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The National Health Service

Volume 666: debated on Wednesday 23 October 2019

I beg to move an amendment, at the end of the Question to add:

“but respectfully regrets that the Gracious Speech does not repeal the Health and Social Care Act 2012 to restore a publicly provided and administered National Health Service and protect it from future trade agreements that would allow private companies competing for services who put profit before public health and that could restrict policy decisions taken in the public interest.”

I am grateful to the Leader of the House for finding time to schedule this important debate. I associate myself with the condolences and sorrow expressed about the horrific tragedy in Essex. I pay tribute to all the emergency services, who must have had to confront the most unspeakable of sights in Essex in the past 24 hours.

In a similar vein, I pay tribute to our hard-working national health service and social care staff, who every day go beyond the call of duty, going the extra mile for each and every one of our constituents, ourselves and our loved ones. They do it after a decade of cutbacks and of the tightest financial squeeze in the history of the NHS, but despite that, our NHS staff are treating more patients every day than ever before. I am afraid, however, that we have a Government who are still expecting our staff to deliver care in the most intolerable working conditions, from bed cuts to staffing shortages and equipment breaking down every day. The dismal consequence of this decade of underfunding and cuts sees patient care suffering and standards of care deteriorating.

Let me share a couple of examples with the House. Somebody from another part of the country got in touch with me and asked me to raise this directly with the Secretary of State, although she asked that we anonymise these exchanges. Her 91-year-old mother fell in her house on a Sunday at around 2.40 pm. She waited two and a half hours for an ambulance. When she got to the hospital, she waited an hour and a half in a cold corridor before being admitted to a bay. Eight hours later, she was seen by a doctor, who recommended an X-ray and scan. She got the result of the X-ray at 1.15 am. Only then was she given pain relief and put on a drip. By 3 am, she still had not been admitted to a ward. At 9 am, she was sent back to her care home—her daughter was not told—with no pain relief or any prescription.

Perhaps I can tell another heartbreaking story, from today’s edition of Pulse. It reveals that a teenage boy—a 16-year-old—was referred to child and adolescent mental health services by his GP, but because his condition was not considered serious enough, CAMHS turned him away. The boy later died by suicide. These are heartbreaking stories, but stories like that are happening far too often in a health system that is under intense pressure.

My hon. Friend is telling tragic stories about the impact on real patients of what is happening in the NHS. Other families who are suffering are those often with children who have very severe conditions, such as epilepsy, who would benefit from access to medical cannabis. The Government have indicated that that access should be available, but it is just not getting to these families, and the children and families are suffering, both because of the pain and financially as a result. Does he agree that the Government should do much more to fast-track availability?

I completely agree, and I pay tribute to my hon. Friend and to hon. Members such as the right hon. Member for Hemel Hempstead (Sir Mike Penning) who have led the charge in this debate. If medicinal cannabis has a medicinal, therapeutic value, it should be allowed. If there are issues in the bureaucracy that are slowing it down, and if that needs legislation, we will work with the Secretary of State to get it through, if that is where the blockage is. If the blockage is in some other area and he needs our co-operation, we will co-operate with him. We need to resolve this, because too many young people are going without the help they need.

The shadow Secretary of State is being very generous, and I thank him for his comments—the families, who are the most important people, will be very conscious of what he has said—but we have to be very careful when describing this: we are after the medical use of cannabis on prescription. The medical use of cannabis often relates to cases where people have felt they would take it in other ways. We are not talking about the casual use of cannabis, about a spliff in the armchair. I will raise this with the Secretary of State when he is on his feet: we are saying that where a qualified consultant feels that cannabis on prescription would benefit the child, particularly if they have epilepsy and fits, it should be available free on the NHS. I think that is what the hon. Gentleman is saying.

Absolutely. There appear to be blockages in the system, however, and my offer to the Secretary of State is this: if those blockages are there because of legislative or regulatory issues that need resolving in this House, I will co-operate with him to get those resolved. If it is not about regulatory issues in this House, I will continue to reinforce the issues that the right hon. Gentleman is putting to him and urge him to intervene using his good offices.

Many vulnerable people are waiting longer for treatment or being denied treatment, sometimes, sadly, with devasting and tragic consequences. The standards of care enshrined in the NHS constitution are simply not being delivered. A&E waits in September were the worst they have been outside of winter since 2010. Our hospitals have just been through a summer crisis, and with flu outbreaks in Australia expected to hit us here, our NHS is bracing itself for a winter of enormous strain yet again.

Last year, 2.9 million people waited beyond four hours in A&E. Since 2010, over 15,000 beds have been cut from the NHS and bed occupancy levels have risen to 98% under this Government. The number of patients moved from cubicles to corridors and left languishing on trolleys has ballooned under this Government. When Labour left office, around 62,000 patients were designated as trolley waits, which was unacceptable, but today under this Government that number is 629,000.

What about cancer?

Before my hon. Friend moves on from the situation in A&E departments, can I bring to his attention the situation at Northwick Park Hospital, which serves my constituents? The last time it met the four-hour target was in August 2014 —over five years ago now. Does he have any sense that the Government are still committed to that four-hour target, or will it be another five years before my constituents can expect that target to be met in our hospital?

My hon. Friend makes a very good point. The targets were routinely met under the last Labour Government—and they were stricter targets as well.

The Secretary of State looked surprised when I mentioned cancer, but he should not be, because we have the worst waiting times on record under this Secretary of State. Every single measure of performance is worse than last year. Shamefully, 34,200 patients are waiting longer than two months for cancer treatment. What about the waiting lists for consultant-led treatment? We now have 4.4 million people waiting for treatment—an ever-growing list of our constituents waiting longer for knee replacements, hip replacements, valve operations or cataract removals. Clinical commissioning groups are rationing more and trusts delaying surgery, which is leaving patients in pain and distress.

My hon. Friend is absolutely right about the pressure on trusts. The chief executive of my NHS in South Tees has recently resigned, calling the current situation underfunded and unsustainable and warning that any more efficiencies would be a step too far. Does he agree that beneath this spin services are at breaking point?

I completely agree. I am not surprised that my hon. Friend’s trust’s chief executive has taken that action. We have just been through a decade of the tightest financial squeeze in the history of the NHS. That is why standards of care have so deteriorated. Since the right hon. Gentleman became Health Secretary, the number of patients waiting more than 18 weeks for treatment has jumped from 504,000 to 662,000. Every day he is Health Secretary, another 330 people wait beyond 18 weeks for treatment. People waiting longer for treatment under him—that is his personal record.

The hon. Gentleman is right to identify the delays that are inevitable in a massive state-led system. Would he agree that there is a huge opportunity for individuals to get treatment in other ways? I have the privilege to represent a couple who have taken themselves to a hospital in Portugal, where they live half the year, and got care there. Their care has been refunded by the NHS at a rate significantly cheaper than that available in the UK. Should we not welcome individuals who are able to do this? Of course it is not for everybody, but should we not welcome it as a possibility?

