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With permission, I would like to provide the House with a brief update on the additional pressures on health this summer as a result of the heat, the action our NHS has taken in response, and some of the next steps the Department is taking on investment and reform to help our NHS improve its resilience and performance in the face of new health challenges.
Before I do that, let me say, as I did last night, what a pleasure and honour it is to be back at this Dispatch Box as Secretary of State for Health and Social Care, 27 years after I first became a Health Minister under the last Labour Government. While there have been many changes in health and healthcare in the last quarter century, the values that underpin our NHS—care and compassion for all of us, based on need and not the ability to pay—are the best of British values, and they have endured through generations.
What has also endured is the incredible dedication of NHS and social care staff. As a result of their work and with the support of this Government, and despite record health demand, we have seen millions of additional appointments; record numbers of patients receiving treatment; waiting lists down by 350,000 in two years; ambulance and A&E waiting times down in the winter; thousands of extra doctors, nurses and mental health workers in place; and patient satisfaction with access to GP services up to 75% from 61% two years ago.
Alongside recognising the dedication of NHS staff, I want to recognise the impact that covid had on staff across our NHS and social care and the pressures they faced. They were there for us then and we should not forget that now. That is one reason why it makes me incredibly angry that the figures show that one in seven NHS workers have faced violence and abuse while doing their job, and the figure is much higher in emergency care. That is a disgrace, and I hope I speak for the whole House when I say to those staff: we are on your side and we will always stand up for you.
Let me pay tribute to my immediate predecessors in this role, my right hon. Friends the Members for Ilford North (Wes Streeting) and for Ealing North (James Murray). I also pay tribute to the work of other Health Ministers over the last two years who together have commissioned the Darzi report, drawn up the NHS 10-year plan and the cancer plan—for which I pay particular tribute to my hon. Friend the Member for West Lancashire (Ashley Dalton)—and driven the additional investment, reforms and improvements in performance we have seen in the last two years.
I want to focus on the immediate pressures on health that our NHS has faced, exacerbated by the summer heat. We have experienced what has officially been registered as the hottest summer on record, with five heatwaves, 40 days of temperatures above 30° and extremes that we now expect to be the new normal because of the impact of climate change. During May and June of this year, it is estimated that there were more than 2,800 excess deaths. To put that in perspective, it is almost twice as many as the 1,500 heat-related deaths during the entire summer of last year. Once the analysis of July and August is complete, it will be clear that the extreme heat we have seen this year has had an unprecedented impact on the health of the nation and represents a new significant threat to the very oldest, the very youngest and the most vulnerable in our society.
Extreme temperatures also pose additional challenges to the normal functioning of the NHS. This July saw the highest number of attendances at A&E of any month in any year in the history of the NHS. Ambulance teams handled over 800,000 incidents that month—the second highest for a month outside winter. This is against a backdrop of continued pressure in A&E. Today’s National Audit Office report recognises that the NHS is beginning to see improvements in A&E performance, but not yet at the scale that we need to see.
The heat has highlighted some of the weaknesses in the NHS estate, including overheated wards and operating theatres. This comes against a backdrop of the damaging under-investment in NHS estates that we inherited. This was highlighted in the Darzi report, which said that the NHS was “starved of capital” after 2009, impacting on productivity and performance as well as letting patients and staff down.
Let me set out the action we are now taking to boost the resilience and performance of our NHS in the face of these new summer and other pressures. First, in the spending review, we allocated for the first time a multi-year £6.75 billion estate safety fund. I can announce the first wave of investment from this fund today, covering 950 hospital projects across England, which will receive a share of a £1.5 billion investment to fix urgent problems with ageing buildings and facilities. The schemes will tackle issues including failing fire safety systems, outdated ventilation and ageing electrical equipment that could put patients and staff at risk. More than £32 million will be spent specifically on projects that include improving cooling and ventilation, and helping hospitals cope with extreme heat as well as winter pressures.
As part of that funding, I can announce 10 major schemes worth £200 million for Wycombe hospital in High Wycombe; the Royal Free hospital in north London; the Linden centre in Essex; the John Howard centre in London; Lister hospital in Hertfordshire; Southend hospital in Essex; the Stepping Hill hospital in Stockport; St George’s hospital in Stafford; the Bristol royal infirmary; and the Queen Elizabeth hospital in Gateshead. I have also asked the NHS to look in particular at extreme weather resilience as part of future waves of capital plans.
The second action is about resilience and planning. For many years, the NHS has run a detailed planning process to ensure that it is prepared for the pressures of the winter months; however, this summer has shown us that seasonal resilience is just as important at other times of year. That is why we have established a new heat taskforce that includes the chief medical officer, NHS England leaders and several NHS chief executives from services that have been most affected. I have requested that the taskforce should examine the impact on vulnerable groups, including the frail, expectant mothers and those with mental health conditions. I will chair its first meeting in the coming weeks.
The taskforce will help to ensure that our summer planning is on the same footing as our winter planning—looking at staffing, expert teams, patient flow, corridor care, links to social care and, crucially, prevention and public health. That comes against a backdrop of a £450 million investment to improve urgent and emergency care, expanding urgent care centres and mental health A&Es, and shifting more care into the community.
