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A Plan for the NHS and Social Care

Volume 695: debated on Wednesday 19 May 2021

I inform the House that Mr Speaker has selected the amendment in the name of the Leader of the Opposition, which will be moved at the start of the debate, and amendments (j) and (g), which will be moved at the end.

I beg to move an amendment, at the end of the Question to add:

“but respectfully regret that the Government has provided insufficient information for its proposals properly to be scrutinised; and therefore beg leave that she will be graciously pleased to give directions that the following papers be laid before Parliament: the DHSC internal review of their operation during the pandemic as referenced by the Prime Minister’s official spokesman on 12 May.”

May I take this opportunity to note that although amendment (e) in the name of my hon. Friend the Member for Rhondda (Chris Bryant) has not been selected, its contents, which relate to brain injury, are important and welcome? I hope that Ministers take on board its recommendations.

It is all too tempting to intervene; I have never objected to temptation. On brain injury, I just want to say that I really want us to think about legislation now. The United States of America has made dramatic changes—it has introduced legislation four times now—and I think it is time we went down that route.

I completely agree. I hope that Ministers on the Treasury Bench have listened carefully. If they are prepared to bring forward legislation, we would work constructively across the House to ensure its speedy passage. May I thank my hon. Friend for the reference in his amendment to the impact of alcohol abuse on children? He knows that it is a subject very close to my heart; on behalf of the children of alcoholics community, I am grateful that he referred to it in his amendment.

Although we have often said this in the House, I still think that the whole House will want to remember today the 127,691 people so far who have lost their lives to covid-19, this awful disease, including the 850 health and care workers. Although repeating the numbers has become almost routine in this House, that does not make the scale or gravity of the loss any less shocking. We grieve as a nation and we all pay tribute to our healthcare workers, our social care workers and our public sector workers.

I am sure that the whole House will want to dedicate itself in good faith to learning lessons for the future. Sadly, we are in an era when, according to the experts, pandemics are becoming more predictable and will become more regular because of climate change and biodiversity loss, so learning lessons is about preparing better for the future rather than settling scores.

We know that the B1617.2 variant is spreading. From the data that I have seen, it appears to have a growth rate advantage of about 13% over the B1117 variant. It could well become the dominant strain in the United Kingdom. Although vaccination should mean that many are much safer and ought to avoid hospitalisation, the Government still have a responsibility to do all they can to contain its spread, minimise sickness and ensure that the 21 June target is not disrupted, if at all possible.

That is why I said on Monday that we need more surge vaccination in hotspot areas. We know that with vaccination there are always pockets where rates are lower than necessary, and we need to drive those rates that up. We have seen that throughout history—with measles, for example. So we urge the Government again to do all they can to drive up vaccination rates in Bolton, Bedford, Blackburn and other areas where we know there is an issue. We also need the Government to do more to contain the virus through test, trace and isolate. We need more surge testing. We need more enhanced contact tracing locally, with local authorities given the resources to carry it out. We need sick pay and isolation support fixed as well.

For those who are going in to work, or for those who are now socialising in premises, those buildings and premises need proper air filtration systems. There are experts now who can easily fix filtration systems in buildings to make them much more covid secure, and we should be inspecting workplaces in all these areas to ensure that every workplace is covid secure.

We need transparency in decision making as well. For the first time in my life, I think, I find myself agreeing with Mr Dominic Cummings. I know the Secretary of State does not often agree with Mr Dominic Cummings, but I find myself agreeing with Mr Dominic Cummings, who tweeted yesterday:

“With something as critical as variants escaping vaccines, there is *no* justification for secrecy, public interest unarguably is *open scrutiny of the plans*”.

Mr Cummings, on this occasion, is correct. [Interruption.] A wry laugh from the Secretary of State. Mr Cummings may well have been saying something different when he was in government; I do not know, but at least his public statement yesterday is correct. That is why our amendment calls for the publication of a Government lessons-learned review; not so that we can try to undermine the Government or find some hole to use across the Dispatch Box, but so that we can learn the lessons in our efforts to contain variants, and ensure that we are better prepared for the future. I hope the Secretary of State looks sympathetically upon that request, and perhaps joins us in the Division Lobby this evening.

I now turn to the contents of the Gracious Speech more generally. This should have been the Queen’s Speech that unveiled a new NHS plan to bring down the elective waiting list, which now stands at 5 million. This should have been a Queen’s Speech that outlined proposals to tackle the backlog of 436,000 people waiting over 12 months for treatment—many of them waiting in pain and anxiety, many of them facing permanent disability as a consequence of those waits.

The shadow Minister and I, and many others in this House, shared that wonderful victory on Saturday. After 139 years of Leicester City, we won the FA cup; it is great news.

I chair the all-party parliamentary group for respiratory health. This morning, we were given some very worrying figures. They indicated that the halting of the lung cancer screening pilots restricted access to diagnostic tests, contributing to a 75% drop in urgent lung cancer referrals. Does the shadow Minister agree with me, and share my concern, that the outcomes for patients with the fastest-progressing cancers, such as lung cancer, are indeed very worrying?

The hon. Gentleman is spot-on. I will come on to cancer in a few moments. He is a great champion for improving cancer care, and I thank him for reminding the House that Leicester City won the FA cup on Saturday. It is a reminder that even when the odds are stacked against them, a small team can still beat a well-funded, complacent opposition.

I will now move on to elective waiting lists. Where is the plan in this Queen’s Speech to bring down the rocketing waiting lists for treatment and surgery? Where is the plan to roll out technology such as in ophthalmology, for the thousands in our constituencies awaiting cataract operations? There are already 81,762 of our constituents waiting over 12 months for orthopaedic surgery. Where is the plan to get on with the hip replacements and knee replacements that many of our constituents will be raising with us in our surgeries, and how much longer will they have to wait? Where is the plan for the 24,407 of our constituents who are now waiting over 12 months for gynaecological surgery? How much longer will they have to wait?

Everyone understands that there has been a pandemic and that that has meant a disruption in care pathways, but the NHS was forced into this unprecedented position because we went into the crisis on the back of 10 years of Tory underfunding and cutbacks. We went into this crisis on the back of a 6% reduction in bed numbers between 2010 and 2019. That is why, at the beginning of 2020 when we debated the last Gracious Speech, 4.5 million people were on the waiting list for treatment. The target of 92% of patients beginning treatment within 18 weeks of referral from their GP had not been met for five years. We need a resourced plan now because the queues are set to lengthen further, as those who may have delayed seeking treatment for fear of covid infection will begin to emerge once again. Even though the NHS is dealing with significantly fewer covid patients, it is still operating at a much-reduced capacity and is unable to treat everyone in need of care.

Infection control measures meant that the number of beds fell by 9% in the first quarter of last year. It has only partially recovered in the past three months, but the number is still 6% lower than the previous year. What that means when we look at the most recent figures is that, on average, there are almost 4,000 fewer patients in NHS general and acute beds than the equivalent pre-covid period.

The Prime Minister has delayed the review of social distancing for entirely understandable reasons, but we must have a plan to drive up this capacity in the NHS. The solution to these capacity issues in the NHS cannot be a multi-billion pound deal with the private sector. The loss of capacity in terms of beds in the NHS is actually far larger than the whole capacity offered by the private sector. In order to reopen those closed and empty general and acute beds in the NHS, we need more capital investment. This investment needs to be built up now, so that the NHS can get on with the routine surgery that it will clearly have to confront in the coming years. I am afraid that, both the Queen’s Speech and, indeed, the Budget from a few weeks ago, failed to deliver that.

Is the hon. Gentleman saying that under no circumstances would he use the independent sector to reduce the pressure on elective surgery waiting lists?

If the hon. Gentleman thinks that the answer to driving up capacity is just a four-year £10 billion deal with the private sector, then we will not be in a position to reopen the beds over the coming years in the NHS. That is the issue. It undermines capacity in the NHS. We need capital investment in the NHS, so that we can drive up capacity.

Let me repeat the question: is the hon. Gentleman explicitly ruling out using the independent sector at all to drive down that backlog?

The independent sector is not the answer to this. The answer is investing in capital in the NHS. In the hon. Gentleman’s local area, there are 8,485 patients waiting for diagnostic tests—that is 25% when the operational standard is supposed to be 1% or less. He should be arguing for capital investment in the NHS, but he is not, and he is not sticking up for his constituents.

I want to make a bit of progress. If the hon. Gentleman wanted more beds in the NHS and greater diagnostic capacity, he would have been arguing for capital investment in the NHS, which we did not get in the Budget and we did not get in the Queen’s Speech.

That brings me to diagnostic capacity—I have just given the hon. Gentleman his local diagnostic figures. [Interruption.] This is not about new hospitals; this is about diagnostic capacity. The Secretary of State knows that we still have some of the lowest numbers of computerised tomography scanners and magnetic resonance imaging scanners per capita in the OECD. We still have only average amounts of RTE radiotherapy machines. We need investment in this technology, which we are not getting in sufficient amounts. That is why, in the past year or so, we have seen 4.6 million fewer diagnostic tests for cancer. Some 46,000 fewer people are starting cancer treatment. We should not have to choose between covid care and cancer care, but, for too many, that has been the reality of the past year, and it means that 4,500 additional avoidable cancer deaths are expected in the next 12 months. It means that progress in survival rates for colorectal cancer, breast cancer and lung cancer is expected to be undone. The proportion of cancers diagnosed while still highly curable has dropped from 44% to 41%.

The long-term plan, on which the Secretary of State fought the election, promised rapid action on cardiovascular disease. Experts now predict the highest cardiovascular mortality in a decade, and they predict 12,000 additional heart attacks and strokes over the next five years. The Queen’s Speech needed to include proposals to expand access to the appropriate cardiovascular healthcare facilities, but it also needed to include real interventions to tackle smoking and alcohol rates, and to reduce salt intake. Yes, there is a commitment to a tobacco control plan, but will there be a reversal of the 17% cuts to smoking cessation services? Given that 7,400 people died last year from alcohol abuse—a record number—will the Secretary of State reverse the cuts to drug and alcohol addiction services, with budgets being cut by 15% over the past three years?

We have been promised action, again, on banning junk food advertising, but when? I have heard the Secretary of State—and, to be fair, his predecessor—make that promise at the Dispatch Box many, many times, but when will we have the ban? When will he reverse the cuts to public health weight-management services?

Narrowing health inequalities should be at the heart of every Government policy, but there can be no levelling up while life expectancy advances stall for the poorest in society. Levelling up and tackling inequalities apply to mental health outcomes as well. More people suffer from depression in the poorest areas of the country than the richest. We know that the mental health problems are prevalent among certain minority ethnic communities —black men, in particular, are more likely to be detained under the Mental Health Act 1983, more likely to be subjected to seclusion or restraint, and less likely to access psychological therapies. We therefore welcome the commitment to reform the Mental Health Act, as we welcomed it last year, and I look forward to working constructively with the Secretary of State on reforming the Act. I would like to put on record my thanks to Sir Simon Wessely for his pioneering work on this front. Simon is a committed Chelsea fan, so I dare say that he will be more responsive to my felicitations this morning than he might have been on Saturday evening.

We face a crisis in mental health now, and we need action now. Two hundred and thirty five thousand fewer people have been referred for psychological therapies; eating disorder referrals for children have doubled; and the pandemic—again, because of infection control measures —has meant a reduction of almost 11% in beds occupied, which is equivalent to 1,700 fewer patients over the past three months compared with a year earlier. When will the Government implement their promise of significant increases in staff and resources for mental health, to ensure that mental healthcare is genuinely given parity of esteem with acute services?

That brings me to staffing more generally. Given that we are short of 200,000 staff across the health and social care sector, why was there nothing new in the Queen’s Speech to recruit more doctors, nurses and social care staff? Why was there no plan to give our NHS staff the pay rise that they deserve? NHS staff, including nurses who have cared for those with covid on wards, and district nurses who, in the first wave, cared for those who were discharged from hospital earlier than planned so that they could stay at home safely, have gone above and beyond, yet they feel that the 1% pay rise, which could well turn out to be a real-terms cut because of inflation, is a kick in the teeth. Is it any wonder that nurses are leaving the profession, including the nurse who cared for the Prime Minister, blasting Ministers for treating NHS workers with a total lack of respect? It is simply not fair. Our NHS staff deserve better.

The gaping hole in the Queen’s Speech is the plan for social care. Two years ago, the Prime Minister stood on the steps of Downing Street and said he had a plan to fix social care. He said:

“we will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve.”

It was not a plan to be developed, or work in progress; no, this was a plan that was already done—oven-ready, you might say, Madam Deputy Speaker. But two years on, where is it? Has the Health Secretary seen it? What do we need to do to see it—perhaps we could pay for some cushions in the Downing Street flat? The Government promised us cross-party talks. They now brief that cross-party talks have taken place, but when—did they forget to send the Zoom link?

However, there is a consensus on social care, isn’t there? Care workers should be paid the living wage and proper sick pay. There should be a cap on costs, as this House legislated for. When the Institute for Public Policy Research, social care and older people’s charities and a House of Lords Committee, which, at the time, consisted of true-blue Thatcherites such as the noble Lords Lamont and Forsyth, have all called for reform of free personal care, why is the Secretary of State not engaging in that debate with us? To be frank, though, lack of cross-party talks is not an excuse for not getting on with reform. A Prime Minister with an 80-seat majority should be able to show some leadership and get on and fix social care.

If the Health Secretary wants to talk social care reform, I am free this afternoon. He knows where I am. I am happy to sit down with him at any time and discuss it. I think we would have very constructive conversations on this one, because it is true to say, as Members have detected, that we have developed something of a bond these past 12 months. The Health Secretary has been so friendly to me across the Dispatch Box that I am half expecting to win a lucrative PPE contract by the end of the day.

Because we have this new friendship, I have, as we say on the Labour Benches, some comradely advice for the Health Secretary. I know he is bringing forward a Bill to neuter the independence of the NHS chief executive and bring powers back to the Secretary of State. I have been around a long time and I remember when Tory MPs used to complain that the NHS needed independence, but we will leave that to one side. I just suggest that he ought to be careful what he wishes for, because I have been reading the Evening Standard, where Mr Tom Newton Dunn reveals not only that Simon Stevens, whom the Secretary of State is trying to neuter, was best man at the Prime Minister’s wedding, but that the Prime Minister is said to be about to appoint Simon Stevens—I beg your pardon, Lord Simon Stevens—to, yes, you guessed it, the newly empowered post of Secretary of State for Health and Social Care. It brings a whole new meaning to the phrase, “the best man for the job”, doesn’t it? But this is a Secretary of State who set up Test and Trace, who was responsible for PPE procurement and who failed to protect care homes. Dominic Cummings said the Department under his leadership was a “smoking ruin”—and now he wants more control.

The Queen’s Speech was remarkably unspecific in its description of the contents of the coming health and social care Bill, so perhaps the Secretary of State can reassure us today. Can he commit to ensuring that neither the NHS nor the partnership force to be set up in each integrated care system will permit the inclusion of private sector participants? Will he rule that out? Can he guarantee that as statutory bodies ICSs will meet in public, publish board papers and be subject to the Freedom of Information Act 2000? What guarantees can he give this House that the establishment of integrated care systems will not lead to more private corporations taking over GP practices, as has happened recently with Centene, or services currently delivered by NHS providers? I hope he can give us those very simple reassurances today.

With nearly 5 million people on the waiting lists and rising, ever-lengthening queues in our constituencies waiting for hip replacements and cataract removals, cancer survival rates worsening, mental healthcare in crisis, social care reform kicked into the long grass, and a costly, morale-sapping reorganisation on the way, we needed a fully resourced 10-year rescue plan for our NHS. I commend our amendment to the House.

Order. At the beginning of this debate, I fear it was not quite clear which other amendments had been selected by Mr Speaker. I have now had an opportunity to look at my notes on my Order Paper. For the sake of clarity, let me tell the House that Mr Speaker has not selected amendment (e) in the name of Mr Bryant, as I predicted earlier. He has selected amendment (g) in the name of the hon. Member for Walthamstow (Stella Creasy), the right hon. Member for Haltemprice and Howden (Mr Davis) and others. He has also selected amendment (i) in the name of the leader of the Scottish National party.

I remind hon. Members that, although their contributions should address the terms of these amendments, it is in order for them also to refer to other matters relevant to the Gracious Speech.

I start by thanking the right hon. Member for Leicester South (Jonathan Ashworth) for his comradely advice, and I just correct the record because, thanks to his steadfast support for the Government’s action through the pandemic and the very grown-up approach he takes to these exchanges, Her Majesty the Queen was pleased to invite him to join the Privy Council, which we on the Government Benches welcome.

I am grateful to the right hon. Gentleman for describing the bond that has grown between us. It is true that, even while challenging each other from time to time in times of pandemic, sometimes relationships are strengthened in the heat of responding to something so serious. That is absolutely true. I think he is a wonderful man. I know that occasionally he has to criticise, because he has to please his Back Benchers, but I know he does not really mean it.

Throughout these great challenges and these difficult months, we have protected the NHS and protected and supported the amazing people who work in it, and we are determined to give the NHS all it needs as we emerge from this pandemic. The Queen’s Speech underlines that commitment, first, with a total focus on beating covid through our unprecedented vaccination programme, and then through an ambitious programme of support for our whole health and care system to tackle the backlogs caused by the pandemic, which the right hon. Gentleman rightly described, and a health and care Bill to set the NHS fair for the future—a Bill whose ideas and central propositions come from the NHS itself—alongside social care reforms to tackle injustices that have remained for far too long, public health reforms to learn the lessons of the pandemic and to promote the health of the nation, mental health reforms to bring that legislation into the 21st century and digital health reforms to harness all the opportunities that modern technology provides. That is our mission, a mission to ensure that, in support of all this, we also turn our nation into a life sciences superpower.

The last year has proved beyond measure the value of the NHS across Britain, the importance of social care and the strength of feeling that people rightly have for these cherished institutions. Our task in this Parliament is to help them further strengthen and build back better, and that is what this Queen’s Speech will allow us to do.

I turn first to the immediate task of tackling covid. With more than 70% of adults now having had a first dose and almost two fifths already double vaccinated, we have much to celebrate. Vaccination underpins our road map, which means we can now have pints in pubs and hugs in homes. Yet, as I updated the House on Monday, the race between the virus and the vaccine has got a whole lot closer. I can tell the House that 2,967 cases of covid-19 with the B1617.2 variant have now been identified. We are protecting the progress we have made and the progress that everybody has worked so hard to achieve, with the biggest surge in local resources of this pandemic so far. That means surging vaccines and testing. In the last week across Bolton and Blackburn with Darwen, we have given 26,094 jabs, as well as delivering 75,000 extra tests.

But this challenge is not restricted to Bolton and Blackburn. We have used the extensive biosecurity surveillance system that we have built and new techniques to identify the areas we are most concerned about, where we will now surge testing and vaccinations further. We, of course, look at the data on cases, variants and hospitalisations, all of which we publish, but we are now able to use further tools. Mobility data shows how often people travel from one area to another, and we look at that in deciding where the virus is likely to spread. We now analyse waste water in 70% of the country, and we can spot the virus and the variants in the water to identify communities where there is spread.

As a result of all that analysis, I can tell the House that we will now surge testing and vaccinations in Bedford, Burnley, Hounslow, Kirklees, Leicester and North Tyneside, and we are supporting the Scottish Government, who are taking similar action in Glasgow and Moray. In practice, this means that we are putting in place more testing and more testing sites, and we are making more vaccinations available to everyone who is eligible. We are not yet opening up vaccinations to those who are 35 and younger, because across the whole country, the message is crystal clear. This episode shows just how important it is that every single person who is vulnerable to covid-19 gets not just one but two doses, because the vaccine offers the best possible protection against this disease.

Turning to our programme for the future, we must learn from the success of this vaccine roll-out, which shows how we can deliver huge projects with huge flexibility at huge pace. We must apply these lessons to how we tackle the backlog, and I want to set out clearly to the House the sheer scale of the challenge left by the pandemic. I agree very much with the analysis that the right hon. Member for Leicester South set out in respect of the scale of the challenge.

We now have 4.7 million people in England waiting for care and more in Scotland, Wales and Northern Ireland. Before the pandemic, we had succeeded in getting the 12-month waiting list down from 18,700 in 2010 to just 1,600 in the months leading up to the pandemic. Now, 380,000 have waited more than a year for care, but these figures do not yet include the returning demand of those people who have a problem but have not yet come forward during the pandemic, often because they have been trying to reduce the burden on the NHS, but are now rightly regaining the confidence to approach the NHS. So the real waiting list is far larger than those figures, and as people re-present with problems that they might not have wanted to bother the NHS with in the past year, we will see the waiting lists go up.

We know that, during the pandemic, 6.9 million fewer patients were added to the waiting list for diagnosis and treatment. The scale of the pent-up demand that will come forward is unknowable, but to give the House a sense of the scale of the challenge, since the start of the pandemic, the NHS performed 70% fewer electives than in a normal year. Some of those will have been resolved without the need for hospital treatment, and that is fine, but some will return. We do not yet know how many will present themselves and add to the waiting lists, but we do know that the NHS needs to operate at a scale never seen before across the whole United Kingdom to clear the backlog, so we are working hard to support the NHS to accelerate the recovery of services.

