Karin Smyth MP: speeches 2025

Speeches

• 27 Jan 2025 · A&E Services: Solihull Borough · Hansard source

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  I congratulate the hon. Member for Meriden and Solihull East (Saqib Bhatti) on securing the debate, and congratulate other Members who have taken part in it. Let me start by thanking the NHS staff at Solihull Hospital for their remarkable efforts, stamina and care in the most challenging circumstances. That point was well made by the hon. Gentleman, and I know he feels passionately that he owes his own life and the lives of many others to their care. The hon. Gentleman said that he did not want to make political points and that politics was about choices, but we did inherit an NHS that was in the worst state in its history. I hope he agrees with Lord Darzi’s diagnosis; we have still not heard from his colleagues whether they agree with it. The condition of the capital estate, as well as NHS services, has shocked the country, notwithstanding the result of the election, but we are working at full scale to making that situation better. The hon. Gentleman is right that politics is about choices, and I think that the wrong choices were made in the past 14 years. It is right to point to the increasing demand for emergency departments in Solihull and elsewhere over the past decade, part of which can be explained by the appalling neglect of GP and primary care services to manage demand, and the failure of all parties—to which the hon. Gentleman alluded—to build consensus on a long-term solution for social care and support the flow of people through those hospitals. As the hon. Gentleman knows, Solihull Borough is within the University Hospitals Birmingham NHS Foundation Trust. In December, 58.2% of people were seen within four hours. Let me set out some of the wider context. We need to remember that we have had one of the busiest flu seasons for a number of years, and although the number of cases is coming down, the number of Norovirus cases is still 80% higher than it was in the same period last year. We want to end the treatment of people in corridors, which has become normal and which it is completely unacceptable. As my right hon. Friend the Secretary of State has made clear, this is not the level of care that staff want for their patients, and it is not the level of care that the Government will ever accept for patients. It will take time to return to the standards that patients deserve, but it can be done. We did it before in government, and we will do it again. To mitigate pressures in Solihull and elsewhere, we are reforming the NHS to shift the focus of healthcare out of hospitals and into the community, freeing up beds for emergency patients and preventing so many people from having to call an ambulance or go to A&E in the first place. In the last two months, we have announced steps to begin rebuilding general practice and immediate long-term action on social care. I understand that in November 2024, NHS Birmingham Solihull integrated care board had an average of 6.3 full-time GPs per 10,000 patients, just above the average in England, which stands at six. A few weeks after the election, we announced an extra £82 million of funding to increase access to GPs, and it is improving. Birmingham Solihull ICB area had 30 more GPs in November than in July, and I hope that that improvement has been felt by the hon. Gentleman’s constituents. In December we announced an extra £888 million in funding for GPs, the biggest funding uplift in years, alongside a package of reforms to bust bureaucracy, slash unnecessary targets, and give them more time to spend with patients as a first step towards bringing back the family doctor. As well as considering demand, we know that there is no solution for accident and emergency activity that does not include fixing our broken social care system. Today there are about 12,000 patients in hospital beds who have no criteria to reside but cannot be discharged. The main reason for the delays is to do with capacity. More than 300 patients in that category are in the Birmingham Solihull ICB. I hope that the hon. Gentleman and, indeed, all Members will work with us to resolve the situation, but that is why the Government are making up to £3.7 billion of extra funding available for local authorities to provide social care, why we are delivering extra 7,800 adaptations through the disabled facilities grant this year and next year, why we have delivered the biggest increase in carer's allowance since the 1970s—worth an extra £2,300 to family carers—why we are introducing fair pay agreements to tackle the 131,000 vacancies for care workers that we inherited, and why we are appointing Louise Casey to develop a national consensus on that long-term solution for social care. It is also clear that we can get our ambulance and A&E services working better, so before the spring we will set out the lessons learned from this winter and the improvements that we will put in place ahead of next winter. We are content to visit and hear from hon. Members from across the House about the situation in their areas. The hon. Gentleman talked about the 2022 Act. I was on the Bill Committee and tabled a number of suggestions for better accountability of ICBs to local Members of Parliament, most of which were not accepted by the Government of the time. I agree with him that those organisations need to be more accountable to him and to other Members of Parliament representing their constituents. We expect integrated care boards to ensure that the areas they run are safe, putting necessary care in the community, investing in technology and doing what is best for the people they are responsible for. The Government are investing an extra £26 billion in our health and care services while undertaking fundamental reform to help the ICB deliver the services that all our constituents expect. If the ICB intends to make substantial changes to the way it delivers services, it must conduct a public consultation and must meet the test to ensure that all proposals are proven to be in the interests of patients and the wider public. I know that the hon. Gentleman will be meeting the ICB in a few weeks, and I am sure that he will continue to make his points to it; I suspect that it is watching or listening to our proceedings. I am sure that he would agree that it is for the people locally in Solihull to determine how their interests are best served. Ministers cannot impose views above the heads of the local ICB. Those decisions are best made in Solihull by people who live in Solihull and not in Westminster. Therefore, what I can do—what the Government are doing—is give ICBs the means to deliver services while undertaking fundamental reform of how those services are delivered. The hon. Gentleman is therefore doing exactly what he should do as an experienced Member of Parliament and making his case to the local ICB. I am sure that it will have heard him this evening and that his voice will be important in representing his constituents. The hon. Gentleman was entirely right to raise population growth and planning, which was also mentioned by the hon. Gentleman’s neighbour, the hon. Member for Solihull West and Shirley (Dr Shastri-Hurst). We are committed to house building, unlike his Government; it is important that that goes ahead. That does put pressure on services. Unfortunately, under the previous Government, developments were not going ahead because of the issue of infrastructure. That is something that we are addressing. The disconnect between ICBs and local authorities must change—the situation with vital infrastructure such as schools and hospitals has gone on for far too long—which is why we are committed to working with colleagues at the Ministry of Housing, Communities and Local Government to ensure that planning includes basic infrastructure. The Secretary of State for Health and Social Care has regular meetings with the Deputy Prime Minister to ensure that we are all pulling in the same direction on that. Communities across the country, including the hon. Gentlemen’s constituents in Solihull, are struggling with poor services and crumbling estates. We are putting record capital funding into the NHS while reforming services to ensure that every penny of that money is spent well. We will return to 95% of patients being seen within four hours at A&E, we will get waiting lists back down to where they were in 2010, and we will fix the front door to the NHS with the GP services that all our constituents deserve. It will take time, but we will deliver an NHS and national care service that provide people with the care they need when they need it, and we will continue to work with all hon. Members across the House to ensure that that happens.

