Wes Streeting
MP for Ilford North · Labour · United Kingdom
“We hope for the best and plan for the worst in terms of the continuation of this war, but we are also actively working to prepare for conditions in which a ceasefire has been agreed by Ukraine, with Ukraine and, from our perspective, for Ukraine.”
“The threats we face are not only evolving; they are getting closer to home. Every day, the UK and our allies encounter espionage, cyber-attacks and military posturing by hostile states.”
“One discipline I have to bring to the Ministry of Defence, drawing on my experience at the Department of Health and Social Care and the NHS, is to ensure there is no culture of routine overspending, that we are improving productivity, that we deliver value for money and that we recognise that the money we are investing in defence comes wi…”
“With permission, I will make my first statement to the House as Secretary of State for Defence on Ukraine, the ongoing threat from Russia and the Government’s approach. It is not yet clear whether freedom or tyranny will define the 21st century. What is clear is that the United Kingdom will not be a bystander in that struggle.”
“I am grateful to my hon. Friend for raising that very serious and important issue. She will understand that, as a matter of policy, I will not comment on intelligence, but I will address the reports she has raised.”
“We know that this Prime Minister and this Chancellor are both fully committed to funding our nation’s defence, including meeting our NATO commitment of 3.5% by 2035 and setting out an earlier 3% commitment at the next spending review.”
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“If only that were true, and if only the strike was not placing intolerable pressure on other NHS staff, and an intolerable risk to patients, which I think is unconscionable.”
“I certainly hope that when making the decision about whether to go to work this week, resident doctors bear in mind the pressures that the NHS is under, the consequences of their actions on their colleagues not just this week but in the coming weeks, and—crucially —the impact that risks having on patients, which is the most important consideration. I ask resident doctors to bear in mind that we offered the BMA the chance to postpone the strike action into January. I think that is a reasonable offer, and the BMA’s rejection of it shows how thoroughly unreasonable it is. I follow what resident doctors say, and I worry that too many seem to think that these strikes are consequence free for everyone but the Government.”
“Thanks to the decisions taken by this Labour Government, we have increased funding for general practice by £1.1 billion, we deployed not just 1,000 more GPs to the frontline in our first year as promised but 2,500 and, through reforms to the Carr-Hill formula, we are restoring the deprivation link to health funding. As a result, the poorest communities with the greatest needs are receiving greater care, support and investment. All this is undoing the damage left by 14 years of Conservative government and it is only possible because people chose to elect Labour MPs.”
“That is very good advice on vaccination. If people require health services and it not an accident or an emergency, they should call 111, visit the website or use the NHS app. There are plenty of services available to help people, but as people will have seen on their television screens and social media feeds, the current pressures mean that the emergency department is not a place to be, unless they have had an accident or it is a genuine emergency.”
“It is a reflection of that fact that we inherited an NHS that was in enormous crisis. It will take time to recover. The key for me is achieving year-on-year improvements to get the NHS back on its feet and to ensure it is fit for the future.”
“We do flex beds depending on needs. For example, there were just over 101,000 beds open on average per day in the past week, which was up on the previous week and broadly the same as it was this time last year. We are investing in the NHS, and we have to ensure that people get the right care, in the right place at the right time. That means not just investing in secondary care; if anything, it means investing in the front and back doors of the hospital—primary care, community services and social care—to deal with the flow of patients through hospitals. I do not pretend that these are easy issues or that everything is going swimmingly in the NHS—quite the opposite. I have seen conditions on our screens in the past week or two that I would not want to be treated in, someone I love to be treated in, or anyone to be treated in.”
“It involved working trust by trust to secure the extra training places, and working with my counterparts in Scotland, Wales and Northern Ireland. Even after all that effort was strained to bring forward something quickly for this application round, the BMA rejected it. It is unreasonable, and to have rejected the offer of postponing strikes until the new year on the grounds of patient safety and doing the decent thing by their colleagues was unconscionable.”
