Oral Answers to Questions Health and Social Care The Secretary of State was asked— NHS Dental Contracting Framework Alice Macdonald (Norwich North) (Lab/Co-op) 1. What assessment his Department has made of the effectiveness of the NHS dental contracting framework. Lewis Atkinson (Sunderland Central) (Lab) 17. What assessment his Department has made of the effectiveness of the NHS dental contracting framework. Jon Pearce (High Peak) (Lab) 23. What assessment his Department has made of the effectiveness of the NHS dental contracting framework. The Secretary of State for Health and Social Care (Wes Streeting) First, may I welcome my hon. Friend the Member for Norwich North (Alice Macdonald) to the House, and say what an absolute privilege it is to have been appointed Secretary of State for Health and Social Care? We have our work cut out for us, with not only the worst economic inheritance since 1945, for which the Conservatives should show more humility, but the worst crisis in the history of our national health service, which we see reflected particularly in NHS dentistry. Some 13 million people in England have unmet need for NHS dentistry, or 28% of the country, and it is disgraceful that rotting teeth are the most common reason for children aged between five and nine being admitted to hospital. During the general election campaign, I pledged to meet the British Dental Association immediately to start conversations on contract reform, and I did exactly that. I look forward to working with dentists and others from across the sector to reform the dental contract and rebuild NHS dentistry. Alice Macdonald I welcome my right hon. Friend to his place. Norfolk is a dental desert and my constituents are suffering. As well as reforming the contract, we need to train more dentists. In the east of England we do not have a dental school, but the University of East Anglia has put forward proposals for one. Will he meet me, other hon. Members from Norfolk and representatives from the University of East Anglia to discuss this important proposal? Wes Streeting It is appalling that Norfolk and Waveney are so poorly served in terms of dentistry. There are only 36 dentists per 100,000 people, compared with the national average of 53, so when my hon. Friend says that her community is a dental desert, Members should know that it is the Sahara of dental deserts. We will work with partners to ensure that patients across the country can access a dentist when they need one. I am aware, not least thanks to her advocacy and the advocacy of other Labour MPs across Norfolk, of the University of East Anglia’s proposal, and I would be delighted to meet her and my colleagues. Lewis Atkinson My constituents in Sunderland Central tell me that NHS dentistry is broken. It is not just that they cannot access routine care, but that if they are struck with, for example, excruciating toothache, they cannot access urgent appointments either. I therefore ask my right hon. Friend what steps he is taking, alongside the welcome reform of the dental contract, to ensure that urgent dental services are available locally in places such as Sunderland. Wes Streeting I welcome my hon. Friend; he certainly has big shoes to fill in Sunderland Central and is a worthy successor to his predecessor. He is absolutely right that alongside contract reform we need urgent action. That is why we committed to providing 700,000 additional urgent appointments and recruiting dentists to where they are most needed, and I am delighted to report that dentists stand ready to assist. We are working with the BDA urgently to get those appointments up and running as soon as possible, and we will keep the House informed on progress as we do. Jon Pearce High Peak is also a dental desert. We spoke to one practice that said it got as many calls for registrations as it did for appointments. Often those calls are deeply distressing, with elderly people unable to eat because they need their dentures sorted. What first steps is the Secretary of State able to take to cure 14 years of Conservative failure in NHS dentistry? Wes Streeting I welcome my hon. Friend to the House. He is absolutely right to point out that these challenges have been 14 years in the making, and it will take time to fix the damage that the Conservatives have done to our national health service. We will start with 700,000 urgent appointments, as we promised, and we will continue with contract reform, which is essential. I reassure him that as we do, we will have the needs of all communities in our country at heart, especially rural communities such as his that have particular challenges. I look forward to involving him and keeping him up to date on progress as we make it. Dame Harriett Baldwin (West Worcestershire) (Con) The NHS dental recovery plan was launched earlier this year, and the Secretary of State has on his desk news about the impact that it is having. Could he share with the House how much the plan has increased appointments in the Worcestershire and Herefordshire integrated care board area? Wes Streeting The Conservative party lauded that plan during the general election, when I think the public delivered their verdict on the progress that it had made. NHS dentistry is non-existent in huge parts of the country. We will stick with some aspects of the previous Government’s dental recovery plan because they are the right solutions, but there are gimmicks that we will not proceed with. We will come forward with a serious plan to reform the dental contract, which the Conservatives committed to in 2010 but failed to do in every single year of their 14 years. Layla Moran (Oxford West and Abingdon) (LD) I have a constituent who has been trying to get a dentist appointment for a year. They have painful abscesses, cannot sleep and cannot eat using the right side of their mouth. We need to get on with this. I note that a review of the NHS has been launched, but the British Dental Association is concerned that that review will delay the changes to NHS dentistry that are so desperately needed. Will the Secretary of State give us a timeline for when we will see change? Wes Streeting I am grateful to the hon. Member for her question and congratulate her on her re-election to the House. She is right to point to the detrimental impact that the Conservatives’ failure is having on people’s lives. In fact, in 1948, when the national health service was founded, Nye Bevan received a letter from a woman who had worked her entire life in the Lancashire cotton mills about how the dentistry she was given by the national health service had given her dignity and the freedom to associate in any company. What a tragedy that 76 years later, the Conservative party has squandered and destroyed that legacy to the point where people are suffering not just pain and agony, but the indignity of being unable to find a job and unable to socialise in polite company because they are ashamed of the state of their rotting teeth. The hon. Member is absolutely right: Lord Darzi is conducting a review on the state of the NHS, and it will report in September. That is not preventing us from making progress, talking to the BDA and working within the Department and across the sector to get those 700,000 appointments up and running as a matter of urgency. I look forward to reporting the progress to her and other right hon. and hon. Members. Joe Robertson (Isle of Wight East) (Con) As the right hon. Gentleman is aware, there is a particular shortage of NHS dentists in coastal and rural communities such as mine on the Isle of Wight. Will he therefore commit to the previous Government’s plan for 240 golden hellos for newly qualified dentists by the end of the year to address that issue? Wes Streeting I welcome the hon. Member to the House—it is a rare thing to welcome new Conservative Members, and he is welcome. He is absolutely right to touch on the workforce issues in NHS dentistry, and to say that we need to incentivise dentists, on two fronts: we need them to commit to and do more