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Commons Chamber

Volume 748: debated on Tuesday 23 April 2024

House of Commons

Tuesday 23 April 2024

The House met at half-past Eleven o’clock


[Mr Speaker in the Chair]

Oral Answers to Questions

Health and Social Care

The Secretary of State was asked—

NHS Treatment Waiting Times

Happy St George’s day, Mr Speaker.

Cutting waiting lists is one of the Prime Minister’s top priorities. We are spending more than £8 billion on additional elective activity and investing in additional capacity including community diagnostics centres, one such centre being in the hon. Gentleman’s constituency. Since September 2023 overall waiting lists have fallen by almost 200,000—the biggest five-month fall in over 10 years, outside of the pandemic.

NHS waiting lists have risen threefold since the Tories came to power, and the Prime Minister’s pledge to cut waiting lists is in tatters. Rather than taking responsibility, the Tories first blamed NHS staff who were trying to get better pay, and now they have opened up a new round of media attacks on the sick and the disabled. Why do not the Government instead go after the tax dodgers, as Labour plans to do, to raise funds and help resolve the crisis in our NHS?

Once again the hon. Gentleman does not condemn the strikes. I would gently say that while we are getting waiting lists down in England, Welsh Labour has the longest hospital waits in Great Britain, putting patients at risk because it does not have a plan to clear the backlog. In December 2023 the Welsh Labour Government had the highest number of patients in Great Britain waiting over two years for treatments. It is an outrage; yet that is the blueprint for what the Labour party says it will implement here in England.

I see increasing numbers of women coming to my constituency surgeries about chronic urinary tract infections, not for themselves but for their daughters. Unfortunately there seems to be no treatment pathway for chronic UTIs among girls. Does my right hon. Friend have any thoughts about that, and would he agree to meet me to discuss the issue further?

Happy St George’s day, Mr Speaker.

Westminster is awash with rumours that the Prime Minister will call a July general election, presumably to avoid giving his Rwanda gimmick the time to fail. I have a very simple question for the Minister: will he repeat the pledge that the Prime Minister made last year and promise that NHS waiting lists will be lower at the time of the general election than when the Prime Minister came to office?

The Prime Minister has been very clear that getting waiting lists down is one of his top priorities, but he has also been clear that performance has been disappointing. One reason is that 1.4 million procedures have had to be rescheduled because of industrial action. I would gently ask the shadow Secretary of State whether he condemns those strikes.

General Medical Council: Oversight Mechanisms

3. What assessment she has made of the adequacy of oversight mechanisms for the General Medical Council. (902429)

The General Medical Council has been constituted by Parliament to ensure that decisions about individual doctors are independent of both the profession and the Government of the day. The Professional Standards Authority oversees the work of all United Kingdom professional regulators and reports to Parliament on their operational performance. Parliament continues to set and oversee the principles and scope of the regulators’ powers.

Good governance means ensuring transparency, and one concern of my constituents is whether GMC decisions can be appealed. Will the Minister reassure me that we can have better transparency in the GMC on the decisions that it makes?

The GMC and other professional regulators have a statutory duty to investigate any concerns about the fitness to practice of one of their registrants and to take appropriate action to protect the public when that is needed. The regulators are overseen by the Professional Standards Authority for Health and Social Care, which has the power to appeal cases where, in its view, a sanction imposed by a regulator is insufficient to protect the public.

The GMC has seven principles of decision making and consent. How will the Minister ensure that GPs can fulfil their obligations when time constraints on appointments mean that they do not have time to listen to every complaint? People have to book a double appointment to talk about more than one issue. What further support can the Government give GPs to enable them to fulfil their GMC-ordered standards of care?

As the hon. Gentleman knows, the Government have committed to delivering 50 million more GP appointments and to making it easier throughout the country to see a doctor. In England in December, we delivered 25.77 million GP appointments compared with 23.31 million in December 2019—an increase of 2.46 million appointments each month. We need to continue to work with programmes such as Pharmacy First, and we are taking other steps to reduce the pressure on GPs so that they have more time to spend with their patients.

GP Retention

General practitioners are a rock. They are the underpinning force of primary care. I want to take the opportunity to pay tribute to them for all they do for the health of the nation. My right hon. Friend is right to raise the issue of GP retention. During covid and since, GPs have been exhausted and the return to primary care provision has been difficult. The Government are doing a lot, such as improving digital telephony and reducing the administrative workload. I am about to launch a future of general practice taskforce to look at what more we can do to provide more support to this critical part of our primary care.

Chelmsford is a growing city, and it is very good that, compared with pre-covid times, we have more clinicians in our GP surgeries, but we need more surgeries as well. One new surgery is being built. I have been told that the limits that local district valuers impose on NHS lease costs make it increasingly difficult for developers to deliver new surgery buildings, not only in Chelmsford, but in other parts of the country. Will my right hon. Friend meet me and other affected MPs to see whether we can resolve that issue and help growing areas, where there are more houses, to deliver the new surgeries that we need?

Of course I would be delighted to meet my right hon. Friend to discuss that issue, which several colleagues across the House have raised with me. She will appreciate that the District Valuer Services is crucial in ensuring value for taxpayer’s money from the rents that are charged for GP practices. Nevertheless, the Department is working hard to support better primary care facilities. I understand the point and would be happy to meet her.

There are 56 fewer fully qualified GPs in Somerset now than there were in December 2016, so it is no surprise that my constituents in Wincanton feel that they can never access one. How will the Minister support general practice to enable it to continue to provide the vital services that our communities deserve?

It is fantastic that hard-working GPs have delivered 60 million more appointments a year than in 2019. That is a credit to their efforts. The Government have undertaken a wide range of approaches to try to reduce the administrative burden. We are focused on trying to deal with some of the issues that GPs have raised with me about the primary and secondary care interface so that they do not have to write all the fit notes and liaise with consultants. We have also spent more than £200 million on digital telephony. Importantly, the additional roles reimbursement scheme has added more than 36,000 more professional staff, from physios to pharmacists to those in GP practices, to try to support patient access.

At the last general election, the Government promised to deliver 6,000 more GPs by 2024-25, but there are still 2,000 fewer GPs than in 2015. Part of the problem is that morale has plummeted in the past decade, meaning that experienced family doctors and newly qualified GPs are hanging up their stethoscopes. What does the Minister say after scrapping two GP retention schemes last month? Will she come clean today about another broken manifesto promise?

The hon. Lady is choosing numbers out of the air. She will be aware that there are almost 3,000 more GPs now than in 2019, and very importantly the long-term workforce plan is scheduled to introduce 6,000 new training places by 2031-32. In 2022, we had the greatest number ever of new trainee GPs. That is great news for GP practice, as they are crucial to primary care.

Hospital Repairs

May I wish you a happy St. George’s day, Mr Speaker? I also wish the hon. Member for Bristol South (Karin Smyth) a speedy recovery; I hope to see her across the Dispatch Box soon.

The Government have invested significant sums to maintain and modernise NHS buildings, including £4.2 billion for integrated care boards this financial year. This is on top of the expected £20 billion for the new hospital programme. We have invested a further £1.7 billion for over 70 hospital upgrades across England, including in mid and south Essex.

I thank the Secretary of State very much for the Government’s commitment to delivering the £110 million in capital funding for south Essex hospitals and for her recent visit to Southend hospital, where she saw in our emergency village how much £8 million can do in the hands of Southend hospital’s inspirational NHS staff. However, our aged buildings do also need urgent maintenance, so what can she also do to deliver the £38 million in maintenance funding also needed for Southend hospital?

I thank my hon. Friend, and also wish her the very best of luck, as she is due to abseil down the hospital next month for its radiotherapy appeal. I very much hope she lands safely and does not trouble Southend hospital. I was delighted to visit the hospital at her invitation earlier this month, and I was very much impressed by the immediate improvements that the £8 million funding has meant in the Dowsett ward and for discharge and treatment times through accident and emergency. This is part of our plan, both through the urgent and emergency care plan and through our recovery plan for electives and the new hospital programme, to rebuild hospitals and provide that investment so that clinicians can use it to treat their local patients.

Last month, I met the chief executive of Stepping Hill Hospital in Stockport. She informed me that the primary out-patient building, which provides 85% of out-patient capacity, was recently condemned. While funding has been secured to build two additional wards, they will not be ready for at least 15 months, causing huge disruption in the interim. Fourteen years of underinvestment has left Stepping Hill Hospital quite literally crumbling. Will the Government provide urgent capital investment for Stepping Hill, so that my constituents and our brilliant NHS staff can have the facilities they need?

I very much hope that the hon. Gentleman has already spoken to his integrated care board, because he will know that responsibility for local investment decisions rightly rests at local level. I can say that, as a Government, we have very much invested in hospital upgrades, including £4.2 billion going to integrated care boards this financial year. I hear the timetable he cites, but I encourage him to go to his integrated care board to ask what more it is doing.

Type 2 Diabetes: Medicine Shortages

It is vital that people have access to the medicines they need. The Department has been working with the suppliers of medicines used in the treatment of type 2 diabetes to seek commitments from them to address the issues, expedite deliveries and boost supplies. As a result, the position is now much improved compared with a few months ago, with new patients now able to receive these critical medicines. We continue to work with industry to address remaining issues as quickly as possible.

We know that obesity in this country is costing the NHS about £20 billion a year, and it is a major contributory factor to type 2 diabetes, which is preventable in a lot of cases by having a healthy lifestyle. What more can we do encourage people to eat healthily and therefore save costs in the NHS?

The hon. Member raises a very important point. Obesity is linked to many health conditions, including type 2 diabetes. We are delivering an ambitious programme of work to create a healthy environment to support people in achieving and maintaining a healthy weight. This includes restricting the placements of less healthy products in shops and online, calorie labelling on food sold in restaurants and a tax on the sugary drinks industry, which has removed the equivalent of 45,000 tonnes of sugar from soft drinks.

A recent Nuffield Trust report shows that medicine shortages are a new normal in the UK. The Minister might claim that this is a global issue, but as the report highlights, shortages are being made worse by Brexit. For example, the creation of a requirement for customs checks at the border and leaving the European Medicines Agency have disrupted the previously smooth supply of medicines. What urgent action will the Minister take to help to tackle the disastrous effects of Brexit on UK medicine supplies?

The SNP, as usual, is a broken record. We all know that diabetes medicine shortages are a global issue affecting countries not just across the whole of the European Union, but across the whole world. Medicine supply chains are highly regulated, complex and global. Issues can occur for multiple reasons, including manufacturing difficulties, regulatory non-compliance, surges in demand, availability of raw materials, sudden spikes in demand, and issues related to the distribution of the product. But once again, as always, the grievance culture of the SNP is: blame everything on Brexit.