• 23 Jan 2025 · Rare Retinal Disease · Hansard source

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  It is a pleasure to serve under your chairmanship, Dame Siobhan. I start by thanking the hon. Member for Strangford (Jim Shannon) for securing this debate on such an important issue and other Members for their contributions. Both the shadow Secretary of State and I are covering for other colleagues this afternoon, so hon. Members can imagine my joy when actual experts walked into the Chamber. The hon. Members for Leicester South (Shockat Adam) and for Torbay (Steve Darling), as has been said, bring great personal and professional expertise to this debate, so it was joyful to see them come in. It was good to hear from my hon. Friend the Member for Doncaster East and the Isle of Axholme (Lee Pitcher); the experience he brings through his wife is really valuable. My hon. Friend the Member for Battersea (Marsha De Cordova) has been such a champion of this issue both in her personal experience and since she came to the House. I understand that it is her birthday today, so I hope she is having a good time. She has brought great expertise to this place. I am going to do my best to answer the questions. I have been billed highly by the hon. Member for Strangford, and I am grateful for that. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Gorton and Denton (Andrew Gwynne), will write to hon. Members about anything that is outstanding. I would like to take time to acknowledge the experiences of those living with rare inherited retinal diseases and their families, who I know will be paying attention to this debate. I pay tribute to all those who work tirelessly to raise awareness of rare conditions and bring about change. Although rare diseases are rare individually, their impacts are far-reaching. One in 17 people will be affected by a rare condition over their lifetime; that is around 3.5 million people in the United Kingdom. As the hon. Member for Strangford said, rare inherited retinal diseases affect around 25,000 people in the UK and collectively represent a leading cause of sight loss in working-age adults. We recognise the impact that these conditions have on patients, families and wider society and the need for innovative approaches to tackle these changes. The Government are committed to improving the lives of people with rare conditions. The hon. Member for Torbay used that quote about providing opportunity, support and determination for people. The UK rare diseases framework outlines four priorities to achieve this aim: helping patients get a final diagnosis faster; increasing awareness of rare diseases among healthcare professionals; better co-ordination of care; and improving access to specialist care treatment and drugs. In England, our annual rare diseases action plan sets out the steps we are taking to meet those priorities. We continue to make progress and are working to finalise our next England action plan for publication this year. It is vital that NHS patients with rare diseases are able to access innovative new treatments as they become available. That includes those with progressive retinal diseases, where early intervention is crucial to preserve sight. Under England’s action plans, NICE, the Medicines and Healthcare products Regulatory Agency and NHS England are working to understand and address the barriers to access for rare diseases treatment. The hon. Member for Strangford asked a number of questions about NICE’s approach that I hope I will cover. NICE does a difficult job well, in my view, and we think its approach is appropriate for the evaluation of treatments for rare diseases. NICE recommended 84% of medicines for rare diseases evaluated through its standard technology appraisal programme in 2023-24. That is comparable to its approval rate for medicines for more common conditions. Those treatments are now available for the treatment of NHS patients. NICE also operates a separate, highly specialised technology programme for the evaluation of a handful of medicines for very rare diseases each year that recognises the challenges of bringing treatments for very rare diseases to market. NICE recommended the gene therapy Luxturna for a type of inherited retinal dystrophy through that route. One of the recipients of that groundbreaking therapy on the NHS has spoken of his gratitude for the positive effects of the treatment on not just his vision, but his confidence and independence. NICE is also in the process of reviewing the criteria for routing topics to its highly specialised technologies programme, which the hon. Member for Strangford asked about. That review will ensure that future routing decisions are more transparent, consistent, efficient and predictable. As part of that process, NICE has launched a public consultation on its progress. I encourage the rare diseases community and hon. Members interested to continue to engage with that process. Research offers a way to accelerate access to new and innovative treatments. Through the National Institute for Health and Care Research, the Government support rare diseases research. There are currently eight active research projects on rare retinal disease funded by the NIHR, with a combined value of over £6 million. The NIHR also invests in infrastructure to support and deliver research studies. The NIHR Moorfields Biomedical Research Centre, which is dedicated solely to vision research, has made significant strides in the field of rare retinal diseases. By harnessing genomic data, the BRC has developed effective treatments, including gene-replacement therapies for inherited retinal disorders. The NIHR is also working closely with commercial companies to bring new medicines and technology to patients. To connect people living with rare diseases to innovative treatments and sources of support, we need to diagnose these conditions as early as possible. The UK is a world leader in genomic diagnosis. Patients in England have access to whole genome sequencing on the NHS. Advances in genomics mean that new causes of rare retinal diseases are being found every year. As part of Genomics England’s generation study, we are harnessing the power of genomic sequencing to screen for over 200 rare genetic conditions that can be treated in the NHS in early childhood to improve outcomes for babies and their families. That includes the rare retinal disease RPE65-associated Leber congenital amaurosis, which can be treated with Luxturna. A central mission of this Government is to build a health and care system fit for the future. The 10-year health plan will ensure a better health service for everyone, regardless of condition or service area. The plan will focus on our three shifts for a modern NHS: moving from hospital to community, analogue to digital and sickness to prevention. All three offer opportunities to improve time to diagnosis and care for people living with rare retinal conditions. The shift from analogue to digital will enable innovative uses of data to improve diagnosis and measure treatment outcomes, while NHS ocular genetics services’ use of video consultations continues to widen patient access to specialist advice, in keeping with the shift from hospital to community. Although many rare diseases are not preventable, early diagnosis, as we have heard, can lead to timely interventions that improve health outcomes. I will outline the treatment pathway for rare retinal diseases. I am thankful for the role played by high street optometrists, some of them here today, in helping to identify patients with sight-threatening conditions. There is good availability of NHS sight-testing services, with over 12 million free NHS sight tests provided to eligible groups annually, including children, individuals aged 60 and over, and those on income-related benefits. Optometrists are required to refer any patient showing signs of injury, disease or abnormality and integrated care boards have been asked to ensure that there are direct referral pathways in place between community optometry and secondary care. As the hon. Member for Leicester South said, the eyes are the gateway into other health conditions. Optometry has a very important role. As one of the busiest outpatient specialties with one of the largest waiting lists, we know that ophthalmology is facing huge challenges and we are working hard on how we can help to build capacity. NHS England is looking at how digital connectivity could improve the triage of patients referred between primary and secondary care. That would allow for images to be shared, and specialist advice and guidance could help to keep patients in the community where possible. We recognise the importance of access to emotional and practical support, especially where treatment may not be available. A diagnosis of sight loss will have a profound impact on any individual, who will be at increased risk of stress, anxiety and depression. NHS England’s patient support toolkit for eye care commissioners and providers aims to ensure that patients with ophthalmic conditions or sight loss are supported throughout their care journeys. The RNIB patient support pathway aims to strengthen that and ensure that support and guidance are available to patients from their first eye care appointment through to having a confirmed diagnosis, and then right the way through to living well with their condition. I know that the work of the all-party parliamentary group on eye health and visual impairment and of other hon. Members will help in giving those people a powerful voice. As we work towards building a health care service fit for the future, it is vital that people living with rare diseases are not left behind. With the UK rare diseases framework coming to an end in 2026, we will look to build on the progress made over the past five years, which the shadow Secretary of State mentioned. We will work with colleagues in the devolved Administrations, as highlighted by the hon. Member for Strangford. We have commissioned an evaluation of England’s rare diseases action plans through NIHR and will also be undertaking engagement this year to inform future policy decisions. The Government are deeply committed to working across the health and social care system and with the rare diseases community to improve the lives of those with rare conditions. Once again, I thank the hon. Member for Strangford for raising this important matter. It is good to have high interest, expertise and experience in this place. We want to work with colleagues here and we thank the rare disease community for their valuable ongoing engagement with us to bring about meaningful change.

