debates/debates2025-03-05a conversation_19
Source: hansard.parliament.uk (2025-03-05)

UK Parliament Hansard data: debates/debates2025-03-05a conversation_19

Seamus Logan:The Scottish fishing industry, by volume and value, is the biggest in these islands, and in my constituency the port towns of Peterhead and Fraserburgh represent a large share of that industry in terms of landed catch and processing. I am sure that the Prime Minister enjoys the occasional fish supper, so does he agree that the interests and future of that industry must be secured and enhanced, as the Government pursue economic growth and reset their relationship with the European Union, especially through the forthcoming trade and co-operation agreement negotiations, so that the jobs of people who work in that sector can never be made expendable for the sake of some other interest? \p Keir Starmer: I thank the hon. Gentleman for raising that issue. I recognise the huge and historic importance of the fishing industry in his constituency, and others, and I am determined to make the sector more secure, sustainable and economically successful. We have already secured over 720,000 tonnes of fishing quota for the year, worth up to £920 million, including through agreements with the EU and Norway. We also want to tackle the problems of labour shortages, which he will be familiar with. I am pleased that his constituents in Peterhead will benefit from £20 million under our plan for neighbourhoods, and we will do everything we can in relation to that issue. \p Naushabah Khan: Medway Maritime hospital in my constituency of Gillingham and Rainham has today received a concerning Care Quality Commission report, following an inspection of the emergency department in February last year. Testimonies include patients having to wait up to 50 hours to be seen, and others being told to soil themselves because staff were not available to take them to the bathroom. Will the Prime Minister please outline what this Government will do urgently to tackle the crisis in our NHS, after 14 years of Tory mismanagement? \p Keir Starmer: I thank my hon. Friend for raising this case. Her constituents deserve the highest standard of care. The Conservatives left the NHS in dire straits. We are investing £26 billion and our reform plan will cut waiting lists. I am really pleased to say that waiting lists are down and we have delivered over 2 million extra appointments to get the NHS back on its feet. \p Richard Holden: Marriage between first cousins carries significant health issues for their children, many of which are not knowable until post-birth. When practised generation after generation, there is a significant multiplier effect. In addition, the real impacts on the openness of our society and women’s rights in our country are significant. After all, there are significant dynamics in sharing the same set of grandparents.  On Friday, this Government have the choice to let my Bill to ban first cousin marriage go through to Committee stage. Will the Prime Minister think again before instructing his Whips to block this legislation? \p Keir Starmer: Mr Speaker, we have taken our position on that Bill. \p Shabana Mahmood: With permission, I will make a statement on capacity in the Crown court.

When this Government took office eight months ago, we received an inheritance from the Conservative Government that was little short of disgraceful: our prisons were in crisis, on the edge of collapse, and our courts faced a record and rising backlog. While the crisis in our prisons was more obvious and visible, the harm caused by the backlog in our courts cannot be overestimated.

Today, the backlog stands at over 73,000 cases. Just five years earlier, it had been half that figure. We should stop and consider that fact, because the backlog is far more than a number. Behind each case is a victim. Many have waited years for justice and some will now not have their cases heard until 2028. With delays that long, it is little wonder that more victims are dropping out, and tragically that is true of victims of the most heinous crimes. Just five years ago, around 3% of adult rape victims whose cases were due to go to trial dropped out before their case was heard. Today, that figure has more than doubled.

An old adage has sadly come true in this country: for far too many, justice delayed is justice denied. Unlike our predecessors, who allowed this backlog to rise and rise, this Government will bear down on it. We will deliver swifter justice for the victims of crime. That starts today with a record investment in our criminal courts.

Each financial year, the Government determine the total number of days that can be sat across all our courts and tribunals, commonly referred to as sitting days. This process is called the concordat. Last year, I committed to concluding the process earlier than in previous years to give our courts greater certainty. We have now done so, several months ahead of last year’s settlement, so today I can announce that the Government will provide a total budget of £2.5 billion for our courts and tribunals in the next financial year. That represents a record level of investment, which will fund up to 110,000 sitting days in our Crown courts—4,000 more days than the previous Government funded last year. If the shadow Lord Chancellor would like to check the record books, he will find no higher allocation in recorded history.

Beyond the Crown court, investment in the family and civil courts brings those jurisdictions to, or close to, their maximum capacity, and the investment in court capacity is matched by an investment in court maintenance. Our courts have been allowed to fall into a shocking state of disrepair in recent years, so this Government will boost funding to £148.5 million, up from £128 million last year. That will be the highest figure spent on maintenance and capital works in the last 10 years, building on a consistent theme of this new Government, and it is a marked difference when compared with our predecessors.

In our first eight months in office, we have consistently invested more in the courts than the last Conservative Government. On entering office, I immediately funded 500 sitting days on top of the allocation provided by the  previous Lord Chancellor. At the end of last year, when resources allowed, I added a further 2,000 sitting days. In October, this Government also increased the sentencing powers of magistrates courts; previously, they could impose only a six-month prison sentence, which we lifted to 12 months. In doing so, we freed up capacity in the Crown court to hear the most serious cases. That single change was equivalent to adding another 2,000 sitting days in our Crown courts. All those changes are necessary for the swift delivery of justice.

However, I must be honest, in a way that my predecessors never were: this investment is necessary, but it is not sufficient to reduce the Crown court backlog. Even with record levels of funding, if we do not take other, bolder measures, the backlog will grow. With a growing number of cases entering our courts and cases of increasing complexity being heard in front of our judges, we cannot simply do more of the same: we must do things differently. In December, I appointed Sir Brian Leveson, one of our most distinguished judges, to conduct a wholesale review of our criminal courts. The review will propose long-term reform as well as reviewing the efficiency and timeliness of court processes from charge all the way through to case completion.

Crucially, I have also asked Sir Brian to address something that too many others have avoided: the question of structural reform. Today, 10% of criminal cases are heard in a Crown court, where a judge presides and a jury decides. Jury trials are a pillar of our justice system for the most serious offences, and that will never change. However, we must ask ourselves whether they are hearing cases that could be handled equally well elsewhere.

Some cases can already be heard in either a Crown court or a magistrates court, which we call “triable either way” cases. Those represent 40% of the courts backlog, but while a conviction—whether determined by a jury or a magistrate—is the same regardless of the type of courtroom, the demand that it places on our justice system is very different indeed. An either-way case is resolved by magistrates five times faster than before a judge and jury. Justice must be done and criminals must always face consequences—on that, I know this House will agree—but we must be willing to ask whether a judge and jury should be occupied, at great length and expense, with crimes that could be dealt with more swiftly elsewhere.

For that reason, I have asked Sir Brian to consider the case for reclassifying some less serious offences, whether magistrates’ sentencing powers are sufficient and the case for a new court to sit between the magistrates court and the Crown court. His recommendations will come later this spring. His goal and mine are one: to bear down on the backlog and deliver swifter justice for victims. The consequences of failing to do so are all too clear—the backlog in the criminal courts will rise, cases will be listed even further into the future, and more victims of crime will decide that the wait is too painful with justice so distant, and as a result, dangerous criminals will walk free.

Today, we have announced a record investment in our courts: 110,000 sitting days funded, which is 4,000 more than the previous Administration funded. For many victims, their case will be heard sooner, but if we are to deliver swifter justice for all, we must embrace reform. This Government will deliver once-in-a-generation reform  of our courts, and we will reverse the decline and the delays of the last Conservative Government. I commend this statement to the House. \p Lindsay Hoyle: I can always help by reopening Chorley court for you.

I call the shadow Lord Chancellor. \p Robert Jenrick: It is great to see the Justice Secretary back in the country after her holiday in Texas. If she can find time to travel to America, why can she not find time to travel to the two category A prisons—[Interruption.] I will be pleased to hear from the right hon. Lady if that is the case. That was not the answer to our written parliamentary question the other day.

Today, the central criminal court has 13 courtrooms sat empty. In Preston, 40% of courtrooms sit empty, and in Winchester the figure is two thirds. That is a result of the court backlog, which has grown under this Justice Secretary. We need to be maximising court capacity, taking full advantage of all available days and probing the judiciary for options to create more capacity. I know that, and I would like to believe that the right hon. Lady knows that, but how did we get here? We got here because, just like in every other area, this Labour Government came into office with no plan whatsoever, and they have wasted their first eight months in office.

Upon the Justice Secretary entering office, the Lady Chief Justice informed her that there were at least 6,500 sitting days available to address the court backlog. The Justice Secretary responded by adding a measly 500 sitting days, and the court backlog kept growing. So frustrated was the Lady Chief Justice that she came to Parliament in November and took the unusual step of publicly chastising the Justice Secretary, and reiterated her offer of 6,500 sitting days. The Justice Secretary responded a month later by adding 2,000 sitting days, and the court backlog kept growing.

Here we are again, eight months on from the Justice Secretary taking office and on the very day that the Public Accounts Committee has published an excoriating report into her Department, with her promising more sitting days. Is it third time lucky for the Justice Secretary? No. What we have learned again today is that she is still turning down available sitting days, and astonishingly, she has conceded that the court backlog will keep on rising. That is simply not acceptable.

Of course, I welcome the changes made by the Justice Secretary, but they are not enough. She says that victims will get quicker justice—tell that to the victims of rape who are having their court cases listed for 2028. [Interruption.] \p Lindsay Hoyle: Order. Please, I need to be able to hear the shadow Lord Chancellor, and when Government Front Benchers shout for so long, I cannot hear. I will decide whether a statement is in order or not—are we understanding each other? \p Robert Jenrick: I do not pretend that cutting the court backlog is easy, or that it will be quick, but the Justice Secretary owes the country a plan and a timetable for when that backlog is actually going to fall. This morning, she was repeatedly asked that question, but refused to give an answer. Can she tell the country now  when the court backlog will begin to fall, by what date her Department has forecast it falling, and why she will not take up the 2,500 additional sitting days offered time and time again by the Lady Chief Justice?

Lastly, the new sentencing guidelines published alongside this statement will make a custodial sentence less likely for those

“from an ethnic minority, cultural minority, and/or faith minority community”.

Why is the Justice Secretary enshrining this double standard—this two-tier approach to sentencing? It is an inversion of the rule of law. Conservative Members believe in equality under the law; why does she not? \p Shabana Mahmood: The shadow Secretary of State asked, “How did we get here?” I will tell him how we got here—his Administration and the 14 years they had in power, and the absolute mess they made of the criminal justice system; a mess that this Government are clearing up. I am sorry to deprive him of what I am sure he thought was a clever attack line on my recent visit to Texas, but I can inform him that I have in fact visited HM Prison Manchester. I did so during the February recess. [Interruption.] \p Lindsay Hoyle: Order. As I said to Members on the Government Benches, I do need to hear. \p Shabana Mahmood: The right hon. Gentleman should welcome our seeking to learn from a tough law and order state in America, which 20 years ago had the same problems that we inherited from his Administration, and which has embarked on criminal justice reform that has seen reoffending at a level that we could only dream of in this country. He should seek to learn from other countries, as we are. If his Government had done so when they were in power, we would not have such a big mess to clear up in the criminal justice system.

The right hon. Gentleman referred to courtrooms sitting empty; one reason why is that one of his Government’s last acts on leaving office was to fund only 106,000 sitting days. I have lifted that number, and today the number of Crown court sitting days is at a record high, funded by this Labour Government. More courtrooms will be put to use. He will also know that to run the system efficiently, the normal practice is that some courtrooms will not be in use to cope with the flux in demand. However, as a result of today’s decision, more courtrooms will be in use than was ever the case under his Administration.

The right hon. Gentleman asked what I have been doing and what is the plan. When I came into office, the first thing I did was immediately to increase the number of sitting days by 500, up from 106,000 when his Government left office. I then made a further allocation and increased that again by 2,000 before Christmas—making progress on the Crown court backlog and picking up the pieces of the mess that his Government left behind. He will know that the changes that I made to magistrates court sentencing powers have also freed up capacity in the Crown courts. We have increased funding for criminal legal aid by £92 million so that we have the money to underpin the system. That is action. That is an increase in sitting days in-year and an unprecedented increase in sitting days for next year. That is what this Labour Government are delivering.

The right hon. Gentleman will also know that even if we were sitting at the maximum judicial capacity—he rightly referred to that, as did the Lady Chief Justice in Parliament—that backlog would still rise, because the demand in the system is fast outstripping the pace at which cases are being disposed of. Knowing that, it would be unconscionable if I stood before this House and behaved as if resources alone would fix the problem. That is why Sir Brian Leveson is considering once-in-a-generation reform of our Crown courts.

The combination of the steps that I have already taken, the funding that I have allocated and the review that will lead to once-in-a-generation reform—that is what a plan looks like to fix the mess that the right hon. Gentleman’s Government left behind. It is a plan that they could have had in place when they were in government, but they failed to do so, and now they carp from the sidelines when someone else is getting on with the job.

Finally, as somebody from an ethnic minority background, I do not stand for any differential treatment before the law for anyone. There will never be a two-tier sentencing approach under my watch or under this Labour Government. \p Lindsay Hoyle: I call the Chair of the Justice Committee. \p Andrew Slaughter: I congratulate the Lord Chancellor on the figures that she has announced and on starting to get to grips with her baleful inheritance. However, there is a long way to go. The Lady Chief Justice told the Lords Constitution Committee last week that she was pressing for Crown courts to sit to capacity. Does the 110,000 figure represent capacity? If not, what is capacity? Given that the backlog is 73,000 cases and rising, will the Lord Chancellor guarantee sitting days up to capacity for the whole of the coming year? In her statement, she rightly promised investment in the family and civil courts to bring those jurisdictions to, or close to, maximum capacity. Will she make the same commitment for the Crown court? \p Shabana Mahmood: My hon. Friend will know that there is a difference between system capacity and maximum judicial capacity. He is right that the Lady Chief Justice has said that the maximum judicial capacity is 113,000 sitting days in the Crown court. We are funding 110,000 sitting days there, because in my role as Lord Chancellor, I must be mindful of managing the wider system capacity—the availability not just of judges to sit in the Crown court but of the lawyers, prosecutors, legal aid and defence barristers that underpin the rest of the system. I am confident that the 110,000 sitting days represent the system capacity, and that is being delivered. \p Lindsay Hoyle: I call the Liberal Democrat spokesperson. \p Josh Babarinde: Tens of thousands of victims and survivors waiting for their day in court is one of the darkest legacies of the last Conservative Government. I feel that sincerely because, under that Conservative Government, I was one of those victims. After two decades of agonising over whether to report my own victimhood as a child, I waited two years for my own opportunity to seek justice in the Crown court. That is years of your heart racing whenever you get a phone call from an unknown number. Is it the court? Is  it the Crown Prosecution Service? There are years of anxiety that your perpetrator will retaliate, and years of your life excruciatingly on hold. Many victims today are being forced to sit with all this for far longer than I did. The Liberal Democrats and I personally welcome the Justice Secretary’s announcement.

However, we all know that a huge backlog will remain, which means that victims and survivors will continue to be let down. At a time when victims and survivors need more support during these agonising waits, Government funding cuts and national insurance contribution increases are putting services such as Safeline and Victim Support at risk. Will the Lord Chancellor outline her year by year targets for reducing this backlog, and will she increase, not cut, support for charities to ensure that victims and survivors get the support that they need and deserve? \p Shabana Mahmood: I thank the hon. Gentleman for his remarks and I pay tribute to him for his bravery in his own personal life, as he has sought justice for the crimes committed against him. His journey reflects that of too many people across our country. I have constituents whose cases are trapped in the Crown court backlog, so I hear regularly of the impact that it is having, and I am alive to the human cost. That is why, at every available opportunity, I have sought to make progress in increasing funding and allocation in-year and have made this record settlement for the next year. Of course, I know that we need to go further and do more. The work of Sir Brian Leveson is crucial because we know that without reform, no matter how much the Crown court sits, that backlog will still rise. I hope that when that review reports, I can count on support for reform from across the House. I hope that all those who want to see the Crown court backlog come down will want that reform. We have ringfenced funding for victims of rape and serious sexual offences, as well as domestic abuse. We will shortly set out our victims Bill, which will include further measures to strengthen the victims code.

The hon. Gentleman asked about targets and timelines—forgive me, the shadow Justice Secretary also raised that point. I have committed to once-in-a-generation reform of our Crown courts. Once Sir Brian Leveson’s review has reported and the Government have made decisions on the recommendations that they will take forward and have legislation ready, we will be able to set out the impact of future legislation to bring down that Crown court backlog. \p Linsey Farnsworth: I am absolutely flabbergasted by some of the things that the shadow Justice Secretary, the right hon. Member for Newark (Robert Jenrick) said today. I assure him that this backlog has not materialised just over the last eight months. I can say that as a Crown prosecutor who worked throughout the 14 years of the last Government and saw the waiting lists go up and up, despite the best efforts of the hard-working staff throughout the criminal justice service. Will the Lord Chancellor confirm that the measures that she has announced will finally allow victims, including those in my constituency, to have some confidence that there is finally a Government who will tackle this issue? \p Shabana Mahmood: “Flabbergasted” is one way of describing it, and it is probably the only one that you will find to be in order, Mr Speaker, so I shall refrain  from using other language. My hon. Friend is a former prosecutor, so she knows whereof she speaks, and I pay tribute to her for the work that she did in her former profession. The message should go out loud and clear to her constituents, and to people up and down the country, that this Government are acting to deal with the Crown courts backlog. We have a plan. We have increased funding, and we are considering the reform that is needed, and has been ducked by too many others, to get the system sorted out once and for all. \p Julian Smith: I refer the House to my registered voluntary interests.

I welcome the statement. Does the Lord Chancellor agree that one way of getting cash into the criminal justice system is to reduce the cost of the civil system? May I urge her to continue to consider alternative methods of dispute resolution, particularly mediation within the civil system? \p Shabana Mahmood: The right hon. Gentleman is entirely right. All the mechanisms at our disposal to reduce the cost of people going to court should be on the table, and we have already been acting to try to amplify the availability of mediation and other ways in which issues can be resolved. Going to court is always very expensive, sometimes for the individuals involved and often for the taxpayer, and it is important that we keep bearing down on those costs. \p Warinder Juss: I thank the Lord Chancellor for her honesty in setting out so clearly the difficult situation that we have inherited from the Conservative party, and I welcome the measures that she has proposed: the record investment in the justice system, and the measures taken to reduce the number of cases going to the Crown courts. \p Robert Jenrick: It is getting worse. \p Warinder Juss: It has got worse, because of the Conservative party.

