House of Commons
Wednesday 8 June 2022
The House met at half-past Eleven o’clock
[Mr Speaker in the Chair]
Oral Answers to Questions
Women and Equalities
The Minister for Women and Equalities was asked—
The Government’s central mission is to level up the UK by spreading opportunity more equally across the country. In February we published our levelling up White Paper, which provides a clear plan to level up every corner of the UK. It will address regional disparities across the country, put more money in the pockets of those who need it the most, and transform our economy by generating higher paid jobs and new investment.
Regional inequalities exist even within large counties such as Devon, so what is my hon. Friend doing to tackle those disparities? For example, Ilfracombe in my constituency has the lowest life expectancy in Devon—10 years lower than Kingskerswell, which has the highest. Child poverty in Heavitree, Exeter, stands at 8.1% compared with 20.3% in Ilfracombe West.
Ilfracombe has been awarded more than £3 million to deliver a marine leisure centre at Larkstone cove, which will provide community facilities for local clubs and groups. More broadly, North Devon has been awarded £9.8 million of levelling-up funding to date. My hon. Friend will be pleased to know that the UK shared prosperity fund will also support our ambitions on levelling up, and that will provide £2.6 billion of new funding for local investment by March 2025.
My officials are delivering the equality data programme, which is examining how access to opportunity is affected by a range of factors, including geography and socioeconomic background. For example, an employee in Wales, Northern Ireland or the north-east of England earns more than £3 less every hour than a similar employee in London, and this geographic pay gap exists even when the cost of living is accounted for. Data from this programme will support our levelling-up agenda, and we encourage Departments to take focused, evidence-based action on those findings.
I welcome the Government’s move to improve access to cash in the Queen’s Speech. It is an issue that affects regional imbalance, as, sadly, more rural banks close. Will the Minister act to ensure that cash is more accepted more widely after the pandemic, as it is still the preferred option for many older people and, more importantly in my constituency and I am sure in others, for carers who are spending their clients’ cash?
My hon. Friend is right to raise that issue. We do understand how difficult the trend away from cash and towards cards and digital payments can be. I have seen that in my own constituency with repeated closures of rural bank branches, which force vulnerable customers into more difficult situations, so I thank him for raising it. The ability to transact cash remains important to millions of people. We cannot force the rural branches to remain open, but we will legislate to protect access to cash. The Government plan to introduce legislation in the Financial Services and Markets Bill to support the continued use of cash in people’s daily lives, but he will be pleased to know that it will also help local businesses to continue accepting cash by ensuring access to deposit facilities.
My constituents will have listened with bewilderment to the Minister’s replies to other Members. This Government have been in office for 12 years now. She talks about tackling regional inequalities. Over those 12 years, child poverty has increased, pensioner poverty has increased, the gap between the richest and the poorest has increased, and life expectancy has stalled and in some areas gone backwards. Which of those achievements is she most proud of?
I am proud of this Government’s achievements. The hon. Gentleman has been very selective in picking data that requires a different baseline of years. I am afraid to say that he is wrong. We have been levelling up the country, and, as we announced in the levelling up White Paper, the Government will continue to do so—for example using the £1.4 billion global Britain investment fund to attract major investments, such as the new £2 billion Britishvolt gigafactory in Northumberland. We are doing a lot across the country to level up and we will continue to do so.
I thank the Minister very much for her responses. When it comes to regional inequality in Northern Ireland, I have some concerns over the geographic pay gap to which she referred. In discussions with the Northern Ireland Assembly, what specifically can be done to ensure that the wages that ladies get here on the mainland are reflected in the wages offered to those in Northern Ireland?
Yes, it is disappointing to see those figures. They do in fact take into account the cost of living. When the data programme is finished, we expect that proposals will be put forward to address those specific issues. I would be very keen for the hon. Gentleman to provide any particular insight that he has from his own constituency, because we do need MPs to bring their regional knowledge into the policymaking agenda.
Our levelling up White Paper calls time on the postcode lottery and sets out far-reaching action to break the link between geography and destiny. To support that, we are delivering the equality data programme, which is our biggest and best analysis of the barriers that people face.
One of the biggest problems in rural communities such as Broadland is low expectations, both academically and economically. Can my right hon. Friend explain what she is doing to take on that soft bigotry and ensure that people have an equal opportunity to succeed wherever they live, particularly in rural communities?
We have appointed Katharine Birbalsingh as chair of the Social Mobility Commission. She has taken on the soft bigotry of low expectations at her fantastic school, the Michaela Community School in Brent. We want her to help the whole country, including rural areas and places such as Broadland. Tomorrow, she will lay out her vision in a speech at Policy Exchange entitled “Bucking the trend: a fresh approach to social mobility”.
I do not agree with that at all. We are entirely focused on tackling the causes of the gender pay gap by making it easier for people to afford childcare, normalising flexible working and helping women to get into the top jobs, particularly in areas such as science, technology, engineering, and mathematics where they can earn more money.
The Women’s Budget Group has pointed out that women are being hit the hardest by this Tory cost of living crisis, and research from the Resolution Foundation has highlighted that the UK Government’s welfare reforms will push 500,000 children into poverty. The reality is that the UK Government are pushing communities down, not levelling them up. Will the Minister ask the Chancellor to follow the example of the Scottish Government and provide families with the support they need to get through the Tory cost of living crisis?
What we are doing is helping more women to get into higher-paid jobs and set up enterprises. We have just set up the taskforce on women-led high-growth enterprises, led by Anne Boden, the chief executive of Starling Bank. We want to help women by giving them opportunities, including to set up new businesses.
This Government take very seriously the challenges women face in getting a diagnosis of endometriosis and in living with the symptoms. That is why it will be a priority area in the women’s health strategy.
My constituent Claire Ciano suffers from endometriosis. It has had a hugely detrimental effect on her career, thanks to the difficulty in getting diagnosed and the lack of treatment available. I commend the Minister on putting forward the women’s health strategy, but will she set out in further detail the steps she will take to raise awareness and improve treatment for sufferers of endometriosis?
The case of my hon. Friend’s constituent is unfortunately only too common. We know the average wait time for a diagnosis is around eight years. Unfortunately, while the National Institute for Health and Care Excellence’s published guidelines suggest how women should be diagnosed and the treatment they should receive, they are not mandatory. However, in the women’s health strategy we will strongly urge that they be followed.
I welcome the Minister’s comments. One of the biggest issues for women suffering from endometriosis is the lack of access to fertility treatment. She will know that I have been campaigning heavily for better access to, and regulation of, in vitro fertilisation treatment. Can she confirm that that will be a key priority in the women’s health strategy, and when can we expect an update to the Human Fertilisation and Embryology Act 1990, which is woefully out of date?
The hon. Lady has campaigned very hard on IVF. I can say that IVF will be in the women’s health strategy; IVF services are commissioned at a local level, but there is disparity in how they are commissioned in local areas, and we want to see consistency of service offered to women and partners.
Endometriosis South Coast does brilliant work supporting women suffering from endometriosis, but it is seeking reassurance from the Minister that, when the women’s health ambassador is appointed, she will be a real champion for those affected by this condition and other women-only conditions that are so impactful on their to continue work. Can the Minister update the House on when the women’s health ambassador will be announced, given that we have been expecting the post since December?
I can reassure my right hon. Friend that the women’s health ambassador will be key in driving change, not just by raising awareness and confidence among women in coming forward for help, but by improving the services women receive, and she will have to wait only days, rather than weeks, before we release the name.
Women’s Health Strategy
As I have said in answer to previous questions, the women’s health strategy will be forthcoming. We have had over 100,000 responses to our call for evidence. We published the vision document in December, and the full strategy will be published shortly.
