Skip to main content

Commons Chamber

Volume 727: debated on Monday 30 January 2023

House of Commons

Monday 30 January 2023

The House met at half-past Two o’clock


[Mr Speaker in the Chair]

Oral Answers to Questions


The Secretary of State was asked—

AUKUS Submarines

I am meeting my Australian counterpart this week to discuss a range of defence issues. The UK is one of the few countries in the world that can design and build nuclear-powered submarines. Developing that capability represents a major undertaking for Australia, and experience suggests that collaboration is often necessary to develop complex platforms. I am optimistic that UK industry will benefit from such collaboration.

I am grateful to the Secretary of State for that answer. He will be aware that when the former Prime Minister made his statement on the AUKUS deal back on 15 September 2021, he was emphatic that the deal would lead to hundreds of highly skilled jobs in Scotland, the north of England and the midlands. When does the Secretary of State think that those jobs will be created, and can he give me any idea about the specific locations?

We also said at the time that there would be an 18-month study programme where we work out both design and work share for this submarine. That is drawing to a close. We are waiting for the Australian Government to make their decision on what AUKUS looks like. Given the amounts of money that Australia will be spending on this enterprise, the need for international collaboration and the fact that both Barrow-in-Furness and Faslane are global centres of excellence that will help to deliver on that deal, I am confident that all those statements will turn out to be exactly as they were made. Let me give the hon. Gentleman some indication of this: we are already increasing the number of jobs in Barrow, from 10,000 people to 17,000, in order to fulfil both the Dreadnought programme—the nuclear deterrent—and the next generation of Britain’s attack submarines.

I thank my right hon. Friend for the considerable effort that his Department, the Government and the Navy have put into securing this important agreement. It was heartening to see the presence of representatives from the Royal Australian Navy and also the Australian Government at the commissioning of HMS Anson, and to hear the announcement that Australian submariners will be training on that vessel, too. With that in mind, does my right hon. Friend agree that this agreement is crucial to securing a new geo-political and strategic agreement with Australia, the UK and the UK on areas such as subsea and cyber to keep us safe?

Barrow-in-Furness, Devonport and Faslane are key components in delivering our nuclear submarine capability and can almost not be replicated around the world. It is very important that we recognise our speciality and skills. When Australia chose to go for nuclear submarines as an option, it did so because it recognised that there were about five countries on earth that could do this, and that it was important if it wanted to retain a strategic edge in the Pacific and its part of the world against any future adversaries. We know that: that is what we did for the past 70 years in the Atlantic alongside our American friends. I am delighted that Australia is joining that programme.

The AUKUS deal was supposed to be the defining agreement of the Indo-Pacific tilt, which this Government said in the Integrated Review—I am sure that the Secretary of State remembers this—would make the UK the European partner with the broadest and most integrated presence in the Indo-Pacific. Given today’s news and the fact that the combination of historic defence cuts and inflation will make the high hopes of the Integrated Review harder to fulfil this time, will the Secretary of State inform the House whether it will still be the UK’s aim to be the European partner with the broadest and most integrated presence in the Indo-Pacific?

The hon. Gentleman is right to ask those questions. It is still our ambition. So far, two of the planks of AUKUS are already in place, and we will be seeing the full details of that. It is no mean undertaking to commit to helping another country build that capability and be engaged in its training and deployment. That is a very deep and enduring deal. The investment of the United States in joining with us all those decades ago has lasted 70 years—that is a tilt on any basis—but we also had a carrier strike group on a visit only two years ago. That has continued, and we plan for another one in 2025.

More broadly, what steps is my right hon. Friend’s Department taking to further strengthen and broaden the AUKUS alliance?

The second pillar of AUKUS includes things such as artificial intelligence, hypersonics, cyber and all sorts of other technologies that are critical not only to complement the deployment of submarines, but to further engage our collective security. Those are technologies that are rarely shared between nations, but the United States recognises that, in order to face up to the challenges till the end of this decade, we need to make sure that we both share our industries and that we have protection from each other’s markets to make sure that we not only share, but get to sell into them as well, which is quite important.

This week, like the Secretary of State, I will be meeting the Australian Defence Minister and discussing AUKUS with him. I want him to know that, while there may be a change of UK Government at the next election, there will be no change in Britain’s commitment to AUKUS. If done well, this pact could deepen our closest alliances, strengthen security in the Indo-Pacific and bring game-changing investment to Britain. What priority has the Defence Secretary given to building the first subs here, and when will the build plan be announced?

I welcome the right hon. Gentleman’s support for AUKUS and I note his point on a Government, though of course there will be no complacency from the Labour party; I hope they will not repeat what happened once in the 1990s. The reality is that AUKUS makes good security sense, and those on this Labour Front Bench recognise good global security, even if those on the last one did not. His questions are a matter for the Australians, who ultimately will make the decisions and are the customer in the sense of where they spend the Australian taxpayer’s money. We have of course contributed to the discussion and offer, but Australia will have to make a decision about time and how quickly it wants the capability, how much it wants to build in Australia and what is the right fit for its ambition: Britain or the United States’ existing fleet. I suspect that will come some time in March, if not in February, and I am happy to keep him up to date. We have put in a good proposition, and I am delighted he is meeting his counterpart, because our relationships matter.

Memorandum of Understanding: MOD and League Against Cruel Sports

3. For what reasons he ended the memorandum of understanding between his Department and the League Against Cruel Sports. (903330)

The Ministry of Defence, as the UK’s biggest landowner, is delighted to welcome a range of people to use the land, including walkers, mountain bikers and riders; as long as they use the land responsibly, they are welcome on it. No one, however, should receive special treatment.

There was a memorandum of understanding that facilitated the monitoring of trail hunting on the Department’s land. Sadly, trail hunting is sometimes used as a smokescreen for illegal hunting, and the Defence Infrastructure Organisation has recorded incidents of foxes killed on Ministry of Defence land and the threatening conduct of some hunt staff. Can the Secretary of State tell us whether he was aware of the serious concerns in the DIO over the behaviour of hunts licensed in his name, and what advice was given by officials?

I am glad the hon. Gentleman has raised the MOU, which was put in place without any announcement to Parliament or any informing of Members of this House. It was not even put in the Library, as would normally happen for a change of policy by any Government. It was obviously disturbing to discover that the policy existed and gave special treatment to one group of users. I am sure he does not want people to have special treatment; I think everyone has a right to use that land that way. The policy also coincided with a large donation to the Labour party at the turn of the century from a whole group of those animal rights people. It is corrupt, Mr Speaker, that is what it is: a policy unannounced to this House after a funding donation to one political party, and now they are asking for special treatment. Everyone should respect each other in how they use that land. Having now investigated even further, I am aware that there are plenty of complaints from other sides, although this is not about sides; it is about whether one group gets special treatment.

MOD Expenditure: Official Development Assistance

4. What proportion of his Department’s expenditure in (a) Ukraine and (b) other countries he plans to classify as Official Development Assistance in (i) this and (ii) the next financial year. (903331)

In that case, I do not expect that the MOD will be taking any credit for the work that the conflict, stability and security fund does. The reality is that over the years, the Government have made a habit of double-counting spending to both the ODA target and the NATO 2% defence target—and of course the Home Office is busy raiding the ODA budget every chance it gets. Does that not do a disservice to what both the NATO 2% target and the ODA target are supposed to achieve?

The connection to the NATO target is somewhat tenuous, but there is a pattern to the hon. Gentleman’s questions. I think this is the fourth time he has asked this in oral questions, and he ask asked it in a number of written questions as well. I also think his point is principally aimed at colleagues in the Foreign Office and Treasury, but if he would like to meet MOD officials to discuss once and for all the MOD’s plans for the use of ODA, I would be very happy to facilitate such a meeting.

Speaking of budgets and Ukraine, may I invite the Minister to respond to comments from the United States—our closest security ally—which tally with the Defence Committee’s findings that the conflict in Ukraine has exposed serious shortfalls in the war-fighting capability of the British Army? This is not about the professionalism of individuals, units or formations; it is about overall combat strength and the equipment they use, as well as the ability to meet increasing demands caused by the deteriorating threat picture.

I am not sure that the United States has said anything about the official development assistance budget recently, but if you will indulge me, Mr Speaker, that is a wider point of news—[Interruption.] Thank you. Everybody is clear, and the Secretary of State has said many times—as have I and other ministerial colleagues —that serial underinvestment in the Army over decades has led to the point where the Army is in urgent need of recapitalisation. The Chancellor and the Prime Minister get that, and there is a Budget coming.

British Shipbuilding

The national shipbuilding strategy and the National Shipbuilding Office are supporting our ambition to grow the UK shipbuilding enterprise and support UK jobs. Five new Type 31 frigates being built in Rosyth will support more than 1,000 UK jobs. The fleet solid support contract will deliver £77 million of investment, and create more than 1,200 jobs in UK shipyards and many more across the UK supply chain.

I thank my right hon. Friend for that encouraging answer. He will know that offshore support vessels will be required for the Crown Estate offshore wind arrangements, for which licences are due to be tendered. Can he do anything to ensure that those vessels are made in the UK?

First, it is predominantly a matter for private companies or indeed non-Government departments to choose how and why to buy those vessels. But of course, to encourage more UK shipbuilding, we announced in the shipbuilding strategy last year the home shipbuilding credit guarantee scheme, which is there to help counter what seems to be a perverse incentive whereby other countries’ export credits encourage British companies to build abroad. We have been working closely on this with the Department for Business, Energy and Industrial Strategy, and I hope that we will be able to announce more details soon.

I thank my right hon. Friend for his answer thus far. Clearly, as we replace ageing ships and increase the size of the Navy, it is important that we ensure that those ships are built in Britain rather than abroad. What measures will he take to ensure that there is a long-term plan so that our shipbuilders can plan for the future?

I point my hon. Friend to the national shipbuilding strategy, which puts in place lots of measures, such as the home shipbuilding guarantee scheme and export credits for foreign buyers, as well as a skills plan, a “yards for the future” plan, which is about what a modern yard should look like and whether we can compete with European yards that have already beaten us to too many contracts, and a shipbuilding pipeline. That is an incredibly important indicator to the industry that there is a long-term pipeline to come through. It is also important to recognise that if we are going to be as successful as we are in the aerospace industry, we will need export, and if we are to export to other markets, we have to recognise that international collaboration is also part of the process. Do I think that Australia and Canada would have bought our Type 26s if we had said, “No way, you are only having ‘British’ on it”? No, and all our supply chain would have suffered as a result.