I am genuinely pleased for the hon. Gentleman’s constituents, but there are 4.4 million people on the waiting list. There used to be around 2 million. Every day, another 330 people wait longer than 18 weeks for treatment, and when people wait longer than 18 weeks, not only do they wait longer in pain, distress and anxiety, but they run the serious risk that their health will deteriorate further. That is what is going on in the NHS today under this Government.

The Queen’s Speech was heavily spun as being about—[Interruption.] The Secretary of State will get his chance in a moment. The Queen’s Speech was heavily spun as being about the NHS. [Interruption.] He says I am talking nonsense. These are the official figures. He wants to run away from his own failure, from the fact that so many more people are waiting beyond 18 weeks for treatment and from the A&E crisis that he is doing nothing about. He thinks an app will solve it all. That is not a serious approach to the NHS. [Interruption.] And he is not as good as George Osborne used to be.

The Queen’s Speech was heavily spun as being about the NHS, but in fact it was a missed opportunity to rebuild confidence in the NHS and provide the health services we want. We will scrutinise carefully the Bills in the Queen’s Speech and engage constructively. We are pleased that the Health Service Safety Investigations Bill has not been abandoned and is back. We will engage on it and explore with Ministers how to strengthen the independence and effectiveness of medical examiners.

If the Secretary of State wants to deliver safe care, however, we need safe staffing legislation and a fully funded workforce plan. Pressures on staff are immense. He will know that suicide rates for nurses are higher than the national average and that among doctors the rate is rising. I congratulate Clare Gerada on her leadership on mental health support, but yesterday the Secretary of State suggested on Twitter that all NHS staff would be eligible for this new mental health support, when it is actually just doctors and dentists. I hope he will clarify his remarks at the Dispatch Box and tell us when 24-hour support for all NHS staff will be available.

I also hope the Secretary of State will tell us how he will resolve the staffing crisis. As he knows, we have 100,000 vacancies across the NHS. We are short of over 40,000 nurses. Under this Government, we have seen cuts to community and district nurses, learning disability nurses, mental health nurses, health visitors and school nurses. On current trends, we will be short of 108,000 nurses in 10 years, according to the King’s Fund and the Nuffield Trust.

My hon. Friend is making an excellent speech. He is right to talk about rationing. My CCG has started rationing referrals to consultants to clear one of the biggest deficits in the country. Will he also talk about the massive backlog of capital? As he knows, I have two world-class hospitals in my constituency, Hammersmith and Charing Cross. It will cost half a billion pounds to bring them up to standard, but there was not a penny of that in the money the Secretary of State allocated. They are lucky they get a few million pounds of seed money to plan for work for which there is not the money to pay.

My hon. Friend is absolutely right. Imperial College Healthcare NHS Trust has one of the worst maintenance backlogs of all trusts. I congratulate him and Labour-controlled Hammersmith and Fulham Borough Council on leading the campaign to save Charing Cross Hospital; it is because of the pressure he exerted that it was saved.

My hon. Friend may be aware that, just today, the Education Committee published its report on children with special educational needs and disabilities. One of our findings was that the staff shortages are having a serious impact on those children, because the plans that are drawn up for them are now being drawn up on the basis of what is rationed and what is available, rather than on the basis of what they actually need. Does he agree that there should be a review of therapy services around the country, so that we can ensure that, wherever a child lives, it gets the support it needs?

My hon. Friend is absolutely right. She has brought home the extent of the impact of staff shortages on service delivery at every turn.

I am going to make a bit of progress. The Whips are looking slightly askance at me because of the number of Members who want to speak.

There is one Bill that will have a fundamental impact on staffing, and that is the proposed immigration Bill, which will end freedom of movement and introduce a points-based system. Does the Secretary of State recognise that freedom of movement has allowed thousands of staff from Europe—doctors, nurses, paramedics, care workers, hospital porters and cleaners—to come to the UK to care for our sick and elderly? Does he recognise that our NHS and care sector needs that ongoing flow of workers from the EU? How does he reconcile the need for the NHS to continue to recruit with the rhetoric and the proposed restrictive policies of the Home Secretary?

The Secretary of State will know that Conservative campaigners have lobbied for a salary threshold of £36,700. If that were applied, 60,000 current staff in the NHS who are not covered by the shortage occupation list would be affected. Is the Secretary of State really going to allow the Home Secretary to introduce a salary threshold of that order, which will have a huge impact on the ability of the national health service to fill vacancies and recruit, and therefore have an impact on patient care?

Will my hon. Friend join me and, I am sure, all other Labour Members, in conveying our solidarity to NHS workers—Unison members—in St Helens and other parts of the country who are on strike this week? Despite doing the same job in the same place and wearing the same uniform, they are paid less than their colleagues because they work for an agency. Will my hon. Friend urge Compass to do the right thing and pay those workers properly, and will he commit a Labour Government to ensuring that there is equal pay for equal work in our NHS?

My hon. Friend is absolutely right. That is what happens when privatisation and outsourcing go wrong: workers are worse off. We should bring an end to it.

I am going to make some progress.

We need clarification from the Secretary of State on whether he will exempt all NHS staff and all care staff from the shortage occupation list in the immigration Bill.

Safe care also depends on safe facilities, but after years of cuts in capital budgets, hospitals are crumbling and equipment is out of date.

In a few moments.

The repair bill facing the NHS has now risen to £6.5 billion, more than half of which relates to what is considered to be serious risk. NHS capital investment has fallen by 17% per healthcare worker since 2010. Across the NHS, the estate relies on old, outdated equipment, which is having an effect on, for instance, diagnostics. The number of patients waiting longer than six weeks for diagnostic tests and scans has increased from 3,500 under Labour to more than 43,000 under this Government.

I will give way in a few moments.

Even if the Secretary of State replaces all the MRI scanners that are more than 10 years old—he has adopted our policy on that—we will still be struggling with the lowest numbers of MRI and CT scanners per head of population in Europe. Is it not time for a proper strategic health review?

In a few moments.

The Secretary of State will say that he has announced plans for six new hospital reconfigurations and seed funding for other acute trusts to prepare bids, but there is no guarantee that that funding is in place and that the Department will give trusts the go- ahead. “Seed funding” is a curious phrase. Can the Secretary of State confirm that there will be no role for private capital in that seed funding? In their 2017 manifesto, the Government promised £3 billion of capital funding from the private sector. Does that still hold? They claim to have abandoned the private finance initiative. We need clarity today.

I will give way in a few moments. Let me just finish this point.

When the Secretary of State announces new hospitals in press releases from Conservative campaign headquarters, he should also announce where he is downgrading hospitals. He should go to Telford and explain why the accident and emergency department there is closing and being replaced by an “A&E local”, which is presumably something like a Tesco Express. We would save that A&E department. The Secretary of State went to Chorley recently. The A&E department there is not open overnight. We would provide a rescue package for Chorley. I wonder whether the Secretary of State will also be visiting Canterbury to apologise, because the Prime Minister promised—

Does my hon. Friend agree that the Prime Minister’s recent false promise of a brand-new hospital in Canterbury was extremely irresponsible? It turned out to be fake news, which left my desperate constituents confused and bitterly disappointed.

