1. What steps his Department plans to take to improve health outcomes in the east midlands. (900621)

Lord Darzi’s report concluded that the health service is in a critical condition across the country, including in the east midlands, where healthy life expectancy has declined in the past decade. Waiting lists in the region stand at slightly below the national average for 18-week waits, at 57% compared to the national average of 58%.

With two thirds of people having to wait more than four hours at Lincoln County hospital’s A&E department and with horror stories from my constituents of people waiting up to 24 hours, does the Minister understand that if we are to save the NHS and give people the timely appointments they need, we must unleash the full power of the private sector?

I thank the right hon. Gentleman for helping to underline the shocking inheritance from the previous Government. He is absolutely right. We are committed to cutting waiting times and serving constituents, like mine, by delivering the long-term reform the NHS desperately needs. The Government are committed to the funding model. We are not going to change it. He tries this every time, but we are committed to the funding model as it exists.

A really important part of improving health outcomes in the east midlands, and across the country, is the use of diagnostics. The Rosalind Franklin laboratory, which was set up in my constituency, was closed down just a few months ago at a cost of £0.6 billion. Does my hon. Friend agree that one of the most important things we could do is to restore good quality diagnostics to our NHS?

My hon. Friend is absolutely right. We are committed to improving diagnostics as part of our reform of the health sector. Analysis of waiting lists shows that 20% of people will end up with a hospital admission, most as a day case. To improve waiting times, the focus must be on early prevention, diagnostics and consultant review at an early stage.

2. What assessment his Department has made of the effectiveness of NHS urgent and emergency care services. (900622)

The recent independent report by Lord Darzi makes it absolutely clear that urgent and emergency care services are also struggling, with the latest data published last week showing that one in 10 patients spend over 12 hours in A&E. We are committed to returning to service standards that patients rightly expect through our ambitious 10-year plan to reform the health service.

In September 2021, Victoria hospital in Deal lost provision for blood testing. After a long campaign by residents, it was agreed that it would return. However, that has stalled in the tendering process. Will the Minister meet me to discuss how we can move this forward?

I commend my hon. Friend for championing this issue on behalf of his constituents. I understand that he has raised it with the chief executive officer of his local trust. He will appreciate that commissioning decisions are a matter for the local integrated care board, in this case Kent and Medway ICB, but I am, of course, very happy to meet him to discuss it further.

I wish the Minister well in her efforts to address this issue, because it is extremely serious. There are very often more than 20 ambulances queueing outside Treliske hospital, which has a serious impact on expectations for patients. Will the Minister please look at the potential for urgent treatment centres to take pressure away from emergency departments, such as the urgent treatment centre at West Cornwall hospital in Penzance, which really needs to be re-established on a 24/7 basis? That would make a real impact.

I thank the hon. Gentleman for his good wishes. It is, indeed, a huge task we have before us. We will maintain ambulance capacity throughout this winter. He makes a valuable point about alternative models to hospital admissions and treatment in the community. That is a matter for the local ICB, as I know he knows. It needs to look at which model is the best fit, particularly in rural areas, to reduce the pressure on frontline A&E services.

Intermediate care for people facing homelessness, which is recommended by the National Institute for Health and Care Excellence, can reduce rough sleeping by around 70%. That is life-changing for people who have been sleeping rough and it plays a significant role in relieving pressure on hospitals. A recent evaluation of intermediate care for people facing homelessness in one county in England found a 56% reduction in A&E visits and a 67% reduction in emergency admissions. What exists currently is a postcode lottery. How can we embed the NICE approach in every integrated care system across England?

My hon. Friend has highlighted an issue that is often overlooked. Homelessness has risen to shocking levels in the last 14 years. When it was addressed under the last Labour Government, people were moved off the streets, and there was decent care at the front end of the hospital system and support in the community. My hon. Friend is right: there are good examples across the country, and we would like to see them embedded as part of our overall goal, across Government, of reducing the scourge of homelessness in society and once again supporting the front end of the health service.

I recently met representatives of the Royal College of Emergency Medicine, who told me that the inadequate state of social care was resulting in the deterioration of people’s physical health, leading to more presentations at emergency departments. Does the Minister agree that if social care were properly funded, pressure on our hospitals would be reduced?

What we see at the front end of the system is a result of the deterioration throughout the system, and the flow of patients from the community, through discharge and, indeed, through social care. Our ambitious 10-year plan will involve examining the entire patient pathway to ensure that care is provided in the community, closer to home. Prevention is a key part of that, as is the look that we are taking at social care.

3. What steps he plans to take to reform adult social care. (900623)

After 14 years of Tory neglect and incompetence, adult social care is on its knees. The number of people receiving long-term care decreased between 2015 and 2023, and there were a staggering 130,000 staff vacancies in the system. Last Thursday, recognising the central role of our amazing care workforce, we took a critical first step by introducing the groundbreaking legislation that will establish the first ever fair pay agreement for care professionals. I think it fair to say that this Government have done more for our adult social care workers in 14 weeks than the last lot did in 14 years.

Given unfunded schemes such as the proposed national care service, given the new negotiating body’s aim of establishing a minimum pay floor, and given what clearly amounts to an expensive top-down reorganisation of the care system, can the Minister explain how he will maintain and enhance the role of local authorities, including Buckinghamshire Council, in targeting and delivering care, and how he plans to maintain day-to-day spending alongside this grand plan for reform, without raising taxes?

It beggars belief that Opposition Members should lecture us on fiscal discipline when there is a £22 billion in-year black hole. We are committed to consulting widely on the design of a fair pay agreement, and we will engage with all who may be affected. We are keen to ensure that all voices are heard so that the financial impacts on the adult social care market, local government and self-funders can be considered, but in a week in which this Government have attracted £63 billion of investment and just days after the publication of the Employment Rights Bill, we are seeing a Government who are pro-business, pro-worker and pro-growth.