Notwithstanding what the Secretary of State has said, we know that many aspects of the shipbuilding industry feel that our Government have been less supportive of them than some of our competitor nations around the world. If the Government continue to award contracts under which large proportions of the work are completed abroad, will that not undermine the British shipbuilding industry? Will the Secretary of State say something more about how we can ensure that more of these ships are built by UK shipbuilding firms?

I really urge the hon. Gentleman not to listen to the propaganda and claptrap of the union leadership. I recently went to Belfast and to Appledore and met the local unions and do you know what? They do not agree with their leadership’s statements and rather bizarre propaganda. Fundamentally, the fleet solid support ships will be entirely put together, and nearly two thirds built or supplied, through the UK. At the same time, we are getting £77 million of investment into the yards to modernise them so that they can compete. For too long, our yards have not won contracts, whether Government or private, because we have found that the big prime contractors have not invested in modernising the skills in the yards. When I meet the workforce, whether in Govan or elsewhere, they say that they want to be invested in.

I refer the House to my declaration in the Register of Members’ Financial Interests. As a proud member of the NATO Parliamentary Assembly, I have been lucky enough to visit some of our fellow NATO Parliamentary Assembly members, such as the US and Spain, which take huge pride in their buoyant shipbuilding sectors. The Secretary of State talks about the ships being put together in this country. With contracts being awarded outside the UK, or a large portion of them being completed abroad, how does he expect to keep investment in the UK—

Order. I am sorry, it is not fair to everybody else. I am bringing you in on a supplementary; it does not mean you can take all day. Try to answer it, Secretary of State.

I can guess the memo that was sent from the union to the hon. Lady about what to ask. The reality is that unless we invest in our shipbuilding industry and unless we collaborate internationally, we will not have a shipbuilding industry. We tried it the other way, and it did not work. We have to build collaboratively. In the aerospace industry, including in Lancashire, where you and I are from, Mr Speaker, we have the Typhoon aircraft, which is an international collaboration and a world-beating success, employing tens of thousands British people.

In an answer to my written parliamentary question on 26 January 2023, the Minister for Defence Procurement, the hon. and learned Member for Cheltenham (Alex Chalk) said that the Type 32 frigates are

“a key part of the future fleet”.

In the National Audit Office report on the equipment plan, it reported that

“Navy Command withdrew its plans for Type 32 frigates…because of concerns about unaffordability.”

How can Type 32 frigates be a key part of the future fleet if there are question marks around their affordability?

That is because the Type 32 frigate will not come in until after 2030 or 2031, because it will come after the Type 31s, which are being constructed in Rosyth as we speak. What the Type 32s are going to be, how they will be designed and who will build them is obviously a matter for between now and towards the centre of the decade. Even if the hon. Gentleman gets into government, no Treasury will give a budget for seven years forward, so it is important to make sure that we do not sign on the dotted line before we have the budget in line. It is absolutely the intention of the Royal Navy to have more frigates and destroyers, including the Type 32.

Military Procurement Standards

Defence procurement is some of the most complex in government, but our defence and security industrial strategy represents a step change that will see industry, Government and academia working closer together, while fundamentally reforming regulations to improve the speed of acquisition and to incentivise innovation and productivity. Our acquisition reforms will drive pace and agility into procurement to improve delivery.

I very much agree with the Secretary of State on the need for increased defence expenditure if we are to remain a tier 1 power. Nevertheless, in every one of the past 21 years, the National Audit Office and the Public Accounts Committee have criticised the MOD’s procurement of equipment, poor identification of military needs, poor quality of equipment, slow delivery of projects, an inability to control costs and a corporate culture too traditional and resistant to change. Those are just some of the criticisms. Does he agree that we need to put those issues right if we are to be a tier 1 power?

I absolutely agree. First, that is why for the second year in a row, and nearly for a third, under my stewardship the Ministry of Defence will come in on budget or under budget—the first time in decades—to make sure that we live within our means. Secondly, it is also important to point out that it is always a challenge for any Secretary of State for Defence that the Treasury likes to deal in one, two, three or four years. Some of the programmes we are talking about, such as the Type 31 or the future solid support ship, are decades-long, and in that long process of complexity, threat changes, technology changes and inflation changes, and indeed there are all the challenges around. If we are going to have Governments investing in long-term infrastructure, whether civil or military, it is important to understand that long-term investment has a different risk profile. If we do everything year by year, we will always end up in a similar position.

The Secretary of State will be aware of growing concerns about the impact of delays and the management of defence programmes on our defence readiness. What specifically is he doing to ensure that the UK will meet our UK NATO obligations in full?

We are still on track to maintain above 2% of GDP on defence spending, if that is the obligation to which the hon. Lady is referring. It is important, as colleagues have pointed out, to make sure we get good value for money. It is also important that we try to deliver on time. Some programmes are on time, and 85% of defence programmes do come on time—the major collaborative ones and the major complex ones over long terms are often the ones that cause us problems. We need to improve that and make sure we do not over-spec. We also need to make sure that, where possible, we collaborate and improve internal mechanisms that often hold things up.

The UK has some of the highest defence procurement standards in the world, and I am glad that the Government are seeking to drive them up still further under my right hon. Friend’s leadership. When co-operating with our international friends, allies and partners—particularly Ukraine—does he agree that it is vital that they have similar levels of transparency in their defence procurement to maintain public confidence and support for Ukraine?

It is important, across the international community, that the public get a sense of where all our donations are going and how they are being used. On a recent visit, I met Ukrainians and other international partners to ensure that we put in place some form of assurance, so that we know where what we are sending is going, because soon the public will rightly say, “What is happening to it?” It is also important to recognise, as Ukraine has shown, that supply chains, whether domestic or multinational, have to be supported to ensure that we can surge them at times of need, rather than having to blow the dust off them and it taking months or years to reopen them.

As the Secretary of State has indicated, Ukraine has made it graphically clear that long-term ordering is vital to the defence industry and to maintaining capacity in machinery and manpower. Does he therefore accept that the failure to place orders for new nuclear submarines between 2010 and 2016, even though there was a clear majority in the House for doing that, was a major strategic error?

I am grateful to the right hon. Gentleman. I will do a deal with him if he admits that that is not the only example: we have all made strategic errors in our defence policies in the last two decades, because the Treasury has worked in the short term, so we have hollowed out the company. Government after Government have wanted more but have not wanted to fund it—his Government were no different, as I know, because I was serving in the Army under them.

The Ajax programme has been so controversial that the Secretary of State personally commissioned an independent review by Clive Sheldon KC into the flow of information surrounding it. Has he yet received that report? When does he intend to publish it? Can he promise the House that he will do so in full and unredacted?

I am informed by the Minister for Defence Procurement that the report is coming imminently, which I hope means in a few weeks, not months. I will read it and then, of course, I will make sure that, at the very least, the findings are shared with the House. I am happy to have a discussion with the Defence Committee about how much we can share with it, subject to any security concerns.

The good news is that Ajax is now starting the next phase of trials. As I have always said, I am determined to fix that troubled programme. We are now on the way to getting it through the next most important trials, after its having passed its user viability trials up to Christmas. I am trying to fix that programme and get it delivered. At the same time, I am delighted to learn the lessons.

The MOD procured services to administer defence housing and accommodation. It is now more than a month since my urgent question, when the Minister for Defence Procurement said:

“VIVO, Amey and Pinnacle are, I know, in no doubt about Ministers’ profound dissatisfaction at their performance.”—[Official Report, 20 December 2022; Vol. 725, c. 144.]

Since then, there have been more cases of poor repair and poor service. Can the Secretary of State say, specifically with regard to defence accommodation, whether the procurement process is fit for purpose and whether he has confidence in the current providers?

It is a timely question from the hon. Gentleman. This weekend, I looked at the different options for finding compensation or recompense from the providers in the first place. I get a weekly update on individual cases and how many cases are in the queues. In some areas, they have made progress and their progress is comparable or better than the private sector, but there is still work to be done. I am most concerned about mould and dampness; we have seen some success around heating. We expect a better service, however, and the Minister for Defence Procurement meets the providers regularly. It is important to note that we will keep their contracts under review and, if we do not get a better standard, I will take other steps.

The question asked by my hon. Friend the Member for Barnsley Central (Dan Jarvis) is a good one, because the Government’s failure on defence procurement is not limited to weapons and ammunition. We need only to speak to people in defence housing with leaky roofs, black mould and broken boilers to realise that defence procurement is failing the people who serve in our military and their families. Last year the MOD paid £144 million to private contractors to maintain service families’ accommodation, yet many homes are still awaiting repairs and not getting the service that they deserve. One of the Secretary of State’s Ministers has admitted that these contracts do not represent value for taxpayer money, so why did the MOD sign them in the first place, and when will he be able to tell all our troops that they have a home fit for heroes?

We always want our homes to be fit for the men and women of our armed forces. I distinctly remember my time in Germany, and indeed in the UK, when the service was in-house, and I can assure the hon. Gentleman that there were issues with living under a standard of home then, which in some cases were worse. We have been monitoring to make sure that we get these reports answered. It was interesting that the start point of some of the problems was a lack of manning of the helpline at the very beginning—people were ringing up at Christmas and almost no one was there—and then having to work through the whole process. We are trying to do more. We will hold the providers to account and take financial action or whatever against them if we have to do so; I am not shy about doing that. We will try to seek compensation for the people suffering and to improve what is happening. However, in some areas, waits over five days are getting better. That is the first point; we are getting closer.

Multiple major procurement projects for which the Submarine Delivery Agency is responsible are late or over budget, or often both. Taxpayers are used to the concept of bonuses, but in the real world these bonuses are linked to performance. Those same taxpayers are haemorrhaging billions of their hard-earned taxes on the demonstrable failures of the MOD, not least those of the SDA. How can the Secretary of State justify giving six-figure bonuses to executives of failing MOD agencies? On the eminently reasonable supposition that he cannot defend the indefensible, what will he do to rectify those incoherent remuneration packages going forward?

