Steve Barclay
MP for North East Cambridgeshire · Conservative · United Kingdom
“I speak to my brief exchange earlier with the Minister. As the previous speaker, the hon. Member for Harpenden and Berkhamsted, said, the draft regulations are fairly benign and very welcome to help people who are struggling with their bills.”
“The issue is not the lack of will; the issue is the alignment between procurement, regulation and clinical leadership, particularly in the colleges, as well as the ability to scale innovation—it is not about having more ministerial pilots.”
“Just to localise it to my own constituency, the Cambridgeshire and Peterborough ICB alone paid out £14 million in redundancies last year. It merged with a number of other ICBs to form the Central East ICB, yet we know hear from the Government that it should align with metro mayors, which means going back to exactly what it was before: the…”
“My right hon. Friend is absolutely right: the Government are spending millions of pounds and there is no plan. The measure was announced without working that out, it came as a surprise to many within the system, and it has had a chilling effect on many decisions. That is not isolated.”
“I rise to speak to clause 1 on the abolition of NHS England and clause 6 on promoting innovation. What characterises the first of those is an announcement without any clear plan. That is what has driven the cost and confusion that a number of Members across the House have spoken about.”
“All this is around 18 months on from the actual announcement. The confusion seems to extend to the Government themselves, because they seem unable to answer pretty straightforward written parliamentary questions. Given the time limit, I will give just a few examples.”
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“The hon. Lady raises extremely important issues and I am happy to give her the assurance that these issues will be explored. NHS England is looking at that. On the concerns expressed around the regulation of managers, the chief exec of NHS England hosted a meeting last week with key stakeholders to discuss these very issues and I will of course relay to the chief exec the points she has raised.”
“The key reforms include Getting It Right First Time, the work of Professor Tim Briggs—I raised with him the issue around Chester and the fact that his team have been reviewing that data—the strengthening of the freedom to speak up guardians, the appointment of a new patient safety commissioner, the strengthening of the Public Interest Disclosure Act, the role of child death overview panels and the scrutiny they provide, and the expanded role of medical examiners, which were not in place. So significant actions have been taken, but it is right that through the inquiry we look at the specific issues raised at Chester and any further steps that are appropriate.”
“It is important that we get the right support for managers, particularly around some of the more difficult trusts to manage, alongside having the accountability. Getting that detail right requires us to work closely with NHS England and the wider NHS family. [ Interruption. ]”
“Just to reassure the right hon. Gentleman, it is not that we are waiting. Having discussed it with NHS England, not least in last week’s meeting looking at the Kark recommendations that were accepted and why recommendation 5 was not accepted, the view at the time was that the accepted recommendations were sufficient in addressing the concern about the revolving door. It is right that we test that, but it is also right that we get the balance right. The right hon. Gentleman mentions concerns that certain trusts may be seen as more difficult to manage. We do not want to create an environment where people are unwilling to go to those more difficult trusts because they fear the risk that they carry.”
“My right hon. Friend is absolutely right about the way that the trial re-triggered a lot of pain and suffering for the families. What I found particularly powerful when talking to them was the fact that they discovered new information during the course of the trial, including harm to their children that they had not been told about hitherto. That was particularly concerning, and clearly serious lessons need to be learned from that. In terms of the support, one of the reasons for wanting to engage with them at the earliest opportunity was to ensure we are doing all we can to support them, and that is central to how I understand the judge will look to structure the inquiry to ensure that the wishes of the families are central to the approach that is taken.”
“I am grateful to the right hon. Lady for raising that extremely important point, because the cases of five of the babies concerned in the trial were cross-jurisdictional. It is important that we take on board those lessons and look at how those cases that apply to a baby or family from Wales are captured, and I know that is something that Judge Thirlwall will give consideration to, shaped by her discussions with the families.”
“I absolutely agree with my hon. Friend’s sentiment in putting families and their wishes central. I hope he will understand that as part of an independent inquiry, it will be for the judge to decide which hearings are held in public and which are in private. In essence, part of the initial discussion on a non-statutory inquiry and my discussion with the families was about balancing privacy concerns versus the more adversarial and public nature of a statutory enquiry. I know that Justice Thirlwall will be sensitive to the families’ wishes and what is the appropriate balance between hearings held in public and those held in private.”
