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Commons Chamber

Volume 724: debated on Tuesday 6 December 2022

House of Commons

Tuesday 6 December 2022

The House met at half-past Eleven o’clock

Prayers

[Mr Speaker in the Chair]

Oral Answers to Questions

Health and Social Care

The Secretary of State was asked—

Covid-19: PPE Procurement

1. What recent assessment he has made of the adequacy of the steps taken by his Department to secure value for money in procuring PPE during the covid-19 outbreak. (902607)

We procured personal protective equipment at pace so that we could protect the frontline and save lives. In a highly distorted market, we worked around the clock to secure the life-saving PPE that we needed.

The Secretary of State will be aware of the high-profile reports in the media regarding Baroness Mone and her connection with PPE Medpro, contact with Government Ministers and the use of a VIP lane in relation to the procurement of PPE. Will he assure me—and more importantly the public—that a full and thorough investigation will take place into these matters and that, following that investigation, the report will be made public?

I can do much better than that. We have commissioned a full investigation and inquiry into the Government’s handling of covid and, as part of that, I am sure that the inquiry will look at PPE. But it is important to put it into context. We secured 23.2 billion items of PPE, which was a huge step, done at pace, to help protect our frontline.

There are concerns that officials and high-ranking associates have reaped the financial benefits of a deadly disease, shamelessly profiteering on public funds. The SNP has long sought to highlight the Government’s rampant cronyism and corruption, and this PPE plundering is the most egregious case that we have seen so far. In Scotland, the Scottish Government have robust procedures in place to ensure protection of procurement in healthcare. How will the Secretary of State better regulate the cronyism of his colleagues? Will he commit now to scrapping the UK Government’s VIP lane for healthcare contracts?

Again, that ignores both the pressure of time at the start of the pandemic and the fact that there was international competition, with companies competing for scarce resources. It is also the case that although more than 19,000 companies were offering PPE, only 2,600 passed initial due diligence checks.

Hospital Bed Capacity

To support operational resilience, the NHS has set out plans to increase hospital bed capacity by the equivalent of at least 7,000 general and acute beds during the winter. That is alongside £500 million of funding to support quick, safe discharge from hospital and free up capacity, and £1.5 billion of targeted investment funding for new surgical hubs, increasing bed capacity and equipment for elective care recovery.

I am grateful for the Minister’s response. Over the last 20 years, Warrington has had among the highest level of new houses built in the north-west of England, but our healthcare infrastructure has not kept pace. We desperately need a new hospital. Our accident and emergency is at breaking point, we do not have enough beds and there is nowhere for those visiting to park their cars. In 2021, my NHS trust submitted a bid to the Department of Health and Social Care for a new hospital. Will he update us on where we are with that process?

I thank my hon. Friend, who has been a long-standing advocate for a new general hospital for Warrington. The expression of interest from the trust has been received. We are currently in the process of reviewing expressions of interest for the eight new hospitals and aim to announce a final decision by the end of the year. I recently met him to hear about the plans, and the people of Warrington could not have a greater champion than him.

May I associate myself with the remarks of the hon. Member for Warrington South (Andy Carter) about the need for investment in Warrington and Halton Hospitals NHS Trust? It is important that both hospitals have that investment. Part of the capacity problem is the lack of social care capacity in the community, whether in a home or in patients’ own homes. Just recently, I had an email from the chief executive of Whiston Hospital, a large acute hospital, where 115 patients were in beds when they did not need to be—they should have been going out of the hospital—out of a total of 721 adult acute beds. Is that not an example of where the Government are failing to provide enough social care out in the community?

We are investing £500 million to create another 200,000 social care placements, but we have significantly increased the number of physical beds available in our hospitals. In July, before we made the commitment to increase bed capacity, we had 96,375 general and acute beds; in October, we had 97,350. We are also delivering that increased capacity outside of hospital through this winter by creating an extra 2,500 virtual ward beds.

Does my hon. Friend agree that it is high time the outstanding care and skill of Hillingdon Hospital staff was matched by commensurate outstanding facilities, and that it is therefore great news that Hillingdon is one of the 40 new hospitals that the Government are building by 2030? Can he confirm that the full funding package will be announced soon, so the whole project can proceed as soon as possible?

I thank my right hon. Friend for his question. The Secretary of State visited Hillingdon Hospital—a hospital I am also aware of—over the summer. There has been no greater champion of Hillingdon Hospital, or of the new hospitals programme more broadly, than my right hon. Friend. Currently, five hospital schemes are in construction, two are now completed and we aim to announce the next eight by the end of this year.

Two weeks ago, a 5-year-old constituent of mine, Yusuf Nazir, died because we no longer have intensive paediatric beds in Rotherham. September saw record-breaking ambulance handover delays and the proportion of patients waiting more than 12 hours in accident and emergency rose to 13.8%, nearly double last September’s figure. In the last 12 years, Rotherham’s NHS has been hollowed out. What is the Minister going to do to reverse that?

First, let me thank the hon. Lady for her question. I am very sorry to hear about the case she highlights. I understand she has written to the Secretary of State on this issue.

Ambulance waiting times are not where we want them to be. We have increased ambulance staff by 40% since 2010. We have invested, with just under 5,000 more staff in NHS 111; 2,500 more staff in call centres; an extra £450 million last year into A&E departments; the creation of the £500 million discharge fund, which will improve flow through hospitals; and 7,000 extra beds this winter. We understand the system is under considerable pressure. I would be very happy to meet the hon. Lady to discuss the challenges in her own trust.

The current state of mental health treatment sees increasing numbers of people languishing on waiting lists becoming more and more unwell, 1.1 million adults denied treatment, and children stuck in emergency departments for days waiting for mental health beds. Are the Government proud that a systemic cutting of a quarter of NHS mental health beds over the last 12 years has led to more patients receiving treatment in private settings? Does the Secretary of State know how much money is given to private mental health providers? Do the Government honestly think they are getting good value for money?

This is not my direct area of responsibility, but of course mental health does present challenges for A&Es and for hospitals more generally. We are investing an extra £2.3 billion every year in mental health, we have 16% more staff and we have an additional bursary to attract more nurses into mental health. But we do recognise the challenges, and the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield) is working hard to address them.

Neurological Diagnosis and Treatment: Waiting Times

3. What recent steps his Department has taken to reduce waiting times for neurological diagnosis and treatment. (902609)

Reducing waiting times for diagnostics and treatment is a priority for this Government. The delivery plan for tackling the elective backlog sets out steps to recover and transform out-patient services across all specialisms, including neurology.

In March 2021, my constituent suffered a severe head injury. By the time they have their first neurology appointment in January 2023, they will have waited nearly two years for treatment. In the meantime, they have been unable to work, been rejected for disability benefits and are in severe pain. Does the Minister accept that this wait is unacceptable, and will she outline what support the Department is making available for those who are suffering while they wait for vital appointments?

I thank the hon. Lady. I know she raised her constituent’s case in a Westminster Hall debate on 22 November and my understanding is that they now have an appointment for January, but there is absolutely a backlog from covid patients. We know that. That is why we are putting in over £8 billion in the next three years to deal with that backlog. That is in addition to the £2 billion we have already provided through the elective recovery fund. We have already virtually eliminated the two-year wait and we are now on track, by April, to eliminate waits of 18 months or more.

Social Care Workforce

I thank all those who work in social care for what they do day in, day out for people whose lives depend on care. We are supporting care homes and agencies in their efforts to recruit staff, including with a substantial national recruitment campaign. In fact, colleagues may have seen some of the adverts while watching popular programmes such as “I’m a Celebrity”. We have also added social care workers to the shortage occupation list, so that social care can benefit from international recruitment to increase the workforce in the short term.

A recent report from the Motor Neurone Disease Association, outlined at the all-party group on motor neurone disease, which I chair, found that most unpaid MND carers provide more than 75 hours of care a week, but many are unable to access respite services due to the lack of adequately skilled care workers equipped to care for the complexity of MND sufferers’ needs. Will the Minister commit to increasing specialised training for conditions such as MND in the social care workforce to protect carers’ health and wellbeing?

My hon. Friend makes an important point. I, too, have heard from family carers about the difficulties that they have faced in getting skilled professional help, which, in turn, gives them support and respite. At the moment, we provide £11 million annually for a workforce development fund, which social care employers can access to help to pay for staff training. Looking ahead, we are working on social care workforce reforms, of which training and skills will form a substantial part. I commit to looking into his suggestion that specialist training for MND care should be part of that.

In the lakes, we have a problem with social care: although the people working in the care industry are phenomenal, talented and dedicated, the average age of the population is 10 years above the national average, so the number of people who need to be cared for is greater and the size of the workforce is smaller. Undoubtedly, poor pay, poor conditions and a lack of career prospects are a major problem in recruiting and retaining the care staff that we need. We also have a special problem in our area because of the absence, or indeed, the evaporation, of the long-term private rented sector, which is where the carers normally would have lived. Will the Minister talk to her colleagues in the Department for Levelling Up, Housing and Communities to make sure that we have a comprehensive package for communities such as mine in Cumbria, so that we have well-paid carers and places in which they can afford to live?

The hon. Member makes a really important point. I will say two things. In the short term, we are supporting social care with £500 million through the discharge fund this winter. That will go into increasing capacity in social care and addressing some workforce challenges in areas such as his. In the long term, we are introducing social care reforms, including in the workforce. One thing we need to look at is ensuring that housing is available for the social care workforce.

I have listened to the Minister talk about increased social care, but I do not recognise that in my area. Northampton General Hospital, which is one of the hospitals that serves my constituency, has around 150 patients who could medically be discharged but cannot be. That accounts for 19% of the beds. At the same time, West Northamptonshire Council is closing Spinneyfields, a 51-bed step-down facility in my constituency, yet it has a private finance initiative contract and, for the next seven years, will pay £700,000 for an empty building. How can that be right? Will the Minister sort it out?

I will take away that example from my hon. Friend’s constituency and look into it. I want to see increased capacity in step-down care and social care during this winter and beyond, but particularly during this winter, supported by the £500 million discharge fund. That will go to areas such as his and across the country to help to make sure that people who do not need to be in hospital can be out of it getting the care that they need.

When will the new Health team wake up to the fact that many of the things that we have discussed this morning—but particularly social care—will be solved only by treating local authorities as friends, allies and partners, rather than the enemy? Please can we have action to make local authorities full partners in delivering every sort of care?

