Karin Smyth MP: speeches

Speeches

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  I am not abreast of all the Health Secretary’s tweets and the responses to them, but Caroline makes a point that has been made by many people in the Chamber today, as well as a number of providers. As I said in my opening statement, we understand the precarious situation that those providers have been put in because of the failures of the past 14 years and the £22 billion black hole that the Government have inherited. As my hon. Friend the Member for Shipley (Anna Dixon) said, general practice has been put in a precarious situation over the past 14 years, with thousands of practices going bust and giving back their contracts. That is a situation that we promised the British public we would change, and we will do so.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  I understand the concerns of the providers that have come to the hon. Gentleman, and he is right to raise them in this place. As he knows, health and social care is devolved to the Welsh Government, and there has been much benefit already from the Barnett consequentials of the Budget. We will continue to talk to the devolved regions—in, may I say, a much more co-operative way than the previous Government did—to ensure that we have a good system across the entire United Kingdom.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  I am grateful to the hon. Member for asking this important question. It gives me the opportunity to say to GPs, dentists, hospices and every part of the health and care system that will be affected by changes to employer national insurance contributions that this Government understand the pressures they face and take their representations seriously. The Chancellor took into account the impact of changes to national insurance when she allocated an extra £26 billion to the Department of Health and Social Care. There are well-established processes for agreeing funding allocations across the system, and we are going through those processes now with this issue in mind. This Government inherited a £22 billion black hole in the public finances, broken public services and a stagnant economy. Upon taking office we were told that the deficit the previous Government recklessly ran up in my Department alone would mean delivering 20,000 fewer appointments a week instead of the 40,000 more we promised. The Chancellor and my right hon. Friend the Secretary of State were not prepared to see further decline in our NHS. That is why we put in an extra £1.8 billion to stop the NHS going into reverse this year. We built on that at the Budget, delivering the significant investment that the NHS needs to get back on its feet, backing staff with investment in modern technology, new scanners and new surgical hubs, and rebuilding our crumbling primary and secondary care estate. Alongside that, we delivered a real-terms increase in core local government spending power of around 3.2%, which will help to address the range of pressures facing the adult social care sector, including £600 million in new grant funding for social care. We are now working through exactly how that money will be allocated, as per normal processes. As the Secretary of State set out yesterday, we will ensure that every pound is invested wisely to deliver the Government’s priorities and provide value to taxpayers. The Department will set out further details on the allocation of funding in due course, including through NHS planning guidance and the usual consultations, including on the general practice contract. As part of these processes, we will consider the impact of changes announced to employer national insurance contributions in a fair and open way over the next five months, before the changes come into force in April 2025.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  The hon. Lady tempts me to make specific commitments, which I am not prepared to do, as I am sure she understands. She is right that people are expressing concerns about some of these decisions. That is because they are in such a precarious situation as a result of what we have inherited from the past 14 years. As the Prime Minister and the rest of the Government have been clear throughout the election and afterwards, we have a 10-year plan because it will take a long time to fix the foundations and build up the sector to make it more resilient and sustain it for the future. We want to fix those foundations, and we will talk closely with everyone affected over the coming months, but this will take a long time. Those providers are precarious because of the mess that we inherited.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  My hon. Friend brings a great deal of expertise to the House from her work in social care, so she knows and understands the precarious nature of the sector, which we cannot stress enough. I do not know whether the Conservatives have actually read the report by Lord Darzi, but that report and its appendices give a really clear idea and diagnosis of the state in which the NHS and social care system was left. It will take a long time to rebuild it, and the sustainability of general practice and primary care is particularly problematic. That is why we took those actions in the summer, and why we will continue to support them and build up a neighbourhood health service.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  I understand the right hon. Gentleman’s point. As I have said, we will continue our conversations with all affected providers in the normal way.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  As I have said, we have made a commitment to general practice and primary care by releasing extra GPs into the system. We recognise the situation in which GPs find themselves. I know this because I worked with GP practices in my previous career. We need those practices to be the foundation of our neighbourhood services, which is why we will talk in the normal process about the allocations over the next few months as part of the contract.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  We understand the precarious situation that hospices are in—the precarious situation that they found themselves in before we came to power— and we are committed to talking to them and other affected providers. We will be going through the normal process of allocations in the next few months.