🤝 Department of Health and Social Care

• NHS Funding and Productivity: The Department of Health and Social Care’s supplementary estimate for the year ending March 2025 was debated. An additional £7.956 billion is authorized for current purposes, while capital spending is reduced by £1.141 billion, and an extra £6.827 billion is set to be issued by the Treasury. Sir Geoffrey Clifton-Brown, the Chair of the Public Accounts Committee, emphasized the need for increased NHS productivity as current productivity levels have dropped by about 23% since the pandemic, and the NHS is not operating at optimal productivity.

• Digital Transformation: Multiple speakers, including Sir Geoffrey Clifton-Brown and Leigh Ingham, pointed out the need for the NHS to transition from paper-based records to digital systems. The government announced £3.4 billion in capital investment for digital improvements by 2027-28, with the aim to achieve a 2% yearly productivity increase.

• Community and Preventative Care: There was a strong emphasis on shifting NHS care from hospitals to the community and focusing on preventative rather than just curative measures. Sir Geoffrey Clifton-Brown and others mentioned the Lord Darzi report, which highlighted that too much of the NHS budget is spent on hospitals and not enough on community and preventive care.

• Social Care Challenges: The inadequacy of the current social care system and the long-standing issue of delayed discharges were addressed by several speakers, including Sir Geoffrey Clifton-Brown and Andrew George. The call was for better integration and funding to manage discharges more efficiently.

• GP and Primary Care: The role of primary care, especially GPs, was underscored as vital, yet underfunded. Despite primary care handling over 90% of patient interactions, it receives less than 10% of the total budget, according to the Royal College of General Practitioners. Danny Beales and others urged for investment and reform in this area.

• Mental Health and Workforce: The importance of addressing mental health, both among staff and patients, was mentioned by Chris Vince and others. Staff retention and conditions were highlighted as key to improving NHS productivity.

• Dentistry and Pharmacy: Issues in dentistry and pharmacy were raised, with Danny Beales noting the crisis in access to dental services and the closing of community pharmacies.

• Capital Investment and Infrastructure: Concerns were raised about the NHS estate, with calls for addressing the maintenance backlog and the need for capital investment in new hospitals and infrastructure, as noted by Sir Geoffrey Clifton-Brown and others.

• Government Investment and Reform Plans: The government has announced over £22.5 billion in increased day-to-day health spending and more than £3 billion in the capital budget. These funds are intended to reduce waiting times and support a shift towards prevention and community care, as outlined by the Minister, Ashley Dalton.

• Public Health Funding: The Minister stressed the government’s commitment to increasing funding for public health, with a cash increase to £3.858 billion in 2025-26.

• Social Care Reform: The government has initiated an independent commission on adult social care, with hopes to build a national care service. Discussions emphasized the urgency of reform due to the existing system’s challenges.

The session had a moderate level of disagreement, characterized primarily by critiques and suggestions regarding the government’s approach to healthcare spending and policy, rather than outright opposition or conflict. Many points of disagreement were centered around the effectiveness and allocation of funding, productivity concerns, and the shifts outlined in the government’s 10-year NHS plan. Here are examples illustrating the disagreements in the session:

1. Funding and Productivity Concerns: A significant point of contention was around the adequacy and allocation of funding, particularly the impact of increased costs (such as national insurance contributions) and whether the additional funding would genuinely result in service improvements. The shadow Minister, Dr Caroline Johnson, argued that the £10.6 billion increase would not lead to improvements as it would merely cover existing costs like inflation and pay rises. This disagreement was highlighted by various speakers, including the Chair of the Public Accounts Committee, Sir Geoffrey Clifton-Brown, who emphasized the need for productivity improvements to prevent funds from being ‘sucked into a black hole’.

2. Impact on Social Care and Community Health: Another major disagreement revolved around the balance between funding hospitals versus community care and social services. Several speakers, including Mr Clive Betts and Helen Morgan, criticized the government’s slow progress in addressing social care and community health needs, arguing that the funding and policies did not adequately support the necessary shift from hospital-centric care to community-based care. This was exemplified by Neil Duncan-Jordan’s advocacy for a National Care Service to bridge the gap between health and social care.

3. Technology and Digitalization: There was a shared concern about the need for more technology in the NHS, but disagreement on the government’s plan for digitalization and its effectiveness. Sir Geoffrey Clifton-Brown acknowledged the recent investment but stressed the need for a more comprehensive productivity plan, including measures to protect against cyber threats. Other speakers such as Leigh Ingham emphasized the need for effective digital systems to increase NHS efficiency.

4. Politics and Policy Critique: The session also saw political tension and critiques of policy direction. The shadow Minister critiqued the government’s approach as a ‘sleight of hand’ with taxes and funding, arguing it lacked a real plan for NHS reform. Conversely, government speakers like the Parliamentary Under-Secretary of State, Ashley Dalton, defended their efforts and approach, highlighting achievements like ending resident doctors’ strikes and introducing the elective reform plan.

5. Specific Policy Issues: On issues such as dentistry, pharmacy closures, and mental health services, there were disagreements about current government plans and their effectiveness. Danny Beales and Helen Morgan raised concerns about the state of dentistry and the impending closure of pharmacies, questioning whether new funding and policies would address these pressing issues.

Overall, despite disagreements, the session maintained a constructive tone aimed at improving the NHS, with more focus on critique and suggestions rather than outright opposition, hence the rating of 2.