After hearing the hon. Member’s point, I should think that he therefore welcomes the fact that we have set up integrated care systems, which bring together health and social care. The £500 million discharge fund that I have mentioned is allocated to local areas to be pooled into the better care fund and spent jointly between local authorities and the NHS. Funding is an important part of this. In the autumn statement, social care received a historic funding settlement of £7.5 billion over the next two years. That is important, as well as ensuring that the NHS and local authorities work together hand in hand.

10-Year Cancer Plan

Earlier this year, we held a successful call for evidence on a new cancer plan, which received 5,000 responses. We are now considering those responses and how we can best support the diagnosis and treatment of cancer patients. I will be in a position to update the House shortly.

I thank the Minister for her response, but it has been five months since July, when the 10-year cancer plan was due to be published, and 10 months since February, when the war on cancer was announced. While the Government have delayed, cancer patients have faced unacceptable waiting times for diagnosis and treatment. Performance over the past five months has been the worst on record against the target of a 62-day wait between the GP referral for suspected cancer and the first treatment. I ask the Minister respectfully: does she agree that we in this House and the people of this country now need a long-term, ambitious plan to reduce waits and ensure that cancer patients in this country have the best outcomes possible? Will she set out a timeline—not just say “shortly”—for delivering such a plan?

As the hon. Gentleman knows, I cannot comment on what is happening in Northern Ireland, because health is a devolved matter. I can only update him on what is happening in England. We are not waiting for a cancer plan to start on the backlogs: that is why this Government are investing £8 billion over three years to clear the elective backlog. We are seeing record numbers of patients. Cancer treatments continued throughout the pandemic, but we are seeing a higher number coming through than usual. Despite the increase of more than 129% in patients getting urgent GP referrals since September 2019, 91% of patients in England are receiving their treatment within 31 days of the decision to treat, compared with just 87% of patients in Northern Ireland in June. We are very committed to reducing cancer waiting times. I suggest that the hon. Gentleman may wish to speak to the Minister in Northern Ireland as well.

Diagnostic activity, whether in vivo or in vitro, forms part of more than 85% of clinical pathways. Will my hon. Friend confirm that it will receive due recognition in the 10-year cancer strategy?

May I thank my hon. Friend for all her hard work during her time as a Health Minister? We are going through the responses to the call for evidence right now; as I have indicated, we will update the House shortly. I will very much take her points on board.

My constituent Jesse, who is 24, was diagnosed with grade 4 glioblastoma multiforme, a type of brain cancer. It has been devastating to her. She has had a very difficult year of treatment; crucially, after her initial round of treatment, there were delays in accessing a scan because of the backlogs in the NHS. There is a real need for a proper cancer care plan to make sure that she gets her scans as regularly as necessary. Other patients need them as well, but her scan was two months later than it should have been under the standard of care, leaving her in absolute terror that her cancer would come back. The fear is almost as bad as the disease itself. What plans does the Minister have to make sure that the 10-year cancer plan really gets to grips to the backlog, which is devastating people’s lives?

I am sorry to hear about the experience of the hon. Lady’s constituent. I am sure that she will welcome the 91 community diagnostic centres that have already been set up to provide a range of tests, including CTs, ultrasounds and MRIs. We are expecting to deliver up to 160 community diagnostic centres in total, with the capacity for up to 9 million more scans per year when they are fully operational. That will not just deal with the backlog, but future-proof our diagnostic services.

The Minister will know that cancer is the biggest cause of death in children under 14. There are countless instances of failure and missed opportunity in how we detect it, how we treat it and how we care for children with cancer. I am grateful to her for meeting my constituent Charlotte Fairall earlier this year, who tragically lost her daughter Sophie. Does the Minister agree that we need a childhood cancer mission embedded in the heart of any cancer strategy if we are serious about saving other families from that tragedy?

I thank my hon. Friend for all her hard work in this space and for leading our debate on childhood cancer outcomes in this Chamber. I was delighted to meet her constituent Charlotte, who is campaigning so hard on the issue. I promised her that we would look at a child cancer mission; we will update the House on our progress shortly.

GP Recruitment

In September 2022 there were nearly 2,300 more full-time equivalent doctors in general practice than there were at the same time in 2019, and more than 9,000 GP trainees.

A constituent of mine, a full-time GP in her 50s, told me that the pension rules mean she has to retire, work part-time or emigrate, which is hardly likely to help her patients to obtain appointments with her. Having hinted at a change in doctors’ pension rules last summer, the Government are only now announcing a consultation that will last until next spring, so there will be no change in these crazy rules until next summer at the earliest. Is this not too little, too late?

It is worth reminding the House that there are 3% more doctors this year than last year. As I have said, we have 2,300 more full-time GPs, and we are recruiting more. However, the hon. Lady is absolutely right about doctors’ pensions; that is a material issue, which is why we launched the consultation, and we are working with Treasury colleagues to address these concerns as quickly as possible.

GP numbers are falling in Wales. Healthcare is devolved to the Welsh Labour Government, and although Ynys Môn is represented by five members of the Senedd in Cardiff, healthcare concerns constitute a staggering 25% of my postbag. Does the Secretary of State agree that families throughout Wales are not receiving the healthcare that they need and deserve from the Welsh Labour Government?

I do agree with my hon. Friend, and I think it would help the House to assess the performance of the Welsh Government if there were more transparency. For instance, the Opposition motion on today’s Order Paper refers to vacancies in England. I am sure it will surprise the House to learn that the Welsh Government stopped collecting statistics for workforce vacancies in 2011. I look forward to Opposition Members’ encouraging their Welsh colleagues to be more transparent.

Members on both sides of the House will have been shocked and appalled by the recent deaths of children from streptococcus A, and our thoughts are with all the families affected. Cases are on the rise, and as we head into winter it is vital for parents to be able to secure for their children the care that they so desperately need. The shortage of GPs means that too many are struggling to see a doctor, and now there are reports of shortages of antibiotics as well. What advice can the Secretary of State give parents whose children are exhibiting symptoms but who cannot obtain a GP appointment, and what assurances can he give on the supply and availability of antibiotics?

This is an important issue which I know is of concern to many families throughout the country, so I am pleased to be able to reassure the House about our response. While GPs are important in this regard, so are directors of public health, who are leading the response in respect of, for example, liaison with schools. We are seeing a peak in cases earlier than usual, which we believe is due to lower exposure during the pandemic, which in turn has led to lower immunity. There is no new strain, and that is one of the key points of reassurance, but the UK Health Security Agency has declared a national standard to improve the co-ordination of our response, including what is being done in schools.

Hospitals: New Builds and Upgrades

As we heard earlier, the Government are committed to a programme to create 40 new hospitals by 2030. We have committed £3.7 billion—[Interruption.] The hon. Member for Ilford North (Wes Streeting) will get a go in a moment, and I look forward to hearing him welcome the increase in the Government’s capital spending, not just on our new hospitals programme but on, for instance, elective surgery. We are putting £5.6 billion into more surgical hubs and community diagnostic centres, and £1.7 billion has gone to more than 70 hospitals to enable them to deliver significant upgrades.

Patients in Carshalton and Wallington will benefit massively from the building of a new hospital in Sutton and the improvement of St Helier Hospital under NHS plans approved by the Government. Will my right hon. Friend agree to meet me, and the NHS trusts? They are raring to go and to get spades in the ground next year.

I know they are raring to go because I personally have spoken to the chief exec about this scheme, but I can offer my hon. Friend something better: the Minister of State, Department of Health and Social Care, my hon. Friend the Member for Colchester (Will Quince), will personally be visiting shortly to discuss this further. But I also need to be transparent with the House: we are fundamentally changing how we are going to be building hospitals in the NHS estate—[Laughter.] I am not sure why something as important as new hospitals—learning from the Department for Education and the Ministry of Justice through a more standardised model that allows us to deliver more at a cheaper unit price and get them built quicker—is a source of mirth to Opposition Members. It is important that we standardise those designs, and that is what my colleague the Minister of State will be discussing with my hon. Friend.

The new children’s hospital, the new adult building and the maternity centre at Leeds General Infirmary will bring much-needed new facilities to Leeds and the region, as well as wider economic benefits. It is unusual among the hospital building schemes. As the Secretary of State knows, the site is clear and the plans are ready, so may I urge him to give the go-ahead as soon as possible?

I visited that scheme over the summer. The right hon. Gentleman will know that the costs have inflated significantly since what was signed off by the Treasury in 2019. I think the point that has been missed by Opposition Members is that the way we deliver these schemes is to grip the cost better by using standardisation, and that is what I will be discussing with Leeds General. I agree with him that it is important that the scheme goes ahead, and we need to work together to make sure that it does so at a price that is affordable.

NHS Dental Contract

In July, we made some initial changes to the reformed system to support NHS dentistry. We have invested an extra £50 million, reformed the contract to create more UDA—unit of dental activity—bands to better reflect the fair cost of work, and introduced a minimum UDA to help practices where the levels are low, allowing dentists to deliver 110% of their UDAs to provide more treatment. The number of dentists doing NHS work last year was up 2.3% but we are working on plans to go further.

The changes made to the dental contract last week were a step in the right direction, but they fall some way short of the holistic reform required to help the estimated 25,000 of my constituents who do not yet have an NHS dentist. Will the Minister consider a change whereby the NHS funds subsidies to underprivileged areas such as Blackpool, thereby allowing NHS practice to offer a greater financial incentive to attract new dentists into those areas?

Absolutely; my hon. Friend and I have talked about this. We are looking urgently at payment models and measures to address areas that are struggling to attract the right workforce. The commissioning of dentistry will be coming down to a more accountable local level in April, and we need to build on that.

My constituents in Durham have told me tales of DIY dentistry, missing teeth, children in pain and the unfairness of only being able to access dental care if they can afford it. Things should not be this way. The British Dental Association does not accept that the Government’s new plans go far enough to halt the decay in NHS dentistry provision. Will the Minister tell me when the Government will put in adequate funding and reform so that people in Durham can get the dental care that they need and deserve?

As well as increasing the number of dentists doing NHS work and the amount of work being done, we are taking further steps to look to the longer term and build NHS dentistry. The number of dental school places is up from 810 in 2019 to 970 in 2021, but of course we want to go further. We are making it easier for dentists to come to the UK to practise. In fact, we laid draft secondary legislation on 11 October to give the General Dental Council more flexibility to do that. Around the country, plans are advancing for centres for dental development to provide not only additional dentists but hygienists and other nurses.

Health Inequalities

We are taking action on public health across the board. The £3 billion that we are investing in the drugs strategy will create an extra 50,000 places in drug treatment. We have doubled the duty on cigarettes since 2010 and brought in a minimum excise tax. We now have the lowest smoking rate on record and will go further. The £300 million that we are investing in Start for Life means new or expanded family hubs in 75 local authorities. We are taking action right across Government, from the £55 billion that we are investing in energy support to the measures that we are taking through at the moment to crack down on non-decent housing.

