Stephen Kinnock
MP for Aberafan Maesteg · Labour · United Kingdom
“I thank the shadow Secretary of State for her kind words and look forward to our exchanges across the Dispatch Box. I am ready to engage with her on getting the maximum benefits for the people of Wales.”
“I thank the right hon. Lady and look forward to working with her. My understanding is that there were challenges around the helicopter capability. Decisions were taken by Natural Resources Wales some time ago to change the way that the tendering for helicopter capability works. We certainly need to look at that.”
“I thank my right hon. Friend for his question. Like him, I pay tribute to all those involved in the collective and heroic response to the wildfires.”
“I thank the right hon. Lady for her question. Many of the ideas coming forward for devolving power right across our United Kingdom, beyond Cardiff Bay and Holyrood, are very exciting, and I look forward to exploring them with her.”
“Just to be clear, this is not about staying out of the issue; it is about respecting the devolution settlement, but being prepared to work constructively where we can in partnership with the Welsh Government. The hon.”
“I know about and welcome the right hon. Gentleman’s strong connections to Wales. I recognise the connectivity benefits that WSMR’s proposal could deliver, particularly for passengers in Wales and the west midlands.”
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“Of course, we want to see consistency and quality right across the board, regardless of who is actually delivering the work. If there are specific issues around private contractors that the hon. Gentleman can flag to me, perhaps he could write to me; we would be very happy to look into them. We have committed to reduce the running costs of integrated care boards and to redirect that funding to frontline services. To deliver that, our 10-year health plan sets out that integrated care boards must focus on their role as strategic commissioners, ensuring the best possible value in securing local services that improve population health and reduce inequalities. However, NHS England has been clear that, although transformation is required, it must be carried out with clear safeguards in place to protect frontline responsibilities.”
“It is about getting more efficiency but also being more responsive to patients and practitioners on the frontline.”
“According to the Office for National Statistics, almost 77% of people described contacting their GP as easy in January this year, up from just 60%, where it was languishing in July 2024. I know that when he gets up, the hon. Member for Hinckley and Bosworth (Dr Evans) will hugely welcome, as will his hon. Friends, the progress that we are making.”
“It will provide a mechanism to hire even more GPs via a new practice-level reimbursement scheme, and it will support the shift from treatment to prevention, as set out in our 10-year plan, through incentives to boost childhood vaccination rates, better care for patients living with obesity and requiring GPs to share data with the lung cancer screening programme. These ideas were not cooked up by someone sat behind a desk in Whitehall. What is happening is that we are taking the best of the NHS to the rest of the NHS, working with pioneering practices that have been doing these things for a long time. Today we can see that our policies are working, and after years of decline in general practice, we are getting the front door back on its hinges. Patient satisfaction with general practice is finally moving in the right direction.”
“We are determined to make the system fairer for coastal communities and deprived areas, so we have launched a review into the Carr-Hill formula to close the gap on health disparities and ensure that funding is targeted on the basis of need. We will shortly update the House in the usual way on our Carr-Hill review. Last year’s GP contract saw the biggest cash increase in more than a decade, and this year we are investing an additional £485 million, taking the total investment made through the contract to more than £13.8 billion this financial year. Investment must always be combined with reform, so the new contract will improve access for patients by requiring that all clinically urgent requests are dealt with on the same day.”
“When we came into office, we found GP services in an appalling state—underfunded, understaffed and in crisis. Since July 2024, this Government have been fixing the front door to the NHS, investing more than £100 million to fix up GP surgeries this year, making online booking available to patients across the country and recruiting 2,000 more GPs who are now serving patients on the frontline. Following investment in advice and guidance, we have seen 1.3 million diverted referrals since April 2025. Those are people who would have otherwise been added to the electives waiting list. A lot has been done, but there is a lot more still to do.”
“In July 2024, patient satisfaction with access to a GP was languishing at a miserable 60% after 14 years of Tory neglect and chaos. Today it stands at 76%, which is a 16 percentage point improvement. The hon. Gentleman asked for statistics; perhaps he should take that statistic and deal with it.”
“If he is looking for statistics on advice and guidance, let me give him that one again: 1.3 million referrals have been taken off electives and dealt with by GPs. That is part of the hospital-to-community shift. The hon. Gentleman asked for a definition of “urgent”. We trust our clinicians. We know that general practitioners are experts in their field. They know when they see an urgent issue, but they also know that that the symptoms might be a more acute manifestation of chronic obstructive pulmonary disease, or that a child’s rash suddenly looks more dangerous than it did the day before. We trust our GPs to make those decisions, and it is a real pity that Opposition Members do not seem to do the same. The hon. Gentleman also wanted a statistic in relation to access.”