The Prime Minister promised that new hospital at the Tory party conference, only for the Department to confirm later that Canterbury was not actually on the list.

In a few moments.

The Tory candidate for Canterbury, one Anna Firth, helpfully explained that the Prime Minister had “clearly made a mistake”. After all,

“He can’t be on top of every little detail”.

We are talking about the £450 million rebuilding of a hospital.

On the subject of £450 million investments, I wonder whether we could have a moment of cross-party positivity, and whether the hon. Gentleman welcomes the £450 million investment in the hospital from which both his constituents and mine will benefit. It is a transformative investment, and we are doing it without PFI. I am sure he agrees that that is wonderful news.

Of course I welcome that £450 million. [Interruption.] It just shows what an effective Member of Parliament for Leicester South I am.

I know that the Secretary of State gets very excitable about this Leicester point, rather like a semi-house-trained pet rabbit. Let me tell him about Leicester. I did not see him on “Question Time” in Oadby the other evening—I do not often watch “Question Time”. I do not want to be disorderly, so I shall be careful about how I read out the transcript. The audience started shouting—well, it is unparliamentary, but essentially they started shouting that the Secretary of State was not being entirely truthful in what he was saying. I do not want to fall out with him, or to be disorderly, but according to the transcript, there were “jeers” from the audience.

One audience member said that hospitals in Leicester were “falling apart”. Another said, “It’s shameful.” A third said,

“It’s not a case of throwing money at it.”

A fourth said that the Secretary of State was

“saying you will invest loads…into Leicester Royal Infirmary, what about…the General?”

What, that audience member continued, about

“the benefit in terms of beds…as a whole?”

The Secretary of State replied:

“We will do all of those things and we’ve guaranteed the money to Leicester and it’s coming in the next couple of years.”

There was then audience “laughter”.

Let me deal with this point first.

The people of Leicester can see what is happening. Although the Secretary of State is putting money into Leicester Royal Infirmary, Leicester General Hospital in the constituency next door loses maternity services, loses the hydrotherapy pool, loses renal services, loses—[Interruption.]

Order. Remember that we were all going to try to be polite. The hon. Gentleman is talking about hospitals that people care about, and we must listen to him.

It loses elective orthopaedics, loses urology, loses brain injury and neurological services, loses gynaecology, and loses podiatry.

Let me just finish this point and then I will bring in the hon. Gentleman. [Interruption.] He is a Leicester Member of Parliament, after all.

The Leicester General can have a sustainable future under this Secretary of State only if he moves the midwifery unit from St Mary’s Hospital in Melton Mowbray. If that is what he is proposing, I hope he is making it clear to Leicestershire MPs.

I am most grateful to the hon. Gentleman, who is a Leicester Member, but I have to say that I am astonished by his tone. Almost the entire county and city welcomed this huge, major investment and reorganisation. Years ago, my former right hon. Friend Stephen Dorrell—he is no longer in the House—explained why the General was likely to close. That is not the case—the hon. Gentleman should recognise that massive investment.

This will be the last intervention I take because I have to get to the end of my speech, but let me just finish this point: the Leicester General is essentially being downgraded. The only thing that remains at the Leicester General is the diabetes unit, unless the Secretary of State is moving midwifery services from St Mary’s in Melton Mowbray to Leicester and, if he is doing that, he should be clear with the right hon. Member for Rutland and Melton (Sir Alan Duncan).

I appreciate the hon. Gentleman being generous with his time. My family used maternity services at the General just last week. We sat on a couch. My wife had not eaten for nearly 24 hours because the General does not have an all-electives list for caesarean sections. That service will be better when services come together in the new maternity hospital that is going to be built. By the way we also used St Mary’s birthing unit in Melton Mowbray. It is a brilliant midwife-led unit and we are not going to close it.

There we go, but the only way the Leicester General has a sustainable future in their own plans—these are the plans the Secretary of State has signed off from the Leicester trust—is if that midwifery unit at St Mary’s moves to the Leicester General. I am sorry that the hon. Gentleman’s family got a poor service at the Leicester General. My daughter was born at the Leicester General as well and we got an excellent service.

I need to move on because I think the House is getting slightly tired of our focusing on our constituency issues and I am abusing my position. I will try to give way again shortly, but I am testing the indulgence of the House on the issue of Leicester.

In the Queen’s Speech, there are also proposals on mental health, and we look forward to the mental health White Paper and hope that Sir Simon Wessely’s review is quickly implemented. He also called for significant capital investment in the mental health estate, yet none of the hospitals the Secretary of State has announced includes mental health trusts.

No they don’t; none of the hospitals the right hon. Gentleman announced at the Tory party conference includes mental health trusts. He knows there are 1,000 beds in old-style dormitory-style wards in desperate need of upgrade. He knows that we have problems with anti-ligature works that desperately need doing in mental health trusts because they are putting lives at risk every day.

On social care, we were told we were going to have the big solution to social care. The Secretary of State was briefing that a previous Chancellor, the right hon. Member for Runnymede and Weybridge (Mr Hammond), was holding him back and he was going to give us a solution on social care. And what do the Government say? They say, “We have not got a social care Green Paper, we have not got social care proposals, we will get proposals on social care in due course.” The Secretary of State is kicking the can on social care down the road again.

Let me come to the Health and Social Care Act 2012. On Second Reading, it was described by the new Minister, the hon. Member for Mid Bedfordshire (Ms Dorries)—I welcome her to her elevation to the Treasury Bench; it was remiss of me not to do that earlier—as one of the most exciting Bills to be put before Parliament in the 62 years since the NHS was established. We were told that there was going to be legislation to undo the worst excesses of that Lansley Act, but all we are getting apparently is draft legislation, again, “in due course”—that is the wording in the explanatory notes to the Queen’s Speech.

I had the privilege of sitting on both Committees that considered the Health and Social Care Bill, as it was then. Section 75 is particularly punitive in terms of its requirements for clinical commissioning groups to put all contracts out to tender. Some £25 billion-worth of public money has gone to the private sector, with the implications of an increase in health inequality, both in access and outcomes. Does my hon. Friend agree that this is an absolute travesty?

Order. Let me say before the hon. Gentleman answers the intervention, that he has been very generous in taking interventions, and that is good for the debate, but I am sure he will bear in mind that he has been at the Dispatch Box for nearly half an hour, and I just say to him gently that that is all right with me, but he will incur the wrath of those who are waiting to speak later in the debate when they only get three minutes.

Thank you for your guidance, Madam Deputy Speaker. You are absolutely right. I will not take any more interventions and I will move to wrap up.

My hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) is absolutely right that the compulsory competitive tendering provisions of that Act have forced through the privatisation of £9 billion-worth of contracts. Everything that was promised in the Act, from delivering on health inequalities to delivering more integrated care, has not come to fruition, which is why everybody understands that it needs to be repealed.

But there is another reason why the Act needs to be repealed: while it is on the statute book, it runs the risk of the NHS being sold off in a Trump trade deal. Under the World Trade Organisation, public services can only be excluded from trade deals where there is no competition with private providers or where they are not run for profit, but the enforced competitive tendering of contracts through the Lansley Act means private health providers already operate in competition with public NHS providers, and the so-called standstill ratchet clauses and the inter-state dispute mechanisms would mean a Trump trade deal would lock in the privatisation of our NHS ushered in by the Health and Social Care Act.

I am going to finish.

Any Government seeking to undo that privatisation in a trade deal are liable to get sued in an international tribunal by private international investors, and there is no appeal. It happened in Slovakia, it happened in Canada and it happened in Australia. It is not taking back control—it is a democratic outrage. It is not just about selling off the NHS; we know that Donald Trump wants to break our pharmaceutical market as well, forcing us to buy more expensive drugs from the US and crippling our national health service.

So if Tory MPs want to save the NHS, they should vote with us in the Lobby tonight, because the party that created the NHS, the party that has always rebuilt the NHS, and the party that will end the privatisation of the NHS is the Labour party and no one will trust the Tories with the NHS.

I rise in support of the Queen’s Speech, which has more action on health than any Queen’s Speech in a generation. At its heart it has five major legislative reforms that will set the course of health and social care for years to come. I will turn to each of these in a moment, but I just wanted to address something that the hon. Member for Leicester South (Jonathan Ashworth) said. Let me be completely clear: the NHS is not, and never will be, for sale under this Conservative Administration. The Prime Minister made it abundantly clear and the President made it clear: the NHS will not be on the table.

We know why the Labour party likes to spread this nonsense about the NHS: it has not got anything constructive to say. Labour Members do not want to talk about Brexit, because they have decided not to decide on their position, and instead they are trying to scare some of the most vulnerable people in our society—the very people they claim to represent. The nonsense we have just heard shows that Labour will stop at nothing to hide its Brexit position, which is just for more delay, more confusion and more indecision, and it shows that the Labour leadership is not up to the job of governing the party, let alone the country. By contrast, the Conservative party has protected and nurtured the NHS for 44 of its 71 years. We are the party of the NHS.

When trying to assess what Labour might do if in government should we not look at the words of Nye Bevan when he said:

“Why gaze in the crystal ball when you can read the book”?

We have the book of the NHS under Labour control in Wales to look at; it is an appalling mess.

There is no doubt that when looking at the facts of the delivery of the NHS in Wales we see what happens to an NHS under Labour control. I support all those who work in the NHS in Wales—they do a great job—but, sadly, it is harder to deliver the NHS in Wales. There is another argument too: we know that we can fund good public services and the NHS only with a strong economy, and the plans of the Labour party would ruin it.

It is absolutely disgusting that the Secretary of State can stand there and say that about the NHS in Wales, when it is his Government who underfund the NHS in the whole of the UK.

I did find it surprising that the hon. Member for Leicester South did not mention the £33.9 billion largest and longest funding settlement in history, but I would also note this: funding for the NHS under the Welsh Government in Wales has risen more slowly than it has in England, because we have funded the NHS properly.

I thank the Secretary of State for giving way, and I also thank him for his announcement earlier this year, first, on guaranteeing A&E services at Charing Cross Hospital and, secondly, on the floor-by-floor refurbishment of that hospital. Last month, Hammersmith and Fulham CCG told me that the popular Parsons Green walk-in centre would have to change to appointment-only after 31 December due to a rule change. Can he confirm that there is no need for it to do that and that the future of the walk-in centre at Parsons Green is as bright and rosy as that of Charing Cross Hospital?

Yes, I can give that confirmation. I have seen some reports from the local Labour party putting fears into people’s minds about the future of the Parsons Green walk-in centre. There are no plans to close the centre, and anybody who says so is simply scaremongering. I am absolutely delighted at the campaign that my right hon. Friend ran to save the A&E and to save the services in west London; it was thanks to him and his efforts that we managed to do exactly that.

Does the Health Secretary not feel ashamed that we have the highest rate of child mortality in western Europe? We also have a declining life expectancy; for women it is getting worse and for deprived areas it is getting worse. We are one of the only developed countries where that is happening, and it is partly as a result of the underfunding of the NHS but more widely because of austerity.

I have great regard for the campaigning that the hon. Lady does on many topics, but I am afraid to say that she was factually inaccurate in what she said just now; it is not true. We are putting the largest and longest investment into the NHS in its history, and I think that that is the right thing to do.

May I just tell the Secretary of State what an amazing job he is doing for Leicestershire and how proud the county is of this forward investment? May I draw his attention, however, to the NHS carbon footprint in England, which is around 27 million tonnes of carbon dioxide equivalents, and suggest that with the new hospital builds across the country, he ought to make better use of zero carbon medicines and treatments? That means embracing acupuncture, herbal medicine, homeopathy, chiropractic and osteopathy. Will he also ensure that the osteopaths and chiropractors who have been regulated by Act of Parliament since 1993 and 1994 work with the orthopaedic surgeons?

I am absolutely delighted to work with my hon. Friend on that subject, and also on the capital investment into Leicester. I do not want to spend too long on the issue of Leicester, because we almost had an Adjournment debate on that subject a few minutes ago. We have announced 40 new hospitals over the next decade, which we will ensure include carbon neutral and green elements; we have discussed that. While we are doing that, however, such is the hon. Member for Leicester South’s commitment to opposition that he even opposes the new hospital we are building in his constituency. He described the £450 million of investment on 29 September as “downgrading” when he talked about local opposition. This is long-term investment that the trust chief executive describes as “completely transformational”. The hon. Gentleman should rejoice at this excellent news. He is so good at opposition that I have a long-term plan for him, and that is to keep him in opposition for the long term.

The Secretary of State will be aware of the successful campaign that I fought to secure £36 million for the Manor Hospital in Walsall to get a new A&E department, so when he is passing junction 10 of the M6, will he come in to meet the staff with me? They are delighted with that investment.

It is thanks to my hon. Friend’s campaigning and bringing to light the importance of the upgrade to the A&E at Walsall Hospital that we have been able to make that investment. There is no greater spokesman for the people of Walsall than my hon. Friend, and I cannot wait to turn left at junction 10 to pay them a visit next time I am going up the M6.

The Secretary of State talks about rejoicing, and Opposition Members have talked about the hospitals that he should visit. He is welcome in Burton at any time. We had £22 million invested in the health village as a result of his last visit, and just this week he has announced another £11 million for two new operating theatres. That proves that it is this Government who are investing in our NHS. It is safe in our hands.