Levelling up is not just about jobs and infrastructure; it is about healthcare too, and dentistry is a key part of that. However, Darlington faces the potential closure of its surgery, which serves 7,000 patients, because the current system of NHS dentistry makes the business case for that surgery unviable. What will my hon. Friend do to ensure that we level up dental services so that my constituents can get the services that they need?

My hon. Friend and I have discussed this, and we are due to meet again shortly. I repeat my offer to speak both to that practice and to local partners so that we can tackle this crucial problem.

Research by the University of Manchester adds to the significant body of evidence showing that addressing disparities in healthcare is key to levelling up. Inequalities have resulted in a 30% productivity gap in the north, which can be attributed to poorer health. Will my hon. Friend outline how the Government are working to address this and to ensure that residents of the north are not at a health and care disadvantage?

I saw that important report, and we have to tackle the problem from both the health end and the economic end. Spending on health in the north grew from £36.5 billion in 2018-19 to £52.6 billion in 2020, so there is significant investment in health and preventing ill health in the north. Economic activity stops people sliding into a cycle of ill health and worklessness, and we are working jointly with the Department for Work and Pensions to roll out more disability employment advisers in jobcentres. The underlying key is to tackle and prevent ill health, hence the £3 billion drug strategy and the measures on smoking, energy and housing.

I will give the Minister a good example of health inequality. Until quite recently, we had a perfectly good consultant-led maternity service based in Caithness. Following the Scottish Government’s rubber-stamping decisions, pregnant mothers now have to make a 200-mile return journey to Inverness to give birth. That glaring inequality is despicable. I hope His Majesty’s Government will share best practice with the Scottish Government on tackling this problem.

I am always keen to work constructively with the Scottish Government. This sounds like a serious problem. My right hon. Friend the Secretary of State set out how we are using our health and capital spend more efficiently, and unfortunately this is an example of where it is not happening in Caithness.

It is well documented that people in rural areas have worse health outcomes than people in urban areas. One driver is that the most vulnerable people lack access to the services they need. Will the Minister consider working with his colleagues in the Department for Transport to figure out how the most vulnerable people can access the healthcare they need?

We are rolling out community diagnostic centres to bring services closer to those who need them, and we are investing in 21,200 extra people working in general practice to make sure that rural services, as well as services in the rest of the country, are improved.

In 2019, the Tories promised to extend healthy life expectancy by five years, but on this they are failing. In the last year, the health disparities White Paper has disappeared, the tobacco control plan has been delayed and they have chickened out on implementing the obesity strategy because the Prime Minister is too cowardly to stand up to his Back Benchers. Health inequalities are widening as a consequence. Does the Minister plan to revive any of these strategies, or have the Conservatives completely given up on prevention?

I have already talked about some of the things we are doing to crack on with improving public health and narrowing inequalities, but I will add some more. We are driving up blood donations from shortage groups and vaccine uptake in areas with the lowest uptake. I mentioned the extra £900 million for drug treatment, taking the total to £3 billion over three years. I will not repeat all the things I mentioned but, across the board, we are working at pace to improve public health and narrow health inequalities.

Sudden Cardiac Arrest

Immediate cardiopulmonary resuscitation doubles or quadruples the chance of surviving an out-of-hospital cardiac arrest. Defibrillation within three to five minutes dramatically improves the chance of survival, which is why NHS England is establishing a network of defibrillators and community first responders to save up to 4,000 lives a year by 2028.

On average, 150 people a day die from sudden cardiac arrest outside hospital. Access to a defibrillator is crucial for survival. Without one, the chance of surviving drops by 10% every minute. I welcome the Government’s commitment to rolling out defibrillators across state-funded schools in England and Wales, but I share the concern that, because of significant ongoing supply chain issues, it might not be achieved. Can the Minister explain how the Department is helping to reach the target of supplying 20,000 defibrillators by 2023?

As the hon. Lady says, access to a defibrillator makes a great difference to the survival prospects of somebody having a sudden cardiac arrest, which most commonly happens either at home or in the workplace. Since May 2020, the Government have required all new school builds and refurbishments to have defibrillators installed. I am happy to look into the concern she raises and get back to her. I am also working on other initiatives to make sure we get more defibrillators into public places.

Like many of my Lincolnshire constituents, I live in a remote village and in the unlikely event of my having a sudden cardiac arrest—I am sure that would disappoint people—there is no prospect of an ambulance coming within 10, 15 or even 20 minutes. The Government could make themselves really popular in rural areas by having a massive campaign to roll out defibrillators in most villages. For instance, we have a good opportunity to put a defibrillator in all those red telephone boxes that BT are now closing down.

My right hon. Friend makes an important point, and this is exactly why work is going on to increase the number of defibrillators across the community, for instance, in villages such as his. Many villages will already have them. We are also supporting the NHS to train community first responders to make sure that there are people all across the community who have the skills to do CPR— cardiopulmonary resuscitation—and use a defibrillator. I look forward to being able to announce shortly a new initiative that will mean further defibrillators across our communities.

Social Care Reform

We are already putting social care reforms into practice. For instance, we want care providers to adopt digital care records, and more than 50% have already done so. I am determined to shine more light on our social care system, so our new Care Quality Commission-led assurance of local authorities’ social care duties will start in April.

One of the worst vacancy rates across the NHS is that of geriatricians. What urgent action is the Minister putting in place to ensure that people either at home with domiciliary care or in social care settings are seeing a geriatrician consultant regularly? If there is a shortage, which I believe there is, what action is she taking to have more doctors train as geriatricians?

The hon. Lady makes an important point about people who are receiving social care also having access to the healthcare they need and these systems working together across our health and social care systems. We are training more doctors overall, and we have an increase in medical school places, which is leading to more doctors coming through. I am happy to take away and look at her question about the number of geriatricians.

On delivering social care reform, does the Minister agree that we also need to be looking at how the funding packages work, particularly across borders? I have a constituent whose case falls between two local authorities. Will she agree to meet me as a matter of urgency to make sure that this poor constituent receives the funding she needs for her husband’s care?

As announced in the autumn statement, we have a record funding settlement of £7.5 billion going into the social care system over the next two years, to improve both access and quality of care. I am happy to meet my right hon. Friend to look into the specific challenge that she has outlined, because it is important that local areas are working together across boundaries.

Let’s just tell it like it is on the Government’s record on social care reform. Their cap on care costs was first promised 10 years ago. In 2015, they delayed it and in 2017 they scrapped it. In 2019, the right hon. Member for Uxbridge and South Ruislip (Boris Johnson) again promised to fix the crisis in social care, but last month the Chancellor buried the policy, once and for all. After 12 long years, what have Conservative Members got to show on social care: the highest ever staff vacancies; millions left without the care they need; hospitals full of people who do not need to be there; and families picking up the strain. Isn’t the truth on social care, just as with our economy, transport, housing and schools, that the Conservatives have run out of excuses and run out of road, and the country deserves a change?

We have delayed our social care charging reforms because we listened to those in the system and we heard local authorities asking for more time to prepare. Importantly, we have allowed local authorities to keep the money allocated to that in their bank accounts to fund some of the current pressures on social care. I ask the hon. Lady to recognise the record funding settlement for social care in the autumn statement—£7.5 billion for social care over the next two years—which she has not even acknowledged. That is coupled with the fact that we are pressing full steam ahead with our system-wide reforms to social care, with funding of more than £1 billion to support the workforce and innovations in social care and to transform the quality and access to social care across the country.

New Hospitals Programme: King’s Lynn

12. What recent assessment he has made of the expressions of interest submitted by Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust to be part of the new hospitals programme. (902619)

I had the question down as No.13, but given who is asking the question I can guess that it is related to the build of the King’s Lynn hospital.

I visited the site and looked at the scheme over the summer. I made it clear in a speech that I gave to NHS Providers that addressing the concerns of the RAAC—the rebar autoclaved aerated concrete——hospitals is my No. 1 priority. Obviously, I cannot comment on individual schemes while the process is ongoing, but I can assure my hon. Friend that we are working actively on it.

I warmly welcome the priority that my right hon. Friend has put on resolving the serious RAAC concrete issues at the Queen Elizabeth Hospital, but the decision on this was due in the spring. Christmas is coming and the only question that people in North West Norfolk have is, when will we get the present that everyone wants—a new hospital for the staff and patients?

I note the extensive support that my hon. Friend has among parliamentary colleagues, including my right hon. Friend the Member for South West Norfolk (Elizabeth Truss), who has recently added her support to the scheme. He will be aware that we allocated £20 million last year and £30 million this year to address some of the immediate issues, but we recognise that it is a priority and we are working on it.

NHS Dentists

13. What recent steps his Department has taken to increase the number of dentists working in the NHS. (902620)

As well as making it more attractive to practise in the NHS, the number of dental school places is up from 810 in 2019 to 970 in 2021, making it easier for qualified dentists to come to the UK. We are putting through secondary legislation on that and encouraging new centres for dental development.

Is the Minister aware that there is a particular problem in Bridlington in my constituency, where an increasing number of residents are finding it not just difficult to access NHS dental care, but impossible to do so? Recently, a dental practice in the town has closed. Will he agree to meet me on this matter to see what can be done to resolve the issue, hopefully sooner rather than later?

Of course, I would be keen to meet to try to address those issues and to build on the work that we are doing nationally.

York has had a dental desert for years. It is six years now to see an NHS dentist and the Government have made no change to improve that situation, or to bring more NHS centres into my area. In March, dentistry will be moving into integrated care systems and integrated care boards. How are they going to solve the problem?

One problem has been that having large, remote regional commissioning for dentistry has meant that it is more unlikely that specific local problems will be picked up. That is why we are taking the step that the hon. Member has described. She is now complaining about it, even though it is a measure to get more local accountability over the way that services are commissioned.

Medical Students: University Places

14. What recent discussions he has had with the Secretary of State for Education on increasing the number of university places for medical students; and if he will make a statement. (902621)

The Department has commissioned NHS England to develop a long-term workforce plan. That plan will help to ensure that we have the right numbers of staff, including doctors with the right skills, to deliver high-quality services fit for the future. The plan will be independently verified. We have funded 1,500 more medical school places in England and opened five new medical schools in Sunderland, Lancashire, Chelmsford, Lincoln and Canterbury, and there are record numbers of medical students in training.

