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Oral Answers to Questions

Volume 748: debated on Tuesday 23 April 2024

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.