Adult social care is under extreme pressure. One in four hospital beds are occupied by patients with dementia. Will the Minister commit himself to the delivery of a dementia strategy in the current Parliament?

That is an extremely important question. I recognise that dementia is a huge issue that impacts on the entire country and, indeed, many Members on both sides of the House. We are absolutely committed to the research that is fundamental to addressing the problem, and our fair pay agreement is about not just pay but training and terms and conditions. We will be ramping up dementia training for our adult social care workforce.

I call the shadow Minister.

The Labour manifesto spoke of the need for a consensus on social care, and the Secretary of State has said that he wants to reach out across the political divide—although the message does not seem quite to have reached the Minister yet. During Health and Social Care questions in July, the Minister said that there would be announcements in the near future, but since then we have heard nothing. We are ready to talk; when will the Government be ready?

I am not sure if the right hon. Gentleman was listening to my previous answer. We have just set out a groundbreaking piece of legislation to settle the issue of adult social care pay, which is more than the last lot did in 14 years. We are absolutely committed to building cross-party consensus. We know that we need a process that will be sustainable and fix adult social care for the long term. That absolutely includes engagement and dialogue across this House, because we want to build a consensus that works. We recognise that successive Governments have failed to get a grip on this issue, but we recognise the vital role that adult social care will play. It is going to be a hugely important part of our 10-year plan for the future of the NHS, and I look forward to engaging with all hon. Members on this issue.

4. What assessment he has made of the adequacy of treatment for post-sepsis syndrome. (900624)

I thank the hon. Member for raising awareness of this important issue. He has spoken powerfully about the experiences of patients in his constituency and his wife’s personal battle with sepsis. The long-term complications of sepsis can have a devastating impact long after discharge from hospital. Through the National Institute for Health and Care Research, the Department is funding research to improve outcomes for sepsis survivors.

Last year, Abbi Hickson from Ashfield lost both her hands and her lower legs to sepsis. The local hospital was very slow to diagnosis her condition, and since then she has been suffering from shortness of breath, fatigue and a lack of sleep. This could be post-sepsis syndrome, yet nobody at the hospital has spoken to her about it. Does the Minister agree that every single sepsis patient and survivor should be advised about this condition?

I absolutely do, and I pay tribute to Abbi, a beautiful woman whom I was privileged to meet after the Westminster Hall debate last week. Although care after sepsis will vary hugely on a case-by-case basis, we need to make sure that the needs of each individual are met. In this case, it sounds like they have not been met. If the hon. Gentleman wants to meet me to discuss this issue further, I am more than happy to do so.

Given that last month was Sepsis Awareness Month, will the Minister join me in paying tribute to the courage of John Snow and his family in my Dartford constituency? Tragically, he has just experienced a quadruple amputation due to sepsis. He has received amazing support from the Dartford community, who have rallied around to help fund support for his family. Will the Minister use that as a spur to improve treatment for sepsis more generally across the country?

I pay tribute to John Snow and, indeed, my hon. Friend’s constituents, who have rallied around him at his time of need. This matter highlights the need to have better joined-up care to ensure that people who have sepsis receive the best care possible, that those who tragically lose limbs as a consequence of sepsis are able to have good-quality aftercare, and that we continue to raise awareness of sepsis and the risks it poses.

We think that about 48,000 people a year lose their lives to sepsis, but the truth is that we do not know, because the data is inconsistent. Will the Minister look at establishing a national registry to track sepsis cases, so that performance can be measured, published and improved?

Given the national standards and framework that have been put in place in this regard, I hope very much that the NHS will be able to do precisely what the hon. Gentleman wants it to do.

Yesterday was Allied Health Professions Day, which raises awareness of 14 professions, including physios, speech and language therapists, and radiographers. Does the Minister agree that all the hard work of those professionals is really important for patient care?

My hon. Friend makes a really important point. The wonderful staff we have working across health and care ensure that our constituents receive, within a very tightly constrained health service, the best possible care that we can give them. The NHS is broken. We have to fix our broken health service, and having good-quality staff at the heart of it is how we are going to achieve that aim.

5. What assessment his Department has made of the adequacy of patient waiting times. (900625)

Waiting times are wholly inadequate in our country. That is because the previous Conservative Government took a golden inheritance of the shortest waiting times and the highest patient satisfaction in history and left behind the worst crisis in the NHS’s history. What is more, they accept no responsibility and cannot even bring themselves to say sorry.

I pay tribute to my own family GP, Dr Islam at the East Hull family practice, who goes above and beyond for his patients. However, I know that GPs are troubled by the amount of time patients have to wait to see them. The disparity between GP numbers in different areas is utterly shocking. In Kingston upon Thames, for example, a GP looks after 1,800 patients, but in Kingston upon Hull it is more than double that number. What is my right hon. Friend doing to sort out the Tory mess of the last 14 years?

May I first, through my hon. Friend, say thank you to Dr Islam and to GPs right across the country who, against the backdrop of the extraordinary challenges they are working through, have none the less managed to deliver more appointments now than when there were thousands more GPs? My hon. Friend is right to point out that we do not have enough GPs in this country. That is why, within weeks of taking office, this Government found just shy of £100 million to put into the frontline to employ 1,000 more GPs who will be seeing patients before the end of this financial year. That will make a real difference, and the shadow Secretary of State should have the humility and to grace accept that.

