A happy new year to you, Mr Speaker, and to everyone across the House. With your permission, I will give an update on health and adult social care reform.
I start by paying tribute to the NHS and social care staff who worked throughout the Christmas break, including by staffing our hospitals, ambulance services, care homes and call centres on Christmas day and throughout the new year. From visiting hospitals and residential care homes in the south-west of England, Essex, London, South Yorkshire and the north-west over the past two weeks, I know the extent of the pressures they are dealing with. They are going above and beyond to keep the NHS standing, to provide people with the social care they need and to give patients and care users the best care they possibly can against the most challenging backdrop.
We have seen more than three times as many patients hospitalised with flu this winter compared with last year, in a service with no slack left to give. Since coming into office, the Government have been doing everything we can to prepare the NHS for winter, including by ending the resident doctors’ strikes. This is the first winter in three years when staff are on the frontline, not the picket line. The Chancellor made an additional £1.8 billion available in-year to fill the black hole left by the previous Government, and we introduced the new respiratory syncytial virus vaccine to protect more than 1.2 million people against the virus.
But I am not going to pretend for a second that the experience of patients this winter is acceptable. The Government have been honest about the state of the NHS since the election, and we will continue to be. The NHS is broken but not beaten. It will take time to fix, but it can be done. That is why the Chancellor made an additional £1.8 billion available in-year to fill the black hole left by the previous Government and to enable us to deliver on our first steps to cut NHS waiting times. That is why we are undertaking fundamental reform, and it is why we are acting on social care.
These are the honest facts. The social care system in this country is failing, leaving hundreds of thousands of disabled and elderly people without the care they need. The failure of social care is piling enormous pressures on the NHS. In November, more than 12,400 hospital patients a day were well enough to leave but had to stay overnight because they were not able to be discharged. We have an ageing society: by 2050, there will be 4 million more people aged 65 and over in England. If we do nothing, social care costs are expected to double over two decades.
Of course, there is plenty of blame to go around. In 2009, when Andy Burnham established cross-party talks on social care, the Conservatives pulled out and leaked details of the talks to attack Labour. In 2017, it was Labour who torpedoed Theresa May’s proposals. And in 2022, the right hon. Member for Richmond and Northallerton (Rishi Sunak) as Chancellor delayed Boris Johnson’s cap on care costs, and then defunded them as Prime Minister. There has not been a shortage of good ideas in the past 15 years, but a lack of good politics. It is time all of us across the House do things differently.
I am grateful to the Secretary of State for his typical courtesy in early sight of his statement, as well for his call last week. Indeed, it was earlier sight than I am used to because I was able to read most of it in the media before coming here, which was not unhelpful.
I echo the Secretary of State’s comments in thanking and paying tribute to NHS and social care staff up and down the country, including those in my university hospitals of Leicester NHS trust, GPs and, indeed, all those in Chorley hospital, Mr Speaker, for all they have done over the festive period. They work full-on day in, day out every day of the year, but they particularly feel the pressure over the festive period when they are not able to spend it with their families, so it is important that we across the Chamber share our recognition of that.
The Secretary of State set out clearly the challenges facing the system. We all know that clinical care, the NHS and social care must work well and as a whole for our health and care system to function, so it is right that his statement addresses both those issues. He also highlighted the challenges we face as an ageing society. We are all living longer, which is a good thing, but that brings challenges of care and more complex needs. Of course, that comes on top of the ongoing challenges of the legacy of the pandemic, which are still with us in many ways.
In his comments, the Secretary of State referred to previous reforms. He opted not to reflect another point in Lord Darzi’s report: his positive remarks about our 2022 reforms, which the Secretary of State knows I took through this House and which laid the foundations on which he is now able to build. Given the serious and cross-party work we have done certainly on social care, I highlight that the challenge is real, and we must address both challenges swiftly.
Before turning to the long term, I turn to the immediate and ask the Secretary of State a few questions about winter and the challenges the NHS is facing. We heard from the Minister before Christmas about the work being done for extra co-ordination and new data, but what extra capacity in beds specifically for the winter period has the Secretary of State put in place to help ease pressure? What additional capacity has he put into A&E? We always recognised that winter is challenging, and we always put in extra resource, support and capacity, so I would be grateful for an update.
