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Commons Chamber

Volume 721: debated on Tuesday 1 November 2022

House of Commons

Tuesday 1 November 2022

The House met at half-past Eleven o’clock


[Mr Speaker in the Chair]

Speaker’s Statement

I would like to make a short statement about the outcome of the inquiry into events during the Division on Wednesday 19 October. At my instruction officials interviewed or took statements from over 40 Members and officials who were there. The report of their investigation will be published shortly and copies made available in the Vote Office. The key findings are as follows.

The atmosphere was tense and Members were raising their voices to make themselves heard, but there is no evidence of any bullying or undue influence placed on other Members. The crowding made it hard to see what was really taking place. While some Members thought that physical contact was being used to force a Member into the Lobby, the Member concerned has said very clearly that this did not happen. Those with the clearest views of the incident have confirmed this. Several Members took photos during the Division, some of which were posted on social media. I would like to remind Members that taking photos during proceedings is prohibited.

It is important that we treat each other with respect. I take allegations of bullying extremely seriously, and will take swift action wherever necessary to address any improper behaviour in the Chamber or in the Lobbies.

Oral Answers to Questions

Health and Social Care

The Secretary of State was asked—

GPs: Continuity of Care

1. Whether he supports the continuity of care and long-term relationship between a GP and their patients. (901945)

The recent Health and Social Care Committee report rightly highlights the importance of continuity of care, recognising that there is sometimes a trade-off between speed of access and continuity of care.

I welcome my right hon. Friend back to the Front Bench in this position; it is great to see him there. Investigations in the United States and in Australia show that if there is a close relationship between a patient and one specific general practitioner, the outcomes are better in terms of both morbidity and visits to A&E. What can the Government do to encourage that practice, and what is the Government’s view of that practice?

My hon. Friend raises an important point. If one looks at the GP survey of patients, around two in five have a GP that they would like to have continuity of care with, and more than one third of those say that they see them a lot of the time or always. It is more pertinent with complex cases, where that continuity of care adds most value, as opposed to patients who want speed of access on an isolated incident.

We have seen a cut of almost 5,000 GPs and the closure of hundreds of practices in the past 10 years. My constituents are having a terrible time trying to get GP appointments and, when they do, the lack of continuity of care is impacting the effectiveness of that care; it is a strain to tell the same story again and again, particularly for older people and those with complex conditions. Can the Secretary of State outline what he is actually going to do about it?

In fact, around 80,000 more GP appointments a day are happening, so significantly more demand is being met. The Government have invested an extra £1.5 billion to create an additional 50 million general practice appointments by 2024, increasing and diversifying the staff available for those patients seeking care.

One way GPs can get better outcomes for their patients is to see them face to face if possible, particularly with prostate cancer in men. Men just do not present themselves to their GP as often as they should. Today is 1 November—Movember—so what is the Secretary of State going to do to promote men’s coming forward to see their GPs so that we can get this disease eradicated?

First, I pay tribute to the work my right hon. Friend is doing to raise awareness of this issue. It is important that those patients who want access to face-to-face appointments are able to get them, and campaigns such as Movember are a great way of raising that awareness.

In Cumbria we have lost one in six of our GPs in the past six years, most recently at the Central Lakes medical practice in Ambleside and Hawkshead. Will the Secretary of State pay special attention to the letting of that new contract to ensure that there is a GP service running out of the surgeries in Ambleside and Hawkshead? Will he also give thought to the fact that the Government’s removal of the minimum practice income guarantee has cost many rural surgeries their ability to be sustainable, and consider bringing back a sustainable small surgeries fund so that small rural surgeries can stay open?

As a rural MP and having worked in Kendal earlier in my career, I know the geography to which the hon. Gentleman refers. That is why we are investing in more GP training, increasing the number from 2,671 in 2014 to 4,000, but it is also why we introduced the payment of £20,000, to encourage GPs into those areas that are hard to recruit in.

The new Secretary of State—it is great to see him back—understands that there is a wealth of evidence that higher levels of continuity of care in general practice are good for patients and, indeed, for GPs themselves. I wonder if I could press him a little further. Is the new ministerial team open to limiting the list size of patients a GP has, as more GPs come online through the Government’s plans? Would he like to see personal lists reimplemented in the GP contract during his tenure?

Alongside the Government, no one wants to see better patient outcomes more than GPs themselves. By their training, they are evidence-led, so I look forward to discussing with the GP workforce how we can work together in a constructive spirit to deliver on whatever the evidence is showing. As I said, there is a body of evidence around continuity of care, but it is more weighted towards those with more complex needs, and not every patient prioritises that in terms of access to their GP.

The Health and Social Care Committee report showed that continuity of care was best for patient safety, which is so important, but in order to deliver that, there needs to be some headroom at practice level to bring about a reorientation of local services. How will the Secretary of State create that headroom, and will he adopt the report’s findings in full?

I know that the hon. Lady has a lot of expertise in this area, and she raises a valid and important point. That is why, through the GP contract framework for 2020-21, we announced a number of new national retention schemes and continued support for existing schemes to retain more GPs. It is also why, at the other end, we are boosting training numbers, to get more GPs into the pipeline.

The Secretary of State says they are investing in GPs, but this Conservative Government have cut 4,700 GPs in the last decade. Patients are finding it impossible to get a GP appointment in the manner in which they want one. Seeing the same doctor for each appointment means better care for patients, but under the Tories, that is becoming rarer and rarer, much like seeing the same Health Secretary at the Dispatch Box. Even his own Chancellor wishes he had done more on the issue of continuity of care, so why is this Secretary of State not matching Labour’s ambition to bring back the family doctor?

First, as I have touched on, the number of GPs in training is up. The number of GP appointments is significantly up, because there is more patient demand, so they are seeing more patients. There is often in this House a real focus on GP appointments, and that is important, but it is about the skills of the primary care workforce as a whole. If one looks, for example, at the women’s health strategy, women want to be able to go to specialist services, not always requiring the GP. It is about looking at the primary care workforce as a whole, alongside the appointment of GPs.

Workforce Shortages: Rural Areas

2. What recent discussions he has had with relevant stakeholders on tackling health and care workforce shortages in rural areas. (901946)

Ministers and officials regularly engage with a wide range of organisations to ensure that we are alert to the staffing issues facing the NHS and care sector across our country. We have increased training places for doctors, nurses and allied health professionals and increased access to clinical placements across a wide range of settings. We have also developed apprenticeships and blended learning opportunities to improve access to training that supports remote and rural communities.

In Devon, workforce shortages are acute. One in 10 nursing places remains unfilled, one in eight mental health roles across the south-west is vacant, and there are no dental practices taking on new NHS patients. That gap is too big to be bridged through current training and recruitment plans. Will the Minister create as a matter of urgency an innovative new career pathway, reducing the time to get new staff to the frontline?

I thank my hon. Friend for her question. She is a passionate campaigner on this issue. I recently responded to a debate on this issue led by her. She also chairs the all-party parliamentary group on rural health and social care. She is right, and we have developed an apprenticeship route for almost all professions in our NHS, allowing people to join the health and care sector immediately on an earn-as-you-learn basis. We continue to work hard to develop pathways into health and care professions, including via our groundbreaking blended online learning programmes.

In terms of district nursing and community midwifery, is the Minister aware that there are real security concerns about entering homes alone, and that that plays into resignations in many rural areas? Will he address that by providing security devices so that rural, isolated nurses and staff know that they are not alone and are safe?

The hon. Gentleman raises an interesting point. It is not something that has come across my desk in the two days I have had this portfolio, but I will of course meet local integrated care system leaders, and if it is something that they are calling for, I will look to see what we can do to assist.

Worcestershire and Herefordshire are rural areas that suffer from a shortage of doctors at both primary and secondary levels. My hon. Friend is an excellent Minister: will he meet me to discuss the strong case for funding places at the Three Counties Medical School in Worcester—a ready-made solution to the problem—which has already seen 851 applications from home students?

I thank my hon. Friend for his compliment. He raises an important issue. I know that my predecessor not only agreed to meet him, but undertook to visit Worcester. I would be happy to make the same commitment.

Wirral and Cheshire have many rural areas, with all the same problems that have been described. When I met healthcare professionals on Friday, they were clear that the problem is not just recruitment, it is also retention. Which of the changes that have happened over the past 12 years to make working life for NHS staff less good than it needs to be will he reverse?

Of course retention is as important as recruitment. Since September, we have had the non-repayable training grant, which is a minimum of £5,000 per academic year, additional funding for certain courses, and extra funding worth up to £3,000 for eligible students to cover childcare costs. That is, of course, on recruitment. On retention, we are looking at more access to mental health support and high-quality support while in training and clinical placement, but of course there is more to do.

Mental Health Services

The NHS long-term plan commits to investing at least an additional £2.3 billion a year by the next financial year to expand and transform mental health services in England. That will be supported by an additional 27,000 mental health professionals in the workforce to deliver that transformation.