“The Kark recommendations that were accepted, which cover events since those covered at Chester, are believed to have addressed the concerns about the revolving door, but given the issues that have come to light through the case in Chester, I have asked NHSE colleagues to revisit that decision without waiting for the inquiry to look at that. Of course, the inquiry will also look at what is the right balance of regulation for managers.”
“I hope that my hon. Friend will note that the appointment of a Court of Appeal judge underscores the seriousness of the inquiry into the murders by Letby. The decision before the summer to place the Essex inquiry on a statutory footing again underscores our commitment to giving answers to those families in Essex, particularly where there are concerns that staff have hitherto not engaged with the inquiry in the way they need to do.”
“Again, I very much agree on the imperative of learning from the various reviews that have taken place. That is why I have personally spoken to the chairs of those reviews over recent days and weeks. I point out that these events took place before a number of the reviews’ recommendations were made and given to the Government, and those recommendations—whether on the medical examiner role, strengthening under the Public Interest Disclosure Act 1998, the use of “get it right first time” to review the data, the freedom to speak up guardians or the new patient safety commissioner role—have been implemented. So significant actions have been taken following those reviews, and those actions have been taken since these events. However, through the inquiry we will of course test whether further action is needed.”
“As I have said, significant action has been taken over those 10 years to strengthen transparency, action taken on data and the ability of freedom to speak up guardians to ensure that more safeguards are in place. Part of the purpose of the inquiry is to test whether further action is needed. I have already asked NHS England to look again at areas where recommendations have been made and what further action we can take.”
“I am happy to commit that the inquiry findings will be shared with the Administrations across Great Britain and Northern Ireland. It is important that the lessons are learned. It is also important that we look at where staff move—that includes not just within England but in Northern Ireland—and at where patients from one jurisdiction may be treated in another for a period of time. Those issues apply across the United Kingdom. We should have a UK-wide approach, including to data and looking at variation across the United Kingdom. I know that the hon. Gentleman will take a keen interest in that.”
“Last year, we announced a number of reforms to the NHS dental system, making the NHS more attractive and helping patients to access care. Treatments and dental care delivered in England went up by a fifth between 2021 and 2022.”
“We recognise that we need to do more. That is why we are making NHS dentistry more attractive by creating more bands of units of dental activity, having a minimum UDA value, and increasing to 110% the amount of activity that dentists can do. Indeed, Shropshire, Telford and Wrekin NHS trust, for example, was above the national average in the 24 months until June 2022. We are putting reforms in place to build more capacity.”
“The elective recovery plan sets out clear steps to eliminate long waits, and that is supported by £8 billion of revenue funding and £5.9 billion in capital over three years.”
“On the last bit of the question, the average waits in Wales are 20.4 weeks as of April, and in England they are 13.8 weeks, which is the exact opposite of the point the hon. Lady raises. We are taking action. We are boosting diagnostic capacity; 111 community diagnostic centres are now open. We are increasing treatment capacity through our surgical hubs programme. We are giving patients choice, which is not available in Wales under the Labour Administration—we are giving them more choice. We are also making better use of the independent sector, which some on the Labour Front Bench support but others do not.”
“We recognise the challenges from the pandemic, and that is why we are boosting capacity, particularly through our community diagnostic centres. The additional capacity has already delivered more than 4 million extra tests and scans. We are rolling that programme out with the target of 160, and 111 are already in place.”
“The hon. Gentleman raises a point of concern across the House that we recognise. That is why we have already taken action, through £3 million to crack down on those selling vapes illegally to children, closing the loophole that allowed free samples to be offered to children, and our call for evidence, so that we can examine what further measures we can take, particularly on the concerns about disposable vapes, which are prevalent among children.”
“As I say, we have already taken action. We took measures in April, and the Prime Minister announced further measures in May. We are keen to follow the evidence. That is why we have had a call for evidence. The ministerial team are looking extremely closely at this, and we will take further action to clamp down on something that we all recognise is a risk to children, which is why we are acting on it.”
“As a former Health Minister, my hon. Friend is well aware of the risks posed by vaping. As the chief medical officer has said, “If you smoke, vaping is much safer; if you don’t smoke, don’t vape”. That is why we are toughening up the regime. We are also working with industry as part of our call for evidence, but we are clear on the need to go further. That is exactly what we will do.”