Does my right hon. Friend agree that, as well as focusing on the measures that she has already proposed, we should continue to focus on reducing crime in the first place, and pursue our policies for tackling youth crime, knife crime and violence against women and girls? \p Shabana Mahmood: My hon. Friend is right. In order to deal with all the problems in the criminal justice system relating to policing, prosecutors and the situation in the Crown courts, we need a system-wide approach. That means taking action on the crimes that affect neighbourhoods up and down the country, which is why the Home Secretary’s recent Crime and Policing Bill is such a landmark piece of legislation. We must all play our part, because the criminal justice system has been left in a truly terrible state by the last Administration, and this Government are getting on with the job of sorting it out. \p Christopher Chope: This announcement is small beer, is it not? The extra £92 million offered for criminal legal aid is exceeded twentyfold by the subsidies given to offshore wind, which amounted to £1.9 billion last year alone. Why do the Government  have such perverse priorities, and when will they put the criminal justice system above the interests of offshore wind operators? \p Shabana Mahmood: We are talking about the highest ever funded allocation in the Crown courts, and 110,000 sitting days, which is a record. The hon. Gentleman says that is small beer; I wonder whether he had been imbibing something before getting to his feet. \p Pam Cox: I welcome the Lord Chancellor’s announcement of additional sitting days. The Justice Committee has been looking into the court backlog issue, and we have also been hearing about the ongoing need for the digitisation of court and wider criminal justice processes. We need to replace the creaking paper-based system, which is contributing to the delays. Will the Lord Chancellor continue to support drives for successful digitisation of those processes, and will she also join me in congratulating the Conservative party on marking International Women’s Day in such style? \p Shabana Mahmood: My hon. Friend is right to make that point about digitisation and efficiency. Following the first phase of the spending review, I have funded ongoing work to improve digitisation of all our court processes, because, as my hon. Friend has said, we need to move away from our current paper-based and paper-heavy systems. Part 2 of Sir Brian Leveson’s work, which will produce a report in the autumn, will involve looking at cross-system efficiency as well. My hon. Friend is right about the need to increase productivity and efficiency, because that will be the final part of the puzzle if we are to sort out the backlog. \p Gideon Amos: I welcome the announcement of the extra sitting days, and also the announcements about reform. I hope that the ancient right to trial by jury will remain.

Somerset Crown court in Taunton was closed in 2023, after work began in 2022 because items were falling on people’s heads from the ceiling. We have just been told that it will be closed for another year, during which victims of crime will have to travel tens of miles further. Some court users are even sleeping under a bush because they cannot travel back and forth. We need to get our Crown court open again, so will the Lord Chancellor please consider expediting these works? \p Shabana Mahmood: I will ensure that the hon. Gentleman has a meeting with the courts Minister, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), to discuss the situation in Taunton. \p Gareth Snell: I am slightly worried about Conservative Members, who appear to be the arsonists complaining that the fire brigade has turned up too late to put out the fire, when they were the ones who lit it in the first place. I worry that they do not understand the scale and magnitude of the challenge that they left behind, which I have heard about from constituents who have been waiting years for their court cases. \p Robert Jenrick: It is getting worse. \p Gareth Snell: It is getting worse. If the right hon. Gentleman spent more time providing leadership, rather than auditioning for it, he would own up to his failures in the House, and admit that the Conservatives left the country in a mess.

Courts are not run just by judges; there are many support staff in courts who make the system work. What cross-governmental conversations has the Lord Chancellor had about ensuring that those staff are available, so that as many courts as possible are operational? [Interruption.] \p Shabana Mahmood: The shadow Lord Chancellor is having such fun with his audition for leadership that it would be a shame to deprive him of it. My hon. Friend has said that Conservative Members do not understand the mess that they have left behind, but I wonder whether they simply do not want to understand it. Members of a party that was willing to reckon with the mistakes it made in office would at least have started with some humility—and, perhaps, an apology for the mess they left behind.

My hon. Friend is right to draw attention to the need for a whole-system approach. One reason why the backlog is scheduled to become worse, no matter how many Crown court sitting days are provided, is the influx of cases into the system, which is actually a good thing, because it means that the police are doing their job and prosecutions are being brought, but even at maximum capacity, demand is far outstripping the disposal of cases. The case mix is more complex, and that requires a system-wide response, which the Government are providing. \p Gavin Williamson: When does the Lord Chancellor expect the additional places to start bearing down on the remand population? \p Shabana Mahmood: The right hon. Gentleman is right: the remand population is growing, and currently stands at 17,000. That has a big impact on prison capacity, which is why I increased magistrates court sentencing powers a few months ago, why I have increased the number of Crown court sitting days, and why we have a record allocation next year. The demand coming into the system is one of the reasons why bearing down on remand has been particularly challenging, but we continue to work on it with the judiciary; listings are, of course, a matter for the independent judiciary. \p Clive Efford: I expected a little more humility from Conservative Members, who left a legacy of chaos in our prisons and a huge court backlog. What we are dealing with, fundamentally, is the backlog that they left behind. My right hon. Friend has set out a process for dealing with this growing backlog, but ultimately the blame lies at the door of the Conservative party, which left the place in chaos. Should we not be hearing an apology from Conservative Members? \p Shabana Mahmood: Sorry does seem to be the hardest word for Opposition Members, and I have long since stopped waiting for that apology. All I would observe—I say this with experience of 14 years of opposition under my belt—is that parties that do not acknowledge their mistakes and sort themselves out rarely get elected. \p Gavin Robinson: In welcoming the statement, I reserve judgment on whether we need an additional court—an intermediate court—particularly if it will be resourced from the existing magistrates and Crown court system. Following on from the question from the right hon. Member for Stone, Great Wyrley and Penkridge (Sir Gavin Williamson), we have a backlog in England and Northern Ireland, and people are on remand for too long. Increasingly, people are being released following a conviction with time served, and there is no opportunity whatsoever for rehabilitation. Will the opportunity to rehabilitate offenders while they are on remand form part of the Brian Leveson review? \p Shabana Mahmood: The right hon. Gentleman is absolutely right to raise issues relating to remand. We do have a problem with the remand population, which is why I have made the changes that I have highlighted, and why both reviews—the one being conducted by Sir Brian Leveson, which looks at once-in-a-generation court reform, and the one by David Gauke and the independent panel, which looks at sentencing—are so crucial. It is essential that we not only bear down on the Crown court backlog, but get our prison capacity back into balance and have a sustainable prison system in this country. \p Jayne Kirkham: Criminal justice was an easy target for Tory austerity cuts, which always impact the people with the smallest voice. Rape victims in Truro and Falmouth have told me that they have waited years for their cases to be heard and had hearings cancelled at the last minute, so I very much welcome this investment. Could I have more detail about the case for a new court that would sit between magistrates court and Crown court, and how that might work? \p Shabana Mahmood: On the possibility of a court that sits between the magistrates and Crown courts, Sir Brian is considering that. My hon. Friend will understand why I want to wait until he has made his recommendations, but that is one of a range of ways in which we could change policy in order to bear down on the Crown courts backlog in the long term. We will consider his recommendations and bring forward legislation for those that we want to take forward in the spring.

I absolutely hear what my hon. Friend says about the terrible experience of victims who have their cases cancelled on the day, and about the impact on rape victims in particular. We have already fulfilled our manifesto commitment to having independent legal advisers for victims of rape, so that their rights in law are always protected. \p Ashley Fox: The Lord Chancellor has been in office for eight months today. Although her announcement of additional sitting days is welcome, it is regrettable that she did not make this statement seven months ago. There is only so long that she can blame the last Government for the Crown court backlog. We all know that the pandemic was largely responsible for the substantial increase. We know that the Lady Chief Justice has offered the Lord Chancellor a further 2,500 sitting days. Why is she not taking advantage of that? There are currently too many people on remand for too long, and it is clear that even the announcement that she made today will not lead to a reduction in the  backlog, so we need structural change. Will the Lord Chancellor give serious consideration to the creation of an intermediate court, so that we can reduce the backlog more quickly? \p Shabana Mahmood: I gently remind the hon. Gentleman that the concordat process, which I have concluded with today’s announcement, has concluded earlier than the one that I inherited from his party would have done, so we have been cracking on. I have been getting on with the job: I increased sitting days immediately, I have taken every opportunity to increase them further, and I have now made a record allocation.

The hon. Gentleman says that the Lady Chief Justice has offered more sitting days, but he will know that she is not able to offer sitting days. She is able to comment on maximum judicial capacity, which she has done, as is appropriate. In order to make sure that sitting days are possible in the Crown courts, I have to consider wider system capacity issues, including the availability of legal aid, prosecutors and defence barristers. We have 110,000 Crown court sitting days—an unprecedented, record number—and I can say that there is capacity in the system overall, not just judicial capacity, for those days. \p Yasmin Qureshi: Yesterday, the Public Accounts Committee published a report that says that rape and serious sexual offences are taking many years to come to trial. When I was a shadow Justice Minister, I asked the previous Government day in, day out from the Dispatch Box about what they were doing to reduce the court delays. For 14 years, they did nothing. In eight months, this Lord Chancellor has provided 110,000 court sitting days. Does she agree that the expression that comes to mind is “the pot calling the kettle black”? \p Shabana Mahmood: I can tell my hon. Friend that many expressions have come to mind as I have been listening to the drivel from some Conservative Members—not all of which would not fall foul of “Erskine May”, so I will keep my counsel on that.

My hon. Friend refers to the Public Accounts Committee report, and I gently observe that I was a long-term member of that Committee. I have the highest regard for the Public Accounts Committee, but I reject its criticism, because this Government clearly have a plan—not just on funding and resources for the Crown court, but on the reform that will ultimately be needed to get the system into balance. \p James Wild: Despite this announcement, the backlog will increase. When cases do go to court, it is important that offenders serve the sentence they are given. Following the Lord Chancellor’s trip to Texas, where some prisoners serve as little as 25% of their sentence, will she rule out adopting such a soft sentencing policy? \p Shabana Mahmood: The Texans had similar problems to those we face today, but they had theirs 20 years or so ago. Their system of good behaviour credits incentivises offenders to engage in rehabilitation activity and to get help for their drug addictions, alcohol problems, mental health issues and so on. If offenders engage with that system and get their good behaviour credits, they can earn their way to an earlier parole hearing. It is the definition of a tough system, because it says to offenders,  “You have to do something good in order to earn the possibility of an earlier release.” It is a system that is well worth learning from, because the reoffending rates are very low compared with ours. One of the prisons I visited in Texas has a reoffending rate of 17%. I dream of that number for us in this country, because every time we bear down on reoffending, that is cutting crime. It is a strategy for making sure that we have fewer victims in the future. I hope that if whatever proposals we bring forward lead to a reduction in reoffending, the hon. Gentleman will back those proposals. \p Paul Waugh: In June 2024, in the dying days of the last Conservative Government and after 14 years of their rule, there emerged a shocking statistic: 60% of rape victims were withdrawing from the court process, mainly because of court delays. Is that not a damning indictment of all Governments who have taken power in this country? What is the Lord Chancellor doing to help reduce the number of rape victims taking that awful decision? \p Shabana Mahmood: My hon. Friend is absolutely right: the figure that he notes is a damning indictment of the last Conservative Government. The announcement we have made today will bear down on the courts backlog, and it will mean that some rape victims get their cases heard as cases move through the system more swiftly. We have already implemented our manifesto commitment on independent legal advisers, because we know that, in addition to delays, one of the things that causes many rape victims to drop out is inappropriate requests for personal information that go beyond what the law requires. Those independent legal advisers will ensure that rape victims’ rights in law are respected and that the process does not feel like it is retraumatising women who are already going through so much, and who are waiting for their day in court to have justice done. \p Bob Blackman: Harrow Crown court has eight court rooms and could help alleviate the capacity problems. Sadly, it has been closed since 2023 as a result of finding reinforced autoclaved aerated concrete in the roof. It was supposed to open last year. That was then moved to April this year, and it is now being said that the court will not open for a further year. Given the improved funding, could the Justice Secretary look at whether we can speed up the process of bringing that court back into action, and help the people who now have to go to Willesden, Amersham, Southwark and elsewhere in London for their cases to be heard, so that they can get justice at a local level? \p Shabana Mahmood: I absolutely understand the hon. Gentleman’s frustration and that of his constituents. I understand that the problems at Harrow relate to RAAC, and that the delays are due to contractor issues. I will make sure that we write to him with a full plan of what we anticipate will happen to get the Crown court back into use. I hope he will recognise the record investment in Crown court maintenance, which is also being announced today. It is up by £28.5 million, which will go some way to alleviating some of the maintenance issues. \p Shaun Davies: Under the last Conservative Government, we saw a reduction in the numbers of Crown court judges in Shropshire and Telford; courtrooms  remained empty for years while victims waited for years for their trials to take place. With Labour, we now have an extra Crown court judge, a remand court back in the county and extra Crown court sitting times.

I have heard from magistrates and Crown court judges in my area that defendants are opting for a Crown court trial because they know it will take years to conclude. Can we make sure that that does not happen in future? We should absolutely tackle the backlog, but can the Lord Chancellor give an assurance that we, unlike the last Government, will not tell police officers to stop arresting people and putting them before the courts? \p Shabana Mahmood: I can absolutely give my hon. Friend that reassurance. This Government will deliver 13,000 extra neighbourhood police officers, because we are absolutely clear that we need neighbourhood policing and bobbies back on the beat in this country. He is right to note that the size of the backlog and the structural problem with the backlog mean that many defendants are gaming the system. They know that they can take their chance, wait it out and hope that the victim gives up or that, for some other reason, the case simply never gets to court. That is why, in addition to the record funding, we have to consider once-in-a-generation reform of our Crown courts. \p Julian Lewis: Does the Lord Chancellor accept that part of the reason for the loss of public confidence lies with the sort of cases that are clogging up tribunal and court time? As explained by Jawad Iqbal in his column in The Times today, these involve dubious decisions about not being able to deport convicted criminals, such as an Iraqi cocaine dealer who cannot be sent back to his homeland because he is considered to be “too westernised”. Quite apart from the perversity of the result, is it not an insult to the genuine victims of crimes who are held up in getting the judgments that they deserve? \p Shabana Mahmood: The right hon. Member will know that it would be inappropriate for the Lord Chancellor to comment on individual judgments. On some of the decisions in the immigration chamber, which have been the subject of some public discussion, he will know that the Prime Minister has been very clear that where a policy or a legal change is required, it is for the Government to bring forward those changes and ultimately for the House to vote on them. In that respect, the Home Secretary is considering further changes to the law. The right hon. Gentleman mentioned deportations, and let me remind him that, under this Government, deportations of foreign national offenders from our prisons are up by 23%. \p Christopher Vince: Mr Speaker, like Chorley’s magistrates court, Harlow’s sadly closed in 2019. I thank the Lord Chancellor for her statement, but does she agree that we need radical reforms to start driving down the Crown court backlog, including the use of magistrates courts—as I say, sadly, we cannot use Harlow’s at the moment—so that we can get through cases more quickly and give victims the justice they require? \p Lindsay Hoyle: We can reopen them together. \p Shabana Mahmood: I am listening very carefully and taking under advisement all these lobbying requests, including from the Speaker himself, about courts in Members’ areas. I thank both you, Mr Speaker, and my hon. Friend for that.

My hon. Friend is absolutely right that we need radical reform. Without radical reform, the backlog, no matter how many Crown court sitting days we fund, will keep going up and up, which is why Sir Brian Leveson’s work is so very crucial. \p Peter Fortune: I speak as a member of the Public Accounts Committee, which worked on the report about how justice delayed is justice denied, and I recommend that Members peruse it. What specific conversations has the Lord Chancellor had with colleagues in the Ministry of Housing, Communities and Local Government about speeding up the planning process so that we can get more courtrooms operating? \p Shabana Mahmood: We are speeding up the planning process. The courts Minister is in regular conversation with the planning Minister. The issue of Crown court capacity is less one of planning and more about funding enough days so that maximum use can be made of every available courtroom, while recognising that there has to be some level of give in the system of courtroom usage to enable it to be run efficiently. Demand ebbs and flows at every court across the whole country, so some spare capacity needs to be maintained, and it was that spare capacity that enabled such a swift response to the summer riots. I hope the hon. Member will reflect on the fact that some spare capacity will always be required, but as I say, those conversations are happening regularly between the courts Minister and the planning Minister. \p Jas Athwal: I thank the Lord Chancellor for her statement and for the record funding. It is just a shame that the shadow Justice Secretary, bereft of any policy ideas, has basically turned up today to tackle the man—or in this case the woman—rather than play the ball. A little humility, contrition and a wholesome apology would not go amiss. Does the Lord Chancellor agree that, in allowing the backlog to spiral out of control, the previous Government failed countless victims? Will she confirm that today’s announcement means victims can have more confidence in the justice system under Labour? \p Shabana Mahmood: I am very happy to fight the shadow Lord Chancellor—woman to man—any time he likes. Conservative Members should own up to the failure of the previous Administration and apologise—if they want a hearing from anybody in politics or, indeed, from the people in the country ever again. This Government have shown that we are determined to clean up the mess we inherited, and victims across the country can take confidence from the fact that we have made record funding available and we are considering the structural reform required to sort out the system. \p Mike Martin: When I speak to the police in Tunbridge Wells, they often comment that a large court backlog has a real effect on levels of  crime. There are more criminals in circulation and, frankly, the system is seen as a bit of a soft touch if cases are never brought to court. May I simply ask the Justice Secretary what is the backlog in Kent and when will it be cleared? If she does not have the figures to hand, would she write to me with them? \p Shabana Mahmood: I would be happy to write to the hon. Member with the specific figures for Kent. However, he will know that the criminal justice system as a whole is under tremendous pressure and extreme stress because of the backlog and the prisons capacity crisis, all of which is the legacy of the previous Government that we are now fixing. \p Dave Robertson: It is no surprise to me that I am the third MP from Staffordshire and Stoke-on-Trent to take part today, because in Staffordshire we now have 1,350 open cases waiting to be heard by Crown courts. That figure more than doubled over the last five years of Conservative mismanagement, and it is the highest number since records began.