work in the NHS—we are looking at a range of things in that regard—and we need to ensure that we get more dentists to the areas in which they are most needed. We will certainly support incentives to that effect. Mr Speaker I call the shadow Minister. Saqib Bhatti (Meriden and Solihull East) (Con) I welcome the right hon. Member and his new team to their places in the Department. The shadow Secretary of State, my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins), prioritised access to care, including NHS dentistry, when she was Secretary of State. The dental recovery plan that she launched announced new dental vans to provide access to care to our most rural communities and coastal communities in England. We had agreed with NHS England that the first vans would be on the road by this autumn, and I know that that timescale was welcomed by colleagues across the House. Will he confirm that dental vans will be on the road by this autumn? Wes Streeting I could not have picked a better example of the previous Government’s desperately low ceiling of ambition than the fact that, after 14 years, they laud their triumph of dental vans roaming the country in the absence of actual dentists and dental surgeries. What an absolute disgrace. I accept that the shadow Secretary of State for Health and Social Care was just the last in a very long list of Health and Social Care Secretaries who had the chance to fix the problems. It was not all on her, and it is important that I say that—not least because of the Conservative leadership election that will be taking place soon. I congratulate the shadow Minister, the hon. Member for Meriden and Solihull East (Saqib Bhatti), on his appointment, but he sat behind Secretaries of State as their Parliamentary Private Secretary year after year, week after week, looking at the utterly abysmal failure of their record. When it comes to criticising this Government on the actions that we will take, the Conservatives do not have a leg to stand on. Access to NHS Dentists Steff Aquarone (North Norfolk) (LD) 2. What steps his Department plans to take to improve access to NHS dentists. The Minister for Care (Stephen Kinnock) I thank the hon. Gentleman for his question and welcome him to his place. Thanks to what the Conservative party has done to NHS dentistry over the past 14 years, a staggering 13 million people are unable to see a dentist. I know that the hon. Gentleman represents the constituency that has the lowest number of dentists per head in the entire country. Our rescue plan will provide 700,000 more urgent dental appointments and recruit dentists to areas that need them. We will rebuild the service for the longer term by reforming the dental contract. Steff Aquarone As the Minister has alluded to, we in North Norfolk have suffered in particular from unallocated units of dental treatment being moved to other parts of the country. The integrated care board has been told that it will have to return this year’s unused money to the Treasury. Will the Minister commit to protecting unallocated dental funds in my constituency? Stephen Kinnock As my right hon. Friend the Health Secretary stated, on the Monday after the general election, he met the British Dental Association to look at a range of issues around the long-term NHS contract. That is an ongoing dialogue—it includes units of dental activity, of course—and we need to ensure that we have the negotiations rapidly. We will work at pace to address some of those long-term issues, but let us not forget that the Conservative party allowed the NHS contract to atrophy and took NHS dentistry to the brink of collapse in our country. Claire Hazelgrove (Filton and Bradley Stoke) (Lab) I congratulate my right hon. Friend the Secretary of State for Health and Social Care and his fantastic team on taking their new place on the Government Front Bench. I also thank my right hon. Friend for his advocacy in the last Parliament for people across my constituency who lack dental access. What assurances can the Minister provide that the important issues of infrastructure and housing will be linked together? As we look to build those much-needed 1.5 million homes across the country, it is vital to make sure that we do not have more dental deserts and that we have the infrastructure we need. How will he work in a cross-departmental way to ensure we achieve that? Stephen Kinnock I thank my hon. Friend for her question, and warmly welcome her to her place and congratulate her on her election. The key aspects of our dental rescue plan include 700,000 more appointments through extra funding that we will generate by cracking down on tax dodgers and closing other loopholes. We will incentivise new graduate dentists to come to areas that are underserved to ensure that we plug the gaps—there will be golden hellos to make that happen. We are also working hard on things like supervised toothbrushing for three to five-year-olds, because prevention is always better than cure. New Health Centre: Maghull Bill Esterson (Sefton Central) (Lab) 3. Whether his Department plans to provide capital funding for a new health centre at Maghull in Sefton Central constituency. The Minister for Secondary Care (Karin Smyth) I congratulate my hon. Friend on his re-election. He will know that capital allocations are a matter for the integrated care boards. We are committed to introducing neighbourhood care centres to bring together vital care services, and I look forward to working with him on Labour’s mission to improve the front door to the local NHS. Bill Esterson I congratulate my right hon. and hon. Friends on their appointments. The predecessors of my right hon. Friend the Health Secretary—there have been quite a few over the past few years—all agreed with me that a health centre in Maghull in my constituency was a priority for the health service, but as my hon. Friend has just said, the allocation of capital by integrated care boards has meant that the priority has been acute hospitals, sometimes at the expense of community facilities. Will my hon. Friend meet me to discuss the importance of investment in health centres such as the one in Maghull, which make such a difference to reducing waiting times in the NHS and improving patient outcomes? Karin Smyth My hon. Friend is first out of the blocks on this issue, and has shown his commitment to improving primary care for his constituents. I am sure the local ICB has listened very carefully to his question, because we know that the existing primary care estate is under a great deal of pressure. That is why building a neighbourhood health service remains at the forefront of our mission to rebuild the NHS, and I would be pleased to meet him to discuss that topic. Newcastle-under-Lyme Landfill Sites: Health Effects Adam Jogee (Newcastle-under-Lyme) (Lab) 4. If he will hold discussions with the Secretary of State for Environment, Food and Rural Affairs on the potential effects of toxic air from landfill sites on people’s health in Newcastle-under-Lyme constituency. The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne) I warmly welcome my hon. Friend, the new Member for Newcastle-under-Lyme, and thank him for raising this important issue. The UK Health Security Agency works with the regulator, the Environment Agency, to advise on health risks from landfill sites. In relation to the site in his constituency, the UKHSA undertakes monthly risk assessments using air quality data. A multi-agency group, including Government agencies and local authorities, meets regularly to review the situation and any interventions needed. I will, of course, raise his concerns with my counterparts in the Department for Environment, Food and Rural Affairs. Adam Jogee I thank the Minister for his answer, and welcome him to his place. Walleys Quarry landfill in Newcastle-under-Lyme is an environmental crisis and a health one too, and my constituents Sheelagh Casey-Hulme, Jan Middleton, Lee Walford and many others are rightly scared and angry about the impact of toxic levels