“Again, I agree that disposable vapes are a particular concern: in our view, the growth in youth vaping is largely due to the growth in the use of disposable vapes. That is why we have particularly focused on that issue in our call for evidence, and that is what we are considering.”
“In the coming years, hundreds of patients identified by the launch pad will join trials for BioNTech’s personalised cancer therapies, broadening the treatment options available to cancer patients. I hope the whole House will welcome the opportunity the deal offers future patients.”
“Last week, on behalf of the Government, I signed a landmark partnership agreement with the pharmaceutical giant BioNTech. It aims to deliver 10,000 personalised mRNA cancer immunotherapies, including vaccines, to UK patients by 2030. This work will harness the groundbreaking mRNA technology that BioNTech used in its world-first cancer vaccine. Cancer vaccines work by stimulating patients’ immune systems to recognise and eliminate cancer cells, preventing their spread. Trials for BioNTech’s colorectal cancer vaccine are under way at multiple sites across the UK. To accelerate trials further, BioNTech is partnering with NHS England’s new cancer vaccine launch pad, a platform that makes it easier for both early and late stage cancer patients to join vaccine trials.”
“I am always very happy for my hon. Friend and other colleagues to meet me or Lord Markham, who leads the capital programme. It is an important scheme. We are delivering it through the standardised Hospital 2.0 approach, using modern methods of construction. We are keen to progress early supported works on site, working closely with colleagues.”
“We have been clear throughout that Government decisions on the pay review bodies’ recommendations are taken on a cross-Government basis. The agreement that we reached with the largest group of NHS staff, those on “Agenda for Change”, has demonstrated that we are willing to work constructively with trade union colleagues, but the demand from junior doctors for a 35% increase is not affordable—indeed, the hon. Gentleman himself has said that he does not support it.”
“He needs to decide on his position. Which is it: his position at the weekend that the Opposition are not offering more money, or his position today, which seems to be that they will?”
“The hon. Gentleman’s message is not even consistent with what he said at the weekend in the media: that he was not in a position to offer more money to the NHS, and that the shadow Chancellor had made that clear—in a vain attempt to demonstrate some sort of fiscal responsibility. The hon. Gentleman has been clear that he does not support the 35% demand from doctors in training. We are demonstrating that we are working constructively with groups such as the “Agenda for Change” group—the largest staff group, made up of over 1 million staff—with which we have reached a deal. We have also been responding constructively to the British Medical Association’s principal demand for consultants, which was for changes to pension taxation. We are willing to engage constructively with trade union colleagues, but the 35% demand is not affordable.”
“Of course we have regular discussions, not just with Cabinet colleagues, but with our counterparts across the UK. I had a meeting just yesterday with Health Ministers, including my counterpart in Scotland, on the shared challenges. On the issue that the hon. Lady raises, as the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien) said a moment ago, we are providing significant support for households—over £3,300 in support—but we also have measures that target schools, including holiday support measures and wider health and wellbeing measures, such as our significant investment in school sport.”
“We are taking action, which is why the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough met my hon. Friend recently. In his area of Humber and North Yorkshire, there has been an increase in the number of children seen by NHS dentists over the previous 12 months, so the picture is improving, but we recognise that there is more to do; that is why we have made a number of reforms to the dental contract and why we will announce further plans shortly.”
“We are taking significant action on mental health, which is why we are investing £2.3 billion more, compared with four years ago. We have targeted measures as part of our urgent and emergency care recovery plan, including 100 mental health ambulances. We are putting in additional capacity, such as crisis cafés, to support emergency departments. We are also making mental health support available through 111 for the first time, which will allow us to get to issues early, before people are admitted to hospital.”
“Not only do I agree, but I have been with my hon. Friend to see this scheme at first hand. He has championed the scheme vociferously and helped to secure that investment for his constituents. I look forward to working with him to ensure it is delivered as quickly as possible.”
“Some of us remember when the Lib Dems were for greater localism. One of the things we are looking at is how to empower commissioners, on a place-based basis, to make decisions on where best to place services. We need to move more services into the community upstream, to address the frail elderly before they get to hospital and to have more community services. I am happy to look at the specific issue the hon. Gentleman raises, but I would have thought the Lib Dems would support the general trend of empowering integrated commissioning systems to make place-based decisions.”