Patient waiting times are reduced dramatically through the recruitment and retention of more GPs, so will the Secretary of State welcome the work of the Anglia Ruskin medical school in Essex, and perhaps have a conversation with myself and neighbouring MPs about how that medical school could be expanded to do much more to support the recruitment and training of more MPs—more GPs in Essex?

I am sure that the right hon. Lady does want more Conservative MPs in Essex. She has raised an entirely constructive point, which I strongly welcome. This Government are committed, as we were in opposition, to doubling the number of medical school places, and that means real opportunities for local medical schools such as hers. As ever, I would of course be delighted to meet her to talk about what more can do with her local university.

The news that we are recruiting more GPs is very welcome. I spent an afternoon shadowing a local GP and saw just how stretched the services were. Will the Secretary of State give a commitment that we are moving towards investment in primary care services and moving from a national health service to a focus on neighbourhood health services?

I am grateful to my hon. Friend for raising that question. When in opposition, I was delighted to spend time with a whole group of GPs from across Sheffield who showed us what primary care reform could look like. We are committed to increasing primary care as a proportion of the NHS’s budget, which will be important, and also to building exactly the kind of neighbourhood health service she describes, with more care closer to people’s homes. General practice has a key role to play in that.

I call the Chair of the Select Committee.

What we measure is often what we end up improving, and one of the great assets of Lord Darzi’s report is the technical annex with its 330 analyses. It is incredibly useful; it is a baseline. Will the Secretary of State make sure that it is updated yearly?

That is a great constructive challenge. I am absolutely committed to transparency and to keeping that dataset updated in the way that the hon. Lady requests. We are not going to get everything right and sometimes we are not going to make progress as fast as we would like, but where that is the case we are never going to duck it or pretend that things are better than they are. The reason that we will succeed where the previous Government failed is that we are willing to face up to the challenges in the NHS rather than pretend that they do not exist.

I call the shadow Minister.

The Prime Minister has repeatedly stressed the importance of preventing people from taking up smoking, as one of his priorities to improve the nation’s health, reduce waiting lists and lessen demand on the NHS, and we agree. The Government like to talk about the record of their first 100 days in office but, according to data from Action on Smoking and Health, 280 children under the age of 16 take up smoking in England each day. That is 28,000 children in England during the Secretary of State’s first 100 days. Why has he not yet reintroduced our Tobacco and Vapes Bill? How many children need to take up smoking before he makes this a priority?

Perhaps the shadow Minister would like to give us the figures for the entire 14 years that his party was in government. By the way, just to set the record straight, not only did I propose the measures in that Bill during an interview with The Times earlier last year, but if it was such a priority for the Opposition, why did they leave the Bill unfinished? Why had it only had its Second Reading? And why did we go into the general election with that Bill unpassed? I will tell him why: because his party was divided on the issue, and the then Prime Minister was too weak to stand up to his own right-wingers who are now calling the shots in his party. The smoking Bill will be back, it will be stronger and, unlike the previous Government, we will deliver it.

I call the Liberal Democrat spokesperson.

My constituent Mel Lycett has terminal cancer. After repeated visits to her GP, she was referred to a two-week urgent pathway in May. She was not diagnosed until the end of July, and she still has not started treatment. Every single target for her diagnosis and treatment was missed. That is not uncommon in Shropshire, and it is not uncommon in the rest of the country. Can the Secretary of State reassure me of what he is doing to deal with this terrible legacy left behind by the Conservative Government? How will he ensure that cancer patients are treated in a timely manner?

I welcome the hon. Lady to her role. I am afraid that this case is just one of countless stories of people whose lives might have been saved had the NHS been there for them when they needed it. It is bad enough when people receive a late diagnosis that equates to a death sentence; it is worse still when people in that position are not given the fighting chance of urgent, life-extending treatment.

The inheritance we have received is truly shameful. I assure the hon. Lady, as a cancer survivor myself—because the NHS was there for me when I needed it—that we will work tirelessly through a national cancer plan to make sure that we deliver the cancer waiting time standards that the last Labour Government met, and that are sorely needed today.

6. If he will make a comparative assessment of the adequacy of access to primary care services for men in (a) England and (b) Scotland. (900626)

As Lord Darzi identified in his NHS review, primary care is broken, with 1,600 fewer fully qualified GPs than in 2017. We recognise that men can face particular challenges in accessing services, which is why we are committed to fixing the front door to the NHS, bringing back the family doctor and shifting the focus of care away from hospitals and into the community. Health is devolved in Scotland, but I welcome opportunities to share learning across our two nations.

In my Paisley and Renfrewshire South constituency, the rate of premature death in men is 47.9% higher than the UK average. According to National Records of Scotland, the number of people who have died by suicide in Renfrewshire as a whole has increased to the highest level in 10 years. Does my hon. Friend agree that this is a damning indictment of the SNP Government’s record on health? Will he commit today to holding a summit in November, with Movember, to raise men’s health up the agenda?

Those statistics are both damning and shocking. Health inequalities in any part of our United Kingdom need to be tackled, and the SNP Government have real questions to answer on these shocking statistics for men in my hon. Friend’s constituency and across Scotland. I will take up her challenge. A summit with Movember, and with her and other interested Members, to talk about men’s health issues is a cracking idea, and I will get straight on to it when I get back to the Department.

I appreciate that the Secretary of State is unlikely to comment on the Chancellor’s forthcoming statement, but he and his Front-Bench colleagues have already mentioned funding issues a number of times this morning, so will he confirm that it is the policy of his Government to take steps to increase the UK’s health spending to the average of other countries in north-west Europe? That would lead to an increase of around £17 billion for the national health service and would help address some of the issues referred to by the hon. Member for Paisley and Renfrewshire South (Johanna Baxter).

