Wes Streeting MP: speeches

Speeches

• 25 Mar 2025 · Independent Review of Data, Statistics and Research on Sex and Gender · Hansard source

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  I will absolutely undertake to share the approach we are taking with my counterparts across the United Kingdom. The approach I have always taken is one that understands the importance of biological sex, that recognises, understands and supports that someone’s gender identity may not always match their biological sex, and that seeks to navigate a way through what has been an extremely toxic and sometimes harmful debate in a way that protects the sex-based rights of women and protects trans people and their identity. I know that my colleagues across Government are taking an equally sensitive approach, and I think it would be in everyone’s interests if we saw a similar approach across the whole of the United Kingdom. It is important not just in the provision of services, but in accurate data and research, that we make that distinction, which does not in any way undermine respect for people’s gender identity.

• 25 Mar 2025 · Independent Review of Data, Statistics and Research on Sex and Gender · Hansard source

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  I am grateful to the shadow Minister for her question. I speak to the Science Secretary on too frequent a basis—on a daily basis. He and I are both looking very carefully at the findings of the Sullivan review and working through its implications for both the health and care services, for which I am responsible, and for the Government digital and data services, for which he is responsible.

• 25 Mar 2025 · Independent Review of Data, Statistics and Research on Sex and Gender · Hansard source

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  The shadow Minister raises a good example of how conflation of sex and gender identity is not helpful both in terms of data analysis and of recognising health inequalities. It is also not helpful in making sure that we understand variances between people based on their different backgrounds and characteristics and that we provide targeted, personalised and effective healthcare that deals with healthcare inequalities. That is why we are carefully studying the recommendations made by Professor Sullivan, with a view to making sure that we are meeting the needs of everyone, including the trans community, who I understand, not least because of the way that the debate has been conducted in recent years, are anxious about the implications of the report. However, I genuinely think that the report will lead to better, more inclusive and fairer outcomes for everyone, including the trans community.

• 13 Mar 2025 · NHS England Update · Hansard source

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  That is an excellent question. We are building an outstanding transformational team with Sir Jim Mackey, which will be announced very shortly. It will bring together some of the best leaders across the country, and expertise from outside the NHS, to drive the scale and pace of transformation that is necessary. My hon. Friend is right to say that it is existential, because we cannot allow the curve of cost and demand to continue to rise to the extent that it is. The NHS’s long-term workforce plan has one in nine people in our country working for the NHS. On the current trajectory, in 50 years’ time, 100% of the public would be working for the NHS. That is clearly not a sustainable position. I tell people who resist this reform out of love for the NHS not to kill it with kindness. We have to bend the curve of cost and demand to ensure that our health services are sustainable for the long term on the equitable foundations of a public service, free at the point of use, that we will always defend. I also say to my hon. Friends on the Government Back Benches that if we do not get this right, goodness knows what will come next. The Leader of the Opposition says that she wants a debate on the funding model for the NHS. The leader of the Reform party—I am not sure whether he is the Leader of the Opposition yet—says that he is up for anything. I am sure he is. That should worry us. To those who want to debate the funding model of our NHS and the equitable principle of it being a public service, free at the point of use, I say that we are happy to have that debate but the Government are unequivocal: under Labour, the NHS is not for sale. It will always be a public service, free at the point of use, so that when people fall ill, they never have to worry about the bill.

• 13 Mar 2025 · NHS England Update · Hansard source

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  That is a great question from my hon. Friend. We have to give people the tools to do the job. The Prime Minister set me and my hon. Friends in the Department an enormous challenge on behalf of the public. In turn, I am setting an enormous challenge for NHS leaders at every level, but particularly for frontline NHS leaders. We have to give them the tools to do the job in terms of data platforms and the technology that they are given to work with, ensuring that they have access not just to cutting-edge treatments and medical technology, but to the back-office productivity support that can drive efficiency and improvement and, frankly, liberate managers and frontline staff from the arcane systems they are working with. Some of the very best people I have met in the last few years, shadowing this portfolio and now holding it in government, are NHS leaders, especially on the frontline. It is my responsibility to give them the tools to do the job. That is not just about financial resources; it means bulldozing through some of the regulatory barriers and overcentralised instructions that stop them making decisions in the best interests of patients, in terms of clinical pathways and value for taxpayers. I have given them an undertaking that I will have their backs, both on the decisions that they will have to take on the frontline and on bulldozing through the national bureaucracy that is tying them up in knots when we need to set them free.