Nurse Recruitment and Retention: GP Practices

We hugely appreciate the work that general practice nurses do. I know that the hon. Lady was a nurse in her previous life, and I absolutely pay tribute to her for her service. She will be aware that last year the Government provided additional funding for the general practice contract to uplift pay by 6%, in line with the pay review body’s recommendations. We are very much aware of the need to try to ensure that general practice nurses feel appreciated and are keen to be retained in GP practices, which is one of the reasons I have launched a taskforce on the future of general practice. As she will know, it is for GP practices themselves to determine the pay uplift for their nurses. I am looking closely at that, because we know that sometimes the pay rise provided by the Government was not passed on.

We have all seen images of people queuing around the block for an appointment at their GP surgery, and in my local integrated care board, there has been a decline in general practice nurses since June 2020. It currently takes 12 months to train nurses wishing to move into general practice. Will the Minister tell me and my constituents in Erdington, Kingstanding and Castle Vale what she is doing to ensure that the retention of experienced nurses and the training of new nurses does not add to the pressure that GPs are already facing?

The hon. Lady raises an important point. The long-term workforce plan commits to increasing the number of general practice nurses by more than 5,000 by 2036-37. In her area, the number of doctors in general practice in the NHS Birmingham and Solihull ICB increased by 134 full-time equivalents between 2019 and 2023, but the number of nurses decreased slightly, by 34 full-time equivalents. However, over the same period, direct patient care staff increased by 1,195 full-time equivalents. I think that demonstrates to the hon. Lady that the actual resources in GP practice are increasing, with specialisms such as physiotherapy and pharmacy, as well as nurse prescribers, to provide patients more access to good healthcare.

Community and District Nurses: Recruitment and Retention

8. What steps she is taking to support the recruitment and retention of community and district nurses. (902434)

As the hon. Member may know, in September 2023, we met our commitment to deliver 50,000 more nurses working in the NHS compared with September 2019. As of January 2024, there are over 68,800 full-time equivalent community nurses working in NHS trusts and other core organisations across England, which is over 2,000 more than a year ago. However, we want to go further, which is why the NHS long-term workforce plan sets an ambition to increase training places for district nurses by 150%, to nearly 1,800. It also commits to improving retention in the NHS.

In Scotland, the vacancy rate for registered nursing posts in the community is 8.5%, and for registered district nurses it is 6.6%—in England, the situation is actually worse in most parts. However, these posts are fundamental, not just to care in communities and to our communities themselves, but to addressing bed blocking. It is obviously for the Scottish Government to address terms and conditions of employment, but their overall funding package is dictated by the block grant and Barnett consequentials. Is it not time that the Department stood up for the NHS? When there is money for weapons abroad, why can we not provide care at home? We were told during the referendum that we would be better together and that the NHS would be protected. Instead, it is being undermined.

We hear from Opposition Members who love nothing more than to crow and criticise as their health system declines around them, despite record funding from the UK Government. Scotland has, sadly, some of the worst health outcomes in the western world. Earlier this year, when the UK Government stepped in to offer support, the SNP Health Minister rejected the offer. I reiterate that if the Scottish Government need help to reduce their waiting lists, we stand ready to provide such support.

Health Inequalities

We are committed to levelling up health, narrowing the gap in healthy life expectancy by 2030, and increasing healthy life expectancy by five years by 2035. That aligns with our mission to reform our health and care system to be faster, simpler and fairer.

In January, Professor Sir Michael Marmot published “Health Inequalities, Lives Cut Short”, which confirmed that between 2011 and 2019, driven by political choices, 1 million people in 90% of areas in England lived shorter lives than they should. The inequalities were amplified by Covid. These lives cut short are matched by shorter lives in good health. Does the Secretary of State believe in evidence-based health? If so, does she accept the overwhelming evidence that current levels of ill health reflect 14 years of escalating poverty, services that have been run into the ground, including the NHS, and the Government’s failure to do what they promised in 2019: level up?

No, I do not, and I would point to the legislation that the Government brought forward last week, which is the largest and most significant public health reform that we can make to help the hon. Member’s constituents and those in other parts of the country who face inequalities. We know that smoking rates are disproportionately higher in poorer communities, which is one of the many reasons why we introduced such landmark legislation. It is just a shame that the Labour party felt that they had to whip their Members to get them to vote for it.

Will the Secretary of State support Breast Cancer Now’s campaign to improve the uptake of breast cancer screening, especially among women in minority ethnic communities, because that is a good way to tackle health inequalities?

I completely agree. Further on ethnicity and inequalities, I have not only prioritised women’s health as Secretary of State, but announced £50 million of research into maternity disparities for women of colour, given the worrying statistics associated with that. I have also responded to calls from brave constituents, put forward by hon. Members on both sides of the House, for further research into lobular breast cancer, because although it is responsible for 15% of diagnoses, we do not have the research or evidence to help women who are affected by it.

The reality is that someone living in the inner city in the Bradford district is likely to live 20 years less than those living in the more affluent parts of the region. That has not just happened; it is a result of 14 years of underinvestment in and cuts to not only our NHS, but our community services. Will the Secretary of State just admit that the Government frankly could not care less about people from places such as Bradford, because otherwise they would have accepted my levelling-up bid, which would have addressed this injustice at its core?

I am so glad that the hon. Gentleman has mentioned levelling up, because presumably he will know from his bid that the 12 levelling-up missions are mutually reinforcing. Conservative Members take the approach that in order to help people with their health—[Interruption.] The hon. Gentleman is shouting at me. I thought that this answer would be important to his constituents.

Levelling up is not just about health. It is about the impact of education, housing and other matters in our environment, which is why in the forthcoming major conditions strategy we will tie together the conditions that have the most impact on a healthy life. We will draw together a cross-Government strategy to help people who are living with those conditions to live longer but also healthier lives.

The Health Secretary will know about the health inequalities across the east of England, including in Maldon district, which will only be made worse if the NHS’s plans to close St Peter’s Hospital in Maldon proceed. Does she agree that the levelling-up funding that has been made available to Maldon District Council should be prioritised to facilitate investment in new localised health services, so that those inequalities can be tackled?

My right hon. Friend makes an important point. The purpose of the levelling-up fund is to help local areas to address what they need locally, rather than respond to diktat from central London. I encourage her to work closely, as I know she will, with local agencies, the council and others making those important decisions, so that their levelling-up announcements include health, as an integral part of her mission to improve the lives of her constituents.

Back in the real world, the record of the last Labour Government is that we increased life expectancy by three years. Under this Government, it has stalled for the first time in a century, with people in Blackpool, for example, expected to live four and a half years less than the national average. Is the Secretary of State proud of this shocking record, or will people have to wait to elect Chris Webb in Blackpool South and a Labour Government at Westminster to finally turn the tide on health inequalities?

As someone who is proud to have gone to school in Blackpool, I do not need a lecture from the hon. Gentleman about what Labour has done to the town centre, or about the important work that Conservatives in Lancashire are doing to help communities such as Blackpool. On Labour’s record, I gently point out, as I try to do at every orals, that the record of the Labour-run NHS in Wales is lamentable. People are almost twice as likely to be waiting for treatment in the Labour-run NHS in Wales. That is not a record of which to be proud.

Bowel Care: People with Spinal Injuries

The hon. Member raises an important issue. It is vital that people with spinal injuries receive care in the most appropriate environment to support their care and rehabilitation. The NHS has developed a range of guidance on the subject, including NHS England’s excellent incontinence care guidance. In addition, guidelines from the National Institute for Health and Care Excellence set out the care that patients with spinal injuries should receive, including through a neurological bowel management programme.

There is a clear need for a national policy on bowel care in NHS settings for people with spinal injuries. I have listened to patients who have been left feeling abandoned and trapped in a hospital bed without the basic dignity of being able to use the toilet—all because of a lack of training for nurses in providing the necessary support. Will the Minister meet me and representatives of the Spinal Injuries Association to discuss how we can make the situation better and ensure that nobody is denied this basic level of care?

I pay tribute to the hon. Lady for the work that she and the all-party parliamentary group on spinal cord injury have done on the issue. I would be more than happy to meet them.

A&E Waiting Times: East Lancashire

11. What steps her Department is taking to improve accident and emergency waiting times in east Lancashire. (902437)

Just over a year ago, we set out a plan to improve urgent and emergency care. The plan is working. At East Lancashire Hospitals NHS Trust, 78% of A&E patients in March were seen within four hours. That is 4.5 percentage points better than last year—the biggest year-on-year improvement outside the pandemic since 2010. We know that there is more to do; that is why we are working with the NHS on year 2 of the urgent and emergency care recovery plan.

I am grateful to the Minister for that response, and grateful to her for agreeing to meet me and other local MPs to discuss the emergency care situation in east Lancashire. Could I ask her to go one step further? Perhaps she and even the Secretary of State could visit Burnley General Teaching Hospital in my constituency, meet the trust, and see what more we can do there, partly to reverse the disastrous decision of the last Labour Government to close the A&E there?

I commend my hon. Friend and other east Lancashire colleagues for their campaigning on this matter. I look forward to the meeting we are going to have to discuss the performance of his local A&E, and I thank him very much for the invitation to visit.

I share an integrated care board with the hon. Member for Burnley (Antony Higginbotham) in Lancashire and South Cumbria. Does the Minister agree that one reason why there are such problems with A&E waiting times is the congestion in our hospitals overall, because of the number of people who are healthy and fit to leave hospital, but cannot have a health and care plan when they return home? Some 24% of all beds in the Morecambe Bay hospitals are occupied by people who are fit to leave, but have no care package. What plan does the Minister have to address the social care crisis in Cumbria? That will include increasing the amount of affordable housing, so that people can afford to live in the area; paying carers more; and having more intelligent visa rules.

The hon. Gentleman makes the point that the performance of A&E depends on the flow of patients through hospital and our ability to discharge them. That is why, as part of our work on urgent and emergency care, we have invested in supporting hospitals to discharge patients, and have been supporting social care. We have seen an increased number of discharges across the country over the last year, which has enabled hospitals to treat more people and supported the improved performance in A&E that I mentioned. We continue to work on that, and of course we are supporting social care with up to £8.6 extra billion funding over two years.

Mental Health Support for NHS Staff

Every day, NHS staff do an extraordinary job for their patients, and it is vital that the NHS supports them in maintaining their mental health. The long-term workforce plan commits the NHS to supporting staff health and wellbeing and asks integrated care systems to develop plans to support them. I am pleased that NHS England is reviewing mental health services for all staff, to ensure that all staff in the NHS have the support that they need.