Order. Questions ought to be linked to the subject being dealt with, which is access to primary care. I am sure that the hon. Gentleman meant to ask, “Will there also be funding to improve access to primary care?”, which I am sure the Minister can answer.

This Labour Government were elected to tackle health inequalities, fix our NHS and ensure that more people live longer, healthier lives. That will require a concerted Government effort, which is why we have the health mission board in place. My right hon. Friend the Secretary of State is making the case for investment and reform at every opportunity, but let us be clear: every single Labour Government have left the country with a better NHS than they inherited, and this Labour Government will fix our NHS once more.

7. What his Department’s timetable is for announcing the outcome of its review of the new hospital programme in relation to the proposed redevelopment of Whipps Cross hospital. (900627)

I must declare an interest, because Whipps Cross hospital serves my constituents, as well as those of the right hon. Gentleman. On that basis, I am well aware that we desperately need the proposed redevelopment of the hospital. That is why, in common with so many Members across the House, I am furious that the previous Government’s new hospitals programme had a timetable that was a work of fiction and money that will run out in March. The assurance I can give to the right hon. Gentleman, his constituents, my constituents, and the constituents of every right hon. and hon. Member across the House whose constituents are waiting for news on the new hospitals programme, is that we will deliver on a timetable that is credible and a programme that is funded, giving our constituents the clarity and consistency they deserve, and rebuilding by placing the Government among our construction industry supply chain.

The Secretary of State knows that we have campaigned together for the redevelopment of Whipps Cross hospital, and whether that is delivered by a Labour or Conservative Government makes no difference to me. I want to drag him to the reality of a specific point about the hospital: it was granted £1.2 million towards undertaking a business case, which it received in August, but that money has run out. A total of £5 million is required to be ready when the decision is made; if it is not available, the hospital will lose the architects and builders. Will he go back to the Department and ensure that the hospital receives that money, so that managers can be ready with the full, detailed business case the moment the decision is made? Otherwise, it will cost £50 million extra over the next year to get the architects and builders back. I beg the Secretary of State—I literally beg him—to look at that carefully.

I am grateful to the right hon. Gentleman for his question. Those practical considerations are very much part of the review. I say to the poor project managers across the country who have had to deal with the previous Government’s stop-start approach that we are not going to make that mistake. We are going to come forward with a credible plan that is also funded, not the work of fiction or the £22 billion black hole that the shadow Secretary of State left in her wake.

Whipps Cross hospital is in my constituency and it is my constituents who have had to endure five years of the previous Government organising photo opportunity after photo opportunity, not putting the contracts in place for the project to be up and running and ready to go. Does my right hon. Friend agree that only a fully costed, long-term approach from this Labour Government can deliver the modern healthcare that my constituents need?

My hon. Friend, my constituency neighbour, is absolutely right. He has been doing an outstanding job of representing the people of Leyton and Wanstead since his arrival. What our constituents, and indeed constituents right across the country, deserve is honesty, clarity and consistency. That is how we will turn the new hospitals programme from a press release into reality and how, in doing so, we will restore trust in politics and, for businesses, the construction industry and the supply chain, restore confidence in public sector procurement.

Many Leicestershire residents are concerned about the Government’s review of the new hospitals programme, which would have seen two new hospitals, a midwifery-led unit and a multi-storey car park in the city. What representations has the Minister made to the Chancellor to retain this vital investment for the NHS in Leicestershire?

The hon. Gentleman asks what representations I am making to retain the funding. If only that were the case. The funding was not there. The Conservative party went into the general election with a programme timetable that was a work of fiction and a claim to have a funded programme that was simply not true. What we arrived to find was a timetable that was a load of rubbish and a £22 billion hole in the public finances that the party hid from the country because it did not want to confront the hard truths. This Government are facing the facts and answering the challenges.

I am probably the only MP in this current Chamber who has recently used Whipps Cross hospital, which also serves my community in Walthamstow, because I had both my children there, so I know at first hand how desperately it needs redevelopment and how poor the facilities are that the amazing staff are having to use. Does my right hon. Friend agree that finally getting this project moving under a Labour Government will also deliver thousands of much-needed homes in our local community? It is a win-win situation, which is why it is such a travesty that, for years, Conservative Ministers came and took photos, but we never saw any diggers or spades in the ground. Does he agree that Labour can change that?

My hon. Friend is absolutely right. This is about not just the necessary hospital projects, but the growth that will come through construction, getting these projects up and running and, of course, the role that the NHS plays as an economic anchor institution in communities, as some of these projects will necessarily unlock new housing sites and a local transport infrastructure. We are mindful of all of that. The most important thing is that we come forward with a timetable that is credible and a programme that is funded, and that is exactly what we will do.

We look forward to getting the land in Chorley on that basis.

8. What assessment he has made of the effectiveness of district hospitals in providing services that meet the needs of local communities. (900628)

Lord Darzi’s report concluded that the health service is in a critical condition across the country. District hospitals have a vital role to play in meeting the needs of their communities, and this Government will support them to reduce waiting times, to improve urgent care and to play their part in building a neighbourhood health service.

Critical care at Furness general hospital in Barrow has been temporarily downgraded, meaning that those in most need of the highest level of care are now exposed to potentially life-threatening delays during a 50-mile transfer on difficult roads. Will the Minister please look at this worrying decision by the University Hospitals of Morecambe Bay NHS foundation trust and do everything to enable the reopening of this service as soon as possible?

My hon. Friend is a doughty fighter for her constituents. I am aware that the decision she mentions is an interim measure made by the critical care network, the Lancashire and South Cumbria integrated care board and the NHS trust. The decision will be kept under review and patients impacted will receive the appropriate support. The Government recognise that more must be done to improve the sustainability of the NHS both nationally and in rural and coastal areas.