The Secretary of State will know that people with traumatic brain injury might well have been treated because they have been in a car crash or something like that over the last year, but then the ongoing neurorehabilitation simply will not have been made available to them. On top of that, we have a new set of people who have neurocognitive problems because of covid. May I urge him to think of putting a single person in charge of the whole sphere of neurorehabilitation and brain injury, to try to get this back on course?

I will absolutely consider that. The hon. Gentleman raises one example of the sort of backlog that has not yet presented itself in many cases to the NHS, and I know that he met the Minister for Health recently to discuss how we can tackle this further.

The Secretary of State heard the intervention I made on the right hon. Member for Leicester South (Jonathan Ashworth). Is he aware that, in January, Ipswich Hospital was able to more than double the number of intensive care unit beds it had available, from 11 to 25, precisely because it moved cancer patients to the Nuffield hospital in the independent sector? Does that not show the danger of ideologically ruling out the use of the independent sector, which immediately reduces the capacity of the NHS?

Yes, my hon. Friend is absolutely right. I thought that his exchanges with the right hon. Member for Leicester South were disappointing, because we know that the Opposition spokesman supports the use of the private sector in the NHS, because he was the guy behind the private finance initiative projects of the last Labour Government. Mr PFI there is a huge fan of the use of the private sector in the NHS, but he cannot admit it, because of the people sitting behind him, and the right hon. Member for Ashton-under-Lyne (Angela Rayner) sitting next to him, keeping watch over him from the hard left of the party.

For goodness’ sake, I was not responsible for a single PFI contract. Actually, I remember that it was for the previous Chancellor of the Exchequer, George Osborne, that the right hon. Member was the chief lickspittle and bag carrier in signing off PFI contracts when he was first appointed to the Treasury. He can go through all the Treasury documents and he can FOI it until the cows come home, and he will find that I was not involved in any PFI contracts when I worked in the Labour Government, but I was responsible for helping invest in the NHS, which brought waiting lists down to their lowest level ever.

Well, it did not actually, because after 2010 we then had to bring waiting lists down, and we brought them down. The 52-week waits came down to just 1,600 before the pandemic, and it is our task and our mission to make sure that we get them down once again. However, this will take time and it will take all the resources that are possible—yes, extra staff, and that is happening; yes, extra capital investment, and that is happening; and yes, extra diagnostics, and that is happening. We have to use all the capacity of everything that we can—north and south, revenue and capital, public and private. What people care about and what our constituents care about is whether they can get the problem fixed, and last year has demonstrated that without doubt. So on the Government side we will use everything in our power to support the NHS. It is only those on the other side of the House who have the ideological divisions, and that just demonstrates once again that we are the party of the NHS.

In March, we committed £7 billion for further funding for healthcare services, including £1 billion to address backlogs from the pandemic, and that has taken our additional funding for covid-19 to £92 billion. We are also helping the NHS to recover medical training, and today I can confirm to the House an additional £30 million for postgraduate medical training. The formula for beating this backlog is looking closely at the demand as we emerge from the pandemic, putting in the right resources to meet this demand and putting in place an ambitious programme of improvement in the NHS.

That brings me to the third thing I want to talk about, which is how we are going to build back better. The Queen’s Speech outlines improvement in almost every area of healthcare, applying vital lessons that we have learned from the pandemic, including from the successful vaccination programme, when the whole health and care system has worked as one in the face of challenge and adversity. The vaccination programme brought a jigsaw of academics, the private sector, volunteers, the NHS, civil servants and many more, and put this together, revealing a bold picture of what is possible in this country when we pull together. That is the spirit and the energy that will underpin our reforms, and all of them have a common thread, which is to improve the health of the nation, based on the principle that prevention is better than cure.

Turning to our health and care Bill, as outlined in Her Majesty’s most Gracious Speech, one of the lessons of the crisis is the importance of integrated working. We knew this before, but it has come right to the front of mind. For years, people in the NHS at all levels have called for stronger integration within the NHS, and between the NHS and others they work so closely with, such as local authorities. The Bill will allow for a more preventive, population health-based approach to how we spend NHS money, helping people to stay healthy in the first place, and that is at the core of our Bill.

The right hon. Member for Leicester South asked about the new integrated care systems. They will bring together decision making at a local level between the NHS and local authorities to ensure that decisions about local health can be taken as locally as possible. The Bill will tackle much of the bureaucracy that makes it harder to do the right thing and free up the system to innovate and embrace technology as a better platform to support staff and patient care.

Her Majesty also set out our commitment to reform adult social care, and we will bring forward proposals this year to give everyone who needs care the dignity and security they deserve. Throughout the pandemic, we have sought to protect the elderly and the most vulnerable, and this will remain our priority as we look to end the care lottery and ensure that people receive high-quality, joined-up care.

This country understands the importance of the NHS and social care, but I also think that there has never been a greater appreciation of the importance of public health. Never have the public been more engaged, and never have we learned quite so much in such a short space of time. We must capture the lessons of the pandemic on how we do public health in this country and put that together with the innovations of the last decade—in data, genomics, population health, science and research.

One of the lessons that we have had to learn quickly is that health security and health promotion each need a single-minded focus. The people who get up in the morning and think about how we increase healthy life expectancy must be different from the people focused on fighting novel pandemic threats. Each is important and each needs dedicated focus. We have split these functions into two purpose-built organisations so that we are better at both.

The new UK Health Security Agency will have a dedicated focus on responding to the current threats, planning for the next pandemic and scanning the horizon for new threats in good times as well as bad. Of course, pandemics do not respect administrative boundaries. The UKHSA’s role is specifically to promote and protect the security of the United Kingdom as a whole.

Next, the job of our new Office for Health Promotion will be to lead national efforts to improve and level up our health—addressing the causes of ill health, not just the symptoms, such as through our plans to tackle obesity and make healthier choices easier and more accessible, and through supporting our colleagues in primary and community care. General practice, after all, is at the forefront of all population health measures and GPs are the bedrock of the NHS. General practice will be central to our levelling up the health of the nation because we know, and they know, that prevention is better than cure. A greater proportion of our efforts will now be directed at preventing people from becoming patients in the first place.

All of that brings me to mental health reforms. To truly level up health and reduce health inequalities, we must level up every part of our health, including mental health. I am determined to see mental ill health treated on a par with physical ill health, and to ensure that support is in place for those struggling with their mental wellbeing. We have provided record levels of funding for mental health services, especially to meet the additional burdens of the pandemic, but we need a better legislative basis—a mental health Act fit for the 21st century.

We are modernising the Mental Health Act to improve services for the most serious mental illnesses and support people so that they can manage their own mental health. The new Act will tackle the disparities and iniquities of our system and improve how people with learning difficulties and autism are supported. Ultimately, it is going to be there for every single one of us if we need it.

I know that my right hon. Friend shares my passion for legislative reform of the Mental Health Act. We go through this process every 20 years or so. I was wondering whether he could unpack how this will go forward, bearing in mind the need to get the law right while delivering it very quickly so that patients get the benefits.

My hon. Friend has enormous expertise and wisdom in this area. He is right to make the argument that we need to support everybody’s mental wellbeing, but that we also need a specific focus on very serious mental ill health, much of which has been, in many cases, exacerbated by the privations that have been necessary during the pandemic. He says that this is a process that happens once every 20 years, but it is almost 40 years since we had a new mental health Act. We want to do this with stakeholders on a consensual basis—I am very glad to hear the reiteration of cross-party support just now from the right hon. Member for Leicester South. Our goal is to bring forward a draft Bill in this Session and a Bill potentially in the next Session, so that we ensure it is legislated for during this Parliament. That is a timetable on which we have worked with the many experts who have informed the process, led by Sir Simon Wessley, of course, whose report sparked off this work. I look forward to working on that with him and the Minister with responsibility for mental health, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries).

I think the Secretary of State just said that we have not had a mental health Act for 40 years, but I remember sitting on the Public Bill Committee for the Mental Health Act 2007. I know that everybody is against lobbying, but my experience as a member of that Committee was that the lobbyists from the mental health charities, the British Medical Association and the pharmaceutical companies were absolutely invaluable in ensuring that we got the legislation right. Will he make sure that is available again this time?

Yes, I am absolutely happy to stress that point. This is a consensual process taking into account all the expertise from those who rightly want to influence. The hon. Gentleman almost made a joke about lobbying. The truth is that listening to people who have an expertise and an interest is absolutely critical to getting such a sensitive piece of legislation right. The legislation that this will replace was introduced in the early ’80s, so it is essentially 40 years old. There have been some updates, but there are still some extraordinarily antiquated things in our current mental health legislation. For instance, if someone does not declare then it is automatically assumed, if they are unmarried, that their father should take decisions on their behalf, rather than them choosing who might take those decisions—not their mother and not just one of their parents, but their father. That is just one example of the antiquated practices in this area that we need to address.

Finally, turning to our digital reforms, the pandemic has shown that one of the greatest allies we have in our battle for the nation’s health is data and technology. Digital health has truly come of age over the past year. There is no doubt about it: data saves lives. As we reshape health and social care, we will do it underpinned by a modern data platform, so we can get the most out of this powerful new technology. I am glad, again, that this is an area of cross-party consensus. Telemedicine has taken off. The NHS covid-19 app has been downloaded almost 24 million times and the wider NHS app, on which we can now demonstrate our vaccine status, was downloaded more times on Monday this week than on any previous day. If Members have not downloaded it yet, I recommend that they do. They can see their medical records and show somebody when you had the jab. NHSX committed to delivering the app by the ambitious schedule of 17 May, and it delivered. I am grateful to everybody who worked on this incredibly important project. The lesson of our data-driven vaccine roll-out must be applied everywhere. As citizens, we value the ability to see our data—after all, it is about us and it effectively belongs to us—and we want to see it used to drive better decisions, better research, better treatment and better support for colleagues on the frontline.

My view is that for years the health system has shied away from the modern use of data, and struggled on with paper forms, fax machines and clunky systems that do not talk to each other—but no longer. The pandemic has proved without doubt the incredible value to patients and clinicians alike of the modern use of data. Because of the gift of a universal NHS, we have the opportunity to have the best data-driven healthcare in the world, and I am determined that we seize it. Our health and care Bill and our new data strategy will drive a whole new approach to unleash that potential.

In addition to all those changes, we must, throughout, support all those who improve our health, including those in our life sciences and those who work in the NHS. Last week, I attended with colleagues a service to commemorate the life of Florence Nightingale. In his bidding, the Dean of Westminster reminded us that in Florence Nightingale, compassion and care had the power to deliver not just healing, but change. That must be our mission too: not just to heal, but to change. I am proud to be a member of a Government who deliver on our commitments. We delivered on our commitment to Brexit. We delivered on our commitment to protect the NHS. We are delivering on our commitment to vaccinate all. This Queen’s Speech is a commitment for healing and for change, for a United Kingdom that is stronger, healthier and more prosperous together, and I commend it to the House.

It might be helpful for the House to know that the initial time limit on Back-Bench speeches will be five minutes, and in that cohort of five-minute speeches we have two maiden speeches this afternoon. I can see the hon. Member for Twickenham (Munira Wilson) looking at her notes, and I am sorry to have to say that when we come to her and those after her on the list, the time limit will reduce to three minutes. [Interruption.] She is taking it very well. [Laughter.] Now we go by video link to Dr Philippa Whitford.

I rise to speak to amendment (i), which stands in my name and those of my colleagues. At the start of my speech, I wish to pay tribute to all health and social care staff, right across the UK, for everything they have done this past difficult year. Although there are real concerns about the rise of the Indian variant in multiple areas, we are all hoping that we can continue, slowly, to open up our society. Our attention is therefore now turning to patients who have been waiting many months for treatment or who have not yet even come forward with their health concerns. All four health services are working on recovery from the covid pandemic, and the Scottish Government have put in place their 100-day plan, to utilise some of the innovations used in the past year to increase the diagnosis and treatment of both elective and cancer patients.

However, the wellbeing and recovery of NHS staff must also be put front and centre, otherwise we will simply lose staff who are worn out. Especially after Brexit, the UK already faces workforce challenges. All NHS staff have worked above and beyond over the past 15 months, and the public have shown how much they value them, by clapping on their doorsteps and sticking rainbows in their windows. It has to be said that the derisory 1% pay rise for NHS staff in England is not exactly making them feel valued; you can’t spend claps in the supermarket. For NHS staff, this feels like a kick in the teeth. Many feel disrespected and are considering whether they will stay in their profession.

By contrast, in Scotland, where our NHS staff were already higher paid, they will get a 4% pay rise, the largest since devolution. Our nurses still get a bursary of £10,000 a year and do not pay tuition fees. That means that the Scottish Government invest £20,000 a year in every student nurse, so that they do not start their careers £50,000 to £60,000 in debt. NHS staff in Scotland have faced the same horrendous pandemic year, but we are trying to say thank you with a simple bonus of £500 and by focusing on their wellbeing and support services during recovery. The four national health services across the UK are not about hospitals or machines; rather, this is about the NHS staff who diagnose us, treat us and care for us, and now it is vital that we look after them so that they can recover.

There can be no NHS recovery without allowing staff to recover. It is only by supporting staff that they in turn will be able to look after patients and contribute to the huge task of treating those who have had to wait because of the pandemic and those who come forward now. Clearing the backlog of cases will take many months, but it will also require significant investment, yet the additional covid funding in England has already started to be removed since April. Although English trust debts were wiped last year and the NHS was told it could have whatever funding it needed, analysis by the King’s Fund shows that the core health and social care budget actually fell by £1.7 billion.

The main piece of health-related legislation in the Queen’s Speech is the health and care Bill, which, less than 10 years on, will repeal some aspects of the Tory-Lib Dem Health and Social Care Act 2012. It was that policy that brought me into politics. I had been following the proposals since 2011, in sheer disbelief that anyone could think that breaking up the NHS in England would somehow make it work better. Although I and others will be glad to see the back of section 75, which forced GPs to put services out to tender, this Government’s management of the covid response does not suggest that they are any less keen on outsourcing.

Exactly how commissioning will work is not at all clear, and that is causing concern for key community services such as dentistry and community pharmacies. Although the Secretary of State rightly highlights that prevention is better than cure, public health in England was decimated by funding cuts and reorganisation before covid hit and even went through further upheaval at the height of the pandemic. With regard to the White Paper and the Bill, the devil will be in the detail. Personally, I am concerned about how the United Kingdom Internal Market Act 2020 is reversing devolution, and particularly about how the procurement Bill might be used to undermine our integrated public NHS in Scotland.

Overall, it is easier to talk about what is not in the Queen’s Speech than what is. The most glaring omission is the long awaited social care Bill. That is in keeping with its complete absence from the Budget in March, but it is unforgivable. Not only has the pandemic highlighted the vulnerability of the social care sector, particularly those living in care homes; it also brought home to all of us the important role played by care staff, whether in care homes or looking after people in their own homes.

During the 2019 election, the Prime Minister claimed to have his fully prepared social care plan, but maybe he was mixing it up with the oven-ready Brexit deal that he was boasting about at the same time. Far from being ready to go, it has yet to see the light of day. Various Ministers have recently tried to blame delays on Opposition parties taking too long to sign up to a cross-party approach. Well, I have certainly never seen it, and I note that the shadow Care Minister, the hon. Member for Leicester West (Liz Kendall), has said the same. I do not know why the Government are finding it so difficult to make contact with us; our email addresses are all in the parliamentary directory.

We have not just been waiting since December 2019 or even last July; a Green Paper on social care has been promised since 2017—four years ago. During that time, social care in England has been allowed to wither on the vine, with the gap between what is funded and what is needed growing to between £8 billion and £10 billion. The Scottish Government spend 43% more per head on social care, which allows us to provide free personal care, letting people stay in their own homes for longer, which is something that all of us would prefer.

After the experience of the covid pandemic last year, the Scottish Government commissioned the independent Feeley review, which has proposed a human rights approach to social care—valuing and enabling participation in society, rather than always looking on care support as a burden. The report outlines the route to establishing a national care service, with Scotland-wide service standards, staff training, and national terms and conditions.

Another key element missing from this Queen’s Speech is any real detail about rebuilding a better society and economy than the one that was driving poverty and inequality before the pandemic brought life to a shuddering halt. We all know that we need a different economic model ahead of 2030 if we are not to burn or consume the planet. With the added economic damage of Brexit, it will take the investment of time, energy and money to recover from covid. We therefore have a choice about what kind of society we want to rebuild: one that exacerbates inequality or one that focuses on the wellbeing of everyone who lives here.

Wellbeing is not about healthcare or the NHS. It is much more than an absence of physical or mental illness. It comes from having a decent start in life, a warm and safe home, enough to eat, and fair opportunities at school and beyond. Scotland already has a broad range of wellbeing policies for all ages, from the baby box to welcome newborns, through to free personal care to support our older or vulnerable citizens. The Scottish Government are founders of the Wellbeing Economy Governments group with Iceland and New Zealand. They have already committed to a wellbeing and sustainability Act to ensure that every level of Government and every public body in Scotland puts the health and wellbeing of local people at the heart of all policy decisions.

We have seen the impact of covid on those in low-paid and insecure jobs, who, without decent sick pay, simply could not afford to isolate when they tested positive. Failing to properly support people to isolate has been one of the biggest mistakes in the UK Government’s covid response, yet we see no evidence that any lessons have been learned and no proposals for change. Where is the employment Bill that we heard about? Where is the plan to tackle child poverty, which has been driven up right across the UK since the first welfare cuts in 2012 and exacerbated by the benefit freeze and heartless policies such as the two-child limit and the rape clause?

There is nothing in this Queen’s Speech about genuine levelling up for the most vulnerable. That is just a slogan for blatant pork barrel politics. In Scotland, the Government pay the bedroom tax and are providing the Scottish child payment to help fight to child poverty, but more people are beginning to recognise the effort and money that is spent just trying to mitigate the policies of Tory-led Governments that repeatedly put the heaviest burden on the weakest shoulders.

Poverty is the biggest driver of ill health, and a decade of Tory austerity has been the biggest driver of poverty, but the Chancellor has already stated that the uplift to universal credit will be cut in September, signalling the start of yet another decade of Tory austerity. The people of Scotland certainly aspire to something better—a fairer society that looks out for those who need support. As we rebuild from the pandemic, we need to move away from an economy based on relentless growth in consumption to a more sustainable one that values people rather than just GDP.

That demonstrates the clear blue water between the UK Government’s plan for yet more austerity, poverty and inequality, and our vision for a fairer, healthier and more sustainable independent Scotland. The people of Scotland have the right to choose between those two visions. In Scotland, more people are beginning to recognise that we need the full powers of a normal independent country to be able to direct our recovery from covid and build the better country we want to live in and pass on to our children and grandchildren.

Let me start by thanking the NHS and care staff who looked after my constituents in South West Surrey so magnificently in the last year. Every resident of Farnham, Godalming and Haslemere is in their debt and incredibly grateful. As this is Dementia Action Week, I also particularly thank those who looked after people living with dementia, whether care home staff, home visitors or family members.

It is to the quality and safety of NHS care in normal times, as well as during pandemics, that I shall address my comments this afternoon. I will never forget the first members of the public who came to see me when I was Health Secretary to talk about issues of quality and safety. They were a young couple from Devon called Scott and Sue Morrish, who lost their three-year-old son Sam to sepsis. An independent inquiry ultimately decided, in two investigations, that every single NHS organisation that they had dealt with—the GP surgery, the out-of-hours service, NHS Direct, as was, and the hospital—had failed Sam in his care.

Scott and Sue are a modest couple—the last people to kick up a fuss—but they said that when they asked politely for a meeting to discuss Sam’s care a few months after his death, the shutters came down and no one was prepared to talk to them; it was like talking to a brick wall. Ultimately, it took them six years to uncover the truth of what happened to Sam. We should never, ever put a grieving family through that kind of agony.

That is why I focused on safety and quality. It is why I introduced Ofsted-style ratings for hospitals, care homes and GP surgeries, which I think have had some success. Indeed, I am happy to say that they have had particular success at the hospital where Sam was treated, where there has been a big change in culture. However, that is the reason why, with these new reforms, it is absolutely essential that safety and quality is at the heart of what we ask from the new integrated care systems. It is vital that they are outward-looking to the needs of patients and not upward-looking to the requirements of NHS bureaucracy. I am delighted that the Secretary of State wrote to me yesterday confirming that safety and quality would be one of the core requirements being asked of the new integrated care systems. On that basis, I will support the reforms and the Bill, as, I believe, will the Health and Social Care Committee, based on the report that we published last week.

However, there were two omissions from the White Paper that I do need to mention. The first—social care—has been mentioned this afternoon, and I know that the Secretary of State will say that reforms are on the way. I just want to say to him, as the only person here this afternoon who has done his job, that I had four winter crises in a row because we tried to fix the problems of the NHS without trying to fix the problems of the social care system at the same time. If we fix one system and not the other, the social care system will continue to export its most vulnerable patients into hospitals, where they are much more expensive to treat and it is much worse for them, particularly people with dementia. I know that money is a big issue—this is a very expensive thing—but if the NHS really is a priority for this Government, the social care system has to be as well, and I urge him Godspeed and all strength in the battles ahead to secure the reforms for social care that are so urgently needed.