I thank my hon. Friend for his answer. He will know that it takes five or six gruelling years to get a Bachelor of Medicine or a Bachelor of Surgery degree—or Doctor of Medicine in Scotland—but many students, having graduated, think that they would prefer more structured development by working as hospital doctors. What can we do to encourage young graduates to go into general practice?

We have record numbers going into general practice, which is the remit of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), but part of the plan is to make it more attractive through practice improvement through cloud-based telephony, the additional roles reimbursement scheme, the 24,000 extra staff in primary care, developing multi-function staff so that people can develop their skills and have specialism but still practise as a GP, increasing the use of pharmacy, moving towards more continuity of care and the new GP contract for 2024-25.

But when are we going to see the workforce plan? The other day I spoke to a radiologist who runs a radiology department. There are meant to be 15, but there are only five and they have not had a single person apply. It needs more radiologists and radiographers. We have a national shortage of dermatologists, which is one reason why skin cancers are not being picked up, and a national shortage of pathologists and histopathologists. We need a dramatic increase in the number of people working in the NHS. When are we going to see that workforce plan?

As I said, we have committed to publishing a comprehensive workforce strategy, which, as the Chancellor set out, will be independently verified. That will come soon. We have also set out new pension flexibilities. However, it is important to point out that we have 29,000 more nurses and we are on track to meet our 50,000 target. We have 3,700 more doctors compared with last year, 9,100 extra nurses and 2,300 more GPs.

Topical Questions

We know that women can benefit from more personalised care, especially in pregnancy. The Tommy’s app is a new clinical decision tool for the NHS and for women, another example of how we are using artificial intelligence to improve our maternity system. That will help to end some of the variation in maternity care from hospital to hospital. I am pleased to tell hon. Members, particularly my hon. Friend the Member for Rutland and Melton (Alicia Kearns), who is a great champion of improved mental health, that today my Department, through our National Institute for Health and Care Research, has agreed to provide the funding needed for the next stage of the app’s development. I pay tribute to Sienna and all those other babies born stillborn to their parents and thank all those in this Chamber who have campaigned passionately on this important issue.

Another dental practice in my constituency recently handed back its NHS contract. When I contacted local NHS management about the impact of the closure, it stated that the area in question was adjudged to be well served for NHS dentistry practices because there are 11 practices within a half-mile radius. The experience of my constituents, now left searching for NHS dental services, is that none of those practices is accepting new NHS patients. What is the Secretary of State doing to ensure that assessments of the sufficiency of NHS dental services reflect the real situation on the ground, and when will we see a sustainable solution to the problems my constituents face?

The hon. Lady raises an important issue that is of concern across the House, as we have already seen in the exchanges the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien) answered. That in part was why, during the pandemic, we used £1.7 billion of funding to protect dentistry and why we got a commitment through the £3 billion a year funding of dentistry, but we are looking at how we localise that commissioning to get better value out of the contract, which was the point my hon. Friend raised.

T2. At 1 o’clock today, patient safety expert Dr Bill Kirkup will be speaking to MPs at the all-party parliamentary group for whistleblowing, to which all colleagues are invited. It is a timely meeting following last week’s “Newsnight” programme, which highlighted yet another NHS trust where a culture of fear left staff unable to speak up on patient safety concerns. It is clear change is needed. Does my hon. Friend agree that supporting whistleblowers in the NHS is crucial to patient safety? (902633)

My hon. Friend is so right. I praise her work with the APPG and I know many colleagues will want to attend. Whistleblowers can save lives and improve healthcare, as I have seen in my own constituency, and she is right to be pressing on this matter.

The chairman of the Conservative party claims that NHS strikes are exactly what Vladimir Putin wants, so why is not the Health Secretary negotiating to prevent them from going ahead?

I have seen the hon. Gentleman make that claim across the media a number of times. Just to reassure him, my door is open and I have been clear with the trade unions that I am available; I am available to them this afternoon or tomorrow. It is not I who set a precondition for those talks. When I met the trade unions, they raised a number of issues; not only pay, but safety of staff and other conditions, the estate, tech and so forth, and I am happy to engage with them on those points.

We get the warm words about wanting to negotiate, but a Government source briefed The Times last week that the Secretary of State’s plan is to wait for public sentiment to turn against striking nurses, saying:

“This is going to affect a lot of people…it could have a big impact on a lot of them and…in the end they will get fed up”.

He knows that this winter is going to be the most difficult that the NHS has ever faced, and he is using nurses as scapegoats to avoid the blame. That is the shameful truth, isn’t it?

First, it is a bit bizarre that, at departmental questions, the best the hon. Gentleman can manage is “a Government source”. Secondly, the revelation from that Government source is that this will affect “a lot of people”. I do not think that comes as any surprise. That is why we regret the action and are very open to having talks. The point is that he himself does not support the 19% pay demand of the trade unions. He stands here saying that we should be talking while he himself does not accept their proposal.

T4. There have been several changes of Ministers, as we know, but officials have carried on working through these changes, so can we know on what day, date and time the long-promised and overdue tobacco control plan will finally be published? (902636)

Whatever format our next steps forward are set out in, we will be pushing forward very quickly and aggressively on this. This year, we are putting £35 million into the NHS to support our services for everyone who goes in to stop smoking. We have doubled duty on cigarettes and brought in a minimum excise tax. Women who are pregnant now routinely get a carbon monoxide test. National campaigns such as Stoptober have now helped 2.1 million people to quit smoking. We are also supporting a future medically licensed vaping product as a quitting aid. We will be pressing forward at the greatest speed.

Intellectual property protections are an important way of protecting healthcare companies’ innovations, as we know. However, developments on intellectual property can also impact the rights of individuals, limiting access to affordable, life-saving and essential medical products. What recent representations has the Secretary of State made to colleagues in the Department for International Trade to seek assurances that nothing in the proposed free trade agreement with India will impact or jeopardise access to affordable medicines for NHS patients in Scotland?

I can reassure the hon. Gentleman on that. I would have thought that he would also welcome the commitment to a £15 billion to £20 billion increase in R&D investment, the championing of life sciences that the Minister for Health, my hon. Friend the Member for Colchester (Will Quince), has been leading on, and the opportunity we have to address greater variation within the NHS by bringing forward the innovations from our life industry and applying them much more quickly.

T7. Several GP practices in Rother Valley, such as Swallownest Health Centre, operate a policy of having to ring the doctor’s surgery at 8 am for an appointment. Residents find themselves being placed 50th or 60th in the queue, and are then told that no appointment is available and to call back the next day. This is clearly an unacceptable way to offer appointments. What steps are my hon. Friends taking to stop the current failed booking system and instead guarantee a system of pre-booked appointments at all GP surgeries? (902639)

That is something that we are working on very actively. As well as financially supporting GPs to roll out new and better ways of managing their appointments, we are looking at what criteria we expect from GPs. We already set out some moves in our summer action plan, but we will be looking further at preventing the lamentable situation my hon. Friend describes of people being asked to ring back or being held in long phone queues. That is not acceptable.

T3.   The public are not daft. They know that the backlogs in the NHS existed well before the pandemic, they know that the NHS was already on its knees, and they know that it was this Tory Government who brought it to its knees. So why do the Government not take up Labour’s policy of scrapping non-dom status, use the £3.6 billion to train nurses, doctors and midwives, and get the NHS back on its feet? People in east Hull want nurses, not non-doms. (902634)

The data is very clear; in fact, it is very stark on the extent to which the backlog is driven predominantly by the pandemic. That is why we have a programme, through the extra investment in the autumn statement: the £6.6 billion over the next two years going into the NHS, but also the £2.8 billion next year and £4.7 billion the year after into social care, and £8 billion in 2024. We recognise the size of those backlogs, so we can fund the surgical hubs and diagnostic centres.

I met local care providers last Friday, and they raised two main points with me: concerns about energy costs and covid in care homes. They were keen to see their nursing staff vaccinated with residents, all at the same time. I recognise that that happens in some places, but can we look at making it the norm throughout the country?

My hon. Friend makes an important point. The NHS is strongly encouraging local vaccination teams to vaccinate staff, as well as residents when they visit care homes. That should be normal practice. I am happy to look into it, if that is not happening in her area. I take this opportunity to encourage any health or social care worker who has not had their covid or flu jab this winter to please go ahead and get one.

T5. Parents are becoming increasingly worried about the current prevalence of strep A. It is a time of year when parents are going to have children with high temperatures and sore throats, so concern is likely to be very high. There are also concerns about the availability of antibiotics. Does the Secretary of State believe that this is a moment where the Government need to make a statement and show clear leadership to calm people down and reassure them about the situation? (902637)

We held a cross-party briefing last night on strep A. We want to reassure parents, and if their children have symptoms and they are concerned, please seek help. GPs are ready and A&E departments are ready, and we have directors of public health proactively going into schools where there are cases. There is no shortage of antibiotics—we want to reassure people on that—and we are keeping an eye on that on a daily basis.

The East Lancashire community diagnosis centre already includes Burnley hospital, and as part of that we are opening two new endoscopy rooms in the spring. Residents, the trust and I know that the local hospital can do even more to reduce the covid backlog with the right Government investment. Will the Minister agree to meet me to discuss phase 9 of the hospital’s development, which would bring a brand-new radiology suite?

My hon. Friend is a strong champion for Burnley, and I congratulate Burnley General Teaching Hospital on the incredible innovative work it is doing. He is right that rolling out 91 out of 160 CDCs is a tremendous effort, but we want to go further, and I would be delighted to meet my hon. Friend to discuss these plans further.

T8.   Last week, the First Minister of Wales, Mark Drakeford, said that pay awards are not being funded at the level they should be. The Wales TUC general secretary said that unless we have a fairer funding settlement for Wales, we are going to struggle going forward. When will this Government listen to the Welsh Government and the Welsh trade unions and provide the proper funded pay award that NHS staff deserve? (902640)

I simply direct the hon. Member to the Barnett consequentials. As a former Chief Secretary who has had those discussions with the Welsh Finance Minister I know, and the hon. Lady should know, that Wales gets significantly more funding per head of population than England. I hope she welcomes the fact that, through the extra £6.6 billion in the autumn statement, the First Minister will have a significant uplift, and it is for him to decide how he wishes to spend that money.

I was recently contacted by Amanda in my beautiful constituency of South West Hertfordshire, whose 88-year-old mother had fallen in her flat and unfortunately broken her hip. After waiting for five hours and making two calls to 999, her mother was still lying on the floor. Once they arrived at A&E, Amanda and her mother waited several more hours before being seen. Can my right hon. Friend assure the House that he is doing everything possible to find a solution to this system-wide issue?

My hon. Friend raises an extremely important case. I am happy to meet him to discuss it further, because it is a concerning case and I am keen to engage with him on it.