Fighting to save a dying child’s life, telling families that their loved one will not make it through the night, and working desperately in substandard conditions—it will come as little shock to hear that all that takes a toll. Last year, 6.4 million mental health sick days were taken across the NHS. Instead of receiving support, our NHS heroes have a Tory Government who treat them with disdain and kick them to the kerb. Will the Minister commit to funding the NHS practitioner health service beyond the next 12 months, or will the Government just try to shut it down again?

As an NHS community first responder who served on the frontline during the pandemic, who had to see people say goodbye to their loved ones for the last time before being admitted to hospital, and who has dealt with cardiac arrests, I know the mental toll that working for or volunteering with the NHS can take on our workforce, and therefore we do give a very high priority to the subject. The NHS people plan sets out a range of actions to build a more modern, compassionate and inclusive culture, and includes a much stronger focus on the availability of quality health and wellbeing support. It is right that we keep services under review, so I will not make a commitment today to continuing to fund something that we have agreed to fund for another year while those services are reviewed.

Women’s Healthcare

We are focused on delivering our women’s health priorities for 2024. Recent successes include new women’s health hubs opening across the country, with £25 million of investment; the investment of nearly £35 million over three years in improving maternity safety, on top of the extra £186 million already being invested each year; the success of the hormone replacement therapy prepayment certificates; and research into the important issue of maternity disparities, which I have already mentioned.

House of Commons Library figures reveal that one in four women with suspected breast cancer are waiting more than two weeks to see a specialist. The waiting list for gynaecological treatments has risen by 40,000 in a year, which means that there are now almost 600,000 women waiting, which is up by a third over two years. Labour has pledged to tackle that backlog, so that more women are seen faster. How much pain, misery or worse do women have to endure before this Government start prioritising their health?

As the hon. Lady will know—she saw the statistics published very recently—we are in fact treating more people at earlier stages of their cancer. I want to take on her point about gynaecological waits, because that is important. We are spending more than £8 billion in this spending review period on additional elective activity, and investing in additional capacity, including community diagnostic centres and surgical hubs, many of which provide gynaecological tests and procedures. She may have missed it, but the latest published management information for March shows that the longest waits for gynaecology services have reduced by nearly 95% since their peak in September 2021. Of course there is more to do, but we are making progress. I thank all the doctors and teams who are involved in that important work.

Today, we have seen alarming figures pointing to the systematic de-prioritisation of women’s health, with 600,000 women in England waiting for gynaecological treatment, 33,000 women waiting more than a year, and under two thirds of eligible women screened for breast cancer in the last three years. Will the Secretary of State come clean and admit that under this Government, women’s health has become an afterthought?

That is absolute nonsense. As I say, I have prioritised women’s health. I am pretty sure that I invited the hon. Lady to the women’s health summit earlier this year.

She is very graciously saying that I did. The point is that I want women to receive the sort of care that we would all hope and expect them to have. I have prioritised that precisely because there are conditions, including gynaecological conditions, that have historically not received the attention they deserve. As our women’s health ambassador Dame Lesley Regan says, the NHS was created by men, for men. I am the Health Secretary who is sorting that out.

Primary Care: Patient Access

We are enormously grateful for the work of GPs in delivering 64 million more appointments nationally than in 2019. Our primary care recovery plan enhances GP access by expanding community pharmacy services nationwide. Some 98% of community pharmacies have signed up to the Pharmacy First offer, with over 125,000 consultations claimed in the first month.

Across Bedfordshire, we suffer from patient to GP ratios that are well in excess of the national average; high housing growth is simply not matched by GP capacity. At Wixams, we have been able to break through 15 years of deadlock by putting stakeholders together, but issues still remain across the county. From Shefford to Stondon, heartbreaking stories are commonplace. The issue is not ICB-specific; it affects people right across the country. What more can we do to ensure that areas with high housing growth have the GP capacity that residents deserve?

The hon. Gentleman raises a really important point. He may be aware that the Bedfordshire, Luton and Milton Keynes ICB received £36 million for its operational capital budget in 2023-24, with over £118 million for this spending review period. That operational capital is core funding provided to ICBs for delivering primary care, among other things. In addition, he will be aware that ICBs are able to provide input to planning permissions to ensure that primary care is delivered where there are new housing developments. I have worked with other hon. Members across the House to tackle this issue, and I am very happy to meet him to discuss it further.

When I speak to my constituents in Brislington, they tell me they have to wait an inordinate time to get through on the phone to their GPs at the Brooklea health centre, and wait over two weeks for appointments. Constituents in Fishponds have been told that it is over an hour’s wait for prescription medication at the local pharmacy—and we all know the situation with dentists. The other thing my constituents are waiting for is a general election. Does the Minister agree that that is the only way we will sort out these problems in the NHS?

I certainly do not agree. If Labour were in government, we would see significantly worse outcomes. Covid was a once-in-100-years pandemic, and we have pulled out all the stops to recover from that. It is a huge tribute to all those working in primary care that they have done so well. In the hon. Lady’s ICB— Bristol North, North Somerset and South Gloucestershire —38.4% of all appointments were delivered on the same day they were booked in February this year, and 84% were delivered within two weeks of booking, with 66% of them face to face. These are extremely positive numbers for the 482,000 appointments delivered in February 2024. What is really important is that the number of patient care staff has increased by 656 full-time equivalents since 2019.

I have listened to the Minister’s comments, but the number of patients per GP in the Bedfordshire, Luton and Milton Keynes area is nearly 25% higher than the national average. Will the Minister explain why her Government think it is a good idea to cut the proportion of doctors being trained as GPs from around one in three to around one in four?

The hon. Lady is simply wrong. She will be aware that, in fact, our long-term workforce plan is intended to raise the number of training places for GPs to 6,000 by 2031-32. In 2022, we had over 4,000 new GPs apply to take training places—an absolute record. There is much more to do, and I am working with GPs on a future for GP practice taskforce to make sure that we do everything we can, including hiring the 36,000 additional professionals now working in GP practices, in order to relieve the pressure on GPs and deliver much better patient access.

Last week, a constituent contacted me to say that her teeth crumbled during pregnancy and she was unable to get a dentist appointment. Another constituent, who was in agony, desperately pleaded for help to find a dentist. My own son, Clifford, has been waiting two years for a tooth extraction, and I have received hundreds of emails about similar issues. It is simply not good enough. What plans do the Government have to sort this out once and for all, and what advice does the Minister have for my constituents?

My hon. Friend raises an incredibly important point. We know that because all dentists were locked down during covid, the recovery in access to NHS care has not been as fast as we would like. That is why we announced our dentistry recovery plan, including a new patient premium, which, since it was launched on 1 March, has already seen hundreds of thousands of new NHS patients who have not seen a dentist in two years. Some 240 dentists will receive golden hellos to encourage them to work in underserved areas. We also have our new Smile for Life prevention programme, which will ensure that babies receive an early dental check for their milk teeth in family hubs, and that pregnant mums receive better dental care and advice. We are now trying to work with dentists to look at reform of the units of dental activity contract, but following the first meeting of the group yesterday, it seems that dentists feel that all the parameters are in place. What we now need to do is ensure that the incentives are there and that we see things changing rapidly.

My GPs are working extraordinarily hard to increase access in the face of ever increasing public demand. I am alarmed by the Labour party’s talk about scrapping the GP partnership model, as I find in the Stroud district that GP practices are some of the most efficient parts of our NHS services. They need support, the removal of bureaucracy and the opening up of funding pots, rather than dismantling. Will my right hon. Friend explain how access to primary care would not be helped by removing the partnership model, and what are the Government doing to help ICBs create more flexible partnership funding pots?

My hon. Friend makes a fantastic point, and I say again that GPs absolutely underpin our primary care. We all absolutely rely on them, and our measures to create 36,000 additional roles in GP practices will provide them with the additional capacity they need so that they can serve their patients better. That is good for patients, good for primary care and incredibly good value for the taxpayer. It is ludicrous that Labour is proposing to undermine the GP partnership model; that would be a disaster for primary care.

Topical Questions

We know that people in work lead happier, healthier lives. However, over 10 million “not fit for work” fit notes were issued last year. Most were repeat fit notes issued without any advice, so we are missing a golden opportunity to give millions of people the support they need to remain in work. That is why we are launching a reform of the fit note process to create a new system in which fit note conversations focus on what people can do, not what they cannot do. As part of this, the Government will consider shifting the responsibility for issuing fit notes away from GPs to reduce the pressures they face and to free up millions of appointments. I thank everyone who has delivered this vital work, and I very much look forward to hearing the results of the call for evidence in due course so that we can reform our welfare system for the sake of our constituents and our GPs.

According to the Association of British HealthTech Industries, it takes, on average, 17 years for lifesaving and life-enhancing technologies to be adopted in the NHS. What steps is my right hon. Friend taking to speed up the adoption of new technologies so that the NHS can save more lives and improve patient outcomes?

I dispute the 17-year figure, as it can vary across innovations. The figure is contested, but my hon. Friend raises an important point. We have a plan to prioritise the acceleration of patient access, thereby ensuring safe, effective and innovative medical technology for patients and the NHS. Our ambition is backed by funding, and we are reforming the medical technology regulatory framework, introducing the innovative devices access pathway pilot and launching frameworks to increase the availability of innovative products for the sake of patients across England and the United Kingdom.

The Health Secretary has promised that the Government will provide an extra 2.5 million dental appointments this year, but the dentistry Minister, the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), says the figure has

“a high likelihood of not being reliable”.

Which one of them is wrong?

I am delighted to be able to tell the hon. Gentleman that we have modelled down the ambitions, so the figure we initially provided was higher than 2.5 million appointments. That is because we are focused on delivering the dental recovery plan, rather than overpromising.

The hon. Gentleman finds it easy to call our children short and fat, but he shies away from welfare reform, calling it shameless and irresponsible. He says he is ready to stand up to middle-class lefties, but Labour has never put patients first by condemning the unions that strike. He makes glossy promises about reforming the NHS in England, yet Labour has failed completely—

Order. I gently say that we need to get a lot of Back Benchers in, and I am sure both sides want to do that.

The last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history, which is a record that the right hon. Lady’s Government cannot begin to touch.

Back to dentistry, the chief dental officer says the announcement is “nowhere near enough.” The British Dental Association says:

“This ‘Recovery Plan’ is not worthy of the title.”

It also says that the recovery plan will not stop the “exodus” of dentists and will not meet the Government’s targets. Who should the public trust, and why should they trust the Health Secretary to deliver when her own adviser, her own Minister and, crucially, dentists all say that she is brushing the truth under the carpet?