The second omission is around workforce reform. We have a NHS where there are gaps in nearly every medical specialty, as well as in nursing. I was proud to set up five new medical schools and that had a big increase in the number of doctors, nurses and midwives we trained, but even with 50,000 more nurses and 6,000 additional doctors, we need a major overhaul of workforce planning. The obvious reform is to give Health Education England the statutory duty to publish annually long-term workforce requirements to act as a kind of Office for Budget Responsibility-style discipline on the Government to train enough doctors and nurses. I hope that the Secretary of State will consider that.

In conclusion, integration of care—offering joined-up care to patients—is a vital objective, but without enough doctors and nurses to do it, and without a social care system that is able to integrate with the NHS, the worthy objectives that we all have for these reforms will not meet the aspirations that people on both sides of the House rightly have.

Alison was 68 when she fell down a long flight of stairs and hit her head. She was bright as a button until that moment but the damage has left her feeling befuddled and trapped.

Heather was seven when she was hit by a car as she turned a corner on her scooter. Thank goodness she survived, but she suffered a terrible blow to the head. She is now 13 and she still struggles to concentrate.

Gareth played rugby from the age of 10 until he retired as a professional rugby player in his 30s. He took blow after blow to his head in the game and was repeatedly concussed, and kept on going back on the pitch. He now suffers from panic attacks, depression and anxiety. He thinks of taking his life every day. He fears dementia.

Rhys is in his 80s. He gets terribly confused and forgetful. He half-remembers that he has been diagnosed with dementia, but sometimes, paranoia sets in and he gets very angry with those who are looking after him.

Kate is 19. She was in a car with three friends when another car suddenly appeared on the wrong side of the road and crashed into them. The ensuing crash left her paralysed from the neck down and with significant cognitive impairment. She feels completely trapped.

Mark is now 19 and lives on his own. He finds it difficult to control his emotions and perform normal executive functions such as turning up on time. His doctor thinks that that is because the boiler in his childhood home was pumping out carbon monoxide for years without being spotted.

Richard and Jane adopted Kia when she was three months old. She suffers from foetal alcohol spectrum disorder.

Nick is a former fusilier in the British Army. He was caught by an improvised explosive device in Iraq, but because there was no physical sign of an injury, he was never checked for brain damage. He, too, suffers from depression, anxiety and suicidal thoughts.

Faisal had covid last year. He has never shaken it off. He suffers from terrible fatigue and brain fog all the time.

Maria is 42. She was in a horrible abusive relationship for a decade, but never dared go to the doctor when her partner smashed her head repeatedly against the kitchen worktop. She suffers from terrible paranoia and has just been sent to prison for possession of illegal drugs.

These people—I have changed their names—and the 1.4 million people like them really need legislation now. A brain injury Act would do five things. First, it would guarantee neuro-rehabilitation for all, bridging the gap between acute services and community services, which so many people miss out on. Secondly, it would put proper protocols in place on concussion in all sports, both professional and grassroots, and make them identical so that children who play more than one sport do not end up terribly confused. Thirdly, it would help to prevent brain injury by legislating on carbon monoxide poisoning and employers’ duties towards their staff, including in the British armed forces.

Fourthly, the Act would ensure research into the causes, effects and treatment of brain injury. It seems remarkable to me, as the child of an alcoholic mother and as somebody who has seen various forms of brain injury in my own family, that we still do not really understand how the mind sits inside the brain. We really need to invest much more dramatically in research in that area.

Finally, the Act would require that all public bodies, including schools, the police, Department for Work and Pensions assessors and the courts, be trained in brain injury. One thing that repeatedly comes back to me is that people know that their injury is not visible to everybody else. The strength of the internal agony that they might be suffering changes from day to day and from week to week. To banish some of the taboos in this field, it is essential that, when they deal with somebody in our public services, they know that that person fully understands. Amendment (e) has not been selected today—I never thought it would be—but I hope that one day we will have proper legislation in the field.

I end by paying enormous tribute to the people in the Rhondda who have been doing the mass vaccination programme. I have seen the work that they do every Friday afternoon when lots of people have not turned up: they are so desperate not to waste a single dose that they ring anybody they know to get them in. That is an enormous tribute to them.

It is always a pleasure to follow the hon. Member for Rhondda (Chris Bryant).

Like other Members across the House, I welcome the performance and incredible dedication of NHS and social care staff throughout the pandemic. In the specific context of the Queen’s Speech, I also welcome the Government’s commitment to greater integration. The NHS is a great institution full of massively dedicated people, but my observation over the years has been that it is also a series of individual institutions, all of which are tenacious in the defence of their own interests. GPs are wary of hospital trusts, community services have a separate set of interests, and so do ambulance trusts and others such as pharmacies, which play a vital role but too often do not feel engaged enough.

The integration that the promised health and care Bill seeks to bring about is exactly the right solution, in a number of fields. Technology is clearly key—not just technology at the cutting edge of diagnostics or life sciences, but straightforward stuff so that systems talk to one another and patients do not have to repeat the same set of symptoms to doctor after doctor in different settings because their records have not been passed on. That kind of frustration has no place in the 21st century and should disappear.

The biggest prize of all is proper integration between the health and social care systems. My right hon. Friend the Secretary of State is absolutely right to focus on that in one of his White Papers, and I welcome that as well, but with two caveats. This must not be a takeover by the NHS of social care. The White Paper suggests integrated care systems, which are fine, but I slightly raise my eyebrows at the proposed dual system where the NHS effectively gets its integrated decision in first and then shares it with the social care system. It is vital that social care has a voice at the table where the decisions are taken.

My second caveat is that the social care voice must be properly representative. Too often when people say, “We have consulted social care”, what they mean is, “We have consulted the local authorities.” Clearly, local authorities have a key role to play in this, but they are not the whole social care sector. There are third sector providers and private sector providers, and their voices need to be heard as well. There are 1.6 million workers in the sector—it is larger than the NHS—and their voices need to be heard.

Of course, all this will mean something only if we have a stable and sustainable solution to the social care conundrum that has defined Governments since the 1990s. On that, I want to make four quick points. The first is on funding, which lies at the root of many of the frustrations. It must come out of national, not local, taxation, and it must certainly involve extra state spending, possibly through a hypothecated national insurance increase for some people. It should also involve extra personal savings from those who can afford it, perhaps based on a small percentage of total assets rather than a flat figure for the whole country.

We need to solve the question of funding to solve this, but as well as that, we need a proper workforce plan, not just with better pay, though that is needed, but with a career structure, so that a social care career can be seen as the equivalent of a career in the NHS. The great value of social care workers should be reflected not just inside the system but in wider Government policy, including, for example, in the immigration system.

We also need changes to our attitude to housing and planning. We need to build homes so that people can live in their own homes for longer than they too often can now. Everyone prefers to live in their own home. And, fourthly, to assist that, we must do much better with technology. We need to use the technologies that are now available—it is not cutting-edge technology—to allow people to spend much more of their life in their own home, living a life in comfort before they may have to go into residential care. That is not only better for people, it is much cheaper for the taxpayer and for the families.

All these reforms are necessary if we are going to have a long-term, stable system. Along with my right hon. Friend the Member for South West Surrey (Jeremy Hunt), I have called for a 10-year plan for social care to go along with the long-term NHS plan. That is absolutely essential. It is also essential that this is the year in which we start down this path. We have talked for too long about social care: we need to act.

We are in for a treat now: one of two maiden speeches today. I remind everybody that, by convention, there will be no interventions. We are not putting the clock on the maiden speeches, but both Members have been told about the time constraints, so good luck! To make her maiden speech, I call Anum Qaisar-Javed.

Thank you, Mr Deputy Speaker. It gives me immense pleasure to be making my maiden speech during an incredibly important debate on the NHS, and it is a pleasure to follow the right hon. Member for Ashford (Damian Green). I thank my constituents for voting SNP—[Hon. Members: “Hear, hear!”]—and for bestowing upon me the greatest honour of my life by electing me as the Member of Parliament for Airdrie and Shotts. I want to take this opportunity to send a strong message to my constituents: I am here for you. I pledge to stand strong and work tirelessly for you, your families and our communities across the constituency.

I would also like to use my maiden speech to pay tribute to my predecessor, Neil Gray, and to congratulate him on his election to the Scottish Parliament. In this place, Neil showed himself to be a fierce advocate for his constituents and for social justice. I very much look forward to working with him in the constituency we now share and delivering for our community from Westminster and Holyrood.

I must confess, Mr Deputy Speaker, I am not altogether unfamiliar with this place, having had the privilege of working for my hon. Friend the Member for Glasgow North West (Carol Monaghan) some years ago. I subsequently followed my other passion and retrained as a teacher. Teaching modern studies and politics has been a delight. In fact, it was only recently that I showed my high school democracy pupils video clips of this very Chamber. It was suggested to me by a colleague that I would miss my school pupils, because no matter how rowdy they were, the House of Commons was much worse. I am pleased to say, however, that my experience so far has not confirmed that.

Some say Scotland is cold, but in Airdrie and Shotts, you will feel a warmth you will remember. The people are friendly, welcoming, honest and thoroughly decent. At the beating heart of the constituency are hard-working activists—people like Sharon Craig, who has continually championed her local community in Craigneuk, and Sarah Quinn, whose dedication knows no bounds and is making young voices heard via the Fortissat Youth Forum.

Upon entering this place, I did in fact ask for an internal map—there are lots of corridors. I was told that the best way to navigate myself through the building was to simply get lost. I must take this opportunity to thank all the House staff, who have been very kind and welcoming, even though they were telling me to get lost—in particular Kate Emms, who has been a source of guidance, and Doorkeeper Sarah Binstead-Chapman, who found me wandering while I was wishing there was a parliamentary sat-nav app.

It is fitting to make my maiden speech while we discuss the NHS. It was in fact a campaign by my SNP predecessor that kept the Monklands hospital in Airdrie. I have witnessed at first hand the sacrifice and dedication of our NHS staff, not least by my husband, Dr Usman Javed, who is sitting in the Gallery today. I take this opportunity to thank all the healthcare workers in my constituency and beyond for the sacrifices they have made this last year.

I wish to make one more plea that goes slightly beyond the NHS. The NHS would have collapsed without overseas staffing and immigrants who have made valuable contributions to this country. This may not be popular in some circles, but the points-based immigration system championed by the Government is deeply flawed. Were it in use when my father planned to come to this island, he would have been blocked and this country would have been deprived of one Member of Parliament, one doctor and one medical student—myself and my siblings. That is one of the reasons why Scotland needs independence, so that policies best suited for our people’s needs are developed and delivered by those in Scotland.

So I end my maiden speech with a plea: please let Scotland be free. In the short term, devolve immigration so that we can set policies that are reflective of the needs of Scotland.

Congratulations. My maiden speech was shocking. [Interruption.] A bit like my other speeches, I know. But yours was accomplished, so many congratulations.

May I start by saying what a pleasure it is to follow the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed)? It was an outstanding maiden speech, and we congratulate her on her success and wish her every success during her time in this House. We wish our best to her predecessor, whom many of us enjoyed chatting to on many different subjects.

I would like to begin my short speech by paying tribute to and thanking the local NHS teams in west Wales, particularly Pembrokeshire, for their outstanding work over the past 12 months, particularly the teams working at Withybush Hospital in Haverfordwest. The national health service occupies a unique place in our national life. It is an institution—more correctly, it is an idea—that fosters national unity in our society. It is an idea that is wrapped in a fair degree of mythology, and one of the key myths about the NHS today is that we have a single national health service. The truth is that we do not have a single NHS, not in a legal sense nor, increasingly, in a practical sense. If someone logs on to they will find a website with no information about any UK-wide health services, and no signposting for residents who live in Wales, Scotland or Northern Ireland—there is precious little of the UK about it at all. Increasingly, the NHS across the UK is about a different set of institutions, a different set of published core values, different policies, different approaches and different governance arrangements.

When I speak to staff in the NHS I get the sense that they genuinely believe that they are working for one integrated, unified organisation and movement, but increasingly the truth is that that is not the case. The point that I want to make is not an active devolution point at all—that is not where I am coming from—but I believe that the experience of the past 12 months has reinforced the importance of better co-ordination and communication, as well as the importance of data. An early argument made by proponents of devolution was that it would enable different policies to be tested in different parts of the United Kingdom, and there may be some truth in that. We should also recognise, however, that we have no meaningful way of judging those different policies—there is no set of UK-wide health metrics. The Nuffield Foundation and the Health Foundation both tried in the past to do studies looking at comparative data on different health services in different parts of the UK, but doing so has become more difficult given the increasing divergence that is under way.

We do not have meaningful debates about the performance of health systems in different parts of the UK, and the debate by Members from different parts of the UK is akin to cheerleading for their party if it is in power in their part of the United Kingdom. I thought the contribution from the hon. Member for Central Ayrshire (Dr Whitford), who is usually very good, characterised that. She seemed to be saying, “The NHS in Scotland is much better than anywhere else,” without any real evidence or information to back that up.

There are things that can be done to strengthen the NHS and create a more unified service without undermining the devolution settlement. I believe that we can strengthen the data sharing protocols between different parts of the system across the UK. The Secretary of State himself spoke about the importance of data. “Data saves lives,” he said. Well, we need to strengthen the way in which the NHS can communicate data between different parts of the UK. We need to improve the way we collect and publish truly comparative data across the UK. I will go even further: I would introduce a more unified inspection regime across the UK. I believe that we should develop stronger, UK-wide health standards so that it should not matter where someone is in the UK—they should have the same right to basic standards of healthcare, whether that relates to cancer care, bereavement care or child and adolescent mental health services. I do not believe that developing a more unified UK approach undermines devolution one bit.

When it comes to learning from the pandemic, I strongly welcome the Prime Minister’s commitment to a public inquiry, which must not tiptoe around the issue of the four-nations approach to the pandemic. This morning, the National Audit Office published a report about its initial learnings from the Government response to the pandemic, and talked about a mixture of devolved competencies and UK-wide competencies, but not once did it mention devolved government. If we are truly to have a meaningful inquiry we need to meet that challenge head-on and have a genuine UK-wide debate.

Thank you, Mr Deputy Speaker, for giving me the opportunity to speak in this vital debate on the NHS and social care.

I want to speak about social care, which is in the midst of a severe crisis. Tragically, 40,000 older people have died in care homes since the beginning of the pandemic. In response to this tragedy, only one sentence of the Queen’s Speech last week was afforded to fixing the care system. In the memory of those people, the Government must put in place a proper social care system that will prevent such an injustice from ever taking place again. Instead, another year goes by where the Prime Minister has nothing to say to the hundreds of thousands of older people neglected by a broken system that still denies them the care that they so desperately need. This Government have been in power for 11 years and have done nothing to act on the matter.

Over the past 20 years, there have been at least 12 Government reviews, royal commissions, consultations, and Green and White Papers, yet still we have no change. During this time, Germany, Austria, France and Japan have all solved the issue. Even the Scottish Government, under a Labour Administration, were able to institute free personal care. This Government have dodged the issue for 11 years to the detriment of the 400,000 older people who go without the care they need. This is a failure of leadership, but it is also a collective failure of our political class to solve one of the defining issues of our time by ensuring that the older generation, after a long life of hard work and contribution to our society, are afforded the dignity that they deserve in older age.

It cannot be right that more than 10% of older people spend virtually all of their life savings on care. When the Prime Minister came to office, he committed to

“fix the crisis in social care once and for all.”

Now, nearly two years on, he needs to do something to fix this problem once and for all.

When it comes to who needs access to care, it is often smokers, so we need to commit to support reduced-risk products as the best way to help people move off cigarettes. We cannot let those in deprived areas continue to suffer from further smoking-led health inequalities. We must establish two distinct categories of regulation to differentiate between the most harmful tobacco products, and the reduced risk products such as vapes and “heat not burn” cigarettes. I am deeply concerned that public health advice is not getting to my constituents. Black, Asian and minority ethnic communities must have access to the right information and advice to quit cigarettes or to move to less harmful alternatives—that could prove to be a distinct success.

As a result of these pressures, we see more and more care homes close every year, with fewer people able to find the beds they need. I urge the Secretary of State on behalf of the thousands who need help today to take two parallel courses of action. First, I urge the Government to immediately commence cross-party discussions in good faith to create consensus, not over the problems, but to find solutions. Over the past half century, at every turn, politicisation has disturbed what window of opportunity we have had available, and the adversarial nature of our politics has not solved this vital problem.

Secondly, the Government must have faith in local government, and give councils the tools and resources to build and then run a cohesive system of social care. Local authorities have performed admirably during covid-19, and have shown that they are truly capable of running such a system. We should take the lessons learned over the past 14 months and put them into action. Local government knows how to run programmes; the Government should give them the resources to do it. Acting now is not a political white flag. It is not compromise; it is showing decisive leadership. It is weak to leave this issue unaddressed. Strength is acting to save lives, and the dignity of everyone forced into the arms of social care. The Prime Minister is—

Order. I am sorry, Virendra; you have just run out of time. I do apologise. No offence is intended.

I call Robin Millar to make his maiden speech.

It is a privilege to rise and speak in this debate, and indeed a pleasure to follow the hon. Member for Ealing, Southall (Mr Sharma). I must say it has been a particular pleasure, too, to listen to speeches in this Chamber for the past 17 months, and I am humbled by the eloquence, the learning, the quick humour and concerns that hon. Members across the House bring to debates such as these.

My predecessor, Guto Bebb, was a man who followed his principles. As a Back Bencher, his campaign on interest rate swaps led to 11 bully banks paying out more than £1.5 billion in settlements to more than 15,000 businesses. He went on to become a Parliamentary Under-Secretary of State for Wales and then Minister for Defence Procurement. In short, he was a three-time winner of general election campaigns, a two-time Minister of State and an effective advocate for the exploited. He earned the respect of colleagues and opponents and secured the affections of his office team. Those are considerable accomplishments, and they have guided me since entering the House, so it is a pleasure to recognise them with these few words today.

I was born and raised in north-west Wales. That is where I learned the importance of family, where I found my Christian faith, and where lifelong values were formed. It is also where I had my first political experience, as a six-year-old in 1974, campaigning for the late Wyn Roberts MP, more recently Lord Roberts of Conwy. Even now I remember his campaign cry of “Win with Wyn”, and I still proudly wear the campaign rosette he gave me to thank me for my decisive contribution to his successful re-election campaign that year.

In Wales we have a word, cynefin, which loosely translates as habitat; but it means much more than that, and carries a sense of belonging and being in the right place. So, although I left family and home for education, a career and for love, it was perhaps inevitable that I should return to Wales and end up in politics. To be sent to Westminster by the people of Aberconwy is a very special personal honour and a great privilege, and I will do all I can to repay the trust and the confidence they have placed in me.

For centuries the beauty of Aberconwy, its heritage and culture have drawn visitors from around the world, including many hon. Members from this House. Many who have come have stayed, and the houses they have built tell a fascinating story of ambition and influence, dispute and resolution. The Victorians enjoyed our seaside towns and villages so much that their houses line the promenades from Llanfairfechan to Llandudno. The Groes Inn on the shoulder of the Conwy valley is the oldest licensed pub in Wales, and has been a place of rest and refreshment for weary travellers since 1573.

Each of the castles of Aberconwy, along the Conwy valley—Deganwy, Conwy itself, Gwydir and Dolwyddelan —offer different perspectives on our rich history of English kings and Welsh princes in their mountain passes. Further up the valley and deep into Snowdonia—or Eryri, as we call it—is Tŷ Mawr, the house of Bishop William Morgan. His translation of the Bible into Welsh not only saved the Welsh language but changed the history of Wales, and it serves as a testament to the relevance of timeless truths to us today in this place.

These are rich seams, and points that I will return to another day, but the subject of today’s debate is the Health and Care Bill and Her Majesty’s Gracious Speech. The UK has a growing and ageing population. Around 18% are over 65 years old, but in Aberconwy that figure is closer to 27%. While there is no cure for old age yet, the challenge that we face is to reduce the burden of care and help ensure longer, better lives. So I support the Prime Minister’s aim to give every older person the dignity and security they deserve. On this one point I will make a simple observation.

This UK Government ensured that residents in all parts of the UK could benefit from the furlough scheme and receive financial relief at a time of crisis; this UK Government ensured that residents in all parts of the UK would benefit from a world-leading and lifesaving vaccination programme; and this UK Government can use the Health and Care Bill to ensure that residents in all parts of the UK will have access to consistent minimum standards of healthcare.

While residents of Aberconwy in north Wales are served by the gifted and hard-working professionals of Betsi Cadwaladr University Health Board, it was in special measures for six years until just a few months ago. Workers there have coped superbly with the pandemic response and are delivering hundreds of thousands of vaccines, yet some 6% of residents in north Wales have been on a waiting list for treatment for over a year. These are UK residents, they need the support of their UK Government, and this Bill, surely, is an opportunity for us to enable that support.

That is just one of the challenges we face in Aberconwy. We must build back a balanced economy, improve our road, rail and telecommunications links, develop green energy schemes, tackle flooding, and more. But whether on climate change, public service finance, social care, national security, our economy or international trade, these challenges are best faced together. I believe that our United Kingdom is the best response to the global challenges we face today. I do not underestimate the difficulty of building solutions across political parties and Parliaments, but we must strengthen the ties that bind us to best serve those we are here to represent.