It seems to be the Conservative line across the board now to say, “You’ve had 14 years in opposition, so why haven’t you sorted it all out in six months?” I say gently that the Conservatives had 14 years in government, and it will take longer than six months to clean up their mess. Honestly, their contributions to discussions in this House might have more credibility and a stronger landing zone if they at least acknowledged their part in the deep mess and malaise that they have created over the past 14 years.
None the less, on social care, I very sincerely and warmly welcome the Conservative party’s support for the independent commission. It is important, as a matter of principle, to try to establish in broad terms the level of consensus about what social care should look like and how it should be delivered to meet the needs of older and disabled people in the 21st century, with changing demography, changing challenges, changing pressures and a changing pace of technology, and about the balance of provision between the individual, the family and the state, and the balance of financial contributions for social care between the individual, the family and the state.
Of course, those issues will inevitably be contested across the party political divide from one election to the next, but just as we have had broad consensus on the national health service since 1948, just as we have had broad consensus on state education since Rab Butler’s reforms, and just as we have mostly had broad consensus for much of the past century on how public services should be delivered, so too should we try to establish the same consensus on social care. That is not to say that we should agree on everything, but we should agree on as much as possible, because whether it was Gordon Brown and Andy Burnham in 2010 or Theresa May in 2017, we can see the extent to which party political wrangling, rancour and sometimes opportunism has sunk well-meaning attempts to grasp the nettle of reform.
Does the Secretary of State agree that his plan to transform adult social care services has already started with Labour’s Employment Rights Bill ensuring that social care workers will get fair national pay and conditions, and increased access to training and progression? Does he further agree that we will never have a quality social care service in this country if we do not value the people delivering it properly, as this Labour Government intend to do?
My hon. Friend is absolutely rightly. The Employment Rights Bill, introduced in our first 100 days, contains provisions for a new fair pay agreement for care workers, and who better to be leading the charge on that than the care worker turned Deputy Prime Minister, my right hon. Friend the Member for Ashton-under-Lyne (Angela Rayner).
I add my thanks to those of the Secretary of State and the shadow Secretary of State to all those who worked in our health and care services over Christmas and the new year.
Our health and social care system is in crisis, so the Liberal Democrats are broadly supportive of the measures that the Government have announced today. However, we do have some concerns, not least that action on social care may arrive too late and that the focus on elective care may come at the expense of emergency care. The Liberal Democrats have long called for cross-party talks on social care, so we are glad that the Government have listened and we look forward to working constructively with the Secretary of State and other UK-wide parties as the review develops. However, carers, care providers and councils are on the brink of bankruptcy and they need solutions right now, not in three years’ time. There have been many such reviews, and what is needed now is action on the recommendations they have made.
It is absolutely crucial that waiting times for elective care are cut radically, so the action announced today to speed up scans and treatment is very positive. A waiting list of more than 6 million people is one of the worst legacies left by the Conservatives, but those legacies include overcrowded A&Es and unacceptable ambulance delays, which can mean the difference between life and death, as people in North Shropshire know only too well. Emergency care is under immense pressure at the moment—one visit to Shrewsbury hospital demonstrates that—and we need bold action if we are to ensure that this is the last ever winter crisis.
As the MP for a rural area, I hear every week from constituents suffering because of the crisis, so they will be following today’s developments closely. Many of my constituents are elderly—far more than average—and they are the people most likely to need the NHS and the most likely to be digitally excluded. According to Age UK, around 29% of people aged 75 and over do not use the internet, and around a third do not have a smartphone. They deserve as much choice and control as everybody else, so can the Secretary of State outline how those without access to the NHS app will be able to benefit from the same options and information as those who do have access?
I thank the Liberal Democrats for their support for the commission and for the way in which their party has put the issue of social care much higher up the political agenda, particularly during the general election campaign. That has been very helpful to me in the last six months and to the Government, and we look forward to working with the Liberal Democrats to build as broad a consensus as we can on the solutions to the social care crisis.
As I have mentioned, we have hit the ground running in a number of respects, including the biggest expansion of carer’s allowance since the 1970s. On investment in health and social care, I just point out that the £26 billion the Chancellor allocated to the Department of Health and Social Care alone at the Budget dwarfed what the Liberal Democrats promised in their manifesto. I know that not all the funding decisions the Chancellor and the Government have made in the last six months for the desperately needed investment in our public services have been popular, but I respectfully say to people who disagree with the decisions the Chancellor has made that they need to spell out which services they would cut or which other taxes they would increase, because those are the choices. We have made our choices; we stand by them. What people cannot do is welcome the investment but not say how they would fund it if they oppose what we have done. The Prime Minister, the Chancellor and the entire Government have been willing to make unpopular choices in the last six months because we believe they are the right choices to get Britain out of the hole it was left in by our predecessors. People will not thank us for resorting to the short-termist, sticking-plaster, government-by-gimmick politics that plagued this House during the last Parliament.