I thank my hon. Friend for that answer. I recently met the child and adolescent mental health services team in Harrogate, and they confirmed that there are long waiting lists for attention deficit hyperactivity disorder and autism diagnosis. Will the Minister consider the criteria to help those who need the service most to get the support they need?

I thank my hon. Friend, who raises a good point. He does a huge amount of campaigning in Harrogate and Knaresborough on this issue. We recognise there can be long waits for diagnosis both for ADHD and autism, and that is why we refreshed our national autism strategy last year, backed by more than £74 million to help to reduce diagnosis waiting times. NHS England is now setting out the process of how children, young people and adults might receive a diagnostic assessment much more quickly.

Delayed discharge from mental health beds is preventing people from getting the treatment that they need. In fact, in Humber NHS trust 42% of learning disability beds are taken by people with delayed discharge, 5.5% of secure beds have patients in waiting for adult social care, as do 70% of adult mental health beds, 22% of CAMHS beds and 27% of community beds. To deal with the problem in mental health, we need to deal with the problem of lack of adult social care placements. When will the Government be able to fix that?

The Government actually started working on the plans around delayed discharges this summer, because of course they affect mental health services. They also affect a range of acute beds. With the winter coming, we know that there will be additional pressure on those beds, and that is why we are working with local government social care services and integrated care boards which have responsibility for that in their local areas.

In the last four weeks, there have been three investigations on abuse in in-patient mental health settings. The Government should be on top of the situation, not relying on undercover reports from Sky, The Independent, or “Panorama” that show patients languishing in seclusion, excessive use of restraints, bullying and dehumanisation, and falsification of medical records. Patients and their families rightly expect to be safe. Tory chaos has meant that the Government have not engaged with abuse allegations. For weeks there has been no functioning mental health Minister. Will the Minister conduct a rapid review of mental health services, respond to our concerns about in-patient services and apologise to patients and their families now?

Of course we apologise for the cases that we have seen; anyone who watched some of those programmes will have seen the distressing and unacceptable care. I am the Minister with responsibility not just for mental health but for patient safety, so I will be looking at the cases in “Panorama” and other programmes, and at cases across the board, because I want to ensure that in-patient mental health services are as safe as possible. We know that these are some of the most vulnerable patients who often cannot speak out when there are problems. We are looking at the staffing, training and reporting mechanisms. On the case that was highlighted in “Panorama”, the Government are working closely with NHS England, the Care Quality Commission and the individual trusts.


Gynaecological conditions, including endometriosis, are a priority in the women’s health strategy, which we published in the summer. We are committed to improving care for women with endometriosis and are particularly looking at the patient experience and journey from first seeing their GP through to diagnosis.

Last week, the all-party parliamentary group on endometriosis heard from many different women about their shocking experiences of getting diagnosed and treated. Despite the very good women’s health strategy, they are not seeing that on the frontline. Long waiting times, poor care and disbelief from medical professionals are all still too prevalent for women with endometriosis. Commitments in the women’s health strategy are long overdue and women are not fully feeling those benefits. When can we expect to see real progress to back that up and end this national scandal once and for all?

I thank the hon. Lady for her question. The Government introduced the first women’s health strategy to make issues such as endometriosis a high priority. Of course it will take time—we published the strategy only in the summer—but work is happening already. The women’s health ambassador is working to better inform young women about the signs and symptoms of endometriosis, so that they cannot be fobbed off with advice such as, “This is just a normal period.” Better and mandatory training for healthcare professionals in women’s health is being introduced and we are working with the royal colleges to streamline the referral process.

Early diagnosis in endometriosis and many other conditions is important, so I welcome the news that a community diagnostic centre was approved in Hinckley last week. That will bring MRI, ultrasound and CT scans to the heart of my community, but we are looking for more. For the likes of endometriosis, people sometimes need to have a day case procedure. Will the Minister meet me to discuss having a day case unit in Hinckley? A bid is going through that I am keen to see ensured, so that we can get the diagnosis of things such as endometriosis in the heart of my community.

My hon. Friend campaigned hard for the CDC in Hinckley and I am glad that he has been successful. Community diagnostic centres will provide a range of tests to speed up the diagnosis process. I am happy to meet him, because they are just the start of a huge opportunity, particularly for conditions such as endometriosis, to get diagnoses as soon as possible.

Cold Weather: Long-term Health Effects

5. What recent assessment he has made of the potential long-term effects of cold weather over the winter on the health of (a) children and (b) pensioners. (901949)

Pensioners and children are particularly vulnerable to cold weather, which is why we are spending £37 billion on our energy support package. A typical household will save a third—£700—of what they would have paid this winter. The 8 million most-vulnerable households will get £1,200 in support this year to help with the cost of living. The record block grant agreed at the spending review will enable devolved Administrations to provide further services to support those in need.

It is a fact that growing up and living in poor and cold housing leads directly to bad health outcomes. The director of University College London’s Institute of Health Equity, Sir Michael Marmot, stated that the Government must act now, because

“we are facing a significant humanitarian crisis with thousands losing their lives and millions of children’s development blighted”.

That was before the Chancellor’s U-turn on the energy price guarantee, which will mean that average household bills are £4,000-plus a year, or more if they are off-gas grid. Does the Minister think that is acceptable, or will he urge his colleagues to do much more?

I actually agree with the first part of the hon. Gentleman’s point. That is why, as well as the huge direct support to households, we are investing £12 billion in Help to Heat schemes to help make people’s homes warmer and cheaper to heat, another £1.1 billion in the home upgrade grant, and £500 million in the sustainable warmth competition. We take this issue very seriously, and colleagues at the Department for Levelling Up, Housing and Communities are taking further actions to clamp down on squalid housing.

Access to GP appointments is particularly important to help to deal with winter pressures, so can the Minister update the House on progress in implementing the improvements promised in October last year to help GPs to expand to meet demand over the winter?

My right hon. Friend is so right, and she has been a powerful champion on this issue. We have invested £1.5 billion to get an extra 50 million GP appointments per year. The number of appointments in September was up 7% compared with the same month in 2019. We now have an extra 2,300 doctors working in primary care compared with 2019, and an extra 19,300 primary care professionals, on the way to the goal of 26,000 extra primary care professionals. This is hugely important, we are investing in it, and my right hon. Friend is right to campaign on it.

We know that, if poorer communities cannot afford to heat their homes, health inequalities will worsen significantly over the winter months and beyond. Despite the seriousness of this issue, the previous Health Secretary—that is the right hon. Member for Suffolk Coastal (Dr Coffey), in case Members are struggling to keep track—planned to ditch the Government’s long-promised health disparities White Paper. Does the current Minister intend to do the same? If he does, how will he seriously address the dreadful health inequalities that have widened after 12 Tory years?

The hon. Gentleman implies that I disagree with him about this. In fact, the Government are working hard to clamp down on squalid housing. That is exactly what we were doing in my previous Department, DLUHC, and I have just mentioned some of the things that we are doing: the £37 billion we are spending to help people to meet the cost of living, the £15 billion of that that is targeted on the very poorest households, and the £12 billion that we are investing in making people’s houses easier to heat. We will continue to tackle health disparities across the board.

The NHS Confederation wrote to the former Chancellor raising its concerns about rising energy costs and the knock-on effects on health and on NHS services. We all know that this winter we will see people making the choice between heating and eating. Both routes will inevitably lead to more illness and worse health outcomes, so what action are Ministers taking, with their colleagues in Cabinet, to avoid this public health catastrophe?

We are taking the action that I have just been describing in terms of direct support for households. Of course, because health is devolved, we are also helping the devolved Administrations. The Scottish Government, for example, receive £126 per person for every £100 per person of equivalent UK Government spending in England and Wales. That enables the Scottish Government to provide extra help for those in need. It is another example, on top of furlough and the energy support scheme, of how this country is strongest when we all work together constructively.

Mental Health Treatment Waiting Times

Waiting time targets for adult talking therapies were exceeded in 2021-22, with 91.1% accessing those services within six weeks and 98.6% within 18 weeks.

Young people in the north-east potentially have to wait up to three years for mental health treatment. Local Metro Radio launched Charley’s campaign to get young people more timely health support. The campaign is in memory of 12-year-old Charley Patterson, who took her own life waiting for treatment. Labour has a fully costed plan to guarantee mental health treatment within a month of referral for patients who need it. Will the Minister commit to adopting that target now?

I thank the hon. Lady for her campaign on this issue. I am very sorry to hear of the tragic case of Charley Patterson. We recognise that, particularly with the pandemic, there has been a significant rise in mental health conditions for young people and children. We are expanding services so that an additional 345,000 children and young people can access NHS mental health support, and we are providing more support in colleges too. I am very happy to meet the hon. Lady to discuss her campaign further.