Congratulations, Robin, and thank you for the Welsh lesson on “cynefin”. I used to see it outside houses in Swansea and always wondered what it meant, so now I know.

We are now going to a three-minute limit on speeches. I call Munira Wilson.

This Government, with their 80-seat majority, are in an enviable position. They could put forward an ambitious and visionary plan to improve the country’s health and wellbeing and put social care at the forefront of their agenda. Yet here we are, following the biggest health crisis in 100 years, at a watershed moment, and the Queen’s Speech presents us with a Government who prioritise unnecessary and discriminatory legislation to introduce voter ID over ensuring that people can get the care that they need and over ensuring that we have a plan to train the next generation of doctors and nurses whom we will all rely on. What a waste of a precious opportunity of a mandate to bring about transformational change to the quality of British citizens’ lives.

Just nine words in the Queen’s Speech were devoted to social care, despite the Prime Minister’s promise on the steps of Downing Street 22 months ago to

“fix the crisis in social care once and for all”,

and there is still nothing on unpaid carers. Instead, reform keeps being kicked into the long grass for this overlooked and critically important sector. Although it is welcome that the health and care Bill seeks to improve integration between health and social care, it does not address the fundamental issues facing our care system in terms of structure, workforce and funding—problems that were highlighted so tragically through the pandemic. Ministers need urgently to commit to cross-party talks. They have a clear choice: to leave a lasting legacy or be responsible for an abject moral and political failure on one of the biggest public policy challenges that this country faces.

If the Prime Minister really wants us to believe that the NHS is safe in Conservative hands and that he genuinely cares about social care, then we need urgent action to ensure that we have enough doctors, nurses, carers, physios and other healthcare professionals both in the short and the long term. In 2019, there were about 100,000 full-time-equivalent vacancies in the NHS, and after a gruelling year, as we saw only yesterday with the nurse who treated the Prime Minister when he was in intensive care, many are needed. They are burnt-out, stressed and fed up of their good will being taken for granted.

With record waiting lists for both physical and mental health treatment, we clearly need some short-term solutions, but we must not shirk the long-term challenges. These shortages predate the pandemic. The Liberal Democrats support calls from the Health and Social Care Committee for a transparent and independent annual workforce report, with requirements for future staffing that cover the next five, 10 and 20 years and regular updates to Parliament on progress and resourcing. I implore the Minister to think big and not to squander this unique opportunity to bring about lasting, positive and long-term change in our health and care services and to improve the wellbeing of the British people.

I congratulate my hon. Friend the Member for Aberconwy (Robin Millar) and the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) on their excellent maiden speeches. Whether it takes 17 months or less than seven days to make a maiden speech, we have seen two politicians on both sides of the Chamber who have come to this place to represent their local constituencies and get things done and who are passionate about really making a difference; I am sure that they will both do that in their respective roles.

It is a pleasure to speak in today’s debate on the NHS. What our NHS has done over the last year is nothing short of remarkable. In Scotland, England, Wales and Northern Ireland, our NHS staff have risen to the enormous challenge that they faced with this global pandemic, and they have responded in such a magnificent way.

Because time is short, I want to focus on my local area of Moray. Moray is one of two local council areas in Scotland that, sadly, did not see an easing of restrictions in the last week. While the rest of mainland Scotland moved from level 3 to level 2, and the islands thankfully moved to level 1, Moray and Glasgow remained in level 3. I am very optimistic that, at the end of this week, Moray will come out of those restrictions. I would say to anyone watching that, hopefully towards the end of this week, Moray will once again be open for business, and I know that our tourism and hospitality sector is ready to welcome people back to our wonderful area. We are only in such a positive position because of the response from our local NHS staff.

One of the keys to getting our spike in cases down has been more testing, rapid testing and an increase in vaccinations. I went along to the Fiona Elcock vaccination centre in Elgin on Sunday and was amazed by the professionalism of the staff and how they have converted a former Topps Tiles shop into a vaccination centre that is even allowing people without appointments to walk up and get a vaccination. We now have 85% of our population in Moray vaccinated with their first dose in response to the spike in cases, and 20% of those have been vaccinated in the last few weeks. That is down to the hard work of Alison Smart and her team in turning that derelict retail unit into a vaccination centre.

Every single member of NHS staff, the Elgin Rotary Club team who are volunteering and everyone involved in that operation have done an outstanding job. As I walked out, Edith Campbell asked me whether there was any way that I could highlight the great work they were doing, and I thought, “Yes, I can.” So today in the House of Commons, I thank Edith, Alison and everyone at the Fiona Elcock centre for what they are doing to get Moray back on track. That is just one example of how our NHS has gone above and beyond to get us out of this crisis.

For a few glorious moments at the start of the debate, I thought that I might have five minutes, but this will be the abbreviated version of my speech.

First, I want to touch on social care. Many Members have mentioned the value and importance of social care in this pandemic, which has really brought out the value of the people who provide social care and the importance of doing so. It is disappointing, therefore, to see no concrete plans being brought forward. We need a plan for social care that looks at not only caps on care costs but properly resourcing and valuing social care workers and giving them parity of esteem with NHS staff. I would also like to mention the role of unpaid carers, who have done so much to support people through this pandemic.

Secondly, I would like to look at the NHS and say a big thank you to all its staff. They deserve so much more than the 1% that the Government are suggesting is appropriate. We have seen a tremendous response from the NHS, but we know that there is a great deal of catch-up to do to ensure that people are followed up. So many organisations have contacted all of us, I am sure, about that. This morning in the all-party parliamentary group for respiratory health, we talked about the importance of catching up on lung cancer tests; it is the same with breast cancer tests. I also want to draw attention to the need for mental health treatment to be improved and caught up with, as too many people have lost out.

I turn briefly to public health. I heard the Secretary of State talk about public health, but we need not just talk, but action and funding. The pandemic has shown the real value of public health, which we know lies behind so many other issues. It is important that we have an effective local public health system. That links to my next point, which is really about child poverty. End Child Poverty has today produced a set of figures that sadly shows that child poverty has increased in the north-east, where my constituency is. More than 4,300 children in my constituency are living in poverty. That must be addressed. We need to retain the £20 universal credit uplift, expand it to legacy benefits and focus on child benefit.

There is so much more that I would like to say about planning reform and accessible housing, but I do not have time. I end by commending the hon. Member for Aberconwy (Robin Millar) on his maiden speech, which showed that he knows his constituency well and cares about it; I wish him well in his future career.

Mr Deputy Speaker, with your ceiling of three minutes, I am going to focus on one aspect of one Bill—namely, the proposal to change the approach to the fluoridation of community water supplies. I am a dentist and a member of the British Fluoridation Society. It is therefore with considerable enthusiasm that I support the proposed change of the procedure for introducing fluoridation of domestic water supplies. Our western nation comparators have between 60% and 80% of their domestic water supplies fluoridated. This country has a shameful 10%.

When I first came to this country as an ethnic minority immigrant, I worked in the national health service in a deprived area of London. I was appalled by the general state of my patients’ teeth, particularly by the state of children’s teeth. Trying to maintain children’s dentition was and still is, as a colleague put it, like trying to fill a bath with the plug out. Far and away the biggest reason for referral of children for general anaesthetics to hospitals in England is to remove rotten teeth. In 2019, hospitals throughout England carried out an average of 177 operations a day on children and teenagers, just removing decayed, rotten and abscessed teeth that should not be in that state. The annual cost is more than £40 million.

Tooth decay is essentially highly preventable. Water fluoridation is the single most effective public measure that could be taken to prevent tooth decay. Implementation of fluoridation is in the powers of the local authority, but little progress has been made since that was introduced in 2013. The costs are to local councils and the cost benefits are to the national health service. The process of consultation is lengthy and tedious, and it is enabling a platform for protestors of the same genre of the anti-vaccination people.

On a more practical point, there are considerable difficulties for both the local authorities and the water companies in that their boundaries are rarely, if ever, coterminous. It makes eminent sense for the implementation process for new schemes of fluoridation to be put in the hands of and driven by central Government. In doing so, I hope the Government will curtail the procedures on consultation, as they only permit continuous reception and repetition of scaremongering stories from people who are basically cranks.

The safety, efficiency, cost-effectiveness and benefits of fluoridated water supplies, whether natural—and they are in many parts of the world—or as an additive, have been proven worldwide for what must be approaching 100 years. With this proposed step and Government determination, rather than lagging behind the rest of the world, we could actually lead.

Mr Deputy Speaker,

“we will fix the crisis in social care once and for all, and with a clear plan we have prepared”.

I am not the first to quote the Prime Minister’s words as he took office and I am sure I will not be the last, and of course I recognise that the Prime Minister has a loose relationship with the truth and a willingness to make commitments with no intention of honouring them, but the Health Secretary has said that the Government will bring forward proposals this year, with the Prime Minister now claiming that he wants cross-party working to develop a plan. I hope he means it, and that there will also be real engagement with those in receipt of care, those who work in care and the hundreds of thousands of unpaid carers.

The pandemic has shone a spotlight on the crisis in social care, but the failure of the system has been clear for a long time. In developing a new approach, we must have real ambition, as our predecessors did in establishing the NHS, with an entirely new model, not just tinkering with payment mechanisms, and viewed in the same way as the NHS, with a comprehensive system of high-standard residential and domiciliary care that ensures no one is denied support because they cannot afford it.

We should take the same approach to those who work in the system, raising the status of carers to that of other healthcare professionals, and training them, supporting them and, crucially, paying them in a way that reflects the critical nature of their work. Of course, it will be expensive, but we need an honest national debate about the costs of reforming the care system and how we pay the price, not branding proposals as a “death tax” or a “dementia tax”, or talking about unaffordability.

We should also recognise that, however good the system, there will always be an important role for unpaid carers, and they must be recognised in the plan too, not cast adrift. According to the Carers Trust, the number providing over 50 hours’ care a week has more than trebled in the past decade, but only one in 10 says they have enough support. They need that support, they need respite and they deserve an adequate carer’s allowance.

We must also do more specifically for the invisible army of young carers—extraordinary children and young adults with huge resilience and strength, facing all the demands imposed on adult carers with the added challenges of schooling and making the most of their young lives. Ministers should act now to require schools and GPs to identify young carers and point them to the support they need, which we must ensure is available in every part of the country.

A Green Paper was newly published in 2017 and in almost every year since. The limited mention of social care in the Queen’s Speech suggests the Government are delaying again. It is not good enough. Millions of people are looking for better. We need a real commitment to act.

There is time enough today to focus on two things: first, a suggestion about how Members of Parliament can work most efficiently with their local NHS trusts; and, secondly, a look at hypothecation—in other words, a dedicated fund to help boost the ways of funding health and care in the future.

It is now 14 months since the leaders of the three NHS trusts, our director of public health, the leader and chief executive of our county council and the six Members of Parliament for Gloucestershire got together virtually—every week, and more recently, fortnightly—to cover all the issues involved in the pandemic. During this process, we have all had a much better understanding of the immense debt we owe them and their staff, GP surgeries and volunteers for all they have done to give my constituents in Gloucester and across the county a service and a vaccination that has given people reassurance and confidence, and I am very grateful for that. I believe that there are opportunities for other parts of the country to benefit from a similar form of partnership, because this resolves problems faster, acts as an early warning signal back to Government, communicates more effectively with our constituents and, ultimately, saves us all a lot of time in helping to get things done.

The second thing I would like to highlight, because inevitably we are going to need more money if we are to resolve the issue of social care, is the possibility of hypothecation. In March 2017, I wrote a paper for the then Chancellor the Exchequer, laying out the case that I and the then hon. Member for Grantham and Stamford made for using hypothecation as a means of linking increases in taxation directly to improved health and social care services. At that time, the Chancellor had already said to us that he would only look at it in more detail if we could find a reputable think-tank to advocate for it, as well as us. We therefore encouraged the King’s Fund to write a report, which it did, recommending hypothecation. The former permanent secretary of the Treasury, now Lord Macpherson in the other place, also agreed that this would be a huge step forward. The reason is this: ultimately, the national insurance fund is not used to insure anything or anyone in particular, but were it to become a health and care fund, with the self-employed and the employed contributing equally, and those who have passed retirement age also contributing, then there would be an opportunity for our constituents to realise that additional taxation into the fund would help them and their families.

This is a Queen’s Speech that lacks the ambition to deliver the transformative change that our country needs and wants. Despite repeated promises, the Government have no plans for how to fix the biggest challenges facing our country today. They have no solution to the rising problems of insecure and low-paid work, they have no solution to address the ever-increasing backlog of treatment needed in the NHS, and they have no solution to tackle the climate emergency. Nowhere is this lack of ambition clearer than on social care.

More than 10 years after the Conservatives entered Government, they still have no solution to the problems facing our broken social care system. Since 2017, the Conservatives have promised 10 times to bring forward proposals for social care and every time they have broken their promises. This continual kicking the can of reform down the road is letting down the people who need care: unpaid family carers and care staff. People deserve to be able to access care to support them to live independently in their own homes for longer, supported by care staff who are paid at least a real living wage. Instead, they face rising charges for care services, shrinking support packages, wage freezes for care staff and no respite for unpaid carers. A Health Minister told me in a debate I led on a carers strategy that only 45,000 carers had received respite care in 2019-20. That is a disgraceful record from the Government when there are now 13.6 million unpaid carers.

The Secretary of State said earlier that the long-promised reforms to mental health law will come in the next Session, rather than this one. We are coming up to the 10th anniversary of the revelations of abuse at Winterbourne View and the Government have failed dismally on the promises they made to close abusive in-patient units and support people to live in the community. Delaying to the next Session will mean two more years in abusive settings. I call on the Secretary of State to bring forward new legislation in this Session, so we can finally change this appalling situation.

With our Greater Manchester Mayor Andy Burnham, we have seen the difference that radical local government can make to people’s lives, with action on homelessness and radical plans to create a public transport system that works for everyone. Instead of building on those plans to deliver transformational change, the Government are content to let people down with this thin Queen’s Speech. Rather than giving our hard-working nurses and doctors a real pay rise to recognise the work they have done this year, they are tinkering with NHS structures and handing more powers to the Secretary of State. Rather than bringing forward plans to ensure older and disabled people can continue to live in their own homes, they are once again kicking the can of social care reform down the road. Rather than bringing forward legislation to protect people at work and end the appalling practice of fire and rehire, they are seeking to roll out unnecessary voter ID legislation. The people of this country deserve better and I urge the Government to change their approach, live up to their promises, and deliver the real change this country needs.

It is a real pleasure to be called in this important debate on the NHS in the Queen’s Speech. I join others in paying tribute to the amazing effort of NHS and social care staff in South Suffolk: all the staff at Colchester, Ipswich and West Suffolk Hospitals, our care homes, and the community pharmacy and vaccine teams in primary care who performed such an extraordinary job. Finally, I would particularly like to mention those volunteers who were standing in the snow of winter when we started the vaccine roll-out to help us to achieve what is basically a miracle of delivery of the vaccine. It should make us all proud of the NHS and proud, frankly, to be British.

I just want to make one key substantive point today, given that we are talking about a Bill that will reorganise the NHS: however we do that, we must maintain diversity of provision. I will refer to three key areas. The first is community pharmacy. I am a great fan of community pharmacy. It does a huge amount already, but it has earnt its spurs during the pandemic, giving out over 3 million jabs to date—more than the entire population of Greater Manchester. I have seen in my constituency how community pharmacies can really make a difference. My constituents have chosen them as their preferred place to receive a jab and it shows what more they can do. We must give them a deeper role in the delivery of healthcare in this country.

The second part of this is the voluntary sector, and I am thinking in particular of mental health. In Norfolk and Suffolk we have a struggling mental health trust, but when constituents have come to me with mental health problems in my surgeries—this was pre-pandemic— and I have been able to refer them to local mental health charities, they have often achieved great improvement in their mental health. Ed Garratt, the brilliant head of our local clinical commissioning group, supports this. We should look at more of the funding that goes to our NHS trusts going directly to those charities so that they become part of mental health capacity.

Finally, we should talk about the independent sector, and on this point I come back to my two earlier interventions on the shadow Secretary of State, because it was extraordinary what we heard today. As I said, Ipswich Hospital was able to double the number of ICU beds it had by moving cancer patients to the local Nuffield hospital. If someone was ideological enough to say, “We won’t work with the independent sector,” they are literally denying that capacity to people who use the NHS and saying, “You can only pay for it.” That is an extraordinary political point and it shows that the Labour party has not moved on from the depths of its dogma. We should deliver the best possible outcomes within the universal NHS, and that means diversity of provision at the heart of its delivery.

I join the hon. Member for South Suffolk (James Cartlidge) in thanking the NHS for all the work it does, but I would ask him to look at the cost of using the private sector, because the lesson we have learnt in London is that it is not always the best value for money.

In the short time available to me, I wish to speak to amendment (g), which is about the groups of people who have been forgotten in this Queen’s Speech. If we do not speak for them in this place, nobody else will. I am talking about some of the most vulnerable people in our communities, particularly children who have been orphaned and victims of domestic abuse. They are people for whom the courts in this country have spoken. I am sure everybody in this House would agree that if we do not uphold the rule of law, how can we ask constituents to do so? Sadly, the Government have yet to act on those court rulings.

Let me tell the House about these two particular instances. Every 22 minutes in this country, a child loses a mother or father. It is estimated that 26,000 children become orphans each year. I know that stat from the Child Bereavement Network, not because this country monitors that—we monitor how many children might be affected by divorce, but we do not recognise death as damaging for children, yet we know that clearly it is. It is estimated that 2,000 families a year who find themselves in that horrific situation—many more will have done so because of covid—are not then eligible for financial support, and the reason for that is very simple: the state has decided that, because their parents are not married, those children must be pushed into poverty. It is estimated that 3,000 children a year—eight children a day—find themselves losing a parent and then possibly losing their home or family circumstances.

The courts said in 2018 that it was wrong to deny children in that situation that funding. In 2020 the Jackson ruling made that point again. Children, such as the children of Joana and Ros in my community, are being divided simply by whether their parents were married or not. The Government know that they have to remedy this situation, because otherwise we are punishing children for the decisions that their parents have made, and I do not think anybody in this House would want that. Let me be clear what remedying it means. It means making sure that we put this right for every child and every family in this situation, including those who brought the court cases, and making sure that no family is punished by the tax or benefit system, by having that money put right.

This is not just about those children; it is also about the domestic violence victims who are paying the bedroom tax because they have a panic room in their house. Again, the courts told us several years ago that this was wrong and that the Government should act, but they have not yet done so. Let us be clear about what remedying that means. It means helping those already affected, who have spent years struggling as a result, so that whenever regulations are made, they do not have to pay this. I ask the Minister to think clearly about those people, who need our voices in this House to ring out loud and clear. We have 54 MPs across the House backing this amendment, saying, “Let’s get it right now.”

I welcome the measures set out in the Gracious Address to deliver the national recovery from the pandemic, which will make all the United Kingdom stronger, healthier and more prosperous than before. I welcome the fact that this Government are pursuing an agenda that will be for all parts of the United Kingdom, including Scotland and my constituents in the Scottish borders.

It is also clear from the Gracious Address that the Government are committed to the Union. I welcome the measures to enhance transport infrastructure, with investment promised to improve connectivity within the United Kingdom. I look forward to seeing more detailed plans in due course, but for my constituents in the Scottish borders there are exciting opportunities to improve cross-border transport links: by getting the borders railway extended to Hawick and Newcastleton and on to Carlisle, and by upgrading the A1.

A theme of today’s debate is the NHS and social care. It is important for me to pay tribute, as others have done, to those across the NHS who have worked tirelessly to deliver the national vaccine roll-out—nurses, doctors and many others within the NHS family have been working incredibly hard to get jabs into arms as quickly as possible. We have been leading the world. We should also recognise the efforts of UK Government Ministers, who have secured a robust profile of 450 million coronavirus vaccines for all the United Kingdom—something from which Scotland has undoubtedly benefited. This weekend, I will proudly roll up my own sleeve and finally become part of the daily statistics, receiving my vaccine at the Borders Events Centre in Kelso. It is worth pausing to reflect that the SNP Scottish Government would have preferred Scotland to have been outside the UK-wide procurement scheme and part of the EU vaccine process instead.

The SNP’s desire to be outside the UK leads me to the conclusion of my contribution, but before I finish I want to congratulate my colleague and friend Rachael Hamilton MSP, who was re-elected to the Scottish Parliament last week. We should also recognise my hon. Friend the Member for Moray (Douglas Ross), leader of the Scottish Conservatives, for his achievement in the election. He took over the leadership in August last year, and in that short period he has dedicated himself to stopping the SNP majority. Many in the press thought that he could not outperform our previous best ever Scottish election performance in 2016, achieved by Ruth Davidson. But not only did he secure 31 Scottish Conservative MSPs last week; he also attracted 100,000 additional Scottish Conservative votes. Crucially, he stopped that SNP majority and a mandate for a second independence referendum.

The SNP went into the election saying that securing a majority would give it a mandate for a referendum; Scottish voters thought otherwise. It should be focusing not on a referendum but on the day-to-day priorities that matter most to Scottish voters: the education system, the NHS and all the other pressing issues that need to be resolved. I congratulate my hon. Friends in the Government for producing this programme for government, and I wholeheartedly support it.

