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Commons Chamber

Volume 716: debated on Tuesday 14 June 2022

House of Commons

Tuesday 14 June 2022

The House met at half-past Eleven o’clock


[Mr Speaker in the Chair]

Speaker's Statement

Before we start today’s business, I want to make a short statement. Members will be aware that today marks the 40th anniversary of the end of the Falklands war. I know that all Members will wish to join me in remembering those who lost their lives during the hostilities, including 255 British military personnel and three Falkland Islanders. We also send our thanks and best wishes to all the veterans.

I hope as many Members as possible will be able to join the service to commemorate the anniversary, to be held in St Margaret’s tomorrow. Please, let us have Members there; it is straight after Prime Minister’s questions. A register will be taken of those who do not attend. [Laughter.]

Oral Answers to Questions

Health and Social Care

The Secretary of State was asked—

NHS Backlogs

1. What progress he has made on tackling the NHS backlogs in elective care caused by the covid-19 outbreak. (900461)

First, may I associate myself with your remarks, Mr Speaker, about the Falklands war as we remember those who lost their lives and their loved ones?

We are making good progress on tackling the covid-19 backlog, having already halved the number of patients with the longest waits and delivered more than a million tests and checks at our new community diagnostic centres. Our elective recovery plan commits an additional £8 billion to deliver approximately 30% more elective activity than before the pandemic, and we have ambitions to go further to transform services, improve patient care and ensure value for money.

The cost of living is foremost on everybody’s minds now, so what assurances can my right hon. Friend give me that my constituents in Heywood and Middleton—a part of the world he knows very well—will get bang for their buck from the extra money they are paying into the NHS and that the money will go on testing and treatment, not management and miscellany?

I am pleased to give that assurance to my hon. Friend. We are ensuring that every penny is spent on the elective recovery and makes the greatest possible contribution to tackling those covid-19 backlogs. We are investing £8 billion more over the next three years, and that will increase elective activity. I am also pleased to say that in his region, we have already opened some four new community diagnostic centres; just those four have done 60,000 more checks and tests for his constituents.

Following the covid-19 outbreak and the roll-out of vaccines, thousands of immunocompromised people are still shielding, so can the Secretary of State update the House on where we are on delivering Evusheld, which would allow them to have the freedom that we all enjoy?

It is an important question, and the hon. Lady will know that specific guidance is already set out for those who are immunocompromised. As she will also know, Evusheld has conditional marketing authorisation from the independent Medicines and Healthcare products Regulatory Agency. With the MHRA and others, further tests are going on via the UK Health Sciences Authority, because it is essential to ensure that Evusheld works well and satisfies clinicians when it comes to omicron.

To tackle the covid backlog, it is essential that we expand the capacity of the NHS, and that means more people, so what is the Secretary of State doing to ensure that we recruit the skilled professionals we need for the NHS?

My right hon. Friend is absolutely correct, and that is why that is one of our biggest priorities. As well as asking the NHS to come up for the first time with a 15-year, long-term workforce strategy, we are also recruiting at a record rate, with more doctors and nurses working for the NHS than ever before.

Demand for eye care services is at an all-time high, with more than 632,000 people waiting on the NHS waiting lists for ophthalmology treatments. Delays to diagnosis and treatment could lead to a loss of sight, as well as stress and anxiety for patients. Given the stark figures, it is vital that we invest in eye health, such as through the national eye care recovery and transformation programme, which, worryingly, is due to end this year. Does the Secretary of State agree that it is essential that funding for this programme is retained so that he can bring down waiting lists and ensure good-quality eye care?

The hon. Lady is right to talk about the importance of eye care services. That is why we are putting record investment into dealing with those covid backlogs. As she rightly points out, many of those are in eye care and ophthalmic facilities and surgeries. That record investment is going in, and we will keep it under review to make sure it is leading to the outcome that we all want to see.

More than 2 million people are affected by the backlog in cancer care. Smoking is the leading cause of cancer, and we know that a key component of tackling the backlog is prevention. Given that, can the Secretary of State assure the House that no current or former tobacco lobbyist working in or with No. 10 will have any influence on the Government’s tobacco control plan, prevention strategy or planned response to the Khan review?

As the hon. Gentleman will know, all decisions are rightly made by Ministers. I agree about the importance of tackling smoking. The Government are committed to a smoke-free 2030, which is exactly why I commissioned the independent Khan review. I welcome its findings and we are carefully considering them.

NHS Dental Care Services

2. What steps he is taking to improve the availability of and access to routine NHS dental care services in (a) Weston-super-Mare constituency and (b) England. (900463)

The best way to improve access to NHS dental services nationally is through our reforms of the NHS dental contract, which will aim to pay dentists more fairly for their work. Specifically on Weston-super-Mare, a number of measures are taking place in Somerset to open up dental access there, including a nurse-led dental helpline to open up the available appointments.

I thank the Minister for her answer. Even before the pandemic, the NHS commissioned enough dentistry to cover only about half the population of England. Covid has massively increased backlogs and inequalities in Weston-super-Mare and many other parts of the country. Dentistry is now the No. 1 problem raised with Healthwatch, and four in five people say that they cannot find timely care. I agree with her that reforming the NHS dental contract is absolutely essential and urge her to redouble her efforts to fix it as fast as possible.

My hon. Friend is absolutely right that the nub of the problem is the dental contract. Negotiations have started and the details are with the British Dental Association as we speak. We expect to make an announcement before the summer recess.

Like the hon. Member for Weston-super-Mare (John Penrose), I have a number of constituents who have had real problems reaching dentists before and since covid, but there have been some particularly distressing cases since covid. There has never been the right package to pay dentists to do the work, which is driving them out of the business, but the inefficiencies of having to go through the central NHS systems for an emergency appointment are costing the taxpayer dear. When will we see proper certainty around the measures that the Minister just described, so that dentists know that it is worth their while sticking with NHS patients?

As I said, the contract is the nub of the problem; it is currently a perverse disincentive for dentists to take on NHS work. We are serious about reforming it, we are in discussions with the BDA, and we will make the announcements before the summer recess.

I thank my hon. Friend for her work on pushing that contract reform through, because it is key to shifting the dial. In areas such as mine, where people are waiting to get on to waiting lists for dentists, there is a huge dearth of dentists to provide treatment. Can she speak about the recruitment challenge that we will have to meet when the reform comes through?

My hon. Friend is right that the issue is not just about the contract, although that is a key aspect of trying to get more dentists to take on NHS work. We are working on a number of incentives to increase recruitment, including working with Health Education England on centres for dental development to train more dentists in those hard-to-reach areas, which tend to be coastal and rural areas.

We are also looking at how we can reform the overseas dentist policy. We are working with the General Dental Council on that and may be bringing legislation forward towards the end of the year to improve that, too.

Kathryn Townsend got in touch with me about her son Max, who has severe complex sensory issues and learning difficulties. He waited up to two years for an appointment. In that time, several rotten teeth have had to be removed. Conservative Governments have had 12 years now to get things right. When will the Minister get an urgent grip of the situation?

The hon. Gentleman says that we have had 12 years, but he may recognise that, during the pandemic—two of the years that he talks about—routine dental appointments were not available because of the type of aspiration procedures that they involve. Only urgent appointments were available. We are now enabling 95% of the usual activity to take place, and that will soon be 100%. That means that there is still quite a backlog to get through, but we are in a better place than we were this time last year.

Like colleagues, I have many constituents struggling to access an NHS dentist. I recently met with Uttoxeter Dental Practice, which has significant concerns about the UDA—units of dental activity—system, as it is not working for dentists or patients. I understand that a review has been promised for many years. Can my hon. Friend update me on when it might take place?

My hon. Friend is right: there is a perverse disincentive in the current contract in that under the UDA dentists are not paid in relation to the level of activity or work they have to do for an appointment. That is the nub of the problem and we are in discussions with the British Dental Association right now; it is reviewing our proposals and we hope to have news very soon.

People with dementia deserve to be treated with dignity and respect. There are ways to enable those living with dementia to lead the lives they want. This is what the all-party group on dementia inquiry is currently investigating. Will the Secretary of State commit to attending the all-party group’s inquiry—

I cannot jump questions; this question is about dentistry so I now call the shadow Minister, Feryal Clark.

Members across the House have been calling on the Minister to fix the crisis in NHS dentistry, but she seems intent on burying her head in the sand. The Government have no plan, with the Minister running scared from even talking to dentists at a conference last week. Patients are suffering as a result, with a third of adults and half of all children not having access to an NHS dentist. In Wakefield alone, a child under 11 is admitted to hospital every day for tooth decay. Does the Minister agree that the people of Wakefield should bear this in mind next Thursday?

I am sure the people of Wakefield are as frustrated as I am that the Labour dental contract, put in place in 2006, is the nub of the problem. If the hon. Lady were to meet with dentists, she would hear loud and clear that the dental contract is causing the problem. [Interruption.] She might not have listened to my previous answers because she is not listening now, but we will be announcing changes before the summer recess.

At the start of this year the Government announced £50 million to create some new dentistry appointments, but that money resulted in exactly zero new appointments in my constituency. I wrote to every single dental practice in my constituency and they said that was because the funding offer was too limited in scope and time and they were given only a week to reply.

On 25 April, I wrote to the Minister asking how many appointments had been created from this money across England and where that money had gone. I have not received an answer. Will we get one today?