• 22 Jan 2025 · New Hospital Programme · Hansard source

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  I thank my hon. Friend; I am happy to take interventions, but I need to finish by half-past 4, so I am conscious of time. He is absolutely right, and I will come on to his point. We need to be very clear and honest with people about what was ready and about the different stages of these programmes, which we are very keen to do. Staff and patients deserve better. That is why the Secretary of State asked officials to review the programme and put it on a firm footing with sustainable funding so that all the projects can be delivered. I thank the hon. Member for Bexhill and Battle for his service to the NHS and his experience. I agree that it is appalling for staff. We all understand that he and I disagree in our political analysis, but he made some really well-informed points about models of care and future models of care, all of which we need to take into account in the delivery of this programme and other parts of the capital programme—and we will. As the Secretary of State announced to the House on Monday, we now have a realistic plan to deliver the programme. I am pleased that we can be honest with people as we start a new chapter setting out a new commitment to deliver these hospitals, which are so important to all our constituents, that is realistic and backed with funding. We have worked closely with the Treasury to secure five-year waves of investment, backed by £15 billion of investment over consecutive waves, averaging £3 billion a year. This will ensure a balanced portfolio of schemes at different development stages being delivered now and into the future. The new delivery plan sets out the order and the waves of investment in which each new hospital will be constructed. Hospitals included in a wave will begin construction, while forthcoming schemes will be undertaking pre-construction work to prepare planning permission and secure business cases. With this approach, we can ensure that schemes are ready to be built as soon as possible. A list of the schemes in each wave has been published on gov.uk and in the plan for implementation. For reference, I will briefly outline the timeline for delivery. [Interruption.] Actually, I think we have seen all the waves, and the hon. Gentleman wants us to move on to Bexhill and East Sussex.

• 22 Jan 2025 · New Hospital Programme · Hansard source

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  I thank the hon. Gentleman for his intervention. We had a good discussion yesterday about North Devon; I understand the rurality of that location, as it is fairly close to my Bristol constituency. Obviously, however we manage it, there are a lot of schemes represented by a lot of MPs. I am open to suggestions about how we go forward. I hope hon. Members feel that we have tried to give as much information as we can to them and the trusts in the announcement and the meetings yesterday. That is the spirit in which we will continue.

• 22 Jan 2025 · New Hospital Programme · Hansard source

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  I thank my hon. Friend for her intervention, which highlights the point that the hon. Member for Bexhill and Battle raised about other capital plans and programmes to help his constituents and others over the coming years. In conclusion, I thank the hon. Gentleman for raising this issue.

• 22 Jan 2025 · New Hospital Programme · Hansard source

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  I thank the hon. Gentleman for that intervention. We learned a lot yesterday from the expert team from the new hospital programme; I thank them for their incredible work in getting to this point. Those colleagues who could make the meetings yesterday found that the team’s knowledge about every single programme was phenomenal. I have yet to ask the team a question about any scheme to which they do not know the answer—I give hon. Members that confident assurance. The team includes colleagues from both NHS England and the Department. When I went to an assurance meeting a few weeks ago, I learned that the relationship between the central control of the programme and the trusts, how we get the schemes delivered for everyone’s constituents, and the value of parliamentarians talking to me—everyone has stopped me in the corridors to raise these issues—are all very valuable. That is a good function of parliamentarians. That is the spirit in which we want to continue. Our commitment is to deliver these hospitals, including the Eastbourne district general, Conquest hospital and Bexhill community hospital schemes, and I am pleased to say that we have an affordable, deliverable plan to do so. It will be difficult, but I look forward to working with the hon. Member for Bexhill and Battle and other colleagues.

• 22 Jan 2025 · New Hospital Programme · Hansard source

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  I will pick up that point. Wave 3, which is what the hon. Member for Bexhill and Battle has secured this debate on, includes schemes that were always part of a post-2030 plan. We now have the confirmed dates. The East Sussex new hospital scheme for East Sussex healthcare trust includes, as the hon. Gentleman says, new buildings and refurbishments at Eastbourne district general hospital, Conquest hospital and Bexhill community hospital. The scheme is in wave 3 of the delivery plan, and construction will commence between 2037 and 2039. We understand that this is disappointing news to some people who were expecting and were told that their hospital would be built earlier, but we can assure them that there is now a credible and funded plan for delivery—no more false promises. Our priority now is to get on and deliver these new hospitals for the benefit of the staff and patients who so vitally need them. We understand the importance of these schemes to local communities and the need to invest in health infrastructure. We will continue to engage with trusts—including Watford, which the hon. Member for South West Hertfordshire (Mr Mohindra) mentioned—over the next few years to establish whether there are any other activities that can be progressed during the spending review. We will be in discussions with all those trusts to understand mitigations in the meantime. That was the source of many questions that came up in the many meetings that I held with hon. Members yesterday. I understand that all these hospitals are critical—they would not be on the list if there were not a major problem with them—so we need to talk to the trusts about how we manage the process in the meantime. I acknowledge that this will be a difficult time for the core teams and all the people who have been working on these schemes, many of which will be stood down. Their expertise and knowledge is extraordinarily valuable. I know that the programme teams will make efforts to ensure that expertise is retained where possible and used to develop the wider programme. The trust is currently developing its strategic outline case, as per the business case process set out in His Majesty’s Treasury’s Green Book. Following the review and approval of the SOC, the next step will be the development, review and agreement of the outline and full business case. I understand that many areas, including Bexhill, have plans for housing to accommodate a growing population. My Department will work closely with integrated care boards and the Ministry of Housing, Communities and Local Government to ensure that those communities have the health provision that they need. Beyond establishing a credible programme, we are taking steps to restore people’s trust through honesty and transparency. We will be setting out further information for each scheme shortly, to ensure a more open way of working and collaborative programme delivery. Yesterday, I held meetings with Members of Parliament from all waves of the process to give them the opportunity to ask more detailed questions about their individual schemes, and to give them the clarity that their constituents deserve. Letters have also been issued to the trusts. That was a very successful way of working; I certainly learned a lot about the individual schemes. Members of Parliament of all parties came to talk about their schemes. I gave a commitment that I would continue to talk to colleagues about them. I absolutely offer the same to the hon. Member for Bexhill and Battle. I will work with Members’ trusts to understand the detail on the ground.