• 13 Mar 2025 · NHS England Update · Hansard source

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  I am extremely grateful to my hon. Friend, and I echo what he said about the talents of people at NHS England. I did not take this decision with the Prime Minister lightly. Indeed, it was not my instinct coming into government, but it has been shaped by what I have seen and experienced over the past eight months. Clinical leadership is vital, and that is not just doctors; it is also nurses and other clinical leadership. We have a brilliant chief nursing officer, who remains in place and will be part of that clinical leadership team. I can assure my hon. Friend that we do not want any political interference in what should be decisions for clinicians. What we need is the right political leadership to give that clinical leadership the tools, power and freedom to do the job that only they can do, and that they do best.

• 13 Mar 2025 · NHS England Update · Hansard source

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  The hon. Gentleman makes a fair challenge on the bureaucratic nature of decision-making. We are working with Treasury Ministers and colleagues across Government to take an axe to that unnecessary bureaucracy. He will be absolutely fuming when he finds out who was responsible for it.

• 13 Mar 2025 · NHS England Update · Hansard source

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  I am grateful to the right hon. Gentleman for that thoughtful question. Let me say two things to him. First, democratic accountability matters, both in terms of patient outcomes and value for taxpayers’ money. One of the things that I, my Labour and many of my Conservative predecessors have reflected on a lot over many years is what the role of the Secretary of State, and Government, is in a national health service where clinical decisions should always be clinically led. It is the Secretary of State’s responsibility to be the champion for patients and for taxpayers and to ensure that the system as a whole delivers better outcomes for patients and better value for taxpayers. The argument that I have started, however, which has ruffled some feathers within the NHS and even more so with some of our country’s most loved charities in recent months, is the fallacy that the Secretary of State can or should just fire endless instructions into the system, as if a Secretary of State or, for that matter, an NHS England could just pull some big levers and drive change in such a vast and complex system. That is a falsehood. Of course, we should set national strategic priorities on behalf of the public. We should ensure that there is more transparency and information so that patients, communities and staff can hold the system and themselves to account to improve performance. However, the overcentralisation has to stop. In future, it will be for the Department and the NHS nationally to do the things that only the national health service can do, providing the enablers for the system as a whole. What we are presiding over and embarking on, however, is the biggest decentralisation of power in the history of our national health service. That will put more power into the hands of frontline leaders and clinicians, but even more fundamental and transformational, more power into the hands of patients. If we get that right, we will have an NHS that can truly be the envy of the world. If people continue to indulge in the fallacy that more targets from the centre or more—or indeed, less—political control is the answer, we will fail. The right hon. Gentleman also mentioned the CQC. It has got itself into a terrible mess and I know that that is not what he intended when he rightly made the decision to create the Care Quality Commission. That is why Sir Julian Hartley knows that he has our full support, not just in turning around the CQC as it is, but in reforming it so that it can be the best guarantee and safeguard of quality that patients and the public deserve. Dr Penny Dash’s forthcoming review findings will also help to drive that reform agenda at pace.

• 13 Mar 2025 · NHS England Update · Hansard source

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  And my friends at DCMS with their considerable spending power. No, I will stick with the Treasury in my order of favourites, thank you very much. I know where my bread is buttered. To return to the point made by the right hon. Member for Salisbury (John Glen), I thank Dame Jenny Harries for her leadership of UKHSA. We are recruiting for an outstanding replacement and successor, and that is an opportunity to look in the wider context at some of the first principles. The right hon. Gentleman mentioned the specific, traditional Porton Down versus Harlow decision, which has been running around the system so long that is now used in a case study for senior civil servant recruitment. The worst decision is indecision. It has plagued us for too long and I hope we can soon report back to the House with a decision on that for everyone’s benefit.