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  The hon. Lady makes an excellent point about the importance of GPs and primary care to the wider sector. Immediately after taking office this summer, we freed up the system to employ 1,000 extra GPs through the additional roles reimbursement scheme—which the previous Government refused to implement—because we recognised the need for that extra capacity. We will be talking to general practice as part of the contract reforms over the next few months, following the normal process, to determine allocations for next year.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  Well, I do agree with my hon. Friend. As I have said, when I became a Member of Parliament in 2015, I remember very clearly the absolute shock that I felt when the Conservatives immediately announced that they were not going to meet the commitment that they had made to implement the Care Act 2014 at that time, and we are still playing catch-up on that issue.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  The right hon. Gentleman tempts me to go into my previous career working with GPs and their employment and contractual status, but I will not do that now, Mr Speaker, as you would rightly curtail me. GPs have a complicated contractual status that has been long in the process. We understand the precariousness of primary care. GPs are crucial to our plans for developing the health service, and we will discuss with them, in the normal process, the allocations for the following year.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  I respect my hon. Friend’s expertise in this area. She is right, and we understand that the pressures are real, which is why we have committed to supporting the NHS and the social care system with the additional funding that my right hon. Friend the Secretary of State for Health and Social Care secured as part of the Budget settlement. We are also working closely with the NHS, in a new relationship, to understand its needs. That is a dynamic conversation, because we want to understand what is happening in local systems as we continue to invest in them.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  I am sure that all those hospices, which do great work, were also in touch with the hon. Lady when she was part of the previous Government. She will know from her time on the Treasury Committee that following the Budget, we go through the planning guidance and have conversations with all core contracted sectors. That is part of the normal process. We are absolutely committed to building back the foundations of the NHS and social care system, making it fit for the 21st century and creating a 10-year plan to which we want everyone to contribute. Community and neighbourhood systems are a fundamental part of that.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  My hon. Friend is right: getting away from short-term fixes and sticking plasters is exactly what we are attempting to do. That is why we put in the extra security of extra GPs over the summer, committed to extra funding in the Budget, and launched our 10-year plan. I encourage all hon. Members and their constituents to submit their views to that exercise at change.nhs.uk.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  The right hon. Gentleman was part of the last Government—I am pleased to note that he is talking to his new constituents. The £22 billion black hole and the report from Lord Darzi indicate the fragility of the system we have inherited. We are ensuring that vulnerable groups are supported through the allocations provided to both the Department for Health and Social Care and the Department for Work and Pensions.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  I agree with the right hon. Gentleman that his hospice, and the hospices in many of our constituencies, do great work. We are aware of the precarious situation that they have been in for a number of years, and we want to ensure that they are fully part of end of life care. He will know from his time in the Treasury that there are complicated processes, both in the Treasury and in the Department of Health and Social Care. When I talk about the normal processes for allocating money, I think he understands that well. We are mindful of hospices’ concerns, and we will continue to talk with them.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  I am so pleased to see my hon. Friend in her place. As I said to the hon. Member for Aberdeenshire North and Moray East (Seamus Logan), the SNP has been in charge of Scotland for a very long time. We have certainly missed having a Scottish Labour voice in this place. She makes an excellent point and shines some sunlight in this place on the actions that have been taken up in Holyrood.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  As the hon. Gentleman knows, health and social care is a devolved issue. We will continue to work closely with all the devolved areas, because we think that that is important, unlike the last Labour Government—the last Conservative Government. [ Laughter. ] I slipped there—I almost got through. We absolutely understand the precarious nature of general practice and, in particular, I understand the really serious issues around health and social care in Northern Ireland. The hon. Gentleman knows that, and he makes a good case for the sector. We want to ensure that it supports people in Northern Ireland with the good primary and community care they deserve.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  My hon. Friend makes an excellent point. We have still not heard from the Opposition whether they agree with the extra investment that has gone into the sector or with Lord Darzi’s report that diagnosed their legacy, including why they left that legacy and the serious issues we now have to address.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  The hon. Gentleman may or may not think that this is political knockabout, but I was very clear in my opening statement that we understand the pressures that the sector is under. We understand the mess that we inherited, and we are fixing it. We are working with social care, GPs, providers and hospices that are affected by any changes in the Budget, and we will continue to talk to them in the usual way. We are committed to doing this faster than the last Government did it. Under the last Government, planning guidance and commitments to the NHS were always running late—they were always playing catch-up. We are committed to making sure that the sector is much more sustainable, so that it can do the important job we are asking it to do.