I will tell the House exactly what happened. My hon. Friend invited me to Burton, and I looked at the changes that needed to happen. I talked to the NHS and we then announced not one but two upgrades as a result, thanks to his campaigning.

Gloucestershire health managers, supported by around £50 million of public money, are in the process of reconfiguring hospital services in Gloucestershire. In the light of evidence suggesting that A&E in Cheltenham might be earmarked for closure, I, together with my hon. Friends the Members for Tewkesbury (Mr Robertson) and for The Cotswolds (Sir Geoffrey Clifton-Brown), have led a campaign to keep A&E at Cheltenham. I know that my right hon. Friend the Secretary of State has taken a close interest in this issue. Can he now give us an update from the Dispatch Box on the issue, which is so important to me, my constituents, my hon. Friends and, indeed, everyone in Gloucestershire?

Yes, I can. In the light of the extensive representations that my hon. Friend made regarding the A&E in Cheltenham, I have spoken to the chief executive of Gloucestershire Hospitals NHS Foundation Trust and I can announce that the A&E will remain open and that no proposals to close the A&E at Cheltenham will be part of the forthcoming consultation.

The Secretary of State might need some help when I tell him that I am quite thankful, because after a massive and wonderful campaign in Huddersfield, we are keeping our A&E open. The £20 million that we got for that and for some other maintenance work is very acceptable, but will he accept an invitation to come to Huddersfield to see the potential for a new hospital that could be an absolutely iconic building in a future innovative national health service?

I will absolutely look at that, and I think that the new hospital is going to be absolutely terrific up in his part of the world. I will also put on record my gratitude to my hon. Friend the Member for Calder Valley (Craig Whittaker), who as a Whip has not been allowed to speak on this issue in the House, but who privately has been campaigning hard. This shows what happens when local MPs have a positive attitude towards the future of our NHS.

While we are talking about positive hospital stories, I would like to raise with my right hon. Friend the case of Sherwood Forest Hospitals NHS Foundation Trust, which has gone from being in special measures to rated as good. It has now been nominated for the trust of the year award, which is a fantastic story for the NHS and those local services under a Conservative Government. I want to move my right hon. Friend on to the issue of health inequalities if I can. We had a Green Paper earlier in the year about smoking cessation. Mansfield has one of the highest levels of smoking in the country; we are the fourth worst area at more than 23%. We have set a target to try to reduce smoking levels by 2030, but that needs action. Will he take that action in the near future?

Yes. There is no greater spokesman for Mansfield than my hon. Friend, and he is absolutely right about smoking. We have set a target of ending smoking by 2030. It is a stretching target, and there is an awful lot that we need to do to achieve it.

I will give way to my hon. Friend the Member for Telford (Lucy Allan), who has already intervened on the Prime Minister today. I hope that I can help out.

I am grateful to my right hon. Friend for giving way, and for coming to Telford to have a look at the women and children’s unit. However, six months later, he signed off an approval to have it closed. It is galling to hear about all the “goodies for all” that are being distributed, but unfortunately not for Telford. I would like to invite him to come back and listen to the people of Telford and to hear why they value their women and children’s unit.

My hon. Friend has campaigned incredibly hard. As she knows, the local NHS brought forward the plan, which we are proposing to amend. I am working on that with her. However, I am delighted to announce that the Princess Royal in Telford will be benefiting from £4 million of winter capital funding that will come on stream for this winter, partly as a result of my hon. Friend’s campaigning.

I am grateful to the Secretary of State for giving way. I get on very well with the shadow Secretary of State on a personal basis and do not expect an apology from him, but was he not wrong on the A&E at the Princess Royal Hospital in Telford? It is not closing. We are having the latest modern thinking on how A&E care is delivered through an “A&E local”, so will the Secretary of State put a little more flesh on the bones of what that means?

My hon. Friend is right that the local NHS came forward with its plans, but I want to ensure that A&E facilities continue in Telford. We are working on the details, and he will be the first to know.

When the Secretary of State goes to Telford, I suggest that he speaks to Councillor Shaun Davies, who will also tell him about Telford’s needs. As the hon. Member for Burton (Andrew Griffiths) said, Staffordshire is blessed with some first-class facilities that were supported by the last Labour Government, but our problem is that our CCGs are all in financial deficit. Half of the country’s failing CCGs are in Staffordshire. With the new money that is going into the health service, will the Secretary of State tell me what he is going to do to address the disparity in funding? Stoke-on-Trent rates 13th for social and health inequalities, but 48th for funding. If money follows need, we can dig ourselves out of our hole.

The hon. Gentleman raises the problem across Staffordshire. We are trying to ensure that the NHS in Staffordshire looks forward with confidence, and that includes addressing long-standing financial issues for which it has had extra support over the past few years. I pay tribute to all the NHS staff right across Staffordshire, who have done great work, especially in Stoke and Stafford, to ensure that the hospital provision there can look forward with confidence.

My right hon. Friend was talking about spending on healthcare across the United Kingdom. Scotland has benefited due to increases in healthcare spending in England, but not all the money that comes to Scotland through the Barnett formula has been spent on healthcare. In fact, had spending increases in Scotland kept up with those in England, there would be half a billion pounds more to spend on Scotland’s NHS.

There speaks the voice of Scotland. As we have put record amounts of funding into the NHS in England, that funding proportionately flows through the Barnett formula to Scotland, but the Scottish Government have refused to increase NHS funding in Scotland. I wish that they would increase it as quickly as we have in England, where we have seen a faster increase in the numbers of doctors and nurses than in Scotland.

Will the Secretary of State help me by pointing me towards an online resource that provides the evidence base for his decisions on the locations of A&E departments and the like? Any medical professional will say that we need a regional and, dare I say, national plan in order to make sure that access to emergency care is equal for every citizen in England and Wales.

The hon. Gentleman makes an important point that capital investment needs to be strategic, and the new health infrastructure plan, which I was discussing at the Health and Social Care Committee yesterday, is intended to put in place that long-term plan for capital investment, and we are building 40 new hospitals over the next decade. It may be fair to say that I got some flak from Labour Members for proposing 10 years’ worth of new hospitals, because they said that only the first part of the health infrastructure plan—the so-called HIP 1—should be announced. I do not think that that is true, however, because we need a long-term approach to capital investment, with 40 new hospitals over the next decade.

I thank the Secretary of State for his vote of confidence in the NHS in Winchester. He has always been willing to listen. After a difficult Care Quality Commission report last year, we managed to secure investment to transform the A&E department, which the Minister for Care, the hon. Member for Gosport (Caroline Dinenage), visited recently. We are working with the sustainability and transformation partnership across Hampshire to reimagine what a district general hospital looks like. I encourage the Secretary of State to come down to Winchester—an hour on the train from Waterloo—to see where a new district general hospital is emerging to deliver long-term safe and sustainable services.