The Royal College of Obstetricians and Gynaecologists has just released figures to show that gynaecology waiting lists have soared by over 60% to half a million people—a bigger proportion than in any other area of medicine. What are the Government going to do to sort this out and get waiting lists down so that women get the healthcare they need?
It is true that the backlog caused by covid is having an impact on gynae procedures. The roll-out of our community diagnostic centres will help significantly with that because GPs will be able to refer women straight to them, and they will be able to get some of their gynae procedures done there without having to have secondary care referrals. We hope that will make an improvement for women.
To be clear, the backlog is not caused just by covid. Figures published by the Royal College of Obstetricians and Gynaecologists shows that the number of women waiting over 12 months for healthcare in England ballooned from 66 women two years ago to 25,000 women today. They include a constituent of mine who recently wrote to me stating that the earliest available gynaecological appointment offered to her was in October 2023—over a year from now. Given that the Government’s long-delayed women’s health strategy still does not exist, what action will the Minister take now to reduce these unacceptable waiting times? After all, this week is meant to be the Government’s Health Week.
Women in STEM Apprenticeships
We are supporting more women to access traditionally male-dominated fields such as STEM—science, technology, engineering and mathematics—and those that offer the highest wage returns. Our apprenticeship diversity champion network is championing gender representation among employers and industries where improvement is needed, and we are promoting STEM apprenticeships to girls in schools.
Providing opportunities in STEM for women is essential, as is showing that there are already women in these roles doing the jobs that they aspire to. I would like to praise two local businesses that have worked tirelessly on this: BAE Systems in Barrow, responsible for our submarine programme, which has increased female participation in its early years programme from 19% to 32% in just five years; and Oxley Developments in Ulverston, which has a 50% female workforce. Clearly there is something going right in this cluster in south Cumbria. With that in mind, could I invite my right hon. Friend to come and visit?
The Minister for Women and Equalities has just lauded her Government’s social mobility tsar. Does the Minister for Higher and Further Education agree with that tsar that
“physics isn’t something that girls tend to fancy…There’s a lot of hard maths in there”?
If not, will she condemn those remarks and others that put girls and women off careers in STEM because of, to use the words of the Minister for Women and Equalities, the
“soft bigotry of low expectations”?
Children with Autism: Classroom Support
The SEND—special educational needs and disabilities—and alternative provision Green Paper aims to create a more inclusive education system to improve outcomes for children and young people with SEND. We are providing nearly £12 million to help the schools and further education workforce to support children with SEND, including autism, ensuring that their needs are met early and effectively.
After a decade of per-pupil funding cuts and with staff workloads soaring, mainstream schools are too often unable to provide places for children with special educational needs and disabilities, including children in my constituency who are unable to access speech and language therapy sessions. Does the Minister think that is acceptable, and what is she going to do about it?
This Government are investing £74 million in the first year alone of our autism strategy to promote a straightforward route to diagnosis and the correct support, and we will shortly be detailing our implementation plan for year two. The Department has been funding the Autism Education Trust since 2011.
Ethnicity Pay Gap Reporting
In “Inclusive Britain”, our response to the Commission on Race and Ethnic Disparities report, we accepted the recommendation to publish guidance for employers to support a voluntary approach to ethnicity pay reporting. Work on this is already under way.
According to the Resolution Foundation, in 2018 the ethnicity pay gap cost black workers over £3.2 billion in the loss of wages. Following the pandemic, the gap is getting wider. As the Minister will know, the Women and Equalities Committee said in February that businesses
“are ready for Ministers to follow through”
on the Government’s manifesto commitment to bring in ethnicity pay gap reporting. Can the Minister therefore explain what the hold-up is, and when the Government will do that?
We remain committed to supporting businesses with pay reporting. There are significant technical challenges to it, and it may not be the most effective intervention for some employers in some areas, but we are working on guidance to make sure it can be as effective as possible.
Menopausal Women in the Prison Estate
I can reassure the hon. Lady that Her Majesty’s Prison and Probation Service is working with NHS England to improve the treatment and support available to women in the prison service, including menopausal women, as part of the national women’s prison health and social care review.
The latest figures show that 39% of female prisoners are over 40, and a further 38% are aged between 30 and 39. Many of them will either be menopausal or perimenopausal already, or reach that stage during their sentence. As we know that menopause can have a significant impact on physical and mental health, including influencing behaviours, does the Minister agree that a menopause strategy within Her Majesty’s prisons would be both productive and beneficial?
I thank the co-chair of the menopause taskforce. We discussed this in our taskforce meeting yesterday, and we have agreed to invite Ministers from the Justice team to work on this issue. The Secretary of State for Justice is sitting beside me, and I am sure he has heard the hon. Lady’s words.
The Government were delighted to support the private Member’s Bill to recognise British Sign Language as a language of Great Britain. We will improve public knowledge and awareness of BSL, including through guidance that will help to promote and facilitate the use of the language, and much more.
I welcome the introduction of the British Sign Language Act 2022, recognising BSL as an official language in England, Scotland and Wales. However, families in Blyth Valley still feel discriminated against in such areas as free sign language classes and educational opportunities for deaf children in schools. Does my right hon. Friend agree that there is still much more to be done to improve the lives of people in our communities?
I commend the women’s organisations, such as Women’s Aid, that have come out in recent months to support single-sex services for women who have suffered violence and abuse. Service providers know that single-sex spaces are crucial to recovery from abuse and violence for many women and children. The Equality Act 2010 recognises this and allows for the restriction of single-sex spaces on the basis of biological sex. The law is clear, it is on their side and we will defend it.
Reducing inequalities is about much more than protected characteristics. Outcomes for education, health and prosperity in Blackpool are among the lowest in the entire country, and they are particularly poor for men. What steps is my right hon. Friend taking to ensure that those who live in Blackpool can enjoy exactly the same life chances as those who live in more prosperous areas?
In March, the Secretary of State for Levelling Up, Housing and Communities announced that Blackpool would be a transformational regeneration place, which means that the Government will partner with Blackpool to address social inequalities, improve productivity and deliver co-ordinated cross-Government support for local priorities. We have already announced measures to support that, including cracking down on rogue landlords and Homes England partnering with Blackpool Council to find exciting new opportunities for regeneration.
I congratulate my hon. Friend on her championing of female veterans. She is absolutely right that we need to deliver services to female veterans that meet their needs and honour their fantastic contribution to the armed forces. That is why the Office for Veterans’ Affairs will commission new research to understand why female veterans need support and the barriers they face.
One of the most unequal workplaces in the land is the other place, where an eighth of the seats are reserved for men only. Will the Minister support a rapid change in the law, so that hereditary peerages go down through the first and oldest child, as the Crown does, rather than the oldest son?
My hon. Friend is referring to the reform of succession to the hereditary peerage, to which I am sympathetic, but which raises a variety of complex issues. Various approaches have been proposed in both Houses to address the issue of male primogeniture for hereditary peerages, but there is not yet a consensus on the way forward. I am happy to work with her to look at the issue.
I cannot give that commitment, but I look forward to joining the hon. Lady and others at the reception this afternoon with Carers UK, because there are many important issues regarding how we can support unpaid carers.
As I have said in answer to many questions this morning, the women’s health strategy will be published shortly. We had over 100,000 responses, we published our vision document in December and we will be publishing the women’s health strategy in the coming weeks. [Interruption.]
The Prime Minister was asked—
This week is Carer’s Week, and I am sure the whole House will want to join me in thanking the millions of carers across the UK for all they do to support their loved ones. We have seen the vital role that carers have played in our communities during the pandemic, and we all owe them a debt of gratitude. Through our reforms on adult social care, this Government are committed to continuing to support carers.
This morning, I had meetings with ministerial colleagues and others. In addition to my duties in this House, I shall have further such meetings later today.
I associate myself with the Prime Minister’s remarks about the importance of carers in our country.
