NHS to ensure that we can make real progress. It is interesting that the Health Secretary does not appear to agree with the approach that his Cabinet colleague has taken.

I will listen to the hon. Gentleman. [Interruption.] I am very generous with interventions, and I know that he brings expertise and experience to the House as well.

I am grateful that you have given way, and thank you for that. I have been sitting listening to you—[Hon. Members: “Shadow Secretary of State.”] I am sorry, I am getting the hang of this. To be honest, I am struggling to recognise what the right hon. Lady is talking about. The state of the health service is a disgrace; the Opposition, who I believe were the Government until quite recently, have totally messed the situation up over a period of 14 years. What Lord Darzi has had to say is a pretty accurate diagnosis of the situation we are in, so it is quite surprising to listen to the shadow Secretary of State talk as if everything was perfect over the last 14 years. That is simply not the case.

I will help the hon. Gentleman, because I appreciate that he is new to this place. If he had been listening carefully to me, he would have heard that I am and have always been—in fairness, I hope the Health Secretary would acknowledge this as well—very open about the fact that the NHS needs reform. In fact, I said as Secretary of State that I wanted to reform our NHS to make it faster, simpler and fairer.

By the way, I speak with personal experience. I know there are some Members on the Back Benches who are new to this place and perhaps have not quite moved on from the natural competitiveness of a general election campaign, but I was diagnosed with type 1 diabetes at the age of three. I have seen the very best of the NHS, but I have also seen some of its darkest corners. The NHS is genuinely one of the reasons why I came into politics, and one of the most damaging things about political discourse and the healthcare system in this country is when people seek to attribute to others a lack of care or commitment to our healthcare system, just because we have different ways of tackling these challenges and different solutions.

This is why—I will say this again, because I am not sure that the right hon. Gentleman is listening—I will work constructively with him to improve the health service, but we have to do this on the facts. Some of the suggestions he made in the debate today and in his discourse during the general election campaign and so on are not accurate, and this is where I will pull him up. For example, he has not mentioned the introduction of Pharmacy First or the 160 community diagnostic centres. Just to help him, those were backed by the largest central cash investment in MRI and CT scanning capacity in the history of the NHS. Those, as well as the new surgical hubs that we introduced, are not only putting healthcare into the community but, critically, helping to improve the numbers of chest checks and scans going through the system, which means speedier diagnosis.

The right hon. Lady mentions Pharmacy First. How many pharmacies went bust on her watch?

As the right hon. Gentleman knows, because I imagine he will have got exactly the same briefing I used to get when I was in his shoes and being advised by exactly the same civil servants—and I am having to let this flow back into my memory here—the average person in England is within walking distance of their pharmacy. He will know that in many high streets in our market towns, as well as in London and other urban areas, there is a density of pharmacies. We want to support those pharmacies to ensure they are able to provide the services that they can provide, and in fairness, to enable pharmacists to work at the top of their licences. He supported Pharmacy First when I introduced it, so I am a little surprised that he appears to be casting doubt on it, but I am grateful for his intervention.

The next point is that our women’s health strategy—it does not have the attention from his ministerial team that it should have at the moment, and I hope that will improve over the coming months—is seeing the roll-out of women’s health hubs across England into every integrated care board area by the end of this year, ensuring that women’s health issues receive the attention they deserve.

Of course, there are parts of the NHS that need to change and do much better. The NHS needs to reform for the future of healthcare, and our focus must be on improving outcomes for patients, not protecting structures, bureaucracy and vested interests in the NHS. As I have said repeatedly, we will scrutinise constructively and support any meaningful efforts to reform the NHS to improve outcomes and experiences for patients, because we all want the NHS to thrive.

However, after nearly 100 days, there has not been anything yet for us to scrutinise or indeed support from this Government. [Interruption.] The Secretary of State says he has just given me a list. Interestingly, I am pretty sure that three out of those four were started under my Government. [Interruption.] I am pretty sure that I was the Secretary of State who ordered the review of the Care Quality Commission, precisely because I was so concerned. He will be able to build on that report, and quite rightly so, but he should please be careful of his facts. Disappointingly, it is the right hon. Gentleman’s fondness for parties and concerts that has made the news recently, rather than his health policies. This Government need to sober up and start taking responsibility for their choices.

On Saturday, I had a surgery appointment with a young lady who has struggled to access support for her eating disorder and mental health issues. She has gone through some of the most difficult experiences anybody can go through. She asked me a simple question: “Why have I been unable to access NHS support for my mental health?” What would the shadow Secretary of State say to my constituent, who, when she looks back at the reasons, frankly blames the previous Government?

First, I am very sorry to hear that. Again, the way we were trying to deal with the enormous increase we have seen in mental ill health across our country was first of all to boost mental health services for children and young people. Indeed, the hon. Member may not be aware of this, but we rolled out mental health support teams across nearly 45% of schools. We wanted to complete that to 100% of schools by the end of the decade, and I very much hope that the Secretary of State will be taking up that policy and delivering it.

The hon. Member for Bournemouth East (Tom Hayes) might know that there seems to have been a real increase in eating disorders since the pandemic. We know, for example, that the impact of social media sites, and the algorithms that sit behind them, can lead people who are already feeling very vulnerable into even darker places. So when the Secretary of State says that there should be a cross-Government piece of work, I very much agree with him—I hope he will achieve that through his mission board. But we really have to look at how we as a society can deal with some of these causes, because I do not think anyone is happy with seeing such a huge increase in anxiety and mental ill health among our young people since the pandemic.

One of the things that came up at our party conference some time ago was a recommendation from the British Medical Association and the General Medical Council to encourage medical students into local trusts by paying their fees, which would pay for itself given the cost of locum doctors in each of our health trusts. Would the shadow Secretary of State support that, and would she in turn encourage the Government to do likewise?

I hope the hon. Gentleman knows by now that when he makes a suggestion, I will take it away. He will appreciate that, as part of a constructive Opposition, I want to look carefully at the ramifications—both the intended and unintended consequences—of policies suggested in the Chamber, but that sounds very interesting. I thank him for his contribution, as always.

I am going to make some progress.

One of the choices facing the Health Secretary is whether he will fight for the investment required from the Treasury to implement the productivity plan. At spring Budget, the Conservatives announced more than £3.4 billion of investment to upgrade IT systems, expand services on the NHS app and make better use of artificial intelligence, in order to reduce bureaucracy for staff and free up clinical time for doctors and nurses. Alongside the long-term workforce plan—the first ever in the history of the NHS—this plan will see productivity grow by 2% a year by the end of the decade and unlock £35 billion of savings, yet the productivity plan is not mentioned anywhere in this 163-page report.

This plan was made in partnership with NHS England and funded by the Conservative Government. While the right hon. Gentleman has talked a good game on productivity, we are still waiting for him to confirm his commitment to deliver the plan that was drawn up with NHS England to help improve productivity. I asked him three weeks ago whether he was cancelling this plan, and he failed to answer. I am very happy to give way now if he wants to commit to it. The whole NHS would like to know.

I am delighted that the shadow Secretary of State has so generously given way. I am not going to pre-empt the Chancellor’s announcements at the Budget and the spending review, but I say to her that the reason why so many of the things she said at this Dispatch Box as Secretary of State were a pile of nonsense is that they were plans built on a pillar of sand—a £22 billion black hole for which she and her party are yet to apologise. Will she do that now?

As the right hon. Gentleman knows, calculations were made in the Treasury for this economic inheritance, but the Treasury cannot even explain how it has arrived at those calculations. If I were him, I would be a little bit careful of relying on that figure, because I fear it may trip up his Chancellor in due course. Perhaps the reason why he cannot answer the question about whether he is in fact committed to the productivity plan is that his friend the former Health Secretary, who has been walking in and out of the Department for Health with all of his private healthcare businesses, has not told him whether he plans to accept it, but we will find that out in due course.

The Secretary of State’s silence continues with new medicines, technology and trials. These will be at the forefront of the reforms needed in health services across the world, let alone the NHS, yet the Darzi report mentioned NICE only once in 163 pages. Even worse, I am hearing from the life sciences sector that he and his team are refusing to meet these businesses, putting at risk the hundreds of millions of pounds of investment that the Conservative Government secured, as well as the highly skilled jobs they provide and the life-enhancing treatments they promise our constituents. It is his responsibility to persuade the Chancellor to continue supporting and investing in this innovation for the future, because patients will not thank Labour if it refuses to engage in the medical revolution with these businesses.

Another choice that the right hon. Gentleman must make—we perhaps have a precursor of what he is going to say—concerns the workforce. We know that NHS staff are at the heart of our healthcare services, and that training, retaining and developing our workforce is critical to the future of the NHS. The Conservative Government created the first ever long-term workforce plan for the NHS—again, a plan that was asked for and welcomed by the whole NHS, and developed hand in hand with NHS England to train the doctors, nurses, midwives and other healthcare staff that we need now and in the future. The plan was described by NHS England’s chief executive as

“one of the most seminal moments in our 75-year history.”

Crikey, even the right hon. Gentleman supported it. Yet this supposedly independent investigation failed to mention the plan once. Will the right hon. Gentleman confirm that this Government stand by this plan and will fund it as the Conservatives would do? [Interruption.] He says that he talked about it, but he did not give an answer, because his job is to ask the Chancellor for this funding—has he done so?

I did.

Right, okay. We have that on the record now and we will wait to see what happens at the Budget.

It is also striking that the report mentions pay and wages only twice in 163 pages, despite the fact that staff costs account for 65% of provider operating costs a year. If the report and the Secretary of State do not acknowledge the single biggest cost pressure for providers, how can they claim to have the answers on reform? He claims to have sorted out industrial action in the NHS, and I must again correct him on something. He keeps referencing when I last had a conversation with the junior doctors committee, as it then was. What he neglects to tell us is that we entered mediation with junior doctors in May—he never thinks to mention that when he is holding forth at the Dispatch Box.

How did it go?

We entered into that negotiation in good faith, and I gently remind Labour Members of Parliament who were here before the last election that again and again I asked the right hon. Gentleman and Labour MPs to condemn the strike actions and they refused to do so, because we know of their links to their union paymasters—[Interruption.] I will just say “train drivers” and leave that hanging in the air.