I turn to some of the other issues that the hon. Lady mentioned. We will make further proposals on urgent and emergency care reform. I want to take the best of the NHS to the rest of the NHS, whether it is “hear and treat” over-the-phone triage—a more appropriate community response that is often faster than ambulance response times—or getting ambulances and ambulance handover speeded up at all our hospitals with the “release to respond” approach. We have seen that working successfully in some parts of the country, but it needs to be consistently rolled out.
Mr Speaker, I take that personally, in a positive way.
This is a very encouraging statement. It is great to start the new year with some good news and to be so clear that we are keeping our promises as a Government. It is also very good that we are taking the necessary time to create this cross-party consensus on social care while keeping the show so firmly on the road. Carers will be supported to carry out more health tasks, as they do already in my constituency with wound dressing and medicine management. The problem is they do not have any possibility of career progression. [Interruption.] I am sorry, Mr Speaker, I forgot your initial encouragement; I will bring this to a close.
Does the Secretary of State agree that as carers are encouraged to do more health tasks, they need proper opportunities for career progression even within the NHS, in collaboration with local authorities?
Brevity was not my hon. Friend’s new year’s resolution, but at your encouraging, Mr Speaker, it is mine. We will provide more training to care professionals to deliver a wider range of tasks in the home, making better use of their skills and the career progression that my hon. Friend describes. Crucially, that career progression must be in status and in pay. That is what we will work with the staff to deliver.
I welcome the consensual parts of the Secretary of State’s statement, but I wonder whether we have been entirely honest with the public about the sheer unaffordability of the cap proposed by Dilnot. I do not absolve my own Government from this: maybe we should start telling the truth to the public. Does the Secretary of State think we need a new social compact on bringing in social insurance so that people can plan for their entire life? They would know that they will have to pay more in taxes during their life for their old age, but at least they would have certain rights.
The right hon. Gentleman is right to say that we need a debate as a country about the balance of financial contribution between the individual, the family and the state. I well understand why David Cameron was so concerned about catastrophic care costs and people having to sell their homes to pay for their care and the problem he was trying to solve. With every Government since, the issue has been seen as less urgent than others, but that does not mean it does not matter or that we should not consider it as part of the Casey commission. We need to consider all these issues in the round and, as much as we can, build a consensus not just in this House, but throughout the country about the balance of financial contribution and what is fair, equitable and sustainable.
Just before Christmas, one of my constituents visited my surgery and gave me pause to reflect on the massive, often lifelong impact on loved ones who have someone in the social care system, and the devastating impact on their ability to work and to live healthy, fulfilling lives. Does the Secretary of State agree that the commission will lay the foundation for real change so that people in the social care system and their families can live the healthy, fulfilling lives they deserve?
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I have written to my opposite numbers and the leaders of all UK-wide parties represented in the House to invite them to help break out of the cycle of political failure. I hope all of us across the House will put aside our ideological and partisan differences, and work together on this, to finally find a way through to a long-term plan that can build the broad consensus we need.
We do not need to agree on everything, but in April we will launch an independent commission on building a national care service. I am delighted that it will be headed by one of our country’s leading social reformers, and Whitehall’s greatest doer, Baroness Louise Casey. Baroness Casey has served Labour, Conservative and Liberal Democrat Governments. She is a trusted, independent figure, who will take views from all parties and, crucially, the public as she seeks to build a cross-party and national consensus on the future of social care. She will get things done. Her first report will be published next year, making a series of recommendations that can be implemented straight away throughout this Parliament, and her final report will come later in this Parliament.
In the meantime, we are stabilising the social care system today. We have legislated for the first ever fair pay agreement for social care, to tackle the workforce crisis—the 131,000 vacancies we see today. In the Budget, the Chancellor provided the biggest increase in carer’s allowance since the 1970s, worth £2,300 a year to family carers, and an extra £3.7 billion for local authorities.