As you will be aware, Mr Deputy Speaker, this is Dementia Action Week. I am co-chair of the all-party parliamentary group on dementia. In conjunction with the Alzheimer’s Society, we are arguing in the #CureTheCareSystem campaign that there is a desperate need to reform social care. While covid cases are going down in most places in the UK, dementia cases are only going to go up. By 2040, it is estimated that well over 1 million people in the UK will have some form of dementia, with a cost to the economy of £94 billion.

During the pandemic, people with dementia have been the worst affected. Figures from the Office for National Statistics show that more than one in four of those who have died from covid also had a diagnosis of dementia, making dementia the most common underlying condition among those who have died from the disease. We know that the number of excess deaths of people with dementia—those not with a covid diagnosis—was about 5,000 higher than in the previous year.

There are a number of reasons for these data. The Government did too little to protect care homes at the height of the pandemic. Hospital patients were quickly moved from hospitals to care homes, all without testing, spreading the virus amongst vulnerable residents. There were also problems in accessing PPE and testing for care staff. Many of us can remember cases of care staff using bin-bags as aprons, or having to make round trips of hundreds of miles to access testing.

The second cause of the excess deaths has been the worsening of people’s conditions, primarily because of the isolation that many have experienced and the lack of ability to use basic skills, such as speech, which they are at risk of losing. For people with dementia living in the community, it is estimated that family and friends have provided an extra 92 million hours of care during the pandemic.

People with dementia and their carers need more than warm words. They need action to address the dementia premium in care home fees. On average, someone living with dementia or their family will pay £100,000 for their care. For them, for their carers, and for the dementia moonshot, we needed much more from the Government in the Queen’s Speech. With the Government’s proposed integration of the NHS and social care in their new Bill, the principle that healthcare and social care should be provided universally and free at the point of need is fundamental. I argue that it should be provided through progressive taxation.

Finally, on health inequalities and the UK’s appalling, high and unequal covid death toll—driven, as Professor Sir Michael Marmot has said, by the key causes of rampant poverty and inequality, a decade of austerity, the underfunding of the NHS and a political culture that fuels division—I repeat my challenge to the Health Secretary and the Prime Minister to adopt Sir Michael’s covid review recommendations and build back fairer.

I welcome the Government’s health service proposals in the Queen’s Speech, the unprecedented commitment and support to the NHS during the pandemic, and particularly the Government’s continued commitment to the hospital building programme, which has resulted in promised commitments to Kettering General Hospital of £46 million for a new urgent care hub, £350 million in health infrastructure plan 2 funding for 2025 to 2030, and a write-off last year of £167 million of trust debt at the hospital.

However, the Minister will know that promises are one thing and delivery is another. I know that as hospitals Minister he has the words “value for money” imprinted on his mind. In that vein, may I press him on the value for money that the Kettering General Hospital redevelopment offers? The problem is that at the moment the hospital faces two funding streams—£46 million for the urgent care hub and £350 million for the phased rebuild—but they are not yet meshing together. Building the original urgent care hub is no longer an option on a stand-alone basis, because there would not be enough room on the hospital site for the health infrastructure plan funding that follows.

The value-for-money solution is to integrate the two funding streams. The best way to do that, which I commend to the Minister, is to designate Kettering General Hospital as an early progress project in the hospital building programme. Kettering General Hospital is ready to go: it owns the land, so no land deals are required and no extra public consultation is needed, and it already has written support from local planners and the regional NHS. This is a phased approach that would deliver visible and real benefits, is shovel-ready and has far lower risks than other hospital build projects.

In developing the whole site plan, the hospital has identified the best way of delivering value for money to get these buildings up and operating, serving local people. Will the Minister look closely at Kettering General Hospital so that Kettering people can have the long-awaited hospital rebuild that we have long been promised and that will be so valued in the local community? The Department needs to be flexible in its funding streams. Let us have an early advance of the HIP2 funding and permission to mesh it with the £46 million for the urgent care hub. We can then have the hospital that Kettering will be proud of for the future. The decision lies in the Minister’s hands.

Wythenshawe Hospital in my constituency is built on the site of Baguley sanatorium, which opened in 1902 to lead the way in tuberculosis treatment, planting the seeds of the excellent heart and lung unit at the hospital now. Those specialisms have been joined by an internationally recognised burns unit, by the fabulous Nightingale Centre breast unit, and recently by a world-class A&E facility after a campaign championed by my late, great predecessor, Paul Goggins.

Last week, the Government announced ambitions that the UK will lead the world in life sciences. I share that ambition and, with co-operation from Government, Wythenshawe and our hospital can be in the vanguard. Wythenshawe Hospital’s strategic regeneration framework sets out a vision for the campus, which will be supported by a world-class research and innovation business park alongside a redeveloped, modern and inviting hospital. Great companies such as Chiesi and Hologic are already based in my constituency. There is now an opportunity, with the SRF, to ensure that the fabric of the site reflects the world-class services at the hospital and the exciting prospect of leveraging the medical park to help Manchester and Britain to continue to be a world-class leader in life sciences.

Inward investments, high-skilled jobs and life-saving research are now more important than ever. The Minister will be pleased, I am sure, that I am not asking today for a pot of public money for this redevelopment. The cherry on top of this masterplan is that it will require no funds from Treasury. In fact, it can be funded on site with the correct commercial partners. I am so proud of this project, and I really wish to discuss it with the Minister at some stage in the near future. We need a mechanism from the Treasury to allow the vision to be realised and Wythenshawe Hospital to become the 21st-century leader in healthcare, research and innovation that we know it can be.

It is a pleasure to rise in support of the Queen’s Speech today. The past year has highlighted the challenges facing our health and social care systems, and I welcome the Government’s legislative agenda, which will tackle some of the most pressing issues. In the short time available, I will focus on three issues: plans to tackle obesity, the potential benefits of UK-wide comparable healthcare data, and the need for better access to, and choice of, secondary and tertiary healthcare for the residents of north Wales.

In the UK, 63% of adults are overweight or living with obesity. This places an enormous strain on the NHS, reduces quality of life and stifles economic productivity. The Government have a clear agenda to tackle obesity, and I welcome, among other measures, the confirmation of a total online ban and a 9 pm TV watershed for the advertising of high-fat, salt and sugar products. The commitment to legislate for calorie labelling in cafés, restaurants and takeaways is also welcome. Although I acknowledge certain concerns on behalf of those with eating disorders, I believe this policy will have a clear net benefit for our national health.

Can progress also be made on introducing calorie labelling for alcohol products? I am in no way anti-alcohol, Mr Deputy Speaker, as you know—in fact, I am a proud member of the beer, and wine and spirits all-party parliamentary groups—but I believe that there is currently poor awareness that alcohol consumption is a significant contributor towards our national obesity crisis. An alcohol calorie labelling programme would be a useful tool to enhance the plans already outlined in the Queen’s Speech.

The availability of comparable data on covid infection rates and vaccination roll-out throughout the country has been a key driver in our response to the pandemic, yet looking at healthcare more broadly, comparisons between England, Scotland, Wales and Northern Ireland can be difficult to draw. My personal experience as a GP, anecdotal evidence and basic comparisons indicate that, despite the hard work and commitment of health staff, patients in Wales often receive inferior levels of service when compared with their friends in England.

By introducing UK-wide health data, politicians at all levels will be held to account, practitioners and policy makers can better share best practice, and, ultimately, equal health outcomes will be promoted. Such an approach would be complemented by the establishment of independent UK-wide healthcare inspection, safety and audit mechanisms. In short, we have opportunities that I believe we must seize to level up healthcare. I ask the Minister to consider what the UK Government can do, beyond the legislative programme already announced, to protect and promote the health of all British citizens.

I am looking forward to seeing the progress of the health and care Bill. I hope that, as part of the legislative process, the Government will consider the challenges that Welsh patients currently experience, whereby access to specialist healthcare treatment in England is typically dependent on restrictive contracts or individual funding requests. Improving access to specialist care—

A recovery plan for the NHS and social care is urgently needed. Almost 5 million people in England are waiting for NHS treatment, and a quarter of people with mental health problems are having to wait months to get help. NHS staff are exhausted from battling coronavirus, and there are nearly 90,000 vacancies across the NHS in England. Social care is in crisis following over a decade of savage cuts by the Conservatives, and 1.5 million older people are not receiving the social care support that they need. Care workers, many of them paid below the real living wage, have been working in extremely difficult circumstances.

However, instead of addressing these issues, the Government have come forward with a damaging White Paper that says very little on care but proposes a major reorganisation of the national health service. To do so at a time when staff are exhausted and millions are waiting for treatment is reckless and irresponsible. It is not acceptable that the Government have not carried out a consultation on their White Paper, and Ministers have failed to communicate the impact that the changes would have on patients and staff.

It beggars belief that the Secretary of State said on Monday that his proposed reforms would help to deal with the backlog. Nothing could be further from the truth. Sir David Nicholson, former chief executive of NHS England, has warned that the Government’s impending shake-up of the NHS could prompt a lot of staff already exhausted by covid to quit.

The Government’s damaging plans to put 42 integrated care systems across England on a statutory footing, with each ICS setting its own plan for health and social care, would embed a postcode lottery, with the health and social care services that people could access varying depending on where they live. The plans would open up the opportunity for private companies to have a say in what health and social care services are provided in an area, and the very same private companies could potentially then provide those services, representing an opportunity for huge conflicts of interest. The plans would also give the Government the power to remove a profession from regulation, with potentially serious implications for patient safety and for the employment status and terms and conditions of workers.

Professor Kailash Chand, honorary vice-president of the British Medical Association, said:

“The core thrust of the new reforms is to deprofessionalise and downskill the practice of medicine in this country, so as to make staff more interchangeable, easier to fire, more biddable, and, above all, cheaper.”

The plans would also allow the discharge of vulnerable patients from hospital before they have been assessed for continuing healthcare, leaving patients at risk and families to pick up the pieces. The Government’s plans would create immense uncertainty for NHS staff and open the door to widespread cronyism and increased privatisation.

On Monday, the Secretary of State told me that my party’s Front Benchers welcome the reforms. He is wrong. Labour’s Front Benchers have not welcomed these reforms. He really should get his facts straight. I call on the Government to pause the whole process of their reorganisation of the national health service until after all covid restrictions have been lifted and they have carried out a full public consultation, so that patients, NHS staff, care workers and unpaid carers can have their say on the proposals.

I wish to put on the record my support for a robust strategy to tackle obesity, but I question plans to ban broadcasters and online platforms from advertising food and drink that are high in fat, sugar and salt before 9 pm. If the Government are going to have any form of impact, even foods that we consider to be health foods will be covered by the ban. Eggs, cheese and avocado—the list of foods that include those items is endless.

Let us take a look at the ramifications of a ban on TV commercials. I started my retail career with the Pizza Hut chain of restaurants 40 years ago, which is probably long enough ago for me not to have to declare an interest today. Before the pandemic, the UK’s three biggest chains, Pizza Hut, Papa John’s and Domino’s, got 90% of their sales of pizza online and from apps such as Just Eat, Deliveroo and Uber Eats. That is 60,000 jobs directly at risk and tens of thousands more in the supply chain, and that is just three companies in the UK. Do the Government seriously consider that a price worth paying?

Similarly, let us look at breakfast cereals. Under these proposals, we will ban the advertisement of some of our everyday breakfast items. The ironic thing is that over 50% of breakfast is no longer bought from a supermarket, but from cafés and greasy spoons around the nation. That immediately puts at risk major brands such as Kellogg’s, which have spent millions of pounds reformulating their products to reduce fat, sugar and salt, yet under the proposals they will be banned from advertising them before 9 pm. Meanwhile, our mainstream TV companies will lose out on approximately £75 million to £100 million of advertising revenue—revenue on which tax is paid in this country.

The Sun reported in March that the Government were considering doing a U-turn on banning online adverts, as evidence showed that it would have little effect. That has instantly created a chasm between mainstream broadcasters and online platforms that contribute little to the financial wellbeing of the nation because they are offshore companies. Millions of small businesses rely on online advertising to promote their businesses in this country, including in Calder Valley. There is absolutely no evidence that the proposed blanket ban for mainstream broadcasters and online advertising would make one iota of difference to reducing obesity, and I urge the Government to rethink these draconian measures.

I want to begin by thanking NHS colleagues from University College London Hospitals and from services all the way up to Scotland, including in my Kirkcaldy and Cowdenbeath constituency, for the incredibly hard shift that they have put in over the last year. The warm words of the Prime Minister telling them that he knew how hard it had been for them must be replaced by swift action.

All that the nine words in the legislative programme demonstrate is that the Government fail comprehensively to understand the interdependencies of care services, from intensive and acute care to social, palliative and end-of-life care. In his first speech as Prime Minister on 24 July 2019, the right hon. Member for Uxbridge and South Ruislip (Boris Johnson) promised to

“fix the crisis in social care once and for all with a clear plan”.

In his 2019 manifesto, he stated that his Government would seek cross-party consensus. In January 2020, he claimed that he would

“get it done in this parliament”,

yet in October last year, the Minister for Care could not give any commitment in Parliament to the Health and Social Care Committee about action on social care.

We must face the reality of a social care system that at the start of the pandemic was underfunded, understaffed, undervalued and at risk of collapse. Any response to covid-19, however fast or comprehensive, would need to contend with that legacy of political neglect. Despite the Government’s espoused commitment to improving the social care system and introducing proposals in 2021, there is nothing on how they will do so, never mind fixing the system. Integration is undoubtedly the way forward to make the system work, but that requires funding and services that are in good order before it begins. Without social care reform, a robustly funded and continuing cancer recovery plan, as well as core funding for palliative and end-of-life care, services will continue to struggle and people will suffer.

There is an absolutely foreseeable risk. Expecting integrated care systems to find the capacity to reorganise and find end-of-life care pathways with fragile resources is recklessly putting the cart before the horse. This all matters in Scotland. As ever, we are more reliant on Barnett consequentials. All the while, the UK Government find ways to squirrel money away, preventing them from triggering our share. The Alba party amendment to the Gracious Speech recognises unequivocally the recent majority for independence parties in Scotland, calling for immediate progress on independence. The fact that that sentiment has been dismissed by the UK Government comes as no surprise, but the fact that it has been neither echoed nor supported by the victors of that election will not go unnoticed at all.

I would like to begin by congratulating my hon. Friend the Member for Aberconwy (Robin Millar) and the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) on their excellent maiden speeches. I remember all too well how daunting that is, having made my own maiden speech in the Queen’s Speech NHS debate in January last year.

Since then, our NHS has had the most turbulent of times. I pay tribute to the dedicated healthcare staff in my constituency, working day and night to keep us safe from coronavirus. I pay special tribute to Dr Poornima Nair, a dedicated and well respected GP at the Station View medical centre who died with coronavirus last year. In the House, I have talked about the light at the end of the covid tunnel. Thanks to the success of the UK’s vaccine roll-out, we are now beginning to see that light.

It was a UK grandmother who became the first person in the world to be given the Pfizer covid jab and, from then on, it has been onwards and upwards. The Government’s early focus on securing an extensive vaccine portfolio means that over 57 million doses have been given in the UK. The pandemic has really highlighted the importance of local healthcare and, as I mentioned in my maiden speech, it is one issue that unites every corner of my constituency. That has never been more true. From Bishop Auckland Hospital caring for covid patients to local GP surgeries and pharmacies vaccinating us to get us out of this pandemic, all parts of my constituency have pulled together.

Local healthcare provision matters, and that is why I will never stop banging the drum in this place for improved health services at Bishop Auckland Hospital. I am campaigning to restore the A&E that was lost under Labour, and I am grateful to both the Health Secretary and the Minister of State for Health for meeting me to discuss the campaign.  So far, the Government have invested £450 million to upgrade accident and emergency facilities in more than 120 trusts, so I know they understand how vital A&Es are to local healthcare provision, and I hope my ministerial friends will hear me clearly when I say I will continue to fight for the restoration of our A&E in Bishop Auckland.

The Queen’s Speech has healthcare at its heart, and I want to focus on one aspect that is close to my heart and to my politics: mental health. I have talked in the past about my own struggles around mental health. The importance of talking about it cannot be overstated. Every speech, every conversation, every time we talk about our own challenges that we have faced, we chip away at the stigma, but it is clear that talking about mental health alone is not enough. I am glad, therefore, that the Government are pushing ahead with their reform of the Mental Health Act 1983. Work is already under way on improving access to community-based mental health support, with £2.3 billion a year as part of the NHS long-term plan, but I am looking forward to seeing what further changes are proposed. The stigma around mental health needs to end, and every time we talk about it we help chip away at that stigma. Let us press ahead with improving the situation on the ground, improving mental health support and helping to ensure that no more lives are lost through poor mental health.

Thanks, Dehenna. Sadly, we had to cut the video—we had a still of you—and the audio was not brilliant. Perhaps you could have a chat with the technicians to try to establish what the problem was.

On Monday, the Health Secretary told the House that he was looking at what more he could do to invest in the NHS on Teesside. I have been making representations on this for 11 years, including in conversations with the Health Secretary. To tackle the health inequalities in my area of Teesside, Stockton needs a new hospital, so when will he make good on his word on dealing with health inequality and build the new hospital that we need—a hospital that his Government cancelled 11 years ago?

Last month, the all-party parliamentary group for longevity’s report on levelling up health noted that health inequality between the north and south cost £13 billion a year in lost productivity. Indeed, even before covid-19, health inequalities in England were estimated to cost the NHS an extra £4.8 billion a year, so I was bitterly disappointed that the Queen’s Speech did not contain improved funding for public health. Cancer Research UK has said:

“If the UK is to tackle inequalities and make sure no community is left behind…then health must be hardwired into the Government’s ‘levelling up’ agenda.”

Let me give the Minister a sense of the scale of the problem we face, although these figures are from before the pandemic and will now be much worse. I will begin with lung health. In England, 6.5% of the population suffer from asthma; in Stockton North, that rises to 7.4%. The level of chronic pulmonary obstructive disease among the population is 1.9%. That rises to 3.1% in Stockton North, yet we have not seen the level of progress we need to tackle the inequalities in health. In fact, we are stagnating. The Government committed in the Prevention Green Paper to making England smoke free by 2030. They are on course to fail, but they could succeed by following the advice of Action on Smoking and Health and making the polluter pay. I ask the Minister: will she?

Turning to cardiovascular health, the level of coronary heart disease in England is 3.1%, but it is 4.1% in Stockton North. In England, 14.1% of people have high blood pressure; that rises to 16.2% in Stockton North. If the Government have learnt anything in the past year, it should be about maintaining good public preventive healthcare, but instead questions remain about the future of Public Health England. On mental health, 11.5% of adults in England have been diagnosed with depression. In my constituency, the figure is 16.1%. Mental health services were overstretched before the pandemic hit and many people face waiting for years. Some do not get any treatment at all. There is no sign of that pay rise for our NHS heroes in the Queen’s Speech either, and disappointingly, no sign of the long-promised blueprint for social care. It is time to address inequality in my constituency. Please Minister, give us the hospital that we need.

I have spoken to two constituents this week who have both given me permission to share their stories. The first is Lachlan Robertson, the son of Christine Robertson, who was a dementia sufferer with some additional medical needs. Mr Robertson described to me what he called “the Kafkaesque chaos” of trying to get someone—anyone—in the health and social care system to take responsibility for his mother’s care. Very sadly she died last year, quite unnecessarily, after a fall that took place in hospital that should never have happened.

The second constituent is Nick Stokes, whose wife Joy died earlier this year of cancer after a litany of missteps and misdiagnoses by his GP’s surgery. Mr Stokes believes his wife would still be with us if she had simply been able to see a doctor in person, rather than be fobbed off with a series of phone calls and online consultations.

These constituents give me licence to be blunt. We all—I certainly do—revere the founding principles of the NHS and honour the staff who work in it, but the fact is that the systems that manage the NHS and, in particular, its internal communications, too often let patients down, and that is why profound reform is so needed. The watchword of that reform should be the simple word “humanity”. We need more human systems.

I am entirely in support of all the digital revolution that is happening. Yes to more online telemedicine, and yes to artificial intelligence and machine learning—I yield to no one except possibly the Health Secretary in my enthusiasm for technology—but all of this tech should simply have one focus, which is to enable more face-to-face consultation and better internal communication.

I particularly welcome the steps that have been set out towards more integrated care services. That is absolutely the right principle. I particularly thank the Health Secretary for the announcement that happened this very day of a new integrated care centre finally being built in Devizes after many years of campaigning. I pay tribute to Ministers and also to my predecessor, Claire Perry, who campaigned long and hard for this treatment centre. It means we can finally end the long tradition of the MP for Devizes standing in an empty field with the Health Secretary on a photoshoot pointing to the empty plot of land where this building is going to rise, because as of next month, shovels will go in the ground. We will now get our integrated care centre, which is absolutely in keeping with the principles that the Government are setting out.

I encourage the Government to be as bold as possible in the reforms that are coming. We are no longer in the 1940s, when a great state system was created. We are not in the 1990s, when market disciplines were introduced into the NHS. We are in a new era, and we need a new NHS that is not state-led, not market-led, but properly community-led. I think that is the direction of travel that the Government are on, and I welcome it wholeheartedly.