“My hon. Friend is absolutely right. Responsible trade unions think about the wider workforce and the impact on service users, whether they are children or other users of public services. Crucially, for most trade unions in this country strike action is a last resort. It is astonishing that the BMA chose to go on strike after a 28.9% pay rise, well ahead of the Government making any decisions on future years’ pay and with the Government willing to discuss future years’ pay with the BMA. It is extraordinary that the BMA has chosen to go on strike after we proposed to take action on jobs, including by bringing forward legislation at an expedited pace. By the way, that involved ensuring that the legal advice was watertight and that, operationally, we could deliver a new application round.”
“Yes. The JCVI makes evidence-based recommendations, and we follow its evidence. With the best will in the world, we of course give out practical, common-sense advice, but we should not infantilise our constituents. They are perfectly capable of working out who can get together this Christmas. They really do not need Government Ministers to start issuing directions about who can get round the table for Christmas dinner and who can get together in the days after. In the exchanges we have in this House there is sometimes a degree of patronising of the British people. They really, really do not need us. They really do not need our advice on the seating plan at Christmas dinner; what they need is for NHS services to be there when they need them, and that is what the Government are focused on.”
“It is the only NHS our country has ever had and, compared with all the alternatives, I would not give up on a publicly funded public service—owned by us and there for all of us—for anything.”
“I speak regularly with my counterparts, and the Ministers who are either side of me this afternoon have been engaging with our counterparts in recent weeks on these issues. We have a good relationship with devolved Administrations, regardless of party or where they sit across the United Kingdom, and that is a good thing. As for the history of Labour Governments’ interactions with the NHS, that is not lost on me. The BMA marched against the NHS. It may be the case that the BMA does not really feel it needs the NHS—the BMA will be all right regardless—but my constituents cannot afford private healthcare, let alone earn money working in it. We will do everything we can to save the NHS, get it back on its feet and ensure that it is fit for the future.”
“There are many examples of great community-based vaccination initiatives. Many of those initiatives are supported by faith-based organisations, which is really important given the vaccine hesitancy in some of those groups. I do not believe that people are hard to reach; I believe that public services often do not try hard enough, and our approach is to do so. We will reflect on our success this year and seek to build on it for future years.”
“I thank the hon. Gentleman for his question. Given that politicians are somewhere below traffic wardens and estate agents in terms of public popularity at the moment, it is quite an achievement for the BMA to have found itself even less popular with the public, but I think it has made very clear through its actions and rhetoric this week that it does not care about public opinion. In fact, the BMA does not seem to care much about the public at all. The hon. Gentleman is quite right that we need to make sure we have a good supply of vaccine available across the whole of the United Kingdom. We work closely with the devolved Administrations, and I speak regularly with my Northern Ireland counterpart. Should the Northern Ireland Executive ever need support or assistance, we are always willing to provide it wherever we can.”
“Further to that point of order, Madam Deputy Speaker. I just wanted to welcome the hon. Gentleman’s endorsement of vaccination. It is by far the most sensible thing he has ever said—that is a low bar, but he has cleared it, and I am very grateful to him. He might want to have a closer look at who his party platforms at its conferences, but that is not a matter for this urgent question.”
“Members for their contributions, and you, Madam Deputy Speaker, for giving us so much time on such an important issue.”
“It is a chance for a fresh start, to end this dispute and look ahead to the future with hope and optimism—a chance to rebuild resident doctors’ working conditions and rebuild our NHS. I urge every resident doctor to vote for this deal, and I commend this statement to the House.”
“Resident doctors face a choice: to continue the damaging industrial action in which everyone loses, or to choose more jobs, better career progression, more money in their pockets and an end to strikes. The deal that is on offer would mean emergency legislation to put our own home-grown talent first; to increase the number of extra specialty training places from 1,000 to 4,000, with a quarter of those places delivered now; to reduce the competition for training places from around four to one to less than two to one; to put more money in doctors’ pockets by funding royal college exam fees, portfolio fees and membership fees, with exam fees backdated to April; and to increase the less-than-full-time allowance by 50% to £1,500.”
“Madam Deputy Speaker, I must report to the House that the BMA’s leadership said no. In the coming days, as the NHS prepares for strike action that may or may not happen, there are patients whose operations will be cancelled. There are NHS staff who will have to tell their families that they will not be home for Christmas because they have to cover for their resident doctor colleagues. This was entirely avoidable—no one should be in any doubt that the BMA has chosen to play politics with people’s lives this Christmas, and to continue holding the spectre of strikes over the NHS. I ask resident doctors to bear that in mind when they cast their votes. The power to end these strikes now lies in the hands of doctors.”