I would love to. I pay tribute to the hon. Gentleman’s work not only on the prevention agenda and public health in government, but on ensuring that the long-term plan approach to capital investment, with a new hospital in Winchester over the next decade, will give the time to ensure that that investment brings the whole health system together in Winchester and really delivers for the people. With him as the local representative, I have absolutely no doubt that that is what will happen.

On the subject of strategic capital investments, the Secretary of State will be well aware that static PET-CT cancer scanning equipment is world renowned for helping people, particularly at the Churchill Hospital, and is much more effective than mobile scanning technology. Why, therefore, have I discovered, having been told that there would be no privatisation of services at the Churchill and that we would not see that material change, that a private provider with mobile scanning equipment will be the back-up to the NHS service? It will be dealing with complex cases from across the Thames valley. Even worse, the chief exec of the local hospital has had to accept a non-disclosure arrangement around the contract negotiations. How can the Secretary of State justify that?

That is a decision taken by the local NHS. The proposals that we are putting forward in law, for debate under this Queen’s Speech, are to change the regulations. We must absolutely get the best solutions for local patients, and I will address the hon. Lady’s point before taking some more interventions, because I want to refer specifically to the amendment tabled in the name of Opposition Members. Not only is it unnecessary, but it is counterproductive. It would do the opposite of what they say that they intend.

The Government believe—I think this is true across the House—in a publicly funded NHS that is free at the point of use according to need, not ability to pay. The Opposition say that they want a publicly provided NHS. I think what matters is what delivers best for patients, and let us look at this point of—

Let me explain my argument and then I will give way. What is not currently publicly provided? What about drugs and pharmaceuticals? Is the hon. Member for Leicester South really saying that only drugs manufactured by the NHS can be used in an NHS hospital? That is what his amendment says. Will he go and tell that to the patients who use Brineura, aspirin or cutting-edge cancer treatments? What about the new breakthrough announced this morning that could delay the onset of Alzheimer’s? My grandmother died with dementia, and his amendment would stop access to new drugs because he is against anything that is not publicly provided. The Government reject that ideology. What about other things that the NHS buys? Will he only buy pencils that are manufactured by the NHS? What about all those blasted fax machines? Is he suggesting that the NHS starts to manufacture its own fax machines? I want to abolish fax machines in the NHS; he wants to nationalise them.

My right hon. Friend is making a powerful point. Does he agree that by insisting on public provision, the Labour party would also abandon virtually the entire primary care network in this country, which is provided by private businesses owned and run by doctors?

My right hon. Friend’s mind is so aligned with my own that that is the very next line in my speech. What of GPs, dentists, opticians and pharmacists? They are all privately provided into the NHS, and they have been since Bevan, but this hard-left amendment would nationalise them.

I like the hon. Member for Leicester South. He is a good and sensible man, so I can only assume that he has been captured by the militant hard-left within his party, whose aggressive proto-Marxist ideology I know, deep down, he has little sympathy for. He is far more right-wing than the right hon. Member for Islington North (Jeremy Corbyn), and I know it because we have it on the record. He used to say that

“there has always been a private element of health provision in this country.”

That is what he really thinks, but he is hostage to the hard-liners and has been captured by Corbyn.

My right hon. Friend knows full well what I am going to raise with him in my intervention, which is the prescribed medical use of cannabis. In my speech later, I will talk about the privatisation that took place under Labour, with the Darzi clinics, polyclinics and the PFI schemes. There is something we could do today for families who are desperate—families who are willing to go on hunger strike and sell their homes because they cannot afford the medication, which this Government have allowed to be prescribed for children who have severe forms of epilepsy and seizures. I know that a lot of work is going on, but these families are desperate. There will be hunger strikes soon and people are selling their homes. We must give them that opportunity to protect their children.

Yes, I entirely understand where my right hon. Friend is coming from, and he has been a tireless campaigner on this issue. On this point, I also want to welcome the cross-party approach set out by the hon. Member for Leicester South. This is an important thing to get right. Of course each decision for an individual patient has to be clinically-led; we cannot have MPs calling for specific clinical interventions, and I think my right hon. Friend and everybody else recognises that. But there is a problem in the system here, and I have asked the medical director of the NHS to lead the work to resolve the problem. We are working on it, and I look forward to meeting my right hon. Friend and others with an interest in this soon.

On behalf of my constituents, may I give a warm welcome to my right hon. Friend’s announcement this afternoon of extra funding to keep the A&E at Cheltenham open? My constituents already have to travel 25 miles to get to Cheltenham, and this announcement will be a huge relief to them.

I am delighted to have been able to give that assurance and I thank my hon. Friend for the work he has done.

This is further to the point made by the hon. Member for Stirling (Stephen Kerr). As this Chamber has heard me say before, pregnant women have a 200-mile round trip to make from Caithness to Inverness to give birth. Some months ago, a mother gave birth to twins 52 miles apart on the A9 from Caithness. In the past two days, a pregnant woman came all the way down from Caithness only then to have hours of agony because there was no bed ready for her. I concede that this is a devolved matter, but would Her Majesty’s Government, for my sake and that of my constituents, share the best safety practice with the Scottish Government and with NHS Highland?

We will absolutely do that. The hon. Gentleman rightly says that this provision is a devolved matter, and we have already had a debate about the relative funding increases, but this case clearly needs looking at seriously. I will make sure I get in contact with my colleagues in the Scottish Government who are responsible for the provision of this service to make sure that it is looked at properly.

I enjoy the knockabout that has been going on, but will the Secretary of State accept that the NHS reforms brought in by Andrew Lansley led to fragmentation, duplication and inefficiencies, which we are now trying to remedy by reconstructing and bringing groups together, as we are doing in north-east London, and that therefore there is merit in that part of the Opposition’s amendment?

Order. If the Secretary of State answers the intervention, I will say to him what I said to the Opposition spokesman, which is that he has been generous in taking interventions but having been at the Dispatch Box for nearly half an hour, I hope he will be careful not to incur the wrath of Back Benchers who will have to wait until 7 o’clock to speak.

Yes, I am trying to take as many interventions as is reasonable. I feel as though I have been sitting down for most of the half hour that I have technically been speaking for—

Hold on, I have not even answered the previous intervention. The truth is that the NHS has proposed measures that will make it easier to run the NHS, to reduce bureaucracy and to change the procurement rules that we discussed. Ultimately, these responses—there have been nearly 190,000 responses to the consultation—have the support of the royal colleges, the Local Government Association and the unions. They have all supported these legislative proposals, and we are working on the detailed plans. They do change some of the measures put forward in the Health and Social Care Act 2012. We will make sure we cut out that red tape and bureaucracy, streamline the procurement, support integration and make sure that the record investment we are putting in gets as much as possible to the frontline. They also help us with recruitment, and I can announce to the House the latest figures for GP recruitment, a matter that I know is of interest to lots of colleagues. Building on the record numbers in training last year, this year we have 3,530 GPs in training, which is the highest number in history. That is all part of our long-term plan.