of hydrogen sulphide on the health and wellbeing of local people. Will the Minister come to Newcastle-under-Lyme to listen, to learn and to smell, and to help us finally stop the stink? Andrew Gwynne Public health and prevention are priorities for me and this Labour Government. Obviously, the Environment Agency takes the lead in this specific instance, but I am more than happy to jump off the train at Stoke—if my hon. Friend will pick me up—and visit his constituents to listen to their concerns, and to ensure that the public health considerations are amplified to Environment Agency colleagues. Fracture Liaison Services Dr Neil Shastri-Hurst (Solihull West and Shirley) (Con) 5. Whether he is taking steps to ensure the provision of fracture liaison services in all hospitals. The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne) I thank the learned and gallant hon. Member for his question. More than 500,000 fragility fractures occur every year, and up to 40% of fracture patients will suffer another fracture. I praise the campaigns by the Sunday Express, The Mail on Sunday and the Royal Osteoporosis Society for their campaigns on this. I am pleased to reiterate the Government’s commitment to expanding access to fracture liaison services. The Department is working closely with NHS England to develop plans to ensure better quality and access to these important preventive services. Dr Shastri-Hurst First, I congratulate the Minister and the rest of the Front-Bench team on their appointments. As a former orthopaedic surgeon, I am mindful of the impact of osteoporosis on many of our constituents, including my own in Solihull West and Shirley. In England, more than 67,000 people suffer a fracture every year, and a disproportionate number of those are women. What we do know, however, is that fracture liaison services, where they are delivered well, can prevent many of those fractures. Currently, half of the country has access to such services. The last Conservative Government made a commitment to roll them out to the whole country by 2030. Will the Minister honour that commitment? Andrew Gwynne The hon. Gentleman makes a really important point, and we are absolutely committed to ensuring that these services across England are better than those we have inherited. Of course, I completely agree with him about the need to improve these services in specific parts of the country, which is something we will be looking at in detail. However, I have to say to the hon. Gentleman that the one thing those of us on this side of the House will not be doing is what he has written about in “ConservativeHome”, which is health rationing and cutting back on treatment. Urgent and Emergency Care Uma Kumaran (Stratford and Bow) (Lab) 7. What assessment his Department has made of the effectiveness of NHS urgent and emergency care services. The Minister for Secondary Care (Karin Smyth) I congratulate my hon. Friend on her election, and I also pass on my best wishes to her and her husband, who I know recently suffered a stroke. We hope he makes a speedy recovery. We recognise the great work of NHS staff for them, and indeed for all our constituents every day, but we do know that the NHS is broken. The latest data confirms the terrible state in which the Conservatives left urgent and emergency care services, with one in four patients waiting longer than four hours in A&E. That is why Professor Lord Darzi will lead an investigation into NHS performance, and the findings will inform our 10-year reform of the NHS. Uma Kumaran I thank the Minister for her kind words today, and I also thank my right hon. Friend the Health Secretary for his wishes on the day. Mr Speaker, may I also take this opportunity to thank you and your staff for the care and kindness you showed me? Residents in my constituency of Stratford and Bow are served by Barts health NHS trust, which includes Newham University, Royal London and Whipps Cross hospitals. In May, their A&E departments had the second highest volume of any trust in England and the highest in London. Overcrowding and capacity constraints mean that the staff at those hospitals are having to treat some patients in corridors rather than on wards. This is the broken NHS that we have inherited from the Conservatives. Will the Minister ask her Department to look at capacity issues at those hospitals and at how community pharmacy prescribing services may be used to alleviate some of the pressures? Karin Smyth My hon. Friend makes an excellent point highlighting the challenges particularly around hospital capacity, something well-known on the Front Bench with my right hon. Friend the Health Secretary representing a nearby area. This type of patient experience is unacceptable, but it sadly became normal under the last Government of 14 years. My hon. Friend makes an excellent point about pharmacies: they will have a central role in our future system, and I would of course be happy to undertake a visit with her. Priti Patel (Witham) (Con) I welcome the new Front-Bench Members to their new portfolios and responsibilities. Essex has actually seen some improvements in emergency care services over the past 14 years, particularly in our ambulance trust, and that should be commended. One way in which pressure on emergency services can be reduced is by having community facilities in our towns and across our districts. Will the Minister commit to meeting me and working with my right hon. Friend the Member for Maldon (Sir John Whittingdale) on looking at ways in which we can safeguard community services at St Peter’s hospital in Maldon, which our communities absolutely need? Karin Smyth I thank the right hon. Lady because she again makes for us the excellent point about what has happened in the last 14 years under her Government: these situations have been allowed to get so much worse both in Essex and across the country. She should also welcome our mission to rebuild the broken front door to the NHS and have more neighbourhood services based in communities, bringing those services together where patients are; that is absolutely what we all want and I am very happy to discuss this with her. Shaun Davies (Telford) (Lab) For 14 years the community in Telford and I have worked hard to safeguard our A&E, but the last Conservative Government made Telford the largest town without a fully functioning A&E. Will the Health team meet me and other Shropshire MPs to discuss this discredited and disgraceful decision? Karin Smyth I welcome my hon. Friend to his place. He knows what we all know, and what we know the entire country knows because we spent the past six weeks campaigning: it is the same story across the country. That is why we are committed to restoring standards and why we will fix this broken NHS, and of course I am happy to meet with him. Andrew George (St Ives) (LD) A decision by the Conservatives two years ago means that the urgent treatment centre at the West Cornwall hospital in Penzance is now closed at night, and that has put pressure on the only emergency department in Cornwall—a long peninsula—at Treliske, where routinely 20 ambulances are parked outside creating a new metallic ward at the front of the hospital. That situation has had a detrimental impact, of course including avoidable deaths. Will the Minister meet me and colleagues and the local NHS to discuss this issue, to see how we can restore our emergency services? Karin Smyth Again, across the country we see the damage done over the last 14 years, and the hon. Gentleman is absolutely right to highlight that the situation in one part of the system knocks on to other parts. That is why we want a 10-year plan to look at this, an immediate look with Lord Darzi, and, critically, to understand which community and primary care services can be supported to support the rest of the system. I am very happy to meet with colleagues across Cornwall, where we now have many Labour MPs. NHS Dentistry: Work Requirement George Freeman (Mid Norfolk) (Con) 8. If he will make an assessment of the