When I recently visited Sheffield College, students told me about the difficulty they face in accessing mental health services, and it is the same every time I visit a school to talk to students about the priorities for this place and for the Government. According to Mind, one in six young people have a mental health problem. We know that referrals for children and adolescents hit record numbers this summer. Early intervention is crucial but is simply not available. Young people are waiting months and months for their first appointment with child and adolescent mental health services after referral. There is a deepening crisis and, frankly, what the Minister just described will not address it, so what more will she do to ensure proper funding of mental health services for young people?

I have highlighted that there are additional pressures—more children and young people are coming forward with mental health conditions—but I assure the hon. Gentleman that we are putting early intervention directly into schools. Mental health support teams now cover 26% of pupils, with the aim of going up to 35% of pupils by April, and we intend to increase that further. So we are getting in as early as possible. Over 420,000 children and young people were treated through NHS-commissioned services in the last financial year. There is more to be done, but we have made a good start.

There is a real danger that prioritisation of mental health services is not what it was a few years ago. Does the Minister agree that we need to take urgent action on workforce development and other measures to increase capacity for mental health services, so we do not let down the hundreds of thousands of young people who are on the waiting lists? We need to take action now.

I agree and we are taking action now. Our aim is to expand the mental health workforce by an additional 27,000 healthcare professionals by 2023-24. We have already seen an increase—almost 6,900 more full-time equivalent staff. The workforce are the key to that, which is why are investing in them so heavily.

Waiting times to access mental health specialists in my area are unacceptably high, and I am constantly told there is simply an inability to recruit mental health specialists. I know the Minister works very hard on this subject and she just mentioned what we are doing over the next couple of years. What practical steps can the Government take to ensure that, this year, 2022, there are more mental health specialists available to serve my constituents in Plymouth and south-west Devon?

My hon. Friend makes a good point. We have introduced standards to measure waiting times because the situation is very diverse across the country. NHS England is consulting on introducing five new standards so we can keep track of where the gaps are. Patients can also refer themselves to talking and psychological therapies: over 1 million people have self-referred through the NHS website without having to go and see their GP, so they can get direct access and support when they need it.

Local Dental Provision

During the pandemic, we provided £1.7 billion to protect dental services. Now, through the improvements announced in the summer and our recent plan for patients, we will pay dentists more fairly and improve access for patients. We are enabling practices to deliver more activity than they are contracted to deliver—up to 110%—practices will have to keep their NHS website details updated, making them easier to find, and we are enabling dentists and their wider teams to work to their full scope of practice, improving access. The number of dentists doing NHS work increased by over 530 last year, but there is much more to do.

The Minister is aware that recent Local Government Association analysis showed that Bolsover has some of the worst dentist provision in the UK. That is highlighted by constituents to me daily. Whether it is getting access to treatment or even registering for an NHS practice, my constituents are struggling. Will the Minister take a look at that and meet me so we can discuss what more we can do for dentistry in Bolsover?

Absolutely. My hon. Friend has been a formidable campaigner on this issue. I know he met the Secretary of State to talk about it in the summer. It is a pleasure to have talked to him already and I am happy to meet with him further. Seven Derbyshire dental providers have been commissioned to deliver extra weekend activity to improve access this winter and, nationally, we are exploring how to incentivise dentists to work in areas where getting an NHS dentist is proving challenging.

Effective dental provision is essential not only for quality of life but for nutrition and confidence. Indeed, not being able to access it at important points in life is storing up more trouble for later, yet nine out of 10 dentists are not accepting NHS patients and, with the soaring cost of living, my constituents cannot afford dental treatment. What will the Minister say to them and do to address the millions who cannot get the dental treatment that they need?

The hon. Lady asks a powerful question. As well as the reforms that we started this summer and I announced in our plan for patients, as we start to think about the next dental contract, we are thinking about all the different things we can do to incentivise dentists to work in particularly poorer areas where there is difficulty accessing services. We are also working with the General Dental Council to review the processes that overseas dentists have to complete before they start to provide NHS care, which are sometimes more arduous than those for doctors. We are also thinking about the internal market of the UK and making it easier for dentists in Scotland to practise in England as well.

I welcome the shift in responsibility for NHS dental services in my area to my local Hampshire integrated care board. That will bring a real improvement by focusing on local priorities, rather than the previous regional approach. Will my hon. Friend join me in encouraging ICBs to ensure that they adequately fund dental services, especially for elderly people and children? Dental health is as much of a priority as any other aspect of our health.

My right hon. Friend is absolutely right. The shift to ICBs is right and it is an opportunity to integrate services in a way that has not been done before. She is right to stress the important preventive role that dentistry can play, which also reduces demand on other services, including accident and emergency.

A constituent of mine recently rang the national health contact centre about the possibility of an NHS dentist in Southampton and was told not only that no dentists in Southampton were taking on patients but that no one within 25 miles of Southampton was taking on patients either. What does the Minister have to say to my constituent, who has no prospect of a dentist now and no prospect of a dentist remotely in the future?

That is extremely concerning. This year, in NHS Hampshire and Isle of Wight ICB, there were 1,255 active dentists, compared with 1,248 the previous year. However, there is clearly an issue, which the hon. Gentleman was right to raise in the House. I am happy to talk to him more about that offline to ensure that we can solve that important problem.

Nursing Workforce: Recruitment and Retention

8. What recent representations he has received on recruitment and retention of the nursing workforce. (901953)

We are on target to meet the 50,000 nurses manifesto commitment, with nursing numbers more than 29,000 higher in August this year than they were in September 2019 and more than 9,100 higher than in August last year. We are working across a range of delivery partners to invest in and diversify our training pipeline, conduct ethical international recruitment, improve retention and support return to practice.

Cancer services are buckling both sides of the border and workforce challenges remain the biggest barrier to reducing waiting lists and meeting need. Will the Minister ensure that the long-term workforce plan being developed by NHS England gives consideration to the plans being prepared by NHS Scotland to minimise duplication and try to ensure the best possible patient outcomes in both countries?

I thank the hon. Gentleman for his question. We remain absolutely committed to growing and supporting our vital NHS workforce. In addition to the work already in place to continue growing the workforce, we have, as he mentioned, commissioned NHS England to develop a long-term plan for the workforce, looking at the next 15 years. It is important that we do that in tandem and I will have conversations—I think later this week—with my counterpart in the Scottish Government.

Workforce does matter enormously to backlogs and cancer backlogs in particular. I have come here straight from a mammogram two years after being diagnosed with breast cancer. Luckily, I am in rude health. [Hon. Members: “Hear, hear.”] However, for my constituents, the Norfolk and Norwich University Hospitals NHS Foundation Trust has met cancer referral targets only once in the last three years. Staff are working extremely hard, including by running more clinics and scaling up services. Will the Minister support the trust to reduce waiting times for my constituents for tests, results and treatment?

I thank my right hon. Friend for her question and I look forward to visiting Norfolk and Norwich University Hospital as soon as possible. She rightly raises cancer referrals. Cancer referrals from GPs are now at 127% of pre-pandemic levels. Cancer treatment levels are at over 107% of pre-pandemic levels, with nine out of 10 people starting treatment within a month. However, as she rightly points out, there is variance across the country and, where trusts have more challenging statistics, we need to address them.

Moving Patients into Social Care

9. What steps he is taking to help move patients who no longer need acute care from hospitals into social care settings. (901954)

When a patient no longer needs acute hospital care, they are usually better off outside hospital and that frees up their bed for somebody else. Delayed discharges are nothing new, but they have been getting worse in part because of the shortage of social care. That is why the Government have announced £500 million to speed up discharges from hospital into social care this winter.

Warrington is at least 90 beds short in terms of step-down care. A local hospital has too many long-term patients who simply cannot be discharged because there is nowhere for them to go. I am told there is capital funding available. We have two local NHS trusts, a local authority and the integrated care board, which is no longer in Warrington but now in Liverpool, but no action is being taken. Will the Minister come to Warrington to meet local NHS leaders and me, so we can secure access for patients who are spending too long in acute hospital care?

My hon. Friend is absolutely right about patients spending too long in acute care in his own hospital. We know this is affecting other people around the country. I am very happy to meet him and I would very much like to visit his hospital and speak to his NHS, the local authority and other stakeholders to ensure we can improve the situation.

Tony Hickmott is an autistic man who was detained in an in-patient unit for 22 years, often in near total seclusion, against his wishes and those of his parents, Pam and Roy. Tony now has his own home in the community, but the NHS spent £11 million on his detention in the last nine years after doctors considered him fit for discharge. Can the Minister comment on the wasted years Tony and his family spent fighting to get him free? What will she do to release the 2,000 other autistic people and people with learning disabilities detained in in-patient settings who would receive far more effective care in the community?

