Karin Smyth MP: speeches 2024

Speeches

• 19 Dec 2024 · Hospice Funding · Hansard source

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  The hon. Lady makes an excellent point about the stability of the workforce across the piece, from diagnosis to the end of life. We absolutely need to consider support for all parts of that through the 10-year plan. I encourage hon. Members and others to ensure that they keep making those points. We are getting excellent contributions from the public, patients and staff, and we look forward to developing the plan over the next few months and years.

• 19 Dec 2024 · Hospice Funding · Hansard source

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  What beggars belief is that person after person—man after man—on the Opposition Benches still feels able to get up and defend their record in government. Not once have we heard that they agree with Lord Darzi’s diagnosis, or that they welcome the extra investment that the Chancellor found by choosing to support the health sector in the Budget. I am afraid that, until they reach that conclusion, they are destined to be on the Opposition Benches for a very long time.

• 19 Dec 2024 · Hospice Funding · Hansard source

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  My hon. Friend is absolutely right to highlight that need. As I said earlier, end of life care and its stability as part of the wider system, which is a commissioning role for ICBs, was not addressed by the last Government over 14 years. As part of our 10-year plan, that will be important to do.

• 19 Dec 2024 · Hospice Funding · Hansard source

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  I thank my hon. Friend for his contribution and, indeed, for his singing. Those events bring joy to people at a particularly difficult point in their life, and they are very welcome.

