Elective Care Recovery in England

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the publication of his Department’s plan for elective care recovery in England.

The covid-19 pandemic has had a huge impact on healthcare systems everywhere. The NHS has performed incredibly, caring for covid and non-covid patients alike and delivering the vaccination programme that has helped us to open up this country once again. Throughout the pandemic, we had to take steps to ensure that we could treat those with the greatest clinical need and that we provided a safe environment for those who needed covid care.

As a result, there is undeniably a huge covid backlog that needs urgent attention. The number of people waiting for care in England now stands at about 6 million, and we know that that figure will get worse before it gets better. Furthermore, our best current estimate is that about 8.5 million people who would normally come forward for treatment have not done so during the pandemic. However, we are pulling out all the stops to help the NHS recover and ensure that patients are receiving the right care at the right time.

Hon. Members will be aware that the Government will have invested more than £8 billion in the NHS in the three years from 2022-23 to 2024-25. As part of the new health and social care levy, we will be putting huge levels of investment into health and social care over the coming three years, and all the time we are announcing new solutions to the problem of how we can ensure that the NHS is on the firmest possible footing for the future.

On Friday we launched a call for evidence that will inform an ambitious new vision for how we lead the world in cancer care. As the Prime Minister announced earlier today, we are setting out some tough targets for the NHS on cancer. We want to ensure that 75% of patients are diagnosed or have cancer ruled out within 28 days of a GP referral, and to return the backlog of people waiting more than two months for their cancer treatment to pre-pandemic levels by March 2023. Today the NHS has also announced the launch of a new platform, My Planned Care, which will provide patients and their carers with relevant and up-to-date information ahead of planned treatment, including information on waiting times for their provider.

Thank you for granting the urgent question, Mr Speaker.

This is not a covid backlog; it is a Tory backlog. We went into the pandemic with NHS waiting lists already at a record 4.5 million, and now 6 million people are waiting on those lists—more than ever before. More than 1 million are waiting for scans and tests used to diagnose cancer, and the NHS itself is waiting—waiting for the Government’s plan to deal with the backlog. So where is it? It was due to be published today but was pulled last night. It is like something from “The Thick of It”, but the reality is worse than fiction—a photo op without a plan; the Government’s own NHS recovery plan just another cancelled operation. But there is no need to worry, because there is a website coming that will tell people that they are waiting a long time, even if there is no plan to ensure that they do not-.

Then there is the “reason” for the delay. Briefings from the Department for Health and Social Care claimed that the Chancellor had blocked the plan. As one Government official said,

“it’s pretty obvious it’s about Treasury reluctance to rescue the PM”.

Is this where the shambles of the Conservative party is taking us? Is the Chancellor seriously playing political games while 6 million people wait for care? No wonder the Health Secretary has not bothered to show his face this afternoon. He is probably still recovering from the embarrassment of this morning’s media round, where the big announcement was literally that there was no announcement. So it has been left to the Prime Minister to clear things up, which tends to go almost as well as breakfast television with the Culture Secretary. No wonder she has been dispatched to the middle east.

Let me turn to the “tough targets” that the Minister mentioned. Today the Prime Minister announced a new target that no one should wait longer than two months for cancer diagnosis, but there is already a target for the vast majority of cancer patients to be treated within two months of referral, and it has not been hit since 2015. Is this not just another example of the Conservatives lowering standards for patients because they consistently fail to meet them? The Prime Minister has also announced that three out of four patients should receive a cancer diagnosis within 28 days, but that is an existing target that was introduced last April and has never been met.

I am grateful to the shadow Secretary of State. As he said, 2 million of those on the waiting list have entered that waiting list since the pandemic began. There is undoubtedly a huge covid backlog, as we had to put in place infection prevention and control measures and ensure the availability of beds for those with covid. I am with him, I suspect, on at least one point, which is that I, like him, entirely understand the impact that this has on people’s lives, their anxiety and their health outcomes. That is why this Government are determined to tackle that waiting list. As I said, this is a once-in-a-generation challenge and it is absolutely right that we make sure we get the plan right. We need to ensure that we have the right plan, delivering the right outcomes.

The hon. Gentleman mentioned delays, and I have to say that this plan is delayed. This is a plan we anticipated publishing in December. The reason that we did not do that was because of the omicron variant and the impact it has had on our health services over the winter. We have made sure that we get this plan right.

The hon. Gentleman also mentioned Her Majesty’s Treasury. I have to say, speaking as a Minister in the Department of Health and Social Care, that we could not wish for better partners than Her Majesty’s Treasury and this Chancellor. They have shown strong support to our health and care system throughout the pandemic, with record levels of funding to support it through the pandemic and to help performance to recover subsequently.

Even before the pandemic, when the current Secretary of State for Health was Chancellor, this Government had already put in place a £33.9 billion increase in funding, enshrined in law. It was one of the first pieces of legislation passed by this Government after the election. We have also set out our long-term funding plans through the health and care levy, which I recall the hon. Gentleman’s party did not support.