I spoke to the police commander in Lichfield on Monday, and one of his major concerns is that delays in justice being seen to be done in courts is making harder his job of building the relationships he needs with our community. The worst cases he has raised with me include serious sexual assault and rape cases that have been delayed for almost five years. What steps will the Secretary of State be taking to make sure that these additional extra sitting days are targeted at the most serious offenders? \p Shabana Mahmood: My hon. Friend raises a very important point. It is my job as Lord Chancellor to make sure that the overall settlement for Crown court sitting days is sufficiently big to help drive down the Crown court backlog, which is why I have made the record allocation today. The listing of individual cases is of course a matter for the independent judiciary, and it would be improper and inappropriate for me to comment on listings decisions. However, taken as a whole—with both the investment we are making and the reform we are considering once Sir Brian Leveson’s review has reported—I think he and his constituents can be confident that this Government are going to sort out the system. \p Jim Shannon: I very much thank the Lord Chancellor for increasing the number of sitting days to attempt to tackle the extremely large delays in court cases that we face in the United Kingdom, which is the sad reality for those seeking justice. As she will know, in Northern Ireland there are currently 18,907 pending cases in magistrates courts, which is an absolutely huge backlog. Given the drastic increase in cases involving violence against women and girls in Northern Ireland, may I gently ask the Lord Chancellor what discussions she has had with the policing and justice Minister to help address the court cases issue and reduce delays in the Province? \p Shabana Mahmood: It is always a pleasure to respond to the hon. Gentleman, and I thank him for his remarks welcoming today’s announcement. A Parliamentary Under-Secretary of State will be meeting devolved Justice Ministers very soon and we will update the hon. Gentleman on the work we are doing with Ministers in Northern Ireland. \p Julia Buckley: I associate myself with the remarks of my hon. Friend the Member for Telford (Shaun Davies), my constituency neighbour in Shropshire, in welcoming today’s much-needed funding announcement, in particular the structural reforms to increase capacity. In Shrewsbury we currently have no working magistrates court, despite being the county town for 350,000 residents. Will the reforms also enable and support the pragmatic reallocation of courtrooms between Crown and magistrate use in areas such as Shropshire, so that spare capacity can be unlocked specifically in towns, such as Shrewsbury, that are better served by public transport for all our rural population? \p Shabana Mahmood: The principle of local justice is incredibly important to this Government and we will endeavour to ensure that it is at the heart of all our proposals and changes. We have also increased recruitment to the magistracy. \p Laurence Turner: I welcome today’s announcement. Recruitment and retention challenges have limited access to justice in recent years. Will the Lord Chancellor outline what steps she is taking to ensure that we have enough barristers and solicitors so that courts can get through as many cases as possible? \p Shabana Mahmood: My hon. Friend is absolutely right to raise the availability of lawyers. That is why the Government have already increased criminal legal aid by up to £92 million and increased the number of prosecutors. We will be bringing forward more changes in the upcoming victims Bill to increase the availability of certain types of lawyers to do prosecution work. \p Nesil Caliskan: I thank the Secretary of State for her statement. As a member of the Public Accounts Committee, I have recently heard details about the shocking state of disrepair in our courts in recent years. The most recent report identified the Nightingale courts set up under the previous Government as a way to deal with the covid backlog. Many years on, some Nightingale courts still exist and in some cases are costing six times more than a normal court. Can she reassure us that they will continue to close and that we can direct that money to the courts that need repairs? \p Shabana Mahmood: My hon. Friend makes an important point. We are keeping the situation in relation to Nightingale courts under review. Where they are making a contribution that is assisting with caseflow through the system, there is a case for keeping them, but it is under review and the courts Minister, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), will be happy to write to her with further details. \p Jake Richards: I have been in this House for only a few months, but I must admit that I am absolutely staggered by the chutzpah of Conservative Members—most have left, but when they were here—in their attitude to this issue. In a competitive field, the state of our criminal courts and our criminal justice system perhaps wins the award for the most acute crisis as a result of the legacy of the previous Government. I really welcome today’s statement, in particular the emphasis not just on capacity but on productivity. May  I just press the Government on whether that approach will also be taken in our family courts? I welcome the investment in infrastructure and capital spend in family courts, but we also need to look at how we can improve productivity. \p Shabana Mahmood: My hon. Friend makes an incredibly important point on productivity. That is why the second phase of Sir Brian Leveson’s work is so crucial. He will know that we have expanded our pathfinder pilot, which is making a really important contribution to the flow of cases through the family court, and we are keeping it under review. \p Richard Holden: On a point of order, Madam Deputy Speaker. There is real concern in Basildon and Billericay about the closure of the South Green surgery. I have raised the matter in Parliament a couple of times, including at oral questions, where the Health Secretary told me it would be a matter for my integrated care board and that he would be happy to make some introductions. However, in response to a written question, the Minister for Care, the hon. Member for Aberafan Maesteg (Stephen Kinnock), told me that new powers under the Health and Care Act 2022 meant that the Secretary of State could intervene under new powers introduced on 31 January 2024. This has caused real confusion among my constituents, particularly the 3,500 who signed a petition led by Justine Norris and Vivienne Conway, and my excellent local councillors, who have been doing all they can to raise the issue. What can Mr Speaker do to ensure that Ministers do not give my constituents accidentally misleading answers and that they correct the record when they make mistakes? \p Judith Cummins: I am grateful to the right hon. Member for giving notice of his point of order. The Chair is not responsible for the content of ministerial answers, but he has put his point on the record and there is a procedure for Ministers to correct the record if they wish to do so. \p Yasmin Qureshi: On a point of order, Madam Deputy Speaker. You will be aware that I have been campaigning for over 12 years on behalf of families affected by the drug Primodos. In December 2023 the Government agreed to look at new evidence that links Primodos to babies born with deformities. In November 2024 the Commission on Human Medicines finally held a session with experts to look at that new evidence. At the session we were told that the conclusion of the review would be published in a matter of weeks. We are now in March. We have written to the Department and tabled questions. How many months and years do the long-suffering families have to wait? There has long been a culture of dither and delay on this issue, and a hope that the families will go away and that they can all be forgotten about. But this issue has tremendous cross-party support. Can you advise me on what more I can do to get the Department’s attention on this matter? \p Judith Cummins: I am grateful to the hon. Member for giving notice of her point of order. This is not a matter for the Chair, but she has put her point on the record and I am sure that those on the Treasury Bench will have noted what she has said. \p Ellie Chowns: On a point of order, Madam Deputy Speaker. Yesterday, during my urgent question on Gaza, the Minister responding, the hon. Member for Hornsey and Friern Barnet (Catherine West), who has responsibility for the Indo-Pacific, said that the Minister with responsibility for the middle east, Afghanistan and Pakistan, the hon. Member for Lincoln (Mr Falconer), could not answer the question himself as he was

“in the region pushing for a peace deal”—[Official Report, 4 March 2025; Vol. 763, c. 166.]

However, I have since received a communication from the press with evidence suggesting that he was at a Labour party networking lunch at Ronnie Scott’s at the time. Could you advise, Madam Deputy Speaker, on whether the record should be corrected if it is shown not to be correct? \p Judith Cummins: I am grateful to the hon. Member for giving notice of her point of order. Has she given notice to the Members involved that she was going to raise this matter in the Chamber? \p Ellie Chowns: I have indeed. \p Judith Cummins: The Chair is not responsible for the content of ministerial answers, but the hon. Lady has put her point on the record and there is a procedure for Ministers to correct the record if they wish to do so. \p Jim Shannon: On a point of order, Madam Deputy Speaker. The Prime Minister rightly referred to the loss of life of young soldiers. He was right to do that to set the tone for the Chamber and thank them. Forty years ago, on Friday past, the IRA launched a mortar attack from Corry Square on Newry police station. How can the murder of nine brave young Royal Ulster Constabulary police officers—the RUC’s biggest single loss of life ever in the Province—be recorded in this House? How can we record their bravery, their courage and their determination in battling for Northern Ireland to have the freedom and peace we now have? \p Judith Cummins: I thank the hon. Member for his point of order. He has put his point on the record. \p UNKNOWN: Presentation and First Reading (Standing Order No. 57)

Gareth Snell, supported by David Baines, Shaun Davies, Dave Robertson, Laurence Turner, Liam Byrne, Maya Ellis, Leigh Ingham, Antonia Bance and Matt Western, presented a Bill to require the indication of country of origin for ceramic products; and for connected purposes.

Bill read the First time; to be read a Second time on Friday 25 April, and to be printed (Bill 191). \p UNKNOWN: Motion for leave to bring in a Bill (Standing Order No. 23) \p Christopher Vince: I beg to move,

That leave be given to bring in a Bill to amend the Dentists Act 1984 in respect of indemnity arrangements.

Like many MPs new to this place, I find that the first Bill I am presenting is not on something I have experience of, but on an issue brought to me by constituents. Clive Worthington was a much-loved resident of Harlow. He worked as a wood machinist and had three children and five grandchildren. I thank my hon. Friend the Member for Lewisham East (Janet Daby) for introducing me to Clive’s daughter, Gina, who is her constituent. When I met Gina, she described her father as fun-loving and full of life—someone who had enjoyed sport and playing with his grandchildren.

In 2008, Mr Worthington had dental implants. Despite several follow-up operations in the years that followed, the procedure was unsuccessful, and he was left in agony. He was awarded £117,378 in damages and legal costs at Chelmsford county court in November 2019—one of the highest payouts for dental negligence in the UK. However, the dentist who carried out the work was only covered via her membership of the Dental Defence Union. Organisations such as the DDU are not insurance companies, but offer professional indemnity on a discretionary basis for members against the risk of dental negligence claims and professional conduct proceedings. The British Medical Association describes discretionary indemnity as

“where legal and financial assistance is provided at the discretion of the provider, for example, not backed by an insurance contract between the healthcare professional and the provider”.

Due to this loophole, Mr Worthington did not receive compensation and, in 2022, unable to stand the agony and feeling as though he had

“lost faith in the system”,

he took his own life. The senior Essex coroner said that the long-term consequences of his unsuccessful dental surgery impacted significantly on his mental health and ability to cope with daily life. As his daughter Gina said:

“It’s such a tragic end to a life. It just makes me so mad—that it didn’t have to end this way.”

Indemnity cover for healthcare professionals, including dentists, was the subject of a consultation launched by the Department of Health and Social Care in December 2018. To move forward and build on both the recommendations from the Paterson inquiry and the Gina’s wishes, this Bill would, via secondary legislation, amend the Dentists Act 1984—as amended in the Health Care and Associated Professions (Indemnity Arrangements) Order 2014—and therefore does not require lengthy primary legislation.

My proposal is an amendment to section 26A(2) of the 1984 Act, as amended in the 2014 order, which currently reads:

“For the purposes of this section, an ‘indemnity arrangement’ may comprise…a policy of insurance…an arrangement made for the purposes of indemnifying a person”

or

“a combination of the two.”

My Bill proposes changing that subsection to:

“For the purposes of this section, an ‘indemnity arrangement’ should comprise of a policy of insurance.”

Question put and agreed to.

Ordered, That Chris Vince, Josh Dean, Jen Craft, Will Stone and Charlotte Nichols present the Bill.

Chris Vince accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 13 June, and to be printed (Bill 192). \p UNKNOWN: Motion made, and Question proposed,

That, for the year ending with 31 March 2025, for expenditure by the Department of Health and Social Care:

(1) further resources, not exceeding £7,956,143,000, be authorised for use for current purposes as set out in HC 655,

(2) the resources authorised for capital purposes be reduced by £1,140,958,000 as so set out, and

(3) a further sum, not exceeding £6,827,154,000, be granted to His Majesty to be issued by the Treasury out of the Consolidated Fund and applied for expenditure on the use of resources authorised by Parliament.—(Anna McMorrin.) \p Geoffrey Clifton-Brown: Thank you, Madam Deputy Speaker, for granting us the opportunity to debate this supplementary estimate, which provides an opportunity for all Members of this House to look at the Public Accounts Committee’s report on health and discuss how the money might be spent on different priorities.

As the Chair of the Public Accounts Committee, I am honoured to introduce the first estimates debate on the supplementary estimate of the Department of Health and Social Care. I made this application jointly with the hon. Member for Oxford West and Abingdon (Layla Moran), the Chair of the Health and Social Care Committee, and my right hon. Friend the Member for Salisbury (John Glen).

As Members of this House will know, the Public Accounts Committee is one of the oldest Committees of this House. It exists to protect taxpayers’ money and ensure that their pound is being used effectively. It goes back, I think, to about 1867. Unlike other Committees, we do not take evidence from Ministers; instead, we take evidence directly from permanent secretaries and the most senior civil servants and public sector officials. The National Audit Office provides us with audited accounts and value for money reports, and we produce reports of our own with recommendations to Government to which they must formally respond as part of the Treasury minute.

At this point, I pay tribute to Amanda Pritchard, who has recently announced that she will be stepping down as chief executive of NHS England this summer. She oversaw the NHS at a time when it was under so much pressure post pandemic, and I wish her well in her future endeavours. I also congratulate Chris Wormald on his promotion to Cabinet Secretary. These vacancies at the head of NHS England and the Cabinet Office provide an opportunity for completely fresh thinking within the NHS. \p Layla Moran: I echo the hon. Gentleman’s thanks to Amanda Pritchard for her time at the head of NHS England. While I  also welcome the appointment of Dr Penny Dash as its new chair, the hon. Gentleman is right to say this is a really important moment in the future of the national health service. \p Geoffrey Clifton-Brown: I thank the Chair of the Health and Social Care Committee for her endorsements of the worthy work that all these individuals have put into the health service.

The Department of Health and Social Care is one of the highest spending Departments in the UK, with a total departmental expenditure limit standing at a huge £210.1 billion. I am not sure anybody believes that the NHS is working at optimal productivity. NHS England is the largest quango with the highest budget in Whitehall; however, when allocating funds, it is also one of the few Departments that is making life and death decisions that affect the lives of literally millions of patients and their families. I think it does, therefore, deserve the highest level of scrutiny, which is part of what we are doing today.

Before even getting on to the figures, the NAO confirmed that the level of productivity in the NHS has dropped by around 23% since the pandemic. I simply say that unless that is sorted, any reform that the Government announce will be sucked into the black hole of the NHS without commensurate value for money or results. \p Leigh Ingham: rose— \p Geoffrey Clifton-Brown: I do not want to give way to too many people; otherwise, you will reprimand me for taking too long, Madam Deputy Speaker. However, I am, of course, happy to give way to the hon. Lady. \p Leigh Ingham: On that point specifically, I was at my local hospital—County hospital, in Stafford—a couple of weeks ago, where I noticed that staff were still using paper to make notes on patients. One of the biggest barriers to the NHS being more efficient is the inability to have effective digital systems. Does the hon. Gentleman agree that the investment that has been announced in the move from analogue to digital in the NHS is long overdue? \p Geoffrey Clifton-Brown: I agree entirely with the hon. Lady. She has obviously been reading my speech— I will cover the announcement later in my speech, at which point she will hear exactly what it says.

As I say, the NAO has confirmed that productivity levels have dropped by 23%. I welcome the Government’s commitment to a 10-year plan for the NHS. We have also repeatedly warned that, with an ageing and increasingly sick population, the NHS will struggle to cope with the ever-increasing multiple complex demands of our population.

I wish to split this speech into three sections: how productivity could be improved in the NHS; funding; and, as the hon. Member for Stafford alluded to, technical advancements and a shift into community care.

The Department of Health and Social Care’s day-to-day spending—RDEL—is set to increase by £10.9 billion—from £187.9 billion to the main estimate as produced today of £198.5 billion. The capital spending is, however, set to decrease by around £1 billion, from £12.5 billion to £11.5 billion—a decrease of 8%. That is worrying as it shows that more and more funds are being redirected from long-term investment—for example, in the new hospitals to which the previous Government had committed themselves. I welcome the new Treasury guidelines that have stopped the practice of the past few years of  redirecting up to £1 billion from capital spending to day-to-day spending. That should help to make more money available.

The NHS estate, as we all know from our constituencies, is in desperate need of investment, and our capital investment programme is running behind schedule. The problems with reinforced autoclaved aerated concrete have only added to the necessity of upgrading our hospitals, and I hope the Minister will listen to this plea.

The latest NAO report on the DHSC annual report and accounts shows that local systems, such as integrated care boards and NHS providers, reported a year-end overspend of £1.4 billion. This has nearly doubled from £621 million in 2022-23. This was despite an extra £4.5 billion of additional funding during 2023-24, which was to support pay deals for non-medical staff, mitigate any impacts from industrial action and provide money to address the costs of new pay arrangements for doctors and dentists.

What I do not think is acceptable is the glacial pace of agreeing priorities and approving final budgets for the local systems. In November, our Committee was shocked to hear that, in the past two years, those local systems—ICBs and others—had not had their financial plans approved by the Department until June and May respectively. That is up to three months after the start of the financial year. How can our poor local systems plan efficiently when these final allocations and guidance are so late? If the Department’s own accounts were finalised much sooner, our local systems would be able to have the money allocated in a more timely way, making wastage and inefficient spending less likely.

I welcome the Secretary of State’s prognosis that the NHS is far too big and complicated. There should be a shift towards allowing NHS trusts more control of their own budgets, as clarified in the 2025-26 priorities and operational planning guidance published in January. Moving more funds directly to NHS trusts, ICBs and local systems will improve accountability and give them a level of flexibility about how their funds should be better spent, rather than just focusing on targets and directives. For example, if they were to run a surplus because they had run their operation so well, they could reinvest the money in desperately needed capital projects rather than returning it to Whitehall. That must also go hand in hand with a need to improve productivity. Between 1996 and 2019, the NHS averaged a measly 0.6% a year increase in productivity.

Since the pandemic, productivity has now fallen by 23%. In March 2024, the Conservative Government announced that the NHS would receive £3.4 billion of capital investment for digital improvements between 2025-26 and 2027-28, which begins to address the point that the hon. Member for Stafford mentioned. As part of that investment, NHS England committed to achieving ambitious average productivity improvements of 2% per year through to 2029-30. However, those digital improvements, presaged by that additional £3.4 billion, have not yet been fully actioned. \p Christopher Vince: I thank the hon. Gentleman for his speech and, importantly, for his scrutiny of the NHS. He reflected on the fact that productivity has worsened since the pandemic. Does he not think that is to do with the mental health of staff?  To support our NHS professionals to be as productive as possible, should we not be considering looking after their health, including their mental health? \p Geoffrey Clifton-Brown: The hon. Gentleman is exactly right. The NHS employs an enormous number of staff—more than 1 million people, I think—and their conditions of work are really important if we are to retain them. That does mean that their mental health needs close attention, especially when they have problems. If the NHS cannot help with mental health issues, who can? The hon. Gentleman has hit on a really important point.