“There are a number of measures in the primary care recovery plan, from how we better use the skills mix within pharmacies to how we deregulate some of the tasks that take up pharmacists’ time, such as the requirement for a pharmacist to be present after drugs have already been prepared or to clip out tablets because they do not match the number prescribed by a GP. There are a number of areas in which we can better use the skills mix, and there are areas where we can take load off pharmacists. We are also funding additional services through Pharmacy First to support the pharmacy model.”
“We set out comprehensive plans for winter preparation in the urgent and emergency recovery plan. Similar to what I said a moment ago, this includes making much better use of community schemes, particularly those targeted at the frail elderly, and making better use of technology through schemes such as virtual wards. It has also put additional bed capacity into hospitals, with more than £1 billion of funding for 5,000 more permanent beds to help alleviate the pressure on bed occupancy and get flow through hospitals, which is so important to addressing the pressure on ambulances.”
“It is characteristically astute of my hon. Friend to zero in on the tie-in, which is an important part of the long-term workforce plan. Around two thirds of dentists do not go into NHS work after training, so having a tie-in is more pertinent there than it might be elsewhere in the NHS workforce. [Official Report, 12 July 2023, Vol. 736, c. 8MC.] I look forward to the Select Committee’s report but, with some of the reforms already in place, we are boosting the number of patients treated. There were a fifth more dental treatments in 2022 than in the previous year. We are also making NHS dentistry more attractive with some of the changes to the previous 2006 contract, but we recognise that there is more to do, which is why we will shortly set out our dental recovery plan.”
“Dr Alex George does a lot of fantastic work. I am due to meet him shortly in the coming days, and I look forward to that discussion. My hon. Friend is right to highlight the importance of getting more mental health support into the community, which is exactly what our additional funding is focused on delivering.”
“We have a long-standing team in the Department focused on medical supplies, which are a continual issue; as a matter of routine business, there are often challenges in that area. If the hon. Gentleman has specific issues he wishes to raise, we would be happy to look at them, but we have a dedicated team in the Department that focuses on that exact point.”
“As my hon. Friend knows, I have already met her to discuss this scheme, and the impediment was the business plan that came forward from the local trust—further work was being done on that. She is right to highlight our capital investment more widely. This Government have committed to investing in the biggest ever hospital building programme, with more than £20 billion. That is in addition to our long-term workforce plan—the first time the NHS has done this—in which we are making a further £2.4 billion of investment.”
“That is allowing us to replace 500 dormitory beds and provide 100 mental health ambulances, three new mental health hospitals, 160 projects such as crisis cafés to support accident and emergency, and £75 million to help those with mental health challenges get back into work, which is one of the best prevention measures we can take for people who are suffering with their mental health.”
“There are two issues here. One is how much investment we are prioritising towards mental health; the other is how local commissioners choose to prioritise services within those communities, and whether we try to run all of those decisions from the centre in Whitehall or embrace the 42 integrated care systems and allow them to make commissioning decisions. The bottom line is that we are spending much more on mental health, with an increase of £2.3 billion compared with the position four years ago.”
“It also reflects a growing need for more general skills in the NHS, as patients with more than one condition require a more holistic approach. The NHS long-term plan, backed by £2.4 billion of new funding, comes in addition to our record investment in the NHS estate. It ensures that we put in place the funding required for a sustainable future for the NHS, alongside the steps that we are taking in the immediate term to reduce waiting lists and ensure that the NHS is there for patients. As the chief executive of NHS England has said herself, the long-term workforce plan is a truly historic moment for the NHS. As such, I commend this statement to the House.”
“It will also help to recruit and retain staff in parts of the country that often find it harder to recruit In the week in which we celebrate the 75th anniversary of the NHS, today’s announcement confirms the Government’s commitment to the first ever comprehensive NHS long-term workforce plan. The plan sets out detailed proposals to train more staff, offers greater flexibility and opportunity to existing staff, and embraces innovation by reforming how education and training are delivered across the NHS. The plan will be iterative; we will return to it every couple of years to enable progress to reflect advances in technology such as artificial intelligence so that the numbers trained can be best aligned with patient services.”