This week’s events have demonstrated just how loathed this Prime Minister is—and that is only in his own party. As his Administration is too distracted by their internal divisions to deal with the challenges that we face, can he explain, if 148 of his own Back Benchers do not trust him, why on earth the country should?
I thank the hon. Lady very much for her question, and I can assure her that in a long political career so far—but barely begun—I have of course picked up political opponents all over the place. That is because—[Interruption.] That is because this Government have done some very big and very remarkable things that they did not necessarily approve of. What I want her to know is that absolutely nothing and no one, least of all her, is going to stop us from getting on with delivering for the British people.
I thank my right hon. Friend for his question. He raises an issue on which the UK has campaigned for a long time, and no country is more committed than we are to bringing war criminals to justice. I know that my right hon. Friend the Deputy Prime Minister has raised the subject recently with the International Criminal Court. However, as he knows—and I will certainly, of course, study the case and take it up appropriately—it is the subject of an ongoing investigation, and it would not be appropriate for me to comment on it further.
Thank you, Mr Speaker. I could not make out whether that introductory noise was cheers or boos. [Interruption.] The trouble is, I do not know whether it is directed at me or the Prime Minister.
I join the Prime Minister in his comments about carers. Why did his Culture Secretary, who I think is hiding along the Front Bench, say that successive Conservative Governments left our health service “wanting and inadequate” when the pandemic hit?
Everybody knows that when the pandemic hit, it was an entirely novel virus for which the whole world was unprepared. Nobody at that stage knew how to test for it and nobody knew what the right quarantine rules should have been. But, as it happens, not only did the UK Government and our amazing NHS approve the first vaccine anywhere in the world but we were first to get it into anybody’s arms and we had the fastest roll-out anywhere in Europe, none of which would have been possible if we had listened to the right hon. and learned Gentleman.
I think the Prime Minister just agreed with the Culture Secretary. He did not deny it. Perhaps she said it because it is true.
It starts with GPs. People were unhappy with the service that they were getting before the pandemic—there were not enough GPs and it was too hard to get an appointment—and that is why he promised 6,000 new GPs, but his Health Secretary admits that he will not keep that promise. Despite the hard work of doctors, people cannot see a GP in person, and they are unhappier than ever with GP services. If GP provision was “wanting and inadequate” before the pandemic, what is it now?
I am afraid that the right hon. and learned Gentleman is simply wrong. He is wrong about what we are doing. Of course, we have got to clear the covid backlogs. Everybody understands that, and everybody understands the pressure that the NHS is under, but it is responding magnificently. I can tell him that, thanks to the investments that the Government have put in, we now have 4,300 more doctors and record numbers in training, we have 11,800 more nurses this year than last year and 72,000 in training. That is because of the investment that we put in, which was opposed by the Opposition. The only reason why we were able to make that investment is because we have a strong and robust economy thanks to the decisions we took.
The Prime Minister talks big but I have a letter here to the Prime Minister from the right hon. Member for Hereford and South Herefordshire (Jesse Norman) in which he said, “under you”—that is you, Prime Minister—
“the Government seems to lack a sense of mission. It has a large majority, but no long-term plan.”
The Prime Minister’s “big plan” act is so tired that even once-loyal MPs do not believe him.
It is not just about waiting for a GP appointment but waiting for all NHS treatment. Take cancer: for over a decade, waiting times for cancer care have been going up. The Prime Minister’s solution was supposed to be diagnostic hubs. The Health Secretary has been on a victory lap this week, but here is the rub: since those hubs were opened last year, 135,000 extra people are now waiting for scans and tests. Can the Prime Minister think of a better way to describe soaring cancer waiting lists than “wanting and inadequate”?
It is entirely right that, after the pandemic, people are now coming forward to get their cancer tests. We have actively encouraged that, and that is the right thing for people to do. But as a result of the community diagnostic hubs that we are bringing in— 100 of them across the country—we are able to cut the times for cancer diagnosis and help people to get their scans and tests faster. Above all, we can do that because we are hiring more radiographers, we are hiring more nurses and we are hiring more professionals in our NHS because of the investments that we made, which, as I say, the party of Bevan tragically opposed.
The problem is that the cancer waits have been going up for 10 years and they are even higher now, so blaming the pandemic just will not wash.
Perhaps the Culture Secretary was talking about the state of NHS buildings. Before the pandemic, the National Audit Office said that they were a risk to patients. The Government’s response: paint jobs and fix-ups, pretending that is the same as building new hospitals. The Treasury and the Cabinet Office apparently do not think the refurbs will even be delivered. Take University Hospital of North Tees: the ceiling is falling in, the roof leaks and staff have to hose down the pipes to stop them freezing over. Failure to fix “wanting and inadequate” NHS buildings is putting patients at risk, isn’t it, Prime Minister?
This line of criticism is satirical coming from Labour, attacking our hospital building programme when the Labour Government were the authors of the PFI scheme that bankrupted so many hospitals. [Interruption.] They were. What we are doing instead is building 48 new hospitals—[Interruption.] Yes, we are—thanks to the biggest capital investment programme in the history of the NHS. From memory, we put in £33 billion as soon as we came in, then another £92 billion to cope with the pandemic, plus another £39 billion in the health and care levy. Labour Members opposed that funding. They opposed the health and care levy. They do not have a leg to stand on. We are building the foundations of our health service’s future and they should support it. [Interruption.]
Oh dear. Prime Minister, dear, dear me. [Interruption.] Pretending no rules were—[Interruption.] He chunters on. Pretending no rules were broken did not work, pretending the economy is booming did not work and pretending to build 40 new hospitals will not work either. Conservative Members want him to change, but he cannot. As always with this Prime Minister, when he is falling short he just changes the rules and lowers the bar. In March, he proposed changing the NHS contract. He wants to double the length of time patients can be made to wait for surgery from one year to two years. On top of that, he scrapped zero tolerance of 12-hour waits at A&E. “24 Hours in A&E” used to be a TV programme. Now, it is his policy. Well, it is health week and he is telling all of them—[Interruption.]
Order. Mr Cleverly, we have a tea party gathering. I am sure you do not want to be part of it. I want to hear the question. The problem is so do our constituents. [Interruption.] I would not if I were you, and I think one or two of you might be going early. Look, I need to hear the question in the same way that I expect to hear the answer, so please.
Mr Speaker, I bet they wish they had been this organised on Monday.
It is health week and the Prime Minister is telling Conservative Members that he is going to turn over a new leaf, so why does he not start by scrapping his plans to green- light “wanting and inadequate” NHS standards?
Not only have we raised standards in the NHS, and not only are we reducing waiting times for those who have had to wait the longest, but more fundamentally, we are doing what the people of this country can see is simple common sense: using our economic strength to invest in doctors and nurses and get people on the wards, giving people their scans, screens and tests in a more timely manner and taking our NHS forward. We are on target to recruit 50,000 more nurses, thanks to this Government—[Interruption.] I am just going to repeat this, because the right hon. and learned Gentleman does not seem to have heard it so far—and thanks to the investments that the Labour party opposed. Perhaps he can explain why they opposed them.
Raising taxes because you have failed to grow the economy is not a plan for the NHS, and everyone sitting behind the Prime Minister knows it. Members of his Cabinet admit that the Conservatives left our health system “wanting and inadequate” when the pandemic hit. He has been in power for three years and things are getting worse, not better. There are fewer GPs, more waits for cancer tests, buildings are still crumbling and he is changing the rules to cover up his failure.
There is real human pain as a result. Today, I spoke to Hamza Semakula. He is 20 and plays semi-professional football for Hendon. He tore his anterior cruciate ligament earlier this year and, because of the two-year wait for surgery, he had to crowdfund for a private operation. I also spoke to Akshay Patel. Last year, his mother woke up unable to breathe. Akshay called 999 six times. In his last call, he said:
“I rang an hour ago for an ambulance as she had difficulty breathing, and now she’s dead.”