One reason that productivity is not improving more is that there are 19% more staff in the NHS, but they are seeing only 14% more patients. At our hearing, NHS officials stated that this was due to more complex and acute health needs, meaning longer stays in hospital. I also understand that it was due to staff sickness, absences and the then ongoing workforce industrial action that affected most patients last year, making targets more difficult to meet. I do not know about other hon. Members, but I am still getting emails from constituents whose appointments and operations were cancelled at the last minute due to that industrial action and who are still waiting for their procedures to be rearranged.

Along with staff, technology plays a big role in improving efficiency and productivity. The 2025-26 priorities and operational planning guidance stated that the NHS organisation

“will need to reduce their cost base by at least 1% and achieve 4% improvement in productivity.”

I understand that these figures are hard to pin down due to the NHS still negotiating with bodies such as the ONS on the definition of productivity and how it can be measured. I say to the Minister that, even if the numbers are disputed, we have still not seen a plan for how these productivity gains can be achieved, and the Committee believes that NHS England has produced unrealistic estimates. We need to have a realistic estimate from the Department of what productivity gains can be achieved over the next few years.

Without significant productivity gains, the NHS will not substantially reform waiting times and achieve the best value for the large amount of money that we spend on it. On average, there is a 4% real terms increase in our spending each year, when the economy is growing by only 1%, which is unsustainable in the long term. If we go back to 2013, the Health Secretary had set the NHS a challenge of going paperless by 2018. Clearly, as we all know, that has not happened, because the NHS is still using fax machines. In a digital age of AI, that lack of modernisation produces a risk to both patients and employees in the NHS. Investing in better technology would help with the Government’s ambition to shift more care into the community.

Community healthcare can take many forms, from GP surgeries and community hospitals to pharmacies, dentists and social care. I fear that when we talk about the NHS budget, we predominantly focus on hospital care, rather than the care that most of our constituents need every day. Indeed, Lord Darzi’s report, which was commissioned by the Government last year, said that

“the NHS budget is not being spent where it should be—too great a share is being spent in hospitals, too little in the community, and productivity is too low”

This is where I would like to pay tribute to our GPs and all their staff across the country, especially in the North Cotswolds. Our GP surgeries are usually the first point of contact with our NHS, from antenatal services to blood tests and vaccinations. They also offer a number of services that could be termed preventive care.

As a Committee, we questioned NHS officials on their prioritisation of preventing ill health rather than treating it, thus avoiding much more expensive hospital interventions in the future and a much better patient experience. Their reply was that they had little additional headroom to grow preventive services, yet the public health grant used by local authorities to commission preventive measures, such as health visitors and drug and alcohol services, is expected to fall in value next year by £193 million, despite the Government’s commitment to maintaining it in real terms. I cannot stress enough how I believe that we should be paying much more attention to prevention rather than cure; it is just so important.

NHS England said that, rather than moving funds, there should be a focus on the role of GPs and how they can advise their patients. However, according to the Royal College of General Practitioners, although more than 90% of patients’ direct experience of the NHS is through primary care and GP practices, less than 10% of the total budget is currently spent on primary care. I say gently to the Minister that we are getting our priorities wrong there.

As a Committee, we have recommended that the Government clearly define what counts as health prevention spending within the next six months and track that spending annually. ICBs should be given more flexibility in how they spend their money, which might include redirecting services to more community settings that are closer to patients. It might also include redirecting funds to help manage discharges from hospital. According to the House of Commons Library, the latest data shows that last year an average of 12,340 patients a day remained in hospital despite being clinically fit to be discharged. Even though there is a slight decrease of 1.2% from last year, more can be done to ensure that patients who are well enough can leave hospital for the community and be closer to their families. That will require better working between social care and hospitals. \p Andrew George: The hon. Member is making a powerful case for reform and review. This morning, the Health and Social Care Committee was looking at the very issue of delayed discharge of medically fit patients. Does he not accept that we need more integration? If only a quarter of those delayed discharges are down to a lack of social care packages, that means many patients cannot be discharged because they have a primary healthcare condition that needs to be taken care of, so we need integration and not just social care reform. \p Geoffrey Clifton-Brown: The hon. Member makes an extremely powerful point. I am coming to the conclusion of my speech, which is on precisely that point.

The social care system is not working in this country. It is a political football that keeps being passed from one Government to another. I understand that the  Government have committed to another review of adult social care and that we should not expect results until at least 2028; for many of our elderly patients, that will be too late. The funding of social care is rising exponentially. There needs to be more focused and joined-up thinking from the DHSC, NHS England and local authorities on how they can support those who need help to be discharged from hospital in a timely manner and live in their own homes for a longer period than they might otherwise be able to do. It should not be a postcode lottery, as exists now.

With more joined-up thinking between different parts of the NHS, the patient experience could be better. However, without substantial increases in productivity, increased spending on preventive care and public health, and a better functioning social care system, our NHS will never be able to operate at the optimal level with world-leading standards. \p Several hon. Members: rose— \p Judith Cummins: I want to try to get everybody in, so I will start with an immediate five-minute time limit. \p Clive Betts: It is a pleasure to follow the Chair of the Public Accounts Committee, the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown). Although we sit on opposite sides in the Chamber, we now spend most of our time in this place on the same side of the table in the Committee. I congratulate him on his appointment and the work he is doing as Chair.

The clear remit from the Secretary of State is to move to prevention, community care and digital services; that is how it is laid down. When we had the officials from the Department and NHS England before the Committee, we said that we thought they were complacent about the NHS’s finances. I thought that there was no sense of purpose or long-term strategy to deliver on the Secretary of State’s objectives; that was the worrying thing.

Let us look at the immediate problems. We have a service where trusts and others can run up deficits and seemingly there is no consequence. Unlike local government, which has to balance the books or go to the Government for approval to capitalise losses, that does not happen in the NHS. We have the problem in South Yorkshire that Doncaster hospital runs at a loss every year—I am not blaming the hospital, because it has an old building that needs massive refurbishment, or probably complete rebuilding, and it has not had the resources—and those losses go into the wider ICB system and put pressure on other hospitals and trusts not to distribute any surplus they might make to community services in Sheffield but to fund others’ losses. That is no way to incentivise a proper financial arrangement.

The hon. Member was absolutely right on moving towards community services, which is about not just getting people out of hospital but stopping them going into hospital in the first place. That certainly could be done. GPs hold 90% of appointments and get 10% of the funding. That is clearly wrong; we have got to switch that.

On social care, about eight years ago the Health and Social Care Committee and the Housing, Communities and Local Government Committee produced a joint  report to which 22 Members of Parliament signed up, but we are still here talking about the funding. Louise Casey is a great appointment as she has a great “get up and go” attitude, but I am sure she could be asked to get up and go a bit before 2028, because that is a long time to wait for any response.

We should be looking a lot more at moving services out of hospitals. There is a proposal around—and I say “around” because the NHS does not tend to act quickly—a diagnostic centre at Crystal Peaks in my constituency. The south-east of Sheffield is a long way from the two teaching hospitals, so to put services such as MRI scans, ultrasound scans, X-rays and CT scans there and to have GPs working with consultants who come to see patients in their clinics in the community would save money and provide a better patient service. But that seems to get locked up in discussions about NHS financing and commissioning, and who gets paid what to see who and when. We have got to unravel that and recognise that services can be made to improve significantly.

On digitalisation, the example of fax machines is of course legendary, but the other week I had to change a hospital appointment a couple of times—the service was really helpful in changing it—and I got not merely three emails and three texts but three letters with a first-class stamp on them, all for one appointment. That is a complete waste of money. I have talked to the hospital in Sheffield, which is bringing in new IT systems to cover the whole of the hospital operation, but that does not link into the GP systems. It is just nonsense that in this day and age we have that sort of unjoined-up thinking.

I will raise a couple of other issues. The consultant who has been treating me for the last seven years—successfully at this stage—for my myeloma has got an idea. People have so much chemotherapy to go through—probably at least six different sessions, twice a week—and for those sessions they have to go into the day ward. That is all right for some people—my timetable was helpfully rearranged to suit me coming down here and going back—but for many that is not possible, particularly if they have to go to a specialist unit that is many miles away. He has developed an idea for home chemotherapy, which works and is good. \p Geoffrey Clifton-Brown: I am sorry to intervene on my deputy, who does an excellent job on the Public Accounts Committee. In the last Parliament, before he joined the Committee, we went to Denmark, where they do precisely what he is talking about: give chemotherapy treatment to people in their homes where they have a history of not reacting to it. \p Clive Betts: Absolutely. Obviously, it is done with a clinician’s approval and with the patient’s agreement. The idea has been around for two years now, but again it is lost in the labyrinth of NHS discussions, boards and committees. Come on—let us do it now. It is a good idea, which is actually cheaper and benefits the patient. Why cannot these ideas be got up and moving much more quickly?

I absolutely agree with the comments made by the Chair of the Public Accounts Committee on public health. It is like an afterthought. The grant for public health comes out at least two, three or four months after the main grants for the NHS and local Government—it is like the money down the back of the sofa that the  Treasury finds at the last minute—and over the years it has been cut significantly in real terms. Public health in Sheffield does an absolutely great job, working with NHS Sheffield Place. It has done some really good work in deprived communities to increase and improve community care in the north of Sheffield. That is the sort of initiative we ought to pursue, and we should give the ICB the wherewithal to support and engage with that.

Finally, we ought to build equality of treatment into our aspirations. In Sheffield, from one end of the city to another, life expectancy changes by 10 years. That is simply not acceptable. However, for child vaccinations, GPs get paid by the number of vaccinations they do, so those GPs with the easy patients to reach—probably those in the wealthier areas—get a lot more money for doing vaccinations than those struggling to engage with deprived communities. That sort of initiative from the NHS is wrong and we need to correct it. \p John Glen: It is a privilege to make a contribution in this important seasonal debate. I pay tribute to my hon. Friend the Member for North Cotswolds (Sir Geoffrey Clifton-Brown) for bringing the debate to the House and commend him on his work chairing the Public Accounts Committee. As he set out, the NHS faces a number of enduring challenges: productivity, the integration of different systems, the challenge of public health, and the enduring issue of social care and how local authorities can provide the space for the NHS to deliver some of the outcomes we all aspire to.

I spent some of my time prior to the election in the Treasury. At every fiscal event that I was part of, whether as Parliamentary Private Secretary to the Chancellor, Economic Secretary or Chief Secretary, more money was given to the NHS. An attempt was made before every fiscal event to ensure that all the relevant stakeholders made the right positive statements about the new commitments, yet six or 12 months later there would be another pressing financial challenge. I say that because it is frustrating—we all come to this place to try to find enduring solutions to problems that are complicated. I therefore want to make some observations about the challenges of multiple systems operating effectively in allocating resources.

I meet GPs in my constituency regularly, as I am sure we all do. One such person is Dan Henderson, who is a partner at Salisbury medical practice. Alongside Anna Morton, who is a practice manager, he explained to me the complicated dynamics with our ICB over how to ensure that the right allocations are made for the inputs that they are organising at GP practices. It is mindboggling how difficult that process of securing the right allocations is and the lack of ability to plan effective systems over one, two or three years and beyond because the budget cycle is so overwhelmed with managing the health system. If we are to tackle the productivity challenge, we have to come to terms with those connection points between ICBs, GPs and local authorities and with how we can embed behavioural shifts that lift productivity.

The second area I want to touch on, despite the record £200 billion of funding going into the NHS, is the problem of public health and coming to terms with how we consume health services as a country. Where  something is free at the point of need, we can become very inefficient in the way we draw down that provision. I really think we have to work on pathways for informing and helping our constituents access health systems effectively.

We have seen an explosion of mental health challenges in recent years and the NHS has done a fantastic job of trying to deal with that. However, we should not tolerate the variable performance of the NHS across different trusts and across the country. One way in which we can raise productivity is by exposing those variances in performance so that those who are leading the NHS can be accountable for them. Those systems will be different for many reasons, with different demographic pressures and different challenges due to their capital estate. We must get those issues out in the open rather than always thinking that just ploughing more money into our NHS system is the way forward.

I welcome the greater investment, once again, in the NHS, but I recognise that we will need radical solutions if we are to change the productivity story. As a House, we need to unite in finding the right fixes and looking at the best ways of bringing them to fruition across our country. \p Danny Beales: When the Labour Government came into office last year, the NHS was in a critical state. Its fundamental promise to be there when we need it had been broken. The uplifted funding package is the first step on the road to making good that promise once again, but the pressures facing our health and care system are not over. Our system needs fundamental reform as well as investment, and achieving the ambitious 4% efficiency targets on which the Budget is premised will be challenging and will require change.

It is vital that we secure additional capital investment. We saw the previous Government continually raid the capital budgets of the NHS to balance the books, leaving the long-term productivity issues that we face today. I have seen in my own constituency hospital wards closed and unable to do procedures, and pharmacy and sexual health services desperate to do more but without the clinical space to expand. The £3 billion uplift in the future capital budget is therefore very good news. In her response, will the Minister outline that commitment to protecting capital budgets and maximising them to deliver the change that we need to see?

Through my work on the Health and Social Care Committee over the past few months, I have heard time and again, and it has become increasingly apparent, that to achieve the three shifts that the 10-year plan addresses we will have to bring together health and social care budgets and change financial flows to provide long-term funding settlements for both sectors. We will also have to fix the front door of our NHS, which is primary care, to which I will address the rest of my comments.

Primary care is best placed to provide preventive advice that keeps people well and deliver community-based healthcare that keeps people out of hospital. Yet it is precisely those primary care services—GPs, dentists, pharmacists and optometrists—that faced some of the harshest underfunding and neglect over the last 14 years of Conservative mismanagement. The Government’s  new deal for GPs, announced last week, is a welcome first step in improving primary care provision, but GPs cannot do it alone. Primary care is much more than just general practice, and other components of primary care are still in a state of crisis.

Community pharmacies are on the same flat funding contract that expired in late 2024, and that funding model is clearly inadequate. Healthwatch has estimated that 400 pharmacies were forced to close permanently in the last 12 months. I recently visited Boots pharmacy in my constituency and saw the great work that it is doing on vaccinations, health advice and so much more, and it is desperate to expand the range of services it offers.

On optometry, having recently met the team at Uxbridge Specsavers, it is clear to me that optometry is much more than just glasses and contact lenses. Through advanced testing, they have recently diagnosed people with a range of conditions, such as high blood pressure and even brain tumours. On dentistry, the dental contract is no longer fit for purpose, with many practices no longer delivering NHS appointments and those that are doing so at a financial loss. In Uxbridge and South Ruislip, the majority of practices are now closed to new NHS patients—both adults and children—and that clearly cannot go on. With that in mind, the provision of 700,000 extra urgent dental care appointments on the NHS, announced last month by the new Government, is a vital and desperately needed action. But clearly, more is needed.

Will the Minister confirm whether the dental budget will continue to be ringfenced? Will we ensure that, unlike the last Government, we will not underdeliver and underspend on the vitally needed dentistry budget? Will she also confirm that negotiations for the new dentistry contract will begin in earnest this year to permanently fix the dentistry crisis?

The mental health investment standard has been crucial in protecting mental health spending, as part of a vital shift to giving mental health parity of esteem. As we shift to neighbourhood health, I hope the Government can explore how to better track community-based health and preventive spending, ideally protecting and growing the share of the NHS budget seen by primary care.

The task of rebuilding our health estate and our primary care system is an immense challenge. However, it is not insurmountable. Labour has turned around the NHS before, and I am confident that this Government will do it again, creating a genuine community-based health and care system. \p Gregory Stafford: As a member of the Health and Social Care Committee, I know that there are serious challenges facing our health and social care system, particularly in the context of current and future funding. We all know that the NHS is under immense pressure. Our population is ageing, health needs are becoming more complex and the effects of the pandemic continue to be felt. If we want a system that works for everyone, we need to address these challenges with smart, strategic and effective solutions.

Before I became a Member of Parliament, I worked in healthcare, most recently as part of the NHS Getting it Right First Time programme. This programme focuses  on improving patient care by studying what works best, comparing data and making practical changes. Through that work, I saw where the system was bogged down by excessive bureaucracy, poor organisation and feeble productivity improvements, leading to unacceptable and unwarranted variations in care. Those problems waste time and money instead of helping patients. We need to streamline processes, modernise services and focus on patient outcomes rather than bureaucracy.

When the last Government were in charge, we increased NHS funding to record levels. In 2023-24, the NHS’s day-to-day budget was nearly £180 billion, and there is even more being spent in the current budget. But the real question is: where is this extra money going? Despite this additional spending, NHS England’s chief financial officer admitted to the Health and Social Care Committee that almost all of this year’s £10.6 billion uplift will be consumed by pay settlements, increased national insurance contributions and rising costs of treatments and medicines, meaning that very little, or indeed none at all, will be left for improving patient care. The Government are pouring billions into the NHS, but without demanding productivity reforms the money is being absorbed by the system instead of reaching the frontline where it is needed the most.

In my constituency of Farnham and Bordon, which includes Haslemere, Liphook and the surrounding villages, we have challenges in ensuring fair access to services across our different areas. In Bordon, rapid housing developments continue, yet healthcare provision has failed to keep pace. The ICB is pushing ahead with proposals for a new health hub, but there are concerns that it will not meet the future demands of a growing population. Residents who rely on the Chase hospital need assurance that new facilities will provide long-term, sustainable care.

In Haslemere, the hospital has made great strides in expanding services, reducing pressure on nearby GP surgeries and major hospitals such as the Royal Surrey County hospital, but ongoing support is needed. Upgrading equipment, increasing staffing and ensuring continued investment will allow Haslemere hospital to remain a cornerstone of our local healthcare provision. Farnham, meanwhile, faces persistent issues with both healthcare and access to dental services. The shortage of NHS dentists is an escalating crisis, leaving many residents without the care they need. Too many people are forced to travel long distances or go without treatment entirely.

Indeed, across the constituency, transport links to places such as Frimley Park hospital remain a concern. As a regional hub, Frimley Park plays a vital role in serving Farnham and beyond. However, for many residents, particularly those in rural areas, accessing treatment there is a challenge. I have worked closely with the local authorities and Frimley Park to improve transport connections, including through the expansion of the Waverley Hoppa service. If the Government truly want to expand services, they need to look at this holistically: not just at the buildings but at how patients can access them.