potential merits of requiring newly-qualified dentists to work for the NHS for a set period of time. The Minister for Care (Stephen Kinnock) I thank the hon. Gentleman and congratulate him on his survival instincts in getting re-elected to this place. NHS dentistry needs urgent action thanks to 14 years of chaos, failure and neglect. Our rescue plan will get NHS dentistry back on its feet, followed by contract reform to make NHS dentistry more attractive. A consultation for a tie-in to NHS dentistry for graduate dentists closed on 18 July and we are now considering the responses. The Government position on this proposal will be set out in due course and I will keep the House updated on this matter. George Freeman I thank the hon. Gentleman for that answer and congratulate him and his colleague the Secretary of State on their appointments. All of us who are serious about the health service and the need for reform, about which the Secretary of State has spoken, have their back in pushing for reform. The hon. Gentleman has his moment of triumph, but may I gently encourage him to reach out and build a cross-party coalition of support for serious reform? The NHS is broken not by Tory cuts but by years—[Interruption.] For years we have been pouring money in; it needs to modernise for the 21st-century. In the spirit of which, on dentistry, may I encourage the Front-Bench team to reach out and have a meeting—a rainbow coalition meeting including the new hon. Members for Norwich North (Alice Macdonald) and for North Norfolk (Steff Aquarone)—of all MPs in Norfolk, which has suffered more than most counties? We desperately need that University of East Anglia dental school. Stephen Kinnock The hon. Gentleman was doing so well at the start, and then he kind of blew it a bit towards the end. It is absolutely right that we put country before party, and we will work with whoever has the best interests of rebuilding our public services at heart. The issue that he raises specifically sounds interesting. What I would say is that unless we get the bigger picture sorted, and unless we make NHS work pay for dentists, we will not be able to rebuild the NHS dentistry system that we should be cherishing and seeking to reform. I am of course always open to conversations with him. Rachael Maskell (York Central) (Lab/Co-op) Just 39.2% of my constituents were able to access an NHS dentist over the past two years. That is an absolute disgrace, but the Health and Social Care Committee put together a report into NHS dentistry, setting out a blueprint for how to resolve the challenges, including access, looking at tie-ins and ensuring that we get more dentists registered. Will the Minister look at that report and follow its recommendations? Stephen Kinnock I congratulate my hon. Friend on her re-election; it is wonderful to see her back in her place. She is absolutely right that the tie-in consultation deadline was 18 July. We are considering those responses with an open mind. On the broader issues that she mentions, our rescue plan is 700,000 more appointments, incentives for new graduates to go to under-served areas, reform of the dental contract and making work pay for dentists. That plan is at the heart of the reforms that she mentioned and that is what we will be doing. NHS Mental Health Services Mohammad Yasin (Bedford) (Lab) 9. What assessment he has made of the adequacy of access to NHS mental health services. Tim Roca (Macclesfield) (Lab) 20. What assessment he has made of the adequacy of access to NHS mental health services. The Minister for Care (Stephen Kinnock) I congratulate my hon. Friend the Member for Bedford (Mohammad Yasin) on his re-election and my hon. Friend the Member for Macclesfield (Tim Roca) on his election. More than a million people with mental health issues are not getting the support they need. This Government will fix our broken NHS. That will include recruiting 8,500 mental health workers, including specialist mental health professionals in every school and rolling out young futures hubs in every community. As announced in the Gracious Speech, we are bringing forward legislation to modernise the Mental Health Act 1983, which is a hugely significant step that has been warmly welcomed by service users, campaigners and, indeed, the former Conservative Prime Minister Theresa May. Mohammad Yasin I welcome the Minister to his place. Funding to bring desperately needed in-patient mental health services back to Bedford has been sitting in the accounts of our local mental health trust for years, but it cannot be used because of the previous Government’s capital expenditure limits. Will the Minister therefore meet me to discuss a way forward to get this urgently needed mental health facility back in Bedford, so that my constituents do not have to travel miles to access this vital service? Stephen Kinnock I know that my hon. Friend has been campaigning with great passion and conviction on this issue for some time, and I am in no doubt that his integrated care board will have listened carefully to every word that he has said today. I would be pleased to meet him so that we can discuss this matter in greater detail. Tim Roca The Prime Minister has been clear that the Government will make, unlike their predecessor, evidence-based policy. While the NHS has made some high-level progress, the figures for those waiting for mental health elective care remains unacceptably high, but the data is incomplete. Does the Minister agree that comprehensive data is crucial if we are to serve the patients we care about? Stephen Kinnock I welcome my hon. Friend warmly to his place. I hope he will not mind if I use this analogy, which is that you cannot make a prescription unless you have the diagnosis, and you cannot make policy on the hoof. We cannot have the chaos, neglect and failure that we have seen from the Conservatives for the past 14 years because they have not made policy based on evidence and data. I am absolutely on board with what my hon. Friend says, and I would be more than happy to discuss it with him further at his convenience. Mr Richard Holden (Basildon and Billericay) (Con) I welcome those on the Opposition Front Bench to their roles and those on the Government Front Bench to their new roles. One of the things that we did very well over the past few years on a cross-party basis was tackling the disparity between mental and physical health. Since 2018, £4.7 billion extra has gone into NHS mental health services. Will the Government commit to that going forward and ensure that the proportion of funding towards mental health services will increase in the coming years? Stephen Kinnock I thank the right hon. Gentleman for his question, but he appears to be living in a parallel universe. We are in the midst of a mental health crisis as a result of 14 years of Tory chaos, neglect and failure. We have a plan, with 8,500 more mental health workers, young futures walk-in hubs, specialist mental health support for young people and mental health specialists dealing with talking therapies. Of course, we will also introduce legislation following the Gracious Speech to deal with helping people who have more severe conditions. That is a plan of action with which I hope we can once again make our country proud of how we deal with this extremely serious issue. Sarah Dyke (Glastonbury and Somerton) (LD) Mental health pressures in the farming community are rising, with the Farm Safety Foundation survey finding that 95% of farmers under 40 agree that poor mental health is the biggest hidden problem facing the industry. Will the Minister work with colleagues in the Department for Environment, Food and Rural Affairs to improve access to NHS mental health services in rural areas and support the continued roll-out of rural health hubs? Stephen Kinnock I thank the hon. Lady for raising that extremely important question. We are indeed looking at that issue through our 10-year plan for the future vision of our health service. Issues around isolation and the huge pressure on