I am very disappointed: that £50 million of funding was for dentistry to access and be able to afford more appointments, and if local commissioners in an area did not bid for that money or ask dentists to take that money on, that is extremely disappointing—those in other parts of the country certainly did. We are putting £3 billion a year into dentistry. Local MPs have a role to play in this: if there was a problem, I would have expected the hon. Lady to have come and seen me before now to lobby for more funding for her local area.

Nurse Recruitment

This Government committed to growing the NHS workforce, including our pledge of 50,000 more nurses by 2024, and we are delivering on that, as we are delivering across Government, with almost 31,000 more nurses so far as of March 2022—the latest data point we have.

I commend the Government on their target to train 50,000 new nurses. I know first-hand how hard the nursing staff work in the NHS as I worked as a mental health support worker for almost 30 years. With that in mind, I welcome the new school of nursing to be built at the Cramlington A&E Hospital. Will my hon. Friend do me the honour of visiting Cramlington to see for himself the construction of this amazing new facility?

I pay tribute to my hon. Friend for his work supporting the NHS and healthcare in this country both prior to and subsequent to his election to this House. I would be delighted to visit Cramlington with him—indeed, on the same visit perhaps I could visit his local health facilities to see modular construction in action. I should also say that his ever-efficient office has already invited me.

More nurses across the country, and particularly in Harrow, would make a real difference in helping those who suffer from diabetes. Given that this is Diabetes Week and that diabetes has a disproportionate impact on those from a south Asian background—particularly, for example, among my Gujarati constituents—when will the Minister put extra resources into tackling this terrible health condition?

I am grateful to the hon. Gentleman for his important question. As he highlights, we are investing more in more nurses, but there is also a large piece of work to do on health education and improving access to those services for people with diabetes. I urge him to look forward with eager anticipation to the health disparities White Paper.

Mr Speaker, you will be aware that I am proud to support the “no time to wait” cross-party campaign to ensure that we have a mental health nurse in every GP surgery across the country. I am delighted to see the hon. Member for York Central (Rachael Maskell), who supports the campaign, in her place.

I was delighted to read that the Secretary of State has said that we will recruit 2,000 mental health nurses into GP practices. Can I have more detail on how that will work? Can we look at Norfolk, which is using primary care networks, and third sector organisations such as Mind to help with that recruitment?

I am grateful to my hon. Friend for drawing attention to this important issue as well as for highlighting what is going on in Norfolk and the opportunities to learn from that. The Government have put record funding into mental health, and I understand that my right hon. Friend the Secretary of State is due to meet him and supporters of the campaign soon.

Working a shift in A&E just two days ago, I could not have felt prouder of the teams of nurses who form the foundation of our NHS. As the Minister is so gushing about the Government’s track record, will he explain why specialist food banks are being opened up in hospitals? Will he explain why, in a report by the Royal College of Nursing, 83% said that staffing levels on their last shift were not sufficient to meet patients’ needs safely and effectively? These lifesavers need a Government who are on their side. Only Labour will deliver for the NHS workforce and ensure that nurses and patients get what they rightly deserve.

I think that I detected the hint of a question in there. On a serious point, I pay tribute to the hon. Lady, as I often do on such occasions, notwithstanding the challenges that she throws at us, for the work that she does in the NHS and the work that she did before she was elected to the House. Through her, I also pay tribute to NHS workers up and down the country for their work.

The Government have put in place record support for our NHS, including nurses, which is about supporting those already on the frontline in the profession—that is absolutely right—and about growing that workforce to ensure that the work that needs to be done is spread among more people. That is exactly what we have done. We have record numbers in our NHS workforce, and we are well on target to meet our manifesto commitment on more nurses.

Primary Care Staff Recruitment

The Government’s commitment to deliver 50 million more general practice appointments is critical for improving access to primary care across the country. Our workforce are crucial for that, and we are well on track to deliver 26,000 more full-time primary care staff by March 2024, with more than 18,000 primary care staff already recruited since 2019.

I thank my right hon. Friend for that answer. Does he agree that when it comes to accessing primary care services, the Government have given GPs the support and guidance that they need and that GPs must now make every effort to see our constituents face to face, which is what they expect? What more can be done to support GP practices to make their processes more efficient for patient access to test results and blood tests and for booking appointments?

I agree with my hon. Friend and am incredibly grateful, as she is, for the huge contribution of GPs during the pandemic in helping to deliver the largest vaccination programme that the NHS has ever seen. Because of the pandemic, we also provided record support to GPs that helped to cut bureaucracy, helped them to share their workload and helped clinicians to give even more support to patients.

We are starting to see the results of that, with face-to-face appointments going up—we would like to see them go up much further. We would also like to see increases in appointments, including for access to blood tests. My hon. Friend might know that yesterday we published our new data strategy, which sets out how, using the NHS app, we will give more people access to their health results.

The United States company Operose Health runs 70 GP surgeries across the country, including the Randolph Surgery in my constituency. Yesterday’s “Panorama” broadcast indicated serious concerns about its quality of service, staffing levels and patient safety. Since then, constituents of mine have approached me to reflect their concerns about the service. What steps is the Secretary of State taking now, urgently, to establish what has gone wrong? Will he meet MPs with those surgeries to discuss our concerns?

First, I will ensure the hon. Lady gets the meeting she requests. She will know that NHS GP services all have to meet the same requirements, the same regulations and the same standards across the country. Where patients are not getting that care and those standards are not being met, we expect local commissioners to take action.

Dementia Care: Social Care Workforce

5. What steps he is taking to help ensure that training for the social care workforce meets the needs of people living with dementia. (900466)

It is crucial that the health and social care workforce have the necessary skills to provide high- quality care for those living with dementia. As announced in the White Paper, we will invest £500 million in training, and we will work with social care staff to co-produce a knowledge and skills framework to include the dementia training standards framework. Later this year, we will set out our plans on dementia for England for the next 10 years, which will include plans for dementia training.

People with dementia deserve to be treated with dignity and respect. There are ways to enable people living with dementia to live the lives they want to lead and that is what the inquiry by the all-party parliamentary group on dementia is investigating right now. Will the Secretary of State commit to attending the APPG’s inquiry report launch in September to hear how that can be achieved? Most importantly, will he commit to taking on board its recommendations? Families of people with dementia feel they are neglected and not getting the attention they need. I urge him to attend the launch of the report.

I completely agree with the hon. Lady that we, of course, must treat all those living with dementia—and all those caring for people with dementia, which is a lot of people in the country—with respect and do everything we can to support them. That is why we will, as I say, be setting out our plans for dementia in England for the next 10 years and why the Secretary of State mentioned dementia in a speech very recently. I will personally commit to attending the APPG. I am very happy to work with her on this issue to understand what more we could be doing and what more we can do to inform the 10-year plan for dementia in England.

I am really grateful to my hon. Friend for her commitment to train social care staff in dementia. Timely and accurate diagnosis is really important to ensuring that people living with dementia get on the right care and support pathway. A lot of my constituents are still struggling to get the face-to-face appointments that are so crucial in that. What is she doing to ensure that GPs in my local area are equipped to recruit, train and be resourced to get early diagnosis in place for people?

My hon. Friend is absolutely right. We had been meeting our dementia diagnosis target consistently at the national level from July 2016 until the end of March 2020, when, obviously, we all know what happened. The diagnosis rate dropped below our target for the first time in almost four years, and reflects the impact the pandemic had on memory assessment services and GP referrals into those services. In the last financial year, we allocated £17 million to specifically address dementia waiting lists and increase the number of diagnoses. That was spent in a range of ways, including on investing in workforce to increase capacity in memory assessment services and on improving access to pre and post-diagnostic support and carer support.

Quality care for our loved ones depends on a well-trained and motivated care force. I think we can all agree on that, and I commend the work of the all-party group. I hear the words of the Minister, but we have had a lot of warm words about a dementia strategy and the promise of a clear date. Can she be more specific about a date for publication, and can she be clearer about the workforce plan, including training for staff, given the Government’s rejection of all workforce amendments to the Health and Social Care Levy Act 2021? We cannot give confidence to people suffering with dementia and their carers without a much clearer plan that is in place very quickly.

I assure the hon. Lady that there is a lot of work happening on workforce across the whole of our health and social care services, whether in mental or physical health. Health Education England is working on the matter now and will publish a framework shortly. The workforce strategy set out in our White Paper is just the beginning. We will work closely with adult social care leaders and staff, and the people who draw on that care and support, to implement it now, and to take forward and build on those policies now and in the future. There is a lot of work, and we are serious about it; the hon. Lady can look forward to seeing a lot of documents before the end of the year.

NHS Integrated Care Systems

6. What assessment he has made of the effect of integrated care systems on cross-boundary NHS trusts. (900469)

NHS trusts have an integral role in the local health and care system. We expect appropriate engagement between integrated care boards, integrated care providers and the respective NHS providers in an area. An NHS trust is a formal partner of an ICB if it provides any services in the ICB area and has the function of participating in the nomination of members to the board. Regulations give details as to how to determine which trusts that provide services in an ICB area should participate in the nomination process.

Notwithstanding the Minister’s comments, Cheshire and Merseyside integrated care system has recently made the decision to stop my West Lancashire constituents accessing routine dermatology at St Helens Hospital, which is the only nearby provider. Due to geography, my constituents are in the Lancashire ICS, and are therefore not represented in Cheshire-Mersey—in place or local authorities.