“In my determination to prevent the havoc that strikes would cause this Christmas, I therefore made one more offer to the BMA, which I will now share with the House, the country and frontline doctors. So that the BMA could run a genuine ballot of its members and call off next week’s strikes while that ballot ran, I offered to extend its strike mandate. This would have allowed enough time for the BMA to reschedule next week’s strikes for the end of January, were the offer to resident doctors rejected in a ballot. It would have avoided the chaos that looming strike action threatens at the most dangerous time of year by removing the spectre of strikes next week. I knew that extending the BMA’s strike mandate would leave me open to attack from political opponents; that was a risk I was willing to take to stop the Christmas strikes going ahead.”
“The allowance for less-than-full-time resident doctors—many of whom are parents and carers—will be increased by 50% to £1,500, helping to close the gender pay gap. In recent days, I formally made this offer to the BMA resident doctors committee. The BMA will now survey its members in the coming days on whether to accept this offer and end its dispute with the Government. The BMA told us that it will survey its members quickly and give us less than 48 hours’ notice of whether the strikes are going ahead. That presents serious operational challenges for NHS leaders, who need certainty now as to whether they are cancelling patient appointments and cancelling staff annual leave to cover strikes.”
“This will not exclude international talent, who will still be able to apply to roles and continue to bring new and vital skills to our NHS, but it will return us to the fair terms on which home-grown medics competed before Brexit. The impact of these changes is that instead of four doctors competing for every training post, it will now be fewer than two doctors for every place. That is a good deal for doctors. Following discussions with the BMA, we are also addressing the specific costs faced by resident doctors that do not apply to other NHS staff. Although I cannot go further on pay this year, I am able to offer today to put money back in resident doctors’ pockets by reimbursing royal college portfolio, membership and exam fees, with the latter backdated to April.”
“The barriers have been legal ones, so I have been working intensively with my team to see how quickly we could introduce legislation. Thanks to their efforts, the co-operation of colleagues across Government, and my counterparts in Wales, Scotland and Northern Ireland, I can notify the House tonight that, subject to the agreement of resident doctors, we intend to introduce urgent primary legislation in the form of a Bill to be presented to Parliament in the new year. The legislation will prioritise graduates from UK medical schools over applicants from overseas during the current application round and in all subsequent years. The reforms will also prioritise doctors who have worked in the NHS for a significant period for specialty training.”
“Our 10-year plan for health set out our commitment to provide that path. It pledged to introduce 1,000 extra specialty training places and prioritisation of medical graduates from the UK and Ireland. Today, in an offer to resident doctors, I can announce that I am able to go further. I want to thank Sir Jim Mackey, the chief executive of the NHS, and his team, who have been going trust by trust to see how many extra places can be funded and are needed. Thanks to their hard work, I am in a position today to be able to offer 4,000 specialty places for resident doctors, starting with an additional 1,000 for those applying this year. In the Department of Health and Social Care, we have been working intensively on UK graduate prioritisation.”
“This year, that number has soared to nearly 40,000 applications for 10,000 places. It used to be the case that UK graduates competed among themselves for specialty roles; now, they are competing against the world’s doctors. That is a direct result of the visa and immigration changes made by the previous Conservative Government post-Brexit, and it is compounded by the Conservatives’ decision to increase the number of medical students without also increasing the number of specialty training places. Taxpayers spend £4 billion training medics every year—we then treat them poorly, and some leave to work abroad or in the private sector. It is time that we protect our investment and give bright, hard-working UK medical graduates a path to becoming the next generation of NHS doctors.”
“Nor would further movement on pay be fair to other NHS staff, for whom I am also responsible and many of whom will never in their careers earn as much as the lowest-paid doctor. As I have made clear to the BMA and other trade unions, I am open to discussing multi-year pay deals with any trade union if we stand a chance of bridging the gap between affordability and expectations. On jobs, I have much more sympathy with the BMA’s demands. I have heard the very real fears that resident doctors across the country have about their futures; it is a legitimate grievance that I agree with. My Conservative predecessors created training bottlenecks that threatened to leave huge numbers of resident doctors without a job. In 2019, there were around 12,000 applicants for 9,000 specialty training places.”