When I asked the right hon. Gentleman during Health and Social Care questions in July whether he was going to cut services or whether the Chancellor was going to raise taxes for the junior doctors pay rise, he assured the House that any pay rise would be affordable. How affordable does his deal look now? He has given resident doctors an inflation-busting pay rise for being on strike, and he is paying them for the days they were on strike. He did that with no reform and no productivity improvements attached to it, and with more strikes threatened for next spring. Completely foreseeably, that has led to nurses and midwives asking why they should accept less. Simply telling nurses, “We’re on your side” will not heat their homes this winter. The report does not deal with the here and now; it looks only at the past. Indeed, the Darzi report talks about the importance of capital investment, so if the right hon. Gentleman intends to use the report to inform his policy decisions, as he says he does, why is he stopping new hospitals from being built?

There are now 24 hospitals whose futures are at risk, despite commitments from the right hon. Gentleman and Labour candidates during the election campaign. Labour candidates in Watford, Hillingdon, Milton Keynes, Leeds and Basingstoke made promises to their voters that are now at risk under this Labour Government. Patients in Chelsea and Fulham, Truro, Harlow, Plymouth and Kettering will not get the investment and upgrades that they deserve, despite the promises of their Labour candidates. [Interruption.] Do not believe a word when this Secretary of State says, as he is saying now, that it is because of the economy. The truth is that he had been planning to pause those hospitals since May 2023. For those who are wondering, the details are in his health mission paper, which was published to great fanfare in May 2023—page 6, if that helps. He was planning this since May last year, which is exactly why the promises made at the election were so cynical and now need to be revealed.

Take a perhaps unhealthy dose of salt with the right hon. Gentleman’s claim that the money runs only until March next year. Let me help this very inexperienced Secretary of State understand basic Treasury rules. The comprehensive spending review period finishes in March. I wish I could have bound this Labour Government to committing to those hospitals in the next CSR period, but I could not. It is his responsibility and his role to fight for funding from the Chancellor to ensure that the hospitals are built. We promised that we would allocate the money needed, and would prioritise the new hospitals in the next CSR period. It is now the job of this Secretary of State to secure the money from his Labour Chancellor.

Through our plans to invest in more capital projects, we also sought to improve cancer diagnosis and treatment. While outcomes have improved since 2010, there is much more to do. That is why we opened 160 community diagnostic centres, rolled out new lung cancer screening programmes, and expanded the use of artificial intelligence to speed up diagnoses. Again, we note the lack of any mention of those centres or hubs, which would reduce waiting lists and speed up diagnoses, in this supposedly independent review by the former Labour Health Minister.

I want a straight answer from the Minister in their winding-up speech on an issue that is worrying families up and down the country. Cancer is the single biggest killer of children under the age of 14. I launched the children and young people’s cancer taskforce, which brought together top clinicians, leading cancer charities and the Government to combat childhood cancer, and improve diagnosis and access to new treatments. Its launch was warmly welcomed by parents and charities, and experts were lending their time to the taskforce for free, yet this Secretary of State has chosen to pause it. Parents and charities including the Teenage Cancer Trust, Young Lives vs Cancer, and Solving Kids’ Cancer UK cannot understand why the Health Secretary has chosen to stop that work. That is his choice, and the Minister must please explain in the wind-ups why the decision was taken to pause it.

The right hon. Lady makes the point that cancer is the biggest killer of people under 40, but glioblastoma brain tumours are the biggest killer of people under the age of 40. What progress has there been in the last 30 years in the treatment and diagnosis of glioblastoma brain tumours?

I think the hon. Lady did not hear me; I said that cancer is the biggest killer of children under the age of 14, not 40. I know only too well how that terrible brain cancer has hurt her family, and the great loss that she has suffered. I know that she has ambitions for the work that we were doing to get cancer treatments, particularly new cancer treatments, as quickly as possible to patients who are getting towards the end of their life. We will of course support anything that the Government do to help people such as the hon. Lady’s sister; again, I come back to the fact that we all want this to work.

I will make some progress, because I know that I am trying your patience, Madam Deputy Speaker.

Lord Darzi says that prevention is better than cure. We agree. The Government say that they are committed to prevention, but actions speak louder than words. Scrapping the winter fuel payment for millions of pensioners will undoubtedly come at a cost to the NHS. The equality analysis estimates that 780,000 of the most vulnerable pensioners who are eligible for pension credit will miss out this winter, and the cut will result in 262,000 pensioners needing NHS treatment because they are living in cold, damp homes, at an additional cost of £169 million in a year. How has the Secretary of State stood by as the Chancellor made that appalling decision, which will affect vulnerable pensioners in his constituency, as well as the NHS?

Finally, we have heard the words that the right hon. Gentleman has used about the NHS in England; it is surprising, to say the least, that he has not used those same words times 100 to describe the state of the NHS in Labour-run Wales. On almost every measure, the NHS performs the worst in Wales, where one in four people is on an NHS waiting list. Wales has the longest waiting times; Welsh patients wait on average seven weeks longer than in England. More than 23,000 people wait longer than two years, compared with just 120 people in England. Given the Secretary of State’s rhetoric about NHS England, why has he not asked Lord Darzi to take a cold, hard look at how Labour has run the NHS in Wales for 25 years?

In conclusion, we Conservatives want to support good reforms and good policies for the better health of the nation, but this backward-looking report will not improve productivity. Headlines will not drive better outcomes for patients, and speeches will not improve the life chances of our constituents. This Government need to move from words to action quickly.

I will be brief. I think there is general consensus on Lord Darzi’s review of the issues facing the NHS, but in spite of what the shadow Minister says, staff morale is low, particularly when compared with 2010. It has never been so low. I express my gratitude to and solidarity with all the staff, clinical and non-clinical, for the work they do.

I will briefly focus on the key drivers. We have heard a little about them from the Health Secretary, particularly in terms of the Health and Social Care Act 2012. I sat on both the Bill Committees. I was aghast, having just come out of the NHS and having faced the issues. I just knew it would be catastrophic, and it was. It had an almost immediate impact on staff morale.

We must also recognise the impact of austerity between 2010 and 2018. NHS revenue budgets grew by just 1% each year—the lowest rate since the NHS was formed. That compares with growth of nearly 4% a year since then. In 2010, the Commonwealth Fund found that the NHS was one of the top-ranking health systems in the world. It was No. 1 for equity in access to healthcare; we are now ranked 10th. If we compare spending on healthcare, we are ranked 26th in the OECD. Austerity impacted not only the overall funding of the NHS, but the funding allocation formulas. The weighting for deprivation was slashed, so areas such as mine received less money, although we had greater health needs. Austerity also had an impact on other aspects of public funding and local government, and metropolitan areas such as mine were particularly badly affected. It stripped the support from people in need.

I came into politics because of a desire to reverse growing inequalities in health and disability. In my constituency of Shipley, there is a 10-year gap in healthy life expectancy between those living in Wharfedale and their neighbours over the moor in Windhill. While lots needs to be done to tackle poor housing and poverty, there are things that the NHS can do. Does my hon. Friend agree that the NHS plan must prioritise prevention, as well as just treating sickness?

As a former public health consultant, I would obviously agree with my hon. Friend. I have similar health inequalities across Oldham. I was about to talk about the impact of other issues, such as social security cuts, which meant greater poverty, including in-work poverty and children from working families living in poverty. That has had a consequential impact on our health as a whole. We have flatlining life expectancy, and in areas such as mine, life expectancy has got worse. That impacts on our productivity and the wealth of our country.

I will briefly mention a couple of points that I know my right hon. Friend the Secretary of State recognises, and might want to consider. An annual report on the state of our health and the state of our NHS, presented to Parliament before each Budget, would pick up on the points that have been raised about cross-departmental impacts on health. We should have a prospective assessment of the impacts of the Budget and the Finance Bill on poverty and inequality, and subsequently on health and the NHS. That can be done; others are doing it. We should have a strategy to identify and address health equity issues in the NHS. We have seen a bit of that through covid, in the inequity around the use of oximeters. We should introduce something like “Improving working lives” for our staff. That had a massive effect on staff when I worked in the NHS. We need a clear commitment to the 1948 principles of the NHS, under which it is funded from general taxation, and a funding allocation based on need.

I call the Liberal Democrat spokesperson.

The findings in Lord Darzi’s report are shocking, but Liberal Democrats—there are many of us here today—find that they echo the hundreds of thousands of conversations we had with people on the doorstep across the country throughout the election campaign. In too many ways, the NHS just is not working as it should, and that is a tragedy, because we all cherish the NHS and want it to succeed. It is one of our country’s greatest inventions and a great Liberal idea. It is one of the things that makes us proud to be British.

We all owe so much to the NHS and the incredible hard-working staff who have kept it going under the most intense pressure imaginable. Despite their heroic efforts, there is no doubt that we have a major crisis in the NHS. Let us not forget, because it is so important—these things are intrinsically linked—that we also have a major crisis in care. The message that the British people sent at the general election in July was clear: fixing the health and care crisis must be this Government’s No. 1 priority.

Before I turn to the Government’s plans, it is worth reminding ourselves of the scale and urgency of the challenge. Far too many people wait weeks to see a GP or NHS dentist, if they can find one. Far too many wait months or even years to start vital treatment for serious conditions. Far too many wait for hours in pain and distress for an ambulance to arrive. I recently spoke to a constituent, Emma, whose 11-year-old daughter Charlotte suffers from a medical condition that means she is red-flagged, or a category 1 priority patient, in the case of a medical emergency. Unfortunately, Emma and Charlotte were recently involved in a car crash. Charlotte urgently needed an ambulance, but after two hours of waiting, her father decided to take her to hospital in the back of his car. She starts her journey to senior school this autumn. Her family have had to devise their own response network to keep her safe and secure, and to allow her to attend school in confidence. Our ambulance service failed Charlotte and her family when they were in crisis, and we cannot let that continue.

The problems do not stop there. Across the country, almost 6.5 million people are stuck on hospital waiting lists. That is one in every nine people in England. Two million of them have been waiting for more than six months. Over the past year, more than 100,000 people have waited more than two months to start cancer treatment after an urgent referral. In my constituency of North Shropshire, almost 20% of urgent referrals took more than 43 days and 10% took more than 62 days. The target is 28 days. It is truly heartbreaking. We know that every day counts when patients are battling cancer.