My question, which I have asked several times, is: what is the Department doing to ensure that there is a mechanism for my constituents in Lancashire ICS to be represented in Cheshire-Merseyside’s decision-making process, which directly affects the care they are given? I have raised this point about cross-border difficulties so many times that I must question whether we any longer have a national health service, or whether we have a series of protected ICS kingdoms.

The hon. Lady and I speak regularly about different aspects of her local health system, and I am happy to do so again on this matter. I do not know the exact details behind the specific example, but I do not think it relates directly to how ICSs are configured in statute and guidance. I would be happy to meet her to understand the local factors that may have contributed to the situation.

Nursing in Care Homes

Nurses play a pivotal role in social care and work hard to deliver high-quality care. Increased funding announced on 11 May for nursing in care homes will support tens of thousands of care home residents with nursing needs, including those with learning and physical disabilities, with a 11% increase in 2022-2023 and an estimated £87 million backdated for 2021-22. Our £500 million workforce reforms will provide a new fund to help nurses to meet their continued professional development objectives.

We have just had Carers Week, in which we recognised the significant contribution of care home staff, domiciliary care workers and unpaid carers. However, I have spoken to care providers in Redcar and Cleveland, so I know that we need to do more to support them, particularly with the recruitment and retention of skilled care workers. Will the Minister come to Teesside to meet me and care providers, and discuss what can be done to support them in their efforts?

My hon. Friend rightly says that our health and social care workforce are our greatest asset; we cannot thank them enough for their extraordinary commitment, working day and night to put people’s care and safety at the centre of everything they do. We accept that there is more to be done to support our adult social care workforce and encourage more people into the sector. Our “People at the Heart of Care” White Paper, backed by our £500 million investment, will develop and support the workforce over the next three years, and help to address long-term structural barriers to recruitment and retention. I would be happy to visit care providers in Teesside with my hon. Friend.

I beg the departmental team to look carefully at something that is close to my heart: AF or atrial fibrillation. In care homes and every nursing setting, we need people to detect the early signs of atrial fibrillation. If it is not detected, it often leads to strokes, which are one of the most expensive things for the NHS to cope with. We do not have enough AF awareness or testing. Can we get a campaign going on the issue?

I am certainly happy to meet the hon. Gentleman to understand more about the issue. At the heart of it, I think, is prevention; we are trying to understand how we can prevent some of what causes greater illnesses later on for those who are in a care home or are receiving social care in their own home. That is certainly a big part of the strategy for our social care reforms.

Health and Social Care: Leadership and Management

8. What steps he is taking to raise the quality of leadership and management across the health and social care sectors. (900471)

16. What steps he is taking to raise the quality of leadership and management across the health and social care sectors. (900480)

In health and care, strong leadership can make the difference between life and death. I have been clear that we can accept only the highest possible standards and that in some cases poor leadership has been tolerated for too long. That is why I have accepted in full the recommendations of General Sir Gordon Messenger’s independent review and will set out a delivery plan to begin what I think will be the biggest shake-up in health and social care leadership in a generation.

Bearing in mind that the NHS will receive approximately £180 billion of taxpayers’ money this year, improving leadership and management in the NHS is extremely important, and nowhere more so than in the Shrewsbury and Telford Hospital NHS Trust. Despite the trust obtaining £312 million from the Treasury to improve accident and emergency services, a lack of coherent leadership has resulted in no decision being taken as to how the money will be spent. With rising costs in the construction industry, that is of great concern to us. Will the Secretary of State intervene with our local hospital trust to make sure that the money is spent as expeditiously and quickly as possible?

My hon. Friend is absolutely right about the importance of leadership. I am pleased to tell him that my Department has just received the strategic outline case for his local A&E’s Future Fit programme, which is currently being reviewed. As he undoubtedly knows, the business case process is led by the trust and is already supported by some early funding; I understand that the trust aims to present the full business case by 2023, with construction starting in the same year and to be completed by 2028. The Minister for Health will shortly visit Shropshire and will meet my hon. Friend and other colleagues.

Orthopaedic surgery at the Princess Royal Hospital has still not restarted since the pandemic. That is causing huge suffering for those who have been waiting for surgery, in some cases for several years. A hip replacement is transformative to quality of life and reduces other care needs, but orthopaedic surgeons continue to be paid despite not operating, and no alternative is being offered to patients—they are not even being given an expected operation date. Will implementing the Messenger review require NHS leadership to be more accountable to the public so that decisions such as refusing to restart much-needed surgery can be challenged?

I thank my hon. Friend for her tireless campaigning on the issue, which she brought up recently in the Health and Social Care Committee. I am pleased to tell her that elective orthopaedic surgery at the Princess Royal Hospital will resume from 20 June.

My hon. Friend is right about the importance of the Messenger review. There were many examples of excellent leadership in it, but sadly there were also examples of poor leadership, including bullying and blame cultures. That is why it is essential that we have this huge reform.

As hard as all hospital leaders and managers work, sometimes something goes wrong on their watch. What follows is one such example.

On Friday, I met Joanna, a lovely mum of two young children, who was diagnosed with secondary cancer three months ago. Since then, she has been passed from pillar to post and has received no treatment at all. Unfortunately, she is now receiving palliative care. What Joanna wants more than anything is to stop what happened to her happening to anyone else. Will the Secretary of State personally look into Joanna’s case to make sure that she finally gets the treatment she urgently needs, and that no one else is failed by the system as Joanna has been?

Yes, of course I can give the hon. Lady that commitment. I am very sorry to hear about Joanna; I think of her, her loved ones and her two children. I will absolutely look personally into the case. I hope that the hon. Lady agrees that where we see poor outcomes, it is important to make sure that we have the best possible leadership in place.

I have already raised the issue of the governance at Walsall Manor Hospital. I welcome the Messenger-Pollard review—the Secretary of State will know that there is also a report called “The snowy white peaks of the NHS”, which says roughly the same thing—but I have been fobbed off because the leadership at Walsall and Wolverhampton remains the same. Could he look into why Walsall Manor should not have its own chief executive?

These are important issues, and I have discussed this with the right hon. Lady. I will take another look at the management of Walsall Manor.

Last week, a BBC Wales documentary reported on the shocking state of Wrexham Maelor Hospital and the NHS in north Wales, which is led by the Welsh Labour Government and was in special measures before covid. The average wait for referred treatment in England is 13 weeks, but in Wales it is 24 weeks. In the words of Nuffield Trust, the

“treatment…may as well not be there”.

Wrexham deserves better, so does the Minister agree that the Welsh Labour Government need to vastly improve the NHS in north Wales before more lives are lost?

I do of course agree with my hon. Friend. There are huge challenges for the NHS here in England, but as she has highlighted, the challenges are much greater in Wales because of how the Labour Government there neglected the NHS, way before the pandemic as well as during it. When it comes to leadership, although the Messenger review was commissioned for England, I think they would do well to learn some lessons from it.

Operose Health is one of the biggest employers in the primary care sector. When it bought up 70 surgeries across England, including in Hammersmith and Fulham, the Government were warned that this would put patient care at risk in pursuit of profit. That is what Operose’s US parent company, Centene, is notorious for. Now that the Secretary of State has evidence of Operose employing half the average number of GPs per patient, and of not reading clinical correspondence for six months, what is he going to do about it?

The hon. Gentleman might know that in 2007 the then Labour Government changed the law to allow takeovers such as that to happen. He might want to reflect on that. In terms of local management, there are consistent high standards that need to be met locally, and local commissioners should be made aware of what he has just said.

Medicinal Cannabis

On 1 November 2018 this Government changed the law to allow the prescription of cannabis-based products for medicinal use by a specialist when clinically appropriate. Licensed cannabis-based medicines such as Sativex and Epidiolex are routinely available on the NHS.

I am grateful to my hon. Friend for that answer, particularly as she mentioned 2018, because it was of course her boss, the Secretary of State for Health, who was the pioneer in all this when he was Home Secretary. But there is a “but” coming, and it is that young children are not getting this vital medicine on the NHS. Some are having to pay £2,000 a month, and in the last three years only three prescriptions have been issued on the NHS. How can we improve the situation?

My hon. Friend has been campaigning on this issue for a long time, particularly on the tragic case of his constituent, Vicky Clarke. I have met the all-party parliamentary group on medical cannabis under prescription and we have had debates on the issue in this place and in Westminster Hall. The key is to get those products licensed, and we have been in discussion with the Medicines and Healthcare products Regulatory Agency on how to do this. It is about gathering the evidence base. I am pleased to say that NHS England and the National Institute for Health and Care Research have recently announced two clinical randomised controlled trials to try to build that evidence base to get more of these products licensed.

The lack of evidence on the quality, safety and efficiency of cannabis-based products for medical use is the main barrier to their being prescribed by NHS clinicians, which is why the SNP continues to support the development of clinical trials. Without proper funding, the UK Government are holding back potential successful health outcomes, so what steps are they taking to increase the priority of medicinal cannabis in research funding?

I met the responsible Scottish Minister in April to discuss this issue. There is not a lack of funding. The National Institute for Health and Care Research has funding available but we are not seeing bids, so this is a plea to the clinicians, researchers and groups for those to come forward. The NHRA is also happy to meet any groups considering undertaking clinical research to ensure that it is the type of research that will provide the evidence they need to licence these products.