Again, let us bring ourselves back up to date. I know the Labour party likes looking back to the last time it found favour with the British public, but Wales is the up-to-date record of today. Labour’s lamentable record of running the NHS in Wales speaks for itself. If the hon. Gentleman is so set on reform, why on earth is he not helping his Labour colleagues in Wales to do exactly as he is promising? It is because they are empty promises, and because the hon. Gentleman and, I am afraid, the Labour party will step back from reform rather than grappling with the issues, as we are doing with our recovery plan.

Finally, on the dental recovery plan, within a month of the new patient premium being switched on, hundreds of surgeries have opened to new patients, which means that patients in the hon. Gentleman’s constituency and elsewhere are getting the care they need.

T2. As my right hon. Friend has already heard from my right hon. Friend the Member for Witham (Priti Patel), the Mid and South Essex ICB has published proposals to close St Peter’s Hospital in Maldon and to relocate medical services elsewhere, despite the huge growth taking place in the town. I have to say to the Secretary of State that my constituents have little confidence in the consultation. Will she therefore look closely at the outcome and, if necessary, intervene to ensure that my constituents are still able to access vital health services within the town? (902453)

I thank my right hon. Friend for raising that matter. I understand that a consultation was conducted locally and that more than 5,000 local people and staff responded. Their feedback will be analysed by an independent research agency, which will produce a report for the Mid and South Essex ICB, and a meeting is due to take place in public in July. I will, of course, continue to take an interest in this matter.

The recent announcements on fit note reform are just the latest in a long string of attacks on the most vulnerable people in society. Sick and disabled people are being vilified, when, as the Joseph Rowntree Foundation points out, almost two thirds of those living in destitution live with a chronic health condition or a disability. The UK Government are continuing their track record in failing, and making life more difficult for, disabled people. Does the Secretary of State understand how much more difficult these changes will make people’s lives?

These reforms are being brought forward because of a simply unsustainable rise in the number of people being given fit notes so that they cannot re-enter the world of work. We want to support people into work, not only because we believe that it is the best way to help them to recover, but because it helps us to fund the NHS. It is funded by people who work and pay their taxes. Again, I draw the hon. Lady’s attention to matters a little closer to home; sadly, Scotland’s record on health is very difficult to read and it includes the worst level of drug deaths in Europe. I encourage her to concentrate on how the SNP is running health services in its local area.

T3. I refer the House to my entry in the Register of Members’ Financial Interests. The British Psychological Society has commended the benefit of Government support for staff mental health and wellbeing hubs and is keen to see that support continue. Will the Minister therefore give an update on the support being provided and the progress being made on the vital issue of staff mental health and wellbeing? (902454)

That is an important point. We know how vital it is to support everyone who is working so hard in our NHS to support patients. NHS England is reviewing mental health services for all staff who need them, to ensure that they can access the support they need. It is working collaboratively with regions and integrated care systems to agree the best approach to doing that.

T4. There is an increasing incidence of bowel cancer among younger patients, such as my constituent Emily, who received a late diagnosis after many months of attending her GP with iron deficiency anaemia. Younger patients often report that bowel cancer was dismissed as a possibility by their GP because of their age, and that symptoms such as iron deficiency anaemia are not taken seriously enough and are not included currently on the list of commons symptoms on the NHS website. What is the Secretary of State doing to ensure that NHS guidelines and practice are fit for purpose for younger patients, who far too often receive a late diagnosis of bowel cancer? (902455)

The hon. Lady makes an important point. As part of the NHS long-term plan, we have an ambition to diagnose 75% of all stageable cancers at stage 1 or 2 by 2028. That means that we need to make significant improvements on the harder-to-detect cancers such as bowel cancer. We are working across systems to deliver those improvements, not only with better screening programmes, but by improving patient pathways. However, I am more than happy to meet her if she wants to have a further conversation specifically about bowel cancer.

Following discussions with constituents who are living with Parkinson’s and with Parkinson’s UK, I am concerned that North Yorkshire has only one dedicated Parkinson’s nurse. Given the complexity of the condition, what steps are being taken further to incentivise nurses to specialise in Parkinson’s and on long-term delivery?

My hon. Friend makes an important point. I know the huge value of Parkinson’s nurses to local patients in my constituency. Under the NHS long-term workforce plan, backed by more than £2.4 billion over the next five years, the NHS will focus on expanding the number of clinicians training for enhanced and advanced roles working as part of multidisciplinary teams with the right skills to meet the changing needs of patients.

T5. The main issue raised by residents at the community coffee morning at the Compton centre in Leeds yesterday was the difficulty in getting access to dentists. The Secretary of State struggled to give any credible answer on this question today. Is she aware of the “Dentists for All” campaign in The Mirror, and will she back it? Its three demands are: to provide access to an NHS dentist for everyone; to restore funding for dental services and recruit more NHS dentists; and to change the contracts, because they are simply not fit for purpose. Does the Secretary of State agree with that, and, if not, why not? (902456)

We switched on our fully funded dental recovery plan, in case the hon. Gentleman was not listening carefully earlier, on 1 March. Nearly 500 more practices in England are accepting new adult patients than at the end of January, and even more will do so under the dental recovery plan. We have plans to bring in new dental vans to help our most isolated communities. We are also bringing in the Smile4Life programme for children, because prevention must be a critical part of our dental recovery plan.

Ministers will be aware of a rather boastful claim last weekend by the makers of Elfbar and Lost Mary vapes. They have already launched rechargeable, refillable products, which, with a coil in each pod, are not by definition single-use or disposable according to the published regulations. Can the Minister reassure the House and parents that they are alive to that and will pivot as necessary now that the Tobacco and Vapes Bill is going into Committee?

I thank my hon. Friend for raising that matter, which shows the cynicism with which the tobacco and vaping industry is approaching these landmark public health reforms. On vapes, we have committed to consulting on the powers that we are adopting in the Bill precisely because we want to ensure that the regulations, when they come to the fore, address the realities of the market and the cynicism of the companies behind it, and help to ensure that our children do not continue being plied with these horrible items to get them hooked on nicotine.

T7. I was disappointed to see the chair of my local hospital trust and the east midlands Labour mayoral candidate use my hospital as a political campaign prop by inviting the shadow Health and Social Care Secretary and the Leader of the Opposition to canvass patients and staff. Can the Minister please explain to me how we can rein in this type of gutter politics and prevent my local hospital being used for Labour’s dog-whistle politics? (902458)

This is a very serious matter, which I have raised with the chief executive of NHS England, and asked her to raise with the regional director and Nottinghamshire integrated care board. We have done so because we believe that it might be a breach of the Nolan principles.

Just yesterday, the Office for National Statistics released data showing that alcohol-specific deaths in 2022 were 4.2% higher than in 2021 and a massive 32.8% higher than in 2019. Will my right hon. Friend now seriously consider a stand-alone alcohol strategy based on this worrying trend and agree to meet me and other interested parties to discuss a way forward to tackle alcohol-specific deaths?

My hon. Friend was an incredibly hard-working health Minister and I pay tribute to her for all she did in this area. She will be aware that our groundbreaking drug and alcohol strategy commits more than half a billion pounds of new funding over the spending review period to rebuild drug and alcohol treatment services, with plans to get an additional 15,000 alcohol-dependent people into substance misuse treatment by 2024-25, which we are currently on track to achieve. I would be delighted to meet her to talk about it further.

At my last surgery, a young woman told me that, thanks to the delay in her GP diagnosing her ovarian cancer, she is now infertile and receiving aggressive treatment. She had made four GP appointments over several months for her unexplained stomach cramps. Only in an emergency admission in another country was the ovarian cancer diagnosed and the tumour removed. How long will it be before the symptoms of female-specific conditions are taken seriously by our medical establishment, from initial training onwards?

I thank the hon. Lady for raising this, and I very much send our best wishes to her constituent. The hon. Lady raises a really important point. The symptoms that women can experience are often very different for conditions relating not just to cancer, but to heart attacks, for example. Part of my prioritisation of women’s health is to get that message out to clinicians so that, as this case demonstrates so tragically, they are able to make the best and most prompt diagnosis for all women.

What is the Secretary of State doing to ensure that the UK Health Security Agency has the budget and the capabilities it needs? The recent expansion of bird flu among mammals in the United States is a salutary lesson. Thankfully, there are no signs yet of human-to-human transmission, but it reminds us of the incredible value and importance of being vigilant in this space and having the best possible technology ready to respond as soon as possible.

I thank my right hon. Friend for his question, and of course for his integral role not just during the pandemic, but in setting up the UKHSA. He will understand that I and others are keeping this under very close review, and the chief medical officer is briefing me as and when needed.

T9. I have had concerns raised about a company based in England but operating across the UK online that shape shifts and is known variously as Young Vibes, Peaky Parents, Kactus Kids, “themumsnet” and, currently, Anxiety Recovery. It offers to fix children’s anxiety in mere weeks, but it is preying on vulnerable families, drawing them into expensive treatments, and inciting them to take out loans and get into debt. It is operating outside regulatory frameworks, so may I ask what Ministers can do about such unscrupulous and exploitative companies? (902460)

The hon. Lady raises an important point, and I ask her to write to me, please, so that we can look into it.

Given the importance of the UK’s life sciences sector, could my right hon. Friend update the House on commercial clinical trial recruitment?

Thanks in part to the sterling work of my hon. Friend, monthly average patient recruitment to commercial clinical trials is almost five times the figure it was back in June 2023. That is hugely positive, but there is clearly more to do in this space.

For over a decade, the Camberwell dialysis unit has provided high-quality NHS care to patients in south London, so my constituents were shocked to hear that these services are to be outsourced to Diaverum, a multinational for-profit health corporation, which has already had one of its clinics rated inadequate and put into special measures. Does the Minister accept that privatising the NHS bit by bit has disastrous implications for care, and will he listen to patients in my constituency and commit to maintaining our NHS dialysis provision?

That sums up the usual contradiction on privatisation between Labour Front Benchers and Back Benchers. Any service changes should be based on clear evidence that they will deliver better patient outcomes. In Lambeth, patients who receive dialysis at the new site in Brixton will receive care in a significantly improved environment with brand new facilities, in a great example of an innovative public-private partnership. NHS England has established the renal services transformation programme to reduce unwarranted variation in the quality of access to renal care.

Will my hon. Friend join me in recognising the good work that the Essex Partnership University NHS Foundation Trust has been doing to improve mental health outcomes, including the creation of a pioneering 24/7 urgent mental health care centre, providing urgent help when it is needed. Is that a model that could be rolled out across the country to improve access to mental health for all?