what are often family businesses are creating tremendous strains for that community. We take that seriously and will of course work with our colleagues in DEFRA to address it. Mr Speaker I call the shadow Minister. Dr Ben Spencer (Runnymede and Weybridge) (Con) May I congratulate those on the Government Front Bench on their appointments? I should declare that I am a former NHS consultant psychiatrist, my wife is an NHS doctor and I participated in the Wessely Mental Health Act review. While I no longer have a licence to practise, I may gently correct the Minister in that it is possible to provide a prescription without a diagnosis. [Laughter.] The Opposition are pleased that the Government intend to build on the work of Conservative Governments, kick-started by the former Member for Maidenhead, to reform the Mental Health Act 1983. We will work constructively with them to make such legislation as effective, fair and compassionate as possible. With that in mind, does the Minister intend to make changes to the code of practice to the Mental Health Act now so that non-statutory changes and protections can be enacted while the Bill works its way through Parliament? Stephen Kinnock I welcome the shadow Minister to his place and congratulate him on his appointment. It is a little bit rich to receive a question like that, given that the Conservatives had 14 years to address the issue; I have been in this position for 16 days. If he looks at the plan that we are bringing forward, he will see that we have more ambition and more boldness in our plans than what we have seen in the last 14 years. We will introduce legislation that will address those extremely important issues for people who have some of the more severe conditions. To the shadow Minister’s specific point on a code of practice, the first step will be to see the legislative process moving forward. But, of course, we remain open to looking at any solution or reform that will help to address this extremely important issue. New Hospital Programme Cat Smith (Lancaster and Wyre) (Lab) 10. What recent progress his Department has made on the new hospital programme. The Secretary of State for Health and Social Care (Wes Streeting) It is painfully clear that the previous Government’s new hospital programme—they said that they would deliver 40 new hospitals by 2030—is not deliverable in that timeframe. I want to see the new hospital programme completed, but I am not prepared to offer people false hope about how soon they will benefit from the facilities they deserve. That is why I have asked officials as a matter of urgency to report to me on the degree to which the programme is funded along with a realistic timetable for delivery. We will not play fast and loose with the public finances, nor will we play fast and loose with people’s trust as the previous Government did. Cat Smith Lancaster’s royal infirmary is at capacity. It is a Victorian hospital, and I am sure it was cutting-edge back then, but it is now not fit for purpose. Yesterday, the joint investment strategic committee expressed its support for the new build scheme in Lancaster, so it will soon be on the Secretary of State’s desk. Will my right hon. Friend commit to meeting me and other interested local MPs in north Lancashire to ensure that, after 14 years of chaos under the Conservatives, the Labour Government will deliver a new hospital for Lancaster? Mr Speaker And a hospital for Chorley. Wes Streeting I was about to say, Mr Speaker, that the good people of Lancaster and Wyre will be delighted to have sent my hon. Friend to Parliament, because she is second only to you in collaring me about a local hospital project—you are the holder of that record. There is a serious point: thanks to her determined efforts to collar me around the parliamentary estate, I know the particular urgency around land. A scheme will be put to me shortly, which I will consider carefully, and I will look at the programme in the round and ensure that I am able to come back to this House and to the country with promises that we can keep and that the country can afford. James Wild (North West Norfolk) (Con) During the general election campaign, Labour said it was “committed to delivering the new hospitals programme, including modernising the QEH at Kings Lynn to address its potentially dangerous RAAC”. Will the Secretary of State honour that pledge, which was made to my constituents and to the staff at QEH, and approve the business case submitted by the trust for the new multi-storey car park, which is a key enabling project for the new hospital that we need by 2030? Wes Streeting Hospitals with reinforced autoclaved aerated concrete are at the top of my list of priorities. I am extremely concerned about the dire state of the NHS estate. Once again, I think that is a bit rich from Opposition Members, whose party was in government only weeks ago. They had a Prime Minister local to that hospital, and they did not do anything when they had the chance, but they should not worry—we will clean up their mess. Mr Speaker I call the shadow Minister. Dr Caroline Johnson (Sleaford and North Hykeham) (Con) I congratulate the right hon. Gentleman on his position. I should declare that I have been working in the NHS for 23 years, currently as an NHS consultant paediatrician. I look forward to using that experience in my new role as shadow Minister of State to scrutinise the Government constructively. Under the new hospital programme, the previous Government had already opened six hospitals to patients, with two more due to open this financial year and 18 under construction. The Government are now putting that at risk by launching a review of that work, delaying those projects, which are vital to patients across the country. Could the right hon. Member please confirm when the review will be completed? Wes Streeting First, I welcome the hon. Lady to her new post. I must say I preferred her much more as a Back-Bench rebel than a Front-Bench spokesperson, but I have enormous respect for her years of contribution to the NHS and the experience that she brings to this House. I always take her seriously. However, on this one, once again I say to the Opposition that they handed over an entirely fictional timetable and an unfunded programme. The hon. Lady might not know because she was not there immediately prior to the election, but the shadow Secretary of State, who is sitting right next to her, knows exactly where the bodies are buried in the Department, where the unexploded bombs are, and exactly the degree to which this timetable and the funding were not as set out by the previous Government. Mr Speaker I call the Liberal Democrat spokesperson. Daisy Cooper (St Albans) (LD) I welcome the Secretary of State and his Ministers to their roles, but let me gently warn him that if he intends to run a contest on which Member can harangue him the most on crumbling hospitals, our 72 Liberal Democrat MPs say, “Challenge accepted.” Under the Conservatives, the new hospital programme ground to a halt. We know the terrible stories of nurses running bucket rotas and all the rest. We have the worst of all worlds at the moment: trusts such as mine in west Hertfordshire are champing at the bit to get going but cannot, and are being held back. Other trusts have capital funds that they want to spend but are not allowed to because of outdated rules, and there are industry concerns that the one, top-down, centralised approach of the Conservatives could decimate competition in that industry, when we need a thriving industry to rebuild our hospitals and primary care. What is the Secretary of State’s response to that approach? Wes Streeting I welcome the hon. Lady back to her place. We worked constructively on the Opposition Benches together and, regardless of the size of the Government’s majority, we intend to work constructively with her on this side of the election, too. By extension, I congratulate her colleagues on their election. I have discovered that I have 72 new pen pals, all sitting