We are grateful to the Opposition spokesman, the hon. Member for Ilford North (Wes Streeting), for his sub-leadership bid in raising this important topic. I say to the Minister that today was not an unusual day, in that a constituent wrote saying that she had nothing but praise for the hospital treatment she was getting. Can I pass on my thought, which is that instead of using the word “elective” we should use the words “planned care”, as my hon. Friend did in his response? Through him, I also remind the House that two years into the last Labour Government there was an edict saying that no hospital could do elective care—planned care—until two years past the time when it was booked. Things are much better now and most of us are grateful.

I am grateful to the Father of the House, who once again brings his typical wisdom and experience in this House to our deliberations in the final point that he makes. He is absolutely right. I am happy to join him and his constituents in expressing gratitude to all those who work in the NHS for the work they have been doing throughout the pandemic and that they do every day, irrespective of the pandemic. I know that those on both sides of the House will share in that. The term “elective” is a technical term used within the NHS, but I take his point that it is easy for us in this House to use the technical terms used within our Departments or in the system, but that it is often helpful if we talk in rather more simple terms that mean something to all our constituents.

As a survivor of breast cancer that was treated in 2019, I was grateful to be seen within 10 days of the referral by my GP and to start treatment within a month. It is frightening that in the months between April and November last year over 90,000 women who might have breast cancer were not seen by a specialist within the target of 14 days of being urgently referred by a GP, and that this year half a million people with suspected cancer will wait longer than the supposed two-week maximum to see an oncologist. The Minister will know that an early diagnosis can be life-saving. What does he think the impact for potential cancer patients will be of the delay to the NHS recovery plan when waiting times are spiralling so much?

The hon. Lady and I often exchange views across the Dispatch Box, and she always asks sensible and reasonable questions. She is right to highlight the importance of cancer care, and that there are some illnesses and diseases like cancer where delay can have a significantly detrimental impact on the outcomes experienced by patients.

Between March 2020 and November 2021, more than 4 million urgent referrals were made for cancer, and over 960,000 people received cancer treatment. Thanks to the amazing work of NHS staff, we maintained cancer treatment at 99.7% of pre-pandemic levels in the latest month for which I have statistics, which is November 2021.

As well as looking to the future with the announcement of community diagnostic hubs and a range of other measures, the plan is not necessary for us to do the work, as we are already doing it. The plan is important for mapping out the future direction of care, but we are not waiting for the plan to improve services, to build back better and to tackle the waiting lists.

If the Treasury was not holding up the plan, can we be told what was holding it up? When will we get the plan?

I am grateful, I think, to my right hon. Friend for his question. As I set out, it is important that this is the right plan and that it does the job for which it is intended. We are working closely with other Departments to make sure the plan, when it is published, does the job for which it is intended, and I look forward to its imminent publication.

It is essential that we address cancer treatment capacity. The Minister talks about diagnostics, which is important, but it is a horse and cart or a hand and glove. I know he is aware of the enormous unharnessed potential of high-tech radiotherapy as a solution to time-critical cancer backlogs, but it still receives only 5% of the cancer budget. Such investment could take enormous pressure off the NHS, especially at this time. Will he arrange a meeting with the Secretary of State so that we can explain to him the important role that advanced radiotherapy could play in tackling the cancer backlog?

The hon. Gentleman and I have previously met to discuss this issue, and I share his view on the value of radiotherapy in helping to tackle the cancer backlog, and more broadly as a treatment. Ministers and I are always happy to meet him.

My hon. Friend spoke earlier of this Government’s record level of investment in the NHS, but each patient waiting for cancer treatment is undergoing a very long and frightening experience as they wait longer than needed. As he focuses on reducing this backlog, how will he ensure that the record level of investment is focused directly only on measures that will reduce the backlog and is not wasted?

My hon. Friend knows of what she speaks, as a serving consultant in our NHS. She is right that investment is important but that the outcomes are what really matter. We have set out measures such as the community diagnostic hubs, which are bringing diagnostic capacity to local communities and making it more accessible. That is just one example of how we will ensure that the money delivers the required outcomes.

Health conditions do not wait until a medic or a bed is available. They deteriorate, often very quickly, and every single one of the 6 million people on the waiting list will have to rely on their GP for extra appointments and extra treatment, and they will possibly rely on their GP to deal with severe complications. What support will there be for primary care while all these people are waiting for their planned secondary care?

The hon. Lady makes a very important point, and I take this opportunity to put on record my gratitude to all those in general practice for the amazing work they have been doing over the past two years. Again, they are the front door to the NHS for patients and all our constituents. Last year we set out the additional funding being made available to help general practice recover from the changes that had to be made during the pandemic, and we continue to look at the system as a whole, not in its component parts. She is right that general practitioners are often the people our constituents go to if their operation is delayed or if they need additional care while waiting for an operation, so it is important that we provide support to general practice, too.

Given that health service waiting lists are higher in Labour-controlled Wales and that my Bridgend constituents are being told that they are going to have to wait until at least 25 March to find out what Labour’s plan is in Wales, does my hon. Friend agree that much of what the Opposition have said here today would be better directed down the M4 towards their Welsh Labour colleagues?

I am grateful to my hon. Friend, who puts his finger on an extremely important point. I believe that one in five in Wales is on a waiting list. This Government have put in place measures already to help bring down waiting lists, and the plan is due to published imminently, but we are still waiting to see what the Welsh Government intend to do—or whether they even have a plan.