The payments represent a number of new appointments that we have made and that we are turning around the Submarine Delivery Agency to improve availability. One area of deep concern has been the consequences of the hollowing out over the decades of maintenance and the availability of dry docks and other things in places such as Devonport which allow us to make sure that submarines are maintained in time to achieve better availability. The work is going well. It is important sometimes to change the workforce and ensure that we get the best, capable people possible to turn things around. I am confident that the new team are able to do that, and I am looking forward to seeing the results.

Veterans UK and Veterans Welfare Service

7. What steps (a) Veterans UK and (b) the Veterans Welfare Service are taking to support veterans. (903336)

17. What steps (a) Veterans UK and (b) the Veterans Welfare Service are taking to support veterans and their families. (903346)

On Thursday I had the great pleasure of visiting Lancashire and in particular Veterans UK at Norcross. I met some really great people who provide a range of support to our veterans. One of the biggest impediments to progress is around data. Consequently, we are putting £40 million into a transformation programme that will digitise our existing processes, enabling our staff to provide more effective and efficient support to our personnel and veterans and substantially improve their experience.

Our veterans and their families have made an invaluable contribution to securing our freedoms and our nation, but broadly only about a quarter are in receipt of a pension that entitles them to support from the veterans advisory and pensions committees across the UK. First, will the Minister join me in paying tribute to the work of VAPCs in supporting veterans? Secondly, will he support my private Member’s Bill on 24 February, which seeks to extend their remit and expand the cohort of veterans to whom they can offer assistance?

I am very grateful to my hon. Friend. VAPCs provide a wonderful and unsung service, as did the war pension committees before them. Of course I look forward to 24 February, and I will give his Bill my wholehearted support.

Those prepared to make the ultimate sacrifice to keep our country safe should not have to rely on benefits to get by. How does the Minister plan to help veterans reliant on universal credit to acquire the skills they need to access well-paid employment?

The hon. Lady will be aware of the career transition partnership. She will be aware too of the special arrangements for veterans who are unfortunately ill or injured to get them into civilian life in a seamless way and provide them with the skills they need for the rest of their lives. It is important to understand that all servicemen and servicewomen are civilians in waiting. They all return to the communities from which they are drawn, and throughout their careers they have preparation to enable them to do so in as seamless a fashion as possible with the skills that they need.

The Minister will know that the all-party parliamentary group on veterans is currently running a survey of the experience of veterans across the UK when claiming compensation, war pensions and other fiscal support from Veterans UK. That survey closes tomorrow. Will he please agree to meet me to discuss its findings and, depending on what they are, will he also agree in principle to any measures that better assure the outputs of Veterans UK?

I am grateful to my hon. and gallant Friend for his chairmanship of the all-party parliamentary group on veterans and for the survey that he has undertaken. I am very much looking forward to the results of that survey. He will be aware that the MOD does a variety of surveys and canvassing, to ensure that we are giving our serving personnel and our veterans and their families what they need to pursue their careers and to ensure that their lived experience is positive. I am very much looking forward to what his group has to say, and of course I will meet him.

The Minister will know and appreciate that mental ill health disproportionately affects veterans and their families. The cost of living crisis is putting even more pressure on access to mental health services, according to veterans’ charities. The Labour party has committed to a £35 million investment in veterans’ mental health. I ask this sincerely of the Minister: will he match that?

First, I have to correct the hon. Gentleman. He is not right to say that veterans, or indeed defence personnel, are more likely than the general public to suffer from mental health problems. The reverse is the case. However, it is absolutely essential that we do all in our power to promote the mental health of our men and women. That is absolutely right, and he will be aware of a number of projects, including Op Courage and throughout peoples’ careers, to promote their mental health. We will continue to do that, but he needs to understand that defence is a positive experience for the vast majority of people who experience it.

The initial headline findings of the independent review of the armed forces compensation scheme state that

“the process is overly burdensome and even distressing for the claimant due to unreasonable timeframes and a lack of transparency.”

That is but one of a number of concerns raised about the compensation scheme, all of which veterans across the country have been telling us about for a long time. Veterans, who have made huge sacrifices to keep our country safe, deserve far better from this Government. Can the Minister tell the House when the full report will be published and what he is doing to ensure its findings will be acted upon swiftly?

The hon. Lady is referring to the quinquennial review, which has published its interim findings and will publish its definitive report in the spring. She is right to highlight some of the findings of that report in its interim form, and of course we will take into account all of those—[Interruption.] If the hon. Lady will allow me, we will take into account all of those in the spring, when the report is published. One of those things is to ensure that the system is less adversarial than it has previously been, but we have to understand that a lot of the delay is baked in because of the need to obtain proper, full, comprehensive medical reports.

Type 32 Class Frigate

The Type 32 programme began the concept phase on 21 September 2022 and will seek to deliver an outline business case in spring 2024. The programme and procurement strategy will be decided following the concept phase, in the normal way.

Further to the earlier exchange between the Secretary of State and the shadow Minister, the hon. Member for Islwyn (Chris Evans), can the Minister confirm that, although this Type 32, so called, will not, as I understand it, come on stream until 2030, the Government are fully committed to having an ongoing warship programme and that, whether we call it the 31A, the 32 or whatever, we remain committed to renewing the Royal Navy’s capability after 2030?

Yes, and last week I had the pleasure of being in Rosyth, where steel was being cut in respect of the Type 31, which is an affordable frigate that can be configured for the mission, whether that is a humanitarian mission, a war-fighting mission or an anti-piracy mission. That flexibility is exactly what we want from our frigates, and we want them to ensure that there is a pipeline into the future.

Ukraine: International Response

11. What steps his Department is taking to progress the international response to Russia’s invasion of Ukraine. (903340)

The UK, our allies and partners are responding decisively to provide military and humanitarian assistance to Ukraine. The UK has led the world with the gifting of modern main battle tanks to Ukraine, and we are engaging international partners through a co-ordinated military and diplomatic effort. My right hon. Friend the Secretary of State for Defence should take some personal credit for that, because at every turn throughout the past year he has sought to understand what the Ukrainians would need next and rallied support across Europe and beyond in that gifting.

I concur with my right hon. Friend that we have shown the way on Ukraine. We have consistently been at the forefront. He mentioned battle tanks; it was our announcement that set the precedent that enabled our allies to make their announcements last week. In the same vein, will my right hon. Friend confirm that we will continue to lead the way on support for Ukraine by pushing our allies to match our commitment to send as much, or more, military aid to Ukraine this year as we sent last year?

The Government have already committed the same amount of money for this year as it did for last year, so in that sense the job is already done. Of course, how this year’s money is used will depend very much on what is going on on the ground. That is the most important part of the gifting programme. The relationship between the UK and Ukraine is now so strong that we are able to discuss very candidly each other’s plans and make sure that we support Ukraine every step of the way.

We heard before Christmas that the Government had finally signed a contract to replenish NLAWs—next-generation light anti-tank weapons—but, in order to ensure that we can continue to be a leader in the international effort in Ukraine, how many other contracts have been signed to replace the consumable military aid that has been sent to Ukraine?

High-velocity missiles have already been placed on contract. Many of the other systems that have been donated were already in the process of being updated and were gifted when they were coming to the end of their life within our current inventory, and thus would not be expected to be placed on contract because they are part of a routine procurement process.

Much of the international support that is going to Ukraine will be deployed to defend Ukrainians against the barbarity of the Wagner Group private militia. Will the Minister explain to the UK’s allies why the UK Government made available the frozen assets of Wagner’s leader, Yevgeny Prigozhin, in order that he could take out a case against a British journalist? Given this inexplicable accommodation, will the Minister confirm whether this Tory Government roll out the red carpet exclusively for Russian warlords? Or is it an inclusive UK service, available to war criminals everywhere?

The presence of Wagner on the frontline in the Donbas is clearly a reflection of just how bad things have got for Putin and the Russian armed forces—so bad that a mercenary group that recruits from prisons is required. As for the substantive part of the hon. Gentleman’s question, it sounds like that might be a question for my Treasury colleagues; I will make sure that they write to him with an answer.

Defence Technology

The Ministry of Defence works closely with British industry and academia, including small and medium-sized enterprises, to identify and invest in innovative technologies that address our most pressing capability challenges, as well as publishing our future priorities to incentivise investment. We are already testing and deploying these technologies.

The best innovation is not necessarily the preserve of the giant players in the sector but can be found among smaller enterprises such as those at the Westcott Venture Park in my constituency, including Flare Bright’s development of autonomous drones for flight in global navigation satellite system-denied areas. Will my hon. and learned Friend assure me that when it comes to the development of new defence innovations, such smaller, dynamic enterprises are as valued to his Department as the more traditional big beasts?

My hon. Friend is absolutely right: a lot of innovation does indeed come from agile SMEs, which is why the MOD’s SME action plan is firmly aimed at improving access for SMEs to work right through the defence supply chain. Indeed, the MOD has a target that 25% of its procurement spend will go directly and indirectly to SMEs—that is up from around 16% in 2016. The latest figures I have seen show that we are at 23% already. We are on the right path but there is further to go.

The Tempest fighter jet and the Challenger 3 are examples of the Government’s commitment to giving our forces good-quality equipment. Does my hon. and learned Friend agree that we must also prioritise the wellbeing of our personnel? One way to do that is to ensure that the quality of their food matches the calibre of their kit.

My hon. Friend is of course absolutely right. Ensuring that our service personnel receive good-quality meals is a vital contribution to defence capability, which is why the Ministry of Defence has established a team of subject-matter experts to overhaul and modernise the delivery of defence catering using the findings of the “Delivering Defence Dining Quality” review and the ongoing Army Eats trials to inform change to the total food offer. The trials began in 2020 and the results are expected imminently. They will inform the future of dining for defence.

If we want to keep our country safe we need to work with our allies to ensure that we remain at the forefront of the latest developments in defence technology. Will my hon. and learned Friend confirm that our new partnership with Japan and Italy will involve collaborating in areas such as weapons and unmanned aerial vehicles, and not just on fighter jets?

The ambition of this truly international programme is principally to deliver a cutting-edge fighter aircraft, providing a credible deterrent to future threats. As my hon. Friend knows, this is a system of systems, and it is likely to include uncrewed aircraft, new sensors, weapons, advanced data systems and secure networks. Those wider capabilities may be developed together with our wider partners, or with our existing partners in that endeavour. We will continue to explore system opportunities between both our core partnership and more widely.