Labour’s tax increases on GPs, pharmacies, care homes and social care providers are putting vital services at risk. The Royal College of General Practitioners has warned that these changes could force some surgeries to close or reduce their services. In my constituency, that was amply demonstrated to me when I visited Badgerswood  GP surgery and pharmacy. I have also spoken to Dr Kabir from the Hampshire primary care network and Tim Corry from Guardian Angels. They told me that these changes are forcing small healthcare providers to cut staff hours, downsize operations and even lay off employees. Hospices are also struggling, with projected cost increases of £30 million. I am lucky that the Phyllis Tuckwell hospice in my constituency is currently going through a major rebuild, but others are not so lucky.

The Government need to focus on real reforms that improve productivity and modernise healthcare. If the Health Secretary is serious about making the NHS better, he must explain how he plans to integrate those innovations into his 10-year plan. The reality is that this Labour Government have failed to build the new hospital programme and to implement the Conservative Government’s cap on social care costs. Labour has no plans to fix the NHS. Instead of returning to the futile model of “Whitehall knows best”, the Government should be looking at actively devolving funding to local systems, with the provision of punishment if they fail. Ultimately, they must have an honest and open conversation with the public about how we deliver, provide and fund healthcare. \p Jennifer Craft: Meeting my constituents in Thurrock serves as a constant reminder of the state of our NHS and the health of our nation. I regularly hear from residents who cannot access NHS services, who are stuck on a waiting list or who are unable to see their doctor. I see how the social determinants of health play out, putting people in parts of my constituency at a disadvantage from day one. Housing, unemployment and education drive health inequalities, and in our most deprived communities, people do not live to see their 80th birthday. That is representative of the immense task this Government have been set. The funding of the health service and the estimates we are discussing today are fundamental to turning the tide on these trends.

Fourteen years of neglect and failure, the highest waiting lists on record, an ageing population that is getting sicker and unmet need in communities across the country mean that the NHS is at a pivotal point in its history. It must fundamentally change how it operates in order to survive. The £22.6 billion of funding committed to revenue spending at the Budget was a welcome and much-needed cash injection, the impact of which is already being felt. The delivery of Labour’s manifesto commitment of 2 million more appointments a year is testament to that. \p Gregory Stafford: I did mention this in my speech, but I think the hon. Lady was there in the Health and Social Care Committee when the chief financial officer of NHS England said that the extra £10.6 billion allocated for this year would be entirely eaten up by other costs, including national insurance rises, and that there would be almost no extra money for frontline patient care. Does she remember that? \p Jennifer Craft: I was indeed at that Committee, and I also remember the reflection that NHS England was incredibly grateful for the amount of money that was being given.  It was the highest amount of money given to any Department at the Budget, and it was much, much more than has been given in previous years.

Waiting lists have fallen for the fourth month in a row—I hope the hon. Gentleman and his colleagues will welcome that—with 160,000 fewer people waiting for treatment than when Labour took office. That includes a member of my own family, so I am very grateful to see that happening. Extending the opening hours of community diagnostic centres, such as the one set to open in my constituency this summer, will be key in catching conditions earlier.

While I welcome those measures, I would like to make the key point that funding alone is not enough to change and save how our NHS operates, and we must turbocharge the left shift to community and neighbourhood healthcare. In my constituency, it is often the front door to the NHS that lets local people down, which drives admissions to A&E when there is no available alternative. We have some of the most acute GP shortages in the country, with an average of 3,431 patients per GP. The neighbourhood health hubs promised by the previous Government have yet to be delivered. People in Tilbury, one of my most economically deprived areas, are still waiting for a long-promised facility, which currently looks like a hole in the ground, and I would welcome a discussion with the Minister about how we can work to deliver it.

The record funding uplift for general practice, with £889 million of investment, is again welcome news, but it highlights the fundamental tension between tackling the crisis in acute care and driving the vital left shift to community care that will be fundamental in turning the tide on the NHS. We must not lose sight of the goal of creating a healthier population in order to reduce pressure on acute services in this country, creating better, healthier lives and delivering the right care at the right time that puts the focus on the individual.

Thurrock community hospital in my constituency delivers excellent integrated community care that brings together social workers from the local authority and NHS staff to meet people where they are, intervening early and reducing pressures on acute care. That is partly thanks to a real partnership between the local authority and the integrated care board, and it has removed the need to focus on which public body benefits and which public body pays. I have to point out that our local authority has one of the lowest spends on adult social care, partly due to measures such as this.

The real focus is on how to deliver for individual patients—what do patients need and how do they get to that place? I welcome the bold move in the recent planning guidance to drastically reduce the strict targets placed on integrated care boards, allowing more of this work to take place by giving ICBs independence to make decisions that are relevant to their local population. However, I have heard from ICBs, including mine, that there is a risk that a focus on the elective care target may draw attention away from prevention.

I would like to point out the removal from the planning guidance of the targets for annual health checks for people with learning disabilities. That community historically has been under-represented and has not had its health needs fully met. This population dies younger and does not access preventive care at the point at which it would be most beneficial for them. Blanket  prevention measures do not cover such populations. People in this community need specific intervention that allows them to access the healthcare that they need, when they need it. While a blanket annual health check is not necessarily the right way forward, it is absolutely critical that historically overlooked groups who are not served as well as others by our healthcare system are not overlooked when we shift to community and prevention work.

I very much welcome the strong investment that the Government are making in our NHS; it is vital in order to turn the NHS around and ensure that it is there for generations to come. I would welcome the Minister’s thoughts on how we can incentivise prevention as well as providing acute care. \p Judith Cummins: I call the Chair of the Select Committee. \p Layla Moran: We are proving that estimates are not dull, although they have a terrible reputation for being so. Everything comes from the money, and if we do not follow the money, we do our constituents a disservice. The Government have announced an incredibly welcome £22.6 billion increase in day-to-day spend on health and social care, in addition to the further £3 billion in capital expenditure. It sounds like, and is, a huge amount of money. The only thing bigger than the uplift will be the disappointment of our constituents if the money is not spent wisely and does not lead to the change that they desperately want and need.

I will start with an example. My constituent was referred to her GP for an NHS-funded assessment for autism spectrum disorder. She took tests, and exceeded the threshold in all of them, and was told that she would be put on a waiting list, with an expected wait of 16 years to 18 years—yes, years. She is 34 with young children, and will be waiting for an appointment until she is 51. That is clearly ridiculous.

We welcome the three shifts, the 10-year plan and the long-term thinking, which hopefully will end stories like the one that I just told; I know Members from across the House will have similar stories. I was interested to hear the Secretary of State choose technology as his top pick when I pressed him to pick a favourite priority at our Committee hearing on 18 December. In recent correspondence with the Committee, which is now online, the Department credited technology with a 0.7% productivity contribution this year alone. I am concerned, though, that we do not have much detail about how exactly technology will achieve that, and we will press the Department on that figure.

Prevention is also incredibly important, and it is always in danger of being overlooked. I assure the Minister—I know she is responsible for prevention—that if the Government do not pursue it, we will press them to, as will the electorate, I am sure, because is a no-brainer. \p Gregory Stafford: If we want prevention, we have to invest in social care, but the Government are putting almost all the investment that the hon. Member talks about into the NHS, rather than social care. Surely there needs to be a rebalancing. \p Layla Moran: In our Committee hearing just this morning, we heard that all parts of the system want this. Acute care trusts recognise that they have the bulk of the investment, but they realise that unless they start pooling budgets and working in an integrated way, we will not achieve the productivity gains that we desperately need. \p Mike Martin: The Government’s policy is actually achieving the opposite for social care of what the hon. Member for Farnham and Bordon (Gregory Stafford) suggests. Peter runs a small domiciliary service in my constituency that is going bust. That means 35 people without a job, a loss of £100,000 in taxes every year, and all those patients now blocking beds in hospitals. Does my hon. Friend the Member for Oxford West and Abingdon (Layla Moran) agree that the Government’s policies are downgrading and trashing social care, rather than boosting it? \p Layla Moran: I share my hon. Friend’s frustration that we are not doing more faster. Indeed, the first inquiry that our Committee has launched is on social care and the cost of inaction, because there is a cost to doing nothing, and we need to quantify that as best we can.

On the three shifts, the shift to the community is incredibly important, not least because successive Secretaries of State have said that they want that shift, yet the money has flowed in the opposite direction. \p Steffan Aquarone: In Cromer in my constituency, about 18 months ago, the Conservative-controlled county council closed down Benjamin Court reablement centre. That is exactly the sort of facility that we need to help bridge the gap between acute hospitals and community and primary care. Does my hon. Friend agree that we must work to reopen those facilities, which do not stand a chance until there is proper integration of NHS budgets and the budgets of adult social care providers? \p Layla Moran: We should be celebrating examples of where this works well, not shutting them down.

In Oxford, the Hospital at Home programme, run by Oxford University hospital ambulatory team, does incredible work. I visited 91-years-young Mavis the other day, who was receiving top-notch ultrasounds in her home—ultrasounds of better quality than those that she would have got in the hospital. That saves hundreds of pounds for the NHS and means no long trip for her and her family. That is definitely something that we should do more of.

Let me turn to the estimates, because they are why we are here. The supplementary estimates have been published. I will not hit anyone over the head with them—they are incredibly heavy. They are worth a read. They talk about a £198.5 billion day-to-day spending budget. At face value, that is an increase of £10.9 billion on the estimate from July, but £9.2 billion is for staff pay increases. Let us be clear: staff deserve that pay rise. It is long overdue. Retention and mental health are important, and we must invest in our workforce, but that does leave just £1.7 billion. \p Jennifer Craft: Will the hon. Member give way? \p Layla Moran: I will make progress, if I may, because the clock is ticking down. As for that £1.7 billion, once we add in national insurance contribution increases and inflationary costs, the NHS has had to ask for an additional £812 million on top, so it is already running a little behind. Next year, the increase is due to be £10.6 billion, but as the Committee heard in a hearing, the expected pressures are £11.7 billion. We can all do the maths. There is a problem. The way it will get solved, at least on paper, is through an enormous 4% productivity increase, combined with cost reduction. We need more detail about how exactly that will be done.

I echo the point made by my fellow Committee member, the hon. Member for Uxbridge and South Ruislip (Danny Beales), about capital expenditure. In these estimates, we see that there has already been a decrease in capital spend of £1 billion from the 2024-25 main estimate. It is explained away as a transfer to day-to-day spending, due to a reclassification of spending on technology and new hospitals as day-to-day spending. I do not know how others feel, but that does not sound quite right to me. I am concerned that the Government are falling into the same trap as previous Governments—perhaps understandably, because they have to pay for the day-to-day somehow. The Government gave an assurance to the Public Accounts Committee that they would stop making those sorts of changes. Is that still the case?

Finally, I want to do more of this; I want to undertake more scrutiny of the estimates, but it is quite hard to do, because there is a lack of detail. For example, in the document, £120 billion comes under the sub-heading, “NHS providers”, and there is absolutely no detail under that. Will the Minister commit to working with the Committee and the House of Commons scrutiny unit to provide Parliament with a meaningful breakdown, so we can have more wonderful debates just like these? \p Several hon. Members: rose— \p Judith Cummins: I will start with an immediate four-minute time limit. \p Neil Duncan-Jordan: I acknowledge the £25 billion of additional funding allocated to health and social care in the autumn Budget. We are already beginning to see improvements in waiting times, the number of dental appointments and access to treatment. That is absolutely what my Poole constituents wanted and needed to see from a Labour Government. \p Gregory Stafford: Will the hon. Gentleman give way? \p Neil Duncan-Jordan: I am afraid I will not.

Funding is more challenging in social care, and that is what I will focus my comments on. There is widespread acceptance that our social care system is neither sustainable nor fit for purpose. For far too long, it has been the Cinderella service of the welfare state, overlooked and underfunded, and it has suffered from a number of problems that started to emerge decades ago but have become critical as a result of severe cuts to funding and increasing demand.

Most people who have looked at the system recognise the huge cost to the NHS of keeping people in hospital when they could be discharged into the community. However, too often there are not the care packages in place to enable that discharge. That will be resolved only when we have a better understanding of the dynamics of social care and a more effective way of managing it. Addressing the crisis in the system requires us to reconsider the meaning of the term “social care,” and to abandon the false divisions between medical, nursing, personal and social care, and instead regard all those activities as part of a single care service.

A new national care service should seek to go further than the existing model of provision. As well as providing free domiciliary and residential care to all users who are self-funding, it should also have to: take account of the 2 million older people who have needs that are not being met by the system; improve terms and conditions for care staff; strengthen regulation and monitoring of services; and provide greater support for the country’s 5 million unpaid carers. There needs to be an immediate national debate about how a new national care service can be publicly funded and delivered, what it should include and who should be responsible for its delivery. The new Casey commission will only delay that debate further, in my view.

We have known about the problems for a long time. Over the last two decades, we have had at least 20 commissions, inquiries and reports analysing what is wrong with the system and what might be done to address the problems. However, successive Governments have all found the issue too difficult to tackle, and have instead favoured short-term answers that have largely left the system untouched. The issue that all politicians have avoided is the false division between health and social care, and the question of how such care should be funded.

No one should face personal costs simply because they are unlucky enough to suffer from conditions such as dementia. That undermines the very principle of our NHS. Society must share the burden, and those most able to contribute must pay their fair share. Our universalist principles must lead us to talk about correcting those inequalities and ensuring that wealth, resources and budgets are used to build a fairer and healthier society for all. \p Joe Robertson: I commend my hon. Friend the Member for North Cotswolds (Sir Geoffrey Clifton-Brown) for his introduction to the debate. I agree with the majority of what I have heard so far.

We must understand the context of the large figures announced by the Government. In particular, the £10 billion for the NHS next year sounds like a big figure, but as my colleague and Chair of the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran), was right to inform us, the vast majority of that money—around £8 billion to £9 billion—will be taken up by union pay deals, the national insurance increases brought about by the Chancellor, and inflation. When all the essential costs that the NHS must meet are taken into account, the £10 billion represents a shortfall. The NHS will be able  to deliver only if it produces productivity gains. We must understand that £10 billion will not even meet the required costs of the NHS. \p Jennifer Craft: Does the hon. Member not consider the workforce a vital part of the NHS? Properly funding the workforce, through a pay deal that appropriately recognises the effort they put in, is part of the work of turning around the outlook for our NHS. \p Joe Robertson: I agree with all those things, and I am happy that the hon. Lady and I agree with each other. I hope that she acknowledges that £10 billion does not cover the basic requirements of the NHS. It delivers nothing more; in fact, it delivers less. The NHS will be able to continue to grow only if it delivers productivity gains, and it should. \p Gregory Stafford: Does my hon. Friend remember, as I do, that when the Secretary of State was in opposition, he was very clear that there would be no pay increases unless there were productivity gains and reforms to the way the NHS operates? Now that Labour is in government, that seems to have completely evaporated. \p Joe Robertson: I remember that clearly. I would like the Minister to spell out how she will deliver those productivity gains through reform. We want to hear more detail so that we can be confident that the NHS is secure.

Let me turn to one area that the Minister might like to reflect on: the use of technology. Penny Dash, the candidate to take over as chair of NHS England, told the Health and Care Committee clearly that she would like technology to deliver and that she sees lots of opportunities. She herself remarked that basic technology in the NHS is not working. I recall that she used the example of nurses taking half an hour to turn on a computer system and having to use five passwords to access it. I said to her that it is hardly sensible to try delivering technology gains around artificial intelligence and all the opportunities that it might bring if we cannot deal with very basic, low-tech problems throughout the NHS. She agreed and accepted that is a challenge. I would like to see how the Secretary of State will, through the Minister, support NHS England in delivering that.

I would also like to see the dementia diagnosis target brought back into the planning guidance document for NHS England. It was taken out this year, in consultation with the Secretary of State—so he allowed that. Diagnosing dementia is the most important thing we can do for people living with dementia and their families. Taking that diagnosis rate target out is inexcusable. I accept the wider point that if everything is a target and a priority, then nothing is a priority, but I think we can all agree that dementia—the biggest killer in this country—must be a priority for the NHS. That target for diagnosis rates must come back into the planning guidance next year. Indeed, the word “dementia” does not even feature in the guidance, which is shameful, frankly.

Let me finish by talking about where the money is spent. We can have disagreements about how much is needed, but Lord Darzi was very clear that it is not being spent in the right places. Too much money in the NHS is being spent on hospitals, and not enough is  being spent in the community. The Secretary of State will have to take some tough decisions, which he accepts, and one of them will have to be to reduce the proportion of money spent on hospitals. That is politically difficult, but across the House we are prepared to back him, if it is part of a plan to deliver meaningful change and to move more people out of hospitals and into communities, which is where they most want to be treated. Nobody wants to be in hospital if they have no medical reason to be there.

Finally, the Chancellor must understand that every decision she takes must be coherent and consistent with delivering the three shifts. When she came to the Dispatch Box to deliver the Budget in October, she recognised that national insurance increases were going to be crippling for healthcare. That is why she exempted the NHS from those increases. However, she failed to exempt other key providers of healthcare, particularly in primary care, such as GPs, so it is no good now saying that the GP pay deal is a record deal, because the money that they must pay in national insurance contributions represents more than 50% of the money that the Government have given them. The Chancellor must back up the left shift with the fiscal decisions she announced at the Dispatch Box. \p Several hon. Members: rose— \p Judith Cummins: Order. Before I call the next speaker, Members may wish to know that, given the time remaining for this debate and the number of Members who wish to speak, I will be unable to get everybody in, even with a four-minute time limit. \p Josh Fenton-Glynn: I am pleased to be called to speak in this important debate, Madam Deputy Speaker. When we talk about the NHS, we can argue either about specific investments or about general principles, and like many colleagues, I have received a great amount of correspondence highlighting no end of specific areas where investment is needed. I could also speak about the need to invest in urgent treatment centres in Todmorden, or to celebrate the work of Calderdale and Huddersfield NHS foundation trust—two things that I continue to raise with my right hon. Friend the Secretary of State for Health and Social Care. However, as I have the privilege, along with others, of sitting on the Health and Social Care Committee, I want to talk in more broad terms about some of the problems facing our health and social care system, and about how the proposed shifts in the NHS need a reprioritisation of resources.