there on the Liberal Democrat Benches, and they have been writing to me about a whole manner of projects. My colleagues and I will get back to them. The hon. Lady is right that this is not just about the new hospitals programme, important though that is; the condition of the whole NHS estate is poor. In fact, backlog maintenance, the direct cost of bringing the estate into compliance with mandatory fire safety requirements and statutory safety legislation, currently stands at £11.6 billion. That is the legacy of the last Conservative Government. Neonatal Care: Parental Accommodation Bell Ribeiro-Addy (Clapham and Brixton Hill) (Lab) 11. If he will take steps to help increase the number of accommodation units available for parents whose babies have been admitted to neonatal care units. The Minister for Secondary Care (Karin Smyth) I congratulate my hon. Friend on her re-election and thank her for raising this important issue. It is not right that three out of four parents are not able to stay with their critically ill baby overnight at such an important point in that new relationship. NHS England recently concluded a review of neonatal estates. It is in the early stages of analysing the findings, which will be used to inform the next steps. We are all determined to support parents to be involved in every aspect of their baby’s care. Bell Ribeiro-Addy I congratulate my right hon. and hon. Friends on their re-elections and on taking their places. Recent research from the charity Bliss showed that when a baby receives neonatal care, their parents are routinely expected to leave them in hospital overnight for weeks or even months at a time. Its research found that for every 10 babies who need to stay overnight in neonatal care, there is only one room available for a parent to stay with them. How will the Minister ensure that the existing guidance about facilities for families is followed, and how will she ensure that trusts can access the resources they need to stop the separation of babies and their parents? Karin Smyth My hon. Friend is absolutely right that the separation of babies and their parents at that time is not acceptable, and about the shocking state of the estate, as we have just heard. We will look at the findings of the NHS review very quickly, and I will be happy to get back to her on those specific points. Jim Shannon (Strangford) (DUP) I thank the Minister for her answer. This issue is clearly not just about accommodation; it is also about providing physical and emotional help for mothers who have been through traumatic circumstances, emotionally and physically. What will be done along those lines to ensure that mothers and babies have all the help they need? Karin Smyth The hon. Gentleman makes a really important point about mental health support in that critical period. We will absolutely make sure that is looked at. Health and Social Care Reform Sean Woodcock (Banbury) (Lab) 12. Whether he plans to hold discussions with NHS staff and patients on his plans for reforming NHS health and social care services. The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne) I thank my hon. Friend the Member for Banbury—words I did not think I would ever say—and welcome him to his place. The answer to his question is yes. We do not just want to discuss with patients and staff; we want them to help shape the 10-year plan for the next decade of reform, which will take our NHS from the worst crisis in its history and make it fit for the future. Social care also needs to change. We will work with care workers and care users to build consensus for and shape a new national care service. Sean Woodcock Does the Minister agree that the voices of frontline staff, whether in hospitals such as the Horton general hospital in Banbury or carers like my mum, are still often ignored when it comes to whistleblowing? More worryingly, those voices are silenced by threats to report them to regulatory bodies. Does he agree that we need to level the field of accountability for managers who ignore whistleblowers, and that there should be a regulatory body with oversight of medical managers? Andrew Gwynne My hon. Friend is absolutely right. We have previously said that bank managers are more regulated than NHS managers. This Labour Government will pursue an agenda of greater accountability, transparency and candour when it comes to those making managerial and executive decisions in our national health service. Dave Doogan (Angus and Perthshire Glens) (SNP) In integrating health and social care it is vital to take the staff component along with you. It is also vital to have sufficient funding. We integrated health and social care in Scotland in 2012 and it has been a difficult road, but health in Scotland is funded £323 per head more than it is in England. Will the Minister commit to put his hand in his pocket and make sure English people enjoy the same health funding as people in Scotland? Andrew Gwynne I welcome the hon. Gentleman back to the House, but I politely say to him that he needs to be a little bit patient. There will be some announcements in the near future on this Government’s plans for social care. He should rest assured that we on the Labour Benches understand the integration agenda. We understand the need to fix both the NHS and social care, and this Labour Government will do that. Mr Speaker I call the shadow Minister. Sir John Whittingdale (Maldon) (Con) I congratulate the Minister and his Front-Bench colleagues on their appointments. I welcome the suggestion that the Government are considering the possibility of a royal commission on social care and intend to address the issue on a cross-party basis, but that will take time. Can the Minister therefore confirm that, as was suggested during the election campaign, the Government will take forward the Dilnot reforms, and in particular that they will introduce a cap on social care costs, as was planned by the previous Government? Andrew Gwynne It was, of course, the right hon. Gentleman’s Government who kicked the can down the road on these issues. They allowed the system to spend the transformation money that had been provided precisely for the purpose of the Dilnot reforms on fixing their broken national health service. He should just be a little bit patient, as we will announce our proposals for social care shortly. He should rest assured that, as I have said to him before, this Labour Government are determined to fix both the broken NHS and the broken social care system that we inherited from 14 years of Tory failure. Mr Speaker I call the Liberal Democrat spokesperson. Daisy Cooper (St Albans) (LD) The Liberal Democrats spoke about care a great deal during the general election campaign. At the heart of our plans was our pledge to introduce free personal care. Will Ministers please confirm whether they intend to open cross-party talks and, if so, whether free personal care will be on the table as one potential option? Andrew Gwynne I thank the hon. Lady for the way in which the Liberal Democrats approached the issue of health and social care during the election campaign. As my right hon. Friend the Secretary of State has already said, we will work with all in the House who want to fix our broken health and social care system. Of course we will work collegiately across parties, and of course all issues relating to how we fix our broken social care system will be discussed during those cross-party deliberations. Topical Questions Carolyn Harris (Neath and Swansea East) (Lab) T1. If he will make a statement on his departmental responsibilities. The Secretary of State for Health and Social Care (Wes Streeting) Our NHS is broken. This Government have been honest about the problems we face because we are serious about fixing them, and we have not wasted a moment. We have appointed Lord Darzi to carry out an independent investigation of the state of our NHS, we are resetting the relationship with junior doctors with negotiations starting today, and we are laying the foundations for the delivery