The measures in the long-term plan Bill would also strengthen our approach to capital. We have discussed the 40 new hospitals in the health infrastructure plan, but I can also tell the House that the plan will not contain a single penny of funding by PFI—we have cancelled that. I have been doing a little research into the history and I want to let the House into a little secret that I have discovered. Who was working in Downing Street driving through Gordon Brown’s doomed PFI schemes, which have hampered hospitals for decades? I am talking about the PFI schemes that led to a £300 cost to change a lightbulb and that have meant millions being spent on debt, not on the frontline. Who was it, tucked away at the Treasury, hamstringing the hospitals? It was the hon. Member for Leicester South. So when we hear about privatisation in the NHS, we have culprit No. 1 sitting opposite us, who wasted all that money. We are cancelling PFI, and we are funding the new hospitals properly.

May I welcome the investment that my right hon. Friend is making in Kent, not just in hospitals, but in healthcare centres? We have a GP surgery that is no longer fit for purpose and, working alongside the county council, another wonderful Conservative institution, he is providing healthcare to people closer to home and nearer to where they want it. I welcome that enormously and urge him to do exactly the same for the hospital in Tonbridge, which he knows, because I keep nobbling him on this one, we need much more investment in, so that we can have those community beds close to home.

My hon. Friend is absolutely right about getting community beds closer to home. I wish to mention four other measures in the Queen’s Speech—

On a point of order, Madam Deputy Speaker. The Secretary of State has made a serious allegation about my hon. Friend the Member for Leicester South. I have been in this House for a long time and I recall when PFI started under the John Major Government. [Interruption.]

I will debate the hon. Gentleman’s involvement in PFI, which hamstrung the hospitals, every day of the week. Now, however, I wish to—

I am delighted that the Secretary of State has elevated me; I was a 25-year-old adviser in the Treasury at the time. I remember sitting in that box as a special adviser listening to Tory shadow Health Secretaries calling for more PFIs in the NHS. The right hon. Gentleman was an adviser to George Osborne, so what about this quote from 2011:

“George Osborne backs 61 PFI projects…the chancellor, is pressing ahead with private finance initiative…on a multibillion-pound scale”.

The right hon. Gentleman should be apologising for PFI.

In 2011, I was the MP for West Suffolk. I opposed PFI in opposition and I have opposed it ever since, and I am delighted that the Government are cancelling it. It is just such a shame that the hon. Gentleman spent so many years driving through PFI when we could have built better hospitals for less money if we had properly put them on the books of the nation’s balance sheet, as we are doing now.

I will take two more interventions and then I must get through dealing with the rest of the Queen’s Speech.

Just in mid-Essex we have 300 new nurse recruits, new specialist services cutting waiting times, amazing new mental health provision for women with post-natal depression, an amazing new A&E emergency village at Broomfield Hospital and the brand-new medical school, training the GPs of the future. I declare an interest, because I have joined the board since visiting it with the Secretary of State. I am shocked by this amendment today if it would stop us from being able to access new medicines. Will he look at a new approach to make sure that those medicines get to children with very rare diseases?

Yes. My hon. Friend is a brilliant advocate for her local community, and I visited the new medical school with her. She makes an incredibly important point about access to new medicines. We want to bring more access to new medicines, rather than saying that if it is not made by the state, people should not have it, which is the approach outlined in the amendment.

Let me turn to the medicines and medical devices Bill, which was in the Queen’s Speech. The intervention by my hon. Friend the Member for Chelmsford (Vicky Ford) was precisely on this point: the potential of technology to bring forward new treatments and new devices is more exciting now than at any point in generations. The new medicines and medical devices Bill will allow our world-beating life sciences industry to be world leaders.

I do not think that we should insist on a state-run medicine company and I do not think we should be requisitioning intellectual property. We should leave that aside, not least because we already have some of the cheapest medical drugs in Europe. The Opposition seem to want to create a British Rail-style drugs system—inefficient, always breaking down and arriving too late. The Association of the British Pharmaceutical Industry said that under Labour’s plans, $183 billion that the industry spends annually on research and development for new drugs would “disappear”. The ABPI is a sober and respected organisation. The proposals would cost taxpayers billions and risk all the work that goes into saving lives. The industry knows they are nonsense, we know they are nonsense, and in his heart the shadow Secretary of State knows they are nonsense. The country will see straight through him.

I thank the Secretary of State for giving way, because he gives me the opportunity to deliver on a promise that I made to the parents of four-year-old Michal in my constituency, who asked me personally to thank the Secretary of State because it was as a result of his intervention that Michal, who has Batten disease—childhood Alzheimer’s—has access to the drug that will save his life. It is a groundbreaking treatment, and it is because the Government are investing in the NHS that Michal’s life will be saved.

My hon. Friend is absolutely right. It was incredibly moving to meet, in my office downstairs here in the House of Commons, some children with Batten disease who needed access to world-class drugs. They are expensive drugs, but we needed to get them at a price that was affordable to the NHS. I met the parents and some of the children, and it was incredibly moving. I met some siblings—one had access to the drug and the other did not—and I saw the difference in their development. We negotiated with the company and got the drugs on the NHS. That is how we should be providing world-class drugs. That is how it has been done under sensible Labour Administrations, and I urge the Opposition to reconsider, because even if it may sound good when they look in the mirror, it is not sensible to undermine our world-class life sciences in this way. I hope they think again.

On a point of order, Madam Deputy Speaker. The Secretary of State has been talking now for nearly half an hour, yet he has not really referred to the amendment in respect of the relationship between public health and trade, particularly the ability of tribunals and companies to sue.

Order. That is not a point of order; it is a point of debate. I understand the hon. Gentleman’s frustration, so I will repeat what I said earlier: the Secretary of State has been, as was the Opposition spokesman, most dutiful in taking lots of interventions. I have allowed those interventions because I recognise that Members want to refer to particular hospitals and other things in their own constituencies. I allowed them, but I now encourage the Secretary of State to cease—

No, it is not a point of order if I say it is not a point of order.

I encourage the Secretary of State to make progress. I appreciate his generosity to his colleagues, but we will have to make some progress.

Quite right. I am voting for you, Madam Deputy Speaker.

On the point made by the hon. Member for Swansea West (Geraint Davies), to whom I will not give way—

I am not going to give way after that nonsense, but on his point, perhaps he was not here at the start, but on the first page of my speech it says that

“the NHS is not, and never will be for sale under this government. The Prime Minster and the President have made it abundantly clear that the NHS will not be on the table in any trade talks.”

How many times do I have to say it? I will say it every day of the week.

My right hon. Friend will be aware of a number of women throughout the country, including Elaine Holmes in East Renfrewshire, whose lives have been ruined by vaginal mesh. One of the big problems they have had has been the poor response by the Medicines and Healthcare Products Regulatory Agency to patient concerns about device licensing. Will the Bill that he is talking about give us an opportunity to look again at how the licensing regime works, and in particular how it responds to patient concerns?

