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NHS Update

Volume 699: debated on Wednesday 21 July 2021

I apologise to you, Madam Deputy Speaker, and to the Opposition spokesperson, the hon. Member for Tooting (Dr Allin-Khan), for the late sight of this statement.

Before I start my remarks, I would like to take the opportunity to pay tribute to the noble Lord Stevens, who will shortly be standing down as chief executive of the NHS. I thank him for his dedicated service over the past seven years, especially his stewardship during our battle against this virus and his huge contribution to this nation’s vaccination programme. I am sure that the whole House will join me in thanking him and giving him our best wishes for the future.

With permission, Madam Deputy Speaker, I would like to make a statement on our support for the NHS. In the NHS’s proud 73-year history, no year has been as tough as the last. Everyone working across the NHS has achieved incredible things in the face of great difficulty—from building the Nightingale hospitals in just a matter of days to rolling out our life-saving vaccination programme. They have been there for us at the best of times and at the worst of times. As a Government, we have sought to give them what they need at every stage of the pandemic.

Today, I would like to set out for the House some of the support we have been giving. Throughout the pandemic, we have worked to deliver manifesto commitments—50,000 nurses, 40 new hospitals and 50 million more GP appointments—and we are taking every opportunity to invest in our NHS to make sure that patients feel the benefits of the latest treatments and technologies.

Only this week, we announced a new innovative medicines fund to fast-track promising new drugs. This builds on the amazing work of the cancer drugs fund, which has already helped tens of thousands of patients access promising cancer treatments, while we use the data to make sure that they represent good value for the wider NHS. It is estimated that one in 17 people will be affected by a rare disease in their lifetime, and this fund will support the NHS to fast-track access to treatments that could have clinical promise. This new £340 million initiative takes our dedicated funding for fast-tracking promising drugs to £680 million, showing that we will do everything in our power to give patients access to the most cutting-edge therapies.

Doing right by the NHS means making sure that colleagues have the right team around them. This was true when we made our manifesto commitment for 50,000 more nurses by March 2024, and it remains especially true in the face of the challenges brought by the pandemic. I am pleased to report that we have almost 1.2 million staff working in NHS trusts, an increase of over 45,300 compared with a year ago. This includes over 4,000 more doctors and almost 9,000 more nurses, taking us to over 303,000 nurses in total, and we are on track to deliver on our 2024 commitment.

We recognise that, with so much being asked of our NHS staff, many will not yet be feeling the difference of these extra colleagues on the frontline, but I can assure those hardworking nurses that you will feel it soon. Yesterday, I heard from NHS Employers that, for the first time, Hull University Teaching Hospitals NHS Trust will have a full complement of nursing staff when the intake of new nursing graduates begins work in September. I know that we all look forward to hearing that kind of news from more and more places across the country.

Finally, I want to update the House on our autism strategy. Our NHS long-term plan set out our commitment to improving the lives of autistic people. Today, we have launched our new autism strategy, which sets out how we will tackle the inequalities and barriers faced by autistic people so that they can live independent and fulfilling lives. I am truly grateful to everyone who has contributed to shaping this strategy, including autistic people and their families, and the all-party parliamentary group on autism in particular. I would like to take a moment to recognise the contribution of Dame Cheryl Gillan, the former Member for Chesham and Amersham, for her incredible advocacy of autistic people, including the inquiries she led in 2017 and 2019. She left an incredible legacy, and we are all so grateful to her for her work.

Today’s strategy builds on our previous strategy, “Think Autism”, and we have made so much progress since then. We now have diagnostic services in every area of the country and a much better understanding and awareness of autism, but there is much more to do. The life expectancy gap for autistic people is still about 16 years on average compared with the general population, and almost 80% of autistic adults experience mental health problems during their lifetime. The coronavirus pandemic has been tough for many autistic people. Far too many autistic people face unacceptable barriers in every aspect of their lives—in health, employment and also education —so we have worked together with colleagues in the Department for Education to extend the strategy to children and young people as well as adults, reflecting the importance of supporting people all through their lives, from the early years of childhood and through adulthood.

The strategy is fully funded for the first year, and it contains a series of big commitments, including getting down the covid backlog; investing in reducing diagnosis waiting times for children and young people; preventing autistic people from avoidably ending up in in-patient mental health services; improving the quality of in-patient care for autistic people when they are receiving it; funding the development of an autism public understanding initiative so that autistic people can be part of communities without fear or judgment; funding to train education staff so that children and young people can reach their potential; and many more commitments. This landmark strategy will help to give autistic people equal opportunities to flourish in their communities, as well as better access to the support that they need throughout their lives, so that all autistic people have the opportunity to lead fuller and happier lives, as they deserve.

