On Tuesday morning the Health Secretary Wes Streeting took oral questions. The hour-long session in the House of Commons offered some insights into where the new Government’s priorities when it comes to health and social care.

Questions were taken by:

• Secretary of State for Health and Social Care Wes Streeting MP for Ilford North
• Minister of State for Social Care Stephen Kinnock MP for Aberafan Maesteg (responsibilities outlined here)
• Minister of State for Secondary Care Karin Smyth MP for Bristol South (responsibilities outlined here)
• Andrew Gwynne MP, Parliamentary Under-Secretary of State in the Department for Health and Social Care for Gorton and Denton (responsibilities outlined here). Interestingly, he took the majority of the social care questions, rather than Kinnock.

Streeting opened the session by highlighting the dire state of the healthcare landscape, saying “we have our work cut out for us. We have the worst economic inheritance since 1975. The worst crisis in the history of the NHS”.

Throughout the session, the Department’s key messages were:

• 14 years of Conservative Government has led to a broken NHS and social care system.
• They will not shy away from doing all they can to fix the NHS and fix the social care system.
• This will not happen overnight, and they will not make promises they cannot keep or afford.
• They are therefore working towards a 10-year long-term plan for NHS recovery.
• Professor Lord Darzi has been commissioned to carry out an investigation into NHS performance. His findings will be delivered in September and will inform the 10-year reform plan.
• They remained tight lipped on social care, stating that cross-party work is needed, an integration agenda is crucial, and announcements will happen “very shortly” on the Government’s plans for social care.
• A Royal Commission has been hinted at for social care specifically.

There was an overriding theme of wanting to level with the public, and to be open and transparent about the state of the NHS and social care. Streeting emphasised firmly, multiple times, that he will not rush into any promises that he cannot keep. There were clear messages of hope and a determination to get to grips with the key issues by working with people in the healthcare system. The Labour Government will need to ensure that they are able to back up this hope and promise of improvement with meaningful detail if they are to prove wrong the cynics who accuse them of trying to buy time with more reviews into where the issues lie.

Below are the key themes of the session and the DHSC’s responses to questions posed.

1. Dentistry

There were several questions on dentistry, including on access to services (particularly in rural communities), commissioning, and training.

• Streeting opened by outlining that, after 14 years of Conservative underfunding, 13 million people (28% of the country) have unmet dental needs, and that rotting teeth is the leading cause of hospital admission for children aged between 5 and 9.
• He outlined Labour’s commitment to providing 700,000 urgent appointments and recruiting dentists to areas where they are most needed, including with ‘golden hellos’ to incentivise this for dental graduates.
• The plan will be funded by “cracking down on tax dodgers and closing other loopholes”.
• He stressed that he has already met with the British Dental Association and that this is a big priority for the Government.
• Streeting pledged to put ‘country before party’ to work with all those who have the best interests of rebuilding public services at heart.

2. Hospital Waiting Lists and A&E Overcrowding

Public polling shows that this is consistently the issue people care about the most, and the Government answered numerous questions on this theme.

• They confirmed that 1 in 4 patients are waiting longer than 4 hours in A&E (as per monthly data released yesterday).
• This will be a central part of the investigation and recommendations made in Lord Darzi’s review and will inform the 10-year plan for recovery.
• Pharmacies and better community services will be central to the future system.
• Labour pledged to restore standards.
• The Department also reaffirmed a commitment to bringing in 40,000 extra NHS appointments a week and doubling the number of diagnostic scanners.

3. NHS Infrastructure and The New Build Hospitals Programme

Many of the questions pertained to the Hospital New Build Programme announced by former Prime Minister Boris Johnson – in his promise to build ‘40 new hospitals by 2030’. Questions asked the current Government to commit to continuing the programme in line with the 2030 deadline. Streeting:

• Described it in no uncertain terms as an “entirely fictional timetable and unfunded programme”.
• Said he is concerned about the “dire state” of hospital infrastructure, but is committed to addressing the issue.
• Wants to see the programme completed but will not give false hope on when people will benefit from these changes.
• Has asked for an urgent report on the degree to which the programme is funded in reality, and what a realistic timeline for delivery will be.
• Stated that he “will not play fast and loose with public finances or public trust”.

4. Social Care

The department was asked about the possibility of free personal care being ‘on the table’ for discussion, and to confirm their commitment to introducing the cap on care costs as per the Dilnot reforms.

• The Minister for Social Care responded by reiterating that issues will be discussed in deliberations across parties, and Labour will work with all those who want to fix the broken health and care system collegiately.
• They reiterated that it was the Conservative government who “kicked the can down the road”.
• Asking people to be patient, they promised announcements “in a short period of time” for the Government’s proposals for social care.
• They made clear that “we are determined to fix social care”.
• They stressed that they want plans to be shaped by social care users and workers to build consensus for, and shape, a new National Care Service.
• When asked about plans to address the fact that the UK has one of the highest rates of dementia in the world (500,000 cases in England alone), Kinnock focused his answer on medications in trial and working with NICE and other bodies to bring these to market safely and in a timely manner.

5. Allocation of Funding and NHS Reform

Bill Esterson MP (Sefton Central) asked the Department about their plans to tackle the issue of capital allocation by ICBs often going to acute hospitals at the expense of community facilities. Priti Patel MP (Witham) asked about community facilities that will improve the NHS.

• Capital allocations remain a priority for ICBs. The Labour Government remains committed to introducing neighbourhood care centres to bring together community healthcare services, and remains at the forefront of NHS recovery.
• Committed to restoring standards and ‘fixing the broken NHS’. This means having more services in communities, bringing them to where people are.
• Community services will be part of the Prof Lord Darzi review and central to the longer term 10-year plan.

6. Mental Health Support

Questions related to access of mental health services in local communities (to avoid people travelling far from home to access crucial services) and equity of funding allocations. The Government committed to:

• Recruiting 8,500 Mental Health workers including specialist mental health professionals in every school.
• The roll out of Young Futures hubs in every community.
• Modernisation of the Mental Health Act as announced in the King’s Speech.

Other points of interest:

There was only one question on maternity care, but Streeting said “of all the things that keep me up at night, maternity safety is the top of the list” and promised that expectant and recent mothers will be at the heart of plans to address issues in this area.

Shadow Health and Social Care Secretary Victoria Atkins asked Streeting how he now felt about the 35% pay increase request by Junior Doctors – she stated he previously claimed this was ‘reasonable’ when in opposition, and asked for his position now that he is in Government. She asked if he was considering cutting patient services to fund this. Streeting countered by stating he had never committed to being able to afford the 35% figure, but that he felt requests for pay increases in line with inflation were reasonable. He stressed that he is negotiating in good faith to agree on a settlement that Government can deliver and that the country can afford.

More details from the session, and the full recording, available here