• 13 Mar 2025 · NHS England Update · Hansard source

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  We will shortly set out our emergency care improvement plan so that we can deliver the year-on-year improvements that people deserve. The long waiting times, not just in emergency departments but in ambulance response times and across the entire system, are completely unacceptable. I refuse to use terms such as “temporary escalation spaces” to describe the true grim reality of corridor care. That is a shameful situation, and I am genuinely sorry that patients are being treated in those conditions and that staff have to suffer the moral injury of working in those conditions. From the moment we came into government, we have worked to ensure that we got through the winter as well as we could. That is reflected in the fact that, despite the winter pressures, waiting lists fell five months in a row throughout the winter. On the targets and standards challenge set out by the Royal College of Emergency Medicine, ahead of the winter I was very clear with frontline leaders that patient safety must come ahead of performance targets—particularly the four-hour target—but the 12-hour target is absolutely related to patient safety, as I think the royal college would agree. We must work together to get waits of longer than 12 hours down as a priority, because those waits are directly linked to safety and patient outcomes.

• 13 Mar 2025 · NHS England Update · Hansard source

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  We have to deliver improved services for patients in every part of the country. Her constituency and mine, which is on the London-Essex border, will have different needs, contexts and set-ups, and services may need to be shaped differently in order to meet those needs, but the standards should be consistent, the quality should be good and the safety should be guaranteed at all times. That is a far cry from where we are, and I genuinely think that decisions about services for her constituents will be far better taken much closer to her constituents and her community than here in Whitehall. That is why, as we are delivering month by month and year by year improvements in services for patients in every part of the country, we will also deliver the biggest devolution of power in the history of the national health service.

• 13 Mar 2025 · NHS England Update · Hansard source

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  I can give my hon. Friend that assurance. That is the objective of what we are doing: to make better use of taxpayers’ money so that we can deliver better care for patients. That is not through bloated central bureaucracy, but through more frontline capability and services.

• 13 Mar 2025 · NHS England Update · Hansard source

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  The frustrating thing is that we are delivering the wrong care in the wrong place at the wrong time, which is delivering poorer outcomes for patients and poorer value for taxpayers. People cannot get a GP appointment, for example, which might cost the NHS £40, and then they end up in accident and emergency, which could cost £400. If people cannot find a bed for a delayed discharge and rehabilitation outside of hospital, they end up stuck in a hospital bed, wasting away at greater cost. In fact, when I was up in Carlisle earlier this year, such intermediate care was being offered by a local social care provider, commissioned by the NHS, at half the cost and of a much better quality than the hospital bed that patients had been discharged from. That shift to the community is about delivering better outcomes for patients and better value for taxpayers, and that will be reflected in our 10-year plan.

• 13 Mar 2025 · NHS England Update · Hansard source

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  I am grateful to the Liberal Democrats for those questions. Much of the change needed can be delivered without the need for primary legislation, which is a relief because, as right hon. and hon. Members will have noticed, this Government have come into office with the most ambitious legislative programme of any incoming Government. Time is at a premium, given the business of this House and the other place. We will work immediately to move forward without changes to primary legislation, but we will need to make them. I am working with the Leader of the House and business managers to ensure an appropriate timetable that enables us to do the things that we need to do in a timely way, but that also safeguards the ambitious legislative programme that has already been set out. The hon. Lady is right to talk about the importance of social care. She asked where the urgency is. It was to be found in the immediate steps that the Chancellor took on coming into office to stabilise the finances of my Department, with an immediate release of funding. It came with the Budget, which delivered an extra £26 billion for the Department for Health and Social Care, protected funding specifically for social care and boosted spending power for local authorities. It came with the biggest expansion of carer’s allowance since the 1970s, and an £86 million increase in the disabled facilities grant not just from next year but released in January for the remainder of this financial year. The urgency is reflected in the Employment Rights Bill, which makes provision for fair pay agreements to deal with the work- force crisis—work with employers and trade unions to prepare for that legislation and the introduction of fair pay agreements is already under way. I regret that we have not convened cross-party talks. That is genuinely due to practicalities on the part of a number of parties involved. We will be in touch over the next week to make arrangements for Baroness Casey to engage with parties across the House.