We owe so much to our NHS and the incredible people who work there. They have done so much to support us at this time of national need. As a Government, we will give them what they need, not just through this pandemic but to face the challenges that lie ahead. I commend the statement to the House.

I declare an interest as an A&E frontline doctor who is working in our NHS.

The contempt that the Government have for the House is unacceptable. I had advance sight of the statement only a few minutes ago. Once again, the Government have had to row back on a shoddy, ill-thought-through position, with their 1% pay rise—a real-terms pay cut—rejected by the independent pay body. What do they do? Nothing. Less than an hour ago, there were competing briefings on what the deal was going to be, but it turned out to be nothing. Our NHS staff deserve better than this. They have worked incredibly hard throughout the pandemic, and their personal sacrifice is astounding. Their hard work never stops, and that is not without consequences. Work-related stress has increased by nearly 10%, and mental health is consistently the most reported reason for staff absence in the NHS, accounting for approximately half a million days lost every single month.

Those issues preceded the pandemic, but the increased pressure, intensity and trauma experienced by staff has taken its toll. Reports published in January found that nearly half of frontline NHS staff were suffering with post-traumatic stress disorder symptoms and severe depression, with many drinking to numb the pain. It is hardly a surprise that a third of staff are considering leaving their job. With vacancies throughout the health service, retaining staff is absolutely vital, especially when the NHS is embarking on a vaccine booster campaign, tackling the coming wave of coronavirus hospitalisations, treating the growing number of long covid cases, and dealing with the ever-mounting backlog.

That is why a fair pay rise and conditions are important. It is not just a moral imperative—it is also about the future functioning of our NHS. By refusing to offer a pay rise, the Government risk workers leaving the health service, creating more vacancies, shortfalls in shifts and increased workloads for the staff who remain. It makes recruitment much harder, with huge gaps in crucial areas such as nursing. It makes the Government’s already insufficient pledge to recruit 50,000 more nurses by 2024 simply impossible. Healthcare staff are rightly angry that they have been treated in this way. We recognise that unions want to consult their members on all proposals, and we support them in that. The fact that even the unions have been kept in the dark is utterly unacceptable.

After the year we have had, there should not be so many unanswered questions, so I ask the Minister: is this really fair on NHS staff who have had to bury their colleagues, as well as their families? Is this really fair on NHS staff who have been sent like “lambs to the slaughter”, without appropriate personal protective equipment for work throughout the pandemic—I am using their words. Is this really fair on NHS staff who are sent to support us and our families, ill-equipped and with inappropriate PPE? Is this fair, when NHS staff nursed our loved ones when they died alone? Is this fair, when staff are exhausted and there is still no end in sight. Minister, this is quite simply an insult of the highest order. After everything our NHS staff have done for us, when will the Government finally make them feel valued and offer them something more than claps?

A statement on the NHS should have concrete plans on how the Government will support the NHS in tackling the summer crisis. If the Minister is so sure that she understands NHS staff and their pressures and workloads, I invite her to do a shift with me on the A&E frontline—she can shadow me for once.

Just before the Minister responds, I will say that Mr Speaker will be annoyed, to say the least, that the hon. Member for Tooting (Dr Allin-Khan) did not receive the statement from the Minister in time. The Minister did apologise at the beginning of her remarks, so I have noted that apology and we do not have to go any further on that, but I have also noted what the hon. Lady has said.

Thank you, Madam Deputy Speaker. I reiterate my apology to the hon. Lady for the late sight of the statement and thank her for her invitation to join her, but I will say that I am shocked by some of the language that she uses. I would just say—[Interruption.]

Order. The hon. Member for Tooting must not shout at the Minister across the Dispatch Box. She was heard, and the Minister must be heard.

What we say in this Chamber is clearly important and it has ripples beyond the Chamber, so I for one consider the tone of what we say to be extremely important. The hon. Lady spoke about pay for NHS staff. As she knows, the Government asked for recommendations from the NHS pay review bodies. The Government are rightly seriously considering those recommendations, and we will be responding as soon as we possibly can. She also knows that last year the Chancellor committed to NHS staff receiving a pay rise at a time when there is a wider freeze on public sector pay, recognising the extraordinary lengths that NHS staff have gone to during the pandemic.