Services at Chase community hospital in my constituency, in Whitehill and Bordon, are being run down by the ICB. This is based on a promise that a brand-new health hub will be built in place, which is much welcomed. It has the support of the Defence Infrastructure Organisation, which owns the land, East Hampshire district council and the community, but the ICB is suffering from inertia. Can the Minister speak to the ICB and suggest that it either builds this new health hub or refurbishes and renovates the Chase community hospital?

I have every sympathy with the case that the hon. Gentleman has put forward. This Government want to see a shift of health services from hospital to community, from analogue to digital, and from sickness to prevention, but these decisions are not taken through inertia; they are taken because of the Government’s inheritance from the Conservative party. We have had 14 years of running down our health services, with needless reorganisations that have destroyed and set back the progress that the last Labour Government made on the NHS. This Government will fix the NHS, including in the hon. Gentleman’s local area, but he has to recognise that the root cause of many of the problems faced by Members across the Chamber lies at the feet of the former Secretary of State and the last Government.

We have heard about the challenges facing Whipps Cross hospital. The Secretary of State’s decisions to pause capital projects across the country and put them under review has caused worry and uncertainty for staff in hospitals nationwide. Can he say when the review will be completed, so that we have certainty about when things will go ahead?

The review will be completed when all the information has been analysed. The hon. Lady should not just be a little more patient; she should be a little more apologetic for the fact that the Government found a hospital rebuilding programme that was not worth the paper it was written on, because the ultimate paper we needed—the cash—was not there.

9. What assessment his Department has made of the effectiveness of the NHS dental contracting framework. (900629)

I pay tribute to my hon. Friend for the excellent work he does for the people of Doncaster East and the Isle of Axholme. The scale of the problem that he points out is massive. One of the most shocking statistics I have discovered since taking up this position is that the most common reason for children aged five to nine being admitted to hospital is tooth decay. That is completely and utterly shocking—truly Dickensian. We cannot fix the matter overnight, but we are committed to reforming the dental contract and working with the British Dental Association to focus on prevention and on the retention of NHS dentists. We are also working at pace to ensure that patients can access an additional 700,000 urgent dental appointments.

The horror stories I hear in my constituency are just awful: from the mum on the Isle of Axholme who could not find an NHS dentist after five years and who carries out her own treatment on her son, to a gentleman in Doncaster East whose teeth are crumbling due to illness, causing him horrendous pain, and who cannot get an appointment. The Government’s pledge to provide more emergency appointments is great, but I know that it will take time to rebuild dentistry. Can the Minister reassure me that people in my constituency will be given the priority they deserve?

My hon. Friend is right. South Yorkshire has the highest level of hospital tooth extractions in England, and I want to assure him that we will target interventions at the areas of greatest need. For example, integrated care boards have started to advertise roles through our “golden hello” scheme, which will drive recruitment of graduate dentists to areas of greatest need for three years. We have inherited a mess and we are working at pace to clear it up.

The Minister is right to underline the issues for children, but can I remind him of the issues for those above the state pension age—which is increasing to 67, including for ladies—in particular when it comes to certain benefits, such as attendance allowance? Will he look at the contract for those who are elderly and in receipt of such benefits?

We are in a situation where a staggering 28% of the country—13 million people—have a need that is unmet by NHS dentistry. There are so many issues that we need to resolve. We are looking at the contract with the BDA and I am more than happy to look into the issue raised by the hon. Gentleman.

Last month, the Secretary of State for Wales told the Labour party conference that this Labour Government will “take inspiration” from Labour-run Wales on dentistry. That is the same health system in which less than 60% of dentistry courses are being completed in comparison with pre-pandemic figures—a rate that is far lower than in England. Does the Minister agree that the Secretary of State for Wales is right and that Wales is a blueprint for what a Labour Government will do in England, or will they drop the bluster, get serious and commit to the dental reforms set out in the dental recovery plan, including a tie-in to NHS dentistry for graduate dentists?

I find it extraordinary that yet again we see a total lack of humility and contrition from the Opposition. The key difference that we will see in how our United Kingdom works is that we now have some grown-ups in charge in Westminster, who will work with colleagues in Cardiff Bay to ensure that a rising tide lifts all boats and we improve the state of NHS dentistry across the United Kingdom.

10. What assessment he has made of the adequacy of access to NHS mental health services. (900630)

15. What assessment he has made of the adequacy of access to NHS mental health services. (900636)

Our mental health service is on its knees, thanks to 14 years of Tory neglect and mismanagement. A staggering 1 million people are waiting to access mental health services, and vacancy rates are around 10%, the highest across the NHS. This Government are committed to fixing our broken NHS so that people can be confident of accessing high-quality mental health support when needed. That includes recruiting 8,500 more mental health workers, introducing specialist mental health professionals in every school, rolling out Young Futures hubs in every community and modernising the Mental Health Act.

Patients tell me they cannot get access to community mental health nurses, putting huge pressure on GP practices and leading to people going to A&E in desperation. Can the Minister confirm whether the 8,500 extra mental health staff pledged in Labour’s manifesto will include much-needed nurses in the community?

I pay tribute to my hon. Friend, who is doing excellent work for the people of North Durham. I would also like to take the opportunity to thank our mental health nurses, who do such vital and valuable work. The Government are committed to shifting from hospital to community, and that of course includes the mental health sector. I can assure my hon. Friend that we are working with NHS England on how best to deploy those additional 8,500 mental health workers.

I wish to pay my respects to the family of Jamie Pearson, the 27-year-old Blackpool man who sadly took his own life in a local hospital in August after waiting nearly 24 hours to see a mental health worker in A&E. Jamie was in a mental health crisis, but got himself to what should have been a place of safety. What steps is the Minister’s Department taking to ensure that no one is left to suffer in A&E because they cannot access mental health treatment in their community, and will he meet me to discuss that tragic issue, so that we can make sure that it never happens again?