of 40,000 more appointments a week to cut waiting lists. The Gracious Speech kick-started a decade of national renewal, with modernisation of the Mental Health Act as well as the smoking reform, which will ensure that this generation of young people is the first smoke-free generation, and will be the first step towards ensuring that that generation is the healthiest in history. Carolyn Harris During their free NHS 40-plus health checks, women are assessed for conditions that may affect them as they grow older, but menopause is not included. To include it would be cost-neutral and would not only help millions of women to recognise the symptoms, but prevent needless GP appointments when those symptoms start to develop. Along with Menopause Mandate, I have been campaigning tirelessly on this issue. Will the Secretary of State please look into it as a matter of urgency? Wes Streeting I am delighted to see my hon. Friend back in the House. She campaigns relentlessly on this vital issue, and it would be very risky for me to do anything other than agree to meet her, because I share her view that progress needs to be made on it. Mr Speaker I call the shadow Secretary of State. Victoria Atkins (Louth and Horncastle) (Con) May I welcome the Secretary of State and his ministerial team to their places, and wish them well in their endeavours? With your indulgence, Mr Speaker, I should also place on the record my thanks to my superb team of former Ministers, to those in the private office and to officials in the Department for their hard work and support, as well as thanking the doctors, nurses and social care and health professionals with whom I have had the pleasure of working. Now, to business. In opposition, the Secretary of State described the 35% pay rise demand by the junior doctors committee as “reasonable’. What he did not tell the public was that this single trade union demand would cost an additional £3 billion, let alone the impact on other public sector workers. Will he ask the Chancellor to raise taxes, or will she ask him to cut patient services to pay for it? Wes Streeting May I welcome the shadow Secretary of State to her new position? She has behaved in her typically graceful and decent way. I enjoyed working with her on that basis, and will continue to do so. Although, I must confess that when I heard about the “abominable” behaviour of the shadow Health Secretary, I thought, “What on earth have I done now?” Then I remembered that our roles have swapped, and that it was not me they were referring to. What I said was that the doctors were making a reasonable case that their pay had not kept in line with inflation, but we were clear before the election that 35% was not a figure we could afford. We are negotiating with junior doctors in good faith to agree on a settlement that we can deliver and that the country can afford. Victoria Atkins I am afraid I do not like it when Secretaries of State do not answer questions, and I am sorry to say that the right hon. Gentleman gave another non-answer, as has been the case for those on the Government Front Bench. I have a question that I hope he will be able to answer. The final act of the Conservative Government was to protect children and young people by banning private clinics from selling puberty blockers to young people questioning their gender. Will the right hon. Gentleman confirm that he will resist the voices of opposition on the Benches behind him and implement in full all of Dr Cass’s recommendations, including exercising “extreme caution”, as she said, in the use of cross-sex hormones in young people? They and their parents deserve certainty from this Government. Wes Streeting Obviously, there is a judicial review of the former Secretary of State’s decision, which I am defending. The matter is sub judice, so I will steer clear of it. To go back to first principles, we are wholeheartedly committed to the full implementation of the Cass review, which will deliver material improvements in the wellbeing, safety and dignity of trans people of all ages. I think that is important. I want to reassure LGBT+ communities across the country, particularly the trans community, that this Government seek a very different relationship with them. I look at the rising hate crime statistics and trans people’s struggles to access healthcare, and I look at their desire to live freely, equally and with dignity. That is what we will work with them to deliver. Mr Speaker Order. I understand that today is a new start with Question Time, but we have to be short and speedy. That is the whole idea of oral questions, because otherwise Members are not going to get in. Satvir Kaur (Southampton Test) (Lab) T2. After 14 years of Conservative mismanagement of our NHS, the waiting list at Southampton general hospital is close to 60,000. I welcome my hon. Friend’s commitment and plan to bring down waiting lists, but can she also outline what support will be offered to those waiting for treatment, many of whom are in pain, as we tackle the shameful backlog we inherited? The Minister for Secondary Care (Karin Smyth) My hon. Friend makes an excellent point about the stress that people face when waiting, and we have talked about the disaster of the past 14 years. People with potentially deteriorating conditions are waiting, and we absolutely need to address this issue as part of our work to reduce waiting lists. Blake Stephenson (Mid Bedfordshire) (Con) T6. The Government have announced ambitious house building targets but, as far as I could tell, the Labour party manifesto was silent on the GP estate upgrades. Does the Secretary of State agree that the Conservative policy of rebuilding or refurbishing 250 GP surgeries in England is a sensible policy to implement? Wes Streeting I am proud that the Deputy Prime Minister will be delivering the commitment to build 1.5 million new homes. It is absolutely vital that the infrastructure needed is delivered alongside those new homes, and we and other colleagues across Government will be working very closely with the Deputy Prime Minister to make sure that the social infrastructure is also provided. Tom Rutland (East Worthing and Shoreham) (Lab) T3. Last week, Worthing hospital came close to having to consider downgrading its maternity services due to a shortage of specialist neonatal nurses and midwives. Will the Minister please update the House on the Government’s plans to build an NHS that is fit for the future, including by addressing staffing shortages? Karin Smyth I welcome my hon. Friend to the House. He makes an incredibly important point about this very stressful time, particularly for women, in his area. We will listen to women and deliver evidence-based improvements to make maternity and neonatal services safer and more equitable for women and their babies, and we have committed to delivering the long-term workforce plan. Victoria Collins (Harpenden and Berkhamsted) (LD) T7. In one month alone at the West Hertfordshire teaching hospitals trust, we lost 843 days because of the social care backlog. The burden of that cost is often taken up by families and individuals, which impacts not only on them, but on the rest of our NHS healthcare. I welcome the talk about working together across parties, but would the Secretary of State also consider introducing greater support for unpaid carers, including paid carers leave and a statutory guarantee of regular respite breaks? Wes Streeting I warmly welcome the hon. Member to her place. She is absolutely right to raise the plight of unpaid family carers. They are part of the team, as far as this Government are concerned, so as we set out our 10-year plan for social care as part of our ambition to build the national care service, we will make sure that unpaid family carers are very much at the centre of our thinking, in no small part thanks to her representations. Sean Woodcock (Banbury) (Lab) T4. The Keep the Horton General campaign in my constituency has recently catalogued the poor experiences of tens of Banbury-based