Yes, that will absolutely be addressed. We also have a report by Baroness Cumberlege that will look specifically in that matter, which is incredibly important for many people. We absolutely have to get it right.

I wish to touch briefly on three further measures: first, the Health Service Safety Investigations Bill. Millions of people receive life-saving care in the NHS, but saving lives also involves risk. It is important that we learn both when things go well and when things go badly. We want to create that learning culture right across the NHS. The legislation will establish in law the first independent body of its kind to investigate patient safety concerns and share recommendations to improve care. I pay tribute to my predecessor, my right hon. Friend the Member for South West Surrey (Mr Hunt), for all his ongoing work in this area.

Let me turn now to adult social care. We have already announced a new £1 billion grant for social care to address urgent needs, building on the 11% rise in social care budgets over recent years. We have to end the injustice that means that after a lifetime of hard work—of striving and saving—people are being forced to sell their homes to pay for care.

I commend my right hon. Friend for his work to improve patient safety. Will he also look into how whistleblowing is being managed in the NHS? We have had a concerning number of issues relating to whistleblowing in my local Dudley healthcare provider. I feel we have not yet managed to get a free and open environment for whistleblowers all the way through the NHS.

I very much agree with my hon. Friend. In many trusts, things have gone very well over the past few years and there is a much more open and less hierarchical culture, with less bullying and more openness to challenge. However, that is not the case in every part of the NHS, and that needs to change. The Health Service Safety Investigations Bill addresses that directly. After the welcome given by the shadow Secretary of State, I hope that Bill will proceed on an essentially consensual basis.

The hon. Gentleman is saying yes, which I am grateful for. I am open-minded to changes and improvements, and to listening to the experts and those with constituency cases that they can bring to bear, to make sure that the Bill is the best it possibly can be.

I hope very much to address the Health Service Safety Investigations Bill in my remarks later, but my right hon. Friend did not include one important element among the characteristics of the investigations, which is that they are to find the causes of clinical incidents without blame. It is not about satisfying a complaint; it is about finding without blame so that we can talk about things that have gone wrong without blaming people. It is about understanding the clinical, human factors that lead people to make perfectly understandable mistakes.

My hon. Friend is quite right. I was trying to shorten my speech, Madam Deputy Speaker, so I missed out a paragraph. I should have said that the purpose of the Bill is to enable staff to speak openly and honestly about errors without fear of blame or liability. That is exactly the point that my hon. Friend made and to which he paid an awful lot of attention in the drafting and prelegislative scrutiny of the Bill.

Finally, let me turn to the proposals on mental health. This country has been on a journey, over a generation, towards recognising that mental health is as important as physical health. There have been contributions to this change in mindset from all sides of the political debate—from Labour Members; especially from the right hon. Member for North Norfolk (Norman Lamb), to whom I pay tribute; and very much from Government Members, too.

I would like to take a moment to say how much I value the enormous contribution that the Duke and Duchess of Cambridge and the Duke and Duchess of Sussex have made to changing attitudes towards mental health on this journey. The Mental Health Act 1983 is nearly 40 years old and some of our law is still shaped by 19th century Acts and, indeed, their views of mental illness, and that is completely out of place in the 21st century.

I am very grateful to my right hon. Friend for giving way. I think that people across the House will be united in ensuring that we reform the Mental Health Act. May I encourage him, as part of the proposals to improve respect and dignity for those who are in treatment, to look at individual care plans to make sure that everyone who is discharged from some sort of residential treatment receives an individual care plan and has access to home visits, especially in those first 72 hours?

Yes, I will look precisely into the matter that my hon. Friend raises, because care plans should be the norm. Across the country, a high proportion of people now leave in-patient care with a care plan in place. If the proportion is not high enough in her area, I will look into it, write to her and make sure that she gets the full details.

I am grateful to the Secretary of State for giving way again; he is being very generous. What conversations has he had with the Secretary of State for Defence about people who are medically discharged with mental health issues from the military and who then transition into civilian life with healthcare provided in civvy street? How do we ensure that the pathway for care is unbroken, is consistent and provides a wraparound service for them as they transition out of the military?

This is another incredibly important point. I will be working with the new Minister for Defence People and Veterans, as well as the Minister for Mental Health, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), to address exactly that sort of concern. This is a long overdue—

Before the Secretary of State leaves mental health, will he address this issue of the 2,300 autistic people and people with learning disabilities who are in in-patient units, as it has been around for far too long? Last week, the Care Quality Commission announced that one in 10 of those units was inadequate. He knows—and I have written to him about it—that Bethany, a young woman, is in seclusion and still in a locked cell. When will he do something about those 2,300 people?

We are absolutely acting on the area that the hon. Lady quite rightly raises. The number of patients who are in in-patient facilities who have learning disabilities and/or autism has been falling—the number has fallen from 2,700 a couple of years ago to 2,250 on the latest figures. We have a plan to reduce that number further. We must ensure that everybody who comes out of in-patient facilities has the proper care plan and the community support to ensure that that is a sustained change in circumstance. It is something on which we are working incredibly hard. In fact, I was having a meeting with the Minister for Care only yesterday on precisely this issue, and I am very happy to ensure that the hon. Lady gets a full briefing on what we are doing.

Order. Before the Secretary of State takes the intervention from the hon. Member for Liverpool, Wavertree (Luciana Berger), I simply make the point that 35 hon. Members wish to speak, and therefore I think I can say with great confidence that he is approaching his peroration.

I thank the Secretary of State for very kindly giving way, and I welcome the fact that he will be taking forward into legislation the recommendations of the independent review into the Mental Health Act. Will that be accompanied by Sir Simon Wessely’s recommendation that the sector needs £800 million of capital infrastructure to bring mental health settings up to the same standards as those of physical healthcare?

I want to pay tribute to the work that Sir Simon has done in bringing this matter forward. We are absolutely looking at the capital requirements, as well as the requirements for revenue funding, which have gone up in this area. We will be publishing a White Paper by the end of the year, and then we will bring forward the new mental health Bill as a draft Bill. Mental health is a priority for the Government. These reforms need to be done with care, and I hope again with consensus. The timetable for reform is that requested by the mental health community, but Members should make no mistake, we will act. I am very happy to talk to the hon. Lady with more details.

I do not think that I have ever taken more interventions in a speech, Mr Speaker, and I am now happily coming to my conclusion. This Queen’s Speech has health and social care at its heart. The reforms will help to improve the delivery of the NHS and to bring new cutting-edge treatments to work. They will make sure that our world-beating life sciences are supported; that we have a safer NHS, where we always seek to learn and to improve; that we have a permanent solution for social care, not just a short-term fix and dignity; and that we have dignity and support for everyone receiving mental health care as we put record funding into mental health services. All that will be properly funded, because we have turned the economy round—without a strong economy, we just cannot properly fund the NHS. Today’s debate has shown why we Conservatives are now regarded as the true party of the NHS and we will make sure that it is always there for generations to come up.

Debate interrupted.