T9. My hon. Friend the Member for Denton and Reddish (Andrew Gwynne), the shadow Minister for public health, touched on health inequalities earlier, but I did not hear the Health Secretary recommit to publishing the White Paper by the deadline. Does he understand that the cost of living crisis and poverty are leading to greater health inequalities and that action is needed urgently? Can he recommit to that White Paper being published? (902641)

We are absolutely committed to addressing health inequalities. Rather than simply looking at 10 years’ time, we are looking at the immediate actions we can take, because what matters—[Interruption.] Those on the Opposition Front Bench chunter about White Papers, but what I am interested in is immediate delivery—what we can be doing now, rather than speculating about what is done in 10 years’ time.

We are seeing a sad increase in suicide rates across the country. In 2012, the then Government published a 10-year cross-Government suicide prevention plan. Earlier this year, the Government under the leadership of my right hon. Friend the Member for Uxbridge and South Ruislip (Boris Johnson) committed to a new 10-year plan that would be published before the start of 2023. There is no sign of that cross-Government 10-year suicide prevention plan, but maybe I am wrong, and perhaps the Government are about to publish it, because I know that so much of the work has already been done. May I ask my right hon. Friend the Secretary of State to show that he takes suicide prevention seriously and publish this plan as soon as possible?

I thank my right hon. Friend and pay tribute to him for all his work in this area; he has driven this agenda forward. I want to reassure him that we are looking at that. He will understand that we have had some changes in recent weeks, but I assure him that tackling the issue of suicide is a high priority, and we will make an announcement shortly.

In a case that is sadly all too typical, a GP in Ealing, who has seen their patient list go up from 3,000 to 9,000 in the last decade, had plans approved for expansion, but NHS estates now will not cough up. What are the Government doing to support doctors in inadequate premises who cannot increase their patient lists to expand and modernise in the current climate?

The total activity done by GPs was about 7% up in October compared with the previous year. We are actively looking at the way that capital works and the contributions of section 106 and the local integrated care board, to ensure that, as well as having those 2,300 extra doctors and 21,000 extra staff, GPs also have good facilities to work in.

Access to dentistry is an acute issue for West Oxfordshire. Can Ministers explain what they are doing to help rural areas such as mine, and can we meet to discuss it further?

I have mentioned the fact that the number of NHS dentists was up 2% to 2.3% last year, as well as the extra £50 million and the reforms we have made to the contract, but we will go further. We want to address those areas, and particularly rural areas, where more provision is urgently needed.

The chair of the Royal College of General Practitioners has expressed concerns about patients with chronic conditions such as asthma, diabetes and even serious mental health conditions refusing sick notes because they cannot afford time off work. What discussions has the Secretary of State had with Cabinet colleagues about the adequacy of statutory sick pay during this cost of living crisis?

I refer the hon. Lady to the autumn statement, in which my right hon. Friend the Chancellor set out a wide range of support packages to help with the cost of living across the United Kingdom, including the cost of energy. That is part of wider discussions that we have on a regular basis with the Treasury.

The pandemic has had a devastating effect on the number of people waiting for treatment. In 2019, there were 54 women waiting more than a year to see a gynaecologist. That number is now more than 40,000. What is my right hon. Friend doing to reduce this wait?

This is a good illustration of the challenge the country faces with backlogs that are very much driven by the pandemic. We are working with senior figures such as Jim Mackey and Professor Tim Briggs and the Getting It Right First Time programme to look at patient pathways, how we use our diagnostics and our surgical hubs and streamlining the way we get services to patients where backlogs have built up.

This morning, we tragically learned that a five-year-old girl who was a P2 pupil at Black Mountain Primary School died yesterday in Belfast with strep A. I am grateful to the Minister for the answer she gave to the hon. Member for Eltham (Clive Efford) on strep A and her encouraging commitment that antibiotics including penicillin are available, but can she ensure that our public health agencies across this United Kingdom co-operate with one another and that if additional resource is required, it will be made available?

I am very sorry to hear about that tragic case in Northern Ireland. We want to reassure people that, while there is a slightly higher number of cases than usual for this time of year, the UK Health Security Agency is on top of this and is not concerned that there is a wider outbreak than would be expected. We want to encourage parents who are concerned that their children are not responding to get help as soon as possible. Antibiotics are available, and local directors of public health should be co-ordinating local activity, but if there are any concerns, Members should come and see me.

On Saturday, I visited Chalkwell Grange, a brilliant new care home in picturesque Leigh-on-Sea which is struggling to recruit due to the guidance that all care workers should wear face masks. Will the Secretary of State give care homes the best Christmas present ever and change the word “should” to “can” or “may”, to put them in charge of their own infection control?

I thank my hon. Friend; it is good to hear that she has visited a local care home. I have also heard what she heard from staff. Although face masks are important for infection control, we know that they have downsides, such as making communication harder. I have asked for updated public health advice on the use of masks in care homes and I look forward to updating hon. Members and the social care sector on the guidance about that shortly.

My constituent is a victim of sexual misconduct by a medical professional, but they cannot challenge that professional’s fitness to practice because of the five-year rule. The General Medical Council wants that rule to be scrapped and the Government consulted on whether to get rid of it more than a year ago. Can the Minister say whether it is the Government’s intention to scrap it? Will she meet me to discuss how important it is that the GMC can explore whether a potentially dangerous medical professional who is still practising may be unfit to do so?

I thank the hon. Lady for her campaigning on this serious issue. I am happy to meet her and I suggest that we also meet the patient safety commissioner, Henrietta Hughes, to discuss it further.

Can the Secretary of State give the House an undertaking that no NHS or social care facility will be decommissioned and used to house asylum seekers in Northamptonshire or the rest of the country?

I am not aware of any proposal on those lines. On my hon. Friend’s earlier point, as I said, I am happy to meet him to discuss the issue of step-down care and I am sure that there will be an opportunity to discuss any other concerns that he has at the same time.

My constituent Margaret Cramman is a full-time carer for her daughter. Throughout the pandemic, she was denied respite care. Now the care setting insists on testing for visitors and mask wearing for staff, which causes distress to some of the young people being cared for, who rely on vital facial recognition. Nearly all the other covid guidance has been reviewed, but the guidance for respite care remains the same. Why are carers and those they care for always an afterthought for the Government?

I point the hon. Member to the answer that I gave to my hon. Friend the Member for Southend West (Anna Firth) a moment ago specifically about face masks. I have asked for updated guidance for the social care sector on the use of face masks. I recognise the difficulties they cause—for instance, in communication—and I am looking forward to being able to give an update to hon. Members and the sector on that shortly.

What assessment has the Secretary of State made of geographic variation in access to innovative liver cancer treatments, such as selective internal radiation therapy?

It is a brilliant question on which to close, because one of the things that all hon. Members should be hugely interested in is how we are adopting innovation more quickly and industrialising that innovation across the NHS as a whole, as opposed to in silos. That is something that we are focused on in the Department and it is a key priority. I am happy to speak to the Scottish Government and others about how we can work together on that.

Point of Order

On a point of order, Mr Speaker. During last week’s debate on Northern Ireland and the reduction of pay for Members of the Legislative Assembly, I raised the fact that absentee Sinn Féin MPs have received £10 million in various allowances over the last 10 years alone. The Minister of State, Northern Ireland Office, the hon. Member for Wycombe (Mr Baker) said that he did not recognise the figure, so I asked the House of Commons Library to research it and it confirmed that it is correct. I then furnished the Minister and the Leader of the House with that. The Leader of the House is responsible for bringing a resolution that ends the scandalous anomaly where MPs whose leader has said that they have “no business in Westminster” continue to receive millions of pounds to do no business in Westminster. Has the Leader of the House indicated to you, Mr Speaker, that she plans to bring a resolution to end that scandalous anomaly?

The quick answer is no, but I am grateful to the hon. Member for giving notice of his point of order. As he will know, I am not responsible for the accuracy of the contributions of Ministers or other hon. Members. If an error has been made, the record should be corrected. In any event, he has certainly put his points on the record.

Employment

Motion for leave to bring in a Bill (Standing Order No. 23)

I beg to move,

That leave be given to bring in a Bill to make provision about employment rights, including the right to request more predictable terms and conditions of work; to amend the definition of worker; and for connected purposes.

Fairness, compassion and equality are not only the basics that should be afforded to each and every working person across these islands, but how we can measure the effectiveness of Governments for those they serve. The covid-19 pandemic has highlighted the many failings in legislative rulings on the workplace in this disunited kingdom. Working people have found that their workplace rights have not secured their jobs and incomes, their livelihoods or their health. Hundreds of thousands of people actually have few of the rights that Parliament has legislated an employee should have, such as the right to a minimum wage and protection against unfair dismissal. For far too many, persistent, undignified and unfair working practices remain their reality.

Workers’ rights are not a priority for this, or indeed any, Westminster Government. Despite committing to an employment Bill on at least 20 occasions so far, Ministers have shelved the legislation at each and every turn. Five years on from the Taylor review, we are yet to see action from the UK Government on improving workers’ rights. The omission of the long-anticipated employment Bill from the Queen’s Speech was yet another missed opportunity.

Last week, during Prime Minister’s questions, in relation to the Retained EU Law (Revocation and Reform) Bill, my right hon. Friend the Member for Ross, Skye and Lochaber (Ian Blackford) said that

“it is such a sad sight to watch this Prime Minister ram through a Bill that would rip up 4,000 pieces of European law—laws that protect workers’ rights, food standards and environmental protections.”—[Official Report, 30 November 2022; Vol. 723, c. 895.]

He was right. If the Tories were intent on protecting workers’ rights, they would simply retain and maintain those that were already enshrined in EU law. Of course, we know that they are either too proud or too pig-headed to admit that some EU law was good law and effective law, and that it protected our workforce. Instead, the Tories power it through, ignoring the fact that Brexit is the greatest political act of self-sabotage in the history of this state, and they further allow workers’ rights to degrade and for hard-working individuals to see their personal circumstances diminish.

If working people are to have a meaningful voice in setting the terms and conditions of their employment, and if callous unilateral decision making is to be stopped, questionable employers must be held to account. Remarkably, we find ourselves in the 21st century fighting 19th-century battles, despite the obscene wealth, progress and sophistication enjoyed by the few at the expense of so many. Under the Tories, the UK already has the highest levels of in-work poverty this century—poverty that disproportionately impacts on people facing high living costs, such as single parents, disabled people and people with caring responsibilities.