My hon. Friend rightly flags the excellent work going on to improve access to mental health services across the country. Last year, 3.6 million people got mental health support. That is an increase of around 30% in just three years, supported by record funding of over £16 billion into mental health care.

Mandatory fortification of flour with folic acid could save many thousands of children from spina bifida, so why is it happening so slowly, at such a low level and applied to too few products?

I assure the hon. Member that we remain firmly committed to the mandatory fortification of flour with folic acid. That will help to protect around 200 babies each year from being born with neural tube defects. The policy is being delivered across the UK as part of a wider review of bread and flour regulations. In January we published our consultation response, and we will bring forward legislation to implement the policy later this year.

Ten days ago I went to the Whipps Cross A&E department to see for myself the pressures that the brilliant team there are under—pressures that are heavily exacerbated by the failure to redevelop the hospital. Originally, we were promised that the new hospital would be open by 2026, but we have still not agreed with the Department a plan and timetable to submit to the Treasury for that redevelopment. As a result, the hospital is having to spend huge amounts of money trying to stem the damage as well as being able to treat patients. It is costing us all. For the sake of patient care and NHS budgets, will the Minister meet me to work out where the hold-up is in getting Whipps Cross redeveloped?

The hon. Member raises the performance of the A&E department in her local hospital. I have worked closely with the NHS over the past year to improve the performance of urgent and emergency care. Since this time last year, we have seen ambulance response times improve by over a quarter and waits in A&E cut. I am happy to meet her to talk about her specific A&E department.

I again thank the Secretary of State for visiting Watford General Hospital earlier this year, where we shared exciting plans for the new hospital, with preparation work starting this year, and construction starting by the end of 2026. I spoke with the West Hertfordshire NHS Trust leadership team this week, who confirmed that they are on track for that delivery within those timescales. Will my right hon. Friend please join me in thanking them for their hard work on that?

I would be delighted to join my hon. Friend, and I thank him again for a really positive visit to his local hospital. That is a great example of a local MP working in his local area for his constituents and, what is more, delivering for them.

As a practical measure to improve radiotherapy waiting times, will the Minister agree to further work on the radiotherapy dataset, to include the collection of data on delays at each stage of the radiotherapy pathway, and by tumour type, so that we can better understand pinch points in services?

We are working to improve radiotherapy services across the NHS, and I would be happy to meet my hon. Friend to discuss that in more detail.

West Hertfordshire Hospital Trust is at the front of the queue for the new hospital programme. We have the land, planning permission, building design, political and staff support, and enabling works are under way. But, like many other trusts around the country, the hospital trust is being asked to submit business case after business case. Will the Secretary of State clarify whether those delays are down to bureaucracy and the new hospital programme, or are they deliberate delaying tactics by a Government who do not want to release funds to hospitals before the general election?

Normally, a Secretary of State would appear at the Dispatch Box after a question like that and say, “I refer the hon. Member to the answer I gave earlier.” On this occasion I will refer her to the question from my hon. Friend the Member for Watford (Dean Russell). He has just set out the business case for Watford General, which is great news, and I hope she will join him and me in welcoming that new hospital when it is open.

Infected Blood Inquiry

(Urgent Question): To ask the Minister for the Cabinet Office to make a statement on the evidence uncovered of experiments on children and the contaminated blood scandal, and update the House on the action that the Government are taking on the second interim report from Sir Brian Langstaff.

Let me start by stating that the stories reported in the recent BBC news article, and indeed The Sunday Times report by Caroline Wheeler, demonstrate the unimaginable suffering of all those impacted by this dreadful scandal. As the House will know, in 2017 the Government established an independent public statutory inquiry chaired by Sir Brian Langstaff, to give those impacted and their families the answers that they deserve.

Since it was established, the inquiry has taken evidence from a range of sources, and the testimonies are indicative of the bravery of every individual who has come forward. The infected blood inquiry’s final report is due to be published within a month, on 20 May, and we expect the inquiry’s findings to cover a set of extremely challenging issues. It would not be right for the Government to pre-empt the findings of this long-prepared and carefully considered report, but the Government have committed to update Parliament through an oral statement on next steps within 25 sitting days following 20 May. It is our intention to make that statement as soon as possible. The 25-day stipulation is a deadline, and certainly not a target.

In January this year, I appointed an expert group to provide technical advice to the Cabinet Office in responding to the infected blood inquiry’s recommendations on compensation. That work is well under way and will build on the recommendations of the infected blood inquiry to inform the Government’s substantive response to the inquiry’s recommendations on compensation. The Government understand the need to move quickly to provide compensation to victims of infected blood. Most recently, we tabled amendments just last Wednesday to the Victims and Prisoners Bill to impose a duty on the Government to establish an infected blood compensation scheme. It also establishes a new arm’s length body, named the infected blood compensation authority, to deliver the compensation scheme. It will operate on a UK-wide basis to ensure parity and consistency. That demonstrates our absolute commitment to deliver long overdue justice to victims of infected blood.

We understand that for many there is an urgent need for compensation. As the House will know, in October 2022, the Government paid more than £400 million in interim compensation to help to ease the short-term needs of those infected. The Government amendment also includes a statutory duty to make interim payments of £100,000 to the estates of the deceased infected people who were registering with existing or former support schemes, where previous interim payments have not already been made to infected individuals or their bereaved partners. That is an important step forward to get substantial compensation into the hands of families and victims of infected blood. Should that Government amendment be supported in the other place, it will return to this House for debate in the usual process of Commons consideration of Lords amendments.

We know that more than 3,000 people have already died in the worst treatment disaster in the history of the NHS. Another 680 have died since the public inquiry started in 2018. With two people dying on average every week, 100 people have died since Sir Brian made his final recommendations on paying compensation in April 2023. He said that

“wrongs were done at individual, collective and systemic levels.”

He also said that in all conscience he could not wait until his final report was published to tell the Government to start paying compensation.

Last week, Hugh Pym of the BBC produced shocking evidence about children, even babies, being experimented on in the 1970s and 1980s without their parents’ consent. These disturbing revelations raise serious criminal and ethical issues for the NHS and the medical profession. There are possible breaches of the 1947 Nuremberg code. Alongside that, The Sunday Times, and Caroline Wheeler, in particular launched a campaign at the weekend for compensation to be paid now to those infected and affected by the contaminated blood scandal. So far, more than 160 MPs have backed the campaign, and 10 parties are represented, including six leaders.

Last week, the Government finally laid those amendments to the Victims and Prisoners Bill in the other place after this House forced the Government to act in December last year. This weekend, Ministers confirmed that even when Sir Brian produces his final report on 20 May, the Government may not respond until as late as 3 July 2024. Meanwhile, there has been no announcement on compensation funding or on any compensation scheme, despite the Government having accepted the moral case for compensation.

What action are the Government taking following last week’s BBC story on the experiments on children? When will Sir Brian’s recommendations on compensation be implemented in full? On what date will payments be made to those infected and affected? Why have the interim payments not been made, as Sir Brian recommended last April? How will those infected and affected be involved in the whole scheme? Why are Ministers rejecting the three-month timeframe for setting up a compensation body that this House agreed to in December last year, and Sir Brian’s recommendation that it should be judge-led?

On all sides of the House, Members know that when people are dying, justice delayed is justice denied. The time to act is now.

I thank the right hon. Lady for her questions and initial comments. Nobody in this House has done more than her to advance the interests of the infected and affected communities, as I have said consistently since I took office on 13 November. I recognise her frustrations and am doing everything I can to address them. Last week, I met her and other Chairs, across parties, as I did just before the Easter recess, and I will continue to update her as regularly as I can.

The right hon. Lady draws attention to commentary from Hugh Pym and other journalists about speculation and allegations, which I believe Sir Brian Langstaff’s report, when it is published on 20 May, should give substantive airing to, drawing on the evidence collected. It would be reasonable for the Government to wait for that authoritative statement on what information and evidence they have gathered before we respond, but that does not mean that, since I took office, I have been doing anything other than move forward everything I can on compensation as quickly as possible.

The right hon. Lady is quite right to say that over 3,000 deaths have occurred since 1970, including 141 last year. I recognise that the challenge of urgently securing interim payments, in terms of the mechanics of how it is done, is not a concern of the infected and affected community. She quite reasonably stands up and urges speed on that, and I am doing what I can. The statutory duty to make an interim payment of £100,000 to the estates of the deceased infected people is the first time that we have put in legislation a duty to pay compensation before the ad hoc schemes, which, over the past 45 or 50 years, have never admitted culpability. I have also put into legislation, with the consent of both Houses, the need to set up the arm’s length body and make it as operational as soon as possible.

As I discussed with the right hon. Lady last week, my concern is to get that arm’s length body up and running as quickly as possible, and there is a legal obligation to do so when Royal Assent is gained—there is no statutory deadline but there is a responsibility to do that. I recognise the concern around a judge-led body. Indeed, Sir Brian Langstaff’s report suggests that a judge-led body would be desirable—I do not rule that out—but at this stage it seems reasonable not to confine it in legislation in case another candidate becomes available. Clearly, however, gaining the confidence of the affected and infected communities is absolutely integral to this process working. As I say, I am doing everything I can to bring forward the Government’s substantive response on the widest issues of compensation as near as I can to the 20 May, and I will update the House as often as I can. Indeed, I have made time available tomorrow for an open surgery for any MP who wants to bring cases to me.

May I follow the tributes to the great Dame—the right hon. Member for Kingston upon Hull North (Dame Diana Johnson)—for what she has been doing?

I have been actively involved in this in one way or another for 25 years. We all know that the justification for having the Langstaff inquiry has been the information that has now come out in public, which was concealed or not known over the decades. We also know that this is different from most of the discussions in the Pearson report on whether there should be compensation when things go wrong in medical treatment. This report is likely to show how, since the war, people have not paid enough attention to the warnings given by those in the field. With the update of Caroline Wheeler’s book and the BBC programme, we now know that, as well as the haemophilia trials published in the 1970s, the 1980s trials showed massive defects by the standards of those days, let alone by up-to-date standards.

I join the right hon. Lady in asking the Minister when it will be possible for people to register their names, backgrounds and circumstances for compensation. Do we have to wait until a month’s time for that to happen, and how will it be dealt with? Obviously, as the Cabinet Office Minister, he follows his predecessor in carrying this responsibility, but how far will the Department of Health and Social Care be involved, and will other Departments be involved?

My hon. Friend makes wise observations. I did not mean not to pay tribute to him in a similar way; his commitment to this cause, probably over my lifetime, is extraordinary.