The hon. Member raises Tony’s individual case, which is very hard to hear about. She and I know there are too many others in this situation. She will know, too, that I listened to this when I was formerly a Health Minister. It is a difficult problem to solve, but we should absolutely continue to work with the NHS, the Care Quality Commission and local authorities to ensure people who are not benefiting from being in in-patient settings are able to get the care and support they need in the community.

The previous Health Secretary promised £500 million social care discharge funding for this winter, but it is 1 November and not a single penny of that money has been seen. I am afraid that the political chaos and incompetence over the last few weeks means that local services cannot properly plan and thousands more elderly people are trapped in hospitals when they do not need to be, with all the knock-on consequences for the rest of the NHS. Will the Minister now tell us: is this money still available? When will it be released? Can she guarantee that it will be genuinely new funding, not found from cuts made elsewhere?

I am sure the hon. Member heard the answer I gave a moment ago to a similar question. I absolutely acknowledge the challenge of discharges. The challenge is nothing new, but it has indeed worsened, in part due to the availability of social care. That is one reason why the Government have announced the £500 million discharge fund. I am just a few days into this job—[Interruption.] I am looking at the proposals on how this will—[Interruption.] If she will listen, I am looking to make sure that we allocate that money effectively, because we know that money is tight and we must absolutely make sure that every penny of the funding is well spent on improving the discharge from hospital to people’s homes.


10. When he plans to respond to the all-party parliamentary group on menopause’s report on the impact of menopause. (901957)

I am very grateful to the hon. Lady for all her work on issues around the menopause and to all those on the all-party group on menopause for their work. I have read her report and the 13 recommendations. The Government are already working on many of those, from the cost of hormone replacement therapy through to supporting women in the workplace.

The lack of information about symptoms is a recognised barrier to diagnosis. As a result, only 14% of the 13 million menopausal women in the UK have a diagnosis and are accessing treatment. More resource, training and awareness are urgently needed. Will the Government listen to the APPG’s recommendations and commit to a menopause-specific health check for all women?

The hon. Lady is right about the lack of awareness. Awareness is increasing through her campaign and the campaigns of many others. That is why we are seeing a significant rise in the number of women being prescribed HRT, but there is more work to be done. I am looking through the 13 recommendations from her report, and I am very happy, when we meet regularly, to discuss that further.

GP Recruitment

We are making progress on increasing numbers. The number of doctors in general practice has increased over the past three years, from 34,729 in September 2019 to more than 37,000 in September this year.

I am grateful for that answer. I recently met representatives of the local GP network in my constituency who described to me their difficulties in employing GPs. What can the Secretary of State do to ensure that people choose to go into general practice and to make the job much more attractive, so that he hits his target of recruiting 6,000 more GPs, which he is woefully way off doing?

I touched on that exact point in an earlier answer. There are parts of the country where it is more difficult to recruit GPs; that is why we have a targeted fund to attract people into those areas, with grants of up to £20,000. Alongside the appointment of GPs, we are also looking at using the wider primary care skills workforce, so that people can get to the appointment that they need.

Will my right hon. Friend tell me how patients in the Witham constituency will benefit from the really important investment in more GPs and more GP training? And if he cannot tell me today, will he write to me about the progress being made on the Witham health hub, through which more health workers and GPs need to come together to serve the local community?

I am grateful for that question. The plan for patients, which was set out by my predecessor, my right hon. Friend the Member for Suffolk Coastal (Dr Coffey), addressed the issue that my right hon. Friend the Member for Witham (Priti Patel) raises on behalf of her constituents. That includes how people make an informed choice about which practice is best for them, how we make it easier for them to book an appointment and how we harness technology better—in particular, the very significant number of patients, including in Witham, who will have downloaded the NHS app and will be able to access services through it from this month.

Topical Questions

It is an honour to return to the Department of Health and Social Care to continue its important work, especially ahead of the challenges this winter. I pay tribute to my predecessor, my right hon. Friend the Member for Suffolk Coastal (Dr Coffey), for everything that she has done to get the system ready for the challenges ahead. I welcome my experienced ministerial team to their posts and thank Ministers from the summer. I am also looking forward to robust, I am sure, but—based on our previous experience—very constructive engagement with Opposition Front Benchers.

I am pleased that all GP practices will soon be able to automatically provide patients aged 16 and over with access to the latest information and their health records through the NHS app. We are switching on that ability from today in a process that we expect to be completed by the end of the month. That is an important milestone for patient empowerment and is part of a process that sees patients play an even more active role in managing their health and care. I hope that Members across the House will welcome that on behalf of patients.

I congratulate the Secretary of State on his reappointment. Will he reiterate the importance of getting ambulance waiting times down? Would he endorse the use of minor injuries units in community hospitals, such as those in Malvern and Tenbury, as a very effective way to open up access through other routes for our constituents?

My hon. Friend raises an important point, particularly for category 3 and 4 ambulance journeys. As she highlights, there are numerous aspects to the challenge of ambulance delays: the blockage in the flow from social care and delayed discharge, which we have debated many times in the House; issues in accident and emergency with pre-cohorting, post-cohorting and triaging nurses; conveyance rates, which often vary significantly between ambulance trusts; call handling, which we have put additional money into; and the work of the auxiliary service. My hon. Friend is quite right that within the portfolio of options, minor injuries units are an area that can help to relieve pressure on busy A&Es.

I welcome the Secretary of State back and welcome his team, but I have had boxes of cereal with a longer shelf-life than Conservative Secretaries of State. As a consequence of the turnover and chaos, the truth is that the NHS is not prepared for this winter—it cannot even get allocated funds out of the door.

Let us turn to the future. Over the summer, the Prime Minister promised to establish a “vaccines-style taskforce” to tackle the Conservatives’ NHS backlog on “day one” and to have overall waiting list numbers falling by next year. May I ask the Secretary of State who is on that taskforce, how many times it has met and what its programme of work is?

I am grateful that the hon. Gentleman raises the issue of vaccines; in fact, I raised it in Cabinet today. The UK is the first country in the world to have introduced bivalent vaccines targeted both at omicron and at the original strain of covid-19. We have now made the covid vaccine and the flu vaccine available to all over-50s; I hope that Members across the House will promote that. I think the UK can be very proud of its work to roll out vaccines against both covid and flu, which are a key part of preventing some of the pressure on our A&Es.

I can forgive the Secretary of State for mishearing the question, but what I find unbelievable is that it seems as if this is the first time he has heard about the Prime Minister’s own proposed taskforce to deal with the Conservatives’ NHS backlog. That is what the Prime Minister promised, and that is what I asked the Secretary of State about. This is obviously another case of the Conservatives over-promising and under-delivering.

If the Secretary of State cannot stand by the Prime Minister’s pledges, what about the views of the man next door? When we announced our policy to train a new generation of doctors and nurses, paid for by abolishing non-doms, it was welcomed by the Chancellor as—and I quote—“something I very much hope the government also adopts on the basis that smart governments always nick the best ideas of their opponents.” In the spirit of constructive opposition that the Secretary of State asks for, Labour has a plan to tackle the staffing crisis. The Conservatives do not. It is fully costed and paid for, so will he nick it?

The hon. Gentleman skirts over the fact that it is this Government who have opened five new medical schools, who have significantly boosted medical undergraduate training, who are investing more in our NHS as per the long-term plan, who have invested a further £36 billion as part of our covid response, and who are investing in technology and the skills of the workforce as a whole. We are boosting the number of medical trainees and—I touched on this question earlier—we are also boosting the number of doctors in training to be GPs.

T2. At a face-to-face surgery this weekend, a constituent mentioned the difficulties that a relative of hers, who has subsequently died, had had in getting a face-to-face GP appointment at a surgery run by an American company called Centene, which now covers 600,000 patients. Will the Government insist that we are fully committed to the traditional approach of a committed and caring family doctor seeing patients face to face, and that we will not allow GP surgeries to be fully commercialised? (901971)

My right hon. Friend raises an important point about face-to-face care, which matters to many constituents, but I gently remind him that in the Lincolnshire integrated care system, 71.9% of appointments were face to face in September 2022. It is not the case that every patient wants a face-to-face appointment; there can be instances in which an online service is better. For patients facing domestic violence, for example, it can often provide a much more convenient service.

Order. I know we are bedding back in, but Front Benchers have to think about Back Benchers. These are their questions as well, so please let us make sure that I can call as many of them as possible.

The Scottish Government introduced new national guidelines to make it easier for retiring NHS staff to return to support the NHS, while drawing their pensions. However, there is a substantive issue of pension tax rules pushing senior clinicians to reduce their commitments or retire early. As we know, pension taxation is a wholly reserved matter, so will the Minister address this issue with Cabinet colleagues in order to find a permanent solution that will allow us to help the NHS retain senior staff?