Young people needing help with their mental health are waiting months and even years to access child and adolescent mental health services. There is no help for them until they are in crisis. As if all that was not bad enough, we have hospitals that are literally crumbling. There is a maintenance backlog of £11.6 billion. Buildings are decades past their use-by date. It is shocking but, as my Liberal Democrat colleagues and I know, far from exceptional. Most of these problems go back decades. The truth is that Governments of all parties have failed to put enough capital investment into the NHS. They have failed to face up to the challenge of an ageing population and, crucially, they have failed to tackle the care crisis, with one honourable exception: the Care Act 2014 was passed by Liberal Democrat Ministers a decade ago, with cross-party support. Sadly, it was ripped up by the Conservative Government after 2015.

The failure and neglect of the Conservative Government left the NHS teetering on the brink. There were so many grand promises—6,000 more GPs, 40 new hospitals and cross-party talks on social care—but they were all fantasies. In Shropshire—which is not an outlier—the Royal College of General Practitioners found that the average GP is seeing 475 more patients than they were in 2016. Patients and their loved ones have been let down so badly.

When the scale of challenges across health and social care is so enormous, it would be easy to succumb to pessimism and defeatism—doom and gloom—but we cannot afford to do that. The patients of today and tomorrow cannot afford for us to do that. This moment demands the same urgency, ambition and vision that drove the creation of the NHS all those years ago. We very much hope that the Government will show that ambition. I welcome the Secretary of State’s recognition of the fundamental importance of shifting more focus to primary care—to GPs, dentists, mental health practitioners and community pharmacists—for our young people.

As the newly appointed Liberal Democrat spokesperson on mental health, I was really concerned to see in the report that mental health is about 20% of the NHS’s burden yet receives only 10% of its funding. Certainly in Winchester—it will be the same for nearly all hon. Members in the Chamber—mental health, and especially the mental health of children, is one of the most commonly brought up subjects.

I know that the Secretary of State agrees that mental health and physical health need to be treated with the same level of importance, but I urge us to recognise that we cannot treat it with the same level of importance if the level of funding does not accord with the demand it is putting on the service. It is not just about funding; it is about making sure that the mental health support that is needed is there in schools, in social care and for people struggling with debt. So many non-medical factors contribute to mental health that we need a cross-departmental look at how we support people’s mental health.

My hon. Friend is exactly right, and we put mental health and access to primary care and health prevention front and centre of our manifesto for that very reason. I encourage the Secretary of State to take our plans where they are complementary to his and run with them. We are happy to have our ideas plagiarised—we will welcome it.

Welcome as that focus is, some of what we have heard gives me cause for concern. First, some weeks ago the Prime Minister suggested that investment can come only after reform. I warn the Secretary of State that I do not think that that will work. The reforms that our NHS needs cannot be done on the cheap. Improving access to primary care means investing in more GPs, more NHS dentists and more community pharmacists. Boosting productivity means investing in better IT systems and bringing hospitals up to date with the new facilities they need. I agree that it cannot be just more investment without reforms, but nor can it be just reform without more investment. We need that investment now. The reports that we have heard of potential cuts to spending in the Budget are deeply concerning. I urge the Secretary of State to guarantee today that they will not happen.

Finally, I am afraid that there still seems to be nowhere near enough focus or urgency when it comes to care. We simply cannot fix the crisis in the NHS without fixing the crisis in care. Right now, more than 12,000 people in hospital are ready and well enough to go home but stuck there because the care they need is not available. That is awful for them and their families, and it is awful for the NHS that 12,000 beds that should be getting used by patients who need them and allowing better patient flow through hospitals are being held up because the care system is in crisis. I urge the Secretary of State again not to put this off any longer but to set up a cross-party commission now so that we can agree a long-term solution to ensure that people get the care they need, when and where they need it, and that carers are properly supported, too.

I support what the hon. Lady is saying about a having cross-party group look at social care, which is a sensible long-term thing that we need to do, and discharges from hospital are an important part of that. Does she agree that discharges from mental health units are also an important part of that? On a recent visit to Basildon hospital, I saw that discharges were not happening in mental health units. That is perhaps as much of an issue in mental health social care as it is in older people’s social care, which the House is more attuned to.

I thank the right hon. Gentleman for his intervention. There is a general problem with care in the community of all types not being there for people. We have people in places where they will not get better as quickly—in some cases, their situation may be deteriorating—because that care is not available. Mental health provision in my constituency is absolutely appalling. People register with a doctor over the border just to access better mental health care. I could not agree with him more.

In conclusion, the Darzi report is shocking, but it is not surprising based on the experience of my constituents. Poor access to primary care—whether that is GPs, dentists or early mental health intervention—is leaving people in pain and distress. Long waiting lists and crumbling hospitals are leaving people unable to get back to work, with their situation deteriorating, and the crisis in social care—the elephant in the room—is depriving people of their independence and leaving them in hospital when they could be at home. The new Government must make fixing the NHS and care their No. 1 priority. Liberal Democrats will be here to provide constructive opposition to ensure that they do.

I call Ben Goldsborough to make his maiden speech.

It is a profound honour to rise as the newly elected Member of Parliament for South Norfolk. The privilege of representing the people of the constituency is not one that I take lightly. I look forward to working with colleagues across the House to ensure that their voices are heard and their needs addressed.

At the outset, I will take a moment to pay tribute to my predecessor, Mr Richard Bacon, who served South Norfolk for over two decades. Mr Bacon’s tireless commitment to the constituency—particularly his efforts to champion the cause of self-build homes—has left a lasting legacy. His work in advocating for those who wish to take control of their own housing future has empowered many in our region and across the country to realise their dreams of home ownership.

One of the joys of representing South Norfolk is the opportunity to stand up for its wonderfully unique places, each with a name as memorable as the community behind it. From Newton Flotman to Saxlingham Nethergate, Tacolneston and the intriguingly named Three Cocked Hat, our constituency is a patchwork of distinct and vibrant villages. It is often said in jest that things are “normal for Norfolk”—we all know what the connotations are—but I want to challenge that label. In fact, if we look closely at what is happening in South Norfolk, we will find it is anything but normal, but in the best sense of the phrase. We are home to some of the most cutting-edge research and innovation in the world, all based at the Norwich research park right in our own back yard. I was so pleased to hear what the Secretary of State said on innovation, science, and research and development because in South Norfolk we have organisations in those fields who will be delighted to hear it.

The Quadram Institute is at the forefront of research into our food science and gut health, shaping the future of nutrition and medicine. The John Innes Centre is world renowned for its plant science and microbiology, the Sainsbury Laboratory continues to lead the way in plant pathology and molecular biology, and there is Tropic—an ambitious company that started in Norfolk which is engineering a new generation of tropical plants, resilient to both disease and looming threats from climate change. Its work is benefiting not just South Norfolk or even the UK; it is having a global impact, ensuring food security and agricultural sustainability for future generations. Heck, Tropic’s work means that in three or more years, we may be eating bananas that were grown in Norfolk—not something that many people would have imagined. Far from being normal, South Norfolk is actually a hub of scientific innovation and global leadership in fields that define the future of our planet. Dare I say, this is something of which we can be tremendously proud.

It would be remiss of me not to mention another gem of South Norfolk: Lotus Cars, which is a symbol of British excellence in engineering. From its headquarters in Hethel, Lotus has been creating iconic sports cars for over 70 years, celebrated for their precision, innovation and performance. Lotus continues to push the boundaries of automotive engineering, with its latest models keeping South Norfolk at the cutting edge of global motorsport and design.

I recently had the privilege—perhaps the thrill—of being let loose on the Hethel test track with the stunning new Lotus Emira. That was my best Jeremy Clarkson impression, by the way. I will not be entering the British Grand Prix anytime soon; I can promise you that, Madam Deputy Speaker. [Hon. Members: “Shame!”] I know. I am pleased to report that both the car and myself, as a newly elected Member of Parliament, left the site entirely intact, much to the relief of the Lotus team, and probably that of local Labour organisers worried about another by-election.

The work done by Lotus is about not just fast cars but pioneering technology that has implications far beyond the racetrack. From lightweight materials to advanced aerodynamics, Lotus continues to be a leader in innovation that drives not only motorsport but the broader automotive industry.

One of the greatest privileges of representing South Norfolk is the opportunity to champion the incredible businesses, community groups and people who make it, in my humble opinion, the best place to live in the country. Let me start with Huggers in Long Stratton, a plant-based coffee shop—yes, you heard me right, and it does sell lovely food—that has taken the town by storm. The millionaire’s shortbread cake there is the best and simply to die for.

Then there is Urban Jungle in Costessey, a haven for those with a love for the weird and wonderful in house plants and tropical plants. After all that plant shopping, Madam Deputy Speaker, you have to check out the fabulous coffee shop. Members may notice that there is a theme with some of these shops.

In Loddon, we have Rosy Lee’s Tearoom, which is a real gem. It is like stepping into a tearoom run by your gran, basically—full of warmth, character and the best tea and cakes around—but more than that it is a hub for the community and a place that cared deeply for those in need during the covid-19 lockdowns, ensuring that no one was left behind in those difficult times. It truly embodies the best of us.

I also want to give a special mention to the Wymondham Community Outreach Project, which is run by Arnie and an incredible team of volunteers. They work tirelessly to ensure that those who are struggling to get by have access to food, clothing and—perhaps more importantly—friendship. Their fantastic book bank ensures that everyone has access to a good book, because they understand that nourishing the mind is just as important as nourishing the body.

Last but no means least is Spurgeons in Brooke. If anyone has not tried its sausage rolls yet, they are missing out, because they are truly extraordinary. The butcher there is second to none and its local produce is some of the best found anywhere in Norfolk. It is businesses like these and the people behind them that make South Norfolk such a vibrant, welcoming and thriving place to live. Each of them contributes to the fabric of our community, providing not just the goods and services but the places of connection and support that bring us together as neighbours and friends.