• 22 Jan 2025 · New Hospital Programme · Hansard source

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  I thank my hon. Friend for his continued campaigning on behalf of the residents of Hillingdon; I used to be one of them. Talking to people is really important, and we have learned a lot from it. In case I have not outlined this enough, let me be clear that all our constituents who are on the programme are in severe need. The programme has looked at clinical need and deliverability. We understand how difficult these choices are, so I thank my hon. Friend for that intervention.

• 22 Jan 2025 · New Hospital Programme · Hansard source

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  If the hon. Member for Bexhill and Battle, whose timing is superb, wants to make an extra point, I will give him the courtesy of a chance to come back in.

• 22 Jan 2025 · New Hospital Programme · Hansard source

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  It is a pleasure to serve under your chairship, Dr Huq. I congratulate the hon. Member for Bexhill and Battle (Dr Mullan) on securing a debate on this important matter. I commend his timing in getting this debate two days after an announcement that nobody else knew about. If he were a Labour MP, there would be howls of “Fix!” There has been a lot of back and forth, but I want to confirm that we pledged to support this programme, and we are supporting it. That is what Monday was about—let us be in no doubt about that. I was part of the largest capital programme in the NHS when I served as a non-executive director under the last Labour Government; this will be the next largest capital programme, delivered under this Labour Government. As Lord Darzi noted in his investigation, the hospitals that we rely on are deteriorating after the NHS suffered years of under-investment. This Government inherited a programme to deliver new hospitals that was unfunded beyond March 2025 and was repeatedly delayed, with no credible delivery plan.

• 22 Jan 2025 · New Hospital Programme · Hansard source

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  We absolutely will. This is one of the advantages of the waves: we recognise, and everybody knows, that there are sometimes unavoidable delays to schemes, perhaps to do with the sites, but the advantage of the pre-construction work and our knowledge of the sites is that most of that should be built into the programme and the timing. But life happens. One of the central issues for the programme is capacity in the construction arena, as well as across the country, in terms of developing primary estate to get these things done. The advantage of the waves is that they give us flexibility if things move, as they inevitably will—that is life. We very much want to keep up relationships with local trusts and inform them. That will be difficult, as my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) says, but that is the spirit in which we want to continue. I give him and other colleagues that absolute commitment. Question put and agreed to.

• 21 Jan 2025 · Welfare of Doctors · Hansard source

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  I will of course adhere to your instruction, Sir John. I am grateful to my hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley) for bringing this important topic to the House. I know it is close to his heart, as a working doctor. I thank him for his continued dedication to the NHS, as a surgeon and an MP, and I thank his family, too, for their dedication to it. We welcome the knowledge and expertise that he has already brought us, and he has done so again powerfully today. What a lovely memento he has of his own father’s service. I thank my hon. Friend for highlighting the incredible role that resident doctors play in our NHS. We absolutely recognise the challenges that they face as they progress through postgraduate training. We are committed to giving them the support that they need to develop and thrive in the NHS. My hon. Friend spoke passionately about the welfare of doctors. Let me acknowledge, as I know he would, the tireless professionalism and dedication that all health professionals show across the NHS daily. The NHS is broken, but we have a plan to fix it. In his investigation into the state of the NHS last year, Lord Darzi identified that this Government have inherited an NHS that is in serious trouble, with record waiting lists, people struggling to see their GP, and quality of care often lagging behind other countries. He found that too many staff are disengaged, that levels of sickness absence are worryingly high, and that many people working in the system are still exhausted from the pandemic and its aftermath, which has resulted in “a marked reduction in discretionary effort across all staff groups.” The Government completely agree with that assessment. We are on a mission to fix our broken NHS by driving fundamental reform to bring our analogue health service to the digital age. Through our 10-year health plan, we will cut waiting lists, reduce waiting times and get the health service delivering for patients and staff once again. Those ambitions will be possible only thanks to the hard-working staff, so it is essential that doctors and others are properly valued, supported and looked after at work. Employers across the NHS play a pivotal role in looking after doctors. Strong and effective leadership is fundamental to building a healthy organisational culture and too many NHS organisations are falling short in that regard. I have been shocked to hear stories, some of which we have heard again today, about the lack of support received by resident doctors, whether on shift patterns and rota changes, access to rest breaks while on duty, or really basic things that we should expect from any employer, such as hydration and the provision of decent food. We have heard about people sleeping in cars and not being able to go to a close relative’s wedding or to be the best person at their best friend’s wedding. It is unbelievable, really, and it cannot continue. It has to improve. We expect better from trusts and employers and we will make sure that that happens. We brought an end to the industrial action by resident doctors that was impacting the NHS’s ability to deliver a good-quality service and having such a corrosive effect on the morale of the workforce. As part of that deal, resident doctors and dentists in training received an average uplift of just over 4% into the 2023-24 pay scales, on top of the average 8.8% uplift they received for 2023-24. The Government have committed to improve the current exception reporting process, and to work in partnership with the BMA and other health organisations to review the current system of training, as my hon. Friend the Member for Bury St Edmunds and Stowmarket highlighted, and rotational placements. That is in addition to the work being undertaken by NHS England to improve working lives. We want to work with the unions on the key issues that doctors face on the frontline, and improve their working lives. That applies to all NHS staff. For example, we are working at the moment with the BMA resident doctors committee to improve the exception reporting process. We know that is important to residents, and we agreed to address it as part of their pay deal. It is vital that we look after the health and wellbeing of the whole NHS workforce. High-quality care and support for patients cannot be effectively provided without a compassionate and inclusive working environment. My hon. Friend listed a number of actions, some of which are more easily addressed than others. We would expect many of them to be included as part of a supportive culture in trusts. I accept that some are more challenging and involve discussions with NHS England, the Government and trusts, but I do not think that many are beyond local trusts and systems, working with the profession, to resolve. The mental health of doctors and all NHS staff is incredibly important. We saw the strain and trauma placed on staff during the pandemic. They do so much for patients, and we owe it to them to ensure that they are properly supported in return. The NHS offers occupational health and wellbeing services for staff when they need them, but provision can be patchy. There is a drive to improve the quality of those services across the NHS. Not only can that reduce sickness absence and improve retention, but proactive and preventive occupational health can lead to improvements in productivity and, in the long run, save taxpayers money. Access to specialist mental health support is important. I know that services such as the practitioner health programme, which we have heard about this afternoon, are highly valued by many doctors. NHS England is currently reviewing the mental health and wellbeing support available across the NHS, and looking at how it can be made more equitable and sustainable. There is no doubt that we need to continue to improve the mental health support available to NHS staff, and I look forward to seeing the outcome of that review. NHS England is also moving forward with a joint initiative with NHS charities to invest £10 million in health and wellbeing initiatives for staff. That will provide grants for better facilities and invest in improved wellbeing support. I want to make a point about violence, which I do not think my hon. Friend particularly highlighted in his speech. Sadly, the threat of violence in the workplace is another thing that NHS staff are dealing with, as we saw in last week’s horrific assault in Oldham—I extend my wishes to the nurse and her family for a speedy recovery, as I know we all do. I reiterate that the Government take a zero-tolerance approach to that type of behaviour. Doctors, nurses and all healthcare workers are the backbone of our NHS and should be able to care for patients without any fear of violence or abuse. At a national level, NHS England is focused on improving workplace experience, with the NHS people promise and the NHS retention programme addressing the issues that matter to staff, whether that be improving opportunities for flexible working, tackling racism and discrimination, preventing and reducing violence in the workplace, or improving facilities so that staff have the basic opportunity to rest and recover. Resident doctors face many challenges as they progress through postgraduate medical training, as my hon. Friend outlined. Expanding access to less than full-time training, rationalising and reforming statutory and mandatory training, and increasing choice and flexibility in rota management are just some of the things we are looking to do to improve their working lives. We are also working with NHS England to support the GP workforce, including with measures to boost recruitment, to address the reasons why doctors are leaving the profession and to encourage them to return to practise. The NHS is working to address training bottlenecks, so that there are enough GPs for the future and patients can get the care they need. We have provided £82 million of additional funding for 2024-25 to address GP unemployment and support the recruitment of more than 1,000 new GPs. In conclusion, through the 10-year plan, we are engaging widely with staff, patients and the public and listening to their views on how we need to reform and modernise the NHS. That applies equally to the NHS as an employer. Our ambition is for the NHS to become a modern, innovative and supportive employer. That is a necessity if we are to continue to attract and retain skilled and experienced professionals, give them the support they deserve as they care for the nation, and build a robust and resilient NHS. I look forward to working with NHS England. My hon. Friend the Member for Bury St Edmunds and Stowmarket will bring great expertise to this work in the House, as will Members more broadly, to make it a reality. Question put and agreed to .