The hon. Lady talked about the pressures on NHS staff, which she and I know go back a long way, but yes, of course they have been so much greater during the pandemic. We know that NHS staff have gone above and beyond, time and again, during the pandemic to care for patients. Recognising that, and knowing that that has been happening throughout the pandemic, I have worked with NHS England, and particularly the people team there, to put in place all possible support for staff during these difficult times. That includes practical support with some of the day-to-day challenges of working shifts and the extra disruption to people’s lives and home lives during the pandemic, as well as mental health support, including setting up 40 new mental health hubs for staff, which I have heard from staff on the frontline are really making a difference. In fact, some of these things are making the NHS a better place to work for the future, and we should try to continue some of the improvements to mental health support for staff, recognising the importance of this to people who are doing extremely challenging jobs.

I also say to the hon. Lady that we now have record numbers of staff in our NHS. We have over 300,000 nurses, as I said earlier—around 9,000 more nurses than a year ago—and record numbers of doctors, so we have more staff in our NHS. We are also seeing a huge interest in NHS careers. For instance, we have seen a 21% rise in applications to UCAS for nursing degrees this year, which comes on top of a rise last year as well. I welcome the fact that so many people now want to join our NHS to support it, and I am determined that we as a Government will continue to support our NHS workforce in the weeks and months ahead.

May I start by echoing the Minister’s thanks to Lord Stevens, who is about to step down as chief executive of the NHS? One of my proudest achievements as Health Secretary was to secure a £20 billion annual rise in the NHS budget, and that would not have been possible without a close partnership with Lord Stevens. Indeed, he taught me a number of things about how to negotiate with the Treasury. He is someone who believes in the NHS to his fingertips, and he will be missed in all parts of the House, both on the Opposition Benches, but also on this side, where we have long forgiven him for his new Labour origins. We wish him well for the future.

This statement is about the NHS. The biggest pressure facing the NHS, apart from covid patients themselves, is the covid backlog, and I draw to the Minister’s attention the concerns that I and a number of people have as we face these enormous waiting lists. The previous Labour Government had considerable success in bringing down waiting lists, to their credit. They would also say that there were unintended consequences in terms of lapses in parts of the system with the safety and quality of care. Will the Minister, as we once again try to bring down waiting lists, agree that the Government will redouble their focus on safety and quality of care so that we do not have to relearn the lessons of Mid Staffs, Morecambe Bay and a number of other sad tragedies?

I thank my right hon. Friend for his question. I know that in his time as Health Secretary, he did a huge amount to raise the standards of safety and have a greater focus on patient safety in the NHS. That is still clearly making a difference today. He is absolutely right that we need to ensure that we focus on that as we work to bring down the backlogs from the pandemic. It is not only that; I am mindful of making sure that we continue to support our NHS workforce as they, on the one hand, look after patients with covid and, on the other, work to reduce the backlog. That pressure is continuing, but I am determined that as we bring down the backlog, staff will continue to be supported and will, in fact, continue to have time off, annual leave, the breaks they need and the wider support so that we look after our workforce as well as providing the care that patients need.

I have listened to what has been said in the statement, and I was surprised that it did not cover the subject of NHS pay, which had been well trailed in advance. I would have hoped that the UK Government would match the 4% that the Scottish Government have offered NHS workers, backdated to December 2020. The Scottish Government have also secured agreement for a real living wage for social care staff at £9.50 an hour and underwritten the promise with £64.5 million in support. Why is it that this UK Government are unable to match the Scottish Government’s commitments to give NHS and social care staff the pay that they deserve and need?

I thank the hon. Member for outlining the approach in Scotland towards pay. Pay is a devolved matter. As I said earlier to the shadow Minister, the hon. Member for Tooting (Dr Allin-Khan), we are reviewing the recommendations from the pay review bodies, and we will be making an announcement for pay in England in due course.

I thank the Minister for her updates. On another matter, I am receiving emails from East Devon constituents concerned that their first, second or both jabs have not been registered properly and do not appear on the NHS app. It is putting their holiday plans in doubt. From September, they may not be able to access some venues when covid passports could be introduced, although not with my support. The papers are filled with similar stories from across the country. Not only will covid passports create a two-tier society but it also appears to be a system that is based on sometimes inaccurate data. Is this really a good idea, Minister?