The Tory-made cost of living crisis is only further exacerbating matters. The Fawcett Society has said that women face “double trouble” because of the combined impact of the cost of living crisis and the difference in their pay compared with that of men. Research shows that in 2022 women will take home, on average, £564 less than men each and every month, and they are far more likely to be in low-paid employment. The Resolution Foundation has also found that low-paid work is often of poor quality, stressful and unfulfilling, and job satisfaction among the lowest earners fell from over 70% in the early 1990s to 56% as early as 2019. These are damning statistics.

Employers often try to persuade workers of the benefits of a lesser contractual status on the basis that it provides flexibility for the worker, but this is a false argument, since legal status has nothing whatsoever to do with whatever flexibility options employers confer on their workers. Flexibility can just as easily be enjoyed by employees if the employer is prepared to concede it.

This all points to a complete lack of consideration for employee lifestyle within the recommended practices placed on workplaces by this UK Government. Workplaces across the United Kingdom have been systematically plagued for years now by zero-hours contacts or work on demand-only requirements, while flexible contractual terms give wide-ranging powers to companies to dictate when, where and how work is to be done.

The emergence of fire and rehire as a corporate tactic is particularly galling to any of us from a true working-class tradition on the SNP Benches. My hon. Friend the Member for Paisley and Renfrewshire North (Gavin Newlands) has submitted two Bills to this Parliament seeking to outlaw fire and rehire practices, with the support of over 100 MPs and the backing of all major trade unions. This UK Government sit idle. In the meantime, collective bargaining coverage has plummeted, collective agreements now reach fewer than one in four workers, which is lower than at any time in the last 100 years. Those are damning statistics. This Bill seeks to ban the callous and sinister practice of fire and rehire once and for all.

The right to strike is constrained by unparalleled restrictions, although workers are now heroically voting in their millions to overcome them. It is no surprise that those working people’s share of the nation’s wealth continues to decline as poverty and inequality continue to increase, threatening the very basis of our threadbare democratic institutions. The differing rates of pay for young people are wholly unjust and discriminatory, and do not take account of people’s personal needs, responsibilities and living circumstances. A day’s work is a day’s work. The age of the person delivering that work should be of no relevance; only the quality of the work itself.

While the setting of the minimum wage is reserved to this place, the Scottish Government continue to encourage businesses in Scotland to pay the real living wage through their Fair Work principles. The SNP also continues to oppose current rules on statutory sick pay, which fall far short of meeting a dignified standard of living and are not flexible enough to meet the real-life needs of real people. We have repeatedly called on the UK Government to increase SSP in line with a real living wage, and make it available to everyone by removing the requirement to be a qualified worker, removing the earnings requirement, and extending it to 52 weeks. Scotland’s ability to tackle unfair working practices and fully protect workers’ rights remains limited while employment law is reserved to this place.

Unaccountable power is unacceptable when exercised by the state, and it is no more acceptable when exercised by rogue employers. The measures proposed in a private Member’s Bill that was laid before the House by my hon. Friend the Member for Glasgow South West (Chris Stephens) aim to strengthen protections for workers with unfair contracts, including those with bogus self-employment and zero-hours contracts. I call on the UK Government either to get behind my hon. Friend’s Bill or to bring forward their own legislation to give millions of workers the same protections that are enjoyed by our friends and counterparts across Europe.

Scotland has everything it takes to be a hugely successful, self-governing, self- sustaining nation, and then we have so much more on top of that—only the staunchest Unionist would disagree. Yet Westminster control has held us back while comparable countries of a similar size go on to prosper. Relative to the UK, comparator nations have fewer people in gainful employment who are at risk of poverty. In the UK, 10.4% of those in work are at risk of facing poverty. In Belgium, Iceland and Finland, the figures sit below 5%. Furthermore, fewer employees are working long hours, with only 0.3% of workers in the Netherlands working more than 50 hours a week, compared with 10.8% of the UK’s population—those are damning statistics. Having the highest percentage of those employed experiencing in-work poverty should prompt this Government to act.

The UK under Conservative rule has experienced the largest wave of workers’ strikes in decades, and we now know that more is planned well into the new year. Protecting workers’ rights has never been, and will never be, a priority for this UK Government, who attempt to water down workers’ rights and take away any remaining dignity at every opportunity. Those practices, and this callous and uncompassionate culture, must end now. I urge the House to support a new dawn for workers everywhere—one that respects them, and holds their rights to the very highest standard.

Question put and agreed to.

Ordered,

That Steven Bonnar, Stephen Flynn, Mhairi Black, Colum Eastwood, Amy Callaghan, Jim Shannon, Patricia Gibson, Dave Doogan, Pete Wishart, Owen Thompson and Chris Stephens present the Bill.

Steven Bonnar accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 3 February 2023, and to be printed (Bill 211).

Opposition Day

[9th Allotted Day]

NHS Workforce

I inform the House that I have not selected the amendment. I call the shadow Secretary of State for Health and Social Care.

I beg to move,

That this House recognises that the National Health Service is facing the worst workforce crisis in its history with a shortage of 9,000 hospital doctors and 50,000 nurses; condemns the Government’s failure to train enough NHS staff to tackle this crisis; regrets that, as a result, patients are finding it impossible to get a GP appointment, ambulance or operation when they need one; calls on the Government to end the 200-year-old non-domiciled tax status regime which currently costs taxpayers £3.2 billion a year; and further calls on the Government to use part of the funds raised to invest in the NHS workforce by doubling the number of medical training places, delivering 10,000 more nursing and midwifery clinical placements, training twice the number of district nurses per year and delivering 5,000 more health visitors to guarantee that the NHS has the staff to ensure every patient can access the care they need.

The NHS is facing the worst crisis in its history. Seven million people are waiting for NHS treatment, and they are waiting longer than ever before; 400,000 patients have been waiting for more than a year. Heart attack and stroke patients are waiting an hour for an ambulance, on average, when every minute matters. “24 Hours in A&E” is not just a TV programme; it is the grim reality facing patients in an emergency. Behind those statistics are people being held back from living their lives: people forced to give up work because they cannot stand the pain; young people, still bearing the scars of lockdown, unable to get the mental health support they need to step into adulthood; families losing loved ones for no other reason than that the NHS was unable to treat them in time.

My friend and colleague the shadow Leader of the House shared with me an email from one of her constituents. A patient with suspected cancer was urgently referred by his GP, which ought to mean being seen by a specialist within a fortnight. Four weeks later he had heard nothing. He phoned the hospital and was told, “two weeks currently means six weeks” and that he would be contacted, not seen, within the next two weeks. He has now had his appointment, during which the doctor identified cancerous cells. He has been told that he will wait up to eight months to have that cancer removed. He said that until waiting lists are down,

“more people will die unnecessarily from cancer. I hope not to be one of them.”

That is not uncommon. That is where we are. That is why Labour is today putting forward our plan to solve this crisis, make the NHS fit for the future, and get patients treated on time again.

Yesterday I spoke to a paramedic who had been with a patient with sepsis, waiting for two and a half hours to be taken in. There were 98 calls at that same Yorkshire hospital waiting to go in. Are we now post-crisis and in complete breakdown, and do we need Labour’s plans to come in now, and not have to wait?

I strongly agree with my hon. Friend. As the Leader of the Opposition has said, the NHS is not on its knees; it is on the floor. How many times were we told during the pandemic that restrictions were needed to stop the NHS falling over? It has now fallen over, and for the first time in its history people no longer feel certain that, when they phone 999 or arrive at A&E, they will be seen in time. It is the first time in our country’s history that people have not felt confident that emergency medicine will be there for them when they need it.

The Conservatives blame the crisis in the NHS on everything from the weather to the pandemic, and even NHS staff. Of course there is no doubt that the pandemic has made things worse, but the Government—the Conservative party—sent the NHS into the pandemic with 100,000 staff shortages. They spent a decade disarming the NHS, before sending it into the biggest fight it has ever faced. They cannot pretend that the NHS was well prepared. The problem for the Conservative party is that people are not stupid. Their memories are not that short. They know that the NHS was struggling to treat them on time before the pandemic, and they know who is to blame.

Is not the point that health is devolved across four different nations, which are each led by a different party? Does this mean that the pandemic has hit all health services, including across the western world? This is a rising tide of the problem of the pandemic and dealing with an ageing population. This is not party political at all, and it is remiss of the hon. Gentleman to try to make it that. What does he say to that?

I would say two things. As I have already said, I accept that the pandemic made the challenge right across the United Kingdom worse. I also accept that, in every part of the United Kingdom, the NHS is under severe pressure. I would say two things in response. First, even if some of our friends on the SNP Benches do not want to acknowledge it, there is no doubt that every part of the United Kingdom would be better off with a Labour Government and every part of the NHS in every part of the United Kingdom would be better off if there were a Labour Government, because the investment that we are proposing in NHS staff today would benefit countries right across the United Kingdom. [Interruption.] In response to the outgoing hon. Member for Peterborough (Paul Bristow), do not say that politics does not make a difference. Do not expect the people to believe that somehow there was an inevitable sense of decline in the NHS. I am sure people remember that, when Labour was last in government, we delivered the shortest waiting times and the highest patient satisfaction in history.

Certainly not. The hon. Member’s plan seems to be simply vote Labour—there is no detail to it and nothing else to it. I suggest that he looks at the good people of Wales, who suffer under a socialist healthcare system. They are certainly not very happy, are they?

I do not pretend that our plan is not vote Labour, but of course those are the means by which we get to better ends. What we propose today is the biggest expansion of the NHS workforce in history. I will explain how that will benefit patients across the country and how we will pay for it. I think that people in Peterborough, 2,788 of whom are waiting more than a month to see a GP, will welcome Labour’s plan for investment. That is why, after the next general election, Peterborough will have a Labour MP.

I want to raise the case of my constituent, Mr Simpson, whose wife died last Tuesday after waiting 16 hours for an ambulance. On 29 November, his wife was confused. At 3 pm, he first called for an ambulance and was told that one might be sent and that he might hear from the service. At 6 pm, he rang the ambulance again. The person wanted to speak to his wife, but she was very confused and unable. He tried to give her a drink at 2.30 am; there was still no ambulance. His wife went to sleep, but she was still moving a bit. He fell asleep. He woke at 7.30 am and found that his wife was not moving; she had passed away. All the while they were still waiting for the ambulance to arrive. I do not believe for one moment that that happened because the ambulance service does not care. Does my hon. Friend agree that the service is desperately understaffed, desperately short of resources and in desperate need of adequate funding?