It is a privilege to speak in this debate today. I start by congratulating those who have made their maiden speeches today and by thanking all our NHS and care staff across my constituency of East Kilbride, Strathaven and Lesmahagow, including allied health professionals. They have gone the extra mile to meet the demands of the past year in relation to treating both physical and mental health.

As a psychologist, I, along with the Royal College of Psychiatrists, hope that the proposed health and social care Bill will mark a very significant step towards parity of esteem for mental health services. In December 2020, there was an 11% increase in referrals, and the UK household longitudinal study found that during the peak of covid, average mental distress was 8.1% higher than normal levels, so we cannot underestimate the potential tsunami of mental health issues that will require to be treated as a consequence of this pandemic. We also cannot forget that staff have been exposed to significant trauma and will require psychological first aid provision to ensure their wellbeing.

I remain concerned by the lack of a statutory requirement in the Government’s White Paper to have mental health representatives on integrated care systems boards. I fear that failure to do so could result in mental health services being sidelined once again.

Our children have coped in their young lifetimes with one of the biggest adjustments and crises we have ever seen. We must be cognisant of their resilience but also the impact, because they have been dealing with a killer disease that they know can take away their loved ones and have had their educational and social lives turned upside down. Ensuring that the mental health concerns of children are identified, referred and treated is of paramount importance. The Royal College of Psychiatrists found that 1.5 million children are predicted to need new or extra mental health support as a result of the pandemic.

Finally, little has been said about people with disabilities. I hope I do not have to remind Government that a comprehensive reform to health and social care that ignores disabled people would not be comprehensive at all. Levelling up for people with disabilities must be at the heart of the response, and as chair of the all-party parliamentary group for disability, I once again implore Government to have a disability-inclusive covid-19 recovery plan.

As a former NHS worker, I warmly welcome this Queen’s Speech, which will not only deliver on our manifesto commitments on health and social care but help our fantastic NHS and social care partners come out of the pandemic even stronger. In the last Parliament, we introduced the NHS Funding Act 2020, enshrining our unprecedented £33.9 billion investment in the NHS in law. We also got started with our commitment to build 40 new hospitals, including in Carshalton and Wallington, where over £500 million has been allocated to improve Epsom and St Helier Hospitals and to build a brand-new third local hospital in Sutton, protecting A&E and maternity services right here in our borough.

While our health and social care sectors could certainly not have been described as quiet pre-pandemic, they have been on the frontline of our pandemic response, dealing with an even greater, extraordinary demand on their services. The challenges that our health and social care sectors face as a result are stark. The NHS long-term plan had already highlighted many of the issues that existed pre-pandemic, especially around workforce and integration, but the coronavirus has also presented challenges around backlogs, including for elective surgeries and cancer treatments, and a spike in demand for mental health services, among many others.

I want to raise in particular the incredible effort throughout this pandemic of our amazing community pharmacists, who are so often left out of the conversation. They have demonstrated just how important they are, and we must reward this effort by reviewing their funding model, expanding their roles and giving them a seat at a strategic ICS level to help shape the future of healthcare delivery in their local areas.

This Queen’s Speech gives further impetus to deliver on the NHS long-term plan and to address not only the challenges faced pre-pandemic but the ones exacerbated and presented by it. Chief among the forthcoming legislation is the health and care Bill, which is designed to develop a more integrated care system, with the NHS, local government and other partners coming together, improving innovation and supporting patients to receive more tailored and preventive care closer to home, not to mention the additional measures to continue the life-saving vaccine roll-out, reform social care and truly embrace the preventive agenda.

This is not about looking backwards, to get the NHS and social care back to some kind of pre-pandemic level. It is about looking to the future and giving our health and social care sectors the ability to deliver a world-class service in a post-pandemic world. By driving integration, catching up on backlogs, tackling the challenges faced before the pandemic and those that came about because of it, reforming social care, helping patients with preventable illnesses and, of course, continuing to vaccinate the nation against coronavirus, this Queen’s Speech gives the NHS and social care the tools necessary to not only recover from the pandemic but deliver positive change and outcomes for patients in the years to come.

A house without foundations will subside. The decennial reorganisation of the NHS has neither sure foundations nor structure. It will struggle to withstand the complex health challenges raining down on it. The one chance to meet the next decade’s health and care needs still awaits the foundational pillars of public health, mental wellbeing and social care White Papers. The Secretary of State’s proposal for yet another mass reorganisation is structurally unsound without those vital foundations.

With 5 million people queuing for operations and appointments, old and disabled people stripped of their money and dignity in a broken care market, mental health challenges enduring and deepening, embedded inequality and complex comorbidities, it is only the love and care of the staff that is holding the whole NHS together, while they are robbed of pay and respect and battling their own mental exhaustion.

I have four points to make. First, for years, Professor Michael Marmot has called for a focus on tackling health inequalities to improve health and wellbeing. This reorganisation will not see such a shift in health outcomes. Secondly, absent of a funding framework and with the national prescription of NHS provision ripped out of the NHS in 2012 by the coalition, the postcode lottery will entrench. In places such as York, rationing denies people vital healthcare.

Thirdly, I know that this Government hate scrutiny, but without it, wrong decisions are made and people suffer. Better accountability, not less, nationally and locally is needed. There is too much blame shift under this teflon Tory Administration. Strong governance and accountability leads to transparency and better outcomes. Fourthly, tragically, this past year has seen the most vulnerable exposed to the greatest risks. Of the 128,000 who have died, a third were in care homes, many alone.

Since 2010, this Government’s annual pronouncements of imminent social care White Papers have been worn like the emperor’s new clothes, laying the Government bare with no resolve. Unless there is a fully integrated public health and care service free at the point of need, we will never build the caring and compassionate society that we need.

The Government’s proposals drive the market through the centre of our NHS. While stripping out section 75 regulations is a must, their purchaser-provider approach conflicts with the planned collaboration necessary to fix the scale of challenge. These reforms provide neither remedy nor cure. There are no foundations, no strong structure. The Minister needs to go back to his architect—in my book, it should be the Labour architect of our NHS—and redraw his plans.

Order. There have been some withdrawals from colleagues wishing to speak, so I will put the time limit back up to four minutes.

It is an absolute pleasure to be called to speak in support of the Queen’s Speech today, especially as I have an extra minute in which to speak.

As the Prime Minister has launched his own agenda of levelling up and building back better and the Queen’s Speech endorses that, I, too, am launching my own levelling-up agenda in my Stourbridge constituency, focusing on regeneration, growth and protection—the protection of my green belt, the regeneration of a town called Lye and growth in terms of jobs. I shall bridge that skills gap beautifully by working with Andy Street, the newly elected Mayor of the west midlands.

First, let me pay tribute to all those who work in the NHS in my Stourbridge constituency. They have gone above and beyond, and we owe them a debt of gratitude. Those on the Opposition Benches paint a picture of the NHS as a crumbling façade held together with sticky plasters, bandages and a bit of surgical glue. Instead, I see a picture of talent and dedication, an NHS that has stood the test of time since its inception and, indeed, through this pandemic. It is an NHS that is leading the way: one that has been truly transformational in adapting to a pandemic; one that is centre stage of the Government’s levelling-up agenda, with the ambitious plan to protect the health of the nation by continuing the vaccination programme and bringing forward legislation to empower the NHS to innovate and embrace technology.

I am always troubled when I hear emotionally charged words such as “a rescue plan for the NHS”. I suggest that it is neither I nor the NHS that needs a rescue plan as a priority. I am not blind to the pressures on the NHS; it is under significant financial pressure. Equally, I am not blind to the fact that it is this Government who have delivered the biggest cash boost in history for the NHS, enshrining it in law and safeguarding it for future generations by investing an additional £33.9 billion in frontline service every year by 2024—that is right, every year. It is the largest and longest funding settlement in the history of the NHS.

I particularly welcome the introduction of the health and care Bill, focusing on delivering better health outcomes for my constituents, making healthier choices easier, focusing on the preventative, and taking action to tackle the growing concern of obesity. I welcome the ban on junk food adverts on television before the 9pm watershed. Our relationship with food must change, and I know that mine must, too.

I strongly believe that every child should have the best start in life, and that includes their physical and mental health. Physical education in schools should not be a painful endurance once a week, but understood to be something more fundamental—upholding our physical wellbeing, keeping our hearts strong and healthy. The worst we can do with mental health is to ignore it, and I particularly welcome the boost to mental health funding of at least £2.3 billion.

I have a tiny bit of extra time, so I shall briefly mention social care reform. I very much welcome the Government’s confirmation that they will bring forward their plans for social care reform this year. My one ask is this: we must look for mechanisms to protect taxpayers’ hard-earned money, and look to increase the threshold for paying for social care to above £100,000.

The Queen’s Speech is more than a mirage and more than the emperor’s new clothes, as described by others. It makes a commitment to the next generation, and a clear commitment to our NHS, to our social care system, to my constituents, to their values and to all they have entrusted in this Government.

As we have heard today, the Government’s continued inaction on social care is failing families across the country. We need a social care system based on the principles of our national health service—free at the point of use and funded by everyone, based on their ability to pay. Sadly, that is not the only damning omission in the Government’s legislative agenda. The tax system in this country is rigged in the interests of the super-rich. The Government know that, the public know that, but there is nothing in the Queen’s Speech to fix that. The Government should be introducing measures to make the super-rich and big corporations finally pay their fair share, but that would mean taking on the super-rich funders of the Conservative party, and we know that they will not do that.

This crisis has shone the spotlight on the deep and deadly inequalities in our society, but while 4.3 million children are in poverty, and while food bank usage soars, some have had a good crisis—a very good crisis indeed. The number of UK billionaires has not only soared; their collective wealth has increased by over £40 billion in the last year alone. That tells you everything you need to know about whose interests our economic system is set up to serve.

There is massive public support for increased taxes on the super-rich and on big business, but this Government just refuse to take on the wealthy and the powerful. So I tabled amendment (f), with cross-party support, calling for changes to our tax system to make the wealthy pay—first, to introduce a windfall tax on companies such Amazon that have made super-profits during this pandemic. Secondly, to introduce a wealth tax on the super-rich, so that they are not grabbing a greater and greater share as millions fall further and further behind. Thirdly, to increase tax rates so that those on over £125,000 a year—the top 1%—pay a fairer share. It really is time to break with the failed trickle-down mantra, which has been used for decades to justify deepening and grotesque inequality. A fairer tax system is how we start to build a fairer society.

If the Conservatives actually wanted to help working-class communities level up—if they wanted to move from rhetoric to reality—they would actually be doing those things. The fact that they are not tells you everything you need to know about who this Government truly represent.

Thank you for calling me, Madam Deputy Speaker. I made my maiden speech in the previous Queen’s Speech debate on health, when you were also in the Chair, so it is a pleasure to speak in this one.

I welcome the commitment to bring forward proposals on social care reform. Covid has emphasised the long-standing issues facing the sector, and in our recent report, the Public Accounts Committee highlighted that among the challenges to be addressed are funding, workforce and the future accommodation model. Importantly, the plan needs to focus on younger adults with learning and physical disabilities and mental health issues, as well, of course, as elderly people. It should also support the essential role that unpaid carers, such as those I have met in North West Norfolk, play in looking after their family and friends.

As well as tackling social care, the Queen’s Speech pledges to increase investment in the NHS, and my constituents are particularly focused on the new hospital building programme. As one of the best buy hospitals, Queen Elizabeth Hospital in King’s Lynn was built with a life expectancy of 30 years. Now in its 41st year, QEH is in need of urgent modernisation due to major structural issues with concrete planks in the roof. The Standing Committee on Structural Safety first issued an alert regarding these rack planks two years ago. Currently there are 194 props across 43 areas of the hospital supporting the roof. The trust’s risk register has a red rating for

“a direct risk to life and safety of patients, visitors and staff due to the potential of catastrophic failure of the roof structure due to structural deficiencies.”

Aside from the safety concerns that the trust is managing, the props create a poor experience for the patients and hard-working staff in the hospital.

I welcome the recognition of the seriousness of the situation by the Secretary of State and my hon. Friend the Minister, and the £20 million of new funding that QEH has received this year will help to deal with the most immediate issues. However, the need is greater, and this is literally money to prop up the roof. As the Secretary of State said last week,

“you get to a point with a piece of infrastructure where continuing to just keep propping it up gets to the end of its usefulness and you need something completely new.”

I agree, and we have reached that point with QEH. The trust estimates that it will cost £550 million over the next decade just to manage the risks, not to improve the situation. In contrast, it has developed a strong case for investment to transform the hospital to meet modern healthcare requirements, deliver healthier lives, and harness innovation and technology, and all at far better value for money.

Other best buy hospitals are on the list of new hospitals, and QEH has a compelling case to be one of the eight additional schemes that the Prime Minister has committed to. I will be grateful if my hon. Friend the Minister can update the House on when the selection criteria for those schemes will be issued. I reiterate the invitation to my right hon. Friend the Secretary of State to come to QEH to see the situation for himself. The need is obvious. Patients and 4,000 members of staff need a hospital that is fit for purpose. Thousands of people locally have signed a petition in support, local council leaders are supportive, and with significant housing growth planned in the area, demand for healthcare is only going to increase. I therefore urge the Government to back our bid to deliver the hospital that patients and staff deserve.

I start by thanking the NHS and all the staff at University Hospital Coventry and Warwickshire for all the incredible hard work that they have done over the past year.

I would like to highlight one of my constituents’ most pressing topics of concern, which is the need to rebuild our NHS and reform social care. Everyone in Britain has the right to be kept in good health and cared for from cradle to grave. It saddens me, therefore, that far too little is being done to fulfil that promise and that our NHS staff are paying the price for the failures of those in government. With children’s mental health referrals increasing by a third last year alone, over 1 million patients waiting more than six months to start treatment, and 370,000 suspected cancer cases that have gone unseen by specialists, now is the time for an NHS rescue plan.

The pandemic has exposed the issues that 10 years of austerity created for the NHS. Unable to paper over the cracks any longer, we can now see how badly the Government prepared our health system for this crisis. The NHS is not failing; it is just being failed. Even before the pandemic struck, we were short of 40,000 nurses and 7,000 doctors in all settings, and the number of community nurses, health visitors and mental healthcare specialists had all been cut between 2010 and 2020—a conscious choice made by this Government to run down the services that we all rely on. That is why we need bolder remedies than the weak response proposed by the Government. Embarrassed by the crisis that their cuts caused, they are short on ideas and even shorter on answers.

Nowhere is this clearer than in social care. Each and every year, we have been promised far-reaching reforms, and every year this Government have proved to be an abject disappointment. One and a half million people have unmet care needs in Britain today. We cannot fix the NHS without fixing social care too, yet the Government have so far been woefully unable to fill the over 110,000 vacancies open in the sector. The care system’s problems run from top to bottom. Carers are paid low wages on zero-hours contracts that rarely provide them with the time or resources to offer the comprehensive, high-quality care that they themselves want to give.

Funding, too, is in a state of acute crisis. The Government’s cowardly choice to pass the brunt of austerity on to local councils has stripped £8 billion from care budgets over the last decade. Millions of older people now fear that they will lose everything they own—everything they have worked for their entire lives—simply to afford the most basic care in their last years.

With 2,000 people with learning disabilities trapped in unsuitable care settings and a lack of beds accounted for by fully one third of patients stuck in hospitals waiting to be discharged, now is the time for wholesale reform. We have a duty to make the “new normal” better than what came before. The NHS needs its funding restored and its vacancies filled. The backlog of operations, referrals and appointments must be cleared. Our care system, left in the lurch for so long, must finally be reformed to meet the standards we expect, with better paid, better trained staff, who have the time to care for those in their charge.

In closing, I will say this. The Government are eager to claim the NHS’s successes as their own, but we should thank instead the thousands of healthcare workers who have done more than ever before to keep the system going. They gave us their all. Who are we to do any less in return?

I rise to welcome the measures in the Queen’s Speech, particularly on skills—legislation to back up our White Paper on adult learning; retraining to help people move across sectors; funding for that learning; and better career paths for people into work. Those are particularly important in the wake of covid and vital to our levelling-up agenda. If we are going to make a long-term impact, capital investment is all well and good, but education is the key to long-term levelling up.

There is a strong expectation among my constituents that we will deliver on immigration, and I welcome that commitment in the Queen’s Speech. There is a strong theme on levelling up and what it means throughout the Queen’s Speech. The east midlands is consistently at the bottom of the charts when it comes to Government and private sector investment, so I would argue that it is most clearly in need of levelling up. I would welcome conversations with any and all Ministers about setting out a clear vision for that.

It is my belief that there is a handful of key decisions—about HS2, devolution, our freeport and our development corporation—that are fundamental to our long-term progress in the east midlands. We cannot afford to let our region down. Given his Leicestershire constituency, the Minister will appreciate the importance of support for the east midlands.

The theme today is health and social care. I have a number of points to make in a short time. First, I am pleased to see Government plans to make progress on social care reform in this Session. I welcome the elements of that in the Queen’s Speech—we know that such reform is long overdue. Although ad hoc grants to support local authorities in the delivery of social care have been welcome, they are not a long-term solution. We need certainty on this issue. Will the Minister give us some time scales, if he has them, for ideas and proposals coming forward?

Secondly, I would welcome some clarity on prevention in the health and care Bill. Perhaps, in truth, we could look again at some of these priorities. I have raised concerns about the obesity strategy a number of times and there are proposals that, in my view, verge on meddling in people’s freedom and choice. Over the past 18 months, we have seen that our public health functions have a huge amount to do to ensure their preparedness for major health issues. We should focus on that, rather than limiting people’s choices in shops, pricing people out of items or banning adverts, which has dubious impacts, if any. Let us support people with information and facilities to encourage healthy lifestyles and exercise; banning two-for-one Mars bars will not have the impact that we would hope for.

The Bill is set to look at a more integrated system of care between the NHS and local authorities. I make a plea to the Minister—I have spoken to him about this already—to start on the right foot by confirming our county’s integrated care boundaries and fixing those to the county boundary in Nottinghamshire. That will allow us to deliver more efficient and effective primary care, and I know that that is in line with Government priorities. Unblocking the gateway in primary care is absolutely vital to offering a better experience to residents. We can make a big impact with an early and good Government decision.

The Government can be proud of the record levels of support and investment in our health service. We need to use this opportunity now to ensure that funding is put to good use, with the most efficient and effective service delivery to residents. Let us not waste it on meddlesome interventions into eating habits; instead, let us look at direct support to improve healthy lifestyles for those who need it. Let us encourage activity, educate and improve access to community-based services, which are key to tackling our health inequalities and are therefore a big part of levelling up life chances.

There is a huge amount to welcome in the Queen’s Speech, and I have not even touched the surface in just four minutes, but I very much welcome the proposals and look forward to supporting the Government in delivering them during this Session.

It is a pleasure to speak in this debate, and I refer Members’ attention to my entry in the Register of Members’ Financial Interests. I would like to take this opportunity to thank all those who work in our NHS and social care system in Peterborough. Both of my parents were nurses in Peterborough’s NHS, so I know first hand about how much the NHS means to the people of Peterborough.

Yesterday, the Health and Social Care Committee took evidence from Jonathan Freeman. Sadly, his mother Gillian died in January, after suffering for many years with dementia. His answers to my questions were powerful and worrying. The death of a parent is upsetting in any circumstances. Unfortunately, it was made far worse because of the difficulty in securing the right care for Gillian, or in fact any financial support. It took Mr Freeman two years to persuade her GP that there was a problem. When advanced dementia was properly diagnosed, he got his mother into a care home. That care home made mistakes and lacked the support for her dementia. He had to move her again. This new home was much better. It encouraged him to apply for funded nursing care to meet his mother’s needs. Years of savings were being rapidly depleted. A month of rental income from her house was paying for less than a week of her care.

To get the assessment, Mr Freeman told me:

“You would not believe how much nagging”

was needed and the

“delays we had”,

but he got there, and he was told his mother qualified. The assessor even told him that her funding would be backdated. The assessor left, six months passed and he pushed for answers. The assessor had registered the claim on the computer, but never filed the paperwork. He was assured it would be sorted out, but instead the clinical commissioning group secretly commissioned a peer-led review of the assessment. Someone who had never met his mother concluded she should get nothing.

“They would not tell me the reasons”

for that, he told me.

“They did not even tell me there was that panel”.

He appealed. They refused. No reasons were given.

Mr Freeman told me that

“I was a senior civil servant. I understand bureaucracies, but this was Kafkaesque.”

Gillian’s illness progressed. He did not want to go through that ridiculous process again, at least until he was certain it would succeed. By that stage, she was immobile and unable to eat by herself or even communicate. So he applied, and after further delay, everyone agreed with all of the assessments, apart from one—mobility. The CCG’s assessor argued that the wrong hoist had been used, but assured him that this would not be used as an excuse not to fund, but it was. He appealed. They refused, and again no reasons were given.

Mr Freeman had to sell his mother’s house to pay for her care. She was denied access to a continuing healthcare package despite the clear view of three expert assessors, and she died without receiving a penny. It was very clear to him that the CCG seized

“any possible excuse not to provide mum with the financial support that was her right”.