Following the recent memorandum of understanding signed by the Royal Air Force and Imperial College London, how do Ministers expect that will impact on the RAF’s technological capabilities, particularly around digital and artificial intelligence?

Digital and artificial intelligence are central to RAF capability. I was delighted recently to announce that significant investment has taken place in Lincolnshire to ensure that when those aircraft take to the skies, they have the weapons systems but also the battlefield management plans that they require to ensure that they can take the fight to the enemy.

Chinese Armed Forces Training

13. What steps he is taking to prevent former UK armed forces personnel from providing training to the Chinese armed forces. (903342)

The National Security Bill contains provisions that will help in prosecuting those who use their knowledge and expertise to train foreign militaries prejudicial to the interests of the UK. In the meantime, while the Bill passes through this House and the other place, we have issued guidance to all defence personnel at risk, and reminded personnel of their obligations to protect sensitive information. That has led to improved reporting of suspicious activity.

I thank the Secretary of State for that helpful response. Qualified RAF pilots are quitting for better paid jobs that involve training the air forces of other countries, and fixed-wing aircraft have dropped by nearly a quarter since 2017. We learned last week that all the RAF’s Hawk jet trainer aircraft have been grounded because of an engine issue. Given that the Government will be in the High Court tomorrow in an effort to justify supplying arms for use in the war in Yemen, what does the Secretary of State have to say to MPs across the House who are concerned about the deployment of RAF personnel to Saudi Arabia in the last couple of months to train the Royal Saudi air force?

I have absolutely no problem with supporting our friend and ally in the region, Saudi Arabia. We have done it for decades, and will continue to do so.

Topical Questions

Colleagues may have read reports this weekend about activity conducted by the Army’s counter-disinformation unit in 77th Brigade. Online disinformation from foreign state actors is a serious threat to the United Kingdom. That is why during the pandemic we brought together expertise from across Government to monitor disinformation about covid. The 77th Brigade is a hybrid unit of regular and reserve personnel that was established in 2015. It delivers information activities as part of broader military effects against hostile state actors and violent extremist organisations based outside the UK. It uses publicly available data, including material shared on social media platforms, to assess UK disinformation trends. It is not to be involved in regulating, policing or even reporting opinion that it may or may not agree with.

My constituent, Daniel, was medically discharged from the Army in 2015, yet in September 2022 he was awarded only tariff-10 compensation. He is housebound and fully reliant on his mother, and psychiatrists agree that sadly his condition is permanent. Seven years on, Daniel is still without compensation that reflects the severity of his mental injury. Will the Secretary of State meet me to review that case, and ensure that veterans who suffer psychological injuries are compensated equally with those who suffer physical injuries?

T5. I have recently been to see some of the RAF housing in Carterton. Given the mould in homes with children present and the fact that requested repairs are left uncompleted, it sems that the Pinnacle-VIVO partnership is failing military families. What are Ministers doing to hold those companies to account? (903359)

I am grateful to my hon. Friend for raising that. I know Brize quite well and the accommodation that he referred to. He may be aware that all top level budgets are meant to be assessing their accommodation against the Defence housing standard and will report by the end of the year. In the meantime, he should know that over the next 10 years £1.6 billion will be invested in barracks accommodation to improve some of the truly awful accommodation that, sadly, our men and women have to put up with.

This month, the Government made important but, again, ad hoc announcements of more military help for Ukraine. We are still waiting for the 2023 action plan of support for Ukraine first promised by the Defence Secretary last August. Will he publish that ahead of the first anniversary of Russia’s invasion next month?

I totally agree with the right hon. Gentleman that we need to set out a plan. But may I also tell him —I chased this in advance of today’s questions following the previous questions—that our donations are not ad hoc? There is a view abroad that they are somehow ad hoc, with the Ukrainians just picking up the telephone. Fundamentally, the donations are set by what happens on the ground, the reaction to Ukrainian defence and how Ukraine needs to adapt. It is not an ad hoc thing; it is a deliberate process, mainly co-ordinated by the United Kingdom and her allies. It is really important to separate that from an overall strategy about announcing to Parliament the different lines of effort that we take to counter Russia.

Last week, the Defence Secretary said that the armed forces had faced a

“consistent hollowing out…under Labour and the early Conservative governments”.

However, when Labour left government in 2010, the British Army stood at more than 100,000 full-time troops and we were spending 2.5% of GDP on defence. The serious hollowing out has happened since. Who does he think has been in charge over the last 13 years?

Mr Speaker, you have only to listen to the veterans on the Government Benches to understand their experience under a Labour Government. Let us remember Snatch Land Rovers and all that awful mess as a result of the Labour Government’s investment. The deal here is quite simple: if the right hon. Gentleman wants to be the next Defence Secretary, he should come here and get off his chest the shortcomings of his former Government. I am happy to say that we have hollowed out and underfunded. Will he do the same, or will he hide behind petty party politics?

T6. Last week, I visited His Majesty’s naval base Clyde with the armed forces parliamentary scheme. I pay tribute to the remarkable men and women we met there who make up our nation’s submarine service. Given that we live in ever more dangerous times, will my right hon. Friend confirm that the Conservative Government remain committed to delivery of the new Dreadnought class of submarines to be based in Scotland to provide a continuous at-sea deterrent and so protect our United Kingdom for decades? (903360)

I am glad that my hon. Friend and many other colleagues went to Faslane last week and enjoyed their visit. We are of course committed to the replacement of Vanguard submarines with Dreadnought. More importantly, he mentioned the brilliant people based at Faslane who deliver day in, day out our nation’s nuclear deterrent, unseen under the oceans of the world. They are incredible people doing amazing work.

T2. It is surely right that non-UK veterans who settle here after their service do not pay visa fees, but it is surely not right that that does not extend to their dependents. Will the Minister match Labour’s commitment to change that? (903354)

I cannot give the hon. Gentleman the undertaking that he asks of me; he will understand that. Obviously, all things are kept under review, but we clearly do value the service of those from overseas who serve in His Majesty’s armed forces, and I think that most of them have a very positive experience.

T8. We ought to be extremely proud of the Government’s impact. We are the second-largest supplier in the entire world of military equipment to the Ukrainians, second only to the United States of America. Today, we have our troops training Ukrainian troops on how to use Challenger 2 tanks. When will those be deployed on to the battlefield so that we can start to see them having a serious impact in bringing this heinous war to an end? (903362)

Obviously, for security reasons, I cannot tell my hon. Friend exactly the timings. It starts with training on the operation of the platforms and then there is training on joining together with formation units to fight as a formed unit—that is important. From then, the tanks will be put in. What I can say is that it will be this side of the summer—May, or probably towards Easter time.

T3. Some 45% of Cheshire military personnel—220 of them—are living in the lowest standard of single accommodation. That is pretty shameful, and something needs to happen about it quite urgently. How will the Minister ensure that they have homes that are genuinely fit for heroes? (903355)

Some 97% of Ministry of Defence service family accommodation meets or exceeds the Government housing standard. That is better than most local authorities and better than most registered social landlords. The hon. Gentleman may be interested to know—I looked this up earlier—that 105 homes owned by his Labour-controlled local authority are below the decent homes standard. I suggest that he takes that up with his council.

I am sure that the Minister will join me in thanking the wonderful team at the Defence and National Rehabilitation Centre, based in Rushcliffe, for their amazing work treating injured members of our armed forces. What assessment has he made of how the expertise and cutting-edge technology at the centre could be shared with our Ukrainian allies to help to rehabilitate Ukrainian heroes who have been injured on the frontline?

As it happens, last Monday I visited the Defence Medical Rehabilitation Centre. I also heard about the NHS-led National Rehabilitation Centre, which will hopefully be stood up by the end of next year: together, they will be able to provide a truly trailblazing international centre for rehabilitation and research. Obviously, this country stands by to help Ukraine in its fight against Putin in any way possible, including in the rehabilitation of its brave men who have given so much not only in defence of Ukraine, but in defence of the rest of us.

T4. Labour’s dossier on waste in the MOD found that at least £15 billion of taxpayers’ money has been wasted since 2010. Can the Secretary of State explain why the Government are failing to get a grip on the defence procurement process and secure value for money for the taxpayer? (903357)

It is a really wonderful dossier, as far as dodgy ones go, because half the waste in it was under a Labour Government.

Will the Secretary of State join me in applauding Poland’s historic announcement today that it is raising its defence budget to 4% of GDP? Can he imagine what conclusion I think our Government ought to draw from that example?

My right hon. Friend always tempts me. I think the Poles who are on the frontline have shown tremendous leadership in the face of Russia’s growing aggression, not only to their country itself but to its neighbours and friends in Ukraine. I think the conclusion that they have drawn is that the world is a dangerous, unstable place and is not likely to get any less so any time soon.

T7. The call for evidence for the LGBT veterans independent review revealed that the police records of veterans convicted during the ban on homosexuality were destroyed. In answer to parliamentary questions, the Department says that that was “in line with data protection”. However, in letters to veterans, it says: “This decision was taken by the Defence Police Chiefs council, who directed that all investigations into…offences relating solely to sexuality…were to be removed from our systems and deleted from the records”. Will the Secretary of State or a Minister write to me to clarify the point? Will they consider making records of meetings of the defence police chiefs council public? (903361)

I am grateful to the hon. Gentleman for raising the matter. There is no question but that between 1967 and 2000, people in the LGBT community were badly dealt with by Defence. That is why we have set up the Etherton review, which will report shortly. Having met Lord Etherton, I can tell the hon. Gentleman that he will be forensic in his examination of the data. I think I can assure the hon. Gentleman that the handling of records, as far as we can tell, was carried out in accordance with civilian practice, but of course we will stand by and wait for his lordship to opine on the matter. We will comment further when he has done so.

Will my right hon. Friend set out what preparations his Department has made for supporting overseas territories in the Caribbean during this year’s hurricane season?

I enjoyed working with my right hon. Friend when she was Minister for the Overseas Territories. She is right to care about the matter. She will know that the Department has done a lot of work over the past few years to develop the resilience of the overseas territories, as well as maintaining naval assets in the region and more at-readiness to assist if required.

During my recent visit to Ukraine with the right hon. Member for Chingford and Woodford Green (Sir Iain Duncan Smith), Ukrainian officials were clear about their need for increased military support. Given that the United States is reportedly discussing the creation of a fighter jet coalition with Ukraine, and given that the German Chancellor is currently ruling out sending fighter jets to Ukraine, what assessment have the Government made in respect of building such a coalition with our NATO allies?