My values were forged in the heart of East Anglia, shaped by the lessons learned from my parents. My mum Sara, a hard-working shop worker, and my dad Wayne, a stable lad—yes, those jobs still exist in the 21st century—instilled in me principles that have guided my life, which I hope to bring to this House. They taught me the importance of honesty; of giving your all, no matter what the task; and of never losing sight of your aspirations. Perhaps most importantly, they taught me to treat people with respect, whether they are a colleague, a constituent or someone I have just met. These are the values that shaped me, and I pledge to uphold them and serve the people of South Norfolk with them.

As I take my seat in the House, I do so with a clear sense of responsibility and deep commitment to the people of the constituency. There are two areas that I am particularly passionate about and that will be at the forefront of my work in Parliament: standing up for the families of children with special educational needs and disabilities, and seeking much-needed improvements to our justice system.

First, supporting SEND families is a cause close to my heart. Far too often, families face unnecessary battles to secure the right support for their children. The system, which should be there to help, can sometimes feel like an obstacle put in their way, leaving parents exhausted and children without the resources they need to thrive. I will work tirelessly to push for reforms in SEND provision so that it is fair, timely and accessible. Every child deserves the opportunity to reach their full potential and every family deserves to be heard, supported and empowered.

Secondly, I am deeply committed to the reform of our justice system. While we can be proud of many aspects of British justice, there are still serious issues that need to be addressed. Victims of crime too often feel let down by delays and an overburdened system, and communities are frustrated by the lack of swift and fair outcomes. I will work to ensure that our justice system prioritises victims’ rights, tackles delays and restores public confidence. We must also ensure that rehabilitation and reformation are at the core of our system, so that those who have served their time have real opportunities to contribute to society once more. These are the challenges that I intend to take with me on this journey through Parliament, and I look forward to working with colleagues across the House to make them a reality.

I believe that South Norfolk has a bright future, and I am eager to work with colleagues in Government to ensure we address the pressing issues of our time, from housing and infrastructure to education and healthcare. The people of South Norfolk deserve no less than our full commitment, and I pledge to give them just that.

Order. As the Front-Bench contributions went on for so long, Back Benchers will now be limited to three minutes, and I ask that maiden speeches be limited to five minutes to squeeze in as many people as I can. I call a tieless Dr Luke Evans.

Thank you, Madam Deputy Speaker. I have removed my neck collar, which I am allowed to do, but if Members see my head wobbling, I ask them to intervene and I will put it straight back on. I welcome the hon. Member for South Norfolk (Ben Goldsborough) to his place. With the respect that he talks about and commands, I am sure he will be an asset to the House.

I come to the debate with a slightly unique perspective, and three minutes is very little time to make my point. I have been a doctor since 2007; I sat on the Health and Social Care Committee for three years; and, most recently—and probably most obviously—I recently had spinal surgery on my neck. However, that is not my only foray into the NHS: I have had both knees and my shoulder operated on and my appendix out, and I ended up in intensive care with bilateral pneumonia after that, so I have seen a fair amount of it.

The bionic man.

Absolutely. In this debate, health is a political football. It always strikes me that there is a rising tide across the western world, and at the four points of the nation. In Scotland, the NHS is run by the SNP; in Wales, it is run by Labour; in Northern Ireland, it is also separate; and we had the Conservatives, who have now handed it over to Labour. All of them are struggling, and we would do well to remember that. I came into politics not to change the world but to solve that—that sounds cheesy. In my last two minutes I have a set of suggestions—as any good doctor would do, I will look at the short term, the mid term and the long term—to try to improve it.

We could start with a root and branch review into prescribing, which is one of the most wasteful things in the NHS. On top of that, it is worth looking at the European working time directive, which hampers doctors when they study. Overnight, that could increase the ability to see more patients by a couple of percentage points. I spent nine months waiting for my operation, and there were a number of appointment letters. I had the ability to understand them and work my way through them, but a root and branch review of communications—the simple bread and butter of the NHS—would be very welcome. Comparable data across the nations, to see what goes on, is so important.

For the medium term, I would like statementing when people go into the NHS. Everyone knows how much it costs when they go to America—£40,000 for a ski accident. It costs that much here, and people would do well to remember that when they do not turn up to their appointments. On the IT system, we focus a lot on patients but I would like more focus on the staff and how they can use IT. I would like capping of GP lists—a sensible way, now that we have a workforce plan in place, to grow our staffing.

Finally, for the long term, in the 20 seconds I have I suggest a national service for SEND, taking education and health together to deal with mental health. Some 40% of the child and adolescent mental health services referrals in Leicestershire relate to autism and ADHD. That is a real problem that could easily be solved. In my final five seconds, I suggest an NHS centre for clinical excellence to share best practice. It is not good enough.

It is a pleasure to follow the hon. Member for Hinckley and Bosworth (Dr Evans).

The report is a tour de force from Lord Darzi, and I thank him for his work. The Secretary of State rightly commissioned the report as a benchmark for future improvement. I was a member of the Health Committee from 2010 to 2015. Given the evidence we heard, there was no alternative but to pause the Bill—the Committee played an important role in that. Chapter 10 of the report sets out the structure. Lord Darzi points out that the 2012 Act was three times the size of the original Act setting up the NHS. The 2022 Act moved into integrated care, and in paragraph 15 on page 121, he raises some concerns about how the ICBs—integrated care boards—operate, and their accountability. Could there be a review into how they operate? Paragraph 37 highlights that trust chief executives’ pay is based on the turnover of the organisation, which encourages trusts to

“grow their revenue rather than to improve operational performance.”

Some are even paid more than the Prime Minister.

The flow of patients is important, which is where working with local authorities is so important. We can move planes around the world, but it seems we cannot move people out of hospital. The Select Committee visited Torbay, which was set up in 2009. We followed Mrs Smith from a single point of contact all the way through. As Lord Darzi said on page 77, collaboration is not the same as integration. On page 5, paragraph 13, he points out that too great a share of the money is spent in hospitals rather than in the community. On page 81, he said that “GP…contracts are complex” and doing the right thing for patients is the wrong thing for GP income. He said, “That cannot be right.”

Our mantra should be “prevention, prevention, prevention”. In our report, we said that public health should be moved into local authorities. As Lord Darzi said, health visitors are dropping. He also said that the NHS is missing an opportunity to intervene early. We had Sure Start, which is where health visitors were focused. He talked about clinical negligence. Some £2.9 billion— 1.7%—of the budget is spent on settling claims. Can the Secretary of State pursue the duty of candour and ask each trust to look at whether they can move cases into arbitration?

Sadly, disparities by ethnicity make very grim and sad reading. Paragraph 24 refers to the median age at death as 62 for white people, 40 for black people, 33 for Asian people and 30 for those from a mixed background. There was supposed to be a chart in the report, but it is not there. Will the Secretary of State look at producing it?

Lord Darzi’s report gives the Secretary of State and the health team an important opportunity to re-set the NHS. It is the envy of the world and free at the point of use. As Lord Darzi said, we cannot afford not to have an NHS.

I call Monica Harding to make her maiden speech.

Thank you, Madam Deputy Speaker. It is a true privilege to be standing here among the green Benches, not only as the Member for Esher and Walton but as the first Liberal MP for my constituency for over 100 years, and its first female MP.

The biggest issue on the doorstep in my constituency is undoubtedly the state of the NHS, so I am pleased to make my maiden speech in this debate. First, however, it would be remiss of me not to point out that Esher and Walton are only two of the towns I represent. My constituency also includes the Dittons, the Moleseys, Claygate, Hersham, Hinchley Wood and Oatlands. I am proud to have called it my home for almost 20 years and it is where I raised my four children.

My constituency is also the playground of the kings and queens of England. Esher and Walton spans the former hunting estate of Henry VIII, which stretched from Thames Ditton to Oatlands Palace, where his daughters Mary and Elizabeth sometimes resided and Charles I was imprisoned. As a result of Henry’s forest, our constituency is almost 60% green-belt land. In the Government’s planning reforms to provide the homes we desperately need, these areas must also be protected.

It was the ease of travel to London via the River Thames, when boats were faster than horses, which led the monarchs to Esher and Walton. Sometimes, our trains into London feel as slow as being on horseback. I look forward to pushing for improvements to our railways, but we are a river community. The Thames provides our border with London, and the chalk stream, the Mole, runs through our constituency and is now one of the most polluted rivers in England. My constituents are so exercised by the sewage pouring into our rivers that they have been explicit about sending me to this place to help sort it out.

Our rowing clubs share their disquiet, not least because they do not want their Olympians getting sick. Molesey boat club sent four members to Paris this year, as did Surbiton hockey club—it is actually in Long Ditton—which sent 11 and has over 1,000 youth players. Every weekend in Esher and Walton, grassroots youth football clubs gear up to welcome over 5,000 players registered. The great Walton and Hersham FC boasts the youngest owners in world football, and so interlinked is football in our community that the five Claygate Royals youth teams are named after Claygate’s five pubs. We are a hub of children playing sport, which matters for their health and wellbeing, and that brings me back to the debate.

Madam Deputy Speaker, I want to tell you a story from my constituency. During the general election campaign, I met on the doorstep a couple unloading their car. I apologised for disturbing them as they were unpacking their shopping. “Not shopping,” they replied, “We are unpacking our son’s belongings. He died.” They went on to tell me that this young 19-year-old man had taken his life while at university. “He met you,” they told me. “He said he would vote for you because you were speaking out on mental health and special educational needs support for young people.”

His mother told me that she counted herself lucky that she had managed to support her son for the years at school because she could afford interventions and therapy. She worried about those children stuck on NHS waiting lists unable to access the support that he had had. In Surrey, there are almost 7,000 children on mental health waiting lists, with average waits of almost eight months. I meet parents on the doorstep whose special needs children are at home, rather than at school, for months and sometimes years, sliding into depression because they cannot access adequate provision.

I promised that young man’s mother that if I was elected I would continue to shine a light on this issue, and I can think of no better way to do so than in this debate. Our children and young people are in trouble, and we must fix it. As a start, we need to put mental health care on an equitable footing with care for physical health. In 2024, that is long overdue; let this new Parliament be the start of it.