I thank my hon. Friend for raising that deeply tragic case. Words cannot express the heartbreak caused to Jamie Pearson’s friends and family. I hope it might be some small comfort to them to know that all acute hospitals should now have a 24/7 mental health liaison service in A&E, and we are looking at how best to take forward the Government’s suicide prevention strategy for England. We will do everything in our power to ensure that the tragic circumstances of Jamie’s untimely death are addressed, and that lessons are learned. I am happy to meet my hon. Friend to discuss that further.

Those providing child and adolescent mental health services in south Cumbria do an outstanding job, but they are without a dedicated crisis team, unlike the rest of Lancashire and South Cumbria NHS Foundation Trust. That is devastating and dangerous for my constituents. Will the Minister use his power to intervene with the integrated care board and Lancashire and South Cumbria to make sure that young people in our communities have access to a crisis team?

I thank the hon. Gentleman for that question and the passion with which he put it. We are committed to rolling out Young Futures hubs across the country and, of course, we need to prioritise areas of particular need. I would be happy to meet him to discuss that further.

A recent review of children’s mental health services in my local authority, the London borough of Richmond, found that, staggeringly, children with mild to moderate needs in tier 2 waited on average 15 months before receiving treatment, and those with more severe needs waited on average nine months. The Minister does not need me to tell him that during that time, children’s conditions get worse; they need greater treatment and, sadly, too many present at A&E self-harming and attempting to take their own life. As well as committing to mental health professionals in every school, will he put some money into acute provision, so that children do not end up in A&E?

We are absolutely committed to the three shifts: from hospital to community, from sickness to prevention and from analogue to digital. The sickness to prevention aspect is important in the question that the hon. Member raises. Treatable mental health conditions such as anxiety and depression should be identified early to prevent them from developing into something more serious and into a crisis, so I absolutely share the sentiment behind her question. They will be at the heart of our 10-year strategy for the future of our health.

11. What steps his Department is taking to improve access to GP appointments. (900631)

14. What assessment his Department has made of the adequacy of patient access to primary care services. (900635)

17. What assessment his Department has made of the adequacy of patient access to primary care services. (900639)

20. What assessment his Department has made of the adequacy of patient access to primary care services. (900642)

As identified in Lord Darzi’s review, primary care is broken. Satisfaction with GP services has fallen from a peak of 80% in 2009 to just 35% last year—a truly damning indictment of 14 years of Tory failure. We will rebuild general practice. We have invested £82 million to recruit 1,000 new GPs, we have launched our red tape challenge, and we are committed to improving continuity of care and ending the 8 am scramble. On primary care more broadly, we are committed to boosting the role of community pharmacies, enabling patients to be treated for certain conditions by their local pharmacists, without the need to see a GP.

The Arborfield Green community in my Wokingham constituency has around 10,000 residents in new homes, with many more to come, but there is no local primary care provision. To see a GP, residents must travel to neighbouring villages, which are often inaccessible because of a lack of public transport. What steps will the Minister take to guarantee that there will be enough GPs in any major new developments that come down the line?

The hon. Member is absolutely right: there are seriously under-doctored areas of the country. Given the finite resources that we have, we must focus on areas with the greatest need. I would be more than happy to meet him to discuss how that might best be reflected in his constituency.

Access to GP appointments is consistently raised with me in Cumbernauld. A number of constituents have informed me that, having made complaints, they have been removed from the list of the general practice at which they have been patients for many years. Will the Minister raise the matter with the Scottish Government’s Cabinet Secretary for Health and Social Care, so that we can get some resolution for my constituents?

Patients have an absolute right to complain about NHS services, and they should not be removed from a practice’s list because of a complaint they have made. Health is of course devolved, but I have asked officials in the Department to engage with their Scottish Government counterparts on that matter to ensure that patients in my hon. Friend’s constituency are treated with the respect and compassion that they deserve.

Residents in Mickleover have been queuing from 7 am to get an appointment with their GP, and Healthwatch says that seven in 10 people in Derby find it very difficult to book appointments. That is the legacy of the previous Government. With new homes being built in and around Mickleover, we need even more additional capacity. Does the Minister agree that GP capacity must be a priority?

We are absolutely committed to the challenge of cutting red tape and reducing the administrative burden for staff to help patients get the care that they need. An important element of our plan will be streamlining access to registration in order to move it online, and we are working at pace to make online registration available in all practices. I am very happy to come back to my hon. Friend on the constituency issue that she raises.

Lord Darzi’s report on the NHS states that people are struggling to see their GPs. Prevention is better than cure, and interventions to protect health tend to be far less costly than dealing with the consequences of illness, both financially and in terms of outcomes. Early and quick access to primary care is therefore crucial. I accept that it is not always necessary to see a GP—an appointment with a nurse may suffice—but what steps are being taken to ensure that patients in my Wolverhampton West constituency have quick, easy and direct access to GP surgeries?

I note that Wolverhampton West has seen a decrease of 28 full-time equivalent GPs since 2018, which of course massively exacerbates the issues to which my hon. Friend refers. We will introduce a modern booking system to end the 8 am scramble and make it easier for patients to contact their GP. In particular, we are committed to increasing the use of the NHS app to view patient records and order repeat prescriptions. All of that will take pressure off the booking system.