• 16 Jan 2025 · Medicines and Healthcare Products Regulatory Agency · Hansard source

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  I congratulate the right hon. Member for Tatton (Esther McVey) on securing this debate and thank her and all those who have spoken for their contributions. We have heard some powerful stories of failure as well as some useful experiences. I have to thank my hon. Friend the Member for Stroud (Dr Opher), the hon. Member for Dewsbury and Batley (Iqbal Mohamed) and the shadow Minister for sharing their expertise. I have heard many of these stories before in my 10 years in this place. Sadly, I have also had a constituent who shared her experiences with me, for which I am grateful. Frankly, those experiences shocked me and my staff. I congratulate my hon. Friends the Members for Camborne and Redruth (Perran Moon), for Washington and Gateshead South (Mrs Hodgson), for Poole (Neil Duncan-Jordan), for Bolton South and Walkden (Yasmin Qureshi) and many others who have brought their experiences to this place, shining a light on the issues. It is right for us to debate this matter. Six months into the job and I am still learning, Madam Deputy Speaker, so I am grateful for being able to take part in this debate. I can assure my hon. Friend the Member for Blackley and Middleton South (Graham Stringer) that I cannot answer everything, and I am glad that he recognised that. The right hon. Member for Tatton has focused my mind, for which I am very grateful. If I do not do justice to the points that have been raised, I will write to Members about specific things. I am meeting representatives from the MHRA and will be very clear about our expectations. It is absolutely the role of Parliament to be the ultimate monitor of its work. The MHRA plays a vital role in fulfilling the Government’s health mission: balancing its responsibilities to maintain product safety and championing innovation. I will, if I may, be clear about the role of an enabler. It is about enabling innovative products to reach patients without compromising patient safety and without unnecessary delay. It is thanks to vaccines and medicines such as antibiotics and modern surgical procedures that we are living longer, healthier, and more active lives. No medical product is completely free of risk; the main objective of the safety monitoring process is to identify any new risks that may emerge. When that happens, the MHRA must take its responsibility seriously, rigorously and transparently when balancing population risks and benefits of each medical product, taking prompt and decisive action whenever that is needed. On supporting safety, the MHRA recognises the need constantly to seek to improve its safety monitoring systems to deliver better results for people. Recent improvements include implementing the new Safety Connect IT system, following recommendations from the Cumberlege Review. This IT system will improve the efficiency of reporting and processing of yellow card reports, much of which we have heard about today, supporting the prompt identification and assessment of new safety concerns. In addition, the MHRA makes use of real-world data via the clinical practice research datalink, which collects anonymised patient data from a network of GP practices, across the UK, encompassing data from 60 million patients, including 18 million currently registered patients. The MHRA has recently launched a pilot, in partnership with Genomics England, to create a rich source of genetic information to investigate the role of genetic pre-disposition in the development of serious adverse drug reactions. The aim is to establish a yellow card biobank to reduce the number of harmful side effects caused by medicines—a step towards personalised prescribing. The Cumberlege review also highlighted the need to improve the regulation of implantable medical devices. In November last year, the Government introduced new regulations to strengthen the requirements for manufacturers to proactively monitor and report on medical devices once they are on the market, which was noted by my hon. Friend the Member for Washington and Gateshead South. We plan to lay further reforms before Parliament this year, including unique device identifiers and implant cards to improve the traceability of implanted devices, as well as increasing the classification of devices to ensure that they receive the highest scrutiny throughout their lifetime. Finally, the MHRA has made some progress in response to the wider set of recommendations set out in Baroness Cumberlege’s report. It listened carefully to the people who gave evidence and to the review’s findings, and is committed to bring about those changes. It is our job to ensure that that happens. The yellow card scheme provides the backbone of our safety monitoring system. The scheme relies on voluntarily reporting from patients, parents, caregivers and healthcare professionals. The MHRA also collects reports of suspected safety concerns involving defective, falsified or fake healthcare products. Last year, it assessed more than 118,000 reports, and identified 134 safety signals, but I take onboard the comments made today. When safety signals lead to confirmed risks, the MHRA can introduce specific risk minimisation measures, such as introducing particular warnings about the risk of side effects in the product information, restricting the use of the medicine or medical device, or suspending or removing the medicine or device from the market. The MHRA will continue to proactively encourage the reporting of adverse effects through improvements such as those within the new Safety Connect system, and will ensure that there are better connections between clinical systems, working with the wider healthcare system. The MHRA recognises that there have been delays in some of the regulatory services that it provides, including licence applications for innovative and generic medicines, variations to licences, and inspections of manufacturing and laboratory premises. Since September 2024, all new applications for marketing authorisations of established medicines are being assessed within expected timescales. That element is therefore improving, but we will keep a close eye on it. I reiterate my thanks to the right hon. Member for Tatton. This has been an informative and, bizarrely, a wide-ranging but focused debate. Trust is really important. Patients have to be at the heart of our work, and that of the MHRA. Patient safety is the foremost priority. The MHRA is continuing to work on improving engagement and involving patients in decision making throughout the life cycle of the products that it regulates. It will continue to work to facilitate patient access to new medicines and medical devices, in collaboration with health system partners across the UK. The regulator maintains its focus on continuous improvement, and has implemented new ways of working to maximise productivity in ways that put patients and public health outcomes first. I take the point made by the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), that communication around that is key. The MHRA has turned around performance on clinical trials and is on track to deliver all regulatory services within statutory timelines by the end of March 2025. Later this year, as part of its programme of reform, we will introduce new point of care manufacturing legislation that will make the MHRA the first regulator in the world to introduce a tailored framework for innovative manufacturing methods, taking the manufacture and supply of medicines to patients. It is truly an exciting development, and I pay tribute to those involved. The process for recruiting the new chief executive is well under way. We welcome Professor Anthony Harnden. His strategic focus is on helping the organisation to protect patient safety through robust surveillance systems, embracing risk-proportionate regulation and fostering an inclusive workplace where people flourish. Without putting him on the spot, we should think about organising a parliamentary event of some sort to bring people together to discuss matters with the MHRA and build that trust. I am pleased to support its work. It is internationally recognised as a regulator. We want to do better. The Government will ensure that the MHRA is better.