Since we took on the battle over getting tanks to Ukraine, people are understandably asking what will be the next capability. What we know about all these demands is that the initial response is no, but the eventual response is yes. We will track the progress, but, as I have said, it is not ad hoc; it is based on need and on defining what is needed on the battlefield. We will of course keep our minds open all the time about what it is possible to do next.

I warmly welcome the announcement of £1.6 billion for the repair and refurbishment of on-site base accommodation. As the Minister has rightly said, the accommodation in both HMS Sultan and HMS Collingwood is truly awful. Meanwhile, we hear that in the Portsmouth area alone, the Royal Navy is spending millions of pounds a year on putting people up in hotels, while Fort Blockhouse, in my constituency—which the Minister knows very well—remains empty. When will the MOD address this?

I am aware that my hon. Friend knows Fort Blockhouse intimately, as indeed do I. It is aesthetically charming, but it is beyond reasonable repair when it comes to accommodating servicemen and women. We are spending money on HMS Collingwood, and I hope that it will be brought up to spec shortly.

A week from today a constituent of mine, Samantha O’Neill—a veteran who served in Iraq and Afghanistan—is due to be made homeless from a hostel by City of York Council, which is a signatory to the armed forces covenant. What steps can the Minister take to ensure that she and her three children are not homeless a week from today?

Obviously I cannot comment on a specific case when I do not have the details, but if the hon. Lady will send them to me, I will certainly look into them. Every local authority that signed up to the armed forces covenant needs to be mindful of its duty to look after servicemen, servicewomen and their families.

The charity Salute Her has reported that 133 women—a third of its caseload —presented themselves to it last year having suffered a sexual assault. They also presented themselves to defence community mental health services, but were subsequently discharged from the military owing to their having a personality disorder. I wrote to the Minister asking for further information, but none was available. Will the Minister look into the service to ensure that due clinical rigour is applied before people are discharged with a personality disorder?

I am grateful to my hon. Friend and predecessor. I see no evidence that people are being misdiagnosed or mismanaged. This is, of course, a matter for healthcare professionals and consultant psychiatrists in particular, and I cannot really interfere with their diagnoses, but I have noted my hon. Friend’s concerns, and I will certainly look into the issue.

Does the Secretary of State agree that what we have learnt from Ukraine is that the future of good defence will lie in having the latest technology and innovation? Are there any new schemes we could have that would increase investment in that new technology, especially involving partnerships with other countries across NATO?

I am delighted that we share the European headquarters of the defence innovation accelerator for the north Atlantic, or DIANA—a unit within NATO—with Estonia. I felt that it was important to partner with a small, innovative country to ensure that we get the very best between us. Our research and development budget is £6.6 billion, and we are one of the leaders in Government in investing it. However, the real lesson—this has always been a problem—is that it is important not only to invest in the inventions, but to pull that into what is actually required. That is traditionally where defence has fallen down, but I am determined to fix it, which means focusing R&D where we know there is a need in our armed services.

Many veterans in my constituency tell me that they sometimes struggle to adapt from frontline service to the jobs that are available locally. It is a huge change, and the scars of service can be challenging. Can my right hon. Friend provide an update on the work of the defence transition service, which helps veterans to get into good, well-paid jobs?

My hon. Friend may be referring to the career transition partnership, which is normally used for people making the transition to civilian life. The defence transition service is for those who have sustained an injury or illness. It is designed to ensure that people have the support that they need in order to adapt to their particular circumstances, and that they have the best possible chance of getting a decent civilian job after they leave the services. It is very successful in what it does, as is the career transition partnership.

A recent news report detailing 14,500 urgent maintenance appointments in armed forces homes being missed is very concerning. Will my right hon. Friend reassure my constituents and me that he is taking every step to ensure that all our soldiers can live in good-quality homes?

Absolutely. It is the top priority for me, the Secretary of State and Minister for Defence Procurement. We must bear in mind that 97% of those houses are above the Government housing standards—better than most councils and registered social landlords. But we must do better, and we are bending ourselves to that task.

Can the Minister confirm that UK operational sovereignty will be a factor in increment 1A of the maritime electronic warfare programme? Will he meet me to discuss that?

The Secretary of State referred to the allegations in the weekend press about 77th Brigade. I know him well enough to know that when he told us that he gave clear instructions and guidelines to the brigade, which operates only against foreign powers and extremists, he was telling the exact truth. However, will he review the issue and ensure that his guidelines have been followed in all cases?

I thank my right hon. Friend for the compliment. I have already instructed that we not only look into the story but check that the instructions that I issued after a visit were carried out.

Urgent and Emergency Care Recovery Plan

Today we have published our new delivery plan for recovering urgent and emergency care services, which has been deposited in the Libraries of both Houses. Given the scale of the pandemic pressures that healthcare systems around the world and across the UK are collectively facing, we are building the NHS back to where we want it to be. That requires the widespread adoption of innovation, building on best practice already applied in specific trusts, together with significant investment in new ways of working, including a £14.1 billion funding boost for health and social care, as set out in the autumn statement.

Today’s announcement is the second of three plans to cut waiting times in the NHS. Our elective recovery plan is already in action, virtually eliminating the backlog of two-year waits in England. Our primary care recovery plan will be published in the next few weeks, to support the vital front door to the NHS through primary care. Today, together with NHS England, we are setting out our plans to reduce waiting times in urgent and emergency care through an increased focus on demand management before patients get to hospital, and greater support to enable patients to leave hospital more quickly through care at home or in the community, supported by a clinical safety net. In addition, the plan sets out how we will adopt best practice in hospitals by learning from the trusts that have displayed the greatest resilience in meeting the heightened pressures this winter.

Today’s announcement on urgent and emergency care does not sit in isolation, but is part of a longer-term improvements plan that builds on the legislative change enacted last year to better integrate health and social care through the 42 integrated care boards, which became operational in July. That was prioritised for additional funding through the £14.1 billion announced for health and social care in the autumn statement. Following the quick spike in flu cases over Christmas, with in-patient flu admissions 100 times that of the previous year and a sevenfold increase in December, we announced £250 million of immediate funding on 9 January for the pressures this winter, giving extra capacity to emergency departments to tackle the issue of patients who are fit to leave hospital but are delayed in doing so.

Today’s plan, developed in partnership with NHS England and social care partners, builds on the actions and investment that I set out to the House earlier this month as we put in place the more substantive changes required to enable the NHS to have greater resilience this time next year. To do that, this plan involves embracing technology and new ways of working to transform how patients access care before and after being in hospital. That in turn will help to break the cycle of emergency departments in particular coming under significant strain in winter.

Our plan has a number of commitments that are both ambitious and credible. First, we are committing to year-on-year improvement in A&E waiting times. By next March, we want 76% of patients to be seen within four hours. In the year after that, we will bring waiting times towards pre-pandemic levels. Our second ambition is to improve ambulance response times, with a specific commitment to bring category 2 response times—those emergency calls for heart attacks and strokes—to an average of 30 minutes by next March. Again, in the following year we will work to bring ambulance response times towards pre-pandemic levels. I am pleased that the College of Paramedics has welcomed the plan, saying that it is

“pleased to see a strong focus in the recovery of those people in the Category 2 cohort”.

Of course, this will not be the limit of our ambition, but it is vital that we get these first steps right and that we are credible as well as ambitious. To put these targets in context, achieving both would represent one of the fastest and largest sustained improvements in the history of the NHS.

Underpinning these promises is one more essential commitment: a commitment to better data and greater transparency. On data, the best-performing hospitals have benefited from the introduction of patient flow control centres to quickly identify blockages in a patient’s journey, and e-bed management systems to speed up the availability of beds when they become free. Through this plan, we will prioritise investment in improving system-wide data, both within the integrated care boards and on an individual trust and hospital site basis. This will allow quicker escalation when issues arise and a better system-wide response when individual sites face specific challenges.

On greater transparency, for some time voices across the NHS have called for the number of 12-hour waits from the time of arrival in A&E to be published. This is something I know the Royal College of Emergency Medicine has long campaigned for—I can see the hon. Member for St Albans (Daisy Cooper) nodding her head—and there has been criticism of the Government, including from Opposition Members, for refusing to provide this transparency. Instead, the data published to date has been a measure of 12 hours from the point of admission rather than from arrival in A&E. For the commitment to transparency to be meaningful, we must be prepared to publish data, even when that transparency will bring challenges, so today I can inform the House that from April we will publish the number of 12-hour waits from the time of arrival. Dr Adrian Boyle, the president of the Royal College of Emergency Medicine, has previously said:

“The full publication of this data will be an immensely positive step that could be the catalyst for transformation of the urgent and emergency care pathway that should help to improve the quality of care for patients.”

I hope this transparency will be welcomed across the House.

Our plan focuses on five areas, setting out steps to increase capacity in urgent and emergency care; grow the workforce; speed up discharge; expand and better join up new services in the community; and make it easier for people to access the right care. Action in each area is based on evidence and experience, learning lessons from the pandemic and building on what we know can work. More than that, we are backing our plan with the funds we need, and the Government are committing to additional targeted funding to boost capacity in acute services and the wider system. That is why this package includes £1 billion of dedicated funding to support hospital capacity, building on the £500 million we have provided over this winter to support local areas to increase their overall health and social care capacity.

Taken together, this plan will cut urgent and emergency care waiting times by, first, increasing capacity with 800 new ambulances on the road, of which 100 are new specialised mental health ambulances. This comes together with funding to support 5,000 new hospital beds, as part of the permanent bed base for next winter.

Secondly, we are growing and supporting the workforce. We are on track to deliver on our manifesto commitment to recruit more than 50,000 nurses, with more than 30,000 recruited since 2019. The NHS will publish its long-term workforce plan this year. We are also boosting capacity and staff in social care, supported by investment of up to £2.8 billion next year and £4.7 billion in the year after.

Thirdly, we are speeding up the discharge of patients who are ready to leave hospital, including by freeing up more beds with the full roll-out of integrated care transfer hubs, such as the successful approach I saw this morning at the University Hospital of North Tees.

Fourthly, we are expanding and better connecting new services in the community, such as joined-up care for the frail elderly. This includes a new falls service, so that more elderly people can be treated without needing admission to hospital.