The CCG does not even monitor its performance for meeting the statutory criteria for appeals. It took an FOI request for the CCG to admit it.

The Queen’s Speech committed the Government to bringing forward proposals to reform social care, and we have heard scepticism today about that, but this Government deserve credit for making that promise, and there is no question—no question at all—but that reform is long overdue.

It is a pleasure to speak in this debate, and to be back here in the Chamber.

The conditions in which people are born, grow, live, work and age all impact on our health, which means that wealth inequalities and health inequalities are inextricably linked. Even before the pandemic, avoidable deaths were twice as likely in poorer parts of Wales compared with more affluent parts of the state. This growing link between poverty and poor health outcomes has been exacerbated by covid-19. Poverty reduction, therefore, must be at the heart of tackling health inequalities not just in Wales, but across the British state.

Yet for all the talk of levelling up, this Queen’s Speech, sadly, is devoid of genuine solutions. Levelling up is clearly an easy slogan for Ministers to use, but what exactly does it mean? Does it mean tackling the long-standing regional wealth disparities within the British state? If so, where is the detail about how meaningful change will be delivered?

There was a damning report this week by the Resolution Foundation and the London School of Economics, which indicated that the UK was facing decades of prolonged stagnation by the end of this decade—by the end of the 2020s—because of the failure of the British Government to come up with a policy solution for the major challenges we face: covid recovery; the challenges posed by Brexit, the green transition and decarbonising the economy; automation and all the challenges that will bring, with the loss of jobs in the economy; and of course the demographic changes and challenges of an ageing population that we are all too aware of. The authors of the report said this week in the newspapers that the Queen’s Speech failed to grapple with any of those major challenges. “Levelling up” is the new “rebalancing” of the Cameron-Osborne era—slogans without detail.

Glaringly missing also from the Gracious Speech was a new Act of Union to reconfigure the British state for the post-Brexit age. Even Unionists in the Welsh Government recognise the need for urgent change and are advocating home rule for Wales. Their problem, of course, is that nothing they advocate is deliverable because of the implosion of the Labour party in Scotland and England. This means that the structures they envisage can only be introduced by a Tory British Government here in Westminster who are hell-bent on a strategy of aggressive Unionism. I know that some on both sides of the House dismiss talk of constitutional matters as a luxury in the context of the deep-rooted social inequalities we face, but they are essential. The truth is that the British state has fundamentally failed to ensure that a sizeable chunk of the population have sufficient income to be healthy. If this place cannot reform, as I suspect is the case, then it is inevitable that more will flock to the banners of YesCymru.

Before I bring my remarks to a close, I would like to touch briefly on another element missing from the Queen’s Speech: support for those who have lost loved ones. The British Government have established a commission on covid commemoration. Having laid a heart on the memorial wall on the opposite side of the river earlier today to my great friend Les Thomas, I do not seek to undermine the value of creating spaces for remembering and coming together. However, if we truly want to build a society that deals with grief compassionately, the UK Government must introduce paid bereavement leave and paid miscarriage leave. Losing a loved one can be one of the most difficult and painful challenges that anyone will face in their lifetime. No employee should have to worry about keeping a roof over their head or food on the table when they are dealing with grief. Being pushed to return to work before they are ready can have a devastating impact on a person’s mental and physical health. Currently, the British Government place the responsibility of supporting employees on to employers and hope they will all be sympathetic. The reality, however, is that not all are.

I start by congratulating the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) and by saying llongyfarchiadau mawr—massive congratulations—to my hon. Friend the Member for Aberconwy (Robin Millar). This has been an interesting debate. I have been here pretty much from the start, and it has been great to hear the breadth of the contributions we have heard today.

I rise in support of the Queen’s Speech, but before I talk specifically about our health service and the NHS I want to talk about fundamental principles. What we saw in the communities I represent in Wednesbury, Oldbury and Tipton two weeks ago is that they back those principles. There are now nine Conservative councillors on Sandwell Council, the first elected in 10 years, which is proof that my communities in Wednesbury, Oldbury and Tipton are endorsing them. Indeed, in Tipton itself, my new adopted home, two out of the three seats are now held by Conservative councillors. I found it quite interesting that the Sandwell Labour group is now bringing in mentors for their councillors to teach them how to do things such as case work. To save a bit of time and money, I would just say that our group is happy to do that and give members of the Sandwell Labour group a bit of a hand if they need it.

This is a really important debate. I pay tribute to the fantastic NHS staff in my communities, to the people at Tipton Sports Academy who have been volunteering with mass vaccination for nearly three months now—I had the honour of volunteering there myself—and to the people at Portway Lifestyle Centre who have also been providing vaccinations.

When we talk about the breadth of the services we offer, social care is fundamental. In my communities, we estimate that roughly 16,000 people provide care in some form or other. It is vital that we get this right. I sit on the Public Accounts Committee alongside my hon. Friend the Member for North West Norfolk (James Wild); I will not go back over the challenges that he highlighted, because he has probably articulated them better than I could, but we have to solve them because they are ever present. I know from our conversations that my right hon. and hon. Friends on the Treasury Bench are aware of them, but now we must find solutions. I pay real tribute to the Sandwell Young Carers, who are truly inspirational in the work that they are doing—they are stepping up.

When we debate adult social care, we have to remember the role of the third sector, because it is quite often overlooked. I have had a lot of conversations with the third sector in Sandwell about adult social care, particularly in preparation for our Committee’s inquiry, and it sees the challenges articulated by my hon. Friend—they are absolutely the same for the third sector, the private sector and the public sector.

I want to focus today on primary care because it has been so prevalent an issue in my communities. I welcome the £1.5 billion that the Government rightly intend to place in primary care, but the key thing for my communities is being able to see a GP. Don’t get me wrong: the investment from the Government has been great—people are excited for the Midland Metropolitan Hospital to come online next year, and it is great to see it come through—but in my communities, particularly in areas such as Oakham in Tividale, people are struggling to see their GP. I have been inundated with correspondence on how we need to ensure that primary care investment works in the right way. I implore my hon. Friend the Minister to look into that. The investment is absolutely there, which is great to see; it is just about making sure that the delivery works.

Finally, may I pick up on a point made by my hon. Friend the Member for Devizes (Danny Kruger)? He was absolutely right that technology is great, but we will never eliminate the need for face-to-face appointments. There are people in my community who are digitally disconnected. They will not be able to have online appointments, so we have to ensure as we move forward that the balance is right.

I would like to correct the record. I heard a number of Conservative Members repeating a statement that the Prime Minister has made on numerous occasions, being somewhat economical with the truth when it comes to the so-called record levels of investment in the NHS. I double-checked on Fact Check during the debate: actually, the largest increase to NHS spending was between 2004 and 2010, and hey—it was by a Labour Government. That was £24 billion. Those are the facts—check on Fact Check. That is not being economical with the truth; it is the truth, so please check that. I correct the record.

It is also a fact that today Jenny McGee, one of the nurses who looked after the Prime Minister when he was incredibly ill with covid—he praised her for her care—has resigned, stating that she was concerned, as were all her colleagues, about the lack of leadership and direction in the covid crisis. She felt unappreciated, beyond the clapping—I take our minds back to the Thursdays—in terms of pay and working conditions. That is a fact; that is the truth.

I will turn now to things that were missing from the Queen’s Speech. It is also a fact that yesterday, while Labour Front Benchers were preparing to highlight the ongoing nightmare of the building safety crisis, I got a call from a local councillor informing me that the roof of part of a building at Northwich station in my constituency of Weaver Vale had collapsed. It was a miracle that nobody was killed or seriously hurt. The emergency services quickly stepped into action. Northern and Network Rail started the hokey-cokey of taking responsibility for making the area safe and eventually reopening the line. An investigation will take place, and I can say with confidence that part of the answer lies in the lack of investment on that line and infrastructure over the last decade—investment that I and other parliamentarians have called for. There has been no leadership, no direction and no investment. Nothing in the Queen’s Speech spoke to my constituents to reassure them that that decade of failure would be put right.

If someone who is disabled is on that line in my constituency, they cannot even travel in one direction. Just after Christmas, in the midst of the pandemic, Northwich again had a major flooding incident—the second one in as many years. Indeed, the good people of Acton Bridge, local schools, businesses and residents felt the brunt of it. Elderly residents were evacuated. In all fairness to the Environment Secretary, he came along and paid a personal visit, but when I pressed him for support and investment in our creaking infrastructure, my words fell on deaf ears.

I am going to set Ministers a challenge to respond to calls from my constituents who want first-rate, affordable transport and stations that do not fall down. They want investment in modern drainage systems, and, let us have a new hospital for Halton, Minister.

I start my short remarks by thanking all NHS and care workers in my Broxtowe constituency for the work that they have done over the past year. There is much to welcome in the Queen’s Speech that will begin to help all areas of the UK to recover from the devastating impact of the pandemic. I welcome the Government’s plans to deliver the health and care Bill, which will put in place better integrated care between the NHS, local government and other partners. The Minister will be aware that any comprehensive health service must focus on mental health as well as physical, so I would like to focus my remarks on that issue.

Mental health affects all corners of our society and has, for far too long, been overlooked as a priority, which is why I am proud that the Government are ensuring that mental health is at the top of the agenda. The Office for National Statistics has shown that, during the pandemic, mental health has worsened across every age group in the UK, and the number of individuals showing symptoms of depression has doubled. The announcement to boost mental health funding by at least £2.3 billion over the course of this Parliament, as well as transforming mental health services and supporting more people in our communities, is very welcome.

Recently, I wrote to the Government to offer my thoughts on the Mental Health Act White Paper. The Government announced landmark reforms to the Mental Health Act to give people greater control over their treatment, ensuring that it is fit for the 21st century and delivering on a key manifesto commitment. The White Paper details an increase in community support. I would welcome a detailed outline of what this expansion of community support will look like at all levels, when it can be expected and how it will be implemented across the country to ensure that all areas of the UK have the same levels of support in place.

I welcome these much needed changes, and I am particularly pleased to see recommendations to ensure that mental illness is the reason for detention under the Act and that neither autism nor learning disability is grounds for detention. I met a number of Broxtowe residents to consider the issues surrounding autism and mental health, and there is a clear need for further support. While speaking to constituents, I have come to understand that a lack of community resources is often the largest barrier to those with autism and learning difficulties returning to their communities after being in in-patient facilities. I would appreciate a commitment to evaluate and improve services in place across the UK to ensure that that support is available. I welcome the Bills outlined in the Queen’s Speech and I look forward to seeing the Government continue to prioritise our nation’s mental health.

Once again, despite big promises, we have a Queen’s Speech that just tinkers around the edges. It falls short of what we need for the country and what is needed for my constituents in Putney.

You may be surprised to know, Madam Deputy Speaker, that the volunteers at Putney Scrub Hub are still working flat out to provided much-needed scrubs for hospitals across London and beyond. Covid exposed the urgent need for a national uniform to save millions of pounds and provide our healthcare workers with the uniform they need at the right place and the right time. Instead, there is a fragmented system—a fragmented bureaucracy —that could not scale up at the speed needed. We do not pay our healthcare and care workers enough—clapping is not enough—and the very least that we can give them is the right uniform. Ministers did not step up at any stage to recognise the problem, take it on and solve it. That has still not happened. I welcome the consultation on a national uniform, such as they have in Wales. I hope that the measure will go through in the next year.

One of the biggest issues for my constituents in Putney is social care. On his first day in Downing Street, the Prime Minister promised to fix social care “once and for all”. Twenty-two months later, we have seen nothing. It has not been kicked into the long grass—it never left the long grass. This morning, the Prime Minister again said that there was a plan, but where is it? This afternoon, the Secretary of State made a passing comment in his speech at the beginning of the debate, saying that it would be brought forward this year—but, again, no plan.

Since the Prime Minister’s first day in office, dementia victims and their families have paid a staggering £14 billion for social care. The Prime Minister and the Government have let down every single one of those families, including many families in Putney. Even before the pandemic, there were 1,628 older people in Putney with unmet social care needs. That translates to 1.5 million people across the country. Adult social-care council budgets have been cut, and it is no surprise that 69% of the public believe that fixing adult social care should be a top priority as we recover from the pandemic.

We need a national social care system that is joined up with the NHS, and we need the much-promised dementia moonshot. Without life-changing treatments, the number of people with dementia is set to grow to 1 million in the next five years. No more empty promises; no more leaving families struggling and despairing. We need a clear, budgeted plan for social care reform, complete with milestones, with reform this year, 2021—not next year, not on the never-never. The reforms must improve access to care and quality of care, and provide better working conditions for care workers, with services joined up between the NHS, social care providers and community providers. I urge the Government to listen to the public and come good on their promises to fix adult social care at last so that we can all recover from the pandemic.

It is a privilege to be called to speak in today’s debate and to support Her Majesty’s Gracious Address, which sets out a bold, ambitious plan to truly unite and level up every region of our United Kingdom more than a year after the 2019 general election, in which the Conservative party recorded its highest vote share and returned Members of Parliament for parts of the country that had either never elected a Conservative or had not done so for a generation.

The Gracious Address sets out how we will recover from the pandemic, supporting our economy and addressing the legacy of covid-19 by improving the health of the nation.

Just two weeks ago, the people of Hartlepool added another blue brick in our blue wall. Another great northern town with a proud history has seen the merit of electing a Conservative MP. That was undeniably a vote of confidence in this Prime Minister and his mission to bring about opportunity across our country and turbocharge our recovery from the effects of the pandemic.

In Darlington, a Conservative MP, a Conservative-led council and a Conservative Mayor—the re-elected Ben Houchen—are working together. It is that collective resolve that has seen a phenomenal level of investment in the short time since I was elected to this House. I can report that this Government’s investment is already seeing the unlocking of private sector investment in Darlington.

My right hon. Friend the Chancellor, in choosing Darlington for his northern Treasury, has unlocked a steady stream of other Cabinet Ministers heading north from King’s Cross, bringing more jobs to Darlington. Those include the Secretary of State for International Trade and, only yesterday, the announcement by my right hon. Friend the Secretary of State for Business, Energy and Industrial Strategy of 100 more jobs. We have seen £105 million invested in Darlington station, £23.3 million from the towns fund and, through the pandemic, millions of pounds to help our council respond and to support our businesses. I look forward to the future opportunities that the levelling-up fund will bring.

That investment is being matched by a firm commitment to continue to improve the health of the nation, investing in our NHS, delivering more nurses and bringing about comprehensive reforms for our social care sector. I welcome the Government’s commitment to introduce a health and care Bill that will deliver an integrated care system, ensure that NHS England remains accountable to taxpayers, tackle the growing problem of obesity and put the Healthcare Safety Investigation Branch on a statutory footing. The Government have committed to bringing forward proposals to reform adult social care, delivering an improved care system that provides the dignity and security that people deserve, as well as embarking on long overdue reform of the Mental Health Act 1983.

While the Opposition continue to focus on their internal strife, this Conservative Government continue to deliver on the people’s priorities. This Queen’s Speech delivers on those priorities, and I am pleased to support it.

The legislative programme outlined in the Queen’s Speech lacks the ambition, depth and understanding needed to address the many health, poverty and social inequalities facing the residents, communities and families of Leicester East.

There is nothing in this legislative programme to save Leicester General Hospital from being downgraded. Our NHS staff and care workers are exhausted and there are nearly 5 million people in the UK waiting for NHS treatment. Rather than investing in our NHS, the proposals actually cut services, including hard-working staff. NHS staff and social care workers deserve much more support than they are currently getting, including a 15% pay rise instead of the insulting 1% real-terms pay cut offered to nurses.

We should all be very worried about the new powers granted to the Health and Social Care Secretary to accelerate the privatisation of our NHS. The Government want more profit and less care. I urge them, rather than downgrading Leicester General Hospital, selling off its land and extending NHS privatisation, to reverse their strategy and properly fund all hospitals in Leicester and across the UK.

On planning, the Government want to give more powers to property speculators and developers while delivering less genuinely affordable housing. The Royal Institute of British Architects has already warned that the Government’s plans could lead to

“the next generation of slum housing”.

On overcrowding, there are pockets of my constituency close to Leicester General Hospital where populations of 2,000 live in areas of 60,000 square meters. Hon. Members may not know what that equates to. It means that each person has an average of 32 square metres of space, which is equivalent to a box bedroom. The UK average is 3,676 square metres of space per person, more than 100 times the space afforded some people living in Leicester East. There is nothing in the Government’s legislative programme to address that stark inequality or to provide the health services that such overcrowded populations need. Rather than making it harder to build homes fit for working families, the Government must properly fund local authorities such as Leicester City Council and rapidly increase the construction of council housing and genuinely affordable family-sized homes.

On jobs and tackling poverty, I was proud to join the picket line in solidarity with workers at SPS Technologies in Barkby Road, in Leicester East, who bravely took strike action, with Unite the union, against their employer’s appalling fire and rehire employment practices. Well, we won. This form of solidarity will now be needed across the country, because the Government have failed to outlaw these exploitative practices.

Endemic wage exploitation in Leicester’s garment industry continues apace, with workers still being paid as little as £3 per hour, while the retail brands make super-profits, profiting with impunity from the exploitative sweatshop labour of workers in Leicester and worldwide. Factories compete to supply at the lowest price possible, and 60% of garments end up in landfill within a year. In addition to strengthening powers of the unions, collective bargaining power and workers’ rights, we need a garment trading adjudicator, similar to the Groceries Code Adjudicator, to ensure that payment terms for suppliers are fair, that wages are paid at a legal rate and that employment is secure. We need a more sustainable and ethical fashion industry and an end to zero-hours contracts and throwaway fashion.

The wellbeing of our entire planet and our health relies on our using the post-pandemic recovery to mitigate the existential threat of climate change with a radical green new deal to rebuild the country in the interests of people and planet.

May I associate myself with the remarks of Members who have once again reminded us just how much we all owe, even in normal times, the health and social care workers across these islands, and how much more we are in their debt for their work over the past 14 months? May I also take this opportunity to congratulate my good friend and colleague Humza Yousaf on his appointment today as Scotland’s Health Secretary, and indeed to congratulate all those who have been appointed to the re-elected Scottish National party Government? May I also congratulate my hon. Friend the Member for Airdrie and Shotts (Anum Qaisar-Javed) on an outstanding maiden speech? Although I am now an adopted Fifer, I was brought up less than 200 yards from her constituency boundary and she now represents a significant number of my relatives, although not nearly enough to account entirely for her magnificent majority last Thursday.

There should be no argument over the fundamental principle that care services need to be much better integrated and co-ordinated. There may be arguments about how we achieve that—there have certainly been arguments in Scotland, where we are quite a bit further forward in the process—but if it is done properly, it can have a huge and positive impact on the lives of millions of people. I understand the concerns that have been raised in a number of quarters about the changes that the Government are proposing, and it has to be said that nearly all of those concerns boil down to one simple problem: people do not trust this Government. They do not think the NHS and the social care sector are safe in this Government’s hands, and I do not blame them. A Government who still refuse to legislate to prevent the back-door privatisation of services as the price of a trade deal with the USA, who refuse to pay health and social care workers anywhere near what they are worth, and who insist on treating immigrant workers as if they were a necessary evil, rather than a valued and welcome part of our society, are always going to struggle to make anyone believe that they really care about our care services.

If the Government think that is an unfair description and want to change that perception, may I suggest a few things they could do? They could outlaw extortionate parking charges at NHS hospitals. They could abolish prescription charges. They could commit to abolishing all charges for non-residential personal care. They could commit to abolishing charges for NHS dentistry. They could commit to a proper living wage of at least £9.30 per hour for all social care staff. They could commit to providing 76 GPs per 100,000 of population, rather than the 60 they currently provide. All of that and much more is already being delivered or has been committed to by the SNP Government in Scotland. All of it is deliverable and affordable in England right now. The only thing that Scotland has that England does not is a Government who care.

On 6 May, the SNP Scottish Government were re-elected for an unprecedented fourth consecutive term of office, receiving more votes than any party has ever received in a Scottish parliamentary election, and a higher share of the vote than the Conservative party has achieved in any UK general election during the 60-plus years that I have been alive. The people of Scotland have insisted at the ballot box that decisions about our NHS and care services are taken by a Parliament of our choosing. They have also made it abundantly clear that now is the time to give the people of Scotland the right to choose whether that Parliament of ours is once again given the full powers of a sovereign, independent nation.

I must admit that I greatly enjoyed the Health Secretary appearing to argue that our health and care sectors need to recover after a decade of Tory government—I could not agree more. The covid-19 pandemic has served to expose the damage done by Tory austerity and privatisation to our NHS and social care sectors. They are understaffed and underfunded, while existing staff are overworked and underpaid. However, unlike the Health Secretary, I do not think that further privatisation is the answer, even if he and his pals are already drooling at the thought of selling off the NHS to every Tom, Dick and Tory donor.

It is clear that our health and social care sectors are in crisis. Before the pandemic, there were over 100,000 NHS vacancies, while a quarter of staff were more likely to leave than in the year before. The Government’s plan to address that is to give NHS staff another real-terms pay cut. Added to that, there are an estimated 112,000 social care staff vacancies. Again, with zero-hours contracts and median pay of just £8.50 an hour, I do not think there is any great mystery behind that shortage. However, the social care crisis goes beyond staffing. Age UK estimates that there are 1.5 million older people not receiving the social care support they need. Councils have had their budgets slashed by nearly 50% on average since the Tories came to power, with around £8 billion taken out of social care budgets since 2010, so is it any surprise?