• 15 Jan 2025 · Endometriosis: Women in the Workplace · Hansard source

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  I congratulate my hon. Friend the Member for Sheffield Brightside and Hillsborough (Gill Furniss) on securing this important debate on the impact of endometriosis on women in the workplace. In opposition I supported the work of the APPG. I echo the praise for the campaigning work of Endometriosis UK and the support that you, Madam Deputy Speaker, and others in the Chamber have given to the APPG. I also remember the work of our friend David Amess. I echo the recognition of the recent report by the Women and Equalities Committee on reproductive health conditions. My Department is working across Government on our response, which will be published in due course. I welcome the progress made on raising awareness—we are moving very fast on this—and on providing better support for women’s health conditions, including endometriosis. Nevertheless, this Government recognise that women with endometriosis have been failed for far too long, and we acknowledge the impact that it has on women’s lives, relationships and participation in education and the workforce. There is still much more work to be done. We are committed to improving support for any women and girls whose periods or women’s conditions disrupt their normal life, work or education. In addition to receiving support in the workplace, all women should have access to healthcare support to help diagnose and manage this condition. We are making progress to ensure that those with endometriosis receive a timely diagnosis and effective treatment.

• 15 Jan 2025 · Endometriosis: Women in the Workplace · Hansard source

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  I thank the right hon. Gentleman for that point, which I will talk about later. On the Employment Rights Bill, our plan to make work pay sets out a significant and ambitious agenda to ensure that workplace rights are fit for a modern economy, empowering working people and contributing to economic growth. On 10 October, the Government fulfilled their manifesto commitment to introduce legislation within 100 days of entering office, by introducing the Employment Rights Bill. As part of the Bill, we are taking the first steps towards requiring employers to publish action plans alongside their gender pay gap figures. The relevant clause sets out that regulations may require employers to develop and publish action plans relating to gender equality, which include measures to address the gender pay gap and support employees going through the menopause. It deliberately does not provide an exhaustive list of matters related to gender equality, giving us the scope to be led by the actions themselves. This reflects the fact that many of the actions employers take will be beneficial for people in a lot of different circumstances; for example, improved provision of flexible working can be valuable for an employee balancing childcare as well as someone managing a health condition such as endometriosis. In the same way, ensuring that employers support staff going through the menopause will necessitate them taking steps that are positive for supporting women’s health in the workplace more broadly. For example, menopause best practice includes greater discussion around women’s health and awareness of potential workplace adjustments—things that have a much wider potential benefit. As my hon. Friend said, we need to start to reduce the stigma and taboos and remove them from the debate. Through the Employment Rights Bill, the Government are also making statutory sick pay payable from the first day of sickness absence. This will particularly benefit those who suffer from conditions such as endometriosis, who may need to take time off to manage a flare up. We are also removing the lower earnings limit and extending statutory sick pay to up to 1.3 million additional low-paid employees, particularly benefiting women, young people and those in part-time work. The Minister for Equalities, my hon. Friend the Member for Llanelli (Dame Nia Griffith), leads for the Government on the Bill from the equalities team, and I can assure my hon. Friend the Member for Sheffield Brightside and Hillsborough that we are working with her and talking about this issue throughout the Government. For example, I regularly join Women and Equalities questions here in the Chamber to make sure we work closely together, and I will continue to work closely with colleagues on these issues. The new measures we are seeking to introduce build on existing Government support for employers, which recognises their key role in increasing employment opportunities and supporting disabled people and those with health conditions to thrive as part of the workforce. The Government’s current offer to employers includes a digital information service that provides tailored guidance to businesses to support employees to remain in work. That includes guidance on health disclosures and having conversations about health, as well as guidance on legal obligations including statutory sick pay and reasonable adjustments. The service is available across Britain and can currently be accessed from a range of trusted locations, including both the Health and Safety Executive and ACAS websites. We are also taking steps to better understand the challenges faced by women with endometriosis in the workplace and to improve workplace support for those with the condition. The Government health and wellbeing fund has awarded almost £2 million to 16 voluntary, community and social enterprise organisations leading projects focused on supporting women who experience reproductive health issues to remain in or return to the workplace, including a project on endometriosis delivered by Endometriosis UK. An Office for National Statistics study is investigating the impact of endometriosis on women’s labour market outcomes. This important study will be a vital step to improving our understanding and will inform future actions policy work. The first publication in this research project, on the characteristics of women diagnosed with endometriosis in England between 2011 and 2021, was published in December. In addition to providing workplace support for endometriosis, the Government are committed to improving healthcare support and ensuring that women with endometriosis can receive timely diagnosis and treatment. We recognise that patients have been let down for too long while they wait for the care they need. Nearly 600,000 women are on gynaecology waiting lists. It is unacceptable that patients are waiting too long to get the care they need. I thank my hon. Friend the Member for Sheffield Brightside and Hillsborough for her sympathy with the task of reducing those lists, but that is our priority. Cutting waiting lists, including for gynaecology, is a key part of our health mission and a top priority for this Government. We have committed to achieving the NHS constitutional standard that 92% of patients should wait no longer than 18 weeks from referral to treatment by the end of this Parliament, and that absolutely includes those waiting for gynaecology treatment. My noble Friend Baroness Merron, the Minister responsible for patient safety, women’s health and mental health, and I recently met with the Government’s women’s health ambassador, Professor Dame Lesley Regan, and NHS England to discuss progress on women’s health and current issues including gynaecology waiting lists. Following that meeting I am pleased that our recently published plan for reforming elective care sets out commitments to support the delivery of innovative models in gynaecology offering patients care closer to home and piloting gynaecology pathways in community diagnostic centres for patients with post-menopausal bleeding. Enabling