Virtual wards are also showing the way forward for hospital care at home, with a growing evidence base showing that virtual wards are a safe and efficient alternative to being in hospital. We aim to have up to 50,000 people a month being supported away from hospital, in high-tech virtual wards of the sort that Watford General Hospital has been pioneering, as I saw last month.

Finally, we are improving patient experience by making it easier to access the right care, including a better experience with NHS 111 and better advice at the front door of A&E, so that patients are triaged to the right point in the hospital without always needing to go through the emergency department—this new approach can currently be seen at Maidstone Hospital, as I saw earlier this month.

These are just some of the practical improvements already being delivered in a small number of trusts that, through this plan, we will adopt more widely across the NHS and, in doing so, deliver greater resilience ahead of next winter.

I am pleased that NHS Providers has welcomed today’s plan, and that the Royal College of Emergency Medicine has called it

“a welcome and significant step on the road to recovery”.

Taken together with all the other vital work happening across health and care, including our plan to cut elective and primary care waiting times, today’s plan will enable better care in the community and at home, for that care to be more integrated with hospital services and for existing practice to be more widely adopted. I commend this statement to the House.

I thank the Secretary of State for advance sight of his statement.

After 13 years of Conservative mismanagement, patients are waiting longer than ever before. Heart attack and stroke victims are waiting more than an hour and a half for an ambulance. Mr Speaker, “24 Hours in A&E” is not just a TV programme; it is the grim reality for far too many patients. Some 7.2 million people are waiting for NHS treatment. Why? The front door is broken—people are finding it impossible to get a GP appointment—so they end up in A&E. At the same time, the exit door is broken because care in the community is not available. Patients are trapped in hospitals, sometimes for months. Between the two is a workforce who are overstretched, burnt out, ignored by Government Ministers and forced out on strike.

Does this plan even attempt to get patients a GP appointment sooner? No. Does this plan restore district nursing so that patients can be cared for in the comfort of their own home? No. Does this plan see Ministers swallowing their pride and entering negotiations with nurses and paramedics? No. And does this plan expand the number of doctors and nurses needed to treat patients on time again? No.

The Health Secretary said a lot of things, but he did not say when patients can expect to see a return to safe waiting times. His colleague the Minister for Social Care, the hon. Member for Faversham and Mid Kent (Helen Whately), rather let the cat out of the bag this morning. She was asked, “Is there any plan at all for when we will get back to 95% of patients in A&E being seen within four hours?” Her answer—and I am not joking—was, “I can’t tell you that.” How can the Secretary of State claim that his plan is ambitious and credible? What kind of emergency care plan does not even attempt to return waiting times to safe levels? It is a plan that is setting the NHS up to fail right from the start—a plan for managed decline.

These targets are not plucked out of thin air; patients waiting more than five hours in A&E are more likely to lose their lives, and so are heart attack and stroke victims waiting more than 18 minutes for an ambulance. Sadly, that is exactly what has happened this winter, it is what happened this summer and it has been going on since before the pandemic began. The four-hour A&E waiting time target has not been met since 2015. The only time the Conservatives have met the 18-minute target for ambulance response times was during lockdown. What is the Secretary of State’s ambition now? It is 30 minutes —30 minutes waiting for a heart attack or stroke victim to receive an ambulance, when every second counts. Is not the truth that the Government missed the targets, so they are moving the goalposts? They are fiddling the figures, rather than fixing the crisis.

The Secretary of State boasts that he is pouring more money in—£14 billion, which is almost as much as his Department has wasted on dodgy, unusable personal protective equipment—yet standards are being watered down. So can he explain why patients are paying more in tax but waiting longer for care? Why is it that under the Conservatives we are always paying more but getting less? So what is their answer? It is:

“There are so many people in hospital who wouldn’t need to be there if we could provide quality care at home… medical science and technology…offers a world of possibility for the NHS to transform patient care… Virtual wards allow people to receive hospital care at home.”

Those are not his words—that is my party conference speech! He did not have a plan for the NHS so he is nicking Labour’s.

I am happy for the Secretary of State to adopt Labour’s plans, but here is what he missed: you cannot provide good care in the community, in people’s homes or in hospital without the staff to care for people. That is the supermassive blackhole in his plan published today: people. Virtual wards without any staff is not hospital at home; it is home alone. So where is his plan to restore care in the community? Labour will double the number of district nurses qualifying every year, so can he hurry up and nick that plan too?

Of course, good care in the community is not a substitute for good care in hospital—we need both, now. So why, in the middle of the biggest crisis in the history of the NHS, with hospitals so obviously short of staff, is the universities Minister writing to medical schools to tell them not to train any more doctors? This is ludicrous. Labour will double the number of medical school places and create 10,000 new nursing and midwifery clinical placements, all paid for by abolishing the non-dom tax status. I know that the Prime Minister might not like that last bit—[Interruption.] Government Members are all complaining, but they did not complain when they put up income tax. The Prime Minister does not like it, but perhaps this would be a good time for the Conservatives to act tough on tax dodgers. So when is the Secretary of State going to nick that plan?

And when is the Secretary of State finally going to get his act together and end the strikes in the NHS? Perhaps I am speaking to the monkey when the Chancellor is the organ grinder. If that is the case, when will we get a chance to question the real Health Secretary on the strikes that this one is causing in the NHS? Labour will create more front doors to the NHS and we will tackle the crisis in social care. The Secretary of State offers sticking plasters and by now it is very clear: only Labour can offer patients the fresh start the NHS needs.

The hon. Gentleman started by thanking me for advance sight of the statement, and then he made a series of remarks that simply ignored what was in it. Even his last point shows how riddled with contradictions the Opposition’s approach is. He says in interviews that he supports the pay review body process—that is the official position, or at least it was—but then he says, “No, we should be negotiating individually with the trade unions and disregarding the pay review process.” There is no consistency on that at all.

The shadow Secretary of State talks about operational performance—[Interruption.] He has just had his go; he should listen to the answers. He says that it is about operational performance, but in my remarks I tried to be fair and said that these are challenges that are shared across the United Kingdom and globally. He seems to think that they are unique to England alone. We need only look at Wales to see that more than 50,000 people—notwithstanding the fact that Wales has a smaller population—are waiting more than two years for their operations, when we cleared that figure in the summer in England, leaving fewer than 2,000 in that cohort.

The shadow Secretary of State talks about the workforce. Obviously, he did not bother to read or listen to what was said in the statement. We are on track to deliver our manifesto commitment of more than 50,000 nurses. We have more than 30,000 so far. We have 10,500 more nurses in the NHS this year compared with last year. The grown-up position is to recognise—[Interruption.] Well, in the first five years we were dealing with what that letter said, which was that there was no money left. [Interruption.] Labour Members just do not like the response, but the facts speak for themselves. We have 10,500 more nurses this year than last year. The grown-up position, as I was saying, is to recognise that we have an older population with more complex needs, and that the consequences of the pandemic are severe—they are severe not only in England, but across the United Kingdom, in Wales and Scotland, and indeed in countries around the globe.

The shadow Secretary of State says that the statement did not cover the plan for GPs. Well, again, I was clear that this was one of three plans. We had the elective plan in the summer, which hit its first milestone. We have the second component today on urgent and emergency care, and we will set out in the coming weeks our approach to primary care. That is the approach that we are taking. [Interruption.] The shadow Secretary of State keeps chuntering. We did not have the pandemic 13 years ago. [Interruption.] I can only surmise that he did not get his remarks quite right the first time, which is why he feels the need to keep chuntering now and having a second, third and fourth go—perhaps next time.

On ambition, the shadow Secretary of State ignores the fact that we need to balance being ambitious with being realistic. These metrics, in the view of NHS England, show the fastest sustained improvement in NHS history. Clearly, his remarks are at odds with NHS England.

On funding, we are putting an extra £14.1 billion of funding into health and social care over the next two years, which reflects the fact that the Chancellor, notwithstanding the many competing pressures he faced at the autumn statement, put health and social care, alongside education, as the key areas to be prioritised.

On virtual wards, I had not quite realised that the shadow Secretary of State was the clinician who had invented virtual wards. I think that the credit for virtual wards actually goes to the staff, such as those I met at Watford, who are driving forward that innovation. It is slightly strange that he sometimes wants to claim ownership of something that has been clinically led by those working on the frontline. We have recognised the value of virtual wards, which is why, at North Tees this morning, at Watford last month, or on various other visits, I have been discussing how to scale up those plans.

We look forward to going through the plan in detail with the Secretary of State when he speaks to the Select Committee tomorrow. May I just ask him about the ambition on the two-hour response to falls at home of the frail and elderly to prevent them from being admitted into the acute sector? Obviously, he will know that that was committed to in the long-term plan. What does he need to put that ambition into practice?

The funding to put that in place has been earmarked from the £2.8 billion next year. The key thing is less to do with the funding than the accuracy of the data, which will help us to see where there are gaps in coverage and how we get the right levels of community response. The integrated care boards have been set up to take an integrated approach on that. One of the best enablers will be the control centres that the ICBs will set up, which will allow us to get much greater visibility on where that has been delivered and how we escalate it when it has not.

The 300,000 vacancies in health and social care mean that, whatever the Secretary of State puts on the table, his plans will never be delivered. What is he doing to retain the burned-out, traumatised staff who currently work in the NHS, to resolve their pay dispute and to put enough money on the table to pay social care staff enough to come and work in the service?

We recognise the huge pressure on social care; that is why, at the autumn statement, the Chancellor set out the biggest-ever increase in funding into social care of any Government, £7.5 billion over two years. We are putting more funding in. On the workforce more generally, the Prime Minister and Chancellor have committed themselves to bringing forward the workforce plan, which will set out the longer-term ambition on workforce and will be independently verified. In addition, we are recruiting more staff, as I updated the House, whether that is the 3% more doctors this year than last year, the 3% increase in nurses, or the 40% more paramedics and 50% more consultants compared with 2010. We are recruiting more staff, but the grown-up position is to recognise that there is also more demand.

I warmly welcome the plans set out by my right hon. Friend today, but he will know that one reason emergency care faces so much pressure is that successive Governments have not focused enough on the prevention agenda. Indeed, last week’s news that the Government will not go ahead with individual focused plans on cancer, dementia and mental health has concerned many. Can he assure this House that the Government’s new major conditions strategy will be published promptly and will be comprehensive and significant?