On Friday, I visited the home of Keith and Elaine in Carlisle. I saw at first hand how extended doorways and the installation of accessible kitchen and bathroom facilities have changed their lives, thanks to the disabled facilities grant, allowing them to live with renewed dignity, independence and happiness. That is why I announced last week the immediate release of £86 million through the disabled facilities grant, to provide an extra 7,800 home adaptations before April, changing the lives of thousands more disabled people for the better, just as Keith and Elaine have experienced.
We are not hanging around on reform either. We are introducing new standards to help people who use care, their families and providers to choose the most effective new technology as it comes on the market. We are joining up care and medical records, so NHS and care staff have the full picture they need to provide the best possible care. And we are training care workers to perform more health interventions to help people stay well and at home. A lot done, a huge amount more to do and, if this House gets this right, the best is yet to come.
Turning to the elective reform plan the Prime Minister has launched today, the Government inherited NHS waiting lists at 7.6 million. The NHS standard, that patients should wait no longer than 18 weeks for treatment, has not been met for a decade. Millions of patients are forced to put their lives on hold while they wait. In his investigation, Lord Darzi listed the causes of this crisis: the undoing of new Labour’s reforms, the disastrous top-down reorganisation, and slashing GPs and community health services, all of which have led to a dramatic drop in hospital productivity. Lord Darzi has diagnosed the condition; now this Labour Government are prescribing the cure.
In November, the Prime Minister set out the Government’s plan for change—a plan to dig this country out of the hole it was left in and an act of resistance against the status quo of managed decline. It committed to cutting maximum waiting times from 18 months today to 18 weeks by the end of this Parliament. Today, we are setting out how we will hit that ambitious target, so that once again the NHS is there for us when we need it. This will demand faster improvement than even the last Labour Government achieved. That means doing things differently. It had to be a plan for investment and reform. Investment and reform is what Labour promised before the election. Investment and reform is what we are delivering. Our elective reform plan will cut waste and inefficiency, ramp up the number of appointments, scans and operations that the NHS performs, and give NHS patients greater choice, control and convenience.
Any patient using the NHS can see the waste and inefficiency in the service when they use it. Staff feel it holding them back every day. When the Government announced significant investment in the Budget, I said that it would come with reform, so that every pound was well spent, and here it is. Resources will be diverted from hospitals to GPs, to get hundreds of thousands more patients cared for faster in the community. Patients will have the choice of whether they want or need follow-up appointments, saving a million pointless appointments a year. GPs will be able to directly refer patients for tests and scans, cutting out the middle man and speeding up diagnoses for patients across a wide range of conditions. For years, restaurants have been texting customers reminders of their bookings, giving them the chance to cancel or rearrange, to cut down on no-shows. The NHS will learn from the hospitality sector, do the same for patients, and cut around a million missed appointments every year as a result.
In opposition, we said that investment in new and more productive ways of working would make a significant dent in waiting times. Today, we are announcing 17 new and expanded surgical hubs to run like Formula 1 pitstops and bust through the backlog. Community diagnostic centres will open at evenings and weekends so that patients do not have to take a time off work for their appointment, and can get diagnosed faster. We are rewarding trusts that cut waiting times fastest with extra capital investment as an incentive, and we are publishing a new agreement with the independent sector—the first of its kind for 25 years—to cut waiting times.
Over the past 14 years, a two-tier healthcare system emerged in this country. People who can afford it are increasingly going private to skip the queue, while those who cannot are left behind. Working people are going into debt, and others are running fundraisers to pay to get an operation. Those stories belong in pre-war Britain. They should shame the Conservative party. I am determined to end two-tier healthcare in this country, so that whether you are the richest or poorest person in Britain, you get timely, quality treatment, free at the point of use. This new agreement will see more NHS patients able to choose to be treated in a private hospital where there is capacity, paid for by the state. More capacity will be available for people in working-class areas of the country, and for women stuck on gynaecology waiting lists. Where we can treat working people faster, we will, and we make no apology for doing so.
Working-class patients in this country deserve the same choice, control and convenience as the wealthy expect—indeed, as we all expect from other apps and services that we use every day, but not the NHS. That is why we are also modernising the NHS app to put patients in the driving seat for their own care. If customers can choose when their Deliveroo meal will arrive, and be kept informed until it is dropped off, why should patients not be afforded the same service by the NHS? With this plan, they will be. Patients will be able to manage their appointments, book tests and scans, view results as soon as they are ready, and choose where they will be treated. We will cut down on letters that arrive in the post after an appointment, and give power back to the patient.