I will focus on what I argue is the most important of those shifts—the so-called left shift of care from hospitals to the community. The hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown) outlined the need for that well—even if to hear him speak one might think that it had come from on high, and not as the result of 15 years of the previous Government. One in 10 people are stuck on waiting lists in a healthcare system that is becoming increasingly hospital-centric, and those lists will only grow if we continue on the same course. There is no solution to our crisis in emergency medicine without the left shift of solving problems earlier and closer  to home.

Of course we need hospitals and to invest in them, but they should be where people go with acute and complex cases, not where they go for want of working services elsewhere. Despite the need to shift to community care being obvious to just about everyone, one of the most glaring revelations of the Darzi report was how poorly successive Governments have gone about achieving that. Meanwhile, we are not training or retaining enough GPs—that is where the renegotiation of the contracts is important.

In Calder Valley, the retention crisis has meant that Bankfield and Church Lane surgeries, Northolme practice, and Rastrick health centre all have a ratio of patients to fully qualified GPs that is far higher than the local, regional and national averages—averages that simply do not meet what is needed from our health service. More than a decade after the Dilnot report, social care remains the forgotten service—the Cinderella service, as my hon. Friend the Member for Poole (Neil Duncan-Jordan) artfully called it. With 1.4 million social care staff, our care system is the same size as the NHS workforce, but it receives nothing like the support or understanding of other areas of our health system. The consequence is that our Committee, week after week, hears about delayed discharge, with 20% of beds in my local hospital taken up by people who should be treated at home or closer to home. Meanwhile, carers are missing their appointments because they are delivering care to loved ones, and they end up with worse illnesses, adding to the strain on the NHS.

In less than a year, this Government have ended the industrial action in our NHS and delivered 2 million additional appointments, and they are now setting up a new deal with GPs. However, that cannot be the extent of our actions. The 10-year plan cannot continue down the same road that the last Government took us on, of trying to fix a crisis in the NHS by putting more money into hospitals and nothing else, because that tackles the symptoms but not the causes of the problem.

Therefore, when setting out the estimates, I urge the Minister to be mindful of the shifts we need to ensure that funding not only increases, but increases with a focus on community and social care. That is what we need for a sustainable system that will protect the rest of our health service in future, because a sustainable system is the only way to deliver better healthcare and better social care for people across the country. \p Seamus Logan: I commend the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown) for introducing the debate, and I pay tribute to the retiring interim chief executive of NHS Grampian, Adam Coldwells, an outstanding public servant who will be sadly missed when he departs his post.

The revised departmental expenditure limit for the Department of Health and Social Care in England sees an overall increase in the estimates of around £10 billion, and I want to comment on how that affects Scotland generally and my constituency in particular. Lest we get giddy about the numbers, let us think about where that expenditure might be going: salaries and wages, price  increases—particularly for fuel and food—and certainly more taxes. It is a new definition of the circular economy as I understand it.

Let us also consider how the changes affect our partners in the enterprise of health and social care. GPs, hospices and charities are already facing huge financial pressures from rising energy costs, staff retention issues and labour shortages. Staff morale is already low and will be further impacted by funding cuts to the vital services they provide, as money is diverted to meet rising costs. Then along comes the increase in employer national insurance contributions for those partners. When we look across the border into England, we see additional GP contract funding of close to £1 billion, which will cushion much of those additional national insurance costs.

Let me share a local example from Aberdeenshire council, on which I was an elected member for more than two years. The cost to the council of the additional NIC changes is about £11 million. The council’s estimated allocation from the Scottish Government to mitigate those additional costs is around £5.5 million. The difference is stark and cannot simply be written off as a Scottish Government responsibility. Indeed, as Wes Streeting constantly reminds us, all roads lead to Westminster when it comes to funding. Our joint enterprise partners, such as GPs and third sector organisations such as Marie Curie—I see Members are wearing a daffodil today—or Chest Heart & Stroke Scotland, and local GP surgeries in places like Longhaven and Cruden Bay, are paying the price.

Turning to hospices, the Minister for Care, Stephen Kinnock, stated that there will be no additional Barnett consequentials— \p Judith Cummins: Order. I remind the hon. Gentleman to refer to Members not by name but by constituency. \p Seamus Logan: Thank you, Madam Deputy Speaker.

There will be no additional Barnett consequentials arising for Scotland for hospices. The Scottish Government are investing an additional £4 million in the hospice sector, but that wider sector faces a £2.5 million bill from the additional employer national insurance contributions. A flat exemption would mean that they would not have to pay that cost.

Perhaps also not evident from the estimates are the eye watering costs of agency staff, which is felt no less in Scotland, partly because of the regressive immigration policies of the last Government, which are now pursued by this Government. We have asked for those powers to be devolved to Scotland, but if Ministers cannot do that, there is an alternative approach—that has already been pointed out by the right hon. Member for Salisbury (John Glen). The Royal College of Radiologists tells us that workforce shortfalls in radiology are around 30%, and around 15% in oncology. It states that the most urgent task facing the NHS is to manage its workforce crisis by investing in an increase of 150 radiology training places and 45 clinical oncology training places, rather than relying on outsourcing and international recruitment. Of course training has costs, and it is every bit as expensive in Scotland as it is here.

In conclusion, through the Minister I say this to the Treasury: do not treat Scottish citizens as if they live in some vassal state; they are taxpayers too. Rather than expecting us to give you thanks, just get your chequebook out because of the pressures that I have listed. \p Nesil Caliskan: May I take this opportunity to thank the Chair of the Public Accounts Committee, the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown), for his work, as well as other Members who I sit on the Committee with?

The financial sustainability of our national health service will have an impact on patients now and in future. Given that such a huge amount of money is spent by the Government, it is imperative that they focus on value for money for the taxpayer so that, at a time when demand is going up but resources are limited, we can deliver the very best health service that the British people deserve and that my constituents in Barking can rely on.

For too long the Department and NHS England have taken a short-term approach to budgeting, relying on reallocating capital budgets to cover revenue shortfalls. Between 2014 and 2019, more than £4 billion was raided from the Department’s capital budgets to fund day-to-day spending. As a former council leader, that approach has always been curious to me, given that, as others have mentioned, local authorities are not permitted to have the same approach. Equally, councils are legally obliged to set annual balanced budgets, and even when they overspend because of demand-led statutory services, they cannot set deficit budgets. \p Josh Fenton-Glynn: Another issue my hon. Friend may wish to reflect on is that the council tax base differs from place to place, so councils are even more disadvantaged than the NHS on funding. \p Nesil Caliskan: My hon. Friend makes an important point, because health inequalities are determined by a multitude of factors and the work that local authorities do on public health is crucial too.

Compare the point I made about local authorities not being able to set deficit budgets with the situation in the NHS, where every year winter pressures mean that our NHS is at crumbling point and that despite the money poured in, the NHS overspends. Last year, that overspend was £1.4 billion, more than double the previous year. Those issues have not emerged in a silo; they are a result of years of mismanagement and failed leadership by former Ministers and by a Government who decided to allow the chaos of one year budget setting, hindering health leaders from being able to effectively plan for the future.

A lack of political commitment, coupled with a refusal to invest in the future, has led to awful consequences for patients. On the NHS estate, the National Audit Office report shows that since 2019, over 5,000 appointments, surgeries and other clinical incidences have had to be cancelled because of issues in buildings. That is absolutely shocking, so I take on board the points made by Members from across the House. \p Anna Dixon: On that point, will my hon. Friend give way? \p Nesil Caliskan: I will not take any interventions at this point—actually, I will. \p Anna Dixon: I thank my hon. Friend for giving way. It is always a pleasure to serve with her on the Public Accounts Committee under the leadership of the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown). She makes an excellent point about the raising of capital budgets. In my constituency, we have the RAAC-infested Airedale hospital. Does she agree that it is only with the new Labour Government and a properly funded and deliverable plan for new hospitals that we will see that put right, following the decision made by the Chancellor to ringfence capital funding? \p Nesil Caliskan: I am very pleased to have accepted my hon. Friend’s intervention and I entirely agree with her. If we want to see an improvement in the estate of the NHS, we need to have money allocated to it.

When the NHS was at breaking point, my constituents had to feel the pain of not being able to get appointments for their sicknesses. The population I represent already has some of the worst health inequalities in the country, exacerbated by the lack of primary healthcare provision. Some wards in my constituency have no GPs at all, so I welcome the remarks made by Members from all parties about the importance of primary healthcare provision.

Without reform, the NHS is simply not financially sustainable, but alongside reform there must be a culture of change in NHS England. The Public Accounts Committee report highlights that last year NHS England failed to approve ICB financial plans until months after the financial year had begun. Working with local NHS bodies, we have seen examples of ICBs, as other hon. Members have said, talking a good talk on prevention and public health, but we see a lack of action from many areas on commissioning in a way that has a positive impact on prevention. \p Gregory Stafford: I entirely agree with the point the hon. Lady makes, but does the impetus not have to come from the top? Unless the Government are making strides to shift moneys from healthcare to social care, why on earth should any of the ICBs follow suit? \p Nesil Caliskan: I do not disagree with that, which is why the Government commitment around reform will be so critical. I sit on the Public Accounts Committee that produced the report that highlighted some of those gaps. As a Committee, we will be looking closely at the reforms that have come forward from the Government, and I would welcome further reassurance from the Minister.

The Government are right to invest in the NHS to help to deal with the current critical waiting lists, but only alongside reform will the additional investment in the NHS be value for money. Only through reform can the NHS improve productivity to make it sustainable. I endorse comments made by Members from all parties about productivity because, without reform, the NHS cannot even meet its own productivity targets. That is why the estimates under discussion are so important. The 4.9% increase in investment is welcome because it will help to cover the pay review body’s recommended pay increase for NHS staff, stop the strikes, improve  staff retention and keep more doctors and nurses at work. That is crucial if we want a properly functioning NHS.

The Secretary of State for Health and Ministers in his team have said time and again that the NHS is beaten but not broken. These estimates are important because they set the foundation and springboard for what is required to fix our NHS. \p Sarah Bool: The Government came into office making all the right noises about tackling waiting lists and delivering a better healthcare service, which all our constituents want to see. However, since their election, I am concerned that Ministers are giving out more money—about £22.6 billion —for the day-to-day running of the NHS, without plans about how that may be spent to reform our health service, make it more efficient and support priority areas, such as dentistry, general practice or hospice care.

The Government are seemingly giving with one hand but taking with the other. No one should overestimate the impact of the increase of the employer national insurance contribution on our GP surgeries. Both Towcester and Brackley medical centres in my constituency have said that that increase will cost at least £40,000 to £50,000 and may result in redundancies, stopping the growth of their practices. Our surgeries are not here to make profit, but to deliver care, and attacks like this make care unsustainable.

The Darzi report said:

“The NHS budget is not being spent where it should be—too great a share is being spent in hospitals, too little in the community, and productivity is too low.” \p Gregory Stafford: I agree entirely with what my hon. Friend says, but has she seen anything from this Government that suggests that there will be a significant shift from acute care in hospitals to community care, despite the rhetoric that we have heard from the Government Benches? \p Sarah Bool: I concur that I have not seen anything, which is why today’s debate is so important. My GPs tell me that more attention needs to be given to GP practices: they are the praetorian guard who can ultimately protect the NHS. Access to timely appointments is crucial, as is rebuilding the key relationship and contact between a GP and their patient. \p Josh Fenton-Glynn: Under the last Government, 20% of NHS doctors were thinking about moving overseas. Does the hon. Lady agree that solving GP contracts is a first step towards keeping GPs working in this country? \p Sarah Bool: I want to encourage all our GPs to remain in the UK, giving back, so I am always fully supportive of anything we can do about that. \p Ben Coleman: On that point, will the hon. Lady give way? \p Sarah Bool: I will make some progress.

That key relationship and contact between a GP and their patient was reinforced by the Public Accounts Committee report on NHS financial stability, published in January, which concluded that a reallocation of funds was needed to focus attention from sickness to prevention.

I am a massive advocate of prevention. Many hon. Members will know that I talk about being a type 1 diabetic; if they have not heard me talking about it, they may have heard one of my sensors going off for a low blood sugar. There is so much we could do in preventative measures in the treatment of diabetes. Treatments can be expensive as an initial outlay, but they will solve many long-term problems. We cannot prevent type 1 diabetes, but we could have earlier testing in children, for example, so that we could avoid them being diagnosed when in a state of diabetic ketoacidosis, which can be fatal. Families could be prepared and ready, and children could avoid hospitalisation, saving costs to the NHS while also saving lives.

We can also ensure access to technology that can avoid huge complications. Poor blood sugar control can result in loss of eyesight and limbs, alongside heart and other conditions. Making continuous glucose monitors and even insulin pumps available across the country can significantly help the patient and, again, in the long term save the NHS money. At the moment there is a very unfair postcode lottery, so I ask the Minister to consider ways to tip the funding balance, to ensure both prevention and community care measures are properly funded.

Finally, any reforms to the NHS must consider the computer operating systems in place. Many of my constituents must go out of the constituency for their hospital care, be it to Northampton general hospital, the John Radcliffe hospital, Horton general hospital, Milton Keynes university hospital or Kettering general hospital, but all those trusts operate on different systems, with the result that my constituents often cannot have their scans or medical notes shared easily. That is frustrating for residents, and potentially fatal. One resident noted that his wife was nearly given a drug that she was allergic to, because her notes had not been able to be shared correctly—it was only his presence that saved her.

We must ensure that money is spent to look at that and to change the systems, which my hon. Friend the Member for North Cotswolds (Sir Geoffrey Clifton-Brown) has explained very conclusively. We owe it to our constituents to work across the House to better our healthcare and to support the fantastic work of our doctors and nurses. \p Judith Cummins: I will start to call Front-Bench speakers at 3.15 pm. \p Alex McIntyre: In my last career, prior to entering this House, I was incredibly proud to represent our NHS and other healthcare providers, and I will continue to fight for our NHS now that I sit here as an MP. I saw at first hand the impact that Tory mismanagement had on our NHS, which breached one of the fundamental principles of medical ethics: “first, do no harm”.

I saw that at first hand this week in my constituency when I visited Gloucestershire Royal hospital. I also met with Gloucestershire ICB this morning, and earlier this year I visited the surgery in Tuffley. The challenges that they face will not surprise anyone in this House,  as they were set out in stark terms in the Darzi report, and they are replicated across the country in many constituencies—maintenance backlogs, lengthy ambulance waiting times, recruitment challenges and an ageing and sicker population. What struck me most about my visits this week was the resilience of our NHS staff, who are committed to people in our county and in my city of Gloucester.

What a difference a Labour Government are making with more investment in our NHS. Waiting lists locally are already coming down, and patients are now able to access emergency dental treatment, rather than pulling their teeth out at home. We have more midwives and dentists and a new GP contract that will help to bring back the family doctor. That is what we can do in eight months—imagine the impact that we could have if we had 14 years, as the Conservative party did.

From a personal perspective, I have seen how important that work is. I used to joke on the doorstep that I should be a poster boy for why prevention is better than cure—it will not surprise Members that I may have a few extra pounds that I could afford to lose. Sadly, the prevention piece came too late for me; I was diagnosed with type 2 diabetes earlier this year. The treatment I have received since then has been phenomenal. I am now on the path to remission programme—available in Gloucestershire, but not across the country—which has already brought my blood sugar levels down and helped me to lose 3½ stone. [Hon. Members: “Hear, hear!”] Thank you very much. It will help countless others across Gloucestershire and across the country. As we move to prevention work, it is so important that we also look at public health measures around diabetes; I echo the comments made by the hon. Member for South Northamptonshire (Sarah Bool).

I also thank all the staff who looked after my little boy last year when he was really sick. We need to ensure that when we look at investment in our NHS, we prioritise maternity services and services for the youngest in our society to ensure they get the healthcare they need.

We have talked about British values a lot in this place over the last few months. When people ask me what makes me proud to be British, I point them to our NHS—a system without comparison in the world that means that everyone can access healthcare, regardless of their wealth. I know that Reform Members are not in their places today, but they say that all options are on the table. I would like the Minister to make it clear in her remarks that standing against our NHS and its principles—being there for everyone, regardless of their wealth—is the opposite of being patriotic and that their options are not on the table.

I welcome the record investment in our NHS and the shift from analogue to digital and from cure to prevention. I would also welcome the Minister’s comments on how we can ensure that we deliver on the people’s priorities in Gloucester. \p Judith Cummins: I call the Liberal Democrat spokesperson. \p Helen Morgan: I thank the Chair of the Public Accounts Committee, the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown), for securing this debate and for his excellent opening speech.

We all know that we have reached a crisis point across the NHS and care sectors, with more patients than ever waiting for treatment. That is affecting not just those in need of care and treatment, but those who work tirelessly across the NHS and care sectors, who are feeling the full brunt of the crisis. The Conservatives have a legacy of hours-long waits for ambulances, treatment in crowded hospital corridors—captured in horrifying detail by the “Dispatches” documentary, which looked into the hospital that serves my constituents in North Shropshire—and communities grinding to a halt under the weight of all sorts of waiting lists and backlogs. We urgently need to move forward.

The Secretary of State has repeatedly outlined the need to shift from treatment to prevention and from hospital to community, and the Liberal Democrats absolutely support him in that endeavour—indeed, we called for many measures that would achieve that shift in our own manifesto. Stronger primary care and community services were the strong recommendations of Lord Darzi’s report, which was commissioned by the Secretary of State and has been broadly welcomed.

There has been a great deal of consensus across the House today that we need to take those measures, but I fear that these estimates paint a picture of an NHS that continues to pour money into the previous, failing model in which capital budgets are drained to pay for day-to-day services and a huge proportion of increased spending goes on NHS staffing, while community care and primary care providers wrestle with the huge increase in employer national insurance contributions.

When that is combined with the decision to scrap targets on mental health and community services for the sake of prioritising targets on elective care, we must ask: when will the stated objectives of the Secretary of State really be matched by actions? The latest estimates are an indictment of the broken state of the NHS after years of Conservative neglect, but we urge the Government to go further and faster to address the failure. \p Ben Coleman: Having heard the hon. Lady’s comments and the comments of those on the Conservative Benches, may I share with her my confusion? She seems surprised that she has not heard the full solution of what this Government are going to do with the NHS, when it is quite clear that there will be the three shifts, a 10-year plan and a huge amount of reform coming down the line. As that seems to have escaped the Opposition’s attention, has it also escaped hers? \p Helen Morgan: There is clearly a point in the debate at which we need to urge the Government to go further and faster. As a constructive Opposition, that is exactly what we will do.