mothers who gave birth at the John Radcliffe hospital in Oxford. Will the Secretary of State or a member of his team meet me to discuss these concerning reports of poor maternity care? Wes Streeting Of all the issues that keep me awake at night, maternity safety is top of the list. We have already heard about the staffing shortages and the actions we will take to address that, but I also want to reassure people that, as we build our 10-year plan for the NHS, patient voices, including those of recent and expectant mothers, will be part of that process. Kit Malthouse (North West Hampshire) (Con) During the election campaign the Prime Minister came to Basingstoke on a visit and specifically promised to replace Basingstoke hospital by 2030. Can we rely on that promise? Wes Streeting I would not rely on anything the former Prime Minister said—[Interruption.] Oh, our Prime Minister? I thought the right hon. Gentleman was talking about the former Prime Minister. In that case, I can reassure him that we are absolutely committed to the new hospitals programme. On the budgets and the timescales, as I have said, we will come forward with an honest appraisal of what we have inherited from the last Government and what we will be able to deliver within reasonable timescales. Matt Western (Warwick and Leamington) (Lab) T5. I congratulate the Secretary of State on his position. Yesterday’s NHS data showed that we have among the highest incidences of dementia in the world, with something like 500,000 cases just in England. I appreciate that this is early days, 16 days in, but does the Minister have any idea why that may be, and what can be done about it? The Minister for Care (Stephen Kinnock) I thank my hon. Friend for that question and welcome him to his place. This issue is personal for me, and I am sure it is for many others across this House. A number of potential new disease-modifying drugs for Alzheimer’s are in the pipeline, including lecanemab and donanemab. We are committed to ensuring that clinically effective and cost-effective medicines reach patients in a timely and safe way. The National Institute for Health and Care Excellence is appraising lecanemab and donanemab to determine whether they will be made available in the NHS. Simon Hoare (North Dorset) (Con) Nearly 10 children a month die from brain tumours, and I know that the public health Minister takes this issue seriously. He was familiar with the work of the Brain Tumour Charity’s HeadSmart campaign. Will he agree to meet me and my fierce campaigner constituent Sacha Langton-Gilks, who lost her son to a brain tumour, to discuss how NHS England could be persuaded to do more to inform and educate parents to identify the symptoms, so that collectively we can reduce the number of deaths? The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne) I am grateful to the hon. Gentleman for that question. He knows that I met his constituents when I was a shadow public health Minister, and I can confirm that I am more than happy to meet him and his constituents now that I have dropped the “shadow”. Dan Tomlinson (Chipping Barnet) (Lab) T8. I am sure the whole House will want to celebrate the fact that the NHS is safe in Labour hands once again. Specifically in the Royal Free trust area, which covers the community that I now have the honour of being the MP for—Chipping Barnet in North London—there are 100,000 people on the NHS waiting list, so what steps will the Minister take to reduce the waiting list in places such as mine so that we can see more people getting the treatment and support that they need from the NHS? Wes Streeting I am delighted to welcome my hon. Friend to his place. I am personally grateful to the Royal Free hospital for saving my life when I went through kidney cancer. NHS waiting lists stand at 7.6 million, which was still rising as this Government took office. Our 40,000 extra appointments, scans and procedures and our doubling of the number of diagnostic scanners will make a real difference to getting that backlog down to where it should be. Lee Anderson (Ashfield) (Reform) During the general election campaign, the Health Secretary visited King’s Mill hospital in Ashfield, and I am sure that helped me to get re-elected. King’s Mill was built on a private finance initiative deal by the last Labour Government and is going to cost £3 billion for a £300 million hospital. Will the Secretary of State please now assure me and the people of Ashfield that this will never happen again? Wes Streeting Despite my best efforts, the hon. Gentleman is back. I congratulate him through gritted teeth. I was very impressed by what I saw at King’s Mill hospital, and I am proud of the last Labour Government’s record of delivering the shortest waiting times and the highest patient satisfaction in history. As I said during the election campaign, we will build on that success and learn from some of our shortcomings, too. Danny Beales (Uxbridge and South Ruislip) (Lab) T9. I welcome the honesty and urgency of reviewing the new-build hospitals programme. Residents in Uxbridge and South Ruislip are sick and tired after 14 years of broken promises on a new hospital. Board minutes have revealed that no business case was agreed under the last Government. No funding was released for a new hospital, and not a brick has been laid. Does my right hon. Friend agree that urgent investment is needed at Hillingdon hospital? Will he come back to the hospital, a year later, to visit staff and discuss their plans? Wes Streeting I welcome my hon. Friend to his place. Better late than never, as they say. I have been to Hillingdon hospital, which has amazing staff and appalling buildings. That is why the people of Hillingdon, and people right across the country, deserve honesty, clarity and certainty about the new hospitals programme. This Government will provide it and stick to it. Esther McVey (Tatton) (Con) Does the Secretary of State agree that handing over powers to the World Health Organisation, undermining the UK’s ability to make its own sovereign decisions, would be unacceptable? Wes Streeting The World Health Organisation is an intergovernmental arrangement. It is of vital importance that, first and foremost, we agree only to things that are in our national interest, but we should not lose sight of the fact that there are lots of things that we need to do together in pursuit of our national interest, from tackling antimicrobial resistance to preventing future pandemic threats. That is exactly what we will do. Marsha De Cordova (Battersea) (Lab) T10. I congratulate the Secretary of State and welcome him to his post. Eye healthcare services are in crisis due to the Tories breaking our NHS. Ophthalmology is the busiest out-patient service, making up nearly 10% of the entire waiting list. My national eye health strategy will seek to tackle some of these issues, so will the Secretary of State meet me to discuss how we can tackle the eye healthcare emergency? Wes Streeting I would be delighted to do that. As my hon. Friend knows, we visited Specsavers during the election campaign. There are lots of high street opticians, and they can make a real difference to cutting the backlog. The Conservatives should have gone to Specsavers, and this Government will. Wendy Chamberlain (North East Fife) (LD) My constituents have struggled to get pre-diagnosis ADHD and autism support for their young daughters. We cannot diagnose children at a very young age, but that does not mean that families do not need help. Can the Minister confirm what engagement he will have with support organisations such as the National Autistic Society to ensure that best practice means that families are not struggling for support? Stephen Kinnock I welcome the hon. Lady to her place. She raises a vital issue. We have a plan for improving mental health services, including 8,500 more mental health workers. Autism is, of course, a vital part of that, and I will be more than happy to meet her to discuss further how we might be able to take it forward.