• 19 Dec 2024 · Hospice Funding · Hansard source

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  The hon. Gentleman was a Government Minister, so he had plenty of opportunities to change the system, had he wanted to do so at the time.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  I think I have addressed the Government’s plans on social care. The hon. Lady makes an excellent point on ambulance delays, which we know to be a problem, and particularly so in the west midlands. That is one of the things I have asked the system to look at particularly, so that the Government and hon. Members can better understand the particular problems in their particular systems. We know that ambulance and handover delays are a particular problem in some systems. We are making sure that clinical and managerial leads from NHS England are visiting those systems and that they are understanding in depth the process issues in some places, where they may not be adopting the best practice that can be learned from others. We need to roll out best practice across the country. When the Secretary of State and I visited the operational centre of the London ambulance service, we sat in on some hear-and-treat calls; in dealing with people in mental health crises, in particular, some places are doing that better than others. Those are the sorts of examples we want to learn from. I absolutely hear what the hon. Lady says about the unacceptable delays in particular parts of the country. That is very much on our priority list.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  My hon. Friend is absolutely right. Many tragedies happen over the Christmas period—my own father died on 23 December. Those staff members go above and beyond to help people at difficult times, but also at times of great joy—babies do not wait for Father Christmas, do they?—and my hon. Friend is right to commend midwives and everyone else who is working at this time. We know that maternity services are particularly stretched across most of the country. Those midwives are doing a tremendous job in keeping the system working, and doing the critically important job of supporting women at a mostly joyous but sometimes very difficult time.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  We have made it absolutely clear, as did the NHS in its letter today, that patient safety is the watchword this winter. We have targets in relation to monitoring the performance of the system, but we absolutely want to ensure that patients are kept safe as we go through the next few months.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  Again, my hon. Friend is already representing the people of his constituency so well by getting to the heart of what is happening on the ground, learning it for himself and bringing such examples to the House. He is absolutely right that there are such examples across the country, working differently in different systems, which are challenging other systems to look at that practice. That is why we say we want to bring the best of the NHS to the rest of the NHS. That is exactly what we mean. I am confident in the work happening centrally at NHS England. It is learning from such examples and wants to go around the country to ensure that we spread those sorts of ideas to other places. We are looking at them all very closely.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  My hon. Friend is absolutely right to highlight those shocking levels of bed occupancy. As I said earlier, running consistently at that high level of occupancy is something we should never have got used to. That discharge rate is demoralising for staff, very bad for patients and a sign of the pressure in the system. We absolutely must ensure the system is incentivised and works properly to make our hospital-to-community commitment, one of our three shifts, operate in practice. People do not want to be in hospital when they do not need to be and it is not the best place for them to be. We will be saying more about that in the new year.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  I commend my hon. Friend for, as a new MP, getting to grips in detail with what is happening in her local system and challenging that system, while also giving us those examples of good practice so that we can all learn from them. As she says, many parts of the NHS across the country want to learn from them, and we want to ensure that they are mainstreamed where possible. There are different solutions for different systems, but she is absolutely right to highlight that one.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  My hon. Friend has already been a fantastic advocate for her local NHS services. Like the hon. Member for North Shropshire (Helen Morgan), my hon. Friend is absolutely right to highlight the acute pressures all year round. We did not always have winter crises under the last Labour Government. It was tough; I worked during some of that time, and it did happen, but getting used to such levels of bed occupancy and pressure in the system all year round is a direct legacy of the Conservatives and what they did to the NHS, particularly with the Lansley reforms, and their refusal to take a grip of it. This matter of a summer crisis going into a winter crisis is a real problem. That is why we are committed to these short-term measures to stabilise and support the system over the winter. However, as I said in my statement, we will also look at medium and longer-term reform so that we do not have to revisit this scenario year on year.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  The hon. Gentleman is wholly wrong to say that winter crises happen under every Government in every year. They happened, and became a fact of the NHS, under his party’s Government. The key difference this year, which the Conservatives will still not address, is the fact that doctors are not on strike. Doctors are working in the system, caring for patients and doing their job, because this Government, on day one and week one and week four, delivered the negotiated settlement with the doctors. We cannot run the NHS and we cannot manage a winter crisis without doctors in the frontline, and that is where they are. That is what the difference is.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  I thank the Chair of the Select Committee for her point. She is right that I did not mention pharmacies, which was an omission on my part. We are running an advertising campaign, “Think Pharmacy First”, to ensure people use pharmacies. She is absolutely right that they stand ready. I will visit mine over the next few days to make sure I am vaccinated. Their support, working with primary care, is critical. Again, in some places relationships are working well and pharmacies support people in the community—that is apparent in the statistics. We are absolutely committed to ensuring that that works better, as part of our long-term reforms.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  Hopefully, we will make announcements on the Royal Berkshire hospital and others as soon as possible in the new year, as I know that this issue is of great concern to all hon. Members. We know that the system will be under pressure, and we thank everyone working in it. We want to make sure that everyone keeps well, and I will take this opportunity to thank the hon. Gentleman for his comments. I am looking forward to returning here in January, hopefully to answer more questions. I thank hon. Members for their questions this afternoon.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  I refer back to what I said in my statement about how we are supporting the system. We absolutely understand the importance of primary care, and of using 111 to make sure that people are directed towards getting the right care in the right place. We know that the system is under pressure, and we will continue to do all we can to support it in the longer term, as well as in the short term.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  I think the hon. Gentleman knows that I cannot do that from the Dispatch Box, but my officials will have heard his request and what he has said about that specific case, and I will ensure that he receives an answer.