• 14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source

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  I thank the hon. Gentleman for his comments and for supporting his local hospice. He is an experienced parliamentarian; he knows that this is not simple and that the provider landscape is complicated. As we heard from my hon. Friend the Member for Sheffield South East (Mr Betts), large private equity companies own many social care providers. We want to ensure that any additional funding from the Budget goes exactly where it needs to be: supporting patients—our constituents—where they live and need care. That is why, over the next few months, we will continue to talk to providers in the usual way about the allocation of those funds.

• 12 Nov 2024 · Breast Cancer: Younger Women · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Vickers. I thank the hon. Member for Bath (Wera Hobhouse) for bringing this debate to the House, as well as other hon. Members for their interventions. I also pay tribute to the hon. Lady for championing the story of her constituent Lucy and others, such as Jessica Parsons, who have done so much to raise awareness. We have a powerful role as Members of Parliament, and I commend the hon. Lady for doing an excellent job. The hon. Lady is absolutely right that awareness raising is key to catching cancer early, and the most effective way to tackle breast cancer in younger women is to encourage them to check their breasts regularly. The NHS is going through the worst crisis in its history, and this Government will turn it around so that cancer patients are diagnosed and treated on time. The investments we are making now in breast cancer treatment and research are part of our plan to make the NHS fit for the future. Although women of any age can get breast cancer, it is much more likely to occur over the age of 50. That is why our screening programme sends women their first invitation at 50. However, I will take this opportunity to emphasise that the take-up of breast cancer screening is currently below 70%. That is worryingly low, and we are determined to change that. I make a plea to all hon. Members to help the Government achieve greater take-up of breast cancer screening in women over 50. Women need to come forward for screening. Taken as a whole, the evidence does not support regular mammograms for women below the age of 50. Decisions on screening, including the age at which to offer it, are made by experts on the UK National Screening Committee, and those decisions are kept under review so that they continue to be based on the best available research. Ultrasound can be used as a diagnostic tool, but it is not appropriate for screening. Mammograms provide a fuller picture of the breast, and are better able to spot early signs of cancer. As the hon. Lady said, mammograms used for screening are less reliable for younger women given their denser breast tissue. Change in the screening age could mean a greater risk of false negatives, where cancer is missed, and there would also be a greater risk of false positives, which may lead to invasive testing when there is no need for it. Our approach is in line with that of most European countries, which screen women between the ages of 50 and 69. For younger women who have a greater risk because of their family history, we offer screening using mammogram or an MRI scan. As I have said, the most effective way to tackle breast cancer in younger women is to encourage them to check their breasts regularly, and to consult their GP straight away if they have any concerns.

• 12 Nov 2024 · Breast Cancer: Younger Women · Hansard source

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  The hon. Member makes a powerful point. When people come in, particularly with a family history, their relationship with their GP should be better and should take that history into account. We know that the sooner cancer is diagnosed, the more treatment options are available, and that treatment is more likely to be effective with an early diagnosis. Primary care and GPs are essential in that pathway and I agree with the hon. Lady that we need to pay attention to the upward trend in demand. NHS England runs campaigns to increase knowledge and awareness of key symptoms, but we can all do more. Breast cancer is thankfully rare among younger women, but the more aware they are of the symptoms, the likelier they are to see their GP, and the GP will be made more aware of those trends. I would like to take this opportunity to highlight Breast Cancer Now’s “Touch, Look, Check” advice. The NHS and the Government support this advice, and I encourage women no matter how young or old they are to check their breasts often. Breast cancer remains one of the most common cancers in England; almost 50,000 people are diagnosed each year. Instances of many types of cancer are rising among young people in this country, and we are not yet certain of the cause of that. Although breast cancer is thankfully less common in younger women, we cannot afford to be complacent and, as the hon. Lady has highlighted, we must remember the human stories behind that number—the lives disrupted, the trepidation of diagnosis and the uncertainty faced by loved ones. We can take some comfort from the fact that more women are surviving breast cancer than ever before. Between 2016 and 2020, the one-year survival rate for breast cancer was over 96%, enabled by advances in screening, treatment and care. There is much more to be done, and I want to reassure hon. Members that it is a top priority of this Government to speed up the diagnosis and treatment of every type of cancer. On 30 October, my right hon. Friend the Chancellor restated and backed that commitment. The first Labour Budget committed £70 million for new radiotherapy treatment machines and £1.5 billion for new surgical hubs and diagnostic scanners. This investment will allow the NHS to undertake 30,000 more procedures each year, and the capacity for diagnostic tests will increase to 1.25 million. This further funding will enable us to ensure that cancer can be diagnosed or ruled out as quickly as possible, which is something we all want to see. We also continue to pave the way in identifying the best possible testing and treatment for all types of cancer. Research is a crucial part of this. That is why the National Institute for Health and Care Research has spent £33 million on directly funding breast cancer research in the last five years. But investment alone will not be enough to tackle the problems facing the NHS; it would be like pouring water into a leaky bucket. We need investment and reform. People who work in the NHS, as I have, see first hand what is great but also what is not working—the things more money will simply not fix. As my right hon. Friend the Secretary of State has said, we need to take the best of the NHS. We need to do more to meet the challenges presented cancer now and in the future for people of all ages. We recently launched the biggest national conversation about the future of the NHS since its birth to help to shape our 10-year plan, which will allow us to do more to prevent cancer where we can, identifying it as early and as quickly as possible and treating it with speed and precision. But we need suggestions from hon. Members on how to go further. We need to learn from the experiences of people like Lucy, which the hon. Member for Bath outlined today. I urge everyone to visit change.nhs.uk and help us build a health service fit for the future. I thank the hon. Lady for bringing this important matter to the House and raising her constituent’s issue. I thank all hon. Members who have made such valuable contributions on this important subject. I am pleased to assure them that rebuilding our NHS and delivering world-class cancer treatment and prevention services for every person will always be a top priority for this Government. Question put and agreed to .