access to adequate healthcare support begins with providing high-quality education and information on menstrual health, as the right hon. Member for Wetherby and Easingwold (Sir Alec Shelbrooke) highlighted, so that women and girls know when and how to seek help for symptoms such as heavy or painful periods. The compulsory aspects of the curriculum on relationships, sex and health education means all pupils are taught about several areas of women’s health, including menstruation, contraception, fertility, pregnancy and menopause. My right hon. Friend the Secretary of State for Education has committed to providing teachers with clear guidance that focuses on the wellbeing of children. Her Department will look carefully at all relevant evidence and engage with stakeholders, including young people and parents, ahead of publishing a consultation response and the revised guidance later this year. I am pleased that Dame Lesley Regan, in her role as women’s health ambassador, has been feeding women’s health perspectives into this work. My Department has worked with NHS England to improve and create new content on endometriosis symptoms, diagnosis and treatment options on the NHS website and YouTube channel. NHS England has also published a decision support tool for managing heavy periods to support women’s understanding of their symptoms and appropriate treatment options to discuss with clinicians. Education and clinical guidelines support healthcare professionals to provide care for women with endometriosis. The General Medical Council has introduced the medical licensing assessment for most incoming doctors, including all medical students graduating in the academic year 2024-25 and onwards. The content for the assessment includes several topics relating to women’s health, including menstrual problems and endometriosis, and will encourage a better understanding of common women’s health problems in all doctors as they start their careers in the UK, which we all want to see. Endometriosis is also already in the core curriculum for trainee GPs, obstetricians and gynaecologists. Last year, the National Institute for Health and Care Excellence published updated guidelines on the diagnosis and treatment of endometriosis, and the new and updated recommendations on referral and investigation should help women receive a diagnosis more quickly. Through the National Institute for Health and Care Research, the Department has also commissioned a number of studies focused on endometriosis diagnosis and treatment and patient experience. In closing, I thank my hon. Friend the Member for Sheffield Brightside and Hillsborough for tabling this debate and for her continued long-standing advocacy for women’s health. Let me affirm the Government’s commitment to supporting the many women who live with endometriosis in the workplace and beyond. This Government are committed to prioritising women’s health as we build an NHS fit for the future. My noble friend Baroness Merron is carefully considering how we take forward the women’s health strategy by aligning it to the Government’s missions and forthcoming 10-year health plan, and women’s equality will be at the heart of our missions. It is vital that we work with women to better understand their experiences and address their concerns, which have been ignored for far too long. Question put and agreed to. 7.27 pm House adjourned.

• 7 Jan 2025 · Mental Health Services: Children · Hansard source

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  The delivery of mental health services for children in Scotland is the responsibility of the Scottish Government. I hope that they will make the best use of the boost from the recent Budget to invest in mental health services. In England, we will support children and young people earlier by providing access to a specialist mental health professional in every school and rolling out Young Futures hubs in every community. We will also cut waiting times by recruiting 8,500 more workers across children and adult mental health services.

• 7 Jan 2025 · Mental Health Services: Children · Hansard source

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  Our plan is to have universal coverage in every school. That was not achieved by the previous Government, and we hope to ensure that it happens.

• 7 Jan 2025 · Mental Health Services: Children · Hansard source

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  My hon. Friend makes an excellent point on behalf of young people. It is disappointing that the Scottish Government do not seem to be allocating the funding as they could. He raises a powerful case, and I know that he will work hard with the Government in Edinburgh to make the situation better for his constituents.

• 7 Jan 2025 · Maternity Leave · Hansard source

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  My right hon. Friend highlights a problem throughout the system, not just in her area. Self-employed contractors to NHS GP surgeries are not bound by national terms and conditions; they can develop their terms and conditions as they see fit. They have the flexibility to set terms and conditions to aid recruitment and retention. We anticipate that good employers will set wage rates and terms and conditions that reflect the skills and experience of their staff. That is better for staff and for patients, and I know that she will continue to highlight that with her local employer. It is certainly something that we need to keep an eye on as we develop services further.

• 7 Jan 2025 · Maternity Leave · Hansard source

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  I thank my new Dame Friend for her question. The Department does not collect data on the number of people who have specifically received enhanced maternity leave entitlements. Access to an enhanced maternity leave benefit forms part of the total reward package for Agenda for Change staff, which we believe is critical for retaining our much-valued and needed NHS workforce.

• 7 Jan 2025 · Care Quality Commission · Hansard source

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  The hon. Gentleman makes an excellent point, particularly with regard to staff, who need support to continue their important work. A new start with new leadership is what they need, as well as implementation of the recommendations.

• 7 Jan 2025 · Care Quality Commission · Hansard source

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  My hon. Friend is right that confidence is the key word in the huge agenda that the CQC has to deliver. Dr Dash and Professor Mike Richards highlighted serious failings that need to be re-addressed. As one of our predecessors said, priorities are our language. Currently, a review of one or two-word ratings is not a priority, but it will be kept under review.

• 7 Jan 2025 · Care Quality Commission · Hansard source

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  In response to the report by Dr Penny Dash, we have made it clear that the CQC is not fit for purpose and requires significant reform. We have increased our oversight of the CQC to ensure implementation of the recommendations in Dr Dash’s review, and we will continue to monitor the CQC’s progress through this period of improvement. We are also supporting the swift and efficient recruitment of CQC leadership roles, including the new chief executive Julian Hartley, who started in December.

• 7 Jan 2025 · Topical Questions · Hansard source

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  My hon. Friend is right to highlight the particular problems in his constituency. Decisions on the configuration of call centres are a matter for local trusts in consultation with staff and representatives, and I encourage him to continue to engage with the trust in the interests of his constituents.