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  With permission, Madam Deputy Speaker, I would like to make a statement on winter preparedness. Before I begin, I want to say a very special thank you to all the staff who will be keeping our NHS going over the Christmas holidays and into the new year. When I was a manager in the NHS, I worked on winter planning, so, if I may, I will say an additional thank you to all the people who are often unseen: the managers and admin staff who also keep the system going. I know how hard it is for people to work in the system with the challenges that winter can bring through increased demand and higher rates of infection. There are things that we cannot predict. Storms Bert and Darragh have added pressure, and we might have a cold snap. I know that many people like a winter cold snap of snow and ice, but it is not something that the NHS ever wants to see. The NHS has excellent people who have done this before and, unlike last year, thanks to the new Government, many of them will not be on strike. While we cannot control the weather, we can plan, prepare and pull together, so today I want to update colleagues with the current picture before moving on to the things that we are doing. NHS England and the UK Health Security Agency will publish the latest statistics tomorrow morning as usual, but we do know that levels of seasonal illness are high. The most recent figures show that last week there was a 350% increase in flu cases compared with the same week last year, but that is comparable to levels we saw two years ago. Norovirus cases are high, but covid rates are low, and although rates of RSV—respiratory syncytial virus—have been high, we expect them to start coming down over the next few weeks. I want to make it clear that the current rates for both bed occupancy and ambulance delays are unacceptably high. I will shortly come to measures about how we are dealing with that capacity. I will not rehearse the Darzi investigation and his findings, except on one thing. I remind the House that he found “a perpetual bed crisis”, particularly during peak periods like winter cold snaps. That means that every winter our staff have been wasting precious time solving process problems, ringing round wards to find beds and desperately trying to hold the system together. We can see that in the figures. On an average evening in 2009, a patient would have been 39th in the queue when they arrived at a typical accident and emergency department. In 2024, they are 100th. The four-hour A&E standard has not been met for nearly a decade and ambulance response times have not been consistently achieved since their introduction in 2017. In November, the average ambulance response time stood at 42 minutes, which is more than double the NHS constitutional standard. A third of the 2.3 million people who attended A&E last month waited more than four hours, and one in 10 of those people—more than 150,000—waited for more than 12 hours. Those life and death delays are the result of deep structural issues in the NHS that cannot be fixed overnight. But this winter, NHS staff will be on the frontline, not the picket line, because we took a different approach on how to work with staff and the unions. To resolve the resident doctors’ dispute, we spoke to them on day one, we met them in week one, and by week four we had negotiated a deal to end their strikes. That is why, for the first time in three years, the Government are fully focused on winter and not on planning for strikes. This is what we are doing. First, the NHS is managing extra demand by strengthening same-day emergency care and offering more falls services for older people, with upgraded 24-hour live data centres. Secondly, we are continuing to support systems that are struggling with direct intervention through the NHS urgent and emergency care tiering programme. Thirdly, the Secretary of State is chairing weekly meetings with me and senior leaders to ensure that we are managing pressures across the entire system. Last week, he specially convened with trusts and told them to prioritise patient safety by focusing on key metrics, including improving emergency ambulance response times, addressing handover delays and tackling the longest waits in A&E. We have made it crystal clear that we do not want trusts to prioritise patients who can be seen and discharged more quickly over those with the greatest clinical need, because this Government will always prioritise people, not performance. This morning, the NHS published a letter outlining how it is prioritising patient safety. Fourthly, I am taking steps to ensure that we get a clear picture of what is happening on the ground. I recently visited Newham hospital’s A&E, Bristol Southmead hospital and the head offices of NHS England to see the aforementioned operational control centre, where it receives data in real time and responds to problems as they emerge. Fifthly, we launched a national communication campaign in the autumn to encourage people across the country to take their winter vaccines, with a particular focus on people who are less likely to come forward. That last point is essential, because the best and easiest way to keep people out of hospital this Christmas is to encourage them to come forward and get vaccinated. Last year, people who received a covid vaccine were half as likely to be admitted to hospital than those who did not. So far, we have delivered over 17 million flu jabs and 9.5 million covid jabs, and we have introduced the first ever public vaccination campaign for RSV, with over a million and counting vaccinations delivered to protect young babies and the elderly. In total, we have delivered nearly 28 million vaccinations for this winter, and I thank every person who has come forward to protect themselves and the vulnerable. Now, I would like to speak directly to anyone who has not yet been vaccinated. No one wants to be separated from their family and stuck in hospital this Christmas, and there is a real risk that people may inadvertently take flu home to loved ones this year. Please protect yourself, your family and the NHS, and book that appointment today, because tomorrow is the last day you can book a vaccine through the NHS app or website, although after tomorrow there will be local solutions. While we tackle winter pressures in the short term, we are fixing the foundations of our NHS with long-term reform. Two weeks ago, the Prime Minister spoke to the nation about our plan for change, and set out our ambitions for the health service over this Parliament. We will get a grip on waiting lists and return to 92% of patients waiting no longer than 18 weeks from referral to treatment by the end of this Parliament. We are also taking action on social care, introducing the largest increase in the carer’s allowance weekly earnings limit since 1976. We will ensure that carer’s allowance meets its objectives, while reviewing unpaid carer’s leave and looking at the benefits of introducing paid carer’s leave. We will publish an improved better care fund framework, using £9 billion of funding to provide better, more integrated health and social care for patients and people who draw on care. We are helping disabled people on low incomes adapt their homes through the disabled facilities grant. The Employment Rights Bill is already in Committee, laying the foundations for the first ever pay agreement for care workers as a first step towards building consensus on the long-term reform needed to create a national care service. By the end of our first year in government, we will deliver an extra 2 million operations, scans and appointments through innovation, investment in additional capacity and productivity gains. We are sharing the best of the NHS with the rest of the NHS, with our Further Faster teams. These are teams of experts that are supporting 20 trusts with long waits to tackle waiting lists and increase productivity. They have been deployed to five trusts so far, and we are already seeing improvements—for example, in theatres. For this financial year, the Government have committed £12 billion