“I thank the hon. Gentleman for the GP-related questions, for which I was grateful when he finally got to them. On clinical evidence for advice and guidance, I think that the evidence speaks for itself. We introduced advice and guidance in the last contract with an £80 million investment, and it has been a stunning success. Take-up across the country has been huge, and—this is the statistic that matters most of all—1.3 million referrals that would otherwise have gone to electives have been dealt with by GPs. [Interruption.] The hon. Gentleman, who is chuntering from a sedentary position, seems not to care about what actually matters for patients, but through advice and guidance they are able to get a response from their GPs within about 48 hours. I can assure him that it takes a great deal longer to secure an out-patient appointment.”
“The Carr-Hill review is happening as we speak, and I expect to get a submission from officials on the first round of analysis that is being conducted by the National Institute for Health and Care Research. That will be the first step towards agreeing on how we make the formula work, with a view to implementing the new Carr-Hill formula from 1 April 2027.”
“Many GPs across the country practise only three days a week, and this is an opportunity to boost that to four or even five days a week.”
“On buildings, we have the £102 million primary care utilisation fund, which will be very important in refurbishing GP practices. We are committed to delivering 120 new neighbourhood health centres by the end of this Parliament, and 250 by 2035. The hon. Lady asks about GP numbers. In our manifesto, we pledged to bring back the family doctor, and that is precisely what we are doing. We said that we would deliver 1,000 new GPs to the frontline, but we are delivering 2,000, so we have smashed through our manifesto pledge. There will be more to come, because we are making the practice-level reimbursement scheme more flexible so that it does not apply only to GPs who have just come out of training; we are now enabling practices to hire more experienced GPs. That will also help with under-employment.”
“I am not able to pre-empt the Carr-Hill review, but we have had a system based on data that is often 25 years old. Of course, we know that the Conservatives have the Tunbridge Wells philosophy. We will always recall the former Prime Minister standing in front of Conservative party members and proudly proclaiming the fact that he had been taking money out of parts of the country that needed it most and pumping it into those parts of the country that were delivering his pork barrel politics.”
“The right hon. Gentleman makes a very important point about bureaucracy. Many of the reforms that we are pushing for in the contract are designed to reduce bureaucracy. For example, by moving to a single point of access and embedding advice and guidance in the contract, we will reduce the number of transactions. In the current system, the practice needs to put in a request for a £20 payment each time it provides advice and guidance; we are embedding that and streamlining it. The other point to make is that at the heart of our 10-year plan is the shift from analogue to digital. I have seen some extraordinarily effective artificial intelligence technology around ambient voice services, which enable an entire consultation to be recorded and put directly into the system, thereby saving the GP hours at the end of the day in writing up notes.”
“My hon. Friend is absolutely right. The £292 million we have made available for advice and guidance is repurposed funding from the capacity and access improvement payments, so it is part of incentivising improved access and better patient outcomes. I can absolutely assure him that Jess’s rule remains fixed as a really important part of ensuring that it is three strikes and a referral. Whatever happens, that will be a top priority throughout the embedding of this contract.”
“I am not familiar with the details of that specific case, but if the hon. Member writes to me, I will be more than happy to furnish her with a response. There is a real concern in some parts of the country, particularly where there have been new developments or populations moving into the area, that the GP practice does not have the required capacity. I am not sure whether that has happened in the case she refers to, but in such cases we also look to developers, including to section 106 and the community infrastructure levy as an opportunity. We have the primary care utilisation fund, and with neighbourhood health centre funding coming on stream, that may also be an opportunity. If she cares to write to me, I will furnish her with a response.”
“Very much along the lines of what I said to the hon. Member for Gosport (Dame Caroline Dinenage), we need to ensure that the social infrastructure is there in such areas of population growth. I would be more than happy to meet my hon. Friend to discuss that further.”
“I thank the right hon. Gentleman, but that is precisely what we have been doing. We said in our manifesto that we would bring back the family doctor. We said we would hire 1,000 more GPs to the frontline and we have delivered 2,000. When we came into office in July 2024 there was a bizarre situation where demand for access to GPs was spiralling, yet the additional roles reimbursement scheme, designed under the previous Government, was not for GPs. It was for physician associates and anybody else in the practice, but not for GPs. We have bulldozed that bureaucracy and invested £82 million in getting the ARRS up and running and fit for purpose. As a result, we have 2,000 more GPs and 1,600 more full-time equivalents through this contract.”