I thank my hon. Friend for raising that heartbreaking case. It is every family’s worst nightmare. All of us now know someone who is waiting for treatment. Many of us know someone who has called for an ambulance and waited for hours and hours—and, in some cases, given up on it and gone to hospital. I have spoken to ambulance service staff who, like many other staff across the NHS, feel a real sense of deep personal moral injury because they know that, despite their best efforts and busting a gut at work every single day, their best simply is not good enough because the system has collapsed. Ambulance turnaround times are not fast enough because A&E waiting times are too high. That is because people cannot see a doctor and the social care is not available, so the beds are full of people who are well enough to go home and would be better off at home. This is the problem in the NHS: the whole system is broken. I am afraid to say that political decisions made in this place by the Conservative party have led us to this tragic situation.

My hon. Friend is making an excellent case. At the James Cook University Hospital in Middlesbrough, the number of people still in hospital who could be discharged into social care amounts to three full wards. That is the situation that we have got to. It is a perfect storm, with ambulances queueing outside and people turning up at A&E because they cannot get to a GP. That will only ever be addressed if we also address staffing in our GP services to ensure that they can attract people who are offered Agenda for Change terms and conditions to alleviate the backlog. Does he agree that we need to invest in all the elements along that supply chain?

My hon. Friend is absolutely right. This is the tragedy of where we have got to on social care in particular. The Government have allocated half a billion pounds to alleviate pressure this winter, but not a penny of it has reached social care providers. Not a penny of it is currently being worked in action to try to deal with delayed discharges. I have no doubt whatsoever that one reason why it has taken so long from that commitment to getting money to the frontline is the constant churn of Ministers that we saw over the summer. The absolute circus that we saw in the Conservative party has had a direct impact on the competence of effective Government in this country. We now have ineffective Government, so even when the Government seek to do the right thing and allocate the resources, they cannot get the money out the door far enough because Ministers seem to change week in and week out.

I commend the shadow Secretary of State for what he is saying. When it comes to staffing issues, one thing should clearly be done. Does he agree that part of the reason why we rely so heavily on agency staff is because our NHS staff have migrated to agency working, where there is less pressure, so the Government should spend less money on agency workers and give our NHS staff greater support and appropriate pay so that they can stay in the NHS?

I strongly agree with the hon. Gentleman. I will come shortly to talk about industrial action, but this should be at the heart of the Secretary of State’s thinking. The demands from staff trade unions, whether on pay, terms and conditions or the wider pay machinery, should be seen not just as a negotiation with staff unions but as a retention issue. We are losing staff faster than we can recruit them in some places—especially in areas such as midwifery—and if we lose the staff that we have, even Labour’s plans to undertake the biggest recruitment in the NHS’s history would not be as effective as they would be if we kept staff in the service today. That is why I urge the Secretary of State to treat those NHS staff with respect, get their representatives around the table, and negotiate a solution.

I am aware that the situation in the NHS in Northern Ireland is the worst that we see throughout the United Kingdom. The shadow Secretary of State for Northern Ireland, my hon. Friend the Member for Hove (Peter Kyle), visited NHS services in Northern Ireland only recently. I have no doubt that we need to get effective governance back up and running again in Northern Ireland as well. I urge the Government to discharge their responsibilities in that area, too. Certainly, when Labour was last in government, I do not remember Labour Prime Ministers taking such a complacent, lackadaisical or indeed absent approach to the governance of Northern Ireland. I hope that we can see a breakthrough of the deadlock so that the people of Northern Ireland get the Government they deserve in Stormont, as well as the United Kingdom getting the Government it deserves here in Westminster.

Waiting lists were already at a record 4.5 million before the pandemic. Ambulances were taking longer than is safe to reach patients in an emergency before the pandemic. Patients were waiting longer than four hours in A&E before the pandemic. The 18-week guarantee for elective treatment had not been met for four years before the pandemic, and more patients have waited longer than two months to start their cancer treatment every year since 2010. From the moment the Conservatives entered power, things began to deteriorate. It is not just that the Conservatives did not fix the roof while the sun was shining; they blew off the roof and ripped up the floorboards, and then they wonder why the storm did so much damage.

My hon. Friend mentioned cancer diagnosis rates. I believe he will be aware that one in four people diagnosed with pancreatic cancer dies within a month of their diagnosis, with 70% receiving no treatment at all because they die before they could be treated. Does he agree that cancer diagnosis rates are a disgrace and that early intervention, early diagnosis and early treatment are vital for people with all forms of cancer, particularly the most aggressive types such as pancreatic cancer, to have any chance of survival?

My hon. Friend is absolutely right. One reason why this country has much poorer cancer outcomes than many comparable economies is precisely because of late diagnosis. I know from my own experience how vital early diagnosis can be for good cancer outcomes. I am terrified by the fact that, within those 7 million patients waiting in the elective backlog, there will undoubtedly be cases of undiagnosed cancer and other conditions. If the NHS had eyes on the patients, they would be detected faster, patients would receive treatment much more quickly and the outcomes would be better. One of the tragedies for the NHS is that, because we do late diagnosis, we get more expensive and less effective treatment. If we could diagnose faster, patients would get better outcomes and taxpayers better value for money. That is the kind of reform to the model of care that Labour would like to see.

On diagnosis, access to GPs is also a vital part of the puzzle. Is it not terrible that the Government are not listening to GPs, who say they need a different visa system? They cannot recruit enough GPs into the system because the Government are so stuck with these immigration rules, and the Home Office does not want to change certain parts of the visa system?

I am grateful for that intervention. We are in the worst of all worlds on immigration and the NHS. The Government try to have it both ways. They talk tough on rhetoric, so we end up with a very bureaucratic, ineffective and costly system, but because they fail to invest in our own homegrown talent, they are over-reliant on immigration from other countries, including those who desperately need their own doctors and nurses. I do not think it is good enough, after 12 years of Conservative Government, that we are turning away bright potential doctors, nurses and allied health professionals because the Government cannot be bothered to pull their finger out and train our own homegrown talent. We need to see improvement, so we that can draw the best international talent and make the system smooth, efficient and effective, but it is also crucial that we train our own homegrown talent.

Turning to more of the Conservatives’ excuses—we have heard the excuses of the pandemic—let us now look at the excuse they are planning to deploy this winter. There is no denying that this winter could be the most challenging the NHS has ever faced. The Royal College of Nursing, for the first time in its more than 100-year history, is planning to undertake strike action. Just this lunchtime we got strike dates from Unison, the GMB union and Unite the Union. That raises the question: why are the Government not even trying to stop the strikes in the NHS from going ahead? Surely, when the NHS already lacks the staff it needs to treat patients on time, the Government ought to be pulling out all the stops, getting around the table and negotiating to stop industrial action? So why aren’t they?

The Secretary of State said in Health questions earlier that his door is open—as if we can just sort of wander in off the street into the Department of Health and Social Care, where there will be a cup of tea and a biscuit waiting, and he will be just waiting for the negotiations. That is not how this works. Everyone knows that is not how it works. He had a nice little meeting with unions after the summer, after Labour complained that we had not seen a meeting between a Secretary of State and the unions since the right hon. Member for Bromsgrove (Sajid Javid). Goodness me, we have had three Secretaries of State since then—and two of them are the Secretary of State on the Front Bench today. Why on earth are they not sitting around the table and conducting serious negotiations? I will tell you why, Mr Deputy Speaker: they know that patients are going to suffer this winter and they do not have a plan to fix it, so instead of acting to improve care for patients and accept responsibility, they want to use nurses as a scapegoat in the hope that they avoid the blame. We can see it coming a mile off. It is a disgusting plan, it is dangerous and it will not work.

If I am wrong, perhaps Conservative Members could explain why the Government are not trying to prevent the strikes from going ahead. Perhaps they could explain why the Secretary of State ignored all requests from the health unions for meetings and conversations this summer while the ballot was under way. Perhaps they could explain what the Government’s plan for the NHS is this winter. Perhaps they could explain why a Government source told The Times newspaper that

“Ministers plan to wait for public sentiment to turn against striking nurses as the toll of disruption mounts”.

They said the quiet bit out loud and they gave the game away.

What else would explain the unedifying and embarrassing spectacle of the chair of the Conservative party going on national television to accuse nurses of doing the bidding of Vladimir Putin? I should not have to make this point, but nurses are not traitors to this country. They bust a gut day in, day out to look after all of us. We clapped them during the pandemic and now the nurses are clapped out. They are overworked, overstretched and undervalued by this Government. Let me say to the chairman of the Conservative party that he would speak with greater authority on what is in Britain’s national interests if he did his patriotic duty in his own tax affairs.

When it comes to sending a message to Vladimir Putin, why does the burden consistently fall on the working people in Britain? Why is it that NHS staff must make huge sacrifices because of the invasion of Ukraine, yet people who live in Britain but do not pay their fair share of taxes here do not have to lift a finger? When it comes to paying the bills, the first and last resort of this Conservative Government is always to pick the pockets of working people, yet the enormous wealth of tens of thousands of non-doms is left untouched. They may blame covid, they may blame health professionals, they may even blame the weather, but it is 12 years of Conservative mismanagement and under-investment that has left the NHS without the doctors, nurses and staff it needs, and patients are paying the price.

I am sure every Member of this House, indeed everyone in the country, knows someone who has been let down when they needed healthcare in recent months. They all say the same thing: the NHS staff were brilliant, but there simply are not enough of them. There is no NHS without the people to run it, yet today there are more vacancies in the NHS than ever before: 9,000 empty doctor posts, 47,000 empty nursing posts, and midwives leaving faster than they can be recruited. There are 4,600 fewer GPs than there were a decade ago, and the right hon. Member for Bromsgrove admitted last year that the Government are set to break their manifesto promise to recruit them back.

I was looking at a message from a constituent this morning who told that he went to A&E having waited four weeks for a GP appointment. Does that not speak to a lack of investment in the NHS workforce over 12 years and a lack of adequate planning? I know how hard GPs work in my constituency, but the lack of GP availability to staff surgeries and provide those appointments is placing unneeded pressure on A&E. That is on this Government’s watch.

I wholeheartedly agree with my hon. Friend. As we see so often with this Government, they make promises but break them. They try to fool the public into thinking they are delivering more GPs—or indeed more police officers—when it was the Conservative party that cut them. They try to give with one hand, but they take with the other, and after 12 years people have had enough.

Of course, it is not only the promise to recruit more GPs that the Conservatives are breaking. We had the promise of 40 new hospitals, which the Secretary of State repeated today, yet in response to the question posed by the right hon. Member for Uxbridge and South Ruislip (Boris Johnson), the Secretary of State said that of those 40 new hospital schemes

“five hospital schemes are in construction, two are now completed and we aim to announce the next eight by the end of this year.”