Primary care providers are on their knees, and I am afraid to say that that has been made worse by the national insurance hike announced in the Budget. They cannot meet demand for local appointments as things stand, and in many cases the constraining factor is the estate in which they operate. Prescott surgery in Baschurch  in North Shropshire wants to provide additional services to the community and keep people away from hospital, but the surgery is physically not big enough. A local developer has provided land for a new surgery, and the local council has community infrastructure levy funding for that building, but it cannot be done because the ICB will not pay the notional rent, which everybody has agreed to forfeit. It is crazy. I hope that the Minister can commit to finding some kind of easy solution to that kind of nonsensical situation that we find ourselves in. \p Nesil Caliskan: On the point about the inability of ICBs sometimes to get things going, in my constituency it has taken the ICB nine months to procure something very similar. Does the hon. Lady agree that it is about not just their ability to pay, but their procurement processes? \p Helen Morgan: I fundamentally agree. There are many such instances, and I chose that one because I spoke to the providers there recently.

I will come on to community pharmacy, because I am particularly concerned about pharmacies, which are a key pillar of care in the community, dispensing prescriptions and providing over-the-counter medicines and advice. Critically, they also provide Pharmacy First, but they are closing at an alarming rate. Analysis by the National Pharmacy Association predicts that another 1,000 pharmacies will close—900 of them by the end of 2027—if the current rate of closures continues. That is because of a 40% real-terms cut in their funding since 2015.

In fact, community pharmacies are essentially subsidising the NHS by making a loss on many of the prescription drugs that they dispense. In a few weeks’ time, in April, they will be clobbered by not only the NICs hike, but the increase in business rates, which will affect high street retailers. Shamefully, they have not even had their funding rates for the current financial year confirmed—the one that ends in three weeks’ time.

Pharmacy First, the flagship plan to move care into the community, has not had its funding confirmed beyond the first week of April this year, which is in just a few weeks’ time, according to the National Pharmacy Association. In her remarks, will the Minister confirm the future of Pharmacy First? Is there a funded plan to deliver that service? What steps are being taken to keep our community pharmacies in business? If we want to see care in the community, it is essential that we support them.

I want to mention dentistry. In Shropshire, Telford and Wrekin, the number of NHS dentists fell by 12.3% from 2019-20 to 2023-24. Many of my constituents cannot access a dentist, and the Government have committed to improving the situation, so can the Minister confirm when the negotiations on the new dental contract will begin?

The crisis that the social care system faces is daunting, not least because of the additional national insurance hike that will take place in a couple of weeks’ time. Last week, caring organisations launched an unprecedented day of action, with thousands of people marching on Westminster to highlight the precarious state of the organisations that provide care. The Darzi review found that people waiting to access social care account for 13% of NHS hospital beds. We all understand the  urgency of tackling social care, but the cross-party talks collapsed last week—they have not started. There is no date for a new meeting, and there are no published terms of reference. We think that 2028 is far too late to resolve this problem, so can the Government urgently reinstate those talks and act now to deal with the social care crisis?

Before I conclude, I will talk about mental health. As Lord Darzi has said,

“There is a fundamental problem in the distribution of resources between mental health and physical health. Mental health accounts for more than 20 per cent of the disease burden but less than 10 per cent of NHS expenditure. This is not new. But the combination of chronic underspending with low productivity results in a treatment gap that affects nearly every family and all communities across the country.”

He is dead right. By April 2024, about 1 million people were on a waiting list for NHS mental health services, of whom 340,000 were children. My casework is full of children who wait months and months for the diagnosis and treatment that they need. The Government have removed the targets for mental health waiting lists; I urge them to reinstate those targets, so that we have parity between mental and physical health in our health service.

I am very conscious of time, so in conclusion, I will just reiterate our asks. Those are to ensure that social care talks start immediately; to deal with the problems with pharmacies; and to make sure that mental health and social care receive parity. \p Judith Cummins: I call the shadow Minister. \p Dr Caroline Johnson: I draw right hon. and hon. Members’ attention to my entry in the Register of Members’ Financial Interests, as I am a consultant paediatrician. I congratulate my hon. Friend the Member for North Cotswolds (Sir Geoffrey Clifton-Brown) on securing this important debate on the finances of the NHS.

Labour said that it had a plan to reform and improve our NHS. Unfortunately, it has become clear from the series of consultations—on the NHS plan, the 10-year plan, the patient safety review, leading the NHS and the independent commission to transform social care, to name just a few that are in progress—that Labour did not have a plan, other than to get into power and then consider what its plan should be. As my hon. Friend the Member for North Cotswolds has said, we need improvements in productivity, technology and long-term investment. I completely agree, and as a medic I could give many examples of wasteful spending, especially in relation to paperwork and increasingly inflexible guidance and procedures that are well-meaning but often unhelpful.

There is general talk of productivity improvements from Government Members, but few specifics. I would be grateful if the Minister could provide any specifics in her closing remarks, but let us see what the Government have said and done so far. In the autumn Budget, the Chancellor announced that overall NHS funding would be increased by £22.6 billion over two years—for this year, that is £10.6 billion. The Government are asking us to welcome that extra money. It sounds great, but is it extra or not?

Julian Kelly, NHS England’s chief financial officer, told the Health and Social Care Committee that the proposed 2.8% pay rise for 2025-26 would cost £3.8 billion. The NICs pressure is worth around £1.7 billion, alongside £1.9 billion in non-pay inflation, £0.8 billion for the GP settlement and £3.5 billion for basic demand growth in the NHS. Right hon. and hon. Members will note that those figures add up to more than £10.6 billion, and with the unions having threatened to strike again for even greater pay awards and with Labour’s propensity to capitulate to the unions, it is likely that that figure will increase. Can the Minister confirm whether the £10.6 billion that Labour talks about will really lead to an improvement in services, or will it merely cover inflation, tax rises and the pay rises given by the Labour Government to their union paymasters? \p Several hon. Members: rose— \p Dr Caroline Johnson: I will give way in a moment; let us first look further at those tax rises. It is clear that the Chancellor had not properly considered the effects of the NICs rise on the wider healthcare system. For example, the Government have exempted the NHS from that tax rise, but that exemption does not cover general practice, hospices, charities, many social care providers—including many care homes—air ambulance charities, dental clinics, opticians, private healthcare providers, agency staff, local pharmacies and other suppliers and contractors, to name but a few. \p Alex McIntyre: I am sure that the shadow Minister is about to come on to this in her speech, but given that she has just criticised this Government for lacking a plan —a plan that is about to come forward to the House later this year—surely she will now put forward her plan for how much extra the Conservatives propose to put forward for the NHS and how they would pay for it, and explain why they did not do that for the past 14 years. \p Dr Caroline Johnson: If the hon. Gentleman looks back at the figures, he will see that there has been a substantial real-terms increase in NHS funding over the past 14 years. That cannot be said for this year, potentially, which is why I am asking the question. \p Clive Betts: Perhaps I will ask the shadow Minister an easier question, then. She has just rejected the pay deals that this Government have agreed to give a proper reward to our nurses and doctors. By how much does she think that pay deal should be reduced to bring it in line with her policy? If she is opposed to the deal that has been agreed, she must have an alternative in mind. \p Dr Caroline Johnson: One of the key things about the Government’s deal is that they have given in on money without asking for anything in return in terms of productivity. The Government needed to agree a pay deal that was sensible and affordable, not talk about the money that they are giving to the NHS while taking away with the other hand in taxes.

Let us hear what some healthcare providers have had to say about the implications of Labour’s NICs rises for their constituents’ healthcare. The Royal College of General Practitioners has warned that the NICs increase will force GP practices to choose between redundancies and closure. The hospice sector believes that the cost of national insurance rises could be £30 million a year. The  Government have given that sector a capital grant worth £100 million, which is welcome and will improve facilities; however, if those facilities are empty and cannot be staffed, they will not deliver much in the way of improvement. Air ambulances are also under threat from the Chancellor’s rise in national insurance and taxes in last year’s autumn Budget, with the local service in my constituency, Lincolnshire and Nottinghamshire air ambulance—which is entirely charitably funded—needing to find another £70,000 just to pay for those national insurance rises.

The Independent Pharmacies Association estimates that the rises in employer national insurance contributions and the minimum wage will cost the average pharmacy over £12,000 a year, totalling more than £125 million for the sector as a whole. Nick Kaye, chairman of the National Pharmacy Association, has warned that

“Pharmacies face a financial cliff edge at the beginning of April, with a triple whammy of rising National Insurance, National Living Wage, and business rates all arriving at once.”

What impact will this have on our constituents’ health? The Government talk a good talk about bringing healthcare closer to the community, but actions speak louder than words, and putting extra pressure on community-delivered services is not a good way of delivering their aims.

The Nuffield Trust suggests that the national insurance rise alone will add a £900 million burden to the adult social care sector. With other new costs factored in, the care sector is believed to be facing a bill of an additional £2.8 billion, dwarfing the £600 million extra allocated to the local authorities responsible for providing social care. This will have a devastating knock-on effect: the amount of care that can be bought by local authorities will fall, the cost of private care will rise—so more people will be reliant on the state, rather than the private sector—and the waiting lists that the Government claim to prioritise will also rise. The Nuffield Trust warns that many small care providers will either have to increase prices, stop accepting council-funded patients, or go bust.

That will have a knock-on effect on the hospital sector, as people are unable to be discharged because there is not adequate social care for them. The Government talk about creating a new national care service, but they have managed to damage the existing one by hiking the costs borne by care homes through national insurance rises and other tax and wage increases.

In January, the Government announced a deal with private hospitals in an attempt to cut waiting lists. The deal, which sounded good to start with, would see private hospitals being paid for each patient that they treated, incentivising them to treat as many people as possible. However, The Times reported that NHS England has recently capped the amount that each hospital can be paid. The chief executive of the Independent Healthcare Providers Network has warned that the policy will actually lengthen waiting times. Will the Minister comment on that?

The Minister is focused on prevention, but when the Government announced that they would be cutting the overseas development aid budget by 40%, the Prime Minister said that the UK would continue to play a key humanitarian role on a range of issues, including global health and challenges such as vaccination. I would appreciate clarification from the Minister on whether the global health budget will be cut, or whether the cuts will be made from other aspects of the ODA budget.

Workforce is the key asset of the NHS, yet sickness levels are running at around 5.5%, which is a considerable cost to Government and drag on productivity. They vary considerably across trusts and professions, with consistently less than 2% of consultants off sick, but almost 8% of ambulance support staff. If those rates could be reduced, it would lead to improved productivity and patients being treated much faster. What is the Minister doing to look at that? Perhaps she will have another one of her reviews. \p Josh Fenton-Glynn: The hon. Member has frequently been quick to criticise NHS pay rises. Will there be more or fewer sickness absences in the ambulance service if its staff are better paid? \p Dr Caroline Johnson: Is the hon. Gentleman suggesting that whether someone becomes ill is entirely dependent on whether they get another 2% in their pay packet? I am not sure that it is.

The Government promised a great deal when they came into power last July. Since then, they have handed out inflation-busting pay rises, raised costs and abandoned election pledges. At the centre of the Government’s approach is a classic socialist trick—a sleight of hand, taking money away from NHS providers in taxes with one hand, and expecting praise when they give some of it back with the other. The public will see straight through it. \p Ashley Dalton: Let me begin by thanking the Chair of the Public Accounts Committee, the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown), for opening the debate. As a Public Accounts Committee alumna, it is my pleasure to have my first outing at the Dispatch Box for this debate.

I also thank all other colleagues for taking part. The number of right hon. and hon. Members who have contributed today speaks to the significant interest in our health and social care services not only in this House but in the country. The wide range of issues raised shows how broad and overarching our NHS and social care services are. I will try to cover as many of those issues as I can, and if I miss anything, I will happily pick it up with hon. Members afterwards. I will also attempt to respond to all hon. Members who have spoken, but if I miss anyone, I hope they will forgive me, because we have had so many contributions.

The Chair of the Public Accounts Committee, as well as the hon. Member for St Ives (Andrew George), my hon. Friends the Member for Poole (Neil Duncan-Jordan) and for Sheffield South East (Mr Betts) and many other Members, talked about social care. Productivity was a key point mentioned by the Chair of the Public Accounts Committee, as well as by the right hon. Member for Salisbury (John Glen), the hon. Member for Farnham and Bordon (Gregory Stafford) and my hon. Friend the Member for Barking (Nesil Caliskan). Prevention in public health was raised by many Members—as the Minister responsible for those areas, I am delighted to discuss that.

My hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) talked about dentistry, and shifts were mentioned by many hon. Members. My hon. Friend the Member for Barking talked about the work not only of public health but of local government, and the role of ICBs. It was great to hear my hon. Friend the Member for Gloucester (Alex McIntyre) talk about his pride in the NHS. This Government will always stand by our NHS and will always keep it free at the point of use.

In her autumn Budget, the Chancellor took the necessary decisions to put our NHS on the road to recovery, with an increase of more than £22.5 billion in day-to-day health spending and over £3 billion more in the capital budget over this year and the next. Thanks to her, we are taking the first steps towards fixing the foundations of our NHS and making it fit for the future. I say to the shadow Minister that yes, this will make a difference, because it is not just about the money but about making the right choices. \p Gregory Stafford: Will the Minister give way? \p Ashley Dalton: I will, but very briefly, because we have very little time. \p Gregory Stafford: I thank the Minister, and welcome her to her place. This, I think, is the fundamental point that Conservatives are making. We all accept that we want to see a shift from acute hospital provision to social care, but when the Chancellor’s Budget does not reflect that and when the national insurance rises hit the social care end of the spectrum, how can the public have faith that what the Minister says is anything more than rhetoric? \p Ashley Dalton: I am coming to all of that.

Since coming into office, the Government have made choices. We have ended the resident doctors strike. We have published our elective reform plan, which will cut maximum waiting times from 18 months today to 18 weeks by the end of this Parliament. We have introduced investment and reform in general practice to fix the front door to the NHS and bring back the family doctor. We have started to get waiting lists falling, and we have kept the promise in our manifesto to deliver an extra 2 million appointments in our first year, a target that we have actually smashed in the first seven months. Anyone who thinks the Chancellor was wrong to make the necessary decisions and trade-offs must explain what they would cut from that list. Anyone who thinks they could have achieved everything we have done in less than a year without the autumn Budget is living in cloud cuckoo land.

Today we are setting out our supplementary estimates to the House. Funding will help the NHS to deliver 40,000 extra elective appointments a week, and to make progress on reducing the number of patients who wait longer than 18 weeks between referral and consultant-led treatment. We will publish our departmental budgets for the next financial year in the spring through phase 2 of the spending review. \p Ben Coleman: Will my hon. Friend give way? \p Layla Moran: Will the Minister give way? \p Ashley Dalton: I will give way very briefly. \p Layla Moran: The Minister will have noted, on page 53 of the estimates, a £1 billion decrease in capital spending in the departmental accounts. Will that be explained, and can the Minister explain now how new hospitals constitute day-to-day spending? \p Ashley Dalton: I will be coming to that, but I thank the hon. Lady for raising it.

We have talked about productivity, an issue that has been raised by many Members including the Chair of the Public Accounts Committee. I am delighted that Members on both sides of the House, including Conservative Members, have now recognised and accepted the value of the Darzi report, which this Government commissioned.

We are committed to meeting a 2% productivity target by 2025-26. To help us to achieve that, there is a £2 billion investment in NHS technology, allocated to freeing up staff time, ensuring that trusts adopt electronic patient records—we have heard a great deal about old-fashioned paper today—and enhancing cyber-security measures, while also improving patient access to services via the NHS. The current measures of health productivity data do not capture all the outputs and outcomes adequately, and NHS England is working with the Office for National Statistics and the University of York to refine those metrics. Reform is at the heart of our 10-year plan.

We are rebuilding our capital-starved NHS through £1.6 billion of national capital funding in 2025-26, which will help us to achieve constitutional standards. The money will help to deliver more than 30,000 additional procedures and more than 1.25 million diagnostic tests as they come online through investment in new surgical hubs and diagnostic scanners, new beds across the estate, and a £70 million investment in new radiotherapy machines to improve cancer treatment. Questions have been asked about the shift from capital to revenue. Some of investment has met historic need, including capital funding for technology and new hospitals programmes, but because of the nature of the funding it needed to be defined as revenue. It is still being spent on those programmes. The autumn Budget included a commitment to ban shifting from capital to revenue, and I can confirm that no shifts of that nature have taken place since then. I will now give way. \p Ben Coleman: I am most grateful to the Minister for giving way to me and not to an Opposition Member this time, splendid though they are.

The Minister probably shared my great disappointment when the last Government put no money into the new hospital programme and threw Charing Cross hospital, in my constituency, out of the programme. May I share with her my delight that the Government have put Charing Cross back into the programme and are funding it, with a timetable that the last Government failed to deliver? \p Ashley Dalton: Everyone knows that the previous Government’s promise of 40 new hospitals was a fiction: there were not 40, they were not new, and many of them were not even hospitals. We have put the programme on a firm footing with sustainable funding, so all those projects will actually be delivered.

In response to the Chair of the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran), I am more than happy to work with the Committee to clarify the funding for NHS providers. I understand that there is already quite of lot of information in the public domain, and I am more than happy to have that conversation  with her.

On financial levers and incentivising prevention, the 10-year health plan is really the driver of all our shifts—from analogue to digital, from hospital to community, and from sickness to prevention. It will set out how we achieve transformational change. As part of that, the plan’s working groups are looking at how payment mechanisms, funding flows and contracting will need to change to build a health system that is fit for the future.

On ENICs, we have been here before. The Government will provide support to Departments for additional ENICs for public sector employees, and commissioned services are all subject to local negotiation with providers.

I want to move on to public health, in which I take a particular interest. I agree with hon. Members on the importance of public health investment. In 2025-26, through the public health grant and the 100% retained business rates arrangements for local authorities in Greater Manchester, we are increasing funding to £3.858 billion—a 5.4% cash increase, and 3% in real terms. It is a priority for this Government to confirm future year allocations as early as possible, and we will seek to do that. It is a priority of mine.