more in everyday spending on health and social care than was planned by the last Government in the spring Budget. We are giving our capital-starved NHS the funding it so badly lacked over the past decade, setting aside at least £1.5 billion next year, which will create additional capacity, including new surgical hubs and diagnostic scanners, and new beds across the estate. That will enable 30,000 additional procedures and over a million diagnostic tests as they come online. That is the difference that a Government of service make. We have also been clear that investment must come with reform. Lord Darzi has given us the diagnosis, and the cure can be found in shifting the NHS from treatment to prevention, hospital to home, and analogue to digital. Harold Wilson once called himself an optimist who carries a raincoat. As someone who has worked in our NHS at this critical time, I am fully aware of the challenges we face and the effort required. I am making sure that we have a firm hold on problems in the short term, while we do the work of fixing the foundations of our NHS with long-term reform. Over the past 14 years, we have limped from one crisis to the next, improvising and making do with sticking plasters. It cannot go on. It is bad for patient care and it is totally demoralising for staff. We are building a health service that is fit for the future, ready to face every winter with confidence, and we will publish our 10-year plan for health in the spring. Anyone who thinks that we cannot do it should remember: we have fixed the NHS before, and we will fix it again. The public rightly expect us to put an end to the annual winter crisis, and that is what we will deliver. I commend this statement to the House.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  I am working very closely with the UK Health Security Agency to make sure that, week on week, we are aware of the movement of different diseases and viruses through the system, and we will continue to publicise the campaign to get people vaccinated. Anything that hon. Members can do to support that campaign, and to make sure that people support themselves and their loved ones, will be gratefully received by the entire system. The campaign is something that everyone can get behind.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  My hon. Friend is absolutely right. We want to make sure that taxpayers’ money is used efficiently and effectively in the right places for the right treatment at the right time. That is why we are looking at our long-term plan. That is why we want to stabilise the system, so we do not have to keep coming back here year after year with a so-called winter crisis.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  My hon. Friend makes an excellent point. We need to get back to normal and we need to recognise that there are different things happening to the system at different times of the year, much of which is predictable. We need to ensure that the system is strong enough to be able to cope with those differences.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  My hon. Friend’s comments reinforce how much pressure, we understand, is front facing. A&E is demonstrative of the overall pressure in the system, not just at discharge but, as she rightly says, in primary care. We took action in the summer to improve primary care, increasing the number of GPs available in the system. It is absolutely critical that primary care community services are integral to winter planning at a local level. That is what we expect from every single system. We will continue to monitor that over the winter period and into the spring. If those services are not involved in planning for any particular systems, enabling them to monitor the surge and flow of people, we very much want to understand how that is working.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  I do not wish to test your patience, Madam Deputy Speaker, but good falls practice has not been prioritised over the past decade, and the failure to prioritise it and continue the work that I know was being done many years ago is yet another testament to the failure of the Conservative party. My hon. Friend is right to refer to the way we can use AI to help the system to improve, so that this hugely preventable problem, which is so damaging to the elderly in particular, no longer occurs.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  I will do my best to address that range of questions. First, as even a stopped clock is right once— [ Interruption. ] Yes, twice. On that basis, I agree with the right hon. Gentleman. On correspondence and answers to parliamentary questions, again, the situation we inherited is not satisfactory. I apologise to all Members who are waiting for correspondence—it is something we are taking a grip of. We want to respond positively to questions. The Conservatives did not; we will make sure that starts to happen. On capacity in the system, again, I remind Members that we came into office in July, which is one quarter of the way through the planning and financial year. We very rapidly looked at the plans that were baked in by the previous Government—I appreciate that the right hon. Gentleman was in the Ministry of Justice at the time, not the Health and Social Care Department—to see whether they were fit for purpose. We wanted to make sure we brought stability to the system. There are, in fact, more beds currently available in the system than last year. If there is a need to increase capacity due to a likely cold snap, the system is absolutely ready to respond in its usual way. That is why we are meeting weekly. On meetings with clinical and managerial colleagues at NHS England—who, frankly, I see more often than many members of my own family—I can tell the right hon. Gentleman that we started those meetings immediately. I would have to check the exact date, but it was certainly in the summer. I have had fortnightly meetings since September, which, as I said, we can move to monthly meetings, chaired by the Secretary of State. We began getting a grip from day one, knowing that winter was coming, which is why I am monitoring the situation weekly. It is also why we visited the operational centre, to understand in real time what is happening across every single system and every single trust—be that ambulance issues or problems at the front end and in A&E. The one question I do not directly have the answer to is what the daily figures are; I will try to get those figures to the right hon. Gentleman later. We all know that waiting for discharge to assess is a massive problem. That is why, as I said in my statement, we want to take a grip of the better care fund, to ensure it works better and to stabilise the social care system. I am not particularly versed in issues on supply, so I apologise if that is wrong. We will certainly get back to the right hon. Gentleman on that matter, because we want people to be taking the vaccinations where necessary. I can confirm that we want an announcement on hospices before Christmas. On winter fuel and its impact, as Opposition Members know, we will continue to monitor the impact of all situations on individuals to ensure they are supported in the community. We urge people to make sure they access pension credit. [ Interruption. ] I have just addressed that, but if I have missed anything, I will come back to it.

• 18 Dec 2024 · Winter Preparedness · Hansard source

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  As I said earlier, different systems have different issues. Funding has been allocated in advance to the NHS so that it understands which systems require funding, and that has now been baked in for this year. I cannot address the hon. Gentleman’s points directly from the Dispatch Box, but I am very happy for officials to take note of them and to check with the system on what is happening in his particular community. Obviously, it is important that Winchester hospital works closely with its local authority with regard to discharge. We want to improve the better care fund, and I am sure that he will work with the local authority and his hospital to make sure that it works better.