In the past six months, we have ended the resident doctors’ strike and invested billions more in our health service, with the biggest investment in hospices and end of life care for a generation. We are delivering investment and reform in general practice to fix the front door to the NHS and bring back the family doctor, and we have started to get NHS waiting lists falling. This plan for investment and reform will press down harder on the accelerator and will change our NHS and the experience of millions of patients. It will put the NHS on the road to recovery, and I commend this statement to the House.
I would be grateful for an update from the Secretary of State on the pressure being felt in respect of the “quad-demic” of various challenges faced by the sector. Also, how many critical incidents have trusts declared since 1 December? I would be grateful if he could update us on the pressures being felt and the response to them in the light of the winter weather. In my Melton and Syston constituency in Leicestershire and in many constituencies across the country, we have seen extensive flooding, which has had an impact on our ambulance services in particular.
Turning to reform and elective recovery, I want to support the Secretary of State where he is doing the right thing, and it is important that he is keen to pursue a bold and innovative agenda. It is in all our interests that he is bold, but I call for him to be more ambitious. Those are not words often spoken about him, and I suspect certainly not in No. 10, but I call for him to be bolder and to go further. That is because, as with so much from the Prime Minister with multiple relaunches of previous announcements, what we see here is yet another relaunch of a previous announcement. The difference is the former Secretary of State Sir Sajid Javid’s announcement from 2022 has been reheated and re-served up today. We delivered 160 community diagnostic centres with 9 million additional appointments, and we delivered 18 surgical hubs. How will the Secretary of State’s plan go beyond that? We worked with the independent sector to allow it to be used to help tackle backlogs. We improved technology and the kit available, with £6 billion of investment. The NHS app created during the pandemic was designed and redesigned by my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay) and his team to allow for regular updates. Again, it is right that the Secretary of State is updating the app, but how is he radically changing what was already in place? I certainly already receive text updates—as, I suspect, do others—on treatments and appointments, so my challenge to the Secretary of State is this: what is he doing that is fundamentally different?
The key underpinning point in the former Secretary of State’s plan was on workforce, because none of this can be delivered without the staff to deliver and interpret tests. He set out his plan to grow the workforce, and we have record numbers of doctors and nurses, and increased medical school places. What is this Secretary of State’s plan to grow the workforce and deliver on his ambitions?
Turning to social care, the Secretary of State will know—because I have said it publicly—that I will work constructively with him and the commission. He is right to highlight the challenges that Governments of all complexions have faced, including a Royal Commission, two Green Papers and a comprehensive spending review that did not deliver under Tony Blair and Gordon Brown. Similarly, Theresa May’s reforms did not deliver. We proposed reforms that were due to come in this year, but the Chancellor scrapped them. I think it is important that we look to the future and at how we can work constructively on social care.
I say to the Secretary of State that we will enter into discussions with him and the commission in that spirit, but I challenge him on the pace of his ambitions. The sector is already under pressure, and that has been added to by the national insurance increases, which it does not yet know how it will pay. The real challenge for him is: why 2028? The sector is crying out for a faster pace—be bolder; be more ambitious—and we will work with him to deliver it. It takes a year-plus to deliver a diagnosis—we know the challenges. He has had 14 years in opposition; he should have a plan now.
We will call out the Secretary of State when he gets it wrong or simply re-announces what is already happening, but he is right in his approach to social care and finding a way forward, and we will work constructively for the good of patients and all our constituents. Many of them already feel let down by promises broken by the Labour party over just the past six months, so I ask him not to break this promise, and to work with us, across the House, to deliver the change that our constituents deserve and expect us to work on together to deliver.
On the question of pace, I reassure people that in our first six months we have already legislated for fair pay agreements, delivered the biggest expansion of carer’s allowance since the 1970s, and immediately injected £86 million into the disabled facilities grant, with another £86 million to follow from April—£711 million in total over the next year—as well as the increased spending power for local government in the Budget and £880 million for social care specifically. With respect to the people who are saying, “Go faster”, I urge them to bear in mind that we have already done quite a lot in six months. We do not pretend that we have solved all the problems—we have not nearly solved all the problems—but that is not a bad start for a Government who are determined to show that we understand the pressures in social care today and are willing to deliver.