Maternity Services

NHS England is making £127 million of investment in maternity systems in the next year to go specifically towards the workforce. This is on top of the £95 million already promised for the recruitment of 1,200 midwives and 100 more consultant obstetricians.

South Tyneside District Hospital’s maternity unit was award winning. In 2019, despite widespread opposition, it changed to a midwife-led birthing centre. It has since been closed, since January. Recently, a whistleblower explained that midwives and expectant mums are being kept in the dark about the future of the unit, staffing levels and bed capacity across the trust. These changes are a direct result of this Government’s forced cuts, so what is the Minister going to do to make sure that babies can be born in south Tyneside?

I have just been very clear that we are investing about £200 million in that workforce. In the hon. Lady’s area, there were staffing pressures during the omicron variant, with high levels of staff sickness, which meant that South Tyneside District Hospital had to make that difficult decision. My understanding is that those staffing numbers are much better, particularly for sickness absence. If she is struggling to find out from the trust when it hopes to reopen the unit, I am very happy to meet her and members of the trust.

Topical Questions

Today, we remember the 72 people who lost their lives and their loved ones affected by the Grenfell Tower tragedy five years ago.

In the Department of Health and Social Care, we are getting on with the job. We are focused on tackling the covid backlogs. Our new community diagnostic centres are springing up in towns and cities across the country, with 90 of the 160 planned already open and 1 million more tests, checks and scans already delivered. Last week, I set out our plans to modernise health and social care leadership, accepting all the recommendations of the leadership review by General Sir Gordon Messenger and Dame Linda Pollard. Just yesterday, I launched our new data strategy, called “Data saves lives”, to close the digital divide between health and care.

Last month, the Joint Committee on Vaccination and Immunisation published an interim statement on the autumn booster programme, in which—once again—unpaid carers have not been included. It is vital that they have equal access to vaccines to paid carers to keep their loved ones safe, as they continue to do right now. Will the Secretary of State advise me when we might receive a final statement from the JCVI on the autumn booster programme?

I thank the hon. Lady for raising the importance of getting vaccinations right. She will know that we rely on the independent advice of our clinicians—the committee known as the JCVI—and I think it is right that it is independent. Ultimately, it decides on its advice, and it is for Ministers whether to accept it. However, she has made an important point about unpaid carers, and I will ask the JCVI to see if that can be properly considered in the autumn booster review.

T6. 2002 I heard what the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), had to say about dentistry earlier, and I recognise the work she is doing to improve the situation. However, in northern Lincolnshire, like many other areas, we have very severe gaps in provision. Could the Minister outline what is being done to ensure that newly qualified dentists actually work in the NHS for a considerable time and that new practices are established in the areas where the need is greatest? (900458)

I am happy to respond to my hon. Friend. He is right that we of course want to ensure that everyone has timely access to NHS dentistry and that the profession is an appealing career choice. Health Education England has a dental education and reform programme, which will help retain new dentists in the NHS by placing training in areas of greatest need, and offer more flexibility and more career pathways. I can also tell him that, in Lincolnshire, commissioners are already looking at ways to support NHS dentistry through support such as the golden hello incentives.

I associate myself with the Secretary of State’s remarks as we remember the anniversary of the Grenfell Tower tragedy and support the families in their ongoing quest for justice. I also associate Opposition Members with your remarks, Mr Speaker, on the 40th anniversary of the end of the Falklands war.

Last night’s shocking BBC “Panorama” investigation into Operose Health revealed the extent of the crisis in GP surgeries, with patient referrals and test results left unread for up to six months, and with patients being seen by less qualified staff standing in for GPs without supervision. This is exactly what happens when private profit is placed above patient health and safety. Why is the Secretary of State asleep at the wheel instead of launching an investigation into this scandal?

As I said earlier, the hon. Gentleman should reflect on the rule changes made by a previous Labour Government that allowed the management of many GP practices to change hands. When such serious allegations are made, it is right that local commissioners investigate them properly and independently. When it comes to GP access and capacity, I hope he will welcome that we are making a record investment, with over £0.5 billion of support during the pandemic, and recruiting GPs at a record rate.

The British people are sick and tired of hearing Conservative Ministers, after 12 years in government, passing the buck to everyone else and failing to take responsibility.

Let us look at another scandal that has happened on the Secretary of State’s watch. It has now been weeks since he was warned about the negligence, the cover-up and the bribing of whistleblowers to stay silent about the scandals at the North East Ambulance Service. Since then, he has done precisely nothing to investigate the scandal. When will he address patient safety, get a grip and stop passing the buck? Or is this another case of the Government being, in the words of the Culture Secretary, found “wanting and inadequate”?

I told Members last week that I will review whether we can have an independent review of the North East Ambulance Service, and the NHS has agreed to an independent review. The hon. Gentleman stands up week after week and tries to claim he is on the side of patients and NHS workers, but we know he is actually on the side of those who are on strike—that is where his loyalties lie. Will he reflect on how many nurses will not be able to get to work and how many appointments will be unattended because of the transport strike? I know he wants to be the second coming of Tony Blair, but he is no more than a pound shop Ed Miliband.

T8. Many in the Scunthorpe area will remember David Hopkins, whom we sadly lost to glioblastoma. Alongside earlier diagnosis, we need improved access to the £40 million the Government have committed to brain tumour research. Will my right hon. Friend look carefully at the findings of the ongoing investigation by the all-party parliamentary group on brain tumours and do all he can to speed up access to this research funding? (900460)

My sincere condolences to the family of David Hopkins. Cancer diagnosis and treatment is an absolute priority, which is why we are putting £2.3 billion into campaigns and new initiatives to encourage people with suspected cancer to come forward. I am pleased that the referral rate is currently 120% of the pre-pandemic level. I will, of course, read the APPG’s report. I visited the largest neurology hospital in the UK last month with my hon. Friend the Member for Hexham (Guy Opperman), and I am determined to ensure that our investment in this vital area of research goes straight to the frontline.

The Government have noted that Sir Robert Francis will give evidence on his work on the infected blood inquiry on 11 and 12 July, and said that they will act after hearing his evidence. What discussions has the Secretary of State had with Cabinet colleagues on the potential impact on victims’ mental health of the lengthy waiting times for compensation in relation to contaminated blood?

The hon. Gentleman raises a very important issue. The House is well aware of the Government’s work to bring justice to those who have been affected by contaminated blood, and we will continue to take that seriously.

A new hospital at Thornbury would provide greater primary care and outpatient services, more GP appointments and a proactive frailty hub to support the elderly to stay in their own home longer. Our bid was submitted against the sustainability and transformation plan wave 4 capital pot, and I thank the Minister for all his work and effort in speaking to me, South Gloucestershire Council and our clinical commissioning group about this bid. Will he update the House on the timescales for its outcome?

I am grateful to my hon. Friend; he rightly alludes to the fact that he is a strong champion of his constituents and has met me on a number of occasions to argue the merits of the Thornbury health centre. As he will be aware, we now have a multi-year capital settlement for our NHS, which will allow us the opportunity, through local systems, to consider the most appropriate projects for investment.

T2. Planned to process 300,000 tests a day, the Rosalind Franklin laboratory is handling just 30,000 a day. I understand that some scientists working there are being paid for five days but working just one day a week. Given that the lab cost £1.1 billion, almost twice the original budget, what does this say about the Minister’s oversight of the programme? (900453)

I am afraid that it was not clear to me which tests the hon. Gentleman was talking about; all I heard was “300,000 tests”. So if he cares to write to me, I will respond properly to his question.

Has the Secretary of State read the study in the British Journal of General Practice that says that people who see the same GP over many years are 30% less likely to go to hospital, 30% less likely to need out-of-hours care and 25% less likely to die? If he has, will he consider changing the GP contract to restore individual patient lists and reverse the change of two decades ago so that everyone has their own family doctor?

I have not read that review, but now that my right hon. Friend has mentioned it I will certainly take a look at it. He raises an important point about access to GPs. He is right to say that many people would want to see the same GP again and again—that would be their preference. One can see how that may lead to better clinical outcomes, but I hope he will respect the fact that others do not mind if they do not see the same GP and just want rapid access. It is important that we get the right balance.

T3.   Despite the Secretary of State’s assertion that we have had record investment in our GP practices, the reality remains that many of my constituents cannot get an appointment to see their GPs for days, if not weeks. That is putting their health at serious risk and forcing them to go to accident and emergency because there is nowhere else to go. In Bradford, we need a new hospital, and I will continue to campaign for that, but our imminent need is for an urgent treatment centre. Will he meet me to discuss that option seriously and provide the funding to our local NHS trust? (900454)

The hon. Gentleman is right to talk about the importance of timely access to GPs, whether in Bradford or across the country. There are, of course, challenges across the country, which is one reason why we put in place an action plan, including some £500 million of extra funding, during the pandemic. On his plea for an urgent treatment centre, I will make sure that the Health Minister will meet him.

Before the jubilee weekend, I was pleased to welcome the Minister to the Queen Elizabeth Hospital to see the cracking RAAC—reinforced autoclaved aerated concrete—which the Department understands needs to be replaced. So will he take the opportunity to build a new QEH, fit for the future? When will the patients and staff at QEH know that they are on the list? They are impatient for a decision.