In respect of the £100,000 payments announced through the Government amendment tabled last Wednesday, we will be working with the existing support schemes to expedite them as quickly as possible for the estates of the deceased infected. On the substantive response on the wider complete compensation, through last week’s intervention, and building on the amendment of the right hon. Member for Kingston upon Hull North (Dame Diana Johnson), we have established the delivery vehicle for compensation.

On the challenge that we were somehow delaying compensation, which was reasonably made, I think that what I have said to the House this afternoon makes it clear that we are committed in legislation to delivering that compensation, but that the terms of how we do so, and how we respond to translating those 18 recommendations into reality, is ongoing work that I will seek to address substantively as soon as possible by 20 May.

I congratulate my right hon. Friend the Member for Kingston upon Hull North (Dame Diana Johnson) on securing an urgent question on this vital issue. Nobody could fail to be moved by the scale of the horror and injustice of this scandal. The latest revelations about apparent experiments on children, to which the urgent question relates, are truly appalling and show yet again how badly the victims have been let down. I pay tribute to all those who have campaigned so hard on the issue.

As part of delivering the justice that is so long overdue, the Government must now deliver on the compensation scheme. Time is of the essence: every week that passes without further Government action matters. Those who were infected with contaminated blood are dying at a rate of one every four days. Ministers have repeatedly accepted the moral case for compensation, but victims understandably have little faith and want to see firm action. That is why Labour was very disturbed to hear that the Government have tabled an amendment to undo the cross-party changes to the Victims and Prisoners Bill passed by this House in December last year. The changes that the Government want would have the effect of removing a clear commitment to delivering on the compensation scheme within three months of the Bill’s passing—yet another missed opportunity; yet another delay.

I would be grateful if the Minister answered the following questions. Will the Government now consider accepting the cross-party consensus of establishing a clear three-month limit for the setting up of the scheme? Can the Minister confirm when victims can expect to receive final compensation payments following the publication of Sir Brian Langstaff’s review?

I thank the hon. Lady for her questions. Respectfully, the amendment tabled by the right hon. Member for Kingston upon Hull North was dependent on Royal Assent. I have tried to make it effective by putting an obligation on the set-up as soon as Royal Assent is granted, which will speed it up. I am working on operational matters around how such a body would work.

The hon. Lady asked me, as everyone does, about the Government’s substantive response on compensation more broadly. As I have indicated, I appointed the expert group in January to examine some of the issues in the recommendations, such as the need for redress for those living with chronic hepatitis B when that chronic infection definition did not exist. I have been seeking professional advice on the operationalisation of the recommendations. The conclusions of those deliberations, and the quantification and discernment of compensation, will be a matter for the Government when the final report has been published.

Like others, I have cases that have been waiting decades for a resolution, and which were pursued by my predecessor. When will those affected be able to start applying for compensation?

I refer my hon. Friend to my reply a few moments ago about the £100,000 payment to the estates of deceased infected persons. The ultimate compensation will depend on what is arranged through conversations across Whitehall as soon as possible after 20 May. We are making good progress, and I want to bring that forward as quickly as I can after 20 May. Given the will of the House and the letter signed by so many MPs, it is pretty clear that it is on the Government to deliver, and that is what I am seeking to do as quickly as I can.

I pay tribute to the right hon. Member for Kingston upon Hull North (Dame Diana Johnson), who has done so much, and to journalists such as Caroline Wheeler of The Sunday Times and all those who have campaigned for decades, despite their own very deep trauma. They include Jan Smith, the mother of Colin, one of the youngest victims who was infected at only 10 months old, and who died aged only seven. She said in The Sunday Times at the weekend:

“When we found out little Colin was going to be treated by a world-renowned haematologist we were over the moon. Professor Bloom was like a God to us and we didn’t question him. We thought our son was being given the best possible treatment. But we will feel forever guilty that we had in fact handed our son over to his killer.”

These parents should not be burdened with this guilt. An estimated 380 children were infected in a massive breach of trust and medical ethics. It is every parent’s worst nightmare. What does the Minister say to the parents of children who were used as guinea pigs, in an utterly despicable practice that was made worse by the lack of redress for those families? When will all those infected and affected receive the compensation they are due, and an apology from this Government?

I can reassure the hon. Lady that I am doing everything I can to bring that forward as quickly as possible. I recognise that the distress is widespread and is felt by individuals and families across the United Kingdom. I am working across the devolved Administrations to ensure that there is a UK-wide arm’s length body. My officials are working with prominent charities, organisations and support groups. I am reaching out to them to share progress, reassure the community that I have heard their concerns and seek their views in advance of 20 May. I am doing that out of deep respect for the suffering that they have experienced. On the substantive matter the hon. Lady asked me about, I refer her to my reply a few moments ago.

When I was Health Secretary, I committed the Government to ensuring that the compensation recommended by Sir Brian be paid, and made the moral case that the UK Government must address this wrong. The stories from Caroline Wheeler and Hugh Pym have made that moral case stronger still. Can I push the Minister to move as fast as possible, but hold in his mind the critical nature of getting the response right as well? I commend his officials, who have worked so hard on this matter for so long. I entirely understand the need for urgency, but he must get it right at the same time. He is a diligent and deeply honourable man, and I hope he will hold that in his heart as he addresses the issue in the weeks to come.

I thank my right hon. Friend for his remarks and for what he has done on this matter. He is right: I feel responsibility both to get the substantive announcement agreed as quickly as possible and to ensure clear communication with the infected and affected community so that they have clear expectations of what will happen following that announcement. From all I have read and all that my officials have briefed me on, I recognise that this is likely to be one of the biggest scandals in the NHS that this country has seen. I respect Sir Brian Langstaff and his extensive work over several years. I wait respectfully for his final report on the wider issues on 20 May.

My constituent contacted me again yesterday. His father and uncles were all infected with contaminated blood, and all but two of the uncles have now died. He said to me:

“I had to grow up in care due to my father being too ill to look after me. We have been fighting for many, many years for justice.”

He thinks that the Government are dragging their feet on compensating victims. He is right, isn’t he?

All I can do is account for what I have done since 13 November. I cannot really comment on the several decades previous to that. As the hon. Lady will know, we have had a series of ad hoc schemes, but the Government’s accepting culpability for what happened many years ago and the subsequent failure to respond will need to be addressed fully after 20 May. The Government’s amendment in the House of Lords is the first time that we will have put in legislation a duty to pay compensation. That is the start of a more comprehensive response that I am working on to secure collective agreement across Government, and I want to bring that forward as quickly as I am able to do so.

The Langstaff recommendation for interim payments was because of the need for speed; because people are so ill. How many people do the Government believe to be still living who were infected in this scandal? How many of them applied for the interim payments? What proportion of those who applied have received the payments? If my right hon. Friend does not have the figures with him today, will he undertake to write to me and place a copy of the letter in the House of Commons Library?

My right hon. Friend customarily asks precise and penetrating questions. I do not want to quote the few figures that I think I know, so I will write him a considered reply, which I will make available. Far too many people have suffered and far too many have died. We need to put this right as quickly as possible.

I congratulate the right hon. Member for Kingston upon Hull North (Dame Diana Johnson) on her work to date. When I engage with my constituents, it is clear that not only have they lost loved ones to a preventable and painful death, but the stigma that those loved ones lived with during their life is part of the issue. Members across the House rightly want answers about the interim payments, because those families have received no compensation and no apology to date. If the Minister cannot give a date that people can expect payments, can he at least give some clarity on how they will be able to apply?

First, I agree entirely with the hon. Lady with respect to the stigma. One cannot fail to be moved by the accounts of people in the 1980s; when they contracted HIV, the stigma in society was very different from where we are today. That has caused damage to relationships, to lives, and obviously to health—many people’s cases have been terminal.

The statutory duty to make interim payments of £100,000 to the estates of deceased infected people will be carried out through the existing schemes. We are working with those schemes to work out how best to do that. That is different from recommendation 12, in that the Government took the view that we did not want to overwhelm the will of the estates—rather than divide it up among family members, which could be problematic and would cause delay. While I cannot give an authoritative date now, urgent work is ongoing to give clarity on the process for those people to register and to receive those payments.

The infected blood scandal is one of the biggest stains on the history of the NHS. I am pleased to hear that we are getting interim payments out as quickly as possible, but the Minister has talked about giving payments to deceased people’s estates rather than named individuals. Could he outline his reasoning? We want to make sure that compensation goes to the correct people quickly.

My hon. Friend makes a very good point. One of the challenges is that some cohorts of people are not registered but have been part of a scheme that does not now exist. How do we best expedite the process across that affected community? Those are the sorts of practical issues that I am working through with officials, so that we can reach the best possible solution when we give our comprehensive response in due course.

“Cheaper than chimpanzees” was how former pupils of Treloar’s school described themselves when they gave evidence to the inquiry. My constituent, Lee Moorey, was one of the pupils of that school, and has described to me how he felt that he was experimented on all those years ago. We have set up the Brian Langstaff inquiry; what more can the Government possibly want to know than what that inquiry is going to uncover, and why are they delaying compensation? Will the Minister confirm that nothing has been preventing the Government from paying compensation since the date that Brian Langstaff published his interim report last April?

There is a challenge in translating 18 recommendations into numbers and into the reality of a transmission mechanism, as well as in the quantification and agreement across Whitehall. The work on the first part is under way: that is why we have engaged the experts to work out how to quantify the payments that will be due across different heads of loss. Quite reasonably, those numbers were not in the report—it would not be for Sir Brian Langstaff to put numbers on every single individual—but that work is under way. We are now working to agree the substantive response as soon as we can after the final report is published.

This week, I will be using the mechanisms of this House to do something that, in 14 years as an MP, I have never before felt the need to do: present a petition. At the top of that petition will be the name of my constituent, Andrew Evans, one of the children who was infected with hepatitis and HIV. By a miracle, he survived to set up and help run the Tainted Blood campaign. Like many of my affected and infected constituents, he feels that this process has already gone on for too long, so I am very grateful to the right hon. Member for Kingston upon Hull North (Dame Diana Johnson) for securing this urgent question.

I am also grateful to my right hon. Friend the Minister for the updates he has given, particularly about support for the estates of the deceased. However, I urge him to continue to meet groups such as Tainted Blood and make sure that the communication on this issue is as clear and open as possible, so that those groups are engaged and can support their members as the process moves forward—and to do so as fast as possible.

I thank my hon. Friend, both for what he has said today and for his engagement privately in recent weeks. I agree with everything he has said, and I have heard his challenge to be clear about communications to prominent charities, organisations and support groups. Letters were sent by my officials yesterday evening to set up those meetings. I have talked to cross-party representatives of the all-party parliamentary group on haemophilia and contaminated blood, seeking input on the names of groups. I am trying to respect their confidence while also meeting as many representative groups as possible, and to do that well before 20 May.