Well, I welcome the fact that so many of my hon. Friend’s constituents have received their vaccination. Where there are problems with the data, I am sure he will know that the vaccines Minister, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi) is very assiduous on these specific matters. I will raise with him the examples. It may well be that the Minister will get directly in touch with my hon. Friend and resolve the situation.

I start by echoing the remarks of the Minister and the right hon. Member for South West Surrey (Jeremy Hunt) regarding Lord Stevens. He happens to be a constituent of mine, but he has also been a phenomenal chief executive of the NHS and I hope he will be making some well-informed interventions on the Health and Care Bill in the other place.

The statement rightly applauds our NHS staff and says how much we owe them. It says that the Government will give them all that they need. Words and clapping are cheap. Where on earth is the widely reported and trailed pay deal announcement that was expected today? Does the Minister really believe that the 1% pay rise, which is actually a pay cut, is giving NHS doctors and nurses what they need? Is that really a just reward for their sacrifices of the last 18 months?

I agree that pay for our NHS workforce is clearly very important. That is why we are considering the recommendations of the pay review body and we will make an announcement on pay in due course.

I hugely welcome the Minister’s statement today, particularly the news about the autism strategy, but as we look beyond the pandemic, there is real concern from charities and patient groups that many patients have missed being diagnosed with some very serious conditions due to lockdown and covid restrictions. GPs have a crucial role in dealing with this issue. Will the Minister set out the steps that her Department is taking to provide an extra 50 million GP appointments a year?

My hon. Friend makes a really important point. We have seen people not come forward for treatment during the pandemic and it is worth reiterating that if anyone is worried about their health, it is really important to seek that help and get a diagnosis or seek treatment. We are working to increase the number of appointments available in primary care. One thing we have also seen during the pandemic is that GPs have increased remote working and virtual appointments. We know that many people need to be able to see a GP in person, but there are also opportunities to combine GPs being able to offer services in person and virtually in a way that is good, hopefully, for GPs and patients.

I thank the Minister for the statement and what she spoke about earlier. I want to ask about the NHS wage increase, which is on my mind. On the TV screens this morning, a nurse gave her story—it was very heartfelt, for those who had the opportunity to hear it—about the difficulties of retaining staff and ensuring that they were able to cope through the process. There is a real need to respond positively on the wage increase. A petition on that has also been handed into Government. I believe in my heart that NHS staff should receive the 3% increase. Does the Minister agree that 3% is enough, given their tireless and admirable efforts in tackling covid-19, and can she confirm that NHS staff will receive the wage increase and that it will be a priority for her and the Government?

The hon. Gentleman is asking me to pre-empt the Government’s response to the recommendations of the pay review body and I am afraid that I am not able to do that at the Dispatch Box today. What I can say is that we are considering its recommendations and we will make an announcement on pay for NHS staff as soon as we can.

I thank the Minister for her update and the announcement on the autism strategy, which is much welcomed. It has been a very tough 16 months for every single worker in the NHS and I salute every one of them around the country, particularly in the Meon Valley, of course. I also praise every volunteer in the vaccine centres that have played such a successful role. I have been keeping in touch with the local NHS bodies and patients about progress towards a new hospital in Hampshire, one of the 40 in our plan. Can my hon. Friend confirm that her Department is engaging with the Hampshire Hospitals NHS Foundation Trust to move this project forward as soon as possible, as it will benefit my Meon Valley constituents?

I join my hon. Friend in thanking NHS staff in the Meon Valley and also, as she says, the many volunteers in her area and across the country who have been so invaluable in their support during the vaccination roll-out. She asked about her new hospital in Hampshire. She will know that the Government are going full steam ahead with bringing forward new hospitals, and I will take up her specific question with my hon. Friend the Minister with responsibility for hospitals.

First, let me associate myself with the Minister’s comments about Lord Stevens and Dame Cheryl Gillan. Both contributed massively to the Public Accounts Committee, albeit from different sides of the witness table.

This statement is disappointing. It is great to hear about the autism strategy, but that was already a written statement today. Why have we not heard about the backlog, social care or NHS pay? The Minister has talked about recruiting more people. I could go to town on how many failed targets there have been, and we are still not sure whether the Government will meet this one. The key issue in NHS staffing is retention of staff. If she cannot tell us about NHS pay now, when, Minister?