It was a great pleasure to visit my hon. Friend before the jubilee weekend and to meet the staff who do such an amazing job at his local hospital. As ever, his puts his case clearly and firmly for a new hospital to replace the QE in King’s Lynn, and we hope to be able to announce the longlist of those expressions of interest in due course.

T4. In response to yesterday’s urgent question on GDP, the Minister cited a drop in covid test uptake to explain the drop in GDP. Coronavirus test device approvals have been moving at glacial speed, with UK companies having to spend significant money preparing to mitigate this. Monkeypox also indicates unexplained changes in viral behaviours, and we know that covid is once again on the rise, so domestic diagnostics should be a vital component of effective prevention and strategic planning. Will the Secretary of State or a Minister meet me to discuss how best we harness these resources? (900455)

As I have said before, no country got every decision right during the pandemic, but one thing we did get right was our response in terms of diagnostics, vaccinations and antivirals. That combination allowed us to become the first country in Europe to open up and therefore also to boost our economy. I will make sure that the hon. Gentleman gets the meeting he has asked for.

As the Secretary of State knows from our previous discussions, we have serious concerns about West Midlands ambulance service and the significant delays we have experienced in north Staffordshire. The way to address the problems is by NHS partners working together, and Staffordshire fire service has said that it wants to do more to help the ambulance service. Will my right hon. Friend agree to do as much as he can to improve ambulance services in Stoke-on-Trent and Staffordshire?

My hon. Friend makes a very good point and some good suggestions. West Midlands ambulance service is my local ambulance service too, and I recently met its chief executive officer and chairwoman. As he knows, the NHS has published and is executing a 10-point plan for emergency service recovery, but I shall certainly take what he says into account.

T5.   Increasingly, hospitals have food banks to help NHS staff to cope with the cost of living crisis. Is it any wonder that the number of nurses leaving the NHS is at its highest for years? After a decade of pay cuts, will not yet another below-inflation pay award mean that even more nurses leave, which will have a hugely detrimental impact on patient care? (900456)

I am pleased to say that we have more nurses working for the NHS than at any point in its history, and last year we recruited an additional 10,900.

Does my right hon. Friend the Secretary of State accept that some people have died as a direct result of having had covid-19 vaccines?

I accept that the vaccine has not worked in the intended way for every single person. I am afraid that this is a risk with any vaccine that has ever been approved in any major country. It is right, however, that when something goes wrong with a vaccination, it is looked at appropriately, and I am happy to discuss this further with my hon. Friend.

T7. On Friday, the cross-party Public Accounts Committee described the UK Government’s procurement of £4 billion of unusable PPE during the pandemic, which is now to be burned, as the result of a “haphazard purchasing strategy”. Who does the Secretary of State believe should be held responsible for this unacceptable squandering of taxpayers’ money through awarding multiple deals to friends and associates of Ministers or senior Tories, and the deadly mismanagement of the supply of PPE? (900459)

I thank the Secretary of State for his recent visit to Doncaster Royal Infirmary. I apologise for the fact that the lights went out while he was there—it was not planned, but it did bolster my campaign for a new hospital. Will he meet me again during Men’s Health Week, to discuss a men’s health strategy, which many Members across the House believe would help an awful lot of men?

When I wrote to the Minister recently about my concerns about NHS dentistry waiting times, I was advised that my constituent was not restricted by geography, which implied that he should travel for an appointment, but the whole of the east of England has been identified by the Association of Dental Groups as a dental desert. The Minister is well aware of this problem, the severe workforce shortages and the broken dentistry contracts. When will the Government stop blaming the dental practices, get on with the job and get the workforce this country needs?

This Government are not blaming dentists for the pressures they are facing. If anyone is to blame, it is the Labour Government for their 2006 contract. We are amending that contract, and will make an announcement before the summer recess.

Suicide prevention organisations such as the Campaign Against Living Miserably and Papyrus are, sadly, needed more than ever, yet in the current economic climate, because they tend to rely on charitable donations, they are struggling to provide the services to meet demand. What will the Government do to make sure they survive and provide the life-saving services that are so badly needed?

Of course every suicide is a tragedy. We must do all we can to help to prevent suicide. In the last financial year, we provided £5.4 million to 113 voluntary, community and social enterprise organisations; we also provided £510,000 for the Samaritans helpline for people experiencing distress. That is in addition to more than £10 million we provided to voluntary and charitable mental health organisations in 2020-21.

As IVF treatment is incredibly time sensitive, will the Secretary of State consider increasing the funding available to allow couples to make use of private facilities on the NHS, to help families have the children that they so much want?

I cannot comment on health in Northern Ireland specifically as it is a devolved matter. IVF will be a significant factor in the women’s health strategy, because we recognise the disparities that exist across the country in how couples currently access IVF.

The site for the new Leeds children’s hospital and the adult hospital building, the Leeds General Infirmary, will be cleared by the end of this month. The trust is raring to go to build these wonderful new facilities. Can the Secretary of State tell me when the final go-ahead for the construction will be given?

The right hon. Gentleman will know that I have visited the site and spoken to local members of the trust. It is a project that we support, and we are in the final stages of the final approvals.

As was pointed out by the hon. Member for Lichfield (Michael Fabricant), this Government promised medical cannabis on the NHS 1,183 days ago. Since then, a child with epilepsy will have experienced, at a modest estimate, 35,490 seizures. We have free NHS prescriptions, which proves that the medicine exists and is approved for use in the United Kingdom. How much longer must those children suffer?

As I have said, I met the Scottish Minister on this. Scotland is facing exactly the same problem. Where medicinal cannabis is licensed, 9,631 prescriptions have been issued in primary care and 58,000 in secondary care, thanks to my right hon. Friend the Secretary of State who changed the law at the time.

Business of the House

With permission, Mr Speaker, I should like to make a short business statement about business for tomorrow.

Wednesday 15 June—Consideration of a Business of the House motion, followed by a debate on a motion on rail strikes, followed by Second Reading of the Genetic Technology (Precision Breeding) Bill.

Thursday’s business remains unchanged and as previously announced. I shall make the usual statement announcing further business on Thursday.

I thank the Leader of the House for the statement. I clearly need to remind the Government that they are the Government. Instead of touring the television studios in an attempt to defend a failing Prime Minister and grandstanding tomorrow in this place, the Transport Secretary should be relentlessly focusing on getting the parties around the table and getting an agreement hammered out. If he continues to fail, that is on him.

The backdrop to this dispute is that the Tories have overseen a managed decline of our railways. If all the Transport Secretary can come up with is to bring in untrained agency staff, it is clear that this is a Government who have really run out of ideas. Slashing safety standards and putting passengers at risk is not a solution. I remind the Transport Secretary of his job. He is meant to be in government. He holds the power to resolve these disputes. Strikes next week are not inevitable and he could make sure that they are avoided.

In Labour-run Wales, train staff are not going on strike, and all sides are working together to manage change. Labour is on the side of working people. We want our railways to work and people to be able to get to work. Instead of grandstanding, the Government should get a grip and sort out this mess.

I think we may have tickled a little nerve somewhere. Perhaps there is a little bit of sensitivity here. I encourage the hon. Lady to approach her union bosses with the same enthusiasm and get them round the table to stop the misery that they are about to inflict on the great British public—on students who will miss their exams, on people who want to get to job interviews. Let us get round the table and discuss this, and I call on her to encourage her union bosses to do exactly the same.

May I congratulate my right hon. Friend on his statement, and on provoking the Labour party into disclosing its true colours as the strikers’ friend?

I thank my hon. Friend for his question and encourage him to be here tomorrow to participate in the debate.

When I first saw that there was to be a change to tomorrow’s business, I just presumed that it was to introduce the “making the UK an international pariah Bill”, which we all expect to see in good time. Of all the things to choose, they have chosen to throw red meat to the Tory Back Benches on their favourite subject: hammering the unions and being as anti-union as possible. There is one very significant statement that has been made in the UK today, and that happened in Bute House, in the office of the First Minister of Scotland, where we have indicated our intention to get out of this trail of devastation that is the United Kingdom and become a country of our own. That process has started and the debate is now engaged, and by God are we going to win that one.

I thank the hon. Gentleman for his question. Perhaps he will want to participate in tomorrow’s debate and offer some advice on how we can get the trains running, just as they got the ferries running.

I congratulate the Leader of the House on changing the business for tomorrow. I think it is the first time, certainly since I have been here, that an Opposition do not want to debate something that the majority of the people want; it is normally the other way around.

My hon. Friend makes an interesting observation. I know that he will be in his place tomorrow to participate in the debate and represent his constituents, who want to go about their business using the trains, as they have a right to do.

Can the Leader of the House enlighten us as to what the motion is likely to say? I presume that, as a responsible Government, they will say that there are two sides to every industrial dispute and call on both parties to get around the table, discuss the issues and come to a negotiated settlement in a statesmanlike way. Or will it be a motion from a Government who have given up on governing and are intent simply on sowing the seeds of division among the people of this country? Which is it to be?

I thank the hon. Gentleman for his question, which actually has the benefit of being a business question. The House will be able to read the motion when it is tabled later today.

If these strikes go ahead, many people will be very concerned about how they will get to medical appointments, and many health and social care workers will be worried about how they will get to their place of work, including in my constituency, where many rely on the trains. Will the Government’s motion outline what contingency measures will be put in place if the strikes go ahead, and will a Health Minister be available to respond to those questions?