This is surely the worst health scandal that we have seen, with Government after Government kicking the can down the road. We need to accept that there is a need for change, including a change in speed and urgency. The continued delays and prevarication—I regret to say that it feels like we have seen some more of that today—exacerbate the suffering. We know that two people are dying every week. The Minister must know that the delay on this issue is indefensible, and he must know its impact. Does he appreciate why such a large number of Members are pushing for action now, and does he understand that that is what we need him to deliver?

Yes, I do understand that. I deeply respect the views of colleagues who have made strong representations on this matter, and I am doing everything I can to move it forward as urgently as I can. I will not repeat myself regarding the things I have said with respect to steps taken last week, or the spirit in which I am engaging and the reasons why I am doing it, but I agree with the hon. Lady that speed is absolutely of the essence.

There has been a lot of speculation in articles in recent days—and, most prominently, in Caroline Wheeler’s book—about the wider issues: what went wrong and why these things happened. Those matters will need to be addressed, but through the lens of Sir Brian Langstaff’s report, which will be published finally on 20 May.

I commend my right hon. Friend the Member for Kingston upon Hull North (Dame Diana Johnson) not just for securing this urgent question, but for all the work that she and others in this place have done on this important matter.

Sir Brian Langstaff made his final recommendations on compensation early—a whole year ago—and recommended that the compensatory body make payments by last December. He did so because he was worried about the effects of a delay on the affected and infected. We have missed all of those deadlines; is this what Sir Brian’s worst fear looked like?

I sincerely hope not. What I have said with respect to the interim payment is a response to the dialogue I have had with Members across both Chambers of the House, working with Earl Howe in the other place. I have been pretty clear that in I am doing everything I can to put preparations in place for giving a legal entity the obligation to pay compensation, and to minimise delay in advance of the final determination of the Government’s response, so that that response can be operationalised as soon as the decision is finally made.

Every time we have these urgent questions, we get a well-intentioned Minister giving a helpful but frustrating update about what is happening. This Minister is one of the most well intentioned, and today’s statement has been one of the most helpful, but what we want to hear—as the House has said clearly today—is a clear timeline for when applications for compensation can be made and when those payments will be made. He has come really close to telling us that today; can I encourage him to get over the line, tell us when it is going to happen, and satisfy all of us who are standing here on behalf of our constituents?

The hon. Gentleman makes a very fair and reasonable point. I would wish to say more than I am saying today, but we have not quite got to that point; I am doing everything I can to get there.

On the hon. Gentleman’s specific point about the mechanics of engagement with communities, I am very seized of the need to have a clear narrative for each different cohort, so that we can be crystal clear when those decisions are made. I recognise how frustrating this is. Obviously, agreeing, quantifying and making provision for those things is a collective process across Government, and I am doing everything I can, using my experience from several years in the Treasury. It is helpful that the Chancellor of the Exchequer was Health Secretary when the public inquiry was set up, and I am working with colleagues across Whitehall to deliver this as quickly as I can.

One of the most upsetting aspects of this whole tragedy is the thought of those pupils at Treloar School being experimented on like “lab rats”, as one of the pupils said. They included brothers Michael and Bill Payne, and I met their widows Cath and Margaret over the Easter recess in Bristol. I accept that the Minister is trying to give detailed answers and that there are complexities, but what it really comes down to is the deep, deep wrong that was done to those little boys at Treloar’s, and compensation and apologies are owed to those people. Can I ask what the Minister is doing to communicate as clearly and effectively as possible with the families of those affected, so that they feel they are not being swamped by bureaucracy and that answers are close at hand?

I have reached out to prominent charities, organisations and support groups to share the progress that has been made—I had to respect the fact that we needed to do that through the parliamentary process last Wednesday—and to seek their views, but not to replicate the considerable trauma that they went through giving evidence in an incredibly painful fashion through Sir Brian Langstaff’s inquiry. I am meeting those charities, organisations and support groups. I obviously cannot meet every single individual, but I am trying to use those meetings to inform the response of the Government and to make representations to my colleagues about what needs to be done so that we can land this in the most effective place as soon as we can from 20 May.

Does the Minister recognise that many people feel that the state, with all its delays in delivering justice to the victims of this scandal and their families, has utterly failed to recognise adequately the egregious harm that has been inflicted and continues to be inflicted on those impacted, leaving tens of thousands of victims and their families in great suffering as they continue to wait for compensation?

Yes, I recognise that all delays are painful and frustrating and cause distress. That is why I am doing everything I can to move this forward as quickly as I can. I am sorry that that is repetitious, but it is the truth. I think I have updated the House meaningfully today on the legislation. I know what we need to do, which is to get to 20 May and, as soon as possible, come up with a comprehensive response on behalf of all those who have lost their lives and the families who have been ruined by this absolute scandal that has happened over 50 years.

May I also give my thanks to my right hon. Friend the Member for Kingston upon Hull North (Dame Diana Johnson) for securing this urgent question? It gives me the opportunity to raise the case of my constituent Mark Fox, who contracted hepatitis C from infected blood when he was given a transfusion. He was just four years of age at the time. He was given contaminated factor VIII for his haemophilia. He was unaware of his hepatitis C diagnosis until he was 17, when he was in care. He has been living with the health consequences of this scandal for over 40 years. He lost his job, and we have mentioned the stigma. I say with all due respect to the Minister, because I know he is doing his best, that interim payments will offer a way of bringing relief to some of the survivors. Mark has asked me to ask the Minister how many more years he will have to wait before he receives either an interim payment or full and fair compensation for the suffering that he has endured.

I thank the hon. Gentleman for his heartfelt representation on behalf of his constituent Mark Fox, and I am sincerely sorry for what he has experienced. I am doing everything I can to bring as much clarity as possible, but I cannot give the hon. Gentleman a definitive timetable today. I am working towards—I hope—giving a definitive timetable at the point of, or very soon after, the publication of this final report. I will do everything I can to bring clarity to all groups involved.

It has been seven years and we have had four Prime Ministers since this public inquiry was set up, and there have been many decades waited before then. Surely the Minister will agree that the stories of children being impacted are tantamount to state-sponsored abuse—abuse similar to that suffered by my constituents Linda Cannon, whose husband died after a contaminated blood transfusion, and Vera Gaskin, who has stage 2 cirrhosis of the liver. Sir Brian Langstaff said that it would clearly take political will to act quickly, and the circumstances here warrant that. When will the victims—our constituents and their families—get compensation and justice? Surely the Minister recognises that issues such as these, whether it is Primodos, the Post Office scandal or contaminated blood, are taking decades and re-traumatising our constituents while they wait and often die before getting justice. It is not good enough.

I very much recognise what the hon. Lady is saying with respect to the impact of time on suffering, and I want to bring this forward as quickly as I can. I am doing that work and sponsoring work to gain the advice we need to make informed decisions that will allow us to make the widest possible decision in a few weeks’ time.

I too am speaking on behalf of a constituent, who lost a brother and sister-in-law and whose nephew was left to be brought up by the family. I want to raise the urgency of this. I appreciate the Minister’s sincerity about what he is trying to do, and the fact that he has been in post for only a few months, but it is over a year now since Sir Brian Langstaff brought forward his report and said that interim payments were absolutely essential. I am trying to understand exactly where the block is. If this was a priority for the Government, it would have been done in that year, so where is the block?

There is not a block. Last year, there was a process of looking at how we could work out the costs and the way of translating and operationalising the recommendations. That work is well under way, and Professor Sir Jonathan Montgomery and his team are helping with that. As I say, I hope that in a few weeks’ time we can get to a point where we will be able to make a substantive assertion of the Government’s position.

Building trust and confidence requires the support of the infected and affected community. Can the Minister confirm that the independent body’s executive will include representation from infected and affected people’s groups who can make decisions on processes, eligibility and decision making in order to build trust and confidence?

I thank the hon. Gentleman for his question and for his engagement with me last week as one of the co-chairs of the APPG, when he made a similar point. I am reflecting carefully on what it takes to satisfy the recommendation to have a body independent of Government while also securing as much authority and as much confidence among the different communities involved as possible. I will update the House on that in due course.

My caseworker Paula was left bereaved as a teenager after her father was killed by HIV and hepatitis from infected blood products. She has suffered enormously since, including being bullied at school as a result of the stigma around HIV. She is now in her 40s and battling cancer, but despite the recommendation from Sir Brian Langstaff’s inquiry a year ago in April 2023 that the children who lost parents should be awarded interim compensation, she has yet to receive a penny. How much longer will the Government keep victims such as Paula waiting?

I very much hope that we will be able to make a clear assessment of what we are going to do in a matter of weeks. I am doing everything I can to be clear about depicting for each different group, including some going back 40 or 50 years, what the process will be going forward. We owe that to all the victims and their families, and I will try and be as comprehensive as I can in that response when it comes.

Does the Minister think that the Prime Minister and senior Ministers will be attending the launch of the report on 20 May?

I do not know. I have not had those conversations yet. If a representative of the Government is asked to be there, I am absolutely sure that that will be the case. If it is me, I will be very happy to attend.

I thank the Minister for his answers, and for his clear commitment to delivering for all those with severe health problems. Does he not agree that reading some of the information supplied by the BBC feels more like reading about a national regime’s atrocities than reading about action by our own healthcare professionals in the 1980s? It is quite distressing. How does the Minister believe that we can ever restore confidence in a process and procedures that allowed this to happen, and what assurances can the general public have that it could never happen again?

When Sir Brian Langstaff publishes his report—and I have absolute confidence in the authority of the report that he will publish—that will be the time for a response from the Government on the wider implications of what went on and what evidence Sir Brian has gathered. As I said at the start of my response, we may have seen some elements of that in recent days, but I want to ensure that the Government respond authoritatively, and as fully as possible, when the moment of publication comes.

Childcare Entitlements

With permission, Mr Speaker, I will make a statement on the successful first stage of the largest ever expansion of childcare in England’s history, achieved by this Government.

The Government have a strong track record of helping parents with the cost of childcare, supporting disadvantaged children and ensuring that childcare is of high quality, with 96% of early years settings rated as good or outstanding by Ofsted. In 2010 we extended the three and four-year old entitlement, commonly taken as 15 hours a week for 38 weeks of the year; in 2013 we introduced 15 hours of free early education a week for disadvantaged two-year-olds; in 2017 the three and four-year old entitlement was doubled to 30 hours per week for working parents; and in March 2023, recognising that childcare is one of the biggest costs facing working families today, my right hon. Friend the Chancellor announced the biggest investment in childcare by a UK Government in history, so that by September 2025 working parents will be able to access 30 hours of free childcare a week from when their children are nine months old until they start school.