Last week, NHS Suffolk and North East Essex integrated care board announced plans to scrap the super-surgery in north Essex. To say that my constituents were incandescent would be an understatement; many of them have waited since 2021 for a replacement to closed surgeries in Bramford, Claydon and Great Blakenham. Many have to use Needham Market surgery, which is also awaiting plans to move to larger premises with increased capacity. Will the Secretary of State meet me to discuss how we can expedite plans to expand primary care in north Ipswich and the surrounding villages?

I thank the hon. Gentleman for setting out a list of all the failures of the past 14 years. He is dealing with that mess thanks to Members on the Benches he sits on. I strongly encourage his constituents to get actively involved in the 10-year plan that we will launch. There will be an important national engagement exercise on shifting from hospital to community, from sickness to prevention and from analogue to digital, because given the total and utter chaos that we inherited, we need systemic reform.

I recently met representatives of Martins Oak and Oldwood surgeries in my constituency. Both surgeries have ambitious plans to move to bigger premises so that they can see more patients, but they face numerous challenges, including the gap between the lease lengths that the integrated care board will support and those that GP practices can get developers to sign up to. There are other challenges that I am sure the Minister can help unpick, so will he meet me to see whether we can help bring those ambitious plans for new surgeries to fruition?

The hon. Gentleman has considerable expertise in this area, given his background. I would be happy to discuss that issue with him, but I remind him that although there may well be specific issues, there is a generic problem: the total and utter failure to ensure investment, reform and strategic thinking about our system.

T1. If he will make a statement on his departmental responsibilities. (900646)

Today, I am publishing the full findings of Dr Penny Dash’s review of the Care Quality Commission. Her interim report made it clear that the CQC was not fit for purpose, with fewer inspections being carried out, urgent follow-ups being neglected and patient safety being put at risk. Today, she makes seven recommendations for improvement, and I have made sure that the CQC has begun urgently putting them into practice. We are also publishing a review of the CQC’s deeply flawed single assessment framework today. Sir Julian Hartley will shortly begin as its new chief executive, with my full support.

My constituent Mark has been unable to find an NHS dentist for his 19-month-old child, even at the seventh time of trying. My right hon. Friend well understands the crisis he has inherited. Will he meet me to discuss the shortage of dentistry in Stockton North and across Teesside?

I am sorry for my hon. Friend’s constituents, and so many others who are dealing with the consequences of the Conservatives’ failure on dentistry. I would be delighted to meet him to discuss the challenges in his area.

I call the shadow Secretary of State.

I congratulate all nominees and winners in the NHS parliamentary awards yesterday. Their success was richly deserved, and the awards were a very good example of the House coming together to celebrate those who work so hard in our health service and social care services.

In the past five weeks, I have asked the Secretary of State 29 questions at this Dispatch Box, yet he has managed to answer only one. For the rest, he has tried to bluster his way out of his policy decisions, as we have seen this morning. Let us try again. When will be the first week in which we see delivery of his promised 40,000 more appointments?

After the performances I had to put up with when the right hon. Lady was at the Government Dispatch Box, she has some brass neck complaining at the Opposition Dispatch Box that I am not answering her questions. She will know that we are working at pace to stand up 40,000 more appointments every week as our first step, as promised in our manifesto, and we will deliver. More than that, we will go into the next election with a record of which the right hon. Lady can only dream.

After 14 years of opposition—two and a half of which the Secretary of State spent on the Front Bench and travelling around the world, funded by other Governments, to look at their healthcare systems—and more than 100 days in government, the right hon. Gentleman does not even know the start date of his own flagship policy. He is no Action Man; he is Anchorman.

Let us deal with Labour’s cruel decision to slash winter fuel payments, which will add pressure not only to patients, but to the NHS. The NHS’s deputy chief operating officer—

Order. I have got a lot of people to get in. Members on both Front Benches must be quicker.

After Labour’s cruel decision to slash winter fuel payments, which will add pressure to the NHS, its deputy chief operating officer warned that this winter our health service will not have the extra capacity or funding that it needs, which the Conservatives had previously provided. Why has the Secretary of State—

Order. I gave the right hon. Lady a hint to come to an end and not to carry on fully. It is unfair to Back Benchers, who I am trying to represent. I want a short answer.

The shadow Secretary of State questions the budget for this winter, but it was set by her Government. Is that finally an admission of failure on her part? Something else that we will have this winter, which we did not have last winter or the previous winter is no—

I call Lola McEvoy.

T2. Will the Secretaryof State meet me to discuss a cross-departmental pilot in my constituency, bringing together the Department for Work and Pensions, the Department for Education and the Department of Health and Social Care, to tackle some of the immediate pressures that face child and adolescent mental health services in my area, and the impact on schooling, the local work force and family outcomes? (900647)

By cutting mental health waiting lists and intervening earlier, we can get this country back to health and back to work. There are 2.9 million people who are economically inactive, a large proportion owing to mental health issues. Many people can be helped back into work through talking therapies. We will put a mental health professional in every school and roll out 8,500 specialists. I would be happy to meet my hon. Friend to discuss the matter further.

I call the Liberal Democrat Health spokesperson.

In England, 4.4 million children have not seen a dentist for at least a year. Meanwhile, in Shropshire, Telford and Wrekin integrated health board, £1 million of dental funding went unspent in 2022-23. The system is clearly broken. When can we expect the Secretary of State to fix it?

It is precisely because of the situation the hon. Member describes—the poor services and, ironically, the underspends in the dentistry budget—that we will work not only to stand up the 700,000 urgent and emergency dental appointments we promised, but to do the prevention work for children in our schools.

T4. Many people in my constituency are grateful that Slough will soon be home to a £25 million community diagnostic centre, which will help to reduce waiting lists, but many are also concerned that the local trust may be contracting out services for MRI scans. Does the Minister agree that, instead of just outsourcing, local trusts should, whenever possible, try to increase expertise and capacity in-house? (900649)

We are committed to expanding community diagnostic capacity to build an NHS that is fit for the future. However, we are clear that independent sector providers have a role to play in supporting the NHS as trusted partners to recover elective services.