I am, of course, very aware that I stand here on the anniversary of the 7 October attacks. I want to add my voice in remembering all those who have lost their lives or are still held hostage, and those across the region who are displaced and suffering or have been killed. As the new Liberal Democrat spokesperson on international development, I urge the Government to use all their levers to get humanitarian aid into the region as winter approaches. I will be pushing this House to renew our leadership in international development by restoring the 0.7% commitment of gross national income to UK aid.

My constituents are outward-looking. They are used to having a Foreign Secretary as an MP in my predecessor Dominic Raab, and I pay tribute to his work—particularly his introduction of the British National (Overseas) scheme, which my party had long called for and which has given my constituency a wonderful new British Hong Kong community. Following 15 years working overseas, I am committed to contributing to the resetting of our standing in the world, recognising our international obligations and participating fully in our international institutions, which will include restoring a closer relationship with our closest neighbour, Europe.

I bring to this House the brilliance of the people of Esher and Walton, and their struggle. As someone once said, politics done well changes lives. It saves lives too, and, in this still new Parliament, I intend, with hon. Members and Friends, to set to work.

I call Terry Jermy to make his maiden speech.

I am delighted to follow the hon. Member for Esher and Walton (Monica Harding), and my hon. Friend the Member for South Norfolk (Ben Goldsborough), to whom I am physically close in the Chamber and geographically close back home in Norfolk.

I am delighted to be able to deliver my maiden speech as the new Member of Parliament for South West Norfolk. I have the pleasure of representing this fantastic part of the country—the place where I was born, and where I went to school and college, bought my first house, and started my business. Until a few years ago even keen political observers could have been forgiven for not quite knowing exactly where South West Norfolk was, but I can certainly pay tribute to my predecessor, the right honourable Liz Truss, for putting us firmly on the map.

Our largest market town is Thetford, where I am from and where I had the honour of serving as mayor. Some Members may be familiar with the popular “Dad’s Army” series, which was largely filmed in Thetford—we are the original Walmington-on-Sea. If Members ever get the chance, the Dad’s Army Museum is well worth a visit, and no trip to Thetford is complete without being photographed sitting next to our life-size Captain Mainwaring statue. There are a number of “Dad’s Army” quotations that I am sure will be relevant to my role in this place. I have already said to myself many times, “Don’t panic, don’t panic!”, but I sincerely hope, Madam Deputy Speaker, that I do not give you cause to address me as “You stupid boy!”

South West Norfolk is beautiful. We have wide-open fields, forests and rivers, and a fantastic history. However, as in so many rural areas, under the surface there are challenges. I am acutely aware that one third of all children in South West Norfolk live in poverty, and there are parts that are in the top 10% for indices of multiple deprivation. Health inequalities persist, with Norfolk regarded as a dentistry desert. There is a crisis in adult social care, with far too many examples of poor-quality care provision. We have a mental health trust with long-standing challenges and placed in special measures, and the Queen Elizabeth Hospital in King’s Lynn is riddled with reinforced autoclaved aerated concrete, literally held up by more than 5,000 metal and wooden props. The challenges are stark, and these are some of the many issues on which I have pressed the Government and will continue to do so.

I think it is fair to say that I was not expecting to win my election. As a result, there are many people wondering, “Who is this person from South West Norfolk?” I do not come from a political family, but I care passionately about my local community, which is why I decided to put myself forward and join the local town council aged 22. I have taken advice and guidance from many fellow councillors over the years, but one lady in particular, Thelma Paines, mentored and guided me, and I owe much of my political upbringing to her. Sadly, Thelma passed away in 2022 and therefore did not see me reach this place, but I certainly would not be here without her encouragement and support. When she stood down as a local councillor, she would still telephone regularly, with her customary, “Listen up, duck; I’ve got something to say.”

While mentioning role models, I must take a moment to mention Baroness Gillian Shephard, our Member of Parliament from 1987 through to 2005. If there is one local MP I would like to emulate, it would be her—a fantastic example of a good constituency MP who was knowledgeable of the area and rooted in the community.

Being a Labour councillor in rural Norfolk can be tough. Fortunately for me, I had family on my side—yes, of course with support and encouragement, but I had an advantage over my rivals. My dad was the youngest of 13, and my mum had seven brothers. With nearly 40 aunties and uncles, and over 100 cousins, I am sure that I owe at least my first election victory to my grandparents’ love for one another and the resulting votes some years later.

It is because of my experiences with my own family and, more specifically, with my father that I made the decision to switch from being a local government candidate to standing for the first time in a national election. It is entirely appropriate, but also somewhat difficult for me, that I find myself here today delivering my maiden speech in a debate about our NHS. In 2013 my dad, Trevor Jermy, had a life-altering stroke aged just 55. He was an engineer. He worked hard from the day he left school at 15 and became an accomplished welder fabricator. Frankly, there was not much that my dad could not fix.

Strokes come in all shapes and sizes. My dad, having shown no warning signs, suffered a major stroke. The physical aspects were painfully easy to see and difficult for a man so used to using his hands, but there was psychological damage too. As a family, we saw up close and over a number of years the awfulness of the current process for applying for personal independence payments, dehumanising work capability assessments and how little we as a country value the contribution of carers. Disabled people and their families continue to come under repeated attack, most recently in Norfolk with changes to the minimum income guarantee.

After 10 further years with my dad, he became unwell. We tried to get him a GP appointment, which, as for so many, was difficult. When we eventually managed to get him in front of a doctor, he was sent straight to A&E with pneumonia. Then he contracted covid. The pneumonia, combined with covid, was too much for his already fragile state, and he was placed in a medically induced coma. As a family, we spent every day for the following two months visiting my dad in intensive care at West Suffolk hospital. Because of the infection risk, he was in a quarantined room and only one of us was allowed in each day for a maximum of an hour, and in full personal protective equipment. His 65th birthday passed, as did Christmas and new year. When the time came to try to wake him, we were devastated to discover that he had had a further stroke while in the coma. Some more weeks passed, but my dad never regained the cognitive and physical abilities that he had just a few months earlier, and he passed away on 29 January 2023, aged just 65.

During the long time that my dad spent in hospital, I saw painfully up close so much of our NHS. I saw ambulances routinely queuing up, the accident and emergency department always busy, and the hospital buildings looking old and tired. I saw how few staff were available during the week, and at weekends the situation was worse. I saw how his catheter bag was left for longer than it should have been, and of course, I saw the impact of this whole nightmare on my mother and the rest of our family. It was at that point that I decided that enough was enough and that, if I could, I should try to do something about it. That is when I decided to stand—not particularly because I wanted to win, but because I wanted to raise the issues. I wanted someone to acknowledge how bad things had become and how we could not carry on like this.

I have been struck by the majesty of this place since I was elected; it is utterly awe-inspiring, and I do not think I will ever quite get used to it. For all the pomp and the politics, this role carries with it a huge burden and a huge opportunity. We cannot fail to succeed. We must do better. We must at all times remember why we are here, because people in this country, particularly the most vulnerable, are absolutely relying on us to succeed, and I hope to do what I can to make their lives that little bit better.

May I start by congratulating the hon. Member for Esher and Walton (Monica Harding) on her deeply affectionate speech? Her constituency is a place that is close to my heart, my grandparents having resided in Claygate for a number of years. I also congratulate the hon. Member for South West Norfolk (Terry Jermy), and I am sure his father would be hugely proud of how he spoke with great affection for his home constituency.

On 5 July this year, 76 years to the day since the NHS came into being, my mother was involved in a serious road traffic accident. But for the skill and care of the health service, she may well not have survived. Many of those who cared for her were my former colleagues in the major trauma service at University Hospitals Birmingham. I know that the care they provided was not an exception; it was not a case of going a little further for a former colleague. No, this was yet another example of the brilliant and dedicated care that our healthcare professionals provide every day.

While we rightly acknowledge and praise the endeavours of all our healthcare workers, we must not put the NHS on such a pedestal that it becomes a sacred cow. While we can all appreciate the hard work and dedication of our NHS staff, it would be unwise and a mistake to construe those same workers and the institution as one and the same thing. There is a real risk that such a religious fervour develops around the institution of the NHS that its growth and development are stifled. We have reached a point where any constructive criticism of the organisation is deemed to be levelling the same criticism at the staff who keep the wheels grinding through every shift.

The NHS was built to provide episodic acute care. Now it is heavily dominated by the management and treatment of chronic conditions. The hospital-centric model that presently exists is arguably outdated, and a paradigm shift to a more preventive, community-based model should be pursued. For far too long it has been the workforce who have risen to the challenge, rather than the organisational structure itself. The principle that our health service should care for everyone regardless of their personal wealth is profoundly important. To undermine that would be to disrupt the foundations upon which it is built. However, we would be doing the NHS a disservice if we failed to have an honest debate about how we improve it.

In the short time that I have remaining, I wish to raise the issue of the over-centralisation of decision making. We have ended up in a position where clinicians and managers on the frontline are less empowered and trusted to make decisions and deliver for their patients. Too many decisions are made at the centre, which leads to overly complicated and often conflicting layers of approval and process. Ultimately, by enabling risk to be held by other parts of the system, local decision makers will be more empowered, decisions will be made in a more timely manner and a greater sense of trust will be established.

Members from across the House will have their own experience of the NHS, but in my case, after caring for my late sister Margaret, who was diagnosed with a glioblastoma brain tumour in 2021, I can say with regret that the NHS failed her, forcing us to travel to Germany when she was at her sickest in order to find some treatment that might extend her life.

In his summary letter published before the report, Lord Darzi told us that he was “shocked” by what he had found, but the 3,200 people who are diagnosed with a glioblastoma brain tumour every year are not shocked. They know just how bad things are. The report has told us that the UK has higher cancer death rates than our European neighbours. For patients with a glioblastoma brain tumour, that is news to no one. In comparison to 33 similar countries, the UK ranks 25th for five-year survival rates. Life expectancy for somebody diagnosed with a glioblastoma is just nine months. There has not been a new treatment in the NHS for more than 30 years, and the diagnosis is still a death sentence.