“It is against that backdrop that the British Medical Association is threatening to douse the NHS in petrol, light a match and march its members out on strike. This represents a different magnitude of risk to previous industrial action. The BMA resident doctors committee is in dispute on two issues: pay and jobs. On pay, resident doctors have already received a 28.9% pay rise—the highest in the public sector. For a first-year resident doctor, that is the equivalent of a £9,400 pay rise. I have been consistent, honest and up front with resident doctors that we cannot go further on pay this year. There is a gap between what the BMA is demanding and what the country can afford.”
“With permission, Madam Speaker Deputy, I shall make a statement on industrial action by resident doctors. I thank you, Mr Speaker, business managers and the official Opposition for facilitating this evening’s statement. As we head into winter, our hospitals are running hot and the pressures on the NHS are enormous. Flu season has come earlier, with a sharp rise in cases and the peak still to come, and this year’s strain is more likely to affect older people more severely. Already, the number of patients in hospital in England with flu is the highest on record at this point in the year. It is 50% higher than this time last year and 10 times higher than in 2023. Some 95% of hospital beds are occupied, growing numbers of staff are off sick and we are already seeing the pressure in our A&E departments.”
“I would say this to resident doctors who are following these exchanges: listen to what the Conservative party has said about trade union laws, and about their rejection of the deal that we struck within weeks of coming into office. There is not a more pro-NHS, pro-doctor Government waiting in the wings. There is a Labour Government who are committed to the NHS, and committed to the NHS workforce, who have gone further than any other Government before on pay, on terms and conditions, and on the pace at which we are improving them. These were never grounds for strike action before, and they are certainly not grounds for strike action now. I appeal to resident doctors, over the BMA, to do the right thing, to vote for this deal, and to work with a Government who want to work with them.”
“While we are aiming to maintain 95% of elective activity, I cannot guarantee that. I cannot give that assurance in all good conscience, given the level of pressure that we are under. I offered to extend the mandate, so that the BMA could reschedule the same amount of strike action for January, if its members reject this offer, and I do not understand why the BMA would not do that. I find it inexplicable. As a Labour MP, I have spent a lot of time in rooms with trade unions and negotiating, and I honestly cannot think of a single other trade union in this country that would behave in this way. I am shocked by it. I am shocked because of the risk that it poses to patients and the pressure that it places on other NHS staff, and shocked because it threatens the recovery of the NHS that we all care about.”
“I must thank them sincerely for the spirit in which, regardless of party, they have worked with this Government; we can give resident doctors that assurance. As for what will happen if the strike goes ahead, let me say first that the shadow Health Secretary was right to say that frontline staff and NHS leaders did a superb job of managing previous rounds of strike action. In fact, during the last round we did indeed maintain 95% of planned care, and I believe—we will see when the waiting list figures are published in January—that the impact on waiting list progress will therefore not have been as severe as it might have been. However, I must be upfront with the shadow Health Secretary and the House and point out that there is a very different degree of risk this time.”
“He is right: we have to ensure that we have enough trainers. Jim Mackey and his team have literally been working trust by trust to ensure that we can give the shadow Health Secretary, the House and resident doctors an assurance that we can facilitate those extra places. When it comes to the legislation, the shadow Health Secretary will know, and people will appreciate, that this is fiendishly complicated. I have had to secure agreement from business managers, as we have a packed legislative programme. We have had to make sure that the Bill would be legally watertight and consistent with both domestic law and our international treaty obligations, and I have needed support from my counterparts in Wales, Scotland and Northern Ireland.”
“By expediting those changes, there will be a direct impact on people applying for speciality places now and those who, even in recent weeks, have experienced the disappointment of not receiving the training place they had hoped for. We can keep that hope alive. We can improve the number of specialty places available if resident doctors vote for this deal, so I urge them to do so. The shadow Health Secretary asked why we had not dealt with this before. I am tempted once again to revert to my usual analogy of the arsonist heckling the fire brigade, but given the constructive terms on which he has offered to work with us on this, I will pull my punches a little. I will say, however, that putting together the 1,000 extra places now, and bringing together the legislation urgently, requires significant operational detail.”