• 13 Mar 2025 · NHS England Update · Hansard source

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  I can certainly give the hon. Gentleman that assurance. We have to cut through the unnecessary red tape that ties leaders and frontline staff up in knots, and we are absolutely determined to do that. Regulatory reform will form a big part of this Department’s agenda and the wider Government’s agenda. As to an NHS free at the point of use, he almost said it with a straight face. I am sure that he meant every word he said. I think he might want to have a word with his party leader, who is his successor and—who knows?—perhaps his predecessor.

• 13 Mar 2025 · NHS England Update · Hansard source

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  I was recently in contact with Mike Nesbitt, offering some of that support and offering to work together to help improve the quality of health services in Northern Ireland, recognising that we have advantages of scale here in England. While recognising the devolution settlement, we want to work closely, just as we are working closely with our friends in the Labour Government in Wales to help them improve their services, and also learning from some of the things that the Welsh NHS does better than England.

• 13 Mar 2025 · NHS England Update · Hansard source

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  The reports relate to the deficits sent into NHS England ahead of the 2025-26 financial year. Those are completely unaffordable for the NHS and completely unrealistic. Those financial plans are being revised as we speak, which is why leaders have gathered in London today to receive that message and that set of instructions. I am asking frontline leaders to improve services and reform ways of working, and they will have my support in doing that. As for the resources that are going in, I gently point out that the investment that the Chancellor unlocked for the NHS and social care in her Budget dwarfs that which was promised in the Green party’s manifesto.

• 13 Mar 2025 · NHS England Update · Hansard source

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  That is a brilliant question. We have put in place a transformation team, led by Sir Jim Mackey, which we will work with to start fundamentally changing the way the NHS works, by shifting more power, resources and responsibility out of Whitehall and closer to the frontline and the communities where decisions are made, and by getting rid of the unnecessary bureaucracy that drives patients and staff to distraction.

• 13 Mar 2025 · NHS England Update · Hansard source

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  This Government committed in our manifesto to doubling the number of diagnostic scanners, and we will deliver that over the course of this Parliament. NHS charities have a valuable role to play. Philanthropy has a valuable role to play as an additional source of support to the NHS. When public funding is as tight as it is, we need to look at how we can maximise the benefits and the impact of bringing together sources of public investment, private investment, voluntary sector and philanthropic investment to deliver the most bang for the buck. Without knowing the details of the specific case the hon. Lady mentions, I would not want to comment too strongly, except to say that we are committed to doubling diagnostic scanners through public funds, but I am not sure I necessarily share the view that NHS charities do not have a role to play.

• 13 Mar 2025 · NHS England Update · Hansard source

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  It always worries me when my hon. Friend says he wants to see me in front of the Select Committee because he does not pull his punches, despite being on the Government side of the House. Let me reassure him that on primary care, I hope that we are beginning to turn what I think has been a deep anger, frustration and anxiety among primary care leaders about the state of the system as it is and a pessimism about its future into increasing amounts of quiet optimism and hope. I think GPs can see we are walking the talk, with the biggest funding uplift in a generation and the fact that we have worked constructively with GP leaders to reform the contract and agree that further, more radical reform is needed together. We will be embarking on that under the auspices of the 10-year plan. As well as delivering that significant achievement with GPs, the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock), is also in the very final stages of work with pharmacists to stabilise the community pharmacy sector, which is vital for the NHS’s future as a neighbourhood service. May I also reassure my hon. Friend the Member for Calder Valley (Josh Fenton-Glynn) that under the auspices of the 10-year plan for health, notwithstanding Baroness Casey’s work on the long-term future of social care, we have an eye on social care and the relationship between health and social care? People will not, therefore, be waiting until next year for the first Casey report or, indeed, later for the final Casey report on the longer term to see action from this Government on social care, particularly as it relates to the NHS.