T3. I welcome all efforts to increase the number of GPs throughout England. Residents in new and growing towns such as Wixams in Mid Bedfordshire need a GP surgery. My local councils have been told that they need to put up the capital to deliver one, causing concern about cash flow and borrowing costs. Will the Minister meet me to discuss a new capital investment programme to ensure that residents in new towns such as Wixams do not have to wait for developer contributions to get the services they need? (900648)

As Lord Darzi outlined, capital development in the NHS is shocking, with a backlog of £11 billion in maintenance. I would be happy to meet the hon. Member to discuss his problem.

T5. Alan Petersen is a senior pharmacist in my constituency. He tells me that pharmacies have experienced high volatility in drugs pricing and big increases in bills in recent years. At the same time, they are expected to do far more in direct consultation with the public. Given the UK Government’s jurisdiction over funding dispensing services in England and Wales, when do they plan to review pharmacy funding? (900650)

Obviously, health is a devolved matter and funding for pharmacies in Wales is the responsibility of the Welsh Government. Nevertheless, I pay tribute to the Welsh Government for securing a deal with pharmacies in Wales in line with DDRB—the review body on doctors’ and dentists’ remuneration—pay recommendations. I know that arrangements in England affect matters in Wales and I am working as a matter of urgency to conclude the consultation on the community pharmacy contractual framework.

T6. To correct the Secretary of State, the Tobacco and Vapes Bill went through its Committee stage in the previous Parliament, with several amendments proposed across the Chamber, which the then Minister, Andrea Leadsom, agreed to take away and bring back. Will he incorporate those amendments so that we strengthen the Bill? (900651)

Whatever stage the Bill got to, it was not completed, was it? We will bring back a tobacco and vapes Bill that is stronger than the Conservatives’ and I look forward to seeing if they support it.

T7. Ingleside, the only birthing centre in the city of Salford, was temporarily closed in 2022 amid an acute midwifery staffing deficit across Greater Manchester. Will the Minister be kind enough to meet me to discuss what he can do to ensure that that unit reopens safely as soon as possible? (900652)

My hon. Friend is right to raise the crisis of midwifery services. We have already had debates in Westminster Hall about this, and the issue affects the entire country. It is a priority for this Government, and I am of course happy to meet her to discuss her constituency issue.

T8. Lord Darzi’s report highlighted the importance of local focus and alignment to co-ordinating local services and improving health, contributing to reduced hospital admissions. In Oxfordshire, the integrated care board is proposing to remove Oxfordshire’s dedicated place director. Will the Secretary of State give his support to place- based roles to maintain local authority alignment, as recommended in Lord Darzi’s report? (900653)

I absolutely take the point the hon. Gentleman is making about the importance of place-based leadership. That is why one thing we will be looking to do, as part of the 10-year plan process, is to clarify roles and responsibilities in different parts of the system to ensure that we have better strategic place-based leadership.

T9.   The Royal Stoke hospital is leading the way when it comes to treatment for stroke patients, but as with so many illnesses, prevention is better than cure. Can the Minister set out what this Government are doing to minimise the number of people affected by these life-altering events? (900654)

I agree with my hon. Friend, which is why we have set a goal for fewer lives being lost to cardiovascular disease. We will make it easier for people to have checks in the comfort of their own homes through, for example, the digital NHS health check and the new workplace trials.

Labour’s cut to the winter fuel payment will cause 262,000 cold pensioners to seek NHS treatment, according to the End Fuel Poverty Coalition. Do the Government agree with those figures, and if not, what are their own estimates?

The decision on the winter fuel allowance is not one that the Government took lightly, but we inherited a £22 billion hole in the nation’s finances. We continue to stand behind vulnerable households by increasing the state pension with the triple lock, delivering the warm home discount and extending the household support fund to support the most vulnerable pensioners.

T10. Prevention is the most important intervention to improve health outcomes, yet since 2015 the public health grant has fallen in value by 25%, and by 30% in York. Will the Minister say what he is doing to restore the value of the public health grant? (900655)

My hon. Friend is incredibly knowledgeable about public health matters both at national and local level. Lord Darzi’s investigation into the NHS set out the impact of past reductions in local government public health funding. We will confirm public health grant allocations for the next financial year as part of the forthcoming spending review, but the points she made have been made loudly and clearly.

Can the Secretary of State update the House on the status of Alan Milburn? Does he still attend meetings in the Department and have access to confidential information? Does he now have an official role in the Department? Does he still have private sector interests in the healthcare sector?

The right hon. Alan Milburn is alive, he is safe and we are treating him well.

October is Breast Cancer Awareness Month, and I stand here today as someone who was diagnosed, treated and cured of breast cancer this year by the amazing staff in the north-east, but not enough women are taking up their breast screening appointments. Will the Minister do more to raise awareness of, and access to, breast screening appointments, and may I urge all women to check themselves regularly?

I pay tribute to my hon. Friend for her work in this area and for setting out eloquently her own personal experiences. Of course this Government will do more to raise awareness and enable more women to access breast screening services.

A significant impediment to improving adult social care is the split of budget and responsibility and policy between the Secretary of State’s Department and the Ministry of Housing, Communities and Local Government. Will he and colleagues work to remove that hurdle, to have better outcomes more cost-effectively delivered to improve the lives of all our constituents?

The hon. Gentleman is right to raise that risk. I assure him and the House that I and the Deputy Prime Minister, herself a former care worker, are working in lockstep to align strategy, policy and delivery.