The third area is social care. Many of those who are most vulnerable to extreme heat are in social care, so the work that our care system does is vital for people’s health. We also know that the persistent lack of join-up between health and social care continues to be a problem, with frail elderly people who would be better cared for at home being sent to hospital and patients being held in hospital for far too long because care support is not in place.
This feels like groundhog day: we were having the same discussions about co-ordination between health and social care when I was last a Health Minister 25 years ago. The Government are taking action, including through the better care fund, neighbourhood health and an additional £4 billion investment into adult social care by 2028-29, as well as through the planning process to improve co-ordination. However, the problems are structural and will need much more substantial reform. That is why the Prime Minister announced this summer that we are bringing forward Baroness Casey’s commission to report next year and, alongside that, taking forward cross-party talks to see what consensus can be built.
The legislation to create our NHS went through this House 80 years ago this autumn. At its heart was the idea that, as Nye Bevan said on Second Reading, it would
“lift the shadow from millions of homes.” —[Official Report, 30 April 1946; Vol. 422, c. 63.]
It was to ensure that there was a health service to care for all of us whenever we needed it, improving the health of our nation. Ensuring that that shadow stays far from our doors for the next 80 years means not just the modernisation of the NHS, the 10-year plan and the improvements we will debate many times in the House; it means building the level of resilience, be it to changing weather and climate or for a changing world that impacts on our health and healthcare. We will do that only by working together and with the dedicated staff, patients and communities across the country. I commend this statement to the House.
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I am grateful, Mr Speaker. I thank the Secretary of State for her statement and for advance sight of it. To date, preparedness statements have tended to focus on winter, as she said, but she is right that we now need such an approach for summer.
I welcome the statement today, but we must also ask about this year—the summer just gone. Yes, the intensity and length of high temperatures was new, along with the spikes that it brought in emergency admissions and all the cancelled appointments, but it was also predictable: high temperatures were forecast. What lessons has the Department learned from the UK Health Security Agency reports on adverse weather and health? What preparations had it made in advance of the summer? What guidance was given? Were trusts left to develop protocols themselves? Specifically, what guidance was given to care and nursing homes?
Of course, the high temperatures this summer were not unique to the United Kingdom—nor indeed is the UK, by quite some way, the hottest country in Europe. What conversations have the Secretary of State and her Ministers been having with counterparts in other countries to make sure that each learns from the other?
Right now, the NHS is amid a massive top-down reorganisation. What assessment has the Secretary of State made of the effect of the uncertainty and upheaval that always comes with a major reorganisation on the NHS’s ability to put in place changes at short notice? Given the extreme heat that staff were enduring, what steps is she taking not only on building and ambient temperature, but to ensure that the design of personal protective equipment, for example, reflects the changed needs? What specific consideration is being given to the ambulance service?
There is a connected issue: the cost of energy, for summer as well as winter. What is the right hon. Lady doing across Government to make heating and cooling more affordable for households and individuals? That would bring down admissions. Will the Government now adopt the cheap power plan that we have set out?
Finally, although we are talking about the summer, it is September already; it is reasonable and timely to ask also about winter. We understand that supply of the RSV vaccine is in place, but what guarantees can she give about wider preparedness? When will the Secretary of State come to the House to set out those plans? The number of people waiting more than 12 hours in A&E for admission is up significantly since the change of Government. What is she doing to grip that well ahead of the coming winter pressures?
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I thank the shadow Secretary of State for his response. As I did not reply to him yesterday, I did not have the opportunity to welcome him to his post. He referred to my personal links to East Hampshire. I should say that I remember going to see the GP at the health centre on Anstey Road in Alton, because of an earache—not that I am associating the right hon. Gentleman with earache.
The shadow Secretary of State raised the issue of this summer. Despite the record demand on the health service in July, there were actually improvements in performance on waiting lists, waiting times and emergency care as a result of the huge amount of planning and work that had been done on performance, particularly for A&E, emergency care and electives. That is a tribute to the work across the national health service and all the planning work that had been done nationally, including to improve performance.
The right hon. Gentleman rightly raised the issue of preparedness for the coming winter. Health Ministers have meetings about the winter in the summer and we are now increasingly going to have to have meetings about summer in the winter as well, but that planning is already well under way right across the NHS and across NHS England. We will provide updates for the House in due course.
The right hon. Gentleman raised some particular issues to do with heat. The NHS approach should be about seasonal resilience to be ready for what might be extremes of flooding, extremes of hot weather and different kinds of conditions that will impact on the country, so that it is able to respond to changing patterns of health need. That is why things such as capital investment are so important in building that greater resilience, which we do not have at the moment because of what we inherited. It is also why we now have a specific heat taskforce to look through the journey on both prevention and how we modernise, and to ensure that the right response is in place right across the NHS.
I am happy to discuss those details further with the shadow Secretary of State as that work progresses. I hope that he will recognise the investment that has gone in over the last two years, in contrast to what we inherited, and the improvements and reforms that are taking place as a result of the changes we have made. I look forward to discussing those with him further.