“A number of things have happened which will help with access to GPs. One is the very significant increase in the number of GPs we have put on the frontline and another is online access. We are now dealing with the 8 am scramble by ensuring we do not have a choke point on the telephone lines because more and more people are able to use online access. On capabilities in terms of physical infrastructure, a very important part of that is our commitment to neighbourhood health. There will be 120 new neighbourhood health centres by the end of this Parliament, which will really help to deliver the hospital-to-community shift that I am sure my hon. Friend’s constituents are looking forward to.”
“The very significant uplift we have made to the contract—the £1.1 billion last year and the £485 million additional investment we are making this year—will go some way to address the hon. Gentleman’s question, but there is, of course, always more we can do. We have to deal with very many competing priorities across the Department of Health and Social Care, but general practice is right at the top of the list. That is demonstrated by the fact that we have invested in more GPs, better online access and more physical infrastructure for general practice.”
“This is about incentivising GPs, working with them as partners as we move forward into the modernisation of our health service.”
“My hon. Friend makes such an important point about paying tribute to the incredible work that our GPs and their teams do right across the length and breadth of our country, including in Gedling; he is an excellent champion for his constituency. This is about marrying investment with reform. In addition to the £1.1 billion in the previous contract, the £485 million this year and the measures I mentioned to recruit more GPs to the frontline, there is also very important work happening around the shift from treatment to prevention in the 10-year plan. We are boosting childhood vaccination rates, providing better care for patients living with obesity and requiring GPs to share data with the lung cancer screening programme.”
“The key point here is that GPs are the clinicians whom we trust to define what urgent means. There are, of course, a number of criteria and conditions that will ring an extra alarm bell and ensure that the patient is registered as urgent. It is worth mentioning that 46% of all GP appointments already take place on the same day as contact is made with the surgery—with the majority of those classified as urgent—so performance is already good. This is not something new that we are landing on general practice; it is much more about ensuring that we have a clear line of sight into who the urgent patients are and ensuring that they get treatment on the first day.”
“My hon. Friend is a doughty campaigner for his constituents. I am not familiar with the details of the case that he mentions, but I would be happy to look into it; if he would write to me, we can take that further.”
“The guidance on neighbourhood health will be published very soon indeed; it is almost complete, and is coming soon. We recognise that general practice will be right at the heart of neighbourhood health, so we have to ensure a single neighbourhood provider contract and a multi-neighbourhood provider contract that are aligned with the best value that we can deliver, both for the taxpayer and in terms of patient outcomes. We will also be consulting on the single neighbourhood provider and multi-neighbourhood provider, with the consultation process starting some time after the overarching neighbourhood guidance, which is coming out very soon.”
“Friend’s survey once she has it; it would be a good way of checking in and ensuring that there is a golden thread between the outcomes that we want to see and the delivery on the ground.”
“My hon. Friend and I have had some discussions about GP practices in her constituency, and I know she is doing excellent work to ensure that performance is always being driven in the right direction. She asks what we are doing right across the country; the Carr-Hill formula will be a nationwide initiative, and the contract itself is also nationwide. It is important that the Government do not try to micromanage and that ICBs and trusts work together. We are there to set the framework and ensure that everybody is clear about the outcomes; it is then up to the people at the coalface to deliver those outcomes. We do need to know where that is not working, so perhaps we could look at my hon.”
“GPs will be able to access the high-level consultant expertise and specialism that they need in order to assess whether or not a particular patient needs to go to an out-patient appointment. It will mean more flexibility, high-level triage and much better outcomes for patients.”
“I thank the hon. Member for his question, but it is pretty clear to us, based on the experience of advice and guidance—I think it is advice and guidance that he is referring to specifically—that the £80 million we invested in advice and guidance under the last contract has been extraordinarily successful, with very high take-up right across the country. As a result, we have kept 1.3 million people out of electives who did not need to go to those out-patient appointments. What we are doing now is embedding that in the contract, because it has been such a success. By embedding it in the contract, we are giving more flexibility and less bureaucracy, because there will be a single point of access in the trust.”
“I thank my hon. Friend for that question; I can feel the passion with which he asks it, particularly because of his family connection. It is vital that clinically urgent patients get treatment on day one. We are confident that that is happening in many cases, but embedding it in the contract means an additional level of transparency and commitment from all sides of the equation. That is really important, because it recognises the good performance that is already happening in many cases but will also drive up performance in areas where it is not at the level at which it should be.”