I am happy to give my right hon. Friend that assurance. I assure the House that our commitment to the cancer mission and the dementia mission through the Office for Life Sciences is absolutely there. He is right that we are bringing that together in one paper—I think we should take a holistic approach—but I share his ambition on prevention. In early January, I set out a three-phased approach: first, the £250 million immediate response to the pressures we saw from the flu spike over Christmas; secondly, as I announced today, building greater resilience into the system looking ahead to next winter; and thirdly, the major conditions paper on prevention, which is about bringing forward the innovative work that colleagues are doing through the Office for Life Sciences to impact the NHS frontline much sooner than might otherwise have been the case.

I want to raise the case of a constituent who described to me the state of Salford Royal’s A&E earlier in January, saying:

“My partner was taken by ambulance yesterday at about 11am. He has a severe chest infection and breathing problems. He was left sitting in a chair on oxygen until 10pm when a trolley was found for him to sleep on. There are no beds available.”

My constituent said that patients and staff

“feel that no one cares”.

After such a long wait, my constituent’s partner was found to have pneumonia and he has been very poorly. Now the Secretary of State is talking about a target of 76% of A&E patients being seen within four hours by next March. Will he tell me and my constituent why he thinks it is acceptable for patients to wait longer than is safe?

We are bringing times down; I think the current mean response for C2s is much more in the region of 25 or 26 minutes than it was in late December-early January, because across the UK there was a massive spike in flu. The hon. Lady will have seen exactly the same in the Labour-run NHS in Wales. Over December there was a 20% increase in 999 calls, for example. That is why we need to put in place greater resilience, as the plan I have set out to the House does.

I strongly support the £1 billion for 5,000 additional beds and 800 more ambulances. I have long argued that, with a growing population and a growing elderly population, we need more capacity. Is it also possible to take some of the £14 billion of additional money to provide even more capacity? I think we are going to need it.

Within my right hon. Friend’s question is, I think, how we get more flow into hospital: once bed occupancy goes above a certain threshold, lack of flow is the key interaction that drives inefficiency within hospitals. That is why we are putting in the extra capacity. It is also a question of reducing the numbers going to hospital in the first place and speeding up the discharge of those who are fit to leave. Whereas at the moment someone might sit on a ward for three days because they have to have antibiotics every day, if one continuous dose of antibiotics can be administered through new kit at home, not only is that a much better patient experience but it relieves pressure on the wards.

I welcome the additional transparency on data for 12-hour wait times, because it is only by shining a light on the problem that we can see just how bad it is, but the targets set out in the plan today are utterly woeful. The Royal College of Emergency Medicine says that we need 13,000 beds; the Government are offering 5,000. The percentage of patients who are seen within four hours should be 95%; the Government are aiming for 76%. Heart-attack and stroke victims should be seen within 18 minutes; the Government are aiming for only 30 minutes. Surely the truth is that this woeful lack of ambition means that our emergency care services are themselves on life support and that patients will continue to die needlessly for a very long time to come.

First, I thank the hon. Lady for recognising the steps that we have taken on transparency. That has been an area of challenge and it is part of my wider commitment to transparency.

The ambition of the targets has to be realistic, and targets are not a ceiling but a floor. It is about saying, “How do we set a target that is realistic?” Of course, we will aim to do better than that, but it is about setting something that the system feels is achievable, because that in turn gets much more buy-in.

On beds, we are increasing capacity, as my right hon. Friend the Member for Wokingham (John Redwood) alluded to. What it is really about is freeing up patients who are fit for discharge from hospital, who should not be there and would actually prefer to be getting care at home. It is about looking at the end-to-end bed capacity, not simply at beds within the acute sites.

I welcome my right hon. Friend’s statement. In the pandemic, the use of local private hospitals by the NHS, particularly in places such as Basingstoke, kept services such as cancer care going uninterrupted. Could the NHS be using more private facilities more widely to relieve some of the pressures that he so eloquently outlined in his statement?

My right hon. Friend makes an important point. Again, within that is patient choice and how we empower more patient choice—providing services that are free at the point of use—to use what capacity there is within the system, including in the independent sector. I absolutely agree that we should be maximising capacity. At Downing Street with the Prime Minister, we had a very useful roundtable with the independent sector about how we can make more use of its capacity. That is certainly an area that we are exploring.

I saw for myself only a few weeks ago the real crisis in our hospitals when I accompanied a close relative to Whiston Hospital, where I saw every single space in the corridors taken up by a bed, a trolley or a chair. Quite frankly, what the staff—doctors, nurses and support staff—were doing was amazing, and they deserve all our praise for the hard work that they are putting in. The Secretary of State’s lauding of the fact that two-year waits have virtually been eliminated is bizarre: when Labour left office, waits were somewhat less, with an 18-week target and many people being seen within weeks, not months. The Secretary of State said that the Government are on track to recruit 15,000 new nurses, but how many have left the NHS in the last two years?

First, the hon. Gentleman is right to recognise the work that the staff have been doing. He mentioned a family member; when I made a statement earlier in January, I recognised that there has been huge pressure on the system. We saw the flu numbers and the spike in cases. On the two-year waits, the point is simply that there has been pressure on services—the pandemic impacts—across the United Kingdom, but the two-year wait is far worse in Wales, whereas we have cleared it in England. On recruitment and retention, we are bringing forward the workforce plan. The fact is that we are recruiting more nurses, but it is about meeting demand pressure as well.

There is no doubt that the 5,000 extra beds will help the NHS to provide the best possible patient care. Community hospitals across East Devon and NHS Nightingale Hospital Exeter can play their part, too. Does my right hon. Friend agree that community hospitals can play a key role in helping to cut waiting lists?

Community hospitals are key to tackling the issue of delayed discharge. Community settings have been a bit of a Cinderella in the past. The data on community settings tends to be weaker than it is in other parts of the NHS. Alongside domiciliary care and making better use of residential care capacity, the third element for discharge is to look at how we use community step-down in a much more constructive way. One key issue there is to have wraparound services so that people do not simply get transferred to a community setting, but that it is a staging post before getting to the home, which is where most patients want to be.

The social care sector is dominated by dedicated staff who are paid low wages. High profits are made from it and there is an insufficiency of spaces. Will the money that the Secretary of State has announced go to local authorities? Can it be spent on public provision? Does he not think it is time to recognise that the internal market and privatisation have sucked money out of health and social care—money that could have been spent on patient care and caring for people in the community and in special facilities?

One area of the right hon. Gentleman’s question where I do agree with him is the importance of local authorities. One reason I am keen to see more clarity on data and transparency is that there can sometimes be a tendency for the local authorities to be blamed for discharge, when often it is factors within the NHS that contribute to some of those who are fit to leave hospital not doing so. On the money allocation, the £2.8 billion is targeted to local authorities—funding set out by the Chancellor—with £4.7 billion the following year. We are increasing the money for local authorities, but alongside that we are working with them to improve the data so that we can see where there are blockages due to local authorities. For example—Mr Speaker will be familiar with this—Blackpool often has visitors from out of the area, so the NHS there deals with a number of local authorities, not simply the nearest one. We are working intently on how we support local authorities as part of the wider discharge package.

I welcome my right hon. Friend’s statement and commend his approach to this difficult problem that he faces and we as a nation face. Does he agree that while speeding up discharge from hospital and freeing up beds for patients needing urgent and emergency care is absolutely necessary, there is a real need for the expansion of new services in the community, which must be a top priority? In my area, one of the biggest reasons for bed blocking in hospitals is that there is no community service to pick up when people go home.

My right hon. Friend hits the nail on the head. He is right: it is about how we better manage demand in the community before people get to the emergency department. That is where, for example, action targeted at the frail elderly is so important. It is also about how we enable people to discharge sooner, where they are fit to do so, so that they can recover, whether in a community setting or, ideally, at home, with the right wraparound support.

The people of Bristol South will be ever so grateful to have data that they are waiting 12 hours, rather than perhaps ringing me up to tell me they have been waiting 12 hours. The Secretary of State is a Treasury man, so he must know we are now paying more for less. In the interest of transparency, can he be assured that in his own ICB, demand and capacity are matched, and will he know that? How will I know that demand and capacity are matched in my own ICB?

I think the hon. Lady was welcoming the transparency on 12 hours—I certainly hope so. The ICBs became operational in July, and we are working with them as to how, by taking a system-wide view, they can baseline the gaps in data, and one key area of that is on the community side. When she talks about matching capacity, part of that is about understanding virtual ward capacity, what conditions that applies to, what the physio wraparound services are, what is available within residential care versus community care and other domiciliary care packages, as the right hon. Member for Islington North (Jeremy Corbyn) touched on in terms of local authorities. We need to look at the data package across the piece on a system-wide basis. That is why we are setting up control centres. I am keen to make that much more transparent, because to be blunt, as a Secretary of State, I get the transparency anyway when things go wrong. Like the hon. Lady, I would rather have much more transparent data so that ICBs themselves can be better held to account, and indeed that is what the Hewitt review is looking at in terms of that wider transparency piece.

I welcome the fact that Barnet Hospital’s emergency department will be expanding and improving its facilities and taking on new staff, and of course I welcome today’s announcement, but I urge the Secretary of State to ensure that it is effective on the ground soon, because there is a real crisis out there. This is a good announcement, but it must be delivered so that patients and staff feel it on the frontline as soon as possible.

I could not agree more, which is why this morning the Prime Minister and I were at University Hospital of North Tees, where it is effective on the ground. It is about looking at hospitals where such measures have been effective and are having an effect on the ground, such as in North Tees and at Maidstone Hospital, and how we take best practice from them. We then have to do what has sometimes been more difficult in the NHS, which is to scale those innovations and get them adopted across the piece.

There are 165,000 vacancies in social care and there was nothing in the statement about how the Secretary of State will address them. Will he do that through better terms and conditions?

We are dealing with that through additional funding—the £500 million for this winter. That relates to the point made by my right hon. Friend the Member for Chipping Barnet (Theresa Villiers) about the impact on the ground, which will be to give ICBs and local authorities discretion. Some of that £500 million is being spent on the workforce, including in social care, so there is discretion as to how they spend that. There is also the £2.8 billion of local authority and ICB funding that will be in place next year, and £4.7 billion the following year.