“In respect of reform, the plan sets out policies to expand the number of associate roles, which provide greater career progression for existing staff and in turn reduce the workload of senior clinicians, allowing them to focus on the work that only they can do. Both measures will improve productivity by enabling more staff to operate at the top of their licence. A constant theme across the long-term workforce plan is our focus on apprenticeships and vocational training, including a commitment to increasing the number of staff coming through apprenticeships from 7% today to 22% by 2031-32. That reflects the strong commitment of the Secretary of State for Education and myself to facilitate greater career progression through apprenticeships.”
“The plan sets out three priorities: to train more staff, to retain and develop the staff already working for the NHS and to reform how training is delivered, taking on board the best of international practice. Let me deal with each in turn. We will double the number of medical school places, increase the availability of GPs being trained by 50%, train 24,000 more nurses and midwives and increase the number of dentists by 40%. When it comes to improving retention, we recognise the importance of flexible working opportunities, especially for those approaching retirement. The plan will build on proposals in the NHS people plan and build on steps already taken by the Chancellor at the spring Budget on pension tax reform.”
“Today I can confirm to the House that, for the first time in the NHS’s history, the Government have committed to publishing a long-term workforce plan, setting out the largest-ever workforce training expansion in the NHS’s history, backed by £2.4 billion of new funding. The plan responds to requests from NHS leaders and has been developed by NHS England. I would like to take this opportunity to thank Amanda Pritchard, the chief executive of NHS England and her team, Gavin Larner and colleagues within the Department of Health and Social Care, and the more than 60 NHS organisations that have engaged closely in the plan’s development, including many of our Royal Colleges.”
“Our national roll-out of our lung cancer screening programme has helped to transform patient outcomes, turning on its head the previous position where 80% of lung cancers in our most deprived communities were detected late, with 76% now being detected early. Alongside the immediate measures we are taking to deal with demand in the NHS, as we celebrate the 75th anniversary we are also investing in the NHS to make sure it is sustainable for the future. Last month, I announced to the House the largest-ever investment in the NHS estate, with more than £20 billion committed to our new hospitals programme.”
“We have already exceeded our manifesto target by 3,000, with 29,000 additional roles in primary care to enable patients to access specialists more quickly, and we are reducing burdens on GP surgeries through the development of the NHS app and improving the range of services offered through Pharmacy First, enabling pharmacists to prescribe drug treatments for seven minor illnesses. Alongside the recovery plans, we are taking action to improve prevention through early diagnosis of conditions, whether through the 108 community diagnostic centres that are already open, or the 43 new and expanded surgical hubs planned for this year.”
“On electives, we have virtually eliminated the two-year wait, which we did this summer, and cleared more than 90% of 80-week waits from their peak at the end of March—in marked contrast to the much longer waits we see in Wales, where the NHS is run by Labour. On urgent and emergency care, we are investing £1 billion in 5,000 additional permanent beds, alongside expanding virtual wards to improve discharge from hospital and investing in community services to prevent admissions, especially for the frail and elderly. On primary care, we are investing more than £600 million, including in improving technology to address the 8 am rush.”
“One in four adults lives with two or more health conditions. Although our population is forecast to grow by around 4% over the next 15 years, the number of those over 85 is forecast to grow by more than 50%. In addressing the challenges both of today and of the longer term, it is right that we have a recovery plan focused on the immediate steps as we rebuild from the pandemic, and longer-term plans to ensure that the NHS is sustainable for the future. This will ensure that the NHS is there for future generations in the way that it has been for us and our families over the past 75 years. We have already set out detailed recovery plans to reduce long waits for operations, improve access to urgent and emergency care and make it easier to see GPs and specialists in primary care.”
“I am sure the whole House would agree that the NHS holds a special place in our country due to the care offered by the people who work for it. It is said that, in 1948, the NHS had fewer than 150,000 staff and a budget of around £11 billion. Today, the NHS employs closer to 1.4 million people with a budget of more than £160 billion. The transformation of the care offered by the NHS through advances in medicine is reflected in the fact that people now live 13 years longer than on average in 1948. Today, alongside the increase in the number of staff, the range of treatments and the improved patient outcomes, demand on the NHS has also increased. People live longer, they live with more complex medical conditions, and we are also dealing with the challenges left behind by a once-in-a-generation pandemic.”