I fully expect that a Transport Minister will be leading the debate at the Dispatch Box tomorrow, and the hon. Lady will have an opportunity to question them then.

Can the Leader of the House tell us, without having to go into the detail of the motion—he has changed the business for tomorrow, so he must have some idea—exactly what substantive decisions he is asking from the House that will help resolve the rail dispute?

The hon. Gentleman will have to wait until the motion is tabled later today, but clearly having the debate tomorrow will bring focus to the challenges being faced, and hopefully will put pressure on the unions to come back to the negotiating table at an early stage, rather than calling strikes as a first resort—they should be a last resort.

I beg the Leader of the House to urge his side not to stoke the fires of this dispute. My constituents want to work and they want to go on holiday; they do not want this disruption. They do not care whether it is beer and sandwiches at No. 10—if that sort of thing is still done—or getting around the table as a leader on conciliation. That is what this House expects and what our constituents expect. Do not stoke the fires of this dispute; make peace.

I wholly agree with the hon. Gentleman. This needs to be resolved around the negotiating table, and that needs two parties. The unions need to call off the strikes and come to the negotiating table, not inflict misery on our constituents.

Might I remind my right hon. Friend that in answer to the SNP’s question today, we should remind them that they cannot be trusted? When we last had a referendum on the Union, we were assured by the SNP that it would be a once-in-a-lifetime, generational choice. They cannot be trusted.

My hon. Friend makes an interesting observation. Once in a generation is certainly not five years; I think it would be nearer to 25 years before it should be considered again.

I thank the Leader of the House for bringing forward the change of business and saying that there will be a motion on rail strikes. Literally hundreds of thousands of people will be affected by the strikes right across the whole United Kingdom, and it is important that we have a solution, so I ask the Leader of the House: will the thrust of the motion that comes before the House tomorrow be to find a solution, or to confront the unions? I would prefer a solution, as would others. May I have an assurance that that will be what the Government are trying to achieve?

I thank the hon. Gentleman for his question. The only solution is to get around the negotiating table, call off the strikes and have conversations rather than industrial action.

Personal Statement

With permission, Mr Speaker, I will make a personal statement in compliance with the findings of the Independent Expert Panel in its report, laid before this House today as paper HC 368.

I accept the findings of the Independent Expert Panel and the Parliamentary Commissioner for Standards in full and without reservation. On 20 October 2016, at an SNP social event, I made an inappropriate physical advance to a junior member of SNP group staff. My behaviour and the intent behind it was a significant breach of the behaviour code and the sexual misconduct policy for the UK Parliament. The breach was aggravated by a considerable disparity in age and authority between myself and the complainant, and further aggravated by excessive consumption of alcohol on my part.

I was wrong to make assumptions about the social and personal relationships that existed or had the potential to exist between myself and the complainant, and wrong to act on those assumptions. Blurring personal and professional boundaries in a work environment can be highly problematic, causing confusion, embarrassment, upset and distress, and I should have been aware of that. I should have been far more cognisant of the significant age gap of 17 years between myself and the complainant, and I should have been far more appreciative of the perceptions other people have of me as an elected representative and the real and perceived power that we hold.

I apologise to the complainant without reservation for my behaviour and for the distress and upset it has caused him. Since the incident in 2016, I have participated in bespoke and generic training, which has helped me to reflect more fully on my behaviour, its impact on others and the steps I must take to ensure it is not repeated. That has had a significant impact on my awareness and understanding of my responsibility towards others, especially those who see me in a position of power or authority. It has helped me to better understand how perceptions of my status by others will have changed following my election to Parliament and how that requires different approaches on my part to professional and social environments and situations.

Mr Speaker, I am profoundly sorry for my behaviour and I deeply regret my actions and their consequences. Any breach of the behaviour code and associated policies risks bringing this House into disrepute and will cause distress and upset not just to the complainant, but to the wider parliamentary community. I give you and this House my firm assurance that I have learned significant lessons through this process, and a firm undertaking that such behaviour on my part will never happen again.

I repeat my apology without reservation to the complainant, and extend that apology to you, Mr Speaker, to this House and its staff, to the residents of Glasgow North, my constituency staff, local party members, family, friends and anyone else who has been affected by my behaviour in any way.

Opposition Day

2nd Allotted Day

HM Passport Office Backlog

I beg to move,

That this House censures the Minister for Safe and Legal Migration, the hon. Member for Torbay, for his handling of the crisis at Her Majesty’s Passport Office; and directs him to come to the House, no later than 20 June 2022, to apologise for the tens of thousands of people who have waited more than six weeks for their passport.

I will start from the outset by saying what this debate is not about. It is not about the hard-working staff who have been so badly let down by the management and the Government. There are countless examples of the fact that the infrastructure that holds our country together is creaking—indeed, in some cases, at breaking point. There can be no doubt that the frankly shambolic state of the Passport Office is an example of the systemic failure that has been designed and delivered by successive Conservative Governments since 2010, because by the time covid hit us in early 2020, a decade of underinvestment had left us with our defences down, lacking resilience and ill prepared for an external shock such as a global pandemic. NHS waiting lists were already at record highs and there were already more than 100,000 staff vacancies. A steady stream of Conservative Chancellors had failed to grow the British economy in line with western competitors, thus depriving the Exchequer of an eyewatering £12 billion of potential income that could have helped us through the pandemic—or indeed £30 billion if the growth trajectory that was established by the last Labour Government had continued.

Manufacturing had been at best ignored and at worst actively undermined by successive Conservative Governments, with 230,000 job losses in manufacturing since 2015 alone, thus leaving our country staggeringly overdependent on China for everything from personal protective equipment to lateral flow tests, and culminating in the disgraceful spectacle of the Government wasting £8.7 billion of taxpayers’ money on PPE that did not even meet the required safety standards. A toxic Tory decade of incompetence and indifference left us in early 2020 with a high-tax, high-inflation, low-wage and low-resilience economy, so that when the pandemic struck, we were left stranded in the storm without so much as an umbrella for protection.

But the catalogue of failure that left us in the lurch when covid struck has been matched only by the litany of errors that characterised the Government’s chaotic approach to planning for the end of lockdown restrictions.

Speaking as the last passport Minister for the Labour party, we saw the problem coming when the banking crisis hit, with a dip in passport applications, and had a plan for what would happen. This Government seem to have no plan and understanding that after two years of no travel there would be an increase in passport applications. Does my hon. Friend not think that the Government were asleep on the job?

My hon. Friend is absolutely right. A Government who fail to plan are a Government who plan to fail, and that is what we have seen throughout this process. We have seen nothing but a Government who are asleep at the wheel, and the British people are paying the price. The catalogue of failure that left us in the lurch is exactly as she says.

Of course, this failure to plan applies to the Passport Office, as set out in the motion before us, but it also applies across Government. The Government are presiding over a country that is mired in bureaucracy, red tape and waiting lists, crippling our economy, costing the taxpayer billions of pounds in emergency spending, and preventing the British people from simply getting on with their lives.

At the risk of making the shadow Minister come back to the actual topic of the debate, which is passports, his motion outlines that the Minister should apologise to anyone who has waited more than six weeks for their passport. Is he aware that for at least a year the official Government policy, and HMPO’s policy, has been a 10-week wait, so would it not have been better for him to check the website instead of coming here and being opportunistic?

On the causes of this, it is absolutely vital to recognise that the lack of investment in our public services is what has fundamentally left us exposed, and these are the problems we are facing today. On the hon. Gentleman’s specific point, the fact of the matter is that there should be an apology to people whose holidays have been wrecked and who have not been able to get to job appointments, funerals and weddings within the timeframe that we are discussing today.

Crime was already at record highs going into the pandemic, but now the court backlog is so long that in 95% of cases victims of violent crime will be waiting more than a year for their day in court—a direct result of Conservative Ministers cutting one pound in every four from the justice budget. Those who need an operation on the NHS can enjoy the luxury of 6 million people on NHS waiting lists, or, if they are in too much pain, they can take their sleeping bag down to their local A&E department for a 12 or 13-hour stay. If you want to go on holiday, you had better hope that you have ridden your luck in the game of pre-flight bingo we are all now forced to play as we cross our fingers and turn up at an airport—that is, of course, assuming that you are lucky enough to receive your new passport. Welcome to backlog Britain.

I am sure the hon. Gentleman will share my dismay at learning that a professional seafarer was forced to miss the crew change on his vessel having waited for 11 weeks to receive a replacement for a damaged passport, specifically because of this Government’s inefficiency. This is a professional seafarer who is a key worker forced to miss his crew change. It is not just a matter of holidays—it is affecting people professionally as well.

The right hon. Lady is absolutely right. There are holidays, weddings and funerals, but there are also direct impacts on people who have needed to go on work assignments abroad. There is the seafarer that she mentioned. There are so many examples of why, when public services are failing, that directly undermines productivity in the private sector. That is why this debate is so important in terms of our economy.

This brings me to a very particular catalogue of failure delivered by the Home Office and a Home Secretary who is completely out of her depth. Under the current Home Secretary, the Home Office is simply not fit for purpose. Crime is up by 18% while prosecutions have collapsed. The six-month asylum waiting lists have hit 73,000 because the number of asylum decisions made under the Home Secretary has halved, costing the taxpayer £4 million a day in emergency hotels alone. The Passport Office delays are causing sleepless nights for thousands of families nationwide.