• 30 Oct 2024 · NHS Winter Readiness · Hansard source

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  I will come on to social care, but I will make the broader point that every system is different, and the pressures in every system are different. Some systems suffer worse from poorer levels of primary or community care. Others, particularly those across borders, struggle with discharges and packages of care. One thing I am keen to do, and we are doing it, is try to understand the different drivers of performance in different parts of the system. I think we all have a role to play in that. I very much support constructive advice from local Members of Parliament, in consultation with their local trusts, about the real drivers in their systems, because we know that some systems are performing much better. We as a new Government want to address that issue, to ensure that taxpayers’ money is being directed to the best place to make the system work better. That is something for the hon. Member for Winchester to take back. The flow is affected for different reasons in different parts of the system. Several hon. Members have mentioned vaccinations. A key part of winter planning is the annual vaccination campaign, which began on 3 October. I thank the hon. Member for North Norfolk (Steff Aquarone), the hon. Member for Winchester and the Opposition spokesperson, the hon. Member for Meriden and Solihull East, for mentioning their support for vaccination programmes, which is absolutely welcome. People talk about verifying the figures, but my understanding—I am happy to be corrected—is that we cannot verify the actual figures now. We have started different vaccination rates at different times, so the figures are not directly comparable. We will not really know that until the year works through, which I think people understand. It is too early in the vaccination season to draw firm conclusions, but we all have a role to play in driving and encouraging people to uptake vaccinations across the piece. I recently visited a local hospital in my city of Bristol which has staff hubs and encourages staff to go into the clinics. All Members’ efforts to help with that is really helpful. Vaccination programmes play an essential role in protecting people, particularly the elderly, children and the clinically vulnerable from serious illness during the winter months and in relieving pressures on hospitals and the wider system. Data from the UK Health Security Agency shows that last year people who received a covid vaccine were around 45% less likely to be admitted to hospital compared with those who did not receive one. That is why we are delivering our usual campaigns for covid and flu for the clinically vulnerable in addition to the RSV work that is going on. With regard to elective activity, for patients who are referred to a hospital we want to do everything we can to bring down waiting lists, which stood at over 7.5 million in August. The NHS is prioritising patient safety, urgent and cancer care and will continue to do its best to maintain appointments and elective procedures by separating elective care facilities and diagnostics wherever possible. In the longer term, we are going to return to 92% of patients waiting no longer than 18 weeks from referral to treatment in our first term, a standard that has not been met consistently for patients for a decade. Our hospitals do not operate in isolation. Improving resilience across the whole system, including social care, is essential to winter planning. On 17 September we wrote to all local authorities setting out our priorities for improving resilience across social care ahead of winter, emphasising the importance of close partnerships and joint planning between the NHS and local authorities. We want people to have fair access to locally delivered services that start at home and support them to live independently for as long as possible. That will include building bridges between the NHS and social care services, getting people home from hospital as soon as they are ready, and providing much-needed support to families and friends who are involved in a loved one’s care. We will also work to ensure that people are not stuck in hospital beds when they are well enough to go home. We cannot forget that the backbone of social care is carers. We have made it clear to all local health and care systems that they must continue to support people providing care for their family and friends throughout the winter. I am sure all hon. Members will join me in supporting the Chancellor’s Budget announcement today to support our carers more widely. We want to make sure that carers can access the support they need to look after their own health and wellbeing, not just that of the people they care for. The better care fund includes funding that can be used for short breaks and respite services for carers. The Government are clear that people who draw on care and support, and their families and carers, should be closely involved in decisions about their care. However, in the long term we clearly need reform. That is why the Secretary of State has called for a new national consensus on social care. The Government are committed to building a national care service. My hon. Friend the Minister for Care is introducing the first ever fair pay agreement for care workers. Again, we have seen today our commitment to further support carers with improvements to carer’s allowance. That is a start, but we know we have a long way to go. We are working radically to reform the NHS through the 10-year plan, building a health service that is fit for the future and ready to face every winter confidently. Lord Darzi gave us the diagnosis; the cure can be found in shifting the NHS from treatment to prevention, hospital to home and analogue to digital. That is why last week we launched an extensive engagement exercise with the public, staff and stakeholders to inform that plan. Some right hon. and hon. Members might be keen to see some of the public’s wilder ideas, perhaps, but alongside some of those we have already had many considered and thoughtful responses, and we look forward to outlining our specific plans in the spring. With regard to the point made by the hon. Member for Strangford (Jim Shannon) about individual training and bursaries and the large number of suggestions about the important issue of recruiting and retaining our staff, we will look closely at the long-term workforce plan—we are already doing that. We are open to suggestions. We need to build a workforce for the future that lines up with our three shifts. It will be a tough process to get right and to keep up with modern technology, but all those ideas will inform that. I commend the hon. Member for North Shropshire for securing the debate today and colleagues for shining a spotlight on the difficulties that our constituents face. I hope colleagues are reassured. As someone who has worked on winter planning in the NHS, I am fully aware of the challenges that we face. That is why we have taken a strong grip of it from the get-go. I know we cannot go on as we have done for the past 14 years, limping from one winter crisis to the next, improvising and making do with sticking plasters. The Government are winter-proofing the NHS with long-term reform, but until that day we will put every hand on deck to tackle the problems as they arise this winter.