In 2018, after Tessa Jowell sadly passed away with a glioblastoma, £40 million of ringfenced Government funding was promised for brain tumour research. Of that £40 million, just £11.3 million has been spent. Six years on, and the National Institute for Health and Care Research cannot even get the money out of the door. That is a real failure of Government. In June 2024, just before the election, a roundtable discussed how to spend £15 million of this money, and I have been trying to find out what it decided. Last week, I received a letter from Professor Lucy Chappell, the NIHR’s chief scientific adviser. Disturbingly, she told me that the NIHR largely funds research based on the importance of the topic to patients and health and care services, value for money and scientific quality, but it does not

“allocate funding for specific disease areas.”

The pharmaceutical industry does not work on glioblastoma. If the NHS also does not, who will? Do we keep on baking cakes?

I have worked in healthcare for most of my career and, as I said in my maiden speech, I think we need an honest discussion with the public about how we fund, provide and deliver healthcare in England. I worked in the NHS for seven years prior to my election, and I worked every day to improve clinical outcomes and patient care, including in the surgical hubs mentioned by the shadow Secretary of State, my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins).

I can assure the House that, although it has significant challenges, the NHS also has significant opportunities, including the opportunity for us to reshape it not only to meet the needs of today but to ensure its survival for future generations. Lord Darzi’s report, like many others, makes it clear that, although it is not broken, the NHS is at a tipping point. His report is wide-ranging, but it could not cover everything. For example, post-natal female care received little attention, but it is essential to ensuring a universal standard of post-birth care for mothers and children.

Despite significant investment from the previous Government, we must be honest with the public not only about the true state of the health service, both nationally and locally, but about the difficult choices that lie ahead. First, we need to rethink how we deliver healthcare closer to home and more efficiently. Expanded partnerships with the private sector, whether in diagnostics, elective surgery or mental health services, can relieve some of the burden on NHS facilities. By fostering public-private partnerships, we can enhance capacity and efficiency while ensuring that the NHS remains free at the point of use.

Technology and innovation are essential to transforming the NHS. Artificial intelligence, digital records and telemedicine have enormous potential to improve outcomes and reduce costs, but the NHS lags behind in digital transformation—the catastrophe of Labour’s IT system casts a long shadow.

Equally, we must have an honest conversation about patient choice and responsibility. The NHS has historically promised to be everything to everyone, but we must ask ourselves if this is realistic. Encouraging patient choice could drive competition and improve service delivery, but we also need to ask patients to take greater responsibility for managing their health, particularly in areas such as preventive care and chronic disease management.

Finally, funding is key to this debate. For too long we have relied on promises of increased funding without fully grappling with how we can sustainably finance the NHS. More money is part of the solution, but where should that money come from? I want an NHS that is free at the point of use, but we need to explore social insurance models, encourage private investment or potentially increase taxes. These are tough questions, but they must be answered. We need a radical rethink of NHS bureaucracy.

In conclusion, although the NHS is one of the major achievements of our time, now is the time to take action to reform it.

I call Ian Sollom to make his maiden speech.

I congratulate the hon. Member for Gloucester (Alex McIntyre) on an excellent maiden speech. He packed an awful lot into just over five minutes and set the bar very high for me. I am aware that I am being watched by you, Madam Deputy Speaker.

It is an immense honour and hugely humbling to address the House for the first time as the first ever MP for St Neots and Mid Cambridgeshire. The new constituency perfectly encompasses the heart of Cambridgeshire. It has countryside that includes some of the most fertile farmland in the UK and the rich ecology at the edge of the fens. It mixes ancient and rural villages with new towns and new communities—and, of course, there is the magnificent market town of St Neots, the largest town in Cambridgeshire. It is a source of great pride that our town has been recognised in the name of a constituency for the first time. Having been entrusted with making that newfound recognition count, I am sure that the House will appreciate hearing a great deal more about St Neots from me over the coming years.

St Neots, which sits alongside the Great North Road, gained its name as a site of pilgrimage. We have welcomed visitors throughout the centuries. In recent times, the whole constituency has gained a proud record of welcoming those who have chosen to make it their home, particularly those who moved from the London overspill to St Neots and the new village of Bar Hill in the 1960s. There are also more recent major developments on the eastern edge of St Neots and the northern edge of Cambridge. There is the new town of Cambourne, which celebrates its 25th birthday this year, and the even newer town of Northstowe, which will become the largest new town in the UK since Milton Keynes. It is exciting to see new residents shaping vibrant communities, creating new traditions and supporting each other.

In a very literal sense, these new communities are why I am here, representing a new constituency, and why I pay tribute not to one predecessor but three: Jonathan Djanogly, Lucy Frazer and Anthony Browne. They all served the communities in my constituency that they represented with dedication and commitment, and served our national interest as, at various times, Members of the Government.

My being here also starkly highlights some incongruities of growth in Cambridgeshire. In creating my constituency, and taking the number of Members representing Cambridgeshire and Peterborough from seven to eight, Parliament has deployed more democratic resources to Cambridgeshire. However, many other resources remain unchanged or lag far behind where they ought to be, whether that is funding for the police, fire and rescue services, education, social or council services or, most pertinently in this debate, health services.

Lord Darzi’s report pulls no punches in articulating the dire state of the national health service, but in St Neots and Mid Cambridgeshire, the problems are exacerbated by a funding model that has taken little account of the growth in our population. That is felt most acutely in primary care services; it is really challenging to get access to GPs and dentists. I urge the Secretary of State to put that right at the earliest opportunity. Moreover, I urge him to follow Lord Darzi’s recommendations by piloting new, innovative multidisciplinary models for neighbourhood care in the NHS in our new communities in St Neots and Mid Cambridgeshire. Such innovation is something that my constituency would surely welcome, and as a scientist by training, I would welcome it, too.

I have focused in this speech on my constituency and my constituents, because it is my greatest source of pride to represent them here, but my background in physics—I have a PhD in cosmology—is something that I am also proud to bring to this role, even if I did think that I had left the study of black holes behind me some time ago. I am of course already the longest-serving member for St Neots and Mid Cambridgeshire, but I hope that the dedication, integrity and judgment with which I have pledged to serve my constituents will see me hold that record for a considerable time to come, making a real difference to the people of my constituency, and working with Members across this House to make a difference to the whole of the UK.

Is a real pleasure to follow the new hon. Member for St Neots and Mid Cambridgeshire (Ian Sollom). I am sure that he will be a rising star on the Liberal Democrat Benches. It is a pleasure to follow all hon. Members who have made their maiden speech today.

I am really grateful for the analysis that Lord Darzi has set out for us. The NHS has never been under such duress, nor have its staff, but following a diagnosis, we need a prescription. That is what I want to talk about today. We live in an ageing society, and while we celebrate the medical advances since Labour was last in power—in diagnostics, treatments, digital and technology—we know the urgency with which we need to apply them. Transformation has to be central to the agenda. I congratulate the Secretary of State on his focus on the NHS bringing about the transformation that is needed.

However, before we can look at that, we need to look at the financial flows in the NHS, which are not working, and the governance structures. I am not talking about reorganisation; I am talking about having one controlling mind in the right place in the service, overseeing the system. At the moment, there is too much focus on secondary care. That is sucking resources and work into that part, and driving inefficiency. Moving services into primary care is the key to unlocking the productivity and savings that are needed. It will improve health as well.

In the short time that I have, let me point to two examples in my community. First, in mental health, 30 Clarence Street is set up to be open access, so that there are no more long queues to see mental health practitioners, and multidisciplinary, with the public sector and the voluntary sector working hand in hand to meet people’s needs. I invite the Secretary of State to come and see that service, because it is what we should be doing across our NHS. Two more hubs are to be set up in my constituency, leading the way on mental health. Then there is the work of Nimbuscare in primary care settings; it is pulling out from the NHS all the services that do not need to be in the secondary part. It is unplugging the backlog at the front door of the health service, while ensuring that we are looking after people at the back door. That is the transformation that our health service truly needs. I wanted to share those examples, and set out how they can be extended to build the NHS of the future.

I call Susan Murray to make her maiden speech.

Thank you, Madam Deputy Speaker, for calling me to make my maiden speech. It is a pleasure to speak after the many excellent maiden speeches we have heard, including from the hon. Members for South Norfolk (Ben Goldsborough) and for South West Norfolk (Terry Jermy), my hon. Friend the Member for Esher and Walton (Monica Harding), the hon. Member for Gloucester (Alex McIntyre) and my hon. Friend the Member for St Neots and Mid Cambridgeshire (Ian Sollom). That took a bit of time, but it is important that those excellent speeches are acknowledged. I enjoyed listening to them all.

It is a great privilege for me to stand here today representing Mid Dunbartonshire, and the communities that are close to my heart. I have lived there for 30 years, and it is where both my sons went to school. Mid Dunbartonshire is in Scotland, in case Members had not noticed. It is a new constituency, following boundary changes this year. It sits 100% inside the East Dunbartonshire council area, as did the old constituency of East Dunbartonshire, but it now includes Lennoxtown and Milton of Campsie to the north and some of Lenzie to the east. I am delighted that these towns are now in the constituency I represent, but my sorrow is that it does not include Kirkintilloch East and Twechar, which are also dear to my heart and where I have been a councillor since 2017. I am sure that the hon. Member for Cumbernauld and Kirkintilloch (Katrina Murray) will look after the community there, and it was good to hear her highlight the problems with local bus services in her maiden speech.

It goes without saying that Mid Dunbartonshire is the best constituency in the UK. Local towns are regularly promoted as the best place to live in the UK—Bearsden in 2021 and Kirkintilloch in 2024—and in 2017 “Woman’s Hour” revealed East Dunbartonshire as the best place in Britain for women to live. Incidentally, that was when Jo Swinson began her third term as the Liberal Democrat MP for East Dunbartonshire, so I thank Jo for all her work in the constituency. I also want to recognise her successor, Amy Callaghan, and particularly the personal challenges that Amy overcame during her time as an MP. She has shown such courage in her service to the community, and I wish her well in the future. I also thank Stuart McDonald, who was the MP for the newer part of the constituency. I know that he is held in very high regard and with much affection in that area.

I am pleased to speak in the debate on Lord Darzi’s report, because I know only too well the challenges that individuals and families have to face when our health lets us down. In 2006 my husband had a brain haemorrhage, which changed our lives in an instant. I became his full-time carer and could not continue in my profession, and he was never able to return to his career. From being comfortably off, life changed to watching every penny. Without the support of our family, we could have lost our home, and we were very fortunate. Friends and our community helped me to survive and get on with life. I cannot praise NHS Greater Glasgow and Clyde enough. My husband spent months getting well enough to come home from hospital. Perhaps we were lucky with the timing, because at that time the excellent, talented and caring staff had the resources, which I have seen decline ever since.