So today Labour Members will be voting to demand an apology from the Minister to the British people for the abject failure of the Passport Office to meet the standards that it has promised and that the taxpaying British public expect and deserve. The Government had two years to prepare for a spike in passport applications once travel restrictions were lifted. Ministers were warned repeatedly about the possible backlog but they failed to plan and so inevitably failed to deliver. Indeed, the Government’s own data shows that the number of full-time HMPO staff has dropped by 681 over the past five years. After a really tough couple of years, British families deserved a well-earned break, but thousands have missed out.

I look forward to hearing what the Minister has to say. This is an important issue. We want to get these passports sorted. However, this backlog has been unprecedented. I did not look at my kids’ passports until very late in the day, after the covid restrictions were lifted, only to find that they were out of date by a number of months. But I was able to get them expedited—not any more so than anybody else—and we got them done. The system actually worked. I hope the hon. Gentleman would agree that one way we can advance the system today is to make sure that civil servants return to working in the Home Office, not from home, because the security checks that need to take place need to be done in that secure environment, not from home, where they cannot be done so efficiently.

I congratulate the right hon. Gentleman on getting those passports. I have to say that he was one of the lucky ones. The reality is that it was absolutely clear that at some point the travel restrictions would be lifted and there would be a surge in passport applications, and there was plenty of time for Ministers to meet Passport Office officials and make a plan for when that happened. That is basic common sense, basic logic and basic planning. It is the opposite of the incompetence and indifference that we have seen from this Conservative Government.

Does my hon. Friend agree that much of the system is broken, because people are phoning up for appointments that they cannot get, and travelling to Belfast from London, or from Yorkshire to London, to get their passport? Information issues, as well as not getting passports in time, are leaving people high and dry. The Home Office is a Department that should be in special measures.

I thank my hon. Friend. What an utterly absurd position to be in that somebody who lives and works in London has to go to Belfast to get their passport processed. What kind of crazy, upside-down world are we living in when that is happening?

It is not just about holidays, as I was saying. People have missed vital work interviews and assignments abroad, weddings and funerals. They have not been with crucial identification needed for renting accommodation and the like. I have been inundated with emails from Opposition Members about these very situations faced by their constituents—usually hard-working families who have had their dreams shattered or their nerves shredded. This morning, my Aberavon office is dealing with seven new cases that came through last night alone. I will talk through just a few examples of these nationwide cases so that the Minister can get a clearer picture.

The point that the hon. Member is making is the most significant one we should make here today. Yes, the Home Office has shown itself to be unfit for purpose at the moment, but these delays in passports and visas—we are also seeing it with driving licences—are having an enormous impact on the lives of ordinary people up and down this country. Every constituency is inundated with people whose lives have been turned upside down by Home Office incompetence. Does he agree that it is past time it did something about it?

The hon. Lady is absolutely right. The cost of this issue is not just in broken-hearted families who were not able to go on long-planned holidays, or to go to weddings and funerals; there is a direct cost to the British economy and to productivity, and the huge cost of people having to pay through the nose for fast-track applications. The cost, when it is finally calculated, will be eyewatering.

To give a few examples of the nationwide cases, one family in County Durham had to cancel a dream holiday of a lifetime just before Easter, at a cost of £6,000, because they had been waiting 10 weeks for their six-year-old’s passport to come through. The guidance at the time of application was that it would take a maximum of three weeks.

Two parents from north Wales had been living and working overseas in France for two years and were due to return home once the father’s visa had expired, with their rent agreement ending this month. They applied for a passport for their new-born baby in mid-February but, four months on, they have still not received that passport, meaning that they have been forced to pay for a hotel at huge personal cost because they are unable to travel back to the UK.

Another set of parents in the west midlands were desperate to get their two-year-old boy, who was having medical difficulties, away on holiday. Despite applying for a passport on 2 January, poor communication from the Passport Office meant they were still waiting several months later.

In my constituency of Aberavon, one individual applied for her first adult passport on 26 February, yet had to cancel her plans to attend a wedding on 4 June. Another of my constituents applied for a passport on 23 March, yet is still waiting 12 weeks on and does not know whether they will be able to travel on 21 June. What does the Minister have to say to those families? Will he apologise to them from the Dispatch Box today?

These failures date back further than the past few months and are about not just resources, but levels of Home Office competence. One man living in east London applied for his first adult passport in September 2021. He was told to send his old passport back. Then, after 12 weeks, he was told that the application had been cancelled. The Passport Office maintained that his old passport had never been received. The man was then advised to make another application free of charge. That application was rejected. Then, after several weeks of telephone and email exchanges, he finally received confirmation that the old passport had been received with his original application and that his original application should never have been cancelled. He was advised to make a third application, which he has done. You could not make it up.

Like Members from all parts of the House, my office has been inundated with queries from constituents distraught at the fact that they either cannot go on holiday or could lose the cost of holiday travel. The situation is chaotic, unacceptable and must be resolved immediately. Does my hon. Friend agree that this could be resolved by the Government if they improved staff retention by meeting the Public and Commercial Services Union’s pay demands, worked with the PCS to end insecure agency staff and outsourcing, and completed the roll-out of the digital application programme as soon as possible?

Is it not extraordinary that the Government’s response to the crisis we are seeing is to cut the civil service by 90,000 jobs? In what world is that going to work, when we clearly need more resources, and people focused on customer-facing services? We need to build morale, not destroy it, and we need to show people that they should have good jobs on which they can raise a family. Instead, it is about cutting, undermining and passive-aggressive notes from the Secretary of State for Brexit Opportunities, I think he is called, put on the desks of his civil servants. It really is a disgrace.

Some applicants are having to travel the length and breadth of Britain to get an appointment. One man, as has been mentioned, had to travel all the way from London to Belfast to get his passport sorted. Others are having to pay extortionate costs for fast-track passport services or face losing hundreds of pounds. The number of monthly fast-track applications has more than doubled since December 2021. In April 2022, British families spent at least £5.4 million on fast-track services. The Passport Office’s own forecasts show that it expects to receive more than 240,000 fast-track applications between May and October this year, amounting to up to £34 million.

My hon. Friend is right to raise the issue of fast-track applications. My constituency office, like his and no doubt like those of every other Member, is inundated with application cases, but even the fast-track applications are only just coming in under the wire, causing lots of anxiety and lots of work for my staff. What does he therefore have to say about the ability of the private contractors operating passport services? The Home Office has known for some time that this privatised system is deeply inadequate in how it operates passport services.

My hon. Friend is absolutely right. He is referring to the two main companies, I think, which are TNT and Teleperformance. In both cases, the level of performance is abject. The question is: to what extent are they being held to account by the Government to ensure that they are delivering? I believe that TNT is on the record saying that its performance is meeting the service level requirements. I would like to see what those service level requirements are, because frankly it is an abject performance.

Like the hon. Member, I have had examples of constituents who have had cases and been delayed, and I am grateful for the support that the Minister has given me to help to get those cases resolved so that people have been able to go to weddings and other life-changing events. I thank the great teams working in Portcullis House to unblock these things. I encourage all Members to take that help up. Does the hon. Member recognise that, by the end of this month, more passports will have been issued this year than in the whole of last year?

I thank the hon. Gentleman for his intervention. It is nice to know that his friend the Minister is helping him out, but the reality is that our inboxes are groaning with issues, failure and the chaos and shambles we are seeing. Because of failure to plan from the outset, we have a bottleneck and a crisis. We hope eventually that the system will catch up, but the pain, heartbreak, missed appointments and missed weddings and funerals have already happened, and the British public cannot get them back. Those moments have passed and that is why this is too little, too late.

Thousands of people have had to wait more than 10 weeks for a passport, making a mockery of the Prime Minister’s initial claim on 25 May that almost everybody was getting their passport within four to six weeks. I am sure he will come back and correct the record, although I am not holding my breath on that. Ten weeks is of course the new target introduced by the Home Office when it failed to meet the standard, long-established Government target of just three weeks. More than 30,000 people are waiting more than six weeks and they deserve an apology from the Minister.

The performance of the Home Office simply is not good enough. Ministers are not doing their jobs and the system is simply not working. The Home Office is currently paying millions of pounds to failing outsourced contracts across the Passport Office, including a courier service that is so incompetent that it loses hundreds of passports every year. The Home Office awarded TNT, the US-owned company that is part of FedEx, a £77 million three-year contract to deliver official travel documents in 2019. It has since been criticised for missed deliveries, poor communication and long delays. Meanwhile, Teleperformance—an ironic name, we have to say—the French private company providing private call centre services, has been criticised by the Immigration Minister himself for providing a service that is, in his words, “unacceptable”.

It is therefore utterly staggering that the Prime Minister’s answer to the problems facing the Passport Office is, in his words, to “privatise the arse” off the Passport Office. Why? If the blame lies with the contractors, rather than the performance of the Ministers dealing with those contracts, how can more privatisation possibly be the answer—unless he feels that the performance of his own Ministers is so poor that he no longer trusts them? We would not disagree with that assessment, because we firmly believe that the buck stops with Ministers and that the Home Secretary and her Ministers need to step up their leadership and recognise that they got the planning for the end of restrictions badly wrong.