Even the Prime Minister must admit that Akshay, Bina and Hamza deserve better than a “wanting and inadequate” Government, utterly unable to improve our NHS.
I think everybody in the House has sympathy with Akshay and the other constituents, and their families, that he mentions. I share their feelings, but when we look at what this Government are doing— I must say this to the right hon. and learned Gentleman—we see that we are making colossal investments in our NHS. We are cutting waiting times, raising standards, paying nurses more and supporting our fantastic NHS. By the way, he continually came to this House—I will just remind him of this—and said that we had the worst covid record in Europe. It turned out to be completely untrue; he still has not retracted it. We can make those investments because of the strength of the UK economy, because of the fiscal firepower that we have to deploy. We have the lowest unemployment now since 1974 and we are going to continue to grow our economy for the long term.
The right hon. and learned Gentleman asks about the mission of this Government. It is to unite and level up across our whole country, to unleash the potential of our entire country. We have the biggest tutoring programme in history for young people and are raising literacy and numeracy standards for 11-year-olds from 65% adequacy to 90%—that is the highest objective that a Government could achieve. We are expanding home ownership, as the Secretary of State for Levelling Up, Housing and Communities and I will do for millions of people who currently do not have it—[Interruption.] No. We are cutting the costs of business to make this the enterprise centre of Europe. That is our vision, creating high-wage, high-skilled jobs for this country. As for jobs, I am going to get on with mine and I hope he gets on with his.
I share my right hon. and learned Friend’s concern. Our sewage plan is the biggest investment by any Government. We have made it clear that water companies must do more. Actually, we are already seeing improvement, but the regulator is ensuring that the water companies do more to deliver on their obligations, and we will not hesitate to take further action as needed.
Thank you, Mr Speaker. May I associate myself with the remarks of the Prime Minister and the Leader of the Opposition in supporting our carers?
Week after week, when I have called on this Prime Minister to resign I have been met with a wall of noise from the Tory Benches. I thought that they were trying to shout me down—[Interruption]—but all this time it turns out that 41% of them have been cheering me on! Let us be clear. At least the numbers do not lie: 41% of his own MPs have no confidence in him, 66% of MPs across the House do not support him, and 97% of Scottish MPs want the Minister for the Union shown the door. We now have a lame duck Prime Minister presiding over a divided party and a disunited kingdom. How does the Prime Minister expect to continue when even Unionist leaders in Scotland will not back him?
I thank the right hon. Gentleman for his characteristically warm words. And actually, the biggest and most powerful and effective advocate of the United Kingdom over my time has been that man there. I do not know how long he is going to last as leader of the SNP here, but long may he rest in place. He is the Araldite that is keeping our kingdom together, and I thank him for what he is doing. [Hon. Members: “More!”]
I can say to the Prime Minister that I will be standing shoulder to shoulder with our First Minister as we take our country to independence.
The Prime Minister is acting like Monty Python’s black knight, running around declaring, “It’s just a flesh wound!” No amount of delusion and denial will save the Prime Minister from the truth. This story will not go away until he goes away. For once in his life, he needs to wake up to reality. Prime Minister, it’s over, it’s done.
The Prime Minister has no options left, but Scotland does. Scotland has the choice of an independent future. It is not just the Prime Minister that we have zero confidence in, but the broken Westminster system that puts a man like him in power. Can the Prime Minister tell us how it is democratic that Scotland is stuck with a Prime Minister we do not trust, a Conservative party we do not support, and Tory Governments we have not voted for since 1955?
We had a referendum, as I have told the House before, in 2014, and I think that the right hon. Gentleman should respect the mandate of the people. He keeps saying that he wants independence for his country. Our country is independent—though the Leader of the Opposition tried 48 times to reverse it —and the only way that independence would ever be reversed is if we had the disaster of a Labour-SNP coalition to take us back into the EU.
In case my right hon. Friend missed what else I said, we are cutting taxes for everybody who pays national insurance contributions by an average of £330 just next month. As for HS2, it will deliver long-term growth and prosperity for the whole country, unite and level up, deliver more revenues and put us in a better position to cut taxes in future.
We have heard reports today that the Prime Minister refused to consult the First Treasury Counsel on his plans to rip up the protocol. This question might be a bit redundant, as the Prime Minister might not be around for very much longer, but given his record of casual lawbreaking, will he give a commitment to the people of Northern Ireland that he will not break international law any time soon?
I can tell the hon. Gentleman that the reports that he has seen this morning are not correct. I can also tell him that the most important commitment that I think everybody in this House has made is to the balance and symmetry of the Belfast/Good Friday agreement. That is our highest legal international priority, and that is what we must deliver.
Listen, I am a great enthusiast for this project. We are looking at it, and I can tell my hon. Friend that Network Rail has received funding to carry out feasibility work on improving north Wales mainline journey times. Travellers in north Wales could have no more effective advocate than my hon. Friend.
I will certainly look into what has happened at the centre in Batley and Spen that the hon. Lady mentions. What I can tell her, though, is that across the country we are investing massively in staff, in premises, in technology and in diagnostic centres. For Opposition Members to carp and criticise is frankly absurd, because they voted against the health and care levy that is putting billions into our NHS. They need to sort out their position: either they support it or they do not.
I thank my hon. Friend for what he has said. He and I have campaigned on this, and I have been following his campaign for a long time. I am told that the Department for Transport is currently reviewing the business case for exactly what he has just requested. We are putting the funding in, which is unlike anything that the Labour party could ever have delivered.
I redirect the hon. Gentleman to what I said to my friend the leader of the SNP, the right hon. Member for Ross, Skye and Lochaber (Ian Blackford). The more SNP Members campaign, in the current circumstances, for breaking up our United Kingdom—with all its strength and all its merits—the more damage they do to their own case.
Actually, I can tell the hon. Gentleman that 91% of people are getting their passports within six weeks, and we are putting hundreds and hundreds more staff members into the Passport Office. The strength of demand, by the way, is a sign of the robustness of the economy, because everybody is wanting to go on holiday, and quite right too.
When it comes to travel chaos, may I ask whether we have yet heard any condemnation from the Opposition of the RMT and its reckless and wanton strike? What about that?
I know that my hon. Friend speaks for colleagues up and down the country. We want to make sure that councils are able to build in the right place and sensitively to local needs. That is what we insist on, but I want to make it absolutely clear that part of the genius of levelling up is that it will encourage us to take some of the pressure and heat out of the south-east of England, which has been overburdened for decades, and we can do it.
Of course I understand the hon. Lady’s indignation about the case she mentions, and I know that my right hon. Friend the Home Secretary will be looking into it, but the record of this country in processing I think well over 100,000—120,000—visas for Ukrainians so far is very creditable and I thank all the staff who have been involved in that effort.
My right hon. Friend will remember that, in March, I asked him about increased research funding for aortic dissection, as called for by the Aortic Dissection Charitable Trust. Will he update me on the progress on that? Will he also recognise the immense value of the patient awareness videos that have been introduced by the trust, featuring “Whispering” Bob Harris, survivors and relatives of patients to help those going through this awful condition for the first time?
I thank my hon. Friend for her fantastic work on this, and I know the personal circumstances that give her an understanding of that campaign. I can tell her that the National Institute for Health Research is looking at what more we can do to support research on aortic dissection, and I know that she is meeting my right hon. Friend the Health Secretary shortly.
I think the hon. Lady needs to bring this particular case to my right hon. Friend the Home Secretary, but I can tell the House—[Interruption.] I know, by the way, that many hon. Members are showing a lead by having Ukrainians to stay in their own homes, and I thank all hon. Members who are doing that, thanks to the scheme that the UK Government have put in place. I think we should be very proud of what we are doing.