“Clearly, a lot of change is happening in the system, but that is because a lot of change was required. Frankly, we have to do what we are doing if we are going to get the NHS back on its feet and fit for the future, with the three big shifts set out in our 10-year plan. Part of that is about the structure. Our view is that we can consolidate more of the back-office activity, which will free up more resources and allow us to do more on the frontline. ICBs play a vital role in that, particularly in commissioning. We want to see more strategic commissioning and more resource and expertise put into the parts of the ICB that are delivering better outcomes in population health. We must also see less duplication and more streamlining of back-office functions.”
“Hon. Members raise this issue with me regularly. There seems to be something of a disconnect when new developments are being built, whereby the section 106 agreement or the community infrastructure levy just do not seem to be delivering the social infrastructure that they should be delivering. I would be happy to meet my hon. Friend to discuss that in relation to the specific case he raises. Then, of course, we could discuss the possibility of a visit.”
“I think the first part of the hon. Member’s question is connected to the second part, because, as he correctly points out, thanks to the 14 years of neglect and incompetence that we saw, the Carr-Hill formula became a very anachronistic way of sharing funding. It should be based on need, but it was based on very outdated statistics and data. We are fixing that, and the changes that we are making will be felt by his constituents. It is disappointing to hear that he has had that feedback, because it does not reflect the nationwide polling from the Office for National Statistics, which shows that satisfaction with access, which was languishing at 60% in July 2024, now stands at 76%.”
“Thanks to the decisions that the Chancellor of the Exchequer has made, significant additional funding has been made available for capital investment in our NHS, and a big part of that is about driving the shift from analogue to digital. The other shifts—hospital to community, sickness to prevention—are not going to work otherwise; they all rely on this pivotal shift from the analogue age to the digital age. It is disappointing to hear the specific feedback that my hon. Friend has heard from the practices in her constituency. If she would like to write to me, or grab me in the Division Lobby, we can talk about the specifics of those cases. But overall the capital budget has been significantly boosted by the decisions that our Chancellor of the Exchequer has made.”
“The hon. Member raises an important point. It is important that we at the Department of Health and Social Care work closely with the NHS regions and the ICBs to keep a close eye on that issue. It is vital that GPs are aligned with the highest professional standards. If we see those standards not being observed in any case, action must be taken. If she has specific evidence to suggest that such practices are going on, she is more than welcome to share it with me.”
“My hon. Friend is right that it is vital that ICBs have a clear understanding of their population health needs and their demographics. It is important that the ICB is ahead of that curve and taking decisions well in advance of a practice closing down so that a commensurate service is provided; that is a really important part of the ICB’s responsibilities. If he has specific examples where he feels that his ICB has not been delivering on that basis, he is welcome to share those with me.”
“On online access, it is clear that there must always be three channels of access to a GP—walk-in, telephone and online—and that for an urgent matter it would be a walk-in or a telephone call. What has really worked is that online access has taken pressure off the telephone lines as people who do not have urgent requirements have been migrating online and using the NHS app—take-up of the app is also excellent—so we are moving in the right direction.”
“On prevention, there are some really important measures in the contract: in essence, we are recalibrating the quality outcomes framework, which is the basis for payments to incentivise the actions that GPs take. By changing the QOF, as it is called, we can shift that in one direction or the other, and we have changed it to incentivise boosting childhood vaccination rates, particularly in those areas of the country where vaccination rates are worryingly low, and better care for patients living with obesity. That is about exactly the things the hon. Member just mentioned: prescribing, if you like, exercise regimes and advising on better nutrition. We are also changing the QOF to require GPs to share data with the lung cancer screening programme. Those are just three examples of what we are doing within the contract.”
“I thank my hon. Friend for that question and ask him to please pass on my best wishes to his father and thank him for the outstanding service he provided over many years. The Carr-Hill formula review is an important piece of work. It will have a complex range of drivers in it, based on remoteness and coastal areas, but socioeconomic indicators will be very much at its heart. Those are the clear terms of reference that we gave to the National Institute for Health and Care Research, and that is the basis of the review. I expect those documents from officials very soon, and we will update the House accordingly. Some of the process was set out in a “Dear Colleague” letter a little while back, but we are also keen to have feedback from MPs in that process.”
“That is another example of the shift from hospital to community, which is so important in enabling people to get the best possible care in the right place at the right time, as close as possible to their homes.”