T4. More than 13,000 people who are in hospital today would be out of hospital if the care system had the necessary capacity, and most of them could go back to their own homes if we had enough domiciliary care workers. Can the Secretary of State assure me, and the House, that he will produce a proper workforce plan for the care sector as a matter of urgency? (901973)

Very much so. The hon. Member for Ilford North (Wes Streeting) asked about a taskforce. With our colleagues in NHS England, we launched a “delayed discharge” taskforce with a “100-day challenge” over the summer; we have also set up an international recruitment taskforce within the Department to prioritise the establishment of a “clearing house for care”. I will not add further to my answer, other than to say that this is a key area of focus.

T3.   I recently visited a local GP surgery which is short of a third of the staff that it needs. Surgeries are finding it increasingly difficult to retain staff owing to stress and burnout. Do the Government recognise that it is stress and burnout that make it so difficult for us to retain GPs in their profession, and for them to retain their staff? If so, what on earth are they going to do about it? (901972)

The wellbeing of staff—especially in the NHS, and especially after the pressure of the pandemic—is a crucial issue, and one on which I have focused in particular since returning to the Department. I look forward to having discussions about it with the hon. Lady.

T6.   Last year I raised with the Department worrying data from the Alzheimer's Society about the number of care home residents with dementia who were being prescribed anti-psychotic drugs when they did not have a psychosis diagnosis. Can my hon. Friend provide an update on the current levels of prescribing? (901975)

I have shared my hon. Friend’s concern about this issue in the past, and I know he has taken a long-term interest in it. We must ensure that people living with dementia are prescribed anti-psychotic medication only when it is clinically appropriate., and NHS England is actively monitoring the position. I have already asked for the latest data, and I will be keeping a close eye on it.

T5. The Secretary of State says that he is boosting GP trainee numbers, but according to the Royal College of General Practitioners, 49% of the more than 40% of GP trainees who are international graduates have reported visa processing problems and 17% are considering leaving the UK altogether, taking their desperately needed skills elsewhere. Why are the UK Government hamstringing the NHS with red tape, and what is the Secretary of State doing to sort this out with ministerial colleagues? (901974)

Across the clinical workforce—whether we are talking about dentistry, nursing, social care or doctors—we are seeking to boost recruitment, including international recruitment, and to remove red tape. Within the GP population, however, we are looking at retention, recruitment and boosting the number of trainees.

T7. The Government have given Epsom and St Helier University Hospitals NHS Trust the green light to get on with improving St Helier and building a new hospital in Sutton. We know that the pandemic has had an effect on timetables, so will my hon. Friend facilitate a meeting between his Department, the Treasury and the trust to ensure that we can get a planning application in by the end of the year? (901977)

We are fully committed to delivering a new hospital in Sutton, one of the 40 new hospitals to be built by 2030. Officials from the Department and the NHS are working closely with the trust at every step in the process, and I look forward to working with my hon. Friend to deliver this much-needed hospital improvement.

T8. In rural areas such as the west country, NHS dentistry is more of a distant memory than a vital service. Does the Minister agree that more must be done to boost NHS dental services in rural areas, and will he commit himself to reforming the NHS dental services contract to ensure that it meets patient need and properly incentivises dentists to take on NHS patients? (901978)

In the hon. Gentleman’s local NHS this year there were 758 active NHS dentists, up from 736 in the previous year. I have already mentioned some of the steps we are taking to tackle the problem of dental deserts and ensure that everyone in the country can see the dentists—and the GPs—whom they need to see.

Members of the Kent and Medway integrated care board are doing their best to recruit more GPs, but they are finding it difficult to attract them to our area. One reason is their close proximity to London, where newly qualified GPs can earn thousands of pounds more than they can if they practise in Kent. Will my right hon. Friend consider extending the NHS London weighting allowance to Kent and Medway?

Part of the reason for having the targeted funding is so that ICSs can look at those areas under particular pressure for recruitment and do that on a place-based basis. It would be interesting to look at the evidence, but I know that the fund has been used by my hon. Friend’s local ICS.

T9. Care workers were already struggling to get by on wages that hardly pay the bills, and now, with an escalating cost of living crisis, care workers in Nottingham and beyond are being pushed deeper into poverty. Does the Secretary of State back trade union calls for a £15 an hour minimum wage for care workers, and what steps is he taking to make this a reality? (901979)

Care workers should be properly paid for what they do, the skills they bring and the compassion they bring to their work. That includes being paid at least the national living wage, which was increased by 6.6% in April. I am also increasing the Care Quality Commission’s oversight of local authority commissioning, and we have created a £1.36 billion market sustainability and fair cost of care fund, which will ensure that local authorities always pay a fair cost of care.

Early access to scans and testing can prevent more serious illness, improve health outcomes, reduce health inequalities and reduce pressure on the acute sector. Will my right hon. Friend prioritise increasing the number of diagnostic centres across the United Kingdom and support my campaign for the establishment of one in Wimbledon town centre?

My hon. Friend is right to say that we are supporting the NHS to deliver up to 160 community diagnostic centres by March 2025, 89 of which are already operational, as part of £2.3 billion of capital funding, delivering around 2 million additional scans so far. Community diagnostic centres are closer to people’s homes in the hearts of communities, and they will help us not just to reduce and bust the covid backlogs but to tackle health inequalities.

As we get older, many of us—individually or our close family and their immediate family—will be touched by cancer. Can the Minister confirm when the 10-year cancer plan will be published in full, and will the Minister agree to meet me and a small delegation from the all-party parliamentary group on radiotherapy to hear more from the experts on the frontline about how we can use this technology to improve cancer outcomes?

Sadly, cancer takes far too many people before their time, and the Government are determined to improve cancer outcomes in the short term and the long term. I am very happy to meet the hon. Gentleman to discuss this further.

What steps is the Minister taking to improve health outcomes and early diagnosis for people with aortic dissections?

I know that my hon. Friend has a real understanding of this particular challenge. In March 2022, NHS England launched an aortic dissection toolkit to support the implementation of robust clinical pathways to identify and manage type A and type B aortic dissection, and English regions are working with the cardiac pathways improvement programme to improve diagnosis and treatment.

Tens of thousands of NHS workers are entirely dependent on the use of their car to do their vital job, but while petrol prices have rocketed, NHS mileage rates have remained frozen since 2011. Will the Secretary of State look at what can be done to increase NHS mileage rates?

That fits within the wider issue of how we work with and support our NHS workforce and what packages we can look at in discussion with Treasury colleagues. Of course, the approach to the NHS is also in line with other Government Departments, but the hon. Gentleman raises an important point and it is obviously one that Ministers discuss.

With flu cases on the rise, what action is my right hon. Friend taking to ensure that all parents are aware that they can access the free nasal vaccine at their GP surgery for all pre-school children?

My hon. Friend’s question gives me an opportunity to thank her for her fantastic work on vaccinations and our world-leading roll-out of vaccines across the country. She has also provided an opportunity to remind everyone of the opportunity to get those life-saving vaccines this winter and to get boosted.

This month a care provider in my constituency is closing, citing the workforce crisis. I have listened carefully to the Ministers’ answers, and the current Chancellor spent the last year telling us about the critical need for a workforce strategy. The door is open. Has the Secretary of State had a conversation with the new Chancellor to ask for a workforce plan on which we can all rely?

Forty per cent. of GP appointments are now related to mental health. That is why James Starkie and I launched the cross-party “No Time to Wait” campaign, which had the support of the Prime Minister when he was Chancellor. We have a fully costed plan with the Royal College of Nursing to pilot such a scheme. Is the Secretary of State willing to meet James and me?

I thank my hon. Friend for his suggestion. We are committed to boosting the mental health workforce, and I am happy to meet him to discuss his suggestions.

My constituent Wilma Ord and her daughter Kirsteen are victims of the Primodos hormone pregnancy drug. Will the Minister update me on where the Government are in getting justice and compensation for the affected families? Many people have died. Will she meet me and other families and representatives from the campaign group to get justice for these families? They have waited far too long.

As the hon. Lady knows, there is an ongoing legal case about Primodos, but I am very happy to meet her and the campaigners because I am keen to hear their experience. Unfortunately, I cannot comment further while there is an ongoing legal case.

I refer to my entry in the Register of Members’ Financial Interests. Last Saturday was World Stroke Day. Will my right hon. Friend the Secretary of State commend the work of the Stroke Association and its “saving brains” campaign? And will he meet members of the all-party parliamentary group on stroke to discuss how we can increase the provision of life-saving thrombectomy services across England and Wales?

I am very happy to commend the work of the Stroke Association, and I would be delighted to meet my hon. Friend to discuss this further.

A respected woman pharmacist in my constituency, with a lifetime of NHS experience, went solo with her own practice in the hope and expectation of an NHS licence, which she has been denied. Will the Secretary of State look into the opaque decision-making process? Our increasing population otherwise means increasing demand, and my constituent cannot survive on private alone.