The Prime Minister knows from his visits to Redcar and Cleveland that we enjoy miles of beautiful, uninterrupted coastline. However, since October last year, we have seen thousands of dead and dying crustaceans being washed ashore. The Department for Environment, Food and Rural Affairs conducted an investigation into that, leading to the theory that algal bloom is the primary cause of these deaths. However, the report does nothing to support the fishermen left devastated by this freak event through no fault of their own. Will the Prime Minister look at how he can support this vital industry to get them back on its feet?
My hon. Friend and I were walking together on the seafront in Redcar—eating a lemon top, actually—when somebody raised that very point with us. I can tell him that we have ruled out chemical pollution, but we are making another £100 million of investment, including in communities such as his, and working with the fishing industry to help it to recover from this problem.
I thank the hon. Member and I can tell him that what we are doing right now is helping 8 million households across the country with £1,200 of support, £300 for pensioners who are in receipt of the cold weather payment, plus £400 for every household in the country. That is the support we are giving right now to help people with the cost of energy. The only reason we can do it, as I have said before to the House, is because of the strength of the economy and the brave, tough calls we got right during the pandemic.
Health and Social Care Leadership Review
With permission, Mr Speaker, I will make a statement on the independent leadership review of health and social care.
This is an important report that comes at a critical time. This Government are embarking on a huge programme of reform to tackle the covid backlogs, to improve people’s experience of the NHS and social care, and to place this system on a sustainable footing for the future. But we cannot seize this opportunity and deliver the change that is so urgently needed without the best possible health and care leadership in place, because great leaders create successful teams, and successful teams get better results. So a focus on strong and consistent leadership at all levels, not just on those who have the word “leader” in their job title, will help us in our mission to transform health and care and to level up disparities and patient experiences.
This review, which I have deposited in the Libraries of both Houses, was tasked with proposing how to deliver a radical improvement in health and social care leadership across England. It sets out a once in a generation shake-up of management, leadership and training, as well as how we can make sure that health and care is a welcoming environment for people from all backgrounds, free from bullying, harassment and discrimination.
The review was led by General Sir Gordon Messenger, former Vice-Chief of the Defence Staff, and Dame Linda Pollard, the chair of Leeds Teaching Hospitals NHS Trust. I thank them both for taking on this role and providing their varied experience of leadership, along with everyone in their review team who has contributed to this important review.
Before I turn to the recommendations of the review, I shall update the House on its findings. The review found that, although there are many examples of inspirational leadership within health and social care, from ward to board, these qualities are not universal. The report states that
“there has developed over time an institutional inadequacy in the way that leadership and management is trained, developed and valued.”
As a result, careers in management are not viewed with the same respect and prestige as clinical careers. The review also found
“too many reports to ignore”
of poor behaviour, and that the acceptance of bad behaviours like discrimination, bullying and responsibility avoidance has become “almost normalised” in certain parts of the system.
We must only accept the highest standards in health and care, where failures in culture and leadership can make the difference between life and death. So we must do everything in our power to share and promote brilliant, innovative management and to act firmly where standards fall short. This means culture change from the top of the system to the frontline. The review identifies a number of areas where improvement is needed, and it makes seven transformative recommendations. I will quickly update the House on each of them in turn.
First, the review recommends new measures to promote collaborative leadership and to set a unified set of values across health and care. This includes a new national entry-level induction for new joiners to health and care, and a new national mid-career programme for managers.
Secondly, the review recommends that we should agree and set uniform standards for equal opportunities and fairness, with more training to ensure that the very best leadership approaches become ingrained. The Care Quality Commission must support this work by measuring progress through regular assessments. This does not mean more people working in diversity but fewer. In my view, there are already too many of these roles and, at a time when our constituents are facing real pressures on the cost of living, we must spend every penny with care. Instead of farming out this important work to a specific group of managers, it must be seen as everyone’s responsibility, with everyone being accountable for extending fairness and equal opportunities at work.
Thirdly, the review recommends a single set of unified leadership and management standards for NHS managers. These standards will apply to everyone, including those who work part time and flexibly, with a curriculum of training and development to help people meet them. This modernisation is well overdue, and completing the training should be a prerequisite for advancing to more senior roles.
Fourthly, the review recommends a more simplified, standardised appraisal system for the NHS, moving away from variation in how performance and career aspirations are managed towards a more consistent system that takes into account how people have behaved, not just what they have achieved.
Fifthly, the review identifies a lack of structure around careers in NHS management. It proposes a new career and talent management function for managers at a regional level, to oversee and support careers in NHS management and to provide clear routes to promotion, along with training and development.
Sixthly, the review recommends that the recruitment and development of non-executive directors needs to be given greater priority due to their vital role in providing scrutiny and assurance. It proposes an expanded specialist appointments team in the NHS, tasked with encouraging a diverse pipeline of talent.
Finally, there is currently little or no incentive for leaders and managers to move into the most challenging roles, as the barriers are often seen as simply too high. I want leaders in the NHS to seek out those roles, not shy away from them. It is essential that we address that and get great leaders into areas that feel left behind. The review proposes an improved offer, with stronger support and incentives to recruit top talent into those positions.
We will be accepting these comprehensive, common-sense recommendations in full. The recommendations have been welcomed by groups representing people who work throughout the NHS, including by the NHS Confederation and NHS Providers. By taking the review forward, we can finally bring how we do health and care leadership into the 21st century, so that we have the kind of leadership that patients and staff deserve, right across the country, and so that we make sure that some of our country’s most cherished institutions can thrive in the years ahead.
I commend this statement to the House.
The Secretary of State has picked quite the week to talk about standards in leadership.
I give a huge thanks to NHS staff and leaders for the work they are doing against the most extraordinarily difficult backdrop. I also thank General Sir Gordon Messenger and Dame Linda Pollard for carrying out the review. Its seven recommendations are sensible, and I am pleased the Secretary of State has already committed to implementing them.
As this is a rare example of decisiveness from the Health Secretary, can he tell us when he intends to publish his implementation plan? All too often, the senior leadership of the NHS still does not represent the diversity of the population it serves. Instead of throwing red meat to his Back Benchers, for reasons that will probably be obvious to everyone, I would like to hear how, in particular, he intends to ensure that equality, diversity and inclusion will be improved, so that the best leaders are incentivised into the most challenging roles and are able to provide inclusive healthcare for the breadth of diversity in our great country. Can he explain why the review has not covered leadership in primary care or social care in any detail? Surely this is a missed opportunity. Let us face it: although he is trying to dress this up as the biggest shake-up in history, I am not sure that giving staff an induction on joining the NHS is a revolutionary development, and it hardly meets the scale of the challenge.
The NHS faces the biggest crisis in its history. NHS staff are in a system under pressure like never before, and there are simply not enough of them. There are currently 106,000 vacancies across the NHS, and staff are leaving in droves. In some specialties, such as midwifery, they are leaving faster than we can recruit them. I do not know how the Health Secretary expects NHS managers to demonstrate good leadership and deliver the best outcomes for patients when there are no staff to lead. For an organisation the size of the NHS, one of the biggest employers in the world, not to have a plan for its workforce is unbelievably negligent. What is the NHS meant to do until he eventually delivers his long-term workforce strategy, which he has been promising for some time? How are managers meant to lead effectively when instead of thinking about patient care as their primary driver, they have become buildings and facilities managers, because the ceilings are falling in? The only place where more than 40 new hospitals really exist is in the Prime Minister’s imagination.