The hon. Lady is absolutely right that retention is vital to us for maintaining the staff that we have in the NHS. For instance, to achieve our 50,000 more nurses for the NHS, there will be a combination of new domestic recruitment, staff training to become nurses, international recruitment, but also retaining the nurses that we have, which is a really important part of it. That is why we worked so hard during the pandemic to support NHS staff to stay with the NHS. What we have seen—I am truly grateful to many staff for this—is people sticking with the NHS during this time. Some staff have even delayed their retirement in order to help the NHS through the pandemic. Looking ahead, we must be ready to continue supporting staff, including, for instance, staff who are nearing the end of their careers, making sure that, if they want to work a bit differently—more flexibly for instance—that should be available. That is one thing among a whole host of things that we are doing in order to support the retention of staff.

I must just say to the House that the hon. Member for Hackney South and Shoreditch (Meg Hillier) is not the only Member this week and in recent weeks who has addressed the Minister as “Minister”. I am sorry to pull up the hon. Lady. I am doing it to her because I know that she can take it and will not be upset by my criticising her. I am rather more gentle with the new Members, so I thank the hon. Lady for helping me in this by allowing me to use her as an example. When a Member asks a question, you do not say, “Minister, are you going to do this?” You say, “Madam Deputy Speaker, or Mr Speaker, does the Minister understand that she must do this?” We must not lose sight of that because it changes the way in which dialogue occurs in this place. Just because it is hot, the end of term and we have covid problems does not mean that we let our standards fall.

On Monday, Sky News was among those who reported that frontline health workers in England are to be spared self-isolation rules in an emergency move to tackle the pingdemic that has triggered an NHS staffing crisis. I am very pleased, because, of course, the NHS has a special place in all our hearts and in all our constituents’ hearts, but so, too, does food in the supermarkets and on our tables, and the capacity of businesses to recover, particularly theatres, which have been in the news. What will my hon. Friend do to ensure that everyone is freed from this great curse of the pingdemic, which is keeping us from our recovery?

Isolation is an important part of our defence against the pandemic. We know that those who are contacts are around five times more likely to be infectious. That is why isolation is so important. My hon. Friend is correct to say that there has been a very specific policy for a limited number of NHS and social care staff in exceptional circumstances and subject to a risk assessment. The conditions for someone to work if they are a contact are: they are double vaccinated; they receive regular PCR testing; and the decision is subject to the approval of the director of public health, or an appropriate public health individual. As I say, the conditions are very limited and specific. The Prime Minister also said that we will make sure that crucial services will be able to continue to operate, even while recognising that many people are currently isolating; that that goes beyond health and social care; and that in mid-August we will introduce a new system.

I spent 20 years working in the NHS, but I have never known the NHS to be under such extreme pressure.

Mental health needs are unmet; NHS waiting lists are going through the roof; GPs are completely overrun and unable to cope; and there is no solution to our social care crisis. The Tories have achieved what I did not believe was possible: they have broken the NHS and care service and they have broken the NHS and care staff. In that shadow, the Minister should be ashamed to bring such a vacuous statement to the House today. Will she now immediately enter into urgent cross-party talks on how we can rescue this disastrous mess before staff and patients bear further sacrifice.

I do not agree with the hon. Lady’s description of the situation. It is clearly absolutely true to say that our NHS staff and social care staff have done tremendous things during the pandemic, and clearly they are still doing so as covid is still so much with us. They have gone above and beyond time and again. It has been important that we have put in place extra support and we will continue to make sure that there is extra support for staff. We will announce our decision on NHS pay in due course.

I thank my hon. Friend for her statement. I take this opportunity to thank all the staff who work at Stepping Hill Hospital in my constituency for their tireless efforts throughout this pandemic.

The past 16 months have reinforced the importance of the Government’s goal of getting 50,000 more nurses in the NHS by the end of this Parliament. I am encouraged by the progress that has already been made in that respect. Will my hon. Friend confirm that her Department will also continue to work hard to improve the recruitment and retention that we will need to meet that crucial target?

I, too, thank the NHS and social care staff in my hon. Friend’s constituency and her local hospital for all that they are doing. I welcome her acknowledgement of the progress we are making towards our target of 50,000 more nurses. We are absolutely going to continue with our strong domestic recruitment, in respect of which we are in a really good position because of the increased number of applications for nursing courses. Even in the face of the pandemic, international recruitment is still really strong. Trusts are doing a great job in bringing and supporting international recruits into their organisations and, of course, supporting staff who were already in the NHS. Retention is so important—we must keep those we already have.

I send solidarity to my fellow gingers in the Chamber and beyond who will no doubt be struggling with the heat today, as I am.