• 30 Oct 2024 · NHS Winter Readiness · Hansard source

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  I will come on to staffing to address some of those points. The hon. Gentleman makes an excellent point about staff recruitment and retention, which is a key part of our future look at the system. On winter planning, the Government should not be micromanaging people in local systems as they do their job. Rather, we need to focus our efforts on where they are needed the most. Notwithstanding the excellent work of individual staff, let me repeat: the NHS is broken. None of us should underestimate how difficult this winter could be, but we are taking immediate steps to cushion the blow. First, we have set out our national winter planning priorities to NHS systems, local authorities and social care providers to support operational resilience over the coming months. Secondly, we are standing up the winter operating function seven days a week to respond to pressures in real time. Thirdly, we are expanding the operational pressures escalation levels framework to give us a clearer picture of what is happening on the ground in all our systems. The framework uses comprehensive data to keep track of hospital pressures, and this year we are expanding its scope to mental health, community care and 111. Fourthly, we are continuing to support systems that are struggling the most through the urgent and emergency care tiering programme. Those are direct interventions to help systems get back on their feet and make the necessary improvements in performance. Fifthly, we are providing targeted, clinically-led support to 19 of the most pressured hospital sites across the country, to help long waits in A&E and avoidable admissions over winter. Those measures are in addition to the aforementioned meetings that I hold with NHS England and UKHSA every fortnight. I am chairing every one of those meetings to ensure that we identify risks as soon as they arise, while supporting NHS England to mitigate them. The party of the hon. Member for North Shropshire has called on the Government to set up a winter taskforce to prepare for an NHS winter crisis. Some might describe what we are doing as a taskforce; I actually think that is my job and the Secretary of State’s job, which, as I have outlined, is why we meet regularly with NHSE. I know that the hon. Member and others are sincere in their efforts to be constructive. I am happy to take away any specific suggestions about what we are not doing to help the NHS, because we all want the system to work well.