The Dilnot proposals were very good technical responses to a question that Andrew Dilnot was set by David Cameron, but we should reflect on why it was that every single Prime Minister since Lord Cameron, including Lord Cameron himself, did not implement those reforms. There has always been something else in health and social care that has been more pressing and urgent. I am sure that Baroness Casey will consider the Dilnot proposals alongside all the other challenges and potential solutions to the wider issues in social care, but we are determined to respond at pace. That is why the first phase of the Casey commission will report next year, setting out an action plan throughout this Parliament. I hope that we can achieve broad consensus on those actions too.
Turning to the winter situation, the right hon. Gentleman has asked what capacity there is. According to the latest figures, there are 1,300 more acute beds this year than last year. Of course, those figures flex up and down depending on pressures, but the pressures are enormous. The number of beds occupied by flu patients is much higher than this time last year—somewhere between three and four times higher. The number of adult beds closed due to norovirus has reduced in the latest figures, but it is still above last year, when 485 beds were closed—the latest figure is 666. On ambulance responses, we have seen many more call-outs this year. There has been a 3.8% increase in emergency admissions compared with the same period last year, with the highest November on record for A&E attendances. Ambulance response times are nowhere near where we would want them to be because of the enormity of the pressure, which is why I have been out on the frontline, including over the Christmas period. We are not just looking at what we can do to mitigate challenges this year; we are already beginning to plan for next year, because I want to see year-on-year continuous improvement in urgent and emergency care.
I now turn to the challenges on the reform plans we have proposed and set out today. Starting with the workforce, one of the reasons we have emphasised the importance of not just investment but reform is the need to free up the staff capacity that we already have in the NHS to best effect. That means dealing with the number of non-attendances by sending reminders to patients and giving them ease and convenience in rebooking. It is why we are getting rid of unnecessary, low-clinical-value out-patient appointments, with the consent of patients in every case. It is why we are asking general practitioners to do more to manage cases in the community with more advice and guidance, and funding them to do so, working with colleagues in secondary care to ease pressure on hospitals.
Today’s reform plan answers the challenge we have heard from people across the NHS: how do we tackle the elective backlog without doing so at the expense of general practice, urgent and emergency care, community care or social care? The truth is that this is a systemic challenge, and we will only be able to deal with the challenge in the elective backlog by also acting on urgent and emergency care, general practice, community care, and delayed discharges in social care. We are taking a system-wide approach to meeting this essential target.
A number of things are different from under the previous Government. For example, on the deal with those in the independent sector, giving them the stability and certainty of working with this Government gives them the confidence to open and invest in new capital estate and new kit, particularly in parts of the country that are relatively underserved by the independent sector. We have insisted they do that with their own staff and resources, and that they put their money where their mouth is in relation to training new staff to deal with some of those pressures. That is how we will ensure that we will not be taking Peter from the NHS hospital to treat Paul up the road at the independent hospital.
Finally—I am happy to take more questions on the detail of the plan—the shadow Secretary of State asked what is different from 2022? In fact, I think he asked me to commend my predecessor Sir Sajid Javid for his work in 2022. In the bipartisan spirit of the new year, let me commend the work that he and Sir Sajid Javid did in trying to undo Lord Lansley’s disastrous top-down reorganisation, and that was a very good thing to do. There will be a very big difference between this Government and our Conservative predecessors: real delivery, shorter waiting times and an NHS fit for the future.
Will the Secretary of State consider fast-tracking the social care review so that the sector can get the urgent attention it needs? Will he commit to rescuing our emergency services by supporting Liberal Democrat calls to make the NHS winter-proof with a new winter taskforce that builds resilience in hospital wards, A&E departments and patient discharging? Finally, will he define what a working-class area is, because the health and care crisis is acute in rural Britain and we cannot afford to be left behind?
The hon. Lady talked about patient choice for those who are digitally disconnected or do not want to organise their lives around their smartphones. That is why I believe very strongly in choice—different courses for different horses. Those of us who do not book appointments over the phone free up the line so that those who prefer doing their business and booking appointments by phone can get through.
The hon. Lady asked us to fast-track the social care work. The first phase of Louise Casey’s commission will report next year, but we are of course willing to talk to parties across the House about how we move forward.
The hon. Lady urges us to set up an urgent and emergency care taskforce. Let me reassure her that the Minister of State for Health my hon. Friend the Member for Bristol South (Karin Smyth) and I have every week—and often more frequently—convened health and care leaders virtually and in the Department to keep a grip on what is going on, to provide as much central support as possible, and to respond to crises as they emerge. If only that was just about setting up a taskforce. We already have one; what we need is sustained improvement from one year to the next and that is what we are determined to deliver.