NHS staff are justifiably angry. The Minister can tone police my hon. Friend the Member for Tooting (Dr Allin-Khan) all she likes, but frankly she will get shorter shrift if she speaks to the exhausted, demoralised and underpaid NHS staff in my area. Rather than clutching her pearls, will the Minister please turn her attention to delivering the much-trailed pay rise that she has failed to announce today—one that fairly reflects the contributions of NHS staff, redresses years of real-terms pay cuts, and addresses the number of NHS key workers who are still shamefully paid below the real living wage?

The hon. Lady has clearly been speaking to NHS staff in her constituency, and I am glad to hear that. As the Minister responsible for the NHS workforce, I speak to NHS staff all the time to make sure that I understand the things that are most on their minds. Pay is of course on staff’s minds at the moment, but so is the importance of having full teams, so I am glad that we are making progress on increasing the number of staff in the NHS more broadly and the number of nurses specifically. We are also putting in place other support, such as the mental health support that I know is so im

The Minister will be aware that Redcar and Cleveland currently has the highest rate of covid in the country, but thankfully this is not leading to a huge increase in hospitalisations and deaths because we are also one of the most vaccinated parts of the country, with 71.2% of people having received both doses. What additional support can the Department give to Redcar and Cleveland to ensure that everyone is able to access the jab and protect themselves and our local NHS?

May I say how good it is to hear that my hon. Friend’s area has taken up the jab so strongly, so that so many people are having the protection of both doses of the vaccination? We know that it does not mean that they definitely will not get covid at all, but we know that their risk of hospitalisation, serious consequences and indeed death is that much lower from being vaccinated. Of course, it is important that those who have yet to be vaccinated but who are eligible still come forward; there are more people still to come forward. If my hon. Friend thinks that there is anything specific that we could do further in his constituency, I hope that he will let me or the Minister for Covid Vaccine Deployment know.

I join my hon. Friends the Members for Tooting (Dr Allin-Khan), for Hackney South and Shoreditch (Meg Hillier), for York Central (Rachael Maskell) and for Warrington North (Charlotte Nichols) in expressing my dismay at the Minister’s statement, which outlines nothing for the many NHS staff—including the hard-working staff across the bridge from this House, at St Thomas’ Hospital in my constituency—who still have not seen the pay rise that they deserve. Our NHS staff have been working tirelessly for more than a year on the frontline; they are exhausted. They have experienced exceptional levels of trauma and crisis for a prolonged period. Recent research by King’s College London found that intensive care staff reported PTSD, severe depression and anxiety. They need support over the coming years. Will the Minister outline what steps the Government are taking to work with our NHS staff in order to support them to deal with the mental health fallout from the pandemic?

I join the hon. Lady in thanking NHS staff in her constituency, particularly in St Thomas’ Hospital, just across the river from where we are now, where I had one of my three children and was extremely well looked after. She asks about mental health support for staff. We recognise the pressure and mental health challenges that staff have been facing, particularly during the pandemic. That is why the NHS is putting in place 40 mental health hubs to provide specific mental health support to NHS and social care staff. That is one of a range of things that we are doing to support the mental health of staff through this time.

I welcome the Government’s commitment to our NHS through the delivery of the biggest hospital building programme in a generation. Will my hon. Friend set out the progress that her Department has made towards identifying and progressing the 40 future hospitals that it will be building and significantly enhancing, such as North Devon District Hospital in my constituency?

We have indeed committed to build 40 new hospitals by 2030. Together with eight existing schemes, that will mean 48 new hospitals by the end of the decade—as my hon. Friend says, the biggest hospital building programme in a generation. The programme is absolutely on track, but I will have to take up the specific hospital in her constituency with the Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar), who is the hospitals Minister.

In order to ensure that the Minister is damned if she says no and damned if she says yes, can she confirm whether she believes that pushing the Government response to the pay review into the long grass or sneaking it out during the recess, when Parliament is not sitting, is an adequate and fair reflection of the sacrifices that NHS staff have made to keep our country safe during the pandemic?

As I have said, we are considering the recommendations of the NHS pay review body. This is an extremely important decision for the Government; it clearly has consequences for a very large number of NHS staff. We will be announcing our decision on pay as soon as we can.

Let me start by commiserating with the Minister, who is clearly grabbing a short straw at the moment. I am not sure what the point of this statement actually is. It seems as though pages 2 to 4 have been torn out at the last minute, and she has just read out the preamble and the end, with nothing in between. However, as this is an opportunity to raise NHS issues with her, may I draw her attention to a growing concern for my constituents, which is the difficulty in getting a GP appointment? Is she aware of that growing issue across parts of Greater Manchester and, no doubt, the rest of England? What is she doing about it?

