7th January 2019

Sir Nicholas’s Question to the Secretary of State for Health & Social Care on the NHS Long Term Plan.

No doubt my right hon. Friend is gratified, as would be the Churchill-led National Government of 1944, by how truly remarkable and amazing the national health service, the baby of that Government, has turned out to be. Will he assure me that this money does not come without strings and that he will enforce a much better system of lessons learned and, in particular, of disseminating best practice more widely through the NHS? Finally, will he please kick the work of the sustainability and transformation partnerships into some form of prompt result?

When I referenced Churchill, I did not realise that it would be in front of his family. My right hon. Friend is quite right about the need for a just culture—a need for understanding the lessons that are learned when things go wrong—in what is a high-risk business of providing medicine and medical care. Those lessons should be properly learned and there should be transparency and openness and a culture of constantly improving the way that things are done, whether that is medically, logistically or organisationally in hospitals. That is a critical part of the review that Baroness Dido Harding will take forward. It is something that she cares deeply about, making sure that we get the culture right within the workforce not only to tackle the high levels of bullying and harassment, which are completely unacceptable in the national health service, but to make sure that there is a spirit and a culture of continuous improvement and of learning from errors that everyone makes. All of us make errors, and we should learn from them and that culture should be inculcated right across the NHS.

Monday 7th January, 2019
Volume 652
No 228
Column 69

Statement by the Secretary of State for Health and Social Care; The Rt Hon Matt Hancock MP

NHS Long-Term Plan

Monday, 7th January 2019

House of Commons


The Secretary of State for Health and Social Care (Matt Hancock)

With permission, I would like to make a statement about the NHS long-term plan. The plan sets out how we will guarantee the NHS for the future. It describes how we will use the largest and longest funding settlement in the history of the NHS to strengthen it over the next decade, rising to the challenges of today and seizing the opportunities of the future.

It is worth taking a moment to reflect on the time when the NHS was first proposed from this Dispatch Box, under the Churchill Government in 1944. Even after the perils of war, infant mortality was nearly 10 times what it is now, two thirds of men smoked and life expectancy was just 66. It came 10 years before we knew the structure of DNA and four decades before the first MRI. The NHS has led the world throughout its history, but one constant has been the core principle set out by the Conservatives in that national Government: the NHS should be available to all and free at the point of use according to need, not ability to pay.

As last year’s 70th anniversary celebrations proved, the NHS is one of our proudest achievements as a nation. We all have an emotional connection to it—our own family story—and we all owe an enormous debt of gratitude to the people who make the NHS what it is and work so hard, especially during the winter months when the pressures are greatest.

Because we value the NHS so much, the new £20.5 billion funding settlement announced by the Prime Minister in June provides the NHS with funding growth of 3.4% a year in real terms over the next five years. That means that the NHS’s budget will increase in cash terms by £33.9 billion, rising from £115 billion this year to £121 billion next year, £127 billion in 2020-21, £133 billion in 2021-22, £140 billion in 2022-23 and then £148 billion in 2023-24.

That rise of £33.9 billion, which is actually over £1 billion more in cash terms than was proposed in June, delivers on our commitment to the NHS and will safeguard the NHS for the long term and help to address today’s challenges. The NHS is facing unprecedented levels of demand. Every day, it treats over 1 million people. Compared with 2010, the NHS carried out 2 million more operations and saw 11.5 million more out-patients last year. Despite record demand, performance was better this December than last December. So we will address today’s challenges, not least with the £6 billion extra coming on stream in under three months.

As well as addressing current challenges, the NHS long-term plan sets up the NHS to seize the opportunities of the future. At the heart of the plan is the principle that prevention is better than cure. In the future, the NHS will do much more to support people to stay healthy, rather than just treating them when they are ill, so the biggest increase to any part of the NHS—at least £4.5 billion—will go to primary and community care, because GPs are the bedrock of the NHS. That means that patients will have improved access to their GPs and greater flexibility about how they contact them, as well as better use of community pharmacists and better access to physiotherapists. Improving the availability of fast and appropriate care will help communities to keep people out of hospital altogether.​

The next principle is that organisations across the NHS, local councils, innovators and the voluntary sector will all work more closely together so that they can focus on what patients need. There will also be a renewed clampdown on waste so that we can ensure that every penny of the extra money goes towards improving services and giving taxpayers the best possible return.