• 13 Mar 2025 · NHS England Update · Hansard source

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  There are 889 million reasons for GPs to be cheerful. That amount was the allocation for general practice before Christmas, and it has resulted in fruitful negotiations with GP leaders that will deliver the necessary reforms and better access for patients, particularly through online access to modern appointment booking. That is something to which we have become accustomed in every other aspect of our lives, and the NHS should be no different.

• 13 Mar 2025 · NHS England Update · Hansard source

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  I will take the more serious questions from the shadow Minister first. On timeframes, we will work immediately to start bringing teams together, as we have done with the one-team culture we have been building over the past eight months. I want the integration of NHS England into the Department to be complete in two years. The shadow Minister asks about the reduction in the number of officials. NHS England has 15,300 staff; the Department of Health and Social Care has 3,300. We are looking to reduce the overall headcount across both by 50%, which will deliver hundreds of millions of pounds of savings. The exact figures will be determined by the precise configuration of staff, and we will obviously keep the House updated on that. The shadow Minister asks about clinical leadership. One change we will be making with the transformation team is to have two medical directors succeeding Professor Sir Stephen Powis, whose departure from NHS England was planned long before these changes. There will be one medical director for primary care and one for secondary care, underpinning our commitment to the shifts we have described. I must say, there are enormous improvements to be made in clinical leadership for patient outcomes, patient safety and productivity, and I am demanding stronger clinical leadership to drive those improvements to productivity. Frankly, many consultants and clinical teams on the frontline will welcome that liberation—they are hungry for change. The shadow Minister asks about the workforce data and complains that we have not been able to give her the precise answers. I agree: it is frustrating not having that precise information at my fingertips. I would gently remind her, though, on this as on so many things, that her party was in power for 14 years. She cannot very well complain eight months in given that they left us a woeful, embarrassing data architecture and infrastructure. The shadow Minister asks about efficiency. Once again, she refers to the resident doctors deal as if it was a failure. The actual failure was leaving doctors on the picket line, not on the frontline, and wasting huge amounts of taxpayers’ money, with cancellations and delays to patients’ appointments, operations and procedures. We stopped that within weeks of coming into office. The deal does include reforms to improve productivity—if she is any doubt about the results, she should look at the fact that despite winter pressures, NHS waiting lists have fallen five months in a row. Once again, we get the facile points about my right hon. Friend Alan Milburn, who is the lead non-executive board member for my Department. I honestly do not know why he bothers to pay for a mortgage; he lives rent-free in the Conservatives’ heads. They need to move on. By the way, just for the record: Alan Milburn has a record on the NHS that the Conservatives cannot even begin to touch. The shadow Minister asks about confidence. I am delighted to be introducing a new transformation team. Different leadership challenges require different leadership skills. As I say, I have been really pleased to work with Amanda Pritchard for the past eight months, including on this transition; people should have no doubt about the confidence I have in her skills, talents and abilities, and I think she has a lot still to contribute to our NHS. We do not need to ask about confidence in the Conservative party; it is reflected in the scarce numbers on the Opposition Benches. What is the lesson from Wales? The lesson is that when there is a Conservative Government in Westminster, the national health service suffers in England, Wales, Scotland and Northern Ireland. That is why we are creating a rising tide to lift all ships. I am sure we will see improvements across the United Kingdom. SNP Members, who are not in their place, do not have any excuses now. As I said before the election, all roads lead to Westminster, and the biggest funding settlement since devolution began is going down the road to Holyrood. There are no hiding places there for the SNP. If people want real reform of the NHS in Scotland, they should vote for Scottish Labour under Anas Sarwar and Jackie Baillie. People can see here in Westminster the difference that new leadership provides. The shadow Minister laughably referred to new leadership in the Conservative party. Well, it is certainly leaner and meaner, but it is the same old Conservative party. The only thing that the Conservatives have shrunk is their own party. The only jobs that they have laid off are those of their poor party staff. The only thing that they are capable of changing— [Interruption.] Well, come to think of it, I do not think that there is anything they are capable of changing. Instead they look over their shoulder at a party leader who cannot even manage a five-aside team, let alone a country. The Conservatives are just so diminished as a party. I appreciate that it must be so painful for them to watch a Labour Government doing the things that they only ever talked about: reducing bloated state bureaucracy; investing in defence; reforming our public services; and bringing down the welfare bill. The public are asking: “What is the point of the Conservative party?” I bet they are glad that they chose change with Labour.