I worked in the NHS before a career in medical marketing. I know the NHS from working in it and with it, and from my experience of visiting my husband. Latterly, I have been aware of the integration of health and social care through my role on the council. I know the pressures that good, kind, caring professionals are under to become as efficient as possible, and they are absolutely doing their best.

Looking back, that was the beginning of my involvement in politics. I was thrown into the space that our society refers to as “community”. I know why it is important for Government to fund local authorities and communities and to give them real power. They prevent costs to the NHS every day by stopping the revolving door of treatment, discharge home and relapse back into treatment, and they support self-care and wellbeing. They are our CPS—not the Crown Prosecution Service, but our community prevention service, which pays back investment in spades by preventing costs.

What makes Mid Dunbartonshire special is its people and communities. Like in other places, during covid the community stepped up to support each other, and groups are still helping with shopping and patient transport. There are groups of volunteers fighting climate change, reducing social isolation, providing mental health support and peer support, supporting carers, providing financial advice, helping with housing problems, looking after community buildings, preserving our heritage, knitting for peace, and promoting fair trade, performance art and more—tackling problems at home and internationally. Mid Dunbartonshire people care and take action. From listening to other maiden speeches, I know that that is happening all over the UK. Liberal Democrats want to harness that power for good.

One message that came across loud and clear on the doorsteps was that residents in Mid Dunbartonshire are tired of voting against things; they want to vote positively for things. Thomas Muir of Huntershill in Bishopbriggs was a famous son of Mid Dunbartonshire. At the end of the 18th century, he was a strenuous advocate of equal representation of the people in the House of the people, where I stand today. He said:

“I have devoted myself to the cause of the people. It is a good cause. It shall ultimately prevail. It shall finally triumph.”

The fight for fair votes prompted revolution at the end of the 18th century, and Thomas Muir was found guilty of sedition and transported to Australia for his efforts. In the 19th century, it took three reform Acts of this House to slowly extend voting rights for men. In the 20th century, the Representation of the People Act 1918 gave voting rights to some women and to men aged over 21. But it was not until 1928 that all adults had the right to vote. Today, in the 21st century, the call for better democracy continues.

The turnout in Mid Dunbartonshire at the last election was almost 72%, but many constituencies had a turnout in the low 40 per cents. The result shows a clear failure to engage a huge number of voters. I call on the Government to consider carefully the mandate that the result gave them, to treat every potential voter with dignity and respect, and to make the change to give every vote an equal weight, no matter where it is cast. This is an opportunity to end self-serving and self-obsessed politics, and to truly introduce the politics of service.

I will join my colleagues in this place in scrutinising Government proposals and working constructively with them to improve the quality of life for my constituents and all residents of the UK who make up the rich diversity of our communities.

I call Luke Murphy to make his maiden speech.

Thank you, Madam Deputy Speaker. It is an honour to rise today to deliver my maiden speech as the Member of Parliament for Basingstoke. I congratulate the hon. Members who have made their maiden speeches today, not least my hon. Friend the Member for South West Norfolk (Terry Jermy). His dad would be very proud.

I recognise the work of my predecessor, Dame Maria Miller, who represented Basingstoke for 19 years. Dame Maria was the first woman to be elected to Parliament in north Hampshire, and she worked hard to see more women sitting on these green Benches and to promote women in all walks of life. Nationally, as Minister for Women and Equalities, and as Chair of the Select Committee on Women and Equalities, she worked to champion shared parental leave, flexible working and support for transgender rights.

In the early hours of Friday 5 July, Basingstoke made another first by voting for change and returning its first ever Labour Member of Parliament. That is not a privilege that I will ever take lightly or for granted, but it is one that I am committed to making the most of for the constituents, town and villages that I represent—and for the country, too. I will support the new Labour Government in delivering the change that people voted for, not least on the subject that we debate today: our NHS.

Nor is this a privilege that I would ever have expected growing up. It is true that my grandparents rubbed shoulders with Members of this House and the other place—including Harold and Mary Wilson, one of Mr Speaker’s predecessors, and various Lords and Ladies—but that was because my grandparents cleaned the mansion blocks in which they lived on Victoria Street. I hope to do Bessy and John Murphy and Elsie French proud. It is because of their extraordinary hard work and that of my parents, Liz and Sean—a carpenter and an IT manager who left school at 15 with no qualifications—that I have been able to make it to this House today.

My parents’ hard work and dedication to my sister’s and my education ensured that we were the first in our family to go to university, and we have both sought to ensure through public service that others are offered the same opportunities. My sister Jude served as an Army officer, doing two tours of Afghanistan, and now I am serving as the first ever Labour MP for Basingstoke, because I have always believed that it is Labour Governments who have done the most to ensure opportunity for all. I firmly believe that people in Basingstoke voted for their first Labour MP this year for the same reason that so many people chose to move to our town and the surrounding villages: because they sought better opportunities for themselves and their families.

Basingstoke has long been favoured as a place to move to for families and businesses alike because of its location and good transport links. Around the town, the constituency boasts delightful countryside and picturesque villages such as North Waltham, Deane, Oakley, Steventon, Malshanger and Wootton St Lawrence, and it has a long and proud history. Our market, held every Wednesday, was fixed by a royal charter over 800 years ago. The town had an important role in the civil war, with Oliver Cromwell himself turning up to end a siege, and Jane Austen danced at assemblies held locally. She would no doubt have been proud of the work of fiction we heard from the Opposition Benches earlier, though I doubt she ever had to undertake such a rapid edit of a piece of work as I have this evening.

Basingstoke has also suffered moments of notoriety. In the late 1600s, it was for burying the same woman alive twice—a lesson for us all in this House to never write off our opponents, lest they make a stunning comeback—but it was the Basingstoke riots of 1881 that made national news, after a group rioted against processions of the Salvation Army because they feared its clampdown on what it called the demon drink. Those riots led one newspaper to describe Basingstoke as a

“benighted little town which appears to be chiefly inhabited by a race of barbarians”.

That episode perhaps provides some valuable lessons for today: do not believe everything you read in the papers, and consider any public health measures wisely. I am sure the Health Secretary is listening keenly.

Since the 1960s and the planned London overspill, Basingstoke has been transformed almost beyond recognition from the old market town. Now effectively a thriving new town, Basingstoke is home to many significant businesses and world-class employers including the AA and Eli Lilly, but it is not just the big players: from renewable energy start-ups such as Tomato Energy to independent coffee shops and restaurants such as Willows and the Gabardine, thousands of small businesses form the backbone of our economy, powered by the institutions that are shaping the minds of tomorrow, including Queen Mary’s college and Basingstoke college of technology.

One of the key strengths of Basingstoke is its sense of community and the diversity within the town. We have vibrant and active Hindu, Nepali and Irish communities, and that strong community spirit is also evident in the incredible work of our local charities and voluntary organisations, such as Home-Start, Basingstoke NeighbourCare and the Café Dome. It is their passion, dedication and generosity that make Basingstoke such a special place to live, and I pledge to support their efforts in any way I can.

Nowhere will I work harder than in support of our NHS, the subject of our debate today. I have seen at first hand the power of the NHS and the increasing strain, mismanagement and decline of the past 14 years. My dad has relied on the NHS for almost his entire life: diagnosed with type 1 diabetes at the age of 17, he has suffered with complex and chronic illness, especially in recent years. I have seen the NHS at its best, saving his life twice after two stays in intensive care just last year. I will always be grateful for the care that the doctors, nurses and other NHS staff gave him, but after many hospital visits, I have also seen how much the system struggles to cope with providing high-quality care for people with multiple long-term conditions.

In the election campaign, no issue was more prominent in my conversations with voters in Basingstoke than their being denied the health service that they rightly believe they deserve. I am proud of this Government’s focus on building an NHS fit for the future, and I want to restore the fundamental promise of the NHS for everyone in Basingstoke: that it will be there when we need it. Securing the return of the family doctor is a popular and much-needed policy locally, and I mean to ensure that we deliver it, just as I will continue to campaign for the delivery of our much-needed new hospital.

As a Labour MP, my guiding principle will be to fulfil the promise of this Labour Government in restoring opportunity for all, whether that is through the NHS, education or tackling climate change. Opportunity is why so many people have made Basingstoke their home over the years, it is why they voted Labour for the first time just over three months ago and it is what my parents and grandparents worked so hard for, for my sister and me. Thank you, Madam Deputy Speaker, for calling me to speak today, and I thank the people of Basingstoke for giving me my opportunity to serve.

I call Adrian Ramsay, who has two minutes, and I can then squeeze in one more speaker.

Thank you, Madam Deputy Speaker. It is a pleasure to follow the new hon. Member for Basingstoke (Luke Murphy) and hear about his pride in his constituency.

Our NHS provides amazing life-saving, dedicated care every day, but we also know that people are too often let down. Too many patients languish, often in pain, on long waiting lists. In rural constituencies such as mine, people often have to travel lengthy distances to access treatment. Lord Darzi points to systemic and chronic under-investment caused by austerity in funding and capital starvation. Resilience was stripped from the NHS before covid, and we owe it to those whose lives were lost or changed forever by the pandemic never to repeat these same mistakes and to do things differently. However, the Chancellor’s arguments about tough decisions and a black hole of £22 billion are alarmingly similar to those made by the previous Government. It is good to see the Chancellor signalling some movement on fiscal rules, and I hope this logic will apply to supporting our public services, which are a crucial investment in our future.

Putting wellbeing at the heart of what we do should help us navigate how we support the NHS. Bad planning, poor housing, weak transport and divisive social policies have a huge impact on health outcomes, for example. So I welcome the Secretary of State’s comments and he has been bullish about reform, but he has not been specific about exactly what he means by private sector involvement in the delivery of NHS services. There are real reasons to keep delivery of the NHS public, and not to outsource it to private providers. The Secretary of State has made statements about using the private sector to reduce waiting lists, but he has not explained whether he considers this to be a short-term plan while the NHS is being rebuilt, or a permanent policy. Lord Darzi’s diagnosis was helpful and the emphasis on prevention is hugely welcome, but to deliver it we require bold action and investment.