Ultimately, staff—the people who work in the NHS—are at the heart of the NHS. The long-term plan commits to major reforms to improve working conditions for NHS staff, because morale matters. Staff will receive better training and more help with career progression. They will have greater flexibility in their work, be supported by the latest technology that works for them and be helped more with their own mental health and wellbeing. That already happens in the best parts of the NHS, and there has been a huge amount of work to support the people who work in the NHS, but I want to see it happen everywhere. We will bring in better training, mentoring and support to develop better leadership in the NHS at all levels. We will build on the work that is already going on to recruit, train and retain more staff so that we can address critical staff shortages.

The plan published today is the next step in our mission to make the NHS a world-class employer and deliver the workforce it needs. To deliver on the workforce commitments, I have asked Baroness Dido Harding to chair a rapid programme of work, which will engage with staff, employers, professional organisations, trade unions, think-tanks and others to build a workforce implementation plan that puts NHS people at the heart of NHS policy and delivery. Baroness Harding will provide interim recommendations to me by the end of March on how the challenges of supply, culture and leadership can be met. She will make her final recommendations later in the year as part of the broader implementation plan that will be developed at all levels to make the NHS long-term plan a reality.

That is the approach that we will be taking to support the NHS over the next decade, but what does it mean for patients and the wider public? It means patients receiving high-quality care closer to home. It means supporting our growing elderly population to stay healthy and independent for longer. It means more personalised care and more social prescribing. It means empowering people to take greater control of, and responsibility for, their own health through prevention and personal health budgets. It means accessing new digital services to bring the NHS into the 21st century. It means more support for mothers by improving maternity services. It means providing more support for parents and carers in the early years of a child’s life so that this country can be the best place in the world in which to be born, in every sense.

We will improve how the NHS cares for children and young people with learning disabilities and autism by ending inappropriate hospitalisation, reducing over- medicalisation and providing high-quality care in the community. The NHS will tackle unacceptable health inequalities by targeting support towards the most vulnerable in areas of high deprivation. To help to make a reality of the goal of parity between mental and physical health, we are going to increase mental health service budgets not by £2 billion, but by £2.3 billion ​a year. For the first time ever, we will introduce waiting time targets for community mental health so people get the treatment they need when they need it. We will also expand services for young people to include those up to the age of 25—something that never happened under the previous Labour Government.

The long-term plan focuses on the most common causes of mortality, including cancer, heart disease, stroke and lung disease. The health service will take a more active role in helping people to cut their risk factors by stopping smoking, losing weight and reducing alcohol intake. The NHS will improve the quality and speed of diagnosis and improve treatment and recovery, so that we can help people to live well and manage their conditions. We will upgrade urgent care so people can get the right care more quickly.

All in all, the NHS long-term plan has been drawn up by the NHS—by more than 2,500 doctors, clinicians, staff and patients. It will continue to be shaped and refined by staff and patients as it is implemented, with events and activities across the country to help people to understand what it means for them and their local NHS services. The experts who wrote the plan say that it will lead to the prevention of 150,000 heart attacks, strokes and dementia cases, and to 55,000 more people surviving cancer each year—in all, half a million lives saved over the next 10 years. It is funded by taxpayers, designed by doctors and delivered by this Government.

This is an important moment in the history of the NHS. Our long-term plan will ensure that the NHS continues to be there, free at the point of use, based on clinical need, not ability to pay, but better resourced with more staff, newer technology and new priorities. It will be fit for the future, so that it is always there for us in our hour of need. I am proud to commend this statement to the House.