I thank the hon. Gentleman for taking the opportunity to raise that point. I am well aware of it, as my constituents in Kent raise the issue of that challenge in my area, and I know others do the same in many other parts of the country. That is why we are working to increase the number of primary care appointments available to people, knowing that demand is going up and that we must make sure that people’s need for local healthcare, which is so important, is met.

Madam Deputy Speaker, it is good to know that you only tick off MPs who can take it; I would not wear a jacket on one occasion on Zoom, so I am appropriately dressed for you on this occasion.

I wish to thank the Minister and the Department of Health and Social Care, because under this Government the Royal Stoke University Hospital has received more than £40 million of investment. Sadly, however, Labour’s legacy in Stoke-on-Trent at the Royal Stoke is Andy Burnham’s disastrous private finance initiative deal, which means that £20 million a year is being stolen from the frontline and going on a hospital PFI debt, meaning that we have had fewer beds than we had before. Does the Minister agree that one way we can help our local NHS is by freeing it of this usuary, so that money can instead go on funding more beds, doctors, nurses and equipment for our fantastic frontline NHS staff?

I agree wholeheartedly with my hon. Friend on that; I am glad that we are able to focus our funding for the NHS on the things that really matter—building new hospitals and supporting the workforce, and, at the moment and in the months ahead, supporting the elective recovery and all the extra work that needs to happen to give people the treatment they need.

Before I ask my question, may I say to the Minister that she might want to think again about coming to this House and ticking off my hon. Friend the Member for Tooting (Dr Allin-Khan) for her tone and language on NHS pay when she has come to this House to say absolutely nothing at all? Worse still, we hear from the media that the social care announcement is now being pushed to September. Let me give the Minister a second chance: can she confirm at the Dispatch Box right now that when we get that social care plan it will match Wirral Council’s priority of getting every social care worker in this country the real living wage—yes or no?

It is very good to hear that Wirral Council is supporting social care workers in its area. Local authorities are a crucial part of our work in social care reform and they have so many of the direct relationships with the care providers who are providing that social care. We are absolutely committed to bold, ambitious reforms for social care. As the hon. Lady knows very well, we will be bringing those forward during this year.

I ought to conclude the statement here, because we are running way behind time. However, I appreciate that Members have important questions to ask and that the Minister will want to answer them. But I ask for much greater speed and brevity, because otherwise it is not fair to people who are waiting for us to come on to the next item of business. I call Dr Ben Spencer.

Thank you, Madam Deputy Speaker. Before I ask my question, may I declare an interest, in that my wife works in the NHS?

I thank the Minister for her statement, particularly on supporting our workforce. When I speak to local health leaders they tell me that the workforce are tired—they have been dealing with covid for the past 18 months, and they are worried that they will have to lurch from covid into tackling 150% of the covid backlog. What reassurance can the Minister give health staff working in my constituency that there will be a sustainable transition from dealing with the pandemic to dealing with all the backlog and consequences as a result of it?

My hon. Friend makes an important point, and it is why I am working closely with my hon. Friend the Minister for Health, who is leading oversight of the elective recovery work. We are very much discussing how we can make sure that, with the pressure of looking after people with covid, with winter approaching and with elective recovery, we are looking after our workforce through this period. Of course, looking ahead to the winter, it is important that people get not only the covid vaccination, if they are eligible, but the flu vaccination, so we can try to have as little flu as possible in what may be a challenging winter ahead.

Although it is welcome that the Government have launched their new autism strategy, they will need to do more than that to ensure that the 2,000 autistic people and people with learning disabilities currently detained in inappropriate in-patient units can move back into the community. For 10 years since the Winterbourne View scandal, the Government have failed to invest in the high-quality community services needed, and they have done nothing to stop the flow of people into in-patient units from the community.

Will the Minister commit to the funding needed to support all current in-patients in the community? Can she say when the Government will finally bring forward reforms to our social care system so that it provides the support autistic people and people with learning disabilities need?

The hon. Lady refers to the importance of making sure that only those who really benefit from in-patient treatment should be in in-patient units. We know that is often not the case for autistic people, and sometimes those with learning disabilities, who are in-patients. We are working through our “building the right support” programme to reduce the number of in-patients, and we will continue to do so.