Suicide is the biggest killer of under-35s in the UK, with more than 200 school-aged children taking their own life every year, including two, very sadly, in my constituency in recent months. We have heard about the pressures on mental health services, so will the Secretary of State look at alternative ways of supporting mental health by meeting the 3 Dads team and his counterpart in the Department for Education to discuss how we can embed age-appropriate suicide awareness and prevention in schools?

Part of the reason why we are putting an extra £2.3 billion into mental health is to recognise the sensitivity and the importance of this issue. I am very happy to look at all practical suggestions. The tragedy for constituents is something that unites the House. In particular, I will look at what technology can do to support people.

The New Statesman has reported that the spend on Healthy Start has fallen by two thirds in the last decade, and this afternoon I will be presenting a Bill that would help to increase take-up. Will the Secretary of State or one of his team meet me to discuss the details of what campaigners and I are proposing so that we can make this helpful benefit reach more of the families it is intended to benefit?

I am very happy to ensure that the ministerial team engages with the hon. Lady. I take this opportunity to commend my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), who has done a huge amount of work on early years, which dovetails with this important issue.

Following a recent unannounced inspection by the Care Quality Commission, some services at Tees, Esk and Wear Valleys mental health trust have improved, but the trust’s overall rating remains “requires improvement.” Can my right hon. Friend assure me and my constituents in Darlington that his Department will keep a laser-like focus on the trust and that he will do everything in his power to ensure the trust carries out the improvements that are so desperately needed?

I thank my hon. Friend for raising this important issue. I understand he recently wrote to the Secretary of State, and we will respond shortly. NHS England and the North East and North Cumbria integrated care board have commissioned an intensive support team review of the trust, and I will keep him updated. He is right to make sure that we keep this high on the agenda.

Children who are born premature or sick are often discharged from neonatal care with energy-intensive equipment, such as oxygen machines, which has an impact in terms of the cost of living crisis. Is the Secretary of State willing to meet Bliss and myself to look at the costs faced by families who come out of neonatal care and how we can support them better?

The Bliss charity is recognised across the House for the extremely important work it does, and I know that the ministerial team will be happy to engage with the hon. Gentleman on how we can work on the matter he raises.

BBC Local Radio: Proposed Reduction in Provision

(Urgent Question): To ask the Secretary of State for Digital, Culture, Media and Sport whether she has considered the impact of the proposed reductions in BBC local radio provision; and if she will make a statement.

I thank the hon. Lady for highlighting this news announcement that we learned about yesterday, as it gives the House an opportunity to demonstrate the value we all place on BBC local radio services.

We are currently celebrating 100 years of BBC radio. With its unique position in the radio market, the BBC has continued to develop and deliver high-quality and engaging audio services to the country and internationally over the years. BBC local radio is one of the BBC’s crown jewels. Developed in the late 1960s and 1970s, the BBC’s 39 local radio services in England still reach 5.7 million listeners each and every week. As hon. Members know, BBC local radio is highly valued outside London, where stations in Derby, Stoke, Humberside, Cornwall, Devon and elsewhere have higher reach or share numbers than the average.

Changes in patterns of listening mean that the BBC needs to look at its services, and the details about new investment in local investigative reporting are very welcome. But overall we do have concerns about the proposals, which we were not given notice of. I want to take this opportunity to stress that the BBC is rightly operationally and editorially independent from the Government, and that decisions on service delivery are ultimately a matter for it. However, the Government are disappointed that the BBC is reportedly planning to make such extensive cuts to its local radio output. We await to hear more from the BBC about how it expects those changes to impact local communities, including in respect of the provision of local news and media plurality.

At its best, as was particularly shown during the pandemic, BBC local radio is able to bring communities together and it plays a vital role in reflecting local experiences and delivering local news. For older residents living in rural areas, it can be a particular lifeline. The BBC must make sure it continues to provide distinctive and genuinely local radio services, with content that reflects and represents people and communities from all corners of the UK.

We recognise that in the current political context the BBC, like other organisations, is facing difficult financial decisions, but we are also concerned that the BBC is making such far-reaching decisions, particularly about its local news provision, without setting out further detail on how it will impact its audiences and the communities it serves. In the context of a £3.8 billion licence fee income, we do not have any details about how much this proposal is likely to save. The BBC board must make sure that the BBC complies with its charter duties. The Government are clear that Ofcom, as the BBC regulator, must make sure that the BBC is robustly held to account in delivering its mission and public purposes.

We note that as part of this announcement the BBC is also proposing establishing 11 investigative reporting teams across England. That will see the creation of 71 new journalism roles, delivering original stories across TV, radio and online services. As the House will be aware, we are currently undertaking a mid-term charter review, which we have set out and which will evaluate how the BBC and Ofcom assess the market impact and the public value of the BBC in an evolving marketplace and how that relates to the wider UK media ecology, including with regard to commercial radio and local news sectors. Handily, I am scheduled to meet the BBC next week, when I shall see the chairman and director general, and I shall raise with them the concerns that are brought to the Chamber today. We also expect the BBC to brief parliamentarians on its announcements shortly.

Thank you for granting the urgent question, Mr Speaker. Let me also welcome the Minister to her place and many of the comments she has made today. BBC local radio stations are vital as sources of information and for sharing communal experiences. I recently attended the Radio Humberside “Make a Difference Awards”, which highlighted the work of local people in their communities. In March last year, Chris Burns, the head of audio and digital for BBC England, celebrated these awards saying:

“The power of radio is huge when it comes to connecting local communities in their hour of need.”

I agree. Local radio, especially Radio Humberside, brings a feeling of belonging and companionship, especially to those who are isolated from everyday interactions. Local radio stations also hold democratically elected local politicians to account, and during the covid lockdowns they provided an invaluable service, enabling and publicising local support initiatives and disseminating up-to-the-minute news.

Local radio has 5.7 million listeners—more listeners than Radio 1 and Radio 5 Live—and it is the embodiment of public service broadcasting, remaining true to the principles behind the creation of the BBC 100 years ago. The plans announced yesterday for changes to the content of local radio—without any consultation at all of local communities—effectively mean that local radio will cease to exist after 2 pm. At Radio Humberside, 139 redundancies are predicted; as well as the impact on the individuals affected, those redundancies represent a collective loss of local expertise and knowledge and of campaigning community voices.

Does the Minister agree that local listeners should have been consulted? Does she agree that the loss of provision will be damaging to local communities as they lose an important voice for their experiences and concerns about local services, democracy and accountability? Finally, does she agree that local radio cannot call itself local when it stops being local after 2 pm?

I thank the hon. Lady for her comments and for highlighting the work done by Radio Humberside, as well as the power of radio to connect us in times of need and to ensure local democratic accountability. The mission and public purposes of the BBC include provision of output and services to the UK’s nations, regions and communities. That provision is a key part of the BBC’s remit and we hold the BBC to account for it via Ofcom; it is also something we will look at very closely in the mid-term review.

The hon. Lady highlighted the loss of local expertise. BBC local radio stations have traditionally been a fantastic way to develop local talent which has gone on to be incredibly important national talent, so we have concerns about that. She talked about the need for consultation. I would have hoped to have had more chance to examine these proposals before they were released, and I shall be talking to the BBC about that next week. I am grateful to the hon. Lady for raising these issues.

Does the Minister recognise the very real concerns about the potential loss of local distinctiveness through the proposed cuts? Should the BBC really be once again aping the commercial sector by coalescing around theme rather than genuine distinctiveness? That is where we are going with these plans. Does the Minister recognise that the cuts make reforms to radio prominence absolutely crucial? Will she quash growing rumours that the main potential vehicle for such reforms—the media Bill—is to be shelved or delayed?

I thank my hon. Friend the Chair of the Select Committee. I am particularly grateful to him and the Committee for their very important work and investigations into local journalism, and for the opportunity to present to the Committee a couple of weeks ago. One of the issues the proposals raise is whether the BBC investing more online has an impact on local news providers, which compete for that online space. On the media Bill, we in DCMS are keen to introduce it as soon as possible and we hope to be able to provide further details.

I thank my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) for securing this important urgent question, and you for granting it, Mr Speaker.

The BBC is a great British institution and local radio is the cornerstone of it. It is what the BBC does best: whether it be local traffic updates, school closures, weather or other news events, BBC local radio keeps over 6 million people across the country connected to their communities. I know that my local BBC station, Radio Sheffield, keeps the people of Barnsley informed. During the pandemic, it served as a lifeline, providing tailored local updates on the latest case numbers and guidance. More recently, local radio has shown that it has the power to keep national politicians accountable to the people we represent. Of course the BBC needs to change with the times and adapt to a world where people consume their media online, but those adaptations need not be in competition with the services that make the BBC the excellent institution it is.