The Secretary of State will be aware of Torbay’s demographics, particularly the growth in the number of people aged over 85. They are living a good long time but, at that age, they need some level of support from the NHS, which obviously creates demand and puts pressure on our systems. On the resources announced today, what engagement is he planning to have with local ICBs, particularly those that cover areas where the demographics mean that they are at the leading edge and driving innovation, but need support to do so?

My hon. Friend makes an important and nuanced point about demographic pressure, which is not evenly spread and is more concentrated in certain parts of the country than others, so the pressure on ICBs is greater in those areas. That is why the ministerial team met almost all the ICBs in a series of meetings with chairs and chief execs in the run-up to Christmas, and it is why we want to bring greater transparency, so that we can right-size solutions for emergency departments and ensure that those facilities keep pace with the increased demand.

Last night, my constituent’s 11-month-old son had to wait in A&E for eight hours, which my constituent found extremely unacceptable. The waiting experience in our hospital is like being in a “disaster zone”, in the words of my constituent, who went on to explain about parents having to sit on floors and wait for hours for their children to be seen by a doctor. I press the Secretary of State on whether there is a plan to return to the standard of 95% of patients who come to A&E being seen within four hours.

As I said, we are not setting out that ambition in this statement, because the impact of the pandemic has been so severe. We need to set a target that is ambitious but achievable, which is what we have done. The president of the Royal College of Emergency Medicine said:

“This plan is a welcome and significant step on the road to recovery and we are pleased to see it released.”

It is about taking best practice from the areas that are working and ensuring that they are socialised across the piece. It is obviously concerning to hear about individual cases, such as the specific one that the hon. Lady mentioned, which are very traumatic for the families. That is why we have set out this plan and why we are putting in the extra funding.

From 2005 to 2006, there was a campaign within the NHS to close many in-patient beds in community hospitals. I was pleased by what the Secretary of State said earlier about beds in community hospitals having a role to play. In that connection, will he reconsider the future of the site of Fenwick Hospital in Lyndhurst in my constituency, where the in-patient beds were closed? The NHS is now proposing to sell it off, but I would have thought that, with a bit of imagination, such a site could increase capacity.

We are encouraging integrated care boards to take ownership of individual decisions, rather than trying to make all the decisions centrally from Westminster, so that those closer to the ground and to the issues are in power to make the trade-offs. I am sure my right hon. Friend will want to have those discussions with the chair and chief executive of his ICB. There is a wider issue of how we make greater use of community sites, not least given the workforce pressures and different staffing ratios that they have, and that is absolutely the way we help to get more people out of hospital who are fit to leave.

Ten days ago, I shadowed one of the brilliant emergency department consultants at Derriford Hospital. They are working their socks off under some very difficult conditions. The additional capacity for beds is welcome, especially because of the structural under-funding and lack of beds in the south-west, but doctors and nurses were saying that they want to slow the flow of people getting to the emergency department in the first place.

Can the Minister look again at the mothballed Cavell Centre programme—the super health hub programme—which would have done so much to slow the flow and deal with collapsing primary care services? In particular, can he look again at the Government’s decision to withdraw £41 million from the super health hub in Plymouth, which would have been the national pioneer, would have shown that this project works and could help our hospitals to deal with the crisis they are facing?

The hon. Gentleman asks how we slow the flow of people going to emergency departments and how we accelerate their discharge once they are fit. The substance of the point he raises is valid and absolutely right. It is why there are schemes such as the community response service and the falls service. We are looking at the likes of the North Tees model and getting more staff into community support, thereby integrating the health and social care side. As I said to my right hon. Friend the Member for New Forest East (Sir Julian Lewis) a moment ago, the trade-offs for individual sites are best determined by ICBs. I am very happy to look with ministerial colleagues at any specific proposals, but it is really for the ICBs to be looking at how to best use their estate.

I warmly welcome my right hon. Friend’s clear and credible plan, but on the uplift of 800 ambulances, which is good news, I urge him when it comes to their deployment to look at rural areas first. In these areas, ambulances by definition spend much longer per patient on the road going in between much more diversely spread out hospitals.

I recognise my hon. Friend’s point, not least as a rural constituency MP myself. I have talked to paramedics, as I am sure he has, and the principal cause of frustration of late has not been the issue of pay—important though that is. It has been frustration over long handover times, which has had a particularly damaging impact. I am happy to look at any specific issues in his area but he is right on the wider point about the pressures in rural areas.

When can the people of Warrington, and indeed Halton, expect to hear about the new hospital campuses, which are much needed by both communities—with sufficient staff to resource them?

This statement is focused on urgent and emergency care. At Health oral questions and on other occasions, we often discuss the wider capital programme and the increased funding we are putting into that programme. Part of that is about outcomes and how we get more from that investment in capital. That is why through the NHS estate we are starting to standardise our builds, starting with the Hospital 2.0 programme. We will be rolling that out more widely through the estate. I am not familiar with the specific issues at the hon. Member’s local site, but I am happy to look at them after the statement.

I welcome this recovery plan and my right hon. Friend’s comments on the role community hospitals have to play in future. The 16-bed Hopewell ward at Ilkeston Community Hospital was re-opened ahead of this season to ease pressures, but it is due to be decommissioned in the spring. To aid with more efficient planning, will he work with my local community health trust and ICB to ensure that these beds form part of the extra beds for next winter and, more importantly, become permanent—rather than this ad hoc approach we have had until now?

Again, decisions on the estate are principally for the ICBs, but I am happy to look at any individual proposals my hon. Friend has on how we get more flow into the system, and that is about putting more capacity into the community.

I think I welcome what has been said about mental health ambulances and trying to divert people in mental health crisis from A&E, but I am a little concerned about whether those attending the scene in those ambulances will have access to the past records of people in that situation or be able to carry out a proper risk assessment for them. Will the Secretary of State reassure me on that, and also on whether there will be places other than A&E to take them to? It is one thing to say that we want to divert them, but we need to have other resources in place.

The hon. Lady raises a fair and important point about what is in the wider package, alongside the mental health ambulances, which I think are a positive step. Last week, I met Baroness Buscombe as part of the pre-legislative scrutiny of the proposed mental health legislation, which will pick up some of the points that the hon. Lady raises. Examples of innovation include empowering people before they have a mental health crisis to use one of the apps that have been developed to set out their statement of wishes and other information, which is very helpful for paramedic crews when they have a mental health crisis. We are looking at how we use innovation to better give voice to the patient, and often to do that before they have the mental health incident, rather than when the ambulance arrives.

I welcome the announcement today; I think the key thing is that it makes a difference in the short term. The Secretary of State will be aware of plans to build a new A&E department at Ipswich Hospital. The plan is for it to open in January 2024. What assessment has been made of the difference that that could make in the medium to long term by increasing capacity and improving waiting times? Will he also be prepared to work with me and the hospital’s trust to potentially expedite the plan, so that it might even happen slightly before January 2024?

In a former role, when I was Chief Secretary to the Treasury, I signed off a significant expansion of A&E facilities. I hope that reassures my hon. Friend of my commitment to putting more capacity into emergency departments, not least because they need a certain level of capacity to be able to ensure same-day access, triage and ways of getting flow into the system. As for the wider site proposal, clearly the ICB for his area will want to prioritise that.

The urgent care and ambulance crisis has been brewing since autumn 2021 in Shropshire, and it has worsened since. Last week, a doctor went on the record to say that the emergency department was “like a war zone” and expressed her fear that, in a fire, not everyone would get out alive. In a six-week period to 12 January, the category 2 response time in the Oswestry area was two hours and 10 minutes. Will the Secretary of State acknowledge that in some areas the crisis is worse than in others? Will he agree to meet me and the other MPs representing Shropshire to discuss how we progress Shropshire further along this track to solve the urgent care crisis that is so serious there?

I am very happy to meet with the hon. Lady and colleagues to discuss this further. I think most people recognise that, since the huge pressures from flu over the Christmas period, the flu numbers have come down, but of course there is continued pressure in the system.

I welcome my right hon. Friend’s statement. In particular, I welcome the announcement today of over £26 million of funding to expand the emergency department at Great Western Hospital in Swindon. He knows from his previous incarnation that we have worked together on this issue. It is particularly important, not just for the integration of emergency services, but for the freeing up of other space in the hospital to allow for further beds or other clinical interventions. Does he agree that it is this sort of long-term measure that will guarantee progress in our much pressed national health service?

My right hon. and learned Friend has been key to securing the funding. He has assiduously lobbied me and ministerial colleagues to make a powerful case on behalf of his constituents, and I think he should be proud of the outcome, which reflects his and his parliamentary colleagues’ work on this issue. He is right; indeed, the case he made was around how this frees up capacity in the system, which will result in much better care for patients in Swindon.

There is nothing in this plan to address the fact that thousands of people are now turning up at A&E as a direct result of being unable to get regular access to an NHS dentist. Last week, another Cumbrian dental practice, in Grange-over-Sands, wrote to all of its 5,800 patients, as it had been forced to quit the NHS too. There is now not a single NHS dental place available anywhere in Cumbria. What will the Secretary of State do to fix an NHS dentistry crisis that leaves a family of four having to cough up an extra £1,000 a year during a cost of living crisis to get access to dental care that they have already paid for through their taxes?

I have addressed that point, in that we are bringing forward the third component of our three plans. I spoke earlier about the elective recovery plan; today’s announcement is on the urgent and emergency care recovery plan; and the third element will be the primary care recovery plan. Of course, alongside the work we are doing on dentistry it is also about access to services, both dentistry and A&E. That comes together in things such as the 111 service and how we review that, as well as the NHS app. It is about looking at how we better manage demand at the front door, and the demand for dentistry is not only through NHS dentistry but often manifests itself through a lot of patients coming forward for dentistry at A&E.

I warmly welcome my right hon. Friend’s plan, particularly his focus on increasing capacity in urgent and emergency departments. I welcome the Government’s recent investment of £8 million to reconfigure the A&E at my local hospital in Southend. Does my right hon. Friend agree that this will increase not just the capacity but the quality of the urgent and emergency care on offer in Southend?

I commend my hon. Friend for her assiduous campaigning on behalf of her constituents in Southend, through which she played a key role in securing the extra £8 million of funding. She is right that that will make a material difference not only to flow and capacity within the hospital but through that to the overall standard of patient care.