There is plenty of evidence that the Home Secretary failed to plan. In April 2021, the vaccination programme was being rolled out and restrictions were lifting, but Passport Office numbers decreased by 5%. This year’s increases are too little, too late; they should have been in the pipeline since last year, as experts were warning of delays throughout the pandemic. Interestingly, Ministers refused to directly answer my recent written question about how many calls the Home Office had had with Teleperformance contractors and TNT to plan ahead in the run-up to lockdown restrictions being lifted. Perhaps the Minister can provide a fuller account of those discussions today, if any took place.

The PCS says that the Home Office originally estimated that 1,700 new staff members would be needed to deal with the backlog but, as far as we know, only around 500 have been recruited, many of whom are agency staff without the full training. Agency staff inevitably cost the taxpayer more money, which is a clear case of how the failure to plan is putting yet more strain on the public finances.

It is not just staffing levels that have caused the problem. It was staggering to learn recently that the new digital application processing system for passports was supposed to be fully implemented three years ago, but staff are still using the older, clunkier application management system. The Home Office will reportedly be paying penalties for failing to implement the new system, but it is unclear what those penalties will amount to. The new DAP system would increase the speed of passport processing, so this is a major error that is again costing British holidaymakers and other travellers dear. To make other things worse, at this time of backlog Britain, the Prime Minister’s second not-so-bright idea is to cut 91,000 civil servants, whom we desperately need to put everything they have into reducing delays and cutting waiting lists.

I have some specific questions for the Minister. What specific steps is the Home Secretary taking to improve the performance of the Passport Office, Teleperformance and TNT? By what date does the Minister expect all passports to be delivered within the 10-week window? How many of the staff brought into the Passport Office are agency staff? What training has been given to agency staff brought in to deal with the surge? Is that training fit for purpose?

Why is the Passport Office still using the legacy AMS? When was AMS originally planned to have been replaced by DAP? Are there any penalty costs for still using the legacy AMS? If so, what are those penalty costs and who will they be paid to? What is the timeline and final implementation date for DAP to be fully functional, and what is the end date for AMS? How many staff are currently engaged in working on the development programme of DAP? How many people were engaged in working on the development programme of DAP on 31 March 2020, 31 March 2021 and 31 March 2022? Why have there been delays in fully deploying DAP and is there a plan to recruit further people to develop and facilitate that? I ask again: how many meetings did the Minister have with the contractors throughout 2021 in preparation for international travel reopening, and what was discussed at those meetings?

The Home Office is simply not fit for purpose under this Home Secretary. The Department has already been placed in special measures twice, with the Ministry of Defence taking over Border Force operations in the channel and the Department for Levelling Up, Housing and Communities managing the Homes for Ukraine scheme. Unless the Home Secretary ups her game, the Passport Office may be taken off her hands as well. More immediately, we need the Minister to apologise to all those people who did what was asked of them throughout the pandemic, worked hard and earned their trips abroad, only to have their hopes dashed and their nerves shredded.

From NHS waiting lists to our courts, from the Driver and Vehicle Licensing Agency to passports, from chaos at our airports and lorry queues at Dover to our broken asylum system, everywhere we look, our country is bogged down in delays and chaos. The year is 2022 and this is backlog Britain. Let us hope that the Minister will do the decent thing today and apologise, and then let us hope that the Government will at least start trying to get their act together, because the British people deserve better than this.

It is an absolute pleasure to respond to what we just heard. From the motion and the opening speech, it is obvious that this debate is focused on not the practical or even items particularly relevant to my brief, but the party political—there were no ideas, no plans and no alternative offered.

Let us start with some facts. Prior to the pandemic, Her Majesty’s Passport Office routinely processed approximately 7 million passports each year. Due to covid-19 and the necessary restrictions on international travel, only 4 million people applied for a British passport in 2020 and 5 million in 2021. As highlighted by my hon. Friend the Member for North West Norfolk (James Wild), that means that we will soon have dealt with more passports in the first half of this year than in the entirety of last year.

This year, many customers who delayed their applications are returning. It is therefore expected that 9.5 million British passport applications will be made this year, which will require a record output. That is a major surge in demand that we are planning for and have dealt with. Extensive preparation, including a regular ministerial board, started long before the Labour Front-Bench team started to show an interest a few weeks ago. Although we have heard attacks today, I thank those from HMPO who have worked hard to prepare for the surge and to deliver record output levels.

In general, the hard-working staff at passport offices, including Glasgow, who have been really good at helping my team to resolve some of the passport issues, and on the MP hotline, are dealing as well as they can with what are difficult circumstances. We all know that happy and healthy staff lead to better outcomes, so can the Minister confirm that staff are being provided with the necessary stress management tools and care for their wellbeing?

I thank the hon. Member for her comments and join her in paying tribute to the staff at the Glasgow passport office, who are working hard to deal with applications, including more complex applications—not every applicant is immediately entitled to a British passport. Ensuring that support is there for staff is one of the things that we discuss with senior managers.

Some staff have worked through weekends as well. We obviously do not enforce weekend working, but there have been overtime opportunities for some months for staff who wish to take them. Alongside that, we are ensuring that there is support for members of staff, because working seven days a week for months on end is not healthy. I thank the hon. Member for the tone and nature of her intervention.

I, too, put on the record my thanks to the Minister and his staff for their responses, and to the Belfast office. Hon. Members have talked about people going from London to Belfast. There is nothing wrong with going to Belfast; I am pleased that people are going and I hope they go there more often. The staff and the offices have done excellent work and they respond very quickly.

To look forward constructively, will the Minister consider increasing staff numbers, increasing the pay band for those working overtime or giving staff a bonus? Those things could help to alleviate some of the concerns and the waiting lists, although I am ever-mindful that the Belfast office is going above and beyond.

I join the hon. Member in paying tribute to the staff at the Belfast passport office, who are working hard and delivering a strong service. I am pleased to hear about the engagement that he and his colleagues have had, which reflects some of the comments of other Northern Ireland Members about support in a previous exchange on passports. There is incentivised overtime, but obviously there has to be a balance in terms of wider pay policies. As I touched on, we need to ensure that people are working sensible amounts of overtime, because working seven days a week for months on end is not healthy or appropriate.

We are certainly looking at the future and what the capacity is in particular locations. We looked to see how we could maximise that, particularly as social distancing regulations ended. We dealt with something like 60,000 people at the counters in March and 74,000 last month. Although that is not the majority of our applications, it is certainly a service that we have looked to expand, as I will come on to in a moment.

I thank the Minister for giving way. Will he please tell us how big the backlog at the Passport Office is at the moment?

We continue to work through a large number of applications. As said, we advise customers to allow up to 10 weeks; however, the vast majority are dealt with well before that, with a quarter of a million applications coming out each week.

I was talking about the actions we have already taken, such as adding over 650 staff since April 2021—not the figure the shadow Minister gave—with a further 550 to arrive into the summer. These actions have been successful: they have increased capacity and output is higher than ever before. Across March, April and May, Her Majesty’s Passport Office completed the processing of approximately 3 million applications. In addition to extra staff we have also brought in additional delivery capabilities, such as working with Royal Mail on the return of documents.

With this level of demand, applications will inevitably take longer—an experience not unique to the UK, despite the picture painted by the Opposition. In April 2021—

Not at the moment.

In April 2021, guidance was therefore changed to clearly advise customers to allow up to 10 weeks to get their passport, despite the comment made during the shadow Minister’s speech. This change to processing times has been communicated widely and over 5 million text messages were sent to UK customers who had an expired or soon-to-expire passport informing them of the need to allow up to 10 weeks to renew their passport. The vast majority of passport applications are being processed within the 10-week published processing time.

In a moment.

Across March, April and May 98.5% of the applications processed were completed within the 10-week standard and, even against the backdrop of such large demand, most applications are processed much more quickly than 10 weeks, with over 91% of applications completed within six weeks.

I will give way first to the hon. Member for St Albans (Daisy Cooper) and then come to those on my own Benches.

I thank the Minister for giving way. He mentioned the 10-week period during which most passport applications are dealt with. A constituent of mine applied for a straightforward passport renewal 13 weeks ago; she has to know today whether to cancel her holiday or try to wing it and possibly lose £3,500. My team of caseworkers have been to the hub in Portcullis House a number of times but were told this morning that there is no guarantee she will get an answer today. What does the Minister think I should tell her?

If the application has been outstanding for over 10 weeks and travel has been booked, we can expedite the process, as I will come on to later in my speech. It is not appropriate for me to discuss the details of an individual case on the Floor of the House, but if the details are supplied to me after the debate we will be happy to follow up.

I will now give way again, as promised, this time to my colleague from Bournemouth, my right hon. Friend the Member for Bournemouth East (Mr Ellwood).

I am grateful to the Minister. I should first declare an interest: I am a US dual national and have to replace my passport soon, and I have been warned to anticipate an 11-week wait for it to be replaced. As this debate demonstrates, we all want the process to be sped up as much as possible. Can the Minister say whether staff working in the office, rather than from home, would help increase the number of passports processed?

I think it is safe to say that the vast majority of Passport Office staff have been back in the office for some time; indeed, as I have touched on, some of them have been in the office for seven days a week working overtime. There is a very small cohort employed specifically to handle digital work that is wholly online and can be dealt with purely online. Mostly that will be what we call simple renewals, where it is not necessary to look at documents—to prove citizenship, for instance. We have done pretty much all we can in getting people back into the office, although we did not exactly get a great deal of support for that approach from the Opposition. I am satisfied that the vast majority are now working in the office; anyone who needs to be in the office to do their work has been in the office now for some time.