Under this Government, however, the BBC has been continually undermined. In an already challenging economic environment, the Government’s looming threat of scrapping the licence fee while providing no alternative model has done nothing but further destabilise the position of the BBC. The consequences of that instability are now showing. The journalists on the ground, doing their job, have had to find out through the media that their jobs are at risk of redundancy.

The Minister must take some responsibility and answer the following questions. She said that there was no discussion between the Government and the BBC prior to the decision. What steps will she now take? May I press her again to say when we will finally see the long-awaited media Bill? How will Ministers ensure that people are still able to get high-quality local news and media that keep them connected, especially as local radio stations are often the last local newsroom standing in many areas? Does the Minister acknowledge that threatening the future of the BBC as a whole is already causing it great harm?

It is important to ask ourselves what “local” means in this context. If several counties or regions are stitched together, the service ceases to be local and relevant to local people, which we have concerns about. We recognise that the BBC is under pressure, as are many other media organisations, which is why we have a series of reforms that we hope to put through in the media Bill to help it with some of those pressures. However, I say to the hon. Lady that the BBC has a £3.8 billion annual income from the licence fee, and it has that income guaranteed for the next five years. Any media organisation would be grateful to have such stability in its funding settlement. I do not see that as destabilising. It is absolutely right that the Government ask some fundamental questions about the licence fee model in the years ahead. This is a rapidly changing media landscape and it is important that we get these decisions right.

On the next steps, as I mentioned to the House, I am seeing the director-general next week. We also have the mid-term review, where we will be examining some of the very matters being raised in this urgent question.

Along with many of my constituents, I am a huge admirer of the news and analysis provided by Radio Kent. It is particularly important these days when local commercial radio has effectively completely disappeared. Can the Minister assure the House that, when she meets the BBC, she will impress on it the importance of striking the right balance between traditional means of disseminating such information through radio and the newer online means, because the BBC will need to carry on doing both effectively if it is to fulfil its public purpose?

My right hon. Friend raises an important point. One thing the BBC does is serve every community, including those audiences who are not so capable of listening to things online and are not so digitally enabled. I am certainly happy to raise the points that he has just mentioned.

Does not the fact that the Minister was not informed by the BBC ahead of these decisions demonstrate the poor relationship that the Government now have with the BBC? What does she think she can do to improve on that?

I think that I have a very positive relationship with the BBC, but it is operationally independent. In the context of some of the changes that are being made, it is important that we have an open and honest discussion about these proposals when we meet next week.

BBC local radio makes a difference to the community that it serves. It is also the service closest to communities that pay the licence fee. I am very concerned by the proposals, which will see an awful lot of programmes shared between BBC Radio Devon and BBC Radio Cornwall, and job losses too. What steps will my hon. Friend take to make sure that local news provision is protected?

My hon. Friend has particular experience as a former manager of BBC Radio Solent and a Select Committee member. As I have said previously, I am very grateful to the Select Committee for looking at some of these quite complex issues around local journalism. The question is: at what point does local journalism cease to be local if there is a merging between large geographical counties such as Devon and Cornwall. That causes me concern, and I would be happy to engage with him further on all of those issues.

Many of my constituents listen to Radio Merseyside, which is an excellent local radio station and probably one of the most popular in the country. It certainly has a good track record in dealing with local issues and in holding its politicians and others to account. I have to say to the Minister that we talk about local radio, but it is ceasing to be local because of what we have heard today. The next thing will be whether some of the local radio stations get closed—perhaps in a year or two’s time. That is where we are going. Should the BBC not be concentrating on investing more and on improving further the local content of radio stations? The Minister said that she was not happy with the way that this had been done. When was her Department told by the BBC that it was making these changes?

I thank the hon. Gentleman for raising the importance of Merseyside radio. On the matter of holding people to account, my understanding is that the proposals include an investment in investigative journalism, which could be a positive thing, but if we had been given further details, information and notice, I would have had a better understanding of the proposals. We were not given notice beyond the news release yesterday.

The Minister is right to say that the Select Committee is very concerned about this announcement. We have taken a lot of evidence, including from her, on this subject. On BBC Radio Solent, which my constituents listen to, we think that, at weekends, there will be no purely local output at all—not even breakfast programmes—except, potentially, sports commentary. That is decimation. We hear that these regional investigative hubs will be put in place of truly local radio. Will the Minister ask the BBC, and will she give the House her opinion, as to whether that is what the licence fee payers—the BBC’s customers—actually want, because I very much doubt that that is the case?

The BBC is a public service broadcaster and it is there to deal with types of journalism that are not covered adequately by the market. That is why the BBC has support. If it is not delivering that kind of distinct local and regional content, we have to ask some very serious questions.

Local radio was brilliant when it questioned the previous Prime Minister. Can the Minister reassure the House that this is not a done deal, and can she update the House on her discussions with the director-general?

I thank the right hon. Lady for raising those interviews with the previous Prime Minister. That has since led to a regular section on the Radio 4 “Today” programme where local radio stations are making a specific contribution to what is a national broadcasting programme, allowing us to get a much better flavour of what is going on across the country, and of the different opinions that regional and local news providers have on those national stories. That is where the value of the BBC really comes into play, and I really hope that that does not wither on the vine.

I urge my hon. Friend to ask the BBC to think again. Will she remind it that stations such as BBC Essex are greatly valued by listeners and provide a service that is unavailable commercially? Online news is already well supplied by the local media, which is under considerable pressure even without greater competition from the BBC. Will she consider asking Ofcom to look into the impact of this decision on local publishers?

My right hon. Friend obviously has a great deal of expertise in these matters and I am grateful to him for raising the great content of BBC Essex. As I have said before, this is a great opportunity to show the strength of opinion across the House; the BBC is there precisely to serve audiences that are not covered by commercial radio. I would be happy to talk to Ofcom, because these are fundamental questions about the purpose of the BBC.

Can we just think about one example of how BBC local radio has impacted on all our everyday lives? During the pandemic the “Make a Difference: Give a Laptop” local radio campaign saw more than 116,000 laptops donated to schools and raised £1 million. I argue that that enabled children to carry on learning during one of the most disabling periods in our recent history. Is that not one incredibly convincing argument as to why we should protect and finance the BBC properly?

I thank the hon. Gentleman for his contribution. He is right to highlight just how important those local radio services were during the pandemic, particularly as we were seeing lots of different restrictions in different parts of the country; they provided people with up-to-date information about the restrictions in their particular area. I appreciate what he says about the funding. We have guaranteed the BBC a large amount of funding for the next five years, but he is right to highlight some of the important work that it has done over the past few years.

With my other half working in local radio as a presenter, I need to declare a personal interest in this issue. However, my support was strong long before we met, because I have always understood the importance of local radio and its value to its listeners, as I know you do, Mr Speaker, having spoken to you on many occasions about your affection for BBC Radio Lancashire. In a county such as Kent, local news delivered by local journalists who understand local need and culture is essential. It is not just about news, but about conversation and engagement. If my constituents want national news, they will go to the News Channel, but if they want local news, travel, weather, sport and what is going on around the county, they will tune into BBC Radio Kent. Merging Kent with Surrey and Sussex would be a travesty. Without being rude, why would Kent listeners want to hear about a local issue in Surrey or Sussex, and vice versa? Does my hon. Friend agree that any manager who thinks that local content should be shifted online neither knows their demographic—those who are most likely to be digitally disconnected—nor listens to it, and does not understand the definition of public service?

I thank my hon. Friend for raising the incredibly important work of BBC Radio Lancashire; I am grateful to be able to give it a shout-out. She raises the prospect of a merged Surrey-Sussex-Kent service, and she is right to highlight that that does not provide the kind of local, specialised content that people are looking for when they turn on the radio, and that there is a real risk that people will just turn to national services because that content is not sufficiently directed at them.

Of course BBC Radio Lancashire is so important, having Mike Stevens and Graham Liver there all the time.

We all appreciate the brilliance, the quality, the objectivity and the outstanding journalism, production and research of BBC radio journalists—not least, in Hull, in the coverage of rugby league, which you and I are both fans of, Mr Speaker. I urge the Minister to impress upon the director-general the crucial importance of that local knowledge in local BBC radio.

I thank my hon. Friend for raising the importance of the sports content in particular. I know there is so much passion for people’s local clubs, and if that news service is not there for those local clubs, that sense of disconnection becomes more prominent. I have not had time fully to absorb the proposals, and I think there is some talk of sports content being untouched by them, but I will ask his question of the director-general when I see him.

BBC Radio Devon is a key part of the news picture in my constituency. We have already seen the decline in commercial media, with the local daily paper becoming weekly and newsrooms closing. How will my hon. Friend satisfy herself that when the BBC promises sports coverage, that is not just commentary—for example, of tonight’s game—but about fully covering the clubs, as we have seen BBC Radio Devon covering well a number of issues affecting Torquay United?