• 13 Mar 2025 · NHS England Update · Hansard source

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  My hon. Friend is absolutely right. Some of the best innovation and improvements for patients I have seen has been led by frontline clinical teams that have had great executive leaders behind them, giving them the freedom and the tools to do the job. I hope that, as a result of these reforms, not only will we see the results for patients in the data, but staff and patients will feel the outcome and the difference in their experience of working in or being treated by the NHS.

• 13 Mar 2025 · NHS England Update · Hansard source

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  My hon. Friend is absolutely right: if we just replicate NHS England as it is with all the challenges in its set-up in ICBs across the land, we will have failed. Frankly, if we replicate NHS England and the Department as they are today just in one organisation, we will have failed to meet the challenge of change. It needs to feel and act like a completely new organisation, culture and way of working to modernise the state, so that if Disraeli, Gladstone, Churchill or Attlee walked into Whitehall at the end of this Government, it would not look so much like the Government they worked in during the 19th and 20th centuries. That is the reality of Whitehall today; it is not a reflection on the people who work in it, but it shows why it needs to change, and that is also true of the NHS. I look forward to working with ICB leaders to reform their ways of working, clarify their priorities, give them clearer marching orders and ensure that they can deliver. Finally, my hon. Friend mentions the staff of NHS England—indeed, this affects staff in my Department, too—and I thank her for the care she has shown. Change is always disruptive and it can be scary, and of course that is particularly the case when job losses are involved. I want to acknowledge that on the Floor of the House, as I have to staff across both organisations this morning. I know that the Permanent Secretary and the chief executive of NHS England have done so in recent days, and I will be holding a town hall with staff next week. This really is not a reflection on them. In fact, I think they will recognise in my description of our ways of working the many things that frustrate them. None the less, they are dedicated and talented people, and some of the best people I have ever worked with in any walk of life or career work in this system. I look forward to working with them in the coming weeks and months with the same dedication and professionalism they have always shown, so that we can all look back on this time with pride, knowing that we were part of the team that took the NHS from the worst crisis in its history to getting it back on its feet and making it fit for the future.

• 13 Mar 2025 · NHS England Update · Hansard source

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  I do think that is the case. I also think that this is not just about form and function but about the opportunities for productivity gains through modern technology and practices. One of my frustrations is that whenever we talk about the exciting frontiers of life sciences and medical technology—this country’s competitive advantage, and how we need to build on that position— I am greeted with a weary sigh from poor frontline NHS staff, and managers for that matter, who say, “That’s lovely, and we agree with you, but we’d just like a machine that turns on reliably, and it would be nice to use systems that do not require seven passwords to deal with a single patient.” I feel their pain. We will prioritise that investment in technology. Finally, we do want to liberate the frontline, and I am grateful for the leadership that GPs have shown in agreeing a contract with the Government for the first time since the pandemic, which contains substantial reform to benefit them and, even more importantly, their patients. We also have to liberate management in the NHS. As Lord Darzi said, it is not the case that there are too many managers, but there are layers and layers of bureaucracy between me as the Secretary of State and frontline staff. We have to liberate frontline staff and managers to help them be more effective, to manage their resources more efficiently and, most importantly, to deliver better and safer care.