The Health Secretary said that we should accept only the highest standards in NHS management, so let me ask him not about the generalities, but about the specifics. Last month, it was reported that North East Ambulance Service bosses oversaw cover-ups of negligence, leaving about 90 families not knowing how their loved ones died. He said yesterday that he is still considering whether to launch a review. Is he seriously considering protecting managers who cover up bad practice, instead of standing up for grieving families? Staff in that service were reportedly paid to sign gagging clauses, and I understand that attempts to get them to sign such clauses are still under way. In a written question, I asked how many non-disclosure agreements had been signed in the NHS since the Government said that they would be banned in 2014. He does not know and he is refusing to investigate the use of gaging clauses in the NHS. So how can he claim to be shaking up NHS culture and dealing with bullying when he has no interest in what is going on under his nose?
Of course the NHS needs good leaders, but when it comes to examples of poor leadership in the NHS, the Health Secretary did not need the Messenger review; he just needed to look in the mirror. This is the man who described the NHS as Blockbuster Video
“in the age of Netflix”,
as if it was the greatest revelation since Moses received the 10 commandments. Who has been in government for the past 12 years? On his watch, on this Government’s watch, we have the highest waiting times in the NHS’s history; the lowest patient satisfaction since 1997; longer waiting times for cancer in every year since 2010; heart attack and stroke victims left waiting for about an hour, on average, for ambulances; and patients at risk of serious injury because the hospital is crumbling around them. He kicked off his own Health Week expecting applause for the fact that, despite his best efforts, there are still 9,000 people waiting for more than two years for treatment. He knows, I know, NHS staff know and the public know that with this Government, NHS staff are lions led by donkeys, wanting and inadequate.
I am not surprised by the typical response from the hon. Gentleman: not really engaging with the real issues and showing once again that he is more interested in theatrics than in the real issues facing our NHS. He started his comments by trying to make some kind of joke about the leadership news this week, but we all know that he is only interested in one leadership review in a political party in this House, and it is not the Conservative party’s.
Let us look at the issues that the hon. Gentleman raised. He rightly talked about the importance of the workforce overall and how we need more doctors and nurses. He should know that we have more doctors and nurses than ever before and that we are recruiting at a faster rate than ever before, with 10,000 more nurses and over 4,000 more doctors in the past year, and more in training than ever before. However, he will know that dealing with the challenges of getting more workers and building those hospitals, all of which are on track, requires proper funding, yet he and his party voted against the funding that the NHS needed to achieve that.
The hon. Gentleman is right to talk about when things go wrong in the NHS. Of course they need to be properly investigated, as they were in Telford and Shropshire, when we learned about the terrible things that had been going on under successive Governments in that trust. When there is a need for other investigations to take place, including independent ones, such as the one I have just asked for in Nottingham, that will be done. But the hon. Gentleman should understand that the best thing, which is far better than doing a review when things go wrong, is not having things go wrong in the first place. That is why he should have welcomed this report.
This is an important review. There have been regular radical changes in the management of the NHS throughout my 25 years in this House, so may I suggest that my right hon. Friend proceeds with care? He rightly says that good leadership of the NHS is important, for example, to ensure that we can deal with the covid backlogs, and that includes consultants. Too many experienced consultants are leaving the NHS because of problems with their pensions, so will he now commit to an urgent review of this issue, including looking at the change in the abatement scheme?
I thank my right hon. Friend for her comments. I always listen carefully to what she has to say, given her important experience. On the pension issue, she will know that in the 2020 Budget, I believe it was, significant changes were made, especially to where the taper rate kicks in—it went from £110,000 to £200,000. That benefited the top 5% of earners in this country, but it was the right thing to do to encourage and incentivise doctors, in particular, to work more. She is right to talk about what more we can do. We are looking precisely at what further flexibilities we can offer on pension arrangements.
The Health and Social Care Secretary talks about strong leadership and culture change. I point out to him his Government’s and his Department’s dismal record in meeting the pledge to close the in-patient units that are being used to trap more than 2,000 autistic people and people with learning disabilities rather than support them in their own homes. We have just passed the 11-year anniversary of the scandal at Winterbourne View. Not only has his Government failed in their pledge to close down these units, which was the original promise made after that scandal, but 560 people in those in-patient units do not need to be there at all, a quarter of them are more than 50 km from their own home, people are spending longer in units now than they were seven years ago, and more people have been admitted to the units year on year from 2015-16. This is one of the biggest scandals and the worst failures of his Department and Government. When is he going to act on it?
The hon. Lady is right to highlight the importance of this issue and she will know that my predecessor had asked for a review on it. It was done and we have accepted its outcome, and it is being implemented. I hope she will understand that in implementing the outcome of that review it is important that we listen to clinical advice from within the NHS and make sure that we put the interests of each patient first.
I thank the Health Secretary for this excellent report and commend Sir Gordon Messenger and Dame Linda Pollard for all their work in putting it together. It has some very important recommendations. People who run hospitals are doing one of the most difficult jobs in Britain today, and anything we can do to give them better support in their careers will help all of us.
Does my right hon. Friend agree that the elephant in the room is that one thing that makes their job most difficult: we have more national targets in the NHS than any other health system anywhere in the world? That means not only that there is a risk of patients turning into numbers, but that we remove the autonomy from managers to show the leadership that Sir Gordon is advocating in this report. So as my right hon. Friend implements the recommendations, will he look at the role of national targets in the NHS and whether we need to simplify and reduce them?
I thank my right hon. Friend for his support of the report. Of course he speaks with incredible experience. He is right to raise the issue of the importance of targets, and sometimes targets can have unintended consequences. The report does talk a bit about the importance of that issue. I can assure him that as we make changes and work with our colleagues in the NHS to make reforms, we will certainly be taking that into account.
As the Secretary of State will have seen over his years as an MP and a Minister, there are managers and leaders who are excellent and outstanding and there are others who are not so good. Is not part of the problem, as the right hon. Member for Maidenhead (Mrs May) mentioned, the continual structural changes, which add to instability, the massive recruitment and retention problems and the record numbers of people using the hospitals? No matter what he does to improve leadership, it will not solve all those problems. Part of the problem is that we do not have enough people coming forward to take up leadership roles. At what point in the next five to 10 years does he expect to have solved the leadership crisis in the NHS?
The hon. Gentleman is right to talk about the importance of recruitment in the NHS—bringing in the right people in the first place and then retaining them—but I hope that he will also recognise that good leadership plays an important part in that. This morning, I went to Chelsea and Westminster Hospital, which is an outstanding and incredibly well run hospital, and heard from the leadership team about the important role that they play in attracting and retaining talent. I hope that he recognises that point as well.
The reason why the Department keeps that under review is that, although the pass has stopped and there is absolutely no prospect that I can see of its ever coming back into place, it is right that, as we wind things down and work on the digital resources, all things are looked at appropriately.
On Thursday 19 May, I and a group of south London MPs met south London nurses from the Royal College of Nursing. They told us that they are tired. They told us that they are fed up. They told us that they are having to use food banks. They told us that they are seeing their salaries squeezed by the cost of living. They told us that they face bullying, intimidation and abuse at work. This was coming from staff members who work in our hospitals, including at St Thomas’s Hospital, in my constituency, which I know the Secretary of State has visited on many occasions.
There is a big gap—an omission—around this leadership issue in social care. We have big retention issues. There are more than 9,000 vacancies. Does the Secretary of State have a plan to address that big omission in health and social care, including retaining the people we need on the frontline?
The short answer is that, yes, the hon. Lady is right to talk about the importance of retaining and recruiting more nurses. When it comes to nurses’ pay, she will know that we gave a 3% rise last year when there was a freeze for the public sector workforce generally. This year, we will be listening carefully to what the independent recommendation is.
I cannot give my right hon. Friend the exact number that he is asking for, but I can answer the latter part of his question. I agree that we want to see a massive improvement in appraisal and performance standards; I am sure that, when he gets to see the report in detail today, he will be pleased by what he reads.
The Secretary of State said that we must accept only the highest standards and act where standards fall short. My constituent, Paul Calvert, bravely exposed the management failures of the North East Ambulance Service and, indeed, the criminal negligence of cover-ups of patient deaths.