I am glad my hon. Friend has taken the opportunity to raise the wonderful club of Torquay United and the important coverage that BBC local journalists provide to grassroots sport, which is key to ensuring that support for those small clubs continues. I shall ask the director-general about the importance of services in Devon and other rural counties when I see him.

Further to the point made by my right hon. Friend the Member for Walsall South (Valerie Vaz) about the effectiveness of BBC local radio in questioning the Prime Minister in September—kicked off, of course, by Rima Ahmed from the wonderful BBC Radio Leeds—the Minister will have heard from Members in all parts of the House just how important that local content is to us and our constituents. I urge her to take that sense of unhappiness to her meeting with the director-general and encourage him to change his mind.

I thank the right hon. Gentleman for his suggestion. As I hope he has gathered from my responses, this urgent question has been a useful opportunity for the House to make clear its very strong feelings on this issue and has allowed everybody to highlight particular parts of the country, the particular stories that come from those parts of the country and the talent that is nurtured in those local radio stations.

It is true that the local media ecology has changed beyond all measurable doubt over the past 20 years, but nobody provides local radio in the UK like the BBC, because it is set up and funded as a public service broadcaster. That should be at the heart of the BBC’s delivery. Can my hon. Friend assure me that Ofcom will look carefully at the provision of local services to ensure that older audiences are not disenfranchised by this decision? How can she ensure that other local media provision, particularly online provision that relies on local revenues to support its services, is not impacted by the BBC disproportionately acting online?

My hon. Friend has great expertise, particularly in the area of radio, so he will understand that there is a delicate ecology here and we must ensure that whatever the BBC does enhances local journalism rather than creating sustainability questions for other local journalists, particularly if it starts to move services online. He makes a good point about radio content being at the heart of the BBC’s public service broadcasting mission, and it is a point I shall make to the director-general.

Thank you for calling me so early, Mr Speaker—obviously accelerated by the complete lack of Scottish Nat Members, which I am sure is by accident and not by design, but I do appreciate it.

Before we get carried away on a wave of claptrap, may I ask the obvious question? Does the Minister agree that there are many savings to be made in how the BBC distributes its regional services, and that those savings should be made? There is much duplication within the BBC. Many of us have given the same interview time and again on the same day for a number of regional radio stations and there has been no sharing of that across the BBC regional network, as should be the case. Of course, we have split services in Northern Ireland: we effectively have Radio Ulster and Radio Foyle, and there has been a removal of exciting local issues to do with, for example, 12 July coverage. All that has been removed from BBC radio locally. The Minister needs to make sure that, when she talks to the director-general, she makes those points also.

I thank the hon. Gentleman for his contribution. I know he has very strong feelings about the BBC, which we discussed only yesterday in the Lobby. The BBC has a licence fee income of £3.8 billion a year, and there are big questions to be asked about what kind of content it should be delivering with that amount of money. I think the strength of feeling in this House is that this very local content is precisely what the BBC is there to deliver, because the commercial sector does not deliver it. People are content to pay for the licence fee when they think it is providing that kind of service.

I declare an interest as a former employee of BBC Radio Tees and freelancer at BBC Radio Leeds. We all welcome investment in digital services and it is good that local sport will continue—speaking particularly as a rugby league fan of the Huddersfield Giants—but the message is coming through loud and clear: the Minister needs to ask the director-general and the chairman to look again at continuation of local coverage after 2 pm. It is vital in my neck of west Yorkshire, not just through the pandemic, but when we have bad weather, for school and college closures and updated road information. It is really important. Will she please press that with the DG and the chairman next week? We need proper local coverage throughout the day, not stopping at 2 pm.

I thank my hon. Friend for his contribution, not least because of his own background and expertise in BBC local radio. I have a great deal of sympathy with the BBC’s trying to future-proof the organisation, to ensure it is more available online and to deal with some of the challenges around digital, but it must look at its fundamental purpose. He is right to highlight the importance of local news in relation to specific local updates, whether that is weather, travel or particularly important democratic stories, and I shall be raising those issues with the director-general.

I am sure you would agree with me, Mr Speaker, that while all local radio stations are good, BBC Radio Lancashire is the greatest of them all. All the more reason, then, to raise my concern that in Lancashire it is proposed that from 2 pm onwards we have shared services with Cumbria, from 6 pm onwards on weekdays it is shared with Greater Manchester and Merseyside, and on weekends just with Merseyside. Does the Minister agree that that fracturing of BBC local radio is a threat to democracy? For strong democracy we need strong, accountable local media to hold politicians right across our counties—including the greatest county, Lancashire—to account.

Let us give another shout-out to BBC Radio Lancashire, just so that Mr Speaker is content with me. The hon. Lady highlights the potential for geographically large and very diverse areas to be stitched together. As I say, after a point that ceases to be local content, and there is a serious question about democratic accountability, given that that is one of the primary purposes of public service broadcasting. Those are very real issues that need to be raised.

I was surprised to hear that the Minister only heard about this in the last couple of days, because I heard about it last week through a whistleblower from my local area. That is very worrying. The second worrying thing is that the public trust local radio as they do not trust “Newsnight” or “Today”—frankly, because they do not listen to them. They trust local radio. If this is about money, then take half a million pounds out of Gary Lineker’s salary, or one of the others who earn extortionate salaries. That would pay for a lot of people at Three Counties Radio to keep their jobs.

I thank my right hon. Friend for raising his concerns. There is a social compact between the public and the BBC that we pay the licence fee on the basis that it provides us with this kind of content, and if it ceases to do that, that raises more fundamental questions. He raises a number of helpful points, and I shall make sure that they are addressed. I know that many Members across the Chamber feel strongly about some of the very large salaries in the BBC, and that goes to the heart of public trust in the BBC. If we had further details and a greater understanding of the cost savings in these proposals, we could have a more serious debate about it.

I am the secretary of the National Union of Journalists parliamentary group, and the Minister can imagine the crushing disappointment among NUJ members, because this comes on top of 450 job losses in BBC England and 400 job losses in the World Service. Our concern is that the digital first proposals are undermining the provision of news at the local, national and global level. I am pleased that she is meeting the BBC next week. I ask her to meet the NUJ group as well, so that we can brief her on what we know is happening on the ground as a result of cut after cut after cut from the BBC.

I am grateful to the right hon. Gentleman for raising the NUJ’s concerns. It is important that many people get their training in local media organisations, which gives them a great grounding for going national. It is regrettable that these proposals come in Journalism Matters Week, at a time when there are a whole host of challenges facing local journalists.

I share the alarm expressed across the House and by the Minister at this move. I represent a part of Hampshire that often finds it hard to identify itself in the BBC schedules, squeezed as it is between BBC Radio Solent, which concentrates on the urban areas to the south of the county that are an hour away, and BBC Radio Berkshire, in a different county altogether, yet the BBC does just enough in my part of the world to make sure that the commercial sector cannot function or thrive in North West Hampshire. I urge the Minister not to mess about with this debate, which we have had many, many times over the years about the BBC. May I suggest that she talks to the Competition and Markets Authority about it doing a full review of the impact of the BBC on the commercial sector, both locally and nationally?

I thank my right hon. Friend for raising the issues in Hampshire. The mid-term review, which is a relatively new innovation, is looking at some of these questions on competition and market impact. If he has further details that he would like to feed into that about his local challenges in that regard, I would be happy to receive them, because the Department is looking at all these issues, and we expect to report next year.

The National Union of Journalists has warned that these cuts will not only cost jobs but risk diluting the breadth and quality of relevant local news, particularly for listeners in my Riverside constituency, who are served by the great BBC Radio Merseyside, which has fantastic journalists. Does the Minister agree that this represents a core part of the BBC’s function, and can she inform the House of what action she will take to protect the future of local news on BBC radio and television?

I am grateful to the hon. Lady for again raising the NUJ’s point of view. As I have said in previous answers, BBC local radio is a great training ground for a number of journalists, and it would be regrettable if it started to be reduced in size. There are opportunities for journalists in some of the proposals that the BBC appears to be putting forward for investigative journalism, and those are to be welcomed. The BBC invests in a number of other initiatives, particularly the Local Democracy Reporting Service, but these are precisely the kinds of initiative that the BBC should be involved in, and we should all be concerned if it seems to be moving away from that.

This is yet another own goal by the BBC, with no consultation and no dialogue with Ministers. The email that Members received referred to “changing audience expectations”. Actually, what thousands of my constituents expect is to be able to press a button and listen to Radio Humberside, which their radios are permanently tuned to. In the short term, may I urge her to get the BBC to drop these proposals? She referred to the charter review. As negotiations about the charter continue, may I urge her to emphasise that local radio is key to BBC provision?

I thank my hon. Friend for his question. He is right to highlight that this is precisely what people expect of and value from the BBC. I have a great deal of sympathy with the BBC needing to change and adapt to the changing media landscape, but it must not at the same time move away from its core purpose.