We desperately need a plan for social care that relieves the pressure on unpaid carers and widens access to adult social care where it is needed, yet the Government appear clueless. This crisis requires a dynamic Government: a Government who are ready to accept the ideological failures of austerity and privatisation, who are willing to invest in publicly-run health and social care services, and who reward the workers who staff them. Instead, the promised plan for social care is still missing, private healthcare firms are being welcomed with open arms, and workers face pay cuts and poverty wages.

The Health Secretary speaks about the prevention agenda, but the main cause of ill health is not obesity alone; it is poverty. He can talk about levelling up, building back better and the rest of their buzzword bingo, but until the Government address insecure work, low wages and welfare reform, health inequalities will continue to grow. The Government need to wake up to the health and social care crisis, because the effects are already being felt by real people—the people this Government promised to help.

I pay tribute to all my constituents in Liverpool, West Derby who work in the NHS and social care; I send my solidarity and thanks to them. My speech will focus on defending these workers and on defending our NHS against the Government’s plan for major reorganisation—words that should terrify every citizen in this country who values this wonderful model of socialism. These worrying plans come at the same time as 5 million people are waiting for NHS treatment, and at the same time that NHS staff are exhausted and those same staff are facing a proposed real-terms pay cut.

Last month, I held a meeting with Royal College of Nursing members. They were visibly exhausted, and I came away genuinely worried for their wellbeing. How can this be? I urge the Minister to listen to the concerns of the Save Liverpool Women’s Hospital campaign, Doctors in Unite, EveryDoctor, Keep Our NHS Public, We Own It and many others who are calling for the reorganisation to be halted and for a full public consultation.

The Government’s proposals for the NHS, as set out in their White Paper, could, as my hon. Friend the Member for Wirral West (Margaret Greenwood) has said, open up privatisation, deregulation and cronyism. They could open up opportunities for private companies to be represented on ICS boards, have a say in what healthcare gets delivered in an area and then provide that service. They could allow for the deregulation of professionals, which would threaten patient safety and have serious implications for the pay, terms and conditions of NHS workers. It is unthinkable that the Government are pushing ahead with these plans after the events of the past year. A person more cynical than me would maybe think that the exhausted state of both the NHS and the nation have created an environment that the Government find ideal for pushing through these changes, which will imperil the public ownership of our NHS even more.

In closing, I ask that this Government find the same values that they discovered earlier in the month, when greedy billionaire capitalists tried to destroy our football heritage, putting profit ahead of the interests of football fans, and the Government reacted. Well, now they are back, but this time it is our NHS that they wish to destroy. I ask the Government to act with equal urgency to protect the greatest jewel in our heritage—to halt these plans for the reorganisation of the NHS and a roll-out of integrated care systems and, instead of pushing ahead with privatisation and threatening the rights of our NHS workers, to give our health service the resources it needs and give our NHS workers a 15% pay rise. They deserve no less.

It is a pleasure to close today’s debate and to hear from many hon. Members across the House, including two excellent maiden speeches. The hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) was a teacher of politics, and I am sure that she will continue to give us all a schooling in the Chamber when she stands up for her constituents as she did today. Even as a granny, I cannot match the lifetime of commitment to politics shown by the hon. Member for Aberconwy (Robin Millar). We have been on opposite sides of the many campaigns that he has fought, but his love of Wales and the beautiful coastline of his constituency are sentiments that I am sure the whole House will share.

Let me add my voice to those of hon. Members on both sides of the House who have reflected on the role that key workers have played throughout this crisis. I want especially to mention those who work now—as I once did myself—in social care. They have worked tirelessly throughout the pandemic. Too often, they became ill themselves, and some tragically paid with their lives for keeping our public services running.

When the Prime Minister took office, he told us that he had already prepared a plan for social care. Two years later, this Queen’s Speech offered just nine words and the promise that proposals would be “brought forward”. So much for that prepared plan. For the 11 years that the Conservative party has been in power, care workers have been given only the promise of jam tomorrow, and tomorrow never comes. In the meantime, the problems facing the sector have only been worsened by the crisis that our health and social care services face.

As a union rep in social care, I saw at first hand the success of the then Labour Government’s delivering the workforce programme. By working together, we improved the quality of care, increased pay for staff, and reduced hospitalisation and ultimately, therefore, the cost to the taxpayer. It is a false economy not to ensure that people can live as independently as possible in their own homes, with the right support at the right time and in the right place.

Today, however, the workers who were praised by everyone in this Chamber are underpaid and overworked, and that has consequences for us all. If only this Queen’s Speech had contained more than a vague promise of proposals and had a Bill to address that issue. My hon. Friend the Member for Liverpool, Wavertree (Paula Barker) even tabled such a Bill in the last Session. Like other private Members’ Bills in the last Session, it fell not because the House rejected it, but because the Government removed parliamentary time.

If the Minister listens to just one thing I say tonight, I hope it will be my plea to make time in this Session for another such Bill, because the low-paid and insecure nature of employment in social care meant that many carers were not entitled to sick pay. That issue is at the heart of our response to the pandemic. There is simply no substitute for raising the level of sick pay and expanding coverage so that all carers can afford to self-isolate.

A healthier country rests on a healthier economy. That goes not just for workers in health and social care, but all workers. That is why we would have legislated for an immediate £10 an hour minimum wage, banned zero-hours contracts and granted full rights from day one, with entitlements to sick pay and annual leave.

We all remember the disgraceful scenes over the past year, when carers did not receive basic protection during the pandemic. Care workers had significantly higher rates of death, but there has not been a single prosecution of a single employer. The promised employment Bill was supposed to create a single enforcement body to protect health and safety and tackle exploitation at work. Perhaps the Minister can tell us why, in the face of a pandemic, tackling that has not been a priority.

The right hon. Members for South West Surrey (Jeremy Hunt) and for Ashford (Damian Green) both spoke of the challenges of integrating social care and health. Let me remind them and others on the Government Benches that they have no mandate to privatise our NHS. The Conservatives have administered an £8 billion cut to social care budgets since 2010, yet they have made millions of pounds available to enforce voter ID as part of this Gracious Speech. If politics is the language of priorities, that says a lot. There was one case of voter personation fraud in 2019, out of the 59 million votes cast that year. The odds of me winning the national lottery are better, so why would the Government think that this crime is more urgent for new legislation than, for example, violence against women? My hon. Friend the Member for Walthamstow (Stella Creasy) touched on that issue with her usual passion. I urge Ministers and Government Members to accept her amendment. We will support her in the Lobby if not.

Voting is safe and secure in Britain. Ministers should be ensuring confidence, instead of spreading baseless scare stories. The fact is that this measure will price some voters out of democracy. Millions of people lack voter ID in this country—in particular, older voters, low-income voters and black, Asian and ethnic minority voters. The Conservatives are reversing decades of democratic progress and urgently need to rethink the policy, because it is yet another example of a Government too focused on gimmicks and slogans, rather than real action.

The so-called levelling-up agenda is another such case. When the Prime Minister set up a business council in January, he promised it would level up opportunity for people and businesses across the UK, but just one of its 30 council members was based in the north of England and two in the midlands, while 25 were in London or its commuter zone. In March, the Industrial Strategy Council warned that the levelling-up agenda was unlikely to succeed because there was too much control from the centre. So what did the Prime Minister do? He set up another unit in Whitehall. A senior Cabinet Office official told the Financial Times that there was “widespread cluelessness” about what levelling up actually meant.

The Prime Minister promised that the Queen’s Speech would put “rocket fuel” into the levelling-up agenda, but no one seems to have told the Housing Minister or the Business Minister, who yesterday could not answer even the basic questions. They did not even know that a levelling-up taskforce existed—not so much a flagship as a ghost ship or, as one of the Prime Minister’s own advisers put it, a “slogan without a purpose”. If only the Government had looked over the Atlantic and drawn inspiration from this President and not the last. The Queen’s Speech could have included the £30 billion stimulus package proposed by the shadow Business Secretary, my right hon. Friend the Member for Doncaster North (Edward Miliband), creating 400,000 new jobs in the industries of the future. It could have built on the lessons of a vaccine roll-out driven by an active interventionist state. Instead, the Government’s investment plan is absolutely tiny in comparison with that of President Biden.

The Queen’s Speech has no employment Bill, and the country will instead face an unemployment bill. Yesterday, the Paymaster General, the right hon. Member for Portsmouth North (Penny Mordaunt), told the House that any criticism of Ministers’ many dodgy deals was anti-business, but I am afraid it is the Prime Minister who famously said exactly what he would like to do to business, and that is one promise that he has kept in the Gracious Address, because he has left business high and dry.

Across the country, small and medium-sized enterprises face a long road to recovery. For months, we have called for a comprehensive plan for British business with debt restructuring at its heart. Instead, we have a Bill that tinkers with state aid and that will leave us investing a fraction of the support that countries such as Germany or Denmark give to their industry.

Many Members across the House have mentioned mental health. We know that the pandemic has left our nation needing more support, and I hope that the Government will take inspiration from the Welsh Labour Government, who have put wellbeing at the heart of their nation.

We face a critical moment as a country. As life begins to return to normal, we are left asking if business as usual is really what we aim to return to. The pandemic has exposed the millions of insecure jobs, the key workers who are underpaid and undervalued even as we applaud them in the streets, the services that they provide collapsing under the strain and an economy that does not work for working people. Last October, the Prime Minister rightly summoned the spirit of our greatest post-war Government and promised to echo Attlee’s plan for a post-war new Jerusalem, but I am afraid he is no Clement Attlee.

This was the moment for our new economic and social settlement to tackle insecurity at work, to meet the climate crisis head-on, to rebuild our public services, to support our businesses and to share wealth and power fairly among our citizens and communities. The British people deserved a Queen’s Speech that met those challenges of the moment, but it has fallen short on every count. This granny knows that it is our grandchildren who will still be paying off the debt that has mounted up over this period. We owe it to them to offer them better-paid jobs, better real affordable homes and a better Government.

I start by welcoming the right hon. Member for Ashton-under-Lyne (Angela Rayner) to her new post, and I wish her well in it. I apologise to her that she is facing me giving the wind-up rather than the Chancellor of the Duchy of Lancaster or the Paymaster General. However, given her encounter with the Paymaster General yesterday, she might be quite grateful for that.

Since the previous Queen’s speech in January 2020 we have all collectively been engaged in responding to the biggest crisis since the war, fighting a highly infectious and highly dangerous virus that has caused so much disruption to our economy and our society. Everyone has made huge sacrifices to get this virus under control, and I would like, as I often do on these occasions, to once again put on record my thanks to everyone in the NHS and social care, and the entire British people, for the massive part that everyone has played in that effort.

We now have a way out, thanks to the vaccination programme that is making this country safer every day, and I pay tribute to the Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), for his work on that; but we all recognise that alongside that successful vaccination programme we must all, as a society, learn to live with residual elements of covid for some time to come. My right hon. Friend the Health Secretary’s vaccination programme has been the biggest and fastest in British history. Around seven in 10 adults have had a first dose, including my right hon. Friend and me—I resisted any temptation to do so without my top on—and around four in 10 have had a second. As we have rolled out the programme, we have been able carefully to remove some of the restrictions that have been so difficult for us all. Even this week we have been able to restore more of those precious moments, like meeting friends and family indoors or having a pint inside a pub once again. As we do that and take the road to recovery, we must take forward what we have learned about all parts of our health and care system, and draw on the spirit and endeavour that we have seen in our vaccination programme and so many other parts of our response, to make the lasting reforms that will allow us to build back better and make us a healthier nation. There is still a lot to do and there is no time to stand still.

This Queen’s Speech sets out an ambitious, positive programme to seize that opportunity. As my right hon. Friend the Health Secretary set out, we need to tackle waiting lists through our catch-up and recovery plan to support the, I believe, 4.7 million people in England—around February—waiting for treatment. We need to continue to deliver our manifesto commitments of 40 new hospitals and 50,000 more nurses. And we need to level up on the health inequalities that the pandemic has laid bare. To meet that challenge, we have an agenda to transform our health and care system, and to give us those firm foundations that we need to thrive in the years ahead.

We have set out our plans for our health and care Bill to enable greater integration—I saw, in my years serving as a local councillor, as I suspect many colleagues in the House have, the benefits of the NHS, local authorities and social care working ever more closely—to reduce bureaucracy, and to strengthen accountability to this House, so that we can allow staff to get on with their jobs and provide the best possible treatment and care for their patients, and give the NHS and local authorities the tools they need to level up health and care across the country.

We will also give the funding and support to help our NHS recover and deliver the care that people need, bringing the total package of additional covid-19 funding to our healthcare system to £92 billion—on top of the legislation that my right hon. Friend the Health Secretary and I passed last year, which will see funding in our NHS increase by £33.9 billion by 2024.

The virus has attacked many parts of our society and our healthcare system. Before returning to some of the key themes in the health space and the care space, I want to mention some of the contributions to the debate. My hon. Friend the Member for North West Norfolk (James Wild) highlighted the importance of knowing what the bidding criteria will be for the extra eight hospitals that we have committed to bring forward. I know, Madam Deputy Speaker, that you and my hon. Friend the Member for Don Valley (Nick Fletcher) came to see me earlier this week to talk about your proposals for Doncaster hospitals. We recognise the eagerness of colleagues to know what that procedure will be, and we will be bringing that forward in the coming weeks. I highlight, of course, that that is dependent on the spending review as well.

Let me turn now to the shadow Secretary of State and some of the points that he raised, which I will endeavour to address. He is a good man, and I know that he will still be basking in the joy of Leicester City’s success on Saturday. He raised some important points. First, he asked where diagnostics were in all of this. I remind him that, in 2019, we brought forward £200 million of additional funding to provide around 300 new diagnostics machines, which have already been bought for our NHS, and we have set out plans for the future for 44 diagnostic hubs.

The right hon. Gentleman talked about capital spending. A total of £3.7 billion in the first tranche has been allocated for our 40 new hospital programmes. He will know, because his constituency neighbours mine, that he is one of the beneficiaries of that, with a new hospital in Leicester. I also point out to the shadow Chancellor of the Duchy of Lancaster that Tameside General Hospital has benefited from considerable capital investment —£16.3 million in 2019 thanks to this Conservative Government and, atop that, there is the £450 million of extra money that we brought forward for urgent and emergency care last year, of which around another £2 million is going to Tameside and Glossop Integrated Care NHS Foundation Trust. This is a record of investment by this Government in communities up and down our country.

The shadow Secretary of State was pressed a couple of times by my hon. Friend the Member for South Suffolk (James Cartlidge) on whether he supported the use of private sector hospital facilities to help get those waiting lists down. He dodged answering that question. I know that he is a sensible and pragmatic chap, and I know that he will recognise the need, as we do, to use every resource at our disposal to get those waiting list down. I hope that he will not give in to the siren voices of some on the Opposition Benches who, in their comments, have highlighted what I think is a real issue for the Opposition. I am talking about this sort of Orwellian “Animal Farm” type tendency: four legs good, two legs bad; public sector good, private sector bad. It is a binary approach. The reality that we have seen throughout this pandemic is that the key has been partnership working: public, private, and voluntary sectors working together, putting ideology aside to get the best outcomes for patients. All I say is that those who advocate a binary approach are actually letting down our public services. [Interruption.] The right hon. Member for Leicester South is getting a new hospital.

Let me move on now to other contributions. I turn to the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) and my hon. Friend the Member for Aberconwy (Robin Millar), both of whom gave eloquent, accomplished speeches. I wish that I had been as eloquent in my maiden speech. They are clearly strong advocates for their constituents. I sincerely hope—indeed, I am sure—that we will rightly hear a lot more from them in the future, and that is all to the good of our democracy.

I want to pick up on a couple of other contributions. The hon. Member for Rhondda (Chris Bryant), who is a strong champion of the cause of those with acquired brain injuries and brain injuries, and my hon. Friend the Member for North Dorset (Simon Hoare) came to see me relatively recently to talk about the importance of that group of people in our resetting of NHS services and our recovery of waiting lists. Not only do I pay tribute to the hon. Gentleman, but I am always happy to meet him to further discuss those issues if he feels that I can be of any assistance.

Turning to some of the key themes of the Queen’s Speech particularly in the health space, the virus, as many hon. and right hon. Members have highlighted, has attacked our population’s mental health just as much as our physical health. On top of the record funding we have already given to mental health—an extra £2.3 billion a year for mental health services by 2023-24, plus the £500 million of additional investment that my hon. Friend the Minister for Patient Safety, Suicide Prevention and Mental Health announced recently—we are determined to address the impact of the pandemic on mental health and wellbeing. I know that that objective and that desire, whatever the party politics that sometimes occurs in this Chamber, will be shared across both sides of this House. While we will rightly be held to account, I hope that we can all move forward in seeking to improve services in that space together. I also hope that we will be able to work together in reforming the Mental Health Act 1983, which, as my right hon. Friend the Secretary of State said, has not been fully updated for nearly 40 years, and in so doing, give people greater control over their treatment and ensure dignity and respect.

As Members have highlighted, there is also more to do so that everyone receives high-quality, joined-up care in our social care system. The Prime Minister and my right hon. Friend have been absolutely clear in their determination that we will bring forward our proposals for reform of social care this year so that everyone receives the dignified care they deserve within a system that is sustainable. While I hope we can move forward together, I will take no lessons from Labour, which, in its time in power, had, in seeking to address this, one royal commission, two Green Papers, and a spending review in 2007 at which it said that it would be the main focus. That is 13 years of consultations and no achievement. I hesitate to draw attention to it, but some of those years would of course be years when the right hon. Member for Leicester South was at the heart of government in the Treasury and in No. 10.

As we do this work, we will be drawing on the considerable strengths that have played a starring role in this pandemic—the technology, the research, and the life sciences so beloved of my right hon. Friend the Secretary of State—to drive innovation in our NHS and social care to make life easier for patients and staff alike and to help us all live healthier and happier lives. In that vein, we will, for example, increase public spending on research and development to £22 billion.

It is an honour to make the final contribution to this Queen’s Speech debate on behalf of the Government. We have seen before us a stark choice between a Government with a clear, ambitious vision for our country and its health and an Opposition yet again devoid of ideas, tired and lacking in energy, whose only solution is yet another policy review. That has been the response to the damning verdict of the electorate when they said they were fed up with being taken for granted and let down by Labour. Over the past six days of debate, we have heard about this Government’s ambitious agenda to level up all parts of our country: an agenda to beat this virus and beat it together, and an agenda that will unleash the potential of the whole of the United Kingdom. I commend the Queen’s Speech to the House.

Question put, That the amendment be made.

The list of Members currently certified as eligible for a proxy vote, and of the Members nominated as their proxy, is published at the end of today’s debates.

Amendment proposed: (i) at end add:

“but respectfully regret that the Gracious Speech fails to include bills that protect workers’ rights, reform social care in England, or deliver a fair pay rise for NHS staff; further believe that the Procurement Bill proposals will undermine devolution; regret that the Gracious Speech does not contain provision to make the £20 Universal Credit uplift permanent, end the freeze of social security benefits or scrap the two-child limit and so-called rape clause attached to child credits; and reject the Government’s proposals for immigration reform, voter ID and policing which will place disproportionate restrictions on people’s human rights.”—(Owen Thompson.)

Question put forthwith (Standing Order No. 33), That the amendment be made.

The list of Members currently certified as eligible for a proxy vote, and of the Members nominated as their proxy, is published at the end of today’s debates.

Amendment proposed: (g) at end add:

“but respectfully regret that measures to create a requirement for the Government to act when the Courts find that Government policy creates an incompatibility with the human rights of a UK citizen were not included in the Gracious Speech; recognise as a result of not addressing rulings made by the courts on these issues children who have lost a mother or father but whose parents were not married, and vulnerable victims of domestic violence who have been required to pay the bedroom tax because they have a sanctuary room, have been discriminated against; note that these rulings were made in 2018, 2019 and 2020 so that there has been ample time for the Government to address those rulings; further note that if the Government ignores the decisions made by Courts on the rights of UK citizens this undermines the integrity of the judicial and democratic process; and call on the Government to bring forward measures to fully remedy those incompatibilities within three months.”—(Stella Creasy.)

Question put forthwith (Standing Order No. 33), That the amendment be made.

The list of Members currently certified as eligible for a proxy vote, and of the Members nominated as their proxy, is published at the end of today’s debates.

Main Question put.


That an humble Address be presented to Her Majesty, as follows:

Most Gracious Sovereign,

We, Your Majesty’s most dutiful and loyal subjects, the Commons of the United Kingdom of Great Britain and Northern Ireland in Parliament assembled, beg leave to offer our humble thanks to Your Majesty for the Gracious Speech which Your Majesty has addressed to both Houses of Parliament.

Address to be presented to Her Majesty by Members of the House who are Privy Counsellors or Members of Her Majesty’s Household.

The list of Members currently certified as eligible for a proxy vote, and of the Members nominated as their proxy, is published at the end of today’s debates.