“First, I thank the shadow Health Secretary for the constructive terms on which he has agreed to work with the Government. That should give resident doctors across the country who receive their survey the confidence of knowing that, should they vote for this deal, emergency legislation will be introduced in the new year. We will be able to work at pace, because with the majority that the Labour party has in this House, and with cross-party support in the other place, we can make sure that we expedite the legislation and achieve our goal of making the changes for international medical graduates that we have always intended to make, and that we committed to well in advance of today.”
“It would be an extraordinary gesture of good will, and it would be a Christmas present for the country. It would benefit doctors, resident or otherwise, and all NHS staff. Most importantly of all, it would benefit patients. I hope that message is heard in good faith by the BMA, even now.”
“I agree entirely with my hon. Friend. She brings considerable frontline experience to this House, having worked in the NHS and dedicated her life to it. I am pretty sure that as well as speaking for her constituents, she speaks for so many other NHS staff. I do not want to see nurse pitted against doctor, or NHS staff pitted against each other. I do not want to see people resenting each other at a time when we should be pulling together to get the NHS back on its feet, and to make sure that it is well down the road to recovery. That is why, even at this late stage, I urge the BMA to think again. There is nothing to stop me extending the strike mandate tomorrow and giving Jim Mackey and NHS leaders the opportunity to stand down planning for strikes next week, even at this late stage.”
“We are committed—and I am personally committed—to working constructively with the BMA on things like workforce planning to address those issues, if it is willing to work with us. That is all I ask. It is all I ask from any part of the NHS workforce. It should work with us constructively, understand our constraints, work through the challenges with us, and we will all get to a better place and create a rising tide in the NHS that lifts all ships.”
“Although I would never pretend that the steps we have taken in our first 18 months in office have solved everything all at once—there is no shortage of things to solve—I say to those BMA members considering how to cast their vote that we have delivered a 28.9% pay rise, have taken action on international medical graduates through urgent legislation, and have expanded speciality training places. This is real progress. It is meaningful change in people’s pockets and to their lives, working conditions, career progression and prospects. The BMA should please not let the perfect be the enemy of the good. We have a lot of fires to put out on a lot of fronts as a Government, and that does take time.”
“I thank the Liberal Democrat spokesperson for his support, as well as for the constructive challenge. He is absolutely right to describe the challenge that we inherited, and we are seeking to deal with it. We have taken a number of steps along the way. For example, we promised to recruit an additional 1,000 GPs to the frontline in our first year. We expanded the additional roles reimbursement scheme in order to do that, and we were actually able to recruit an extra 2,500. The international medical graduate dimension of the deal means that the extra speciality training places go even further.”
“They are not in it for themselves, but because they believe in public service and want to improve the health of our nation. We are so much better able to achieve our shared goals if we work together, and we can grasp that opportunity if doctors vote for this deal, we draw a line under this dispute, and we try to reset the relationship between me and this Government on one hand, and the BMA’s leadership on the other.”
“I wholeheartedly agree with my hon. Friend. I was about to say that it is always a disappointment when Reform and Green Members do not appear in the Chamber, but I would not want to be accused of misleading the House. I am sure they had a better offer, and there is a Christmas party up the road. In all seriousness, my hon. Friend is absolutely right. The tragedy of the past couple of rounds of industrial action is that each round costs about a quarter of a billion pounds. Each round, despite the best efforts of NHS leaders and frontline staff, does cause disruption, and we all lose when that happens. One of the things that is really hard for staff is that they are also confronted in a very real way with the impact of the state of the NHS on their patients.”
“They cannot believe we do not already do this, so I think they will understand what we are doing and why. I hope they will be reassured that international recruits who have given service to the NHS will also be able to apply for specialty places, because we want to recruit and retain great talent, but they will also recognise how this is a game changer for the ratios for homegrown talent. I think they will understand that. I think they will respect that. Not least, I have been at pains as Health Secretary, given some of the ugly rhetoric that has come from one corner of this Chamber, to emphasise that, while some people in this House might tell those international recruits to go home, as far as we are concerned they are home.”