Mr Calvert, who gave me his permission to raise this case—I met him in person last week—is being bullied, harassed and blackmailed, but he still refuses to sign a non-disclosure agreement. He was offered £41,000 conditional on his silence and on destroying the evidence that he has of wrongdoing. Tomorrow, we anticipate his employment being terminated. Mr Calvert and grieving families want a public inquiry into the North East Ambulance Service. Does the Health and Social Care Secretary agree, and will he outline how the Messenger review will protect NHS whistleblowers such as my constituent, Mr Calvert?
I thank the hon. Gentleman for bringing Mr Calvert’s case to my attention. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), has listened to that carefully. She is meeting some of the families affected by that case very shortly, and Mr Calvert is someone to whom she can reach out directly.
Like the hon. Gentleman and, I am sure, the whole House, I am very concerned about what I have heard about this ambulance service. I am not satisfied with the review that has already been done. We need a much broader and more powerful review. I will have more to say on the matter very shortly.
I welcome this review and thank my right hon. Friend for bringing his statement to the House. Good leadership is important because it drives the culture within an organisation. It was terrible to hear what the hon. Member for Easington (Grahame Morris) had to say just now. We can see that bullying and harassment in an organisation often come down to how the leadership and the processes are operating.
Whistleblowers need to know that they can rely on the processes within organisations, but who do they go to as well? The National Guardian’s Office would be one, as would the local guardians in the hospitals. I recently introduced a whistleblowing Bill to ensure that people are able to go to another body, because they cannot be constricted within their organisation. We need to be able to benefit from whistleblowers who speak out and expose wrongdoing so that we can close down these cultures that we have seen operating in our organisations.
My hon. Friend is right: it is important that, where people who are working within the NHS or social care see wrongdoing or things that concern them, they have a safe space to report that and to make sure that their concerns are properly addressed. She will know that the Health and Social Care Act 2022 contains new provisions, including one for the Health Services Safety Investigations Body, but I have listened carefully to what she has said and I will consider what more we can do.
The Secretary of State might recall that, as a member of the all-party group for management, I have had a long interest in management and good management. I congratulate him on having this review, because the NHS is a complex organisation.
The Topol review that was carried out only two or three years ago showed a world of technology and change that is almost beyond belief for such a massive human organisation. I have not had the time to read the report yet, but is the Secretary of State sure that we have high-quality training for our managers? Many of the business schools and many of the people providing the training in our universities are not training for that kind of environment. We do need first-rate, high-quality management schools with a health bias.
I agree with the hon. Gentleman. I know that he has a long-standing, valuable interest in this issue. I appreciate that he has not had time to look at the report, but I think he will be pleased when he reads our recommendations around a modern training plan.
The most important thing that happened in Westminster this week was yesterday’s reception for Harry’s Pledge. Harry is a young boy who needs a lot of care. Harry’s Pledge campaigns for the needs of carers and those who are cared for. I am introducing a private Member’s Bill to give guidance for that. Will the Secretary of State look at that Bill to see whether the Government could support it? Leaders in care need to have the guidance to judge whether they are succeeding.
NHS staff are exhausted and demoralised, and now we are asking them to deal with the growing waiting lists. We still have a huge vacancy problem within our NHS. Where is the plan to deal with that issue? If we are to improve our NHS going forward and have anything there for these managers to manage, we need to deal with that problem within the workforce.
I thank the Secretary of State for his statement and congratulate him on the work he has been doing in this important area. Does he agree that for too long there has been a culture of a lack of accountability among NHS senior management, and too often a blame culture, where things go wrong but are not transparently acknowledged? Does he agree how awful that is for the patients concerned? Will he do everything possible to ensure that we tackle the blame culture and the lack of accountability to the public, who the NHS is there to serve?
I agree very much with my hon. Friend. She will know from her own NHS trust, particularly the maternity problems there and the terrible cases set out in the Donna Ockenden report, just where that kind of culture can lead. Of course there are fantastic examples day in, day out of great culture and great leadership in the NHS, but there are also poor outcomes. She is absolutely right that we need to tackle those. That is exactly what is in this report.
I cannot really understand why yet another restructure of the NHS is the answer to the crisis we face. The last one diverted billions of pounds from patient care, and millions of people are suffering as a result. Instead of yet another costly restructure, why does the Secretary of State not just get on with building the new hospitals we need, such as the one at North Tees in Stockton, and tackling the health inequalities that blight our communities?
I warmly welcome my right hon. Friend’s statement on the review and his strong support for inspirational leadership, which is key for our NHS. Does he agree that relevant training and career development are vital for all staff working in the NHS, to allow them to gain career advancement?
I hope the Secretary of State will agree that it is key that managers in the NHS and local authorities can work together effectively. I give great credit to the leaders in the clinical commissioning group, the hospital trust, the director of public health, the social care directors and the city council, who worked really well together in Sheffield during the pandemic to deliver a joined-up service and have kept us as MPs thoroughly involved.
As we move on to the slightly wider integrated care system and integrated care board, will he give a commitment that the place-based working that has been so effective in the past will be allowed to continue at local authority level?
I welcome Gordon Messenger’s review, but does the Secretary of State not agree that in the history of the national health service, reorganising senior management has often been a distraction? Will he prioritise the area that would make a real change to health and care—the interface between the two—and focus on career progression and development for care workers in particular, who hold the key to unblocking the awful problems that we have in both sectors?
I know my right hon. Friend speaks with experience, and I appreciate that he will not have had time to look at the report in detail yet, but I think when he does read it he will find that it is precisely what he has just asked for. This is not a reorganisation; it is all about strengthening management, and the report sets out in quite some detail how that can work.
I agree with the right hon. Member for Maidenhead (Mrs May) on NHS reorganisations. I once met a very senior and very able NHS manager who said they had been through 14 restructures of the NHS and they quite liked number five. How will this review better integrate ambulance services with their local hospitals to improve performance standards for local patients?
When it comes to ambulance services, an important part of the NHS, this review is just as important. We all want to see good leadership in ambulance services, but if we get better leadership across the board we will see better collaboration and co-ordination—something heavily referred to in the report.
I welcome this statement; leadership is vital and it is something we do not talk enough about in this country, whether in the private or public sector. My right hon. Friend referred to recommendation 6 on non-executive directors. Does he agree that we need to attract a more diverse set of non-executive directors, with regard to their skillset as much as anything else?
I thank the Secretary of State for his statement and for the commitment to quality leadership within the NHS. As he said himself, that is so important. The review findings and recommendations are a method to deliver that improvement. Retention of staff—the consultants, the GPs, the doctors and the nurses—is core to any improvement, so what is being done to retain staff and not lose them? Is it the Secretary of State’s intention to share the findings with regional Administrations, particularly the Northern Ireland Assembly, to provide betterment across all the United Kingdom of Great Britain and Northern Ireland?
The hon. Gentleman will know that the review specifically looked at the NHS and care in England, but there are important lessons here that can be drawn on by, for example, the health service in Northern Ireland. On the issue of retaining staff, the NHS is undertaking many initiatives to improve that, but I hope he will agree with me that one key way to retain staff is to ensure we have good leadership and good managers.
The review underlines how vital leadership is to driving change and improvements in care. I put on record my thanks to the chief executive and board of the Queen Elizabeth Hospital Kings Lynn NHS Foundation Trust, who have taken that hospital out of special measures, thanks to the hard work of the staff. As my right hon. Friend knows, to continue to improve care and to retain and recruit staff there is a pressing need for a new hospital for the QEH. I urge him to make an announcement on the new hospitals programme and to back QEH’s bid.
I thank my right hon. Friend for his statement and for the report. Recommendation 4 talks about a standardisation of appraisal. Does he agree that cutting out variation in performance is key, and will he therefore confirm that the recommendations from Tim Briggs’s “Getting It Right First Time” report will be embedded in that standardisation procedure?