“Please do pass on my thanks to the Laurie Pike and al-Shafa practices for the outstanding work they do. We are not really doing ringfencing; we are embedding prevention in the contract through the quality outcomes framework. Those incentives are the best way to give practices the flexibility they need while ensuring that they are clear about what we expect in terms of outcomes. Issues such as cardiovascular disease and diabetes are part of the quality outcomes framework. It is also worth mentioning the Pharmacy First scheme, which is looking to move some of this work out of GPs and enabling pharmacists to operate at the top of their practice.”
“They will be helped, supported and cared for close to home, without having to go into hospital, which will have a positive knock-on effect right through the system.”
“My hon. Friend is right: avoiding preventable admissions is right at the heart of what we are trying to achieve. Of course, we have challenges with delayed discharge—something like 14% of patients in hospital beds are medically fit for discharge—and if we look at the flow of patients through hospital, we see that we can address a lot of the problems at that end of the process by preventing avoidable admissions in the first place. The advice and guidance element of the contract is therefore very important, because it is by improving co-ordination and teamwork between primary care and secondary care that we will ensure that the 1.3 million people who would have ended up on the electives waiting list or going into outpatient clinics no longer need to be there—they will be dealt with by the teamwork between consultant specialists and GPs.”
“I thank the hon. Member for his kind words about the Government’s work. I do have an excellent relationship with the Minister in Northern Ireland. Devolution is vital to the Government, and we are certainly not in the business of trying to micromanage what is happening both across the regions of England and in the devolved nations of our United Kingdom, but it is clear that there should be learning in both directions. When I speak to the Northern Ireland Minister, we are clear that we want to see the best possible performance and outcomes right across our United Kingdom. I look forward to continuing to work with him on that basis.”
“I thank the hon. Gentleman for that question. It would be deeply troubling if such an important service to the community were to be removed, so I would certainly be happy to speak to him. Perhaps he would like to write to me to provide more details. Looking to the medium to longer term, the review of the Carr-Hill formula could well end up benefiting communities such as the one he has mentioned, because remoteness and rurality will be an important factor in the Carr-Hill review, but I accept that that might be a bit too far off for what sounds like a more urgent issue. If he would like to write to me, I am sure we can look into that.”
“Friend the Member for Bexleyheath and Crayford for his tireless advocacy and work to ensure that this issue receives the attention that it deserves. I congratulate him, once again, on securing this important debate. Question put and agreed to.”
“For young people with cerebral palsy, that means earlier preparation for transition, co-ordinated support from a multidisciplinary network and clearer expectations for how professionals should plan and hand over care. No young adult with cerebral palsy should reach their 18th birthday and face a cliff edge. They have waited far too long for the NHS to acknowledge their existence in policy, planning and commissioning. They deserve the dignity of services that reflect the reality of their lifelong condition. They deserve the best, and we are delivering improvements through integrated, system-wide reforms designed to support lifelong person-centred care. The steps under way provide a more effective and sustainable foundation for improving outcomes for adults with cerebral palsy. Again, I thank and congratulate my hon.”
“Although not currently mandated through the quality and outcomes framework, those reviews remain an important mechanism for identifying changes in mobility, pain, fatigue and mental health, and for ensuring that people are offered appropriate interventions early. The 10-year health plan’s focus on personalised and proactive care will support integrated care boards to improve access to those reviews as part of a more consistent offer for adults with cerebral palsy. The plan will also ensure that no young person is lost in the gaps between children’s and adult services, a point at which many families tell us that they feel most vulnerable. NHS England’s children and young people transformation programme provides a clear nought-to-25 model of care to achieve that.”
“Work is under way to determine the definition of complex needs in the context of that target and how care plans will be delivered in the future, including who will be best placed to co-ordinate and support their delivery. We know that key shared decision making is central to patients’ ongoing care, and care plans will look to promote that further. In developing future models of care planning, we will continue to take into account the varied experiences and needs of people with different conditions, such as cerebral palsy. We also recognise the importance of preventive, proactive care, including annual reviews, as recommended in NICE guidance for adults with cerebral palsy.”
“The plan focuses on delivering more care in the community, making greater use of technology and building a more preventive health service that supports people to stay well for longer. Our 10-year health plan will ensure that people with complex needs are supported to be active participants in their own care. As part of that, 95% of people with complex needs or long-term conditions will have an agreed personalised care plan by 2027. Care plans will be a feature of the developing neighbourhood health service, which will deliver more care in local communities and move away from a one-size-fits-all approach, giving people more power and choice over the care that they receive.”