“I think it would do it the world of good in the eyes of the public, and in the eyes of its members and the wider NHS family. I am really glad that the Chair of the Select Committee raised the point about international medical graduates and the overseas workforce. The NHS has always been an international employer. We have been so fortunate as a country that, since 1948, people have come from around the world to help us build and sustain a national health service. Without them, it would collapse, and we never want to be a country that closes the door to international talent. What is extraordinary is that many of those overseas doctors, when they see the competition ratios and compare our approach to that of their home country and other countries, think we have lost the plot.”
“I thank the Chair of the Select Committee for that contribution, which is really important on two fronts. First, she is absolutely right that this really is not the time for this kind of disruption, and I think the BMA knows that. I do not think that those I am dealing with are bad people. I think they are frustrated with me and this Government—they do not think we have gone far enough—and I am equally frustrated with them, and the fact that they do not recognise how far we have come, and how fast, but that is the nature of the dispute. With the extended mandate, there is an opportunity for us all to park this and, in the worst-case scenario, revisit it in January. I hope, even now, that the BMA will seize that opportunity.”
“I understand their cynicism about politics and their grievances with the situation they are working in, but I ask them also to recognise the progress we have made when we work together. There is an opportunity confronting them now to make further progress and I urge them to seize it.”
“I am grateful to my hon. Friend and I hope that point is not lost on the BMA. On the Labour Benches, we are the party of labour. We were created by the trade union movement to represent the interests of working people. That has been our calling for more than a century, since this party was founded. We have shown through our actions, not just our words, that this is a party in government who are committed to defending and extending the rights of working people, to improving pay and conditions, to clamping down on exploitation, and to making sure that this is a Government with and for the people. The BMA has a willing partner with this Government. I sometimes feel like the Government have changed, the policies have changed and the approach has changed, but the BMA’s tactics towards us have stayed the same.”
“We are doing that because I was asked to do so by the partners that we will need, to ensure that the modelling and assumptions underpinning the workforce plan are good. I am always prepared to take a little bit more time to get it right, than to rush something out. That is the spirit in which I have engaged in workforce planning.”
“I thank the hon. Gentleman for the first bit. As for the rest of it, let me just say that the NHS workforce plan we inherited came in the 14th year of the Conservative Government. It was so absurd—it was so absurd—that on its trajectories for the increase in staffing numbers, within this century, 100% of the public would have to work for the NHS to sustain that level of workforce growth. And that is against the backdrop of AI, machine learning, genomics and the revolution in life sciences and medical technology that will change the NHS workforce and change the face of medicine. We are working with the royal colleges, think-tanks and trade unions to make sure that in the new year our workforce plan is more credible. The hon. Gentleman is right to say that we are taking a bit longer with the workforce plan than I had originally intended.”
“My hon. Friend is absolutely right. I do wish the BMA would take yes for an answer sometimes; I would like it even more if the BMA gave yes as an answer to me once a while, but that has not happened in a little while. He is right to talk about the need for workforce planning. The workforce plan, which is in production, is all about making sure we have the right people in the right place at the right time. He mentioned mental health specifically. Our manifesto committed to 8,500 extra mental health workers over the course of this Parliament, and I am happy to report that we have already delivered well over 6,500. There is lots done, but more to do.”
“I know that lots of people have campaigned hard for pay restoration and that many people are involved in the Doctors Vote campaign in pursuit of that aim. I think there are many doctors, however, who recognise that there has been real progress on pay and that what we are putting forward now is meaningful progress on jobs, too. I say to all members of the BMA: do not let the perfect be the enemy of good, especially when the stakes are so high.”
“I will say to the right hon. Gentleman that we are doing everything we can to mitigate against harm during the proposed strike dates, but I cannot in all honesty and integrity assure him that no patient will come to harm next week should the strikes go ahead, because the situation is so dire. I really urge the BMA to reflect on that overnight and into tomorrow and to ask themselves—perhaps their members will also ask this of their reps—whether it is really necessary to strike next week, given the offer of an extension to mandate. To the right hon. Gentleman’s final point, when I was the president of the National Union of Students, I was once asked by a Labour member of a Select Committee that I was appearing before whether I was speaking for my members or for my activists. There is sometimes a difference between the two.”