• 6 Jan 2025 · NHS Backlog · Hansard source

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  I wish you, Madam Deputy Speaker, and all hon. Members a happy new year. I thank the hon. Member for North Shropshire (Helen Morgan) for securing this debate. I am delighted to be able to respond. It has been a passionate and well-informed debate, and I am genuinely grateful for the opportunity to build on what the Secretary of State said in his oral statement today, because we have a great deal to say about our plans to build more capacity and give patients more power over their care. Colleagues across the House have set out how 14 years of failure have damaged their constituents, letting down the people we represent and breaking the NHS. That was starkly illustrated by my hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley), who should have been doing something else this morning but was not. That is a loss to his patients. It was also highlighted by the hon. Members for Epsom and Ewell (Helen Maguire) and for Wokingham (Clive Jones). The Lib Dem spokesperson, the hon. Member for Chichester (Jess Brown-Fuller), outlined how it impacts on her own father as well as her constituents. Years of neglect, lack of funding and unresolved industrial action meant that this Government inherited an appalling backlog of people waiting for treatment—the 7.5 million-strong waiting list. I gently remind the hon. Member for Farnham and Bordon (Gregory Stafford) and the Opposition spokesperson, the hon. Member for Sleaford and North Hykeham (Dr Johnson), that that waiting list stood at 4 million people before the start of the pandemic. The Darzi investigation described how these waits were becoming the new normal, with patients waiting far too long for treatment. As a result, public satisfaction with one of our most beloved institutions is at an all-time low. That was eloquently put by my hon. Friend the Member for Carlisle (Ms Minns), who highlighted the figures from 2010 and now, as they affect her constituents. On average, 58% of people do not receive treatment within 18 weeks of referral. The NHS constitutional standard sets out that 92% of patients should receive treatment within this timeframe, but that has not been met consistently for almost a decade. In other words, there are people today younger than me who would have no memory of the NHS working efficiently and delivering a timely service. Colleagues are right to point out the impact on our constituents, with people putting their lives on hold while they wait for a diagnosis, for a new hip or for eye surgery. If the human tragedy were not enough, the economic and social effects of waiting times are almost incalculable. That is why today the Prime Minister set out our plans to tackle hospital backlogs and finally meet the NHS standard of 92% of patients in England waiting no longer than 18 weeks for elective treatment. I confirm for my hon. Friend the Member for Bury North (Mr Frith) that that is an average. I also wish his grandmother well—that is unfortunate for her time of life, and I hope she is getting good care. Our elective reform plan sets out a bold package of productivity measures and reforms to deliver fundamental change for patients by building a health service defined by patient choice and patient control. I agree with the hon. Members for Runnymede and Weybridge (Dr Spencer) and for Farnham and Bordon about local accountability. My own comments on the 2022 Act, which I think the Government at the time should have done more on, are well-made. I regularly encourage all hon. Members to engage proactively with their ICBs. It is incumbent on ICBs to engage with elected representatives on behalf of all our constituents. I certainly have always done with mine, and I commend everybody else to do the same. Under our plan, NHS care will be increasingly personalised and digital. We will focus on improving experiences and convenience, empowering people with choice and control over when and where they will be treated. Different models of care will be more widely and consistently adopted, following on from the work by the hon. Member for Farnham and Bordon on Getting It Right First Time, which I also commend. We will roll out artificial intelligence and other technology to boost capacity and deliver excellent care consistently across the country. I will not have time to go into the details of all the drivers of the backlog, but we recognise the pressures on primary and community care and social care. That is why last month we were able to put forward proper proposals for a new GP contract, with extra money to slash red tape and bring back the family doctor—the biggest funding boost to primary care that we have seen. I have been really impressed by some of the fantastic work going on in women’s health hubs. We continue to welcome the cross-party support for our proposals on social care, and I hope we build that cross-party support for Baroness Casey’s work. Social care was highlighted by my hon. Friends the Members for Ashford (Sojan Joseph) and for Calder Valley (Josh Fenton-Glynn), among others. On the key drivers, in diagnostics we will reduce the waits for scanners by extending the work of community diagnostic centres to seven days a week. Patients will be able to receive same-day tests and consultations, direct referrals from primary and community care, new consulting rooms and at least 10 straight-to-test pathways by March 2026. Pathway improvements will get us only so far, though. We are also setting clear expectations that funding must be used responsibly to provide the best value for money for both patients and the taxpayer. That is why, under our plans, money will follow the patient and the organisations that do the best will get the most reward, so that incentives drive improvement. I will just say gently to the Opposition spokesperson that many places do offer online access—I get texts regularly from my hospital, because I, too, am a patient. However, it is not universal, and that was the Conservatives’ failure in government. We want to take the best of the NHS to the rest of the NHS. On cancer, the 62 and 31-day cancer waiting time standards were last met in 2015 and 2020 respectively. Cancer is a priority for this Government: cancer patients are waiting too long for a diagnosis and for treatment, and we are determined to change that. We will get the NHS diagnosing cancer earlier and treating it faster so that more patients survive. I assure the Lib Dem spokesperson, the hon. Member for Chichester, that we remain committed to all three targets. We know that swift diagnosis is key to improving outcomes and ensuring that patients get a diagnosis and treatment quickly, which is why expanding CDCs is a core plank of achieving those standards. We recognise that a cancer-specific approach is needed to meet the challenges in cancer care, which is why, after the 10-year plan, we will follow up with a dedicated national cancer plan, which will help us to go further for cancer patients. This Government are tackling challenges beyond routine elective care, such as the crisis in emergency care. Last month, a quarter of the 2.3 million people who attended A&E waited for more than four hours; in November, the average ambulance response time stood at 42 minutes, which is more than double the NHS constitutional standard. These figures do not come close to the safe operational standards set out in the constitution. It will take time to turn things around, but our action to quickly end the junior doctors strike means that, for the first time in three years, NHS leaders are focused on winter preparedness and not planning for strikes. NHS England has set out a national approach to winter planning and is managing extra demand, with upgraded 24-hour live data centres, strengthening same-day emergency care and offering more services for older people. As we have heard, mental health waiting lists are far too long. We want to build on our mission and ensure that we recruit 8,500 additional mental health workers to reduce delays. We will also provide access to specialist mental health professionals at every school in England, roll out young futures hubs in every community and modernise the Mental Health Act 1983. As the hon. Member for Guildford (Zöe Franklin) highlighted, young children and young families are being particularly badly affected. The Chancellor backed our plans in the Budget with an extra £5.6 million over the next two years to open new mental health crisis centres and help reduce pressure on A&E services.