The focus that the Health Secretary is giving to leadership management training must be right. We all know that in a Care Quality Commission report on a hospital or an Ofsted report on a school, one of the key differences between adequate and outstanding is the quality of leadership. All credit to the report for focusing on that; I think we would all benefit from understanding that it is one of the key characteristics of hospitals whose internal staff surveys show strongly positive morale—often a key leading indicator.
Will the Secretary of State say a word or two about the point raised by the hon. Member for Easington (Grahame Morris)? The report and what has come out of the North East Ambulance Service are truly shocking and highlight what I think Sir Gordon Messenger called a need for a change of culture. How can we encourage all our NHS trusts to be open and transparent about what has gone wrong, so that we do not have future scandals like that?
My hon. Friend will see when he has had the opportunity to read the report in full that it does rightly talk about the importance of that particular issue: ensuring that people within the NHS and care feel comfortable coming forward when they see wrongdoing, so that we can act much more quickly. That is why we will be implementing all the recommendations. Regarding the North East Ambulance Service, I hope he heard what I said earlier about the need to look at that again very carefully.
As a former chair of the all-party parliamentary group on cancer for 10 years, I welcome this review. However, I put it to my right hon. Friend that at least part of the problem with waiting times and lists is the fact that only around half of all NHS staff are clinically trained. There is an imbalance there. Following my amendment during the passage of the Health and Care Act 2022, which he accepted, I suggest that one thing that could really help would be to get the NHS to focus more on outcomes such as one-year cancer survival rates, as a means of encouraging earlier diagnosis, and less on processes, which are very management-heavy.
I thank the Health Secretary for this vitally important report at this critical time. Is he aware of reports circulating in the media that some NHS health information pages appear to have been de-sexed in their language about conditions affecting women? Is he, like me, very concerned about this, and will he look into it?
My hon. Friend will not be surprised to learn, I hope, that as Health Secretary I think an individual’s biological sex is incredibly important when trying to meet their health needs. I have seen the reports. In fact, I do not think they are just reports. With regard to the NHS website on ovarian cancer, I think it is actually has been, as she puts it, de-sexed. That is not something that I agree with. Of course, issues of gender, rather than sex—I distinguish the two—should be approached with compassion and sensitivity, but it is right that when it comes to healthcare, where there are health issues that impact only people of a particular biological sex, such as ovarian cancer and prostate cancer, the health service recognises that.
I am very concerned that the review found evidence of a blame culture and responsibility avoidance. We have to be clear that this culture is not just damaging but actually kills patients, because lessons are not learned from mistakes that are actively hidden. What can we learn from the airline industry, which adopted a no-blame culture and, through that, dramatically reduced airline-related deaths?
I recognise the importance of leadership and reform of the NHS. Can we now show some leadership and reform in the area of NHS dentistry? The Labour Government wrecked NHS dentistry when they brought in the contracts that have led to dentists leaving the profession in droves. When people up and down the country, including my constituents in North Norfolk, cannot see an NHS dentist, is it not about time that we reformed the rotten contracts that Labour brought in?
My hon. Friend is right. It is well known how the Labour Government came up with contracts with the British Dental Association that are leading to poor outcomes for millions of people across the country. We have already made some short-term changes, and we are in the process, right now, of making some longer- term strategic changes that will create all the right incentives.
Point of Order
On a point of order, Mr Speaker. You will remember that I recently challenged the relevant Minister with an urgent question about the poor performance of the Passport Office. A constituent who applied for a passport in February is due to travel next week, so yesterday, after queuing up at Portcullis House, I found out that their extra paperwork has been stuck in the post room at Peterborough for two weeks and not taken forward.
In recent weeks, I have tabled 10 or so written parliamentary questions seeking clarification on the size of the Passport Office backlog, the extra income received by the Department after constituents had to apply for fast-track applications, and how soon the current 10-week turnaround for applications can be brought back down to the normal three weeks. My reasonable questions are being dodged. The Government’s incompetence is worrying for families who are afraid that the bedlam will ruin their summer holidays. How can I get these points on the record and get the Government to up their game and help families across our country?
The main thing is that the hon. Member has certainly now put that on the record again, and quite rightly. I do not think there is a Member here whose inbox has not seen a problem with the passport situation. I expect questions to be answered quickly and not to be dragged out or lost somewhere in the system. Although it is not a point of order for me, it is on the record. But I do give notice that when questions are laid they should be answered as soon as possible.
Levelling-up and Regeneration Bill
Before I call the Minister to move the Second Reading, I wish to remind Members of the House’s conventions. With a large number of Members seeking to participate today, Members will recall that if they participate in the debate they should be present throughout the opening speeches and the wind-ups, be present for most of the debate, and, as a minimum, remain in the Chamber for at least two speeches after their own. Also, while we appreciate that interventions are an important part of our debates, if Members intervene repeatedly they are likely to find themselves being called later in the day than might have otherwise been the case. This is so that we all respect other and treat each fairly and in the best possible way.
I beg to move, That the Bill be now read a Second time.
I am delighted to be able to move the Second Reading of this Bill. The Government are getting on with the job, and no Department is doing more than my own. There are five Bills in the Queen’s Speech generated from our Department. As well as the Levelling-up and Regeneration Bill, there is legislation to improve conditions for those in social housing, to improve the rights of those in the private rented sector, to ensure that business rates can be updated so that our economy thrives, and to get rid of the pernicious employment of boycott, divestment and sanctions policies by those who seek to de-legitimise the state of Israel. I hope that all five pieces of legislation will command support across this House. They are designed to address the people’s priorities and to ensure that this Government provide social justice and greater opportunity for all our citizens.
This Bill looks specifically at how we can ensure that the Government’s levelling-up missions laid out in our White Paper published in February can be given effect, how we can have a planning system that priorities urban regeneration and the use of brownfield land, and how we can strengthen our democratic system overall.
My right hon. Friend will know that perhaps one of the most exciting pages in the levelling-up White Paper is page 238, which announces that there will be a new hospital health campus in Harlow over the coming years. He knows how important that is because of the fact that our current hospital estate is not fit for purpose despite the incredible work that staff do. Can he confirm that the timeline for our new hospital will be announced in the coming months?
My right hon. Friend makes an important point. Of the more than 400 pages in the White Paper, page 238 is perhaps one of the most important, not least because it contains an image of what we can hope to see and what my right hon. Friend the Secretary of State for Health and Social Care will be announcing, which is action to ensure that my right hon. Friend’s constituents get the state-of-the-art, 21st-century hospital that they deserve. That would not happen, I am afraid, under the Opposition, because it is only through the investment that we are putting in and the sound economy that has been created under my right hon. Friend the Prime Minister’s leadership that we are able to ensure that the citizens of Harlow get the hospitals that they need.
I wonder if there is a page missing in my copy of the Bill, because I was looking for the net zero test, which I am sure the Secretary of State would agree ought to be applied to all planning decisions, policies and procedures, yet it is conspicuous by its absence. Does he agree that if we are serious about using this Bill to really level up, then we need to have that net zero test? Can he commit to that now?
I will say three things as briefly as I can. First, the national planning policy framework that will be published in July will say significantly more about how we can drive improved environmental outcomes. Secondly, there is in the Bill a new streamlined approach to ensuring that all development is in accordance with the highest environmental standards. Thirdly, as the hon. Lady knows, under the 25-year environment plan and with the creation of the Office for Environmental Protection, the non-regression principle is embedded in everything that we do. The leadership that my right hon. Friend the Prime Minister has shown, not least at COP26, in driving not just this country but the world towards net zero should reassure her on that front.[Official Report, 13 June 2022, Vol. 716, c. 2MC.]