Local services, businesses and schools across my Colne Valley constituency have been severely impacted by absences as a result of staff being pinged. We already know that, from mid-August, those who have been double jabbed will not have to isolate when pinged, but with such a successful roll-out of vaccinations in my part of Yorkshire, why can it not happen now?

I appreciate my hon. Friend’s point, but the fact is that isolation is an important part of our defences against this virus. At the moment, therefore, we have to ask people who are pinged by the Test and Trace app to isolate in order to break the chains of infection.

The whole country wants to see a proper pay rise for NHS staff, and we await the Government’s announcement. The central ethos of healthcare through generations and centuries has been the Hippocratic oath, which gives equal value to the lives and health of every single human being, including those over 80 years of age. Will the Minister stand up for the NHS and its core principle by rejecting the Prime Minister’s brutal philosophy of abandoning our older neighbours, friends and relatives?

I do not accept what the hon. Gentleman says. From my position during the pandemic, I can say that we have tried, at every step of the way, to protect those who have been most vulnerable to this virus. It is a cruel virus, and it is particularly cruel to those who have weaker immune systems and those who are older. We have done all we possibly can, including putting over £2 billion of funding, PPE, testing and vaccinations into social care to do our utmost to protect those who are most at risk.

The pandemic has shown the vital need for effective collaboration across health and social care, and the need for individuals, such as nurses, to be able to work flexibly across both systems. What steps have the Government taken to ensure that parity of esteem is achieved across the health and social care workforce, in their training—preferably together—in their work opportunities and in their pay, which should be comparable?

My hon. Friend makes an important point, and we have seen some really effective collaboration across health and social care during the pandemic. We want to continue to build on that. One of the things I am doing is working with Health Education England, which is launching a review looking ahead at how we can go further in bringing together our healthcare workforce and registered staff in the social care workforce.

The Minister is quite rightly embarrassed because she can say nothing about NHS pay, but she should be equally embarrassed that she cannot answer the question about parity of esteem for care workers. Over 100,000 care worker vacancies exist in this country. What are the Government going to do to make sure not only that the care workers in post are not exhausted but that people who need care get the care workers that they need?

It is true that the social care sector does face a challenge and has faced a challenge in recruiting people. We are supporting the sector and we have supported the sector during the pandemic. As part of our work on social care reform, we are looking at the workforce to see, for instance, how we can make sure that social care is an attractive place to work, particularly for people coming into the workplace for the first time, and then provide career progression opportunities so that they stick with social care for a long time.

Access to a GP is now very patchy. Some of my constituents have no difficulty in getting a face-to-face appointment; others find it almost impossible. We all accept that there are new ways of working and some GP appointments can be virtual, but that is not appropriate in all cases. Over the coming months, if not years, if access to appointments does not improve, we will see that tackling the backlog, and keeping pressure off A&E and our ambulance services, will only get worse. What steps can the Department of Health and Social Care take to support and encourage GPs to get back to operating as normal and get patients through the door?

My hon. Friend is absolutely right about the importance of people being able to access GPs and to get healthcare close to home. NHS England has been clear to GPs that they must ensure that they are offering face-to-face appointments as well as remote appointments. In general, practices are taking this approach, and we will continue to support GPs to provide that access over the months ahead.

Last week, the Minister for Health, the hon. Member for Charnwood (Edward Argar), said in response to a question from my hon. Friend the Member for York Central (Rachael Maskell) that

“it is not the intention that ICBs”—

integrated care boards—

“depart from “Agenda for Change”.—[Official Report, 14 July 2021; Vol. 699, c. 474.]

However, given that the Health and Care Bill will revoke the national tariff and places a clear emphasis on a move to tariffs varying by area and other factors, coupled with strict financial controls for ICBs, is it not inevitable that it will undermine “Agenda for Change” and the pay and terms of conditions of over 1 million NHS workers in England?

Thank you, Madam Deputy Speaker; we much appreciate you extending this session.

Before any major change is made in the NHS, there is a full impact assessment done to see how it affects wider society. Would the Care Minister be able to say when last week, when the statutory instrument on compulsory vaccination of care staff was put before the House, she had the opportunity to read the SI, the explanatory notes and the full impact assessment? If there was no full impact assessment, why did the Government proceed in laying it before Parliament?

I was asked about this at the time and during the debate, and I did apologise for the fact that there was an error in the explanatory notes. We have since published an impact statement, and a full impact assessment is going through the formal approval process.