Order. Thank you so much, but please be seated.

Fixing the NHS is our great task and our solemn promise, for there is much to fix after 14 years of managed chaos and decline under the neglectful eyes of our mostly absent predecessors. The candid assessment of the state of the NHS from Lord Darzi is truly alarming, and as my right hon. Friend the Secretary of State has said, it presents an accurate diagnosis of our difficulties. The report makes clear many of the problems of resources, management and structure, but today I would like to speak up for medical research, of which this country has such a proud record.

We all know of the catastrophic potential of infection, witnessed so very recently during the covid pandemic. Indeed, like many of us new Members, I too caught covid right here in this House in the crush to hear the King’s Speech. I do hope that hon. Members of a certain age, such as myself, will remember to get vaccinated. However, let us remember Jenner, who devised vaccination, Lister, who pioneered antisepsis, and Fleming, who discovered penicillin. These British scientists leading the fight against infection were probably responsible for saving more lives than any other people in the long history of medicine.

Last week, we learned of the first successful trials from Oxford of vaccines for ovarian cancer, and we will see many amazing advances in the year to come. Today, we can be excited about molecular genetics, artificial intelligence and the huge power of our people’s NHS data to unravel so many of the mysteries of modern medicine. I know that our Government will develop bold plans to repair the embattled NHS, but on this day I urge our brilliant new Government to pledge to do their utmost to support vital NHS medical research, which carries such promise.

Order. Thank you so much, but you must not continue speaking when I am standing. I call the shadow Minister.

I am mindful of the need to be brief, but I wish to congratulate the hon. Members for South Norfolk (Ben Goldsborough), for South West Norfolk (Terry Jermy), for Esher and Walton (Monica Harding), for Gloucester (Alex McIntyre), for St Neots and Mid Cambridgeshire (Ian Sollom), for Mid Dunbartonshire (Susan Murray), and for Basingstoke (Luke Murphy) on excellent maiden speeches.

When I first heard that the Government had commissioned Lord Darzi to conduct a report on the NHS I wondered two things: why has this report been commissioned, and why has a former Labour Minister been asked to do it? The answer to the first question is still somewhat unclear after this debate. Much of the information is publicly available, and Labour had access to the civil service for six months before the general election, as is routine to help with planning. Before the election, in its manifesto Labour claimed to have a plan, and the Secretary of State said that he and the Government have a 10-year plan to reform and modernise the NHS. In the draft speech that I brought to this debate I was going to say that I assume that is the case, so where is that plan and when will it be published, but during the debate the Secretary of State said that he will soon meet to engage with patients and staff who will write the plan. Does it exist, or is it yet to be written? Given that Lord Darzi specifies that policy suggestions are outside the remit of his report, and notwithstanding the amount of time and dedication he has put into it, what primary purpose does it serve? Is it simply a political statement to cover the right hon. Gentleman’s plan and an increase in taxes in the Budget when it comes?

Will the hon. Lady give way?

I will not because there is not much time. A potential answer to the second question of why a former Labour Minister has been asked to conduct the report is its silence on a number of issues, for example on increasing the number of medical students. I could not find any reference in the report to the five additional medical schools that were commissioned and opened by the former Conservative Government, and whose first new doctors have recently graduated. Indeed, I found no mention of the NHS workforce plan at all.

My constituency mailbag, no doubt much like that of Members across the House, is full of letters from elderly people who are frightened that their homes will be cold this winter, and that they will become ill, or perhaps even die, as a result. It is notable—again, perhaps this answers my second question—that despite being published two months after the Government’s announcement about the winter fuel allowance, the Darzi report appears to be silent on the subject. The chief medical officer said that,

“cold homes and fuel poverty are directly linked to excess winter deaths”

in his annual report from 2023. Is it remarkable that this report by a former Labour Minister does not mention cold homes? Perhaps it does not recognise the impact of such a decision because no impact assessment has been made.

On 29 July, I asked the Chancellor of the Exchequer what estimate she had made of the impact that her winter fuel payment changes would have on the NHS. Her answer implied to me that that was something that had not been given enough consideration. On 5 September I submitted a written question to the Secretary of State, asking whether he would make an assessment of the winter fuel payment changes on a range of factors relating to the NHS and the health of elderly people, including hospital admissions, deaths, GP appointments and so on. The answer to whether he will do something or not is clearly “yes”, “no”, or “I have already done it”, but it seems the Government struggled to answer that question and I would be grateful if the Minister could do so today: will the Secretary of State make an assessment of the various effects of the changes to the winter fuel allowance and the consequent cold homes on the NHS and the health of elderly people?

Earlier, the Secretary of State said that investment without reform would reduce productivity. He even said that it was “killing with kindness.” Actions, however, speak louder than words, so what substantial productivity gains come with the junior doctors’ 22% pay rise? None. What productivity benefits arise from a significant increase in the wages for train drivers? None. The NHS and the Government are now facing potential future industrial action from groups seeking similar pay deals. The Government’s willingness to take money from pensioners and give it to already well-paid train drivers suggests that such union demands will be successful, further creating a vicious cycle of industrial action that will ultimately be damaging to patients.

I fear that the Labour party sees the Darzi report as a political bludgeon rather than as a blueprint for any meaningful reform. There are undeniable challenges within the NHS—something that I as a doctor see—and we must be honest about them, but instead of a constructive conversation on policy, Labour brings partisan attacks to the table. We now need real leadership, specific reforms, and the courage to make the tough decisions that will keep the NHS suitable for generations to come.

I thank all Members for their contributions to this debate. We should all be grateful to Lord Darzi for his rapid and comprehensive review, although we still do not seem to know at the end of this debate whether the Opposition agree with the diagnosis or not. Essentially, it is evidence of their record, and they do not like it.

This has been a passionate debate with colleagues from all parts of the House addressing how 14 years of failure have damaged their constituencies, let down the people they represent and broken the NHS. Lord Darzi’s report is as breathtaking as it is distressing, whether it is discussing the chaos unleashed by Andrew Lansley’s top-down reorganisation, the plunge in productivity and patient satisfaction, the disproportionate impact of the pandemic compared with countries across the world or the failure to modernise ways of working. It beggars belief how the previous Government allowed that to happen on their watch. Behind every page of that report, we should remember the real-world suffering caused by the neglect. It is a record of missed opportunities and squandered potential.

Those things are all the more galling for me, as someone who has worked in the NHS and who still cares passionately about its survival. In fact, the reorganisation was so bad that it led me to stand for Parliament. I would not be here today, were it not for Andrew Lansley. The House can make of that what they will. When I worked for the NHS under the previous Labour Government, I saw at first hand the power of politics to improve the system. I saw a health service delivering the shortest waiting times and highest patient satisfaction in history, and since then I have seen it decline in my constituency and the effect that has had on my constituents. When the system lets them down, they have no other options. They cannot afford to go private, they do not have the assets to sell and their families are in the same boat. Health inequalities and inequality of access led me to join the health service, and the Lansley reforms drove me to become an MP. That is why I will not rest until we have completed our health mission to restore the fundamental promise of our NHS: that it will be there for all our constituents when they need it. The charge sheet is too long for me to make too many comments on it.

In the short time I have, I will address the maiden speeches in particular. I worked with my hon. Friend the Member for South Norfolk (Ben Goldsborough) in opposition. I was so delighted to hear that he had won the day after the election. He talked about the global reach of South Norfolk and in particular productivity at the University of East Anglia, which I went to as a student 40 years ago this week, astonishingly. It makes a huge contribution to the economy of South Norfolk, and I know that he will be a good champion. I wish him good luck on SEND and justice. South Norfolk is lucky to have him.

The hon. Member for Esher and Walton (Monica Harding) gave a lovely history of her constituency. She moved us all with the tragic story of the death of her constituents’ 19-year-son. She has kept her promise to that mother already in her place today.

My hon. Friend the Member for South West Norfolk (Terry Jermy) is a worthy successor to his predecessor. He rightly highlights poverty, particularly in rural areas, and he spoke so eloquently about his father, his care and sadly his death. That is an experience that many people will recognise from covid and will be moved by. I am pleased he is using that experience in this place. His dad and Councillor Thelma would be very proud of him.

My hon. Friend the Member for Gloucester (Alex McIntyre) —I am delighted to have another new Labour Member in the south-west—did a great campaign while having a young family. His passion and pride for Gloucester shone through, whether that is the Romans’ military innovation or that Viennetta comes from Gloucester, which I did not know—shame on me. He wants to achieve for all the people in the rich diversity of Gloucester.

The hon. Member for St Neots and Mid Cambridgeshire (Ian Sollom) is the first and longest-serving Member for his constituency, and long may that last. I look forward to his explaining black holes to us all.

It is not a thing, but the hon. Member for Mid Dunbartonshire (Susan Murray) certainly wins the award for suited people coming to represent their constituents. She spoke movingly about her predecessor and the cost of caring for her partner.

Finally, my hon. Friend the Member for Basingstoke (Luke Murphy) spoke movingly about his family’s hard work and dedication that led him to this place. Cromwell and Jane Austen would be very proud of his editing capabilities.

There is an old Irish joke about somebody travelling down from the city to a wedding in the countryside. He cannot remember how to get there so asks a farmer for directions. The farmer says, “I wouldn’t start from here.” None of us wants to start from here, but this is where the last Government left us, with a broken NHS, a social care system on its knees and an economy failing its people. That is why early next year the Government will publish a 10-year plan setting out how we will deliver the three big shifts that will make the NHS fit for the future.

As my right hon. Friend the Secretary of State said, the choice before us today is to reform or die. There are no quick fixes. But as Lord Darzi reminded us, the NHS’s “vital signs are strong”. We can tap into the immense reservoir of dedication and talent in our universities, life sciences sector and, above all, the NHS. Getting the NHS back on its feet will be a team effort. Working with patients and the public, alongside 1.5 million NHS staff, we will rebuild our public services, fix the foundations of our economy—

Order. We did manage to get in 16 speakers even though we had a short amount of time due to Front-Bench contributions.