By the time this expansion is complete, parents using the full 30 hours can expect to save an average of £6,900 a year, a hugely significant saving for their family finances. We are staggering the expansion to ensure that there are the staff and places available to meet parental demand, and this month marked the first stage of the roll-out, with eligible working parents now able to receive 15 hours of Government-funded childcare for their two-year-olds for the first time. Last month my right hon. Friend the Secretary of State for Education told the House that we expected 150,000 children to benefit from the expansion from the beginning of this month. As we said in our official statistical report, 195,355 parents were already benefiting from it on 17 April, and we have subsequently broken the 200,000 mark. We will publish further official statistical reports in due course.

As Members will know, the system involves parents applying for a code that they take to a provider to be validated in order to obtain a place. The first phase of the roll-out is showing a trajectory similar to that of our last expansion of childcare, in 2017. On 5 September 2017, 71% of codes had been validated; as of 17 April this year, 79% had been validated, and we have broken 81% as of this week. With every roll-out, some eligibility codes go unused for a variety of reasons, such as parents changing their minds about formal childcare, or being issued with a code automatically although they did not need one. In the case of our well-established offer for three and four-year-olds, about 12% of codes have not been validated, but as with previous roll-outs, we expect the number of children benefiting from this new entitlement—and the number of codes validated—to grow in the coming weeks and months.

As was the case in 2017, no local authorities are reporting that they do not have enough places to meet demand. I pay tribute to early years providers, local authorities, membership bodies and other key stakeholders who have worked closely with us to ensure that the first phase of the roll-out was successful and parents could access places, and we will continue to work closely with them for the next phases of the roll-out. The first of those will begin in September, but parents will be able to start applying for 15 hours of childcare for their nine-month-olds from 12 May. I am also delighted to announce that parents on parental leave, and those who are starting new jobs in September, will be able to apply for childcare places from 12 May, instead of having to wait until 31 days before their first day of work, as has been the case until now.

Delivering such a large expansion requires more staff and more childcare places. We estimate that we will need 15,000 more places and 9,000 more staff by September 2024, and that for September 2025, which is the largest phase of the roll-out, a further 70,000 places and 31,000 staff will be needed. Last year the number of childcare places increased by about 15,000, and the number of staff by about 13,000, even before the roll-out began and before the significant steps that the Government are taking, beginning with rates, to increase capacity in the sector.

The Institute for Fiscal Studies has independently confirmed that funding for the new two-year-old entitlement is significantly higher than average parent-paid fees. According to the Government’s provider pulse survey published last week, the largest barrier identified by the sector—by 45% of respondents—to expansion of its provision was future funding certainty, a message that I have heard clearly from the many providers I have visited in recent months. In his 2024 Budget, the Chancellor committed himself to ensuring that funding rates for all entitlements would increase in the 2025-26 and 2026-27 financial years by the measure used last year. That estimated £500 million of additional funding over those two years will provide a level of certainty that we are confident will help to unlock tens of millions of pounds in private sector investment, ensure that rates keep up with provider cost pressures, and give providers a greater opportunity to increase staff pay.

This year, to support recruitment to the sector, we launched a £6.5 million recruitment campaign entitled “Do something BIG. Work with small children”, and thousands of people are visiting the campaign website every week to find out more about the great early years and childcare careers that are available. In January we introduced changes to the early years foundation stage to give providers greater flexibilities to attract and retain staff, and yesterday we launched a technical consultation setting out the Department’s proposals for how a new “experience-based route” could work for early years staff who have relevant experience from other sectors but do not have the full and relevant qualifications that we require.

Owing to the falling birth rate over recent years, some primary schools have space that they are no longer using, and some have closed entirely. In order to support our expansion of childcare, we have launched a pilot to explore how some of the unused school space could be repurposed to enable childcare settings to offer more places. If the pilot is a success, the Government will roll that out more widely.

Our progress in delivering this transformative expansion in early education and childcare underscores this Government’s unwavering dedication to empowering families, supporting the childcare sector, and building a prosperous future. I look forward to Labour Members welcoming this month’s news and/or finally telling us what their plan for childcare is, and I commend my statement to the House.

I thank the Minister for advance sight of his statement, but with red lights flashing across the board, this is a weak attempt by the Government to defend their bungled expansion of childcare provision. The Opposition are absolutely clear in our commitment to building a modern childcare and early years education system, and are putting quality at the heart of our vision. We support the expanded entitlement, but there are serious questions about whether the Government’s plans are deliverable. Ever since the Chancellor’s announcement in the 2023 Budget, parents and the early years sector have been crying out for a detailed and credible plan for the roll-out of the expansion, but the Government have consistently dismissed concerns and acted as if there were no problems when the problems are clear to see.

Today’s statement is yet another desperate attempt by the Government to avoid scrutiny of their childcare plans; it comes just hours before what we understand to be a highly critical report from the National Audit Office. It would have been far better if the Minister had come to the House following the publication of the NAO report, so that hon. Members could properly scrutinise his response to it.

The Department’s own modelling suggests that an extra 85,000 childcare places and 40,000 additional full-time equivalent staff will be needed by September 2025. That is a huge challenge when providers across the country are already struggling to recruit the skilled staff that they need; many are on the brink of closure. The Department’s recently published pulse survey, which the Minister is quoting in aid, found that two thirds of all group-based providers and staff of school-based providers continued to experience staffing problems, with little change since 2022. Nine in 10 providers responding to the survey have either reduced the number of places that they offered last year, or kept the same number of places. Similarly, data from Ofsted shows that in the six months following the Chancellor’s original announcement, childcare places fell by more than 1,000. How can the Minister credibly claim that everything is on track when that is the feedback from the sector?

Coram’s annual survey of childcare providers is also clear about the Government’s failure. Just 28% of local authorities are confident that they will have enough places for the expansion to children from the age of nine months; that is almost three quarters of communities where parents will not be able to access the childcare that the Government have promised. Across every age group and category, Coram found a fall in the number of local authorities able to deliver sufficient childcare in their area. Some 87% of areas saw the workforce crisis as the biggest barrier to the expansion, but there is still no detailed workforce plan from the Government. Just 6% of areas are confident that they will have sufficient childcare for disabled children, which is a truly shameful failure.

We need a serious plan to ensure childcare expansion is a success for children, parents and providers. The Opposition are clear that we will be led by the evidence. That is why we have commissioned Sir David Bell to review the challenges facing the sector and inform our plans for future reform. How many of the codes that the Minister’s Department issued in the April expansion have translated into provision of a childcare place? Where is the additional £500 million of investment announced in the Budget being funded from, and what is being cut to provide that funding? What urgent discussions is he having with the early years sector about the impact of the April expansion on its financial sustainability? Will he guarantee today that every family will be able to access a childcare place following the planned further expansion in September—yes or no?

Children’s voices are not heard often enough in this place, so on their behalf, I warn Ministers: childcare and early education are too important to be put at risk by the mess they are making. The issue today is not simply about places, the staff in our nurseries or even work choices for parents, but life chances for our children. Ministers must, for the sake of all our children, get a plan in place now.

The shadow spokesperson says it is not her job. With a general election later this year, it is not her job to have a plan.

Staffing had gone up by 13,000 people before we even started the expansion. Our winter survey showed that at the end of last year, applications for vacancies at group-based providers went up from two for each vacancy to five for each vacancy. I did not entirely hear the question asked by the hon. Member for Dulwich and West Norwood (Helen Hayes), but I think she asked how many children had received something as a result of the expansion—if that was not her question, I will write to her. The answer is 200,000 and counting. We expect the number to go up in the coming weeks and months, as it has with other expansions.

The funding for 2025-26 and 2026-27 increases to rates will come from day-to-day spending. The April expansion is the point at which providers will see a significant increase in their rates. By the way, that increase is £4 more per hour than parents are currently paying for under-twos provision. That is a significant increase in the rates that are being provided. Just as I was confident about the April roll-out, which has now been delivered, despite all the noise and sniping from the Opposition Benches, I am confident about the September roll-out.

The shadow Secretary of State has said that the hours model has failed and that we should move away from it. She said that she would have a childcare plan that would be like the creation of the NHS. Nobody knew what that meant, and 15 months later, it seems that neither did she, because she has had to ask somebody to write a plan for her instead. The truth is that while this Conservative Government have just successfully delivered the first stage of their childcare expansion, which 200,000 parents are benefiting from, Labour still has no plans, no policy and no idea how to help families with childcare.

There is much in this statement to be welcomed. The Education Committee welcomed the expansion of childcare, broadening the offer, and the increase in funding for the funded hours, and this delivers on some of that. It is an early success story, but as the Opposition have said, there are clearly serious risks as the plan expands exponentially over the coming years. In order to address those risks, the Minister needs to secure more funding and more places.

The 13,000 places are a welcome start and more staff in the sector are vital, but can he assure me that on top of the very welcome half a billion pounds that was secured in the spending review, he will keep making the case and keep listening to the providers about the funding they need to keep moving this forward? Can he ensure that the same quantum of increase is there for the under two-year-olds as it is for the two-year-olds, compared to what is currently paid in the private sector?

I thank my hon. Friend for raising some important issues. He is right that certainty and increasing those rates have been some of the most important things that the sector has asked for. It was very warmly received that we were providing that certainty for 2025-26 and 2026-27, which we think will help the sector. According to various reports that have been carried out, it will help them to unlock private sector investment and capital to help them expand, because that was the biggest thing they felt might be holding that back. It is part of a doubling of the amount that we are spending on childcare, from £4 billion to £8 billion. I will continue to work with my hon. Friend in ensuring we address the sector’s needs.

I start by declaring an interest as a parent of a two-year-old child. What all of us parents are talking about is the cost of childcare, and the Minister did not address the cost. The survey clearly showed that over half of all nurseries and pre-schools say that the funding does not cover the cost of providing the service in the way that the Government are asking them to provide it. It does not take a rocket scientist to work out that somebody’s got to pick up the bill—a toddler could do it.

The estimate before the Government announced the new hours was that fees would rise by 8.5%. Every single parent of a child in a nursery in my local community who has come to me has said that their fees have gone up as a direct result of this policy, because that is how nurseries are trying to stay open and make ends meet. Will the Minister prove me wrong? Will the Minister commit to publishing the data on the fees that parents of all children under five in nurseries and pre-schools are paying in this country, prior to and post the changes in hours?