So, where are the other 25? Where are these 40 new hospitals? As far as I can tell, they exist only in the imagination of the former Prime Minister. Yet the script has not changed—Ministers are still here claiming 40 new hospitals.

When I visited Leeds with the shadow Chancellor, my right hon. Friend the Member for Leeds West (Rachel Reeves), I saw a vast pile of dirt where a new building was due to go up. We heard today that the Government cannot even negotiate an agreement with the hospital to get the site working and get the new facilities built. With every minute, every month and every year of delay construction costs are going up, so taxpayers are left in the worst of all worlds: broken promises, no 40 new hospitals, and paying through the nose for the ones that are being built because of Government incompetence.

We see the tragic consequences of the shortages and broken promises in the NHS. My hon. Friend the Member for Rotherham (Sarah Champion) raised the tragic case today at Health questions of a five-year-old boy who had what his doctor described as the worst case of tonsilitis he had ever seen. He was turned away from hospital, with his parents told there were no beds and not enough doctors. His infection worsened and five-year-old Yusuf later passed away. His death certificate recorded the primary cause of his death as pneumonia and the secondary cause as tonsilitis. What kind of country are we living in when a five-year-old boy can die of tonsilitis? This is criminal.

I met Yusuf’s uncle, Zaheer Ahmed, last week, and I did not know what to say to that poor man and his grieving family, who lost that little boy in the most unimaginable circumstances. I invite the Secretary of State to meet Yusuf’s family to hear how that little boy was failed and to hear at first hand about some of their interactions with the NHS, which I thought were completely unacceptable and intolerable. On that note, I welcome the independent inquiry that has been committed to. That is really important for the family who have been failed in this heartbreaking case. We do not want to see more cases like that.

At the heart of the crisis in the NHS—as with so many of the problems facing our country—is a failure to plan. The NHS has not had a workforce plan since 2003. That would be unacceptable in a multinational company one one-hundredth the size of the NHS. The failure to plan means that short-term fixes are always favoured over what is in patients’ long-term interests. That is why the Government cut the nursing bursary and why, this summer, in the middle of the biggest crisis in the history of the NHS, they took the infuriating decision to cut a third of medical school places.

The hon. Gentleman has been to medical school; does he think that it was a good idea to cut the number of places this summer?

When we talk about Labour’s record on training, the hon. Gentleman may forget that, in 2007, the medical training application service ended up in judicial review. Many of my colleagues moved out of disciplines that they loved dearly because of Labour’s mess in making those plans. He has been speaking for almost half an hour, setting out his exposé of what is going on in the health service, but I am yet to hear a plan. I hope that he will spend the next half an hour telling us about the detailed plan of how we get to 10,000 new medical places, because when it comes to firms in hospitals, there is not enough space for medical students to get that experience, so I am looking for him to solve that problem.

The hon. Gentleman is not looking forward to me solving the problem half as much as I am looking forward to solving the problem. As far as I am concerned, the general election cannot come soon enough. I say to Government Members, “Be careful what you wish for”, because I intend, indeed, to set out Labour’s plans in detail. I am happy to stretch that to half an hour if that is where the demand takes us.

I am grateful for a number of the interventions, not least the most recent one. Is it not true that, as hospital trusts meet with regard to the new hospital programme today, they will discuss how big the new hospitals should be? Given that we need more space to train the doctors and nurses of the future, does the hon. Member agree that it would be criminal if they tried to cut corners by planning hospitals that are smaller than they need to be?

I wholeheartedly agree. I seemed to hear from the Health Secretary this afternoon a one-size-fits-all approach from the Government, as though every hospital’s needs will be the same and we can import a standardised model for every hospital site. I would be happy to be proven wrong, and I would be even happier if the Secretary of State got the ball rolling on some plans that are already agreed, and on which trusts have spent a significant amount of time and taxpayers’ money. I would be even more delighted if we got some of those hospitals open, but I would wager that when we get to the end of the Government’s life, we will not have seen anything like 40 new hospitals delivered or even in the pipeline.

My hon. Friend is making a compelling case. I think I know where we could get some of the money from for training places, and perhaps he will agree. We forgo about £3.2 billion in revenue from non-doms every year. There are 68,000 non-doms, there or thereabouts, which works out at about £44,000 a non-dom. Does he think that he could do much with that?

My hon. Friend has led me neatly towards setting out Labour’s plans, which rely on people who come to this country and make Britain their home actually paying their taxes here. That is the right and fair thing to do, and I think people across the country would agree that we need nurses more than we need non-doms.

I have listened with interest to what has been said about the new hospital building programme, not least because we have been waiting for a new hospital in Warrington for a very long time. We recently opened the new Health and Social Care Academy at Warrington & Vale Royal College with some of our town deal fund money, but surely people need excellent, cutting-edge training facilities to go into in a hospital once they leave the college. The Government’s lack of progress on building us a new hospital in Warrington undermines some of the other excellent work that we are doing locally to try to train up the people we need to fill those workforce shortages.

I totally agree, and I heard of a really awful case in Warrington the other day. A Warrington resident who contacted me said that they waited 12 hours in agonising pain in accident and emergency before giving up and going home after midnight because she simply could not take it any more. The A&E department was so packed that she could overhear other patients’ conversations with clinicians, including sensitive medical information. Those are the kinds of conditions that patients are experiencing and in which the poor NHS staff have to work. It is simply unacceptable.

I thank the hon. Gentleman for being so generous in giving way. Does he agree that keeping the working environment safe is core to workforce planning, retaining the people who are trained and stopping spending eye-watering sums on agency nurses? He outlined many scenarios in which staff are forced to work in unsafe conditions. Does he agree that the core message coming from health unions is their desire to have appropriate staffing levels to provide the service on which all our constituents rely?

I strongly agree. In fact, I spoke to the general secretary of Unison last week. She said that as the unions look at safe staffing levels in critical services, in their determination to maintain patient safety in the event that industrial action goes ahead, they have found that on non-strike days, the NHS already operates at staffing levels below what the union would intend to operate on a strike day. That is an unbelievable state of affairs.

I am really worried about industrial action. Like patients across the country, I do not want industrial action to go ahead—it will mean ambulance delays, cancelled operations and even greater pressures on the NHS—but the tragedy is that we see the conditions that I just described every single day in the NHS. Pat Cullen from the Royal College of Nursing said, “We are striking for patients”. I have heard that line time and again from RCN members. It is partly about NHS staff’s pay and the conditions in which they work, but more than anything else, they are telling me that they voted for industrial action—some for the first time in their entire careers—because they have had enough and can no longer suffer the moral injury of going to work, slogging their guts out and going home petrified that, despite their best efforts, they still did not deliver the care that patients deserved. What an intolerable situation they find themselves in. Their backs are against the wall, and that is why the Government should negotiate.

My hon. Friend is making an excellent speech. Does he agree that it is completely reprehensible for Government Ministers, when talking about potential pay strikes by nurses, to say that by going on strike, they are somehow enabling Putin’s regime?

That was a reprehensible thing to say and it shows how desperately the Government are scraping the barrel to make excuses for their negligence and mismanagement of the NHS.

As I said, I found it astonishing that this summer, in the middle of the biggest crisis in the history of the NHS, the Government took the infuriating decision to cut a third of medical school places. Thousands more straight-A students in Britain who want to help have been turned away from training to become doctors. It is like the clip of the former Deputy Prime Minister Nick Clegg saying in 2010 that there was no point in building new nuclear power stations because they would not come online until 2022. This country needs Governments who think beyond short-term electoral cycles and put the long-term interests of the country first. That is the approach that Labour would take, but it has been sadly missing for the past 12 years.

Just as the Government failed to build our energy security, leaving us exposed to Putin’s war in Ukraine, they failed to train the staff the NHS need, leaving us exposed as the pandemic struck. Their failure to prepare has left us in the ludicrous situation in which UK universities are now offering medical degrees only to overseas students. That’s right: the Government are refusing to allow bright British students to achieve their dreams of becoming doctors, so Brunel University is forced to take exclusively students from overseas. The Chair of the Select Committee on Education, the hon. Member for Worcester (Mr Walker), has warned that there is a real risk that medical schools will

“only train overseas students who go off and get jobs elsewhere”.

What a criminal mismanagement of our higher education system. What a failure to plan to meet our staffing needs with our own home-grown talent.

My hon. Friend is making an excellent point. Given that there were nearly 30,000 medical school applications last year from British students who really want to study medicine, does he agree that it is absolutely disgraceful that the Government have a cap of 7,500? That shows that we are not investing in our workforce or in home-grown British doctors. It is appalling that the Government cannot see the importance of that.

I wholeheartedly agree. To deal with that problem—and, indeed, to satisfy the demands of the Conservative party, which looks to Labour for answers—we are putting forward a plan today to solve the crisis, to bring down waiting times, to get patients the treatment they need and to build a healthy society.

Where the Conservatives are holding the best and brightest students back from playing their part in the health of our nation, Labour will unleash their talent in the NHS: we will double medical school places, training 15,000 doctors a year so that patients can see a doctor when they need to. Where the Conservatives have left nurses working unsafe hours, unable to spend the time they need with patients to provide good care—where the Conservatives have left the NHS so short of midwives that expectant mothers are turned away from maternity units that do not have the capacity to deliver their child—Labour will act: we will train 10,000 more nurses and midwives every year.

We will go further. The way we deliver healthcare has to change. For many patients, a hospital is not the best place to be, yet in the past 12 years all the other parts of our health and care service have been eroded by underinvestment. When our society is ageing and people increasingly want to be cared for in the comfort of their own home, surrounded by their loved ones, why have four in 10 district nursing posts been cut? Labour is proud to have district nursing at the heart of our plans to modernise the NHS, and we will double the number of district nurses qualifying every year.

Many colleagues across the House have campaigned for years on the importance of the early years of a child’s development. All the evidence says that the first 1,000 days of a child’s life are vital to their development and life chances, yet the number of health visitors has been cut in half since 2015. Labour will ensure that every child has a healthy start to life, training 5,000 more health visitors. That is what our motion would deliver.

The hon. Member raises children and early intervention, but one area he has not touched on is the tidal wave of cases relating to children and young people’s mental health. As we all see in our casework every week, children and young people who have not been treated early get worse and worse and therefore get referred to acute services. In the past year, referrals to child and adolescent mental health services have gone up almost 25% and consultant psychiatrist numbers have come down. In terms of early intervention, we are not seeing enough mental health support in our schools. In Richmond, we cannot recruit clinical psychologists even though we have the money to do so. Does the hon. Member agree that we really need to focus on the future of this country—our children—by training more psychiatrists, counsellors and psychologists?