We have talked a lot about social care. Louise Casey commands great respect across political parties, the Government and the NHS, which is why she will lead the independent commission on adult social care as part of our critical first steps towards delivering a national care service. She will begin her work in April, drawing on people who need care and their families, staff, politicians, and the public, private and third sectors to inform the recommendations on how we rebuild adult social care. \p Anna Dixon: I welcome the Minister to her place and congratulate her on her new role. On building a national care service and the Casey review, will she reassure me and other Members of the House that there will be a first-phase report in 2026 to inform the spending review, and that we will have action sooner than the 2028 final report? \p Ashley Dalton: I can confirm that, as has already been stated, those interim reports will take place, with a view to informing spending reviews.

I want to pick up on the point made by the hon. Member for North Shropshire (Helen Morgan) about the cross-party talks. My right hon. Friend the Secretary of State wrote to colleagues from all the UK-wide parties to invite them to joint cross-party talks in February. Not everybody was able to take part—a significant number of people were not—and we think it is really important to have a wide range of views at such talks. We have taken the decision to reschedule them, but we will make sure that they take place. We are seeking to reorganise those talks at the earliest opportunity, and I can confirm that the intention is to go ahead with them.

We have committed to look at how we can further expand the role of pharmacies and better utilise the clinical skills of pharmacists, and we have now resumed our consultation with Community Pharmacy England regarding the funding arrangements for 2024-25 and 2025-26. I am unable to say any more on that until the consultation has finished.

To wrap up, we are undertaking the largest capital investment in our national health service since Labour was last in office, but if we are to deliver our promises to the British people, we must deliver faster improvement than even the last Labour Government achieved. Investment and reform are what we promised before the election, and investment and reform are what we are delivering. We will ensure that the NHS is there for people when they need it; we will tackle the big killers, such as cancer; and we will create a fairer Britain, where everyone lives well for longer, while making sure that every penny of taxpayer money is well spent. I commend the estimates to the House. \p Geoffrey Clifton-Brown: I shall be brief. I thank the Minister for her very comprehensive reply, and I congratulate her on her new role. I also congratulate everybody who spoke in this debate; there were some excellent speeches. Can I ask the Minister to thank her officials for appearing before my Committee? It is very much appreciated. I also thank the members of the PAC, a very hard-working Committee that produces two major reports a week, and in particular my deputy, the hon. Member for Sheffield South East (Mr Betts).

To sum up, as I said in my speech, productivity is the key to long-term reform of the NHS. Increasing funds at 4% per year in real terms when the economy is growing at only 1% in the long term is unsustainable, so something has to be reformed in the health service. As I did in my speech, I ask the Minister to consider producing a productivity plan, so that, without all the arguments with the Office for National Statistics and everybody else, we can see the DHSC’s best estimate for productivity gains over the next five to 10 years, and can start to see how such goals will be met. In such a productivity plan, modern digital technology will be really important. The Minister skated over one word that I am really concerned about, which is “cyber”. We had a wake-up call with WannaCry two or three years ago. The NHS has some very important personal data, so it is vital that we move towards modern machines that can withstand cyber-attacks better than some of the analogue equipment in the NHS.

It has been a great debate, and I am sure that the Minister will have plenty to think about.

Question deferred (Standing Order No. 54). \p UNKNOWN: [Relevant documents: Oral evidence taken before the Foreign Affairs Committee on 13 January 2025, on the work of the British Council, HC 609; Oral evidence taken before the Foreign Affairs Committee on 18 and 27 November 2024, on the work of the Foreign, Commonwealth and Development Office, HC 385; Oral evidence taken before the Foreign Affairs Committee on 19 November 2024 on the future of the BBC World Service, HC 384; Correspondence between the Foreign Affairs Committee and the British Council on the work of the British Council, reported to the House on 4 March 2025; Correspondence between the Foreign Affairs Committee and the BBC on the future of the BBC World Service, reported to the House on 4 March 2025.]

Motion made, and Question proposed,

That, for the year ending with 31 March 2025, for expenditure by the Foreign, Commonwealth and Development Office:

(1) further resources, not exceeding £592,196,000 be authorised for use for current purposes as set out in HC 655,

(2) further resources, not exceeding £439,129,000, be authorised for capital purposes as so set out, and

(3) a further sum, not exceeding £862,823,000, be granted to His Majesty to be issued by the Treasury out of the Consolidated Fund and applied for expenditure on the use of resources authorised by Parliament.—(Stephen Doughty.) \p Nusrat Ghani: I call the Chair of the International Development Committee. \p Sarah Champion: I thank the Backbench Business Committee for selecting this subject for this very timely debate, which is in my name and the name of my right hon. Friend the Member for Islington South and Finsbury (Emily Thornberry). I also thank the members of the International Development Committee and the Foreign Affairs Committee for their support in securing it.

Let me start this debate by welcoming the Government’s commitment to increasing our defence spending; that is long overdue and much needed. However, there was no need to announce a decision on where the funding was coming from before the spending review or, indeed, before the defence review concluded. It will not surprise the House to learn that I will use this debate to argue that the decision to take all the defence uplift from official development assistance was wrong.

When the former US Defence Secretary General James Mattis was asked in Congress whether it was wise to properly fund international development work, he replied:

“If you don’t fund the State Department fully, then I need to buy more ammunition”.

It pains me to say so, but the Prime Minister is setting exactly this dangerous course for the UK. By planning to take 40% out of ODA, he is taking the axe to our most effective tool for reducing global conflicts and for increasing our national security. Do not take my word for it. Instead, consider this warning given last week  by General Richard Dannatt, the former Chief of the General Staff:

“Every pound we cut from development aid today risks costing us far more in future military operations…slashing aid further to fund defence spending is not just shortsighted—it is dangerously counterproductive.”

He added:

“we are setting ourselves up for greater instability, which will require even more military spending in the long term…If we cut aid, we will be forced to deploy military resources in areas where we could have mitigated instability through targeted development.”

I urge the Prime Minister to recognise that if we abandon our commitments to the world in this way, we will see greater numbers of people displaced from their homes as a result of climate disasters, poverty and war. More people will lose hope, and will instead look to extreme ideologies for the answer, and civil societies will no longer have the skills to hold rogue Governments to account.

It concerns me greatly, as it should the whole House, that the Government have yet to carry out an assessment of the impact of their decision, which has been rushed through without proper scrutiny. I urge Ministers to study carefully an analysis by the ONE Campaign, which demonstrates the real-world impact of cutting ODA assistance from 0.5% to 0.3% of national income. It has calculated that if the 40% reduction in UK aid  is distributed evenly across global health and food programmes, there will be nearly 40 million fewer children immunised; 600,000 fewer lives will be saved because of reduced support to the Global Fund to Fight AIDS, TB and Malaria; and almost 300,000 fewer school children will receive nutritious meals and essential food assistance through the World Food Programme.

I appreciate that the Prime Minister has pledged to protect what he considers to be the most vital areas of spending—Gaza, Sudan and Ukraine, vaccinations and climate—but as the powerful resignation letter written by my right hon. Friend the Member for Oxford East (Anneliese Dodds), the former development Minister, lays bare, that is, sadly, a delusion. As my right hon. Friend, who knows the reality better than anybody else, has written:

“It will be impossible to maintain these priorities given the depth of the cut; the effect will be far greater than presented…It will likely to lead to withdrawal from regional banks and a reduced commitment to the World Bank; the UK being shut out of numerous multilateral bodies; and a reduced voice for the UK in the G7, G20 and in climate negotiations.” \p James Naish: I thank my hon. Friend for her work as Chair of the International Development Committee, on which I sit. Earlier today, I had the privilege of meeting representatives from Gavi, the Vaccine Alliance, to hear at first hand about its lifesaving work. Gavi has, of course, played a pivotal role in ensuring that millions of children worldwide receive vaccines against deadly diseases, protecting global health and preventing pandemics. Does she agree that we need to make an urgent commitment to the Gavi replenishment, which is under debate at the moment? \p Sarah Champion: I thank my hon. Friend and fellow Committee member. As he is well aware, the Committee is doing a value-for-money inquiry, and Gavi is one of the best ways to get value for money by vaccinating children around the world. It is not just that the House wants that commitment to Gavi and all other bodies. Do the British public really want us to step away from  the international stage, and to lose all our soft power and ability to support the most vulnerable in the world, so that they can lead a healthy, prosperous life? \p Marsha de Cordova: My hon. Friend is making an excellent speech and case against the cut to aid. She knows that the world’s most vulnerable children include disabled children. The Government’s disability inclusion and rights strategy was going a long way towards supporting those children through healthcare, and when it came to social protections. Does she agree that unless we get clear assurances, many millions of disabled children will end up suffering greater loss? Brilliant organisations such as Able Child Africa, which is based in my constituency, are deeply concerned about the impact the cuts will have on disabled children. \p Sarah Champion: My hon. Friend is absolutely right. The work that the Foreign, Commonwealth and Development Office has done to protect the most vulnerable—I am thinking particularly of children, people with disabilities and people in marginalised communities—is exemplary, but I cannot stand here and say that we will be able to continue funding that. I just do not think it is technically possible.

Research commissioned by More in Common has found that 55% of the British public support the UK giving both humanitarian and military aid to Ukraine, and that more than half believe that aid spending is worthwhile if it helps to boost the UK economy and protect national security.

Even with a reduced aid budget, much better decisions can and must be taken going forwards. In recent years, a scandalously large amount of ODA has been diverted primarily to the Home Office to support asylum seekers and refugees in the UK. In 2023, this took up 28% of the entire aid budget, costing £4.2 billion. It is welcome that the proportion of the ODA budget spent domestically is set to decrease very slightly this year, but unless these costs are reduced significantly in the next two years, the UK is set to spend nearly half its remaining ODA budget on domestic refugee costs by 2027. That cannot be right. Of course, these people need supporting, but that should not come out of the ODA budget. I urge the Government to cap the amount of ODA that the Home Office can draw on for in-country refugee costs; if they do not, there is simply no incentive for the Home Office to address its spending.

The Home Office is, of course, not the only Department raiding aid. The Departments for Environment, Food and Rural Affairs, for Education and for Science, Innovation and Technology all regularly draw down ODA and do not, in some cases, deliver as well or as transparently as the FCDO. Will the Minister comment on taking these programmes back into the FCDO, or asking the Departments to reimburse at least part of the finance that they draw down from ODA?

The supplementary estimates saw a boost in the FCDO’s allocation of headline ODA spending for this financial year. However, a large proportion of this increase—almost £500 million—was sent to British International Investment in what appeared to be a last-minute panic to ensure that the Government fulfilled their commitment to spending 0.5% of national income on aid. Do not get me wrong: BII does excellent work investing debt and equity in businesses in the developing  world for the long term to facilitate beneficial and developmental economic growth. However, it is not set up to take immediate and short-term investment decisions, and should not be expected to do so. Debate is also ongoing over giving BII the ability to borrow against its investments; in the fiscal circumstances, I urge the Minister to look at that closely.

There are a number of issues on which the Government could consider changing policy and legislation, including debt relief, illicit finance and special drawing rights. That could have significant impact on the lives of the poorest in the world, at no expense to the British taxpayer. Could the Minister also comment on potential multipliers of aid? I am thinking specifically about philanthropic match funding and UK Aid Match, which could be used more readily.

This year’s estimates enable the FCDO to continue to employ world-leading experts in development aid. In a rapidly changing world in which we face huge challenges, maintaining this expertise is not a luxury but a necessity if the UK is to achieve global progress and safeguard our collective future. Despite the damage done to its budgets, the FCDO must prioritise protecting its skilled staff, who offer so much to low and middle-income countries when deployed effectively. My Committee and I were with FCDO staff in Scotland when these cuts were announced last week. Staff were understandably devastated, with this announcement adding considerably to the uncertainty they have faced over the past five years.

The best way to retain our staff, and indeed our international reputation, is with clarity about the forthcoming spending cuts. Will there be a defined step down or a cliff edge to funding in 2027? A commitment today that the budget will be 0.4%—or more—in ’26-27 would be hugely reassuring, as would confirmation that there will be no additional cuts in the spending review for this financial year. I urge that an equality impact and risk management assessment be done, and presented to the House, before the Government make their tough decisions on what to cut and what to save. In the 2021 round of cuts, we saw funding for women and girls  cut by 66% from its peak in 2017. Let us never do that again.

From 2023, the UK was the 10th largest spender of aid as a proportion of its gross national income. A cut to 0.3% will leave us in 25th place. That is simply unacceptable for a nation with such a proud history in helping those most in need and a Government who are rightly placing themselves as a leader on the international stage.

I wish to finish with the powerful words of a speech delivered in this Chamber on 13 July 2021, when the Conservative Government’s decision to reduce aid spending from 0.7% to 0.5% was confirmed. The House was told:

“Cutting aid will increase costs and have a big impact on our economy. Development aid—we all know this—reduces conflict, disease and people fleeing from their homes. It is a false economy to pretend that this is some sort of cut that does not have consequences.”

The speaker continued:

“Our overseas aid budget goes beyond that moral obligation: it also helps build a more stable world and keeps us safer in the UK…This cut will also reduce UK influence just when it is  needed most, and of course it risks leaving a vacuum that other countries—China and Russia, for example—will fill.” —[Official Report, 13 July 2021; Vol. 699, c. 177-178.]

That speaker was the then Leader of the Opposition putting forward an inarguable case against the folly of making massive aid cuts. His words are as true now as they were then. May I urge the Minister and the Government to listen to the words of the then Leader of the Opposition, the now Prime Minister, and reconsider this? \p Nusrat Ghani: Colleagues can see how heavily subscribed this debate is. I need to fit in another debate before 7 o’clock, so many colleagues will be disappointed that they will not be called to speak. They can judge that as they may. We shall set a speaking limit of four minutes so that I can get as many people in as possible. \p Andrew Mitchell: It is a pleasure to follow the brave and principled speech of the Chair of the International Development Committee.

The Government are absolutely right to increase defence expenditure, and President Trump is right, too, in saying that Europe must shoulder the burden against Russian imperial expansion. But development should be part of that strategy. Development, defence and diplomacy are intertwined. I remind everyone that the development budget tackles conflict, helps build better societies and builds prosperity. It helps tackle migration, disease, medicines, education, vaccinations, growth, jobs, British International Investment—I do not entirely agree with the hon. Lady on this, because BII is an outstanding example of British success in development—transparency, accountability, and anti-corruption. All are independently verified by the Independent Commission for Aid Impact, which is the taxpayers’ friend. That is what development does and it ought to be unanswerable that this is of vital importance.

The cut from 0.7% to 0.5% was terrible, but we did manage to find a number of ingenious ways of augmenting that money through guarantees, co-financing, insurance, and the use of special drawing rights, but the reduction to 0.3% will destroy any incipient recovery. And, as the hon. Lady said, who will fill the gap? It will be China and Russia. It will be music to the ears of the many terrorist organisations that exist across sub-Saharan Africa. The failure to do some of the things that the hon. Lady set out so clearly will result in the clarion call of the terrorist being heard.

Furthermore, the stopping and starting of development is very bad value for money for taxpayers. I know that Foreign Office Ministers will have fought against this terrible decision and it gives me a chance to pay tribute once again to the Foreign, Commonwealth and Development Office and the civil servants and diplomats who work there. It is the finest diplomatic corps in the world. I also want to pay tribute to the right hon. Member for Oxford East (Anneliese Dodds) whose principled and brave resignation letter will serve her very well.

We all know that this is an example of the iron fist of No. 10 cynically conquering the extremely good arguments put up by the Foreign Office, to take the low-hanging   fruit. In my view, that is entirely wrong. Many are horrified to see a Labour Government behaving in this way, bludgeoning development, which was already badly damaged by the abolition of the Department for International Development and the previous cuts in the last Parliament.

I ask colleagues on the Labour Benches to make a principled decision and ensure that their voices are heard in government. They should imagine those Prime Ministers who really drove forward international development and the cause of development, turning Britain into a development superpower: Prime Minister Blair, Prime Minister Brown, Prime Minister Cameron and Prime Minister May. Those four Premiers drove the cause and did so much good, saving so many lives. I very much hope that Labour Members will exert influence and explain to the Government why this is the wrong decision at the wrong time and that it must be reversed. \p Emily Thornberry: Since the election of the Labour Government last July, I am proud to say that Britain is back on the world stage. When we are at our best, we are a respected and influential global player. We have many things to our advantage: we are the bridge between the US and Europe; we have a place on the Security Council; and our security services and defence are very respected. Under recent Governments, it must be said that we lost our way, fighting among ourselves about Brexit and everything else and threatening to break international law, but under this Government we are taking a lead again.

The question is: are we going to step up to the challenge? We are more than capable of that, but we cannot do it on two Chewits, a button and a postage stamp. Alongside a pivot to hard power, the Prime Minister has set out his priorities for the reduced aid budget: Gaza, Sudan and Ukraine. To achieve peace, we need that investment in hard power, but if we abandon Britain’s soft power strength we cannot secure it.

In Ukraine, for example, political and financial investment and military might are key to ending the war, but when we reach the ceasefire, there will be shockwaves across eastern Europe that must be absorbed. There are many ways in which Russia will continue on the offensive, and that is not just about tanks; it is about misinformation, telling lies and trying to influence people by not telling the truth. The best way to counter that is to tell the truth.

How are we going to tell the truth? Well, we could rely on the BBC World Service, which is internationally respected and recognised. There is nothing like the BBC World Service, yet we spend only £137 million on it, which is given from the Foreign Office, and roughly 80% of that comes from ODA. Russia and China combined spend more than £8 billion each year on their state media. When we vacate the airwaves, which we have done, Russia moves in and takes over the same frequencies. \p Julian Lewis: I entirely endorse what the right hon. Lady says about the BBC World Service. There used to be a ringfenced grant for BBC Monitoring as well, but now that falls on BBC  general income and expenditure. Does she agree that that monitoring service performs an equally crucial role to the World Service in terms of open source information? \p Emily Thornberry: I do, although I think that the role has changed given the rise of the internet.

If we lose the World Service, will this be remembered as the moment not just when Britain abandoned Africa to the Chinese, but when we abandoned our historic role of telling the truth and speaking the truth of a united west around the world?

The second priority for the aid budget is Gaza. I visited Jordan last week with the Foreign Affairs Committee. Jordan, which relies on US and UK aid, has absorbed over 2 million Palestinian refugees. Its continued stability is fundamental to a lasting peace in the region. Can that be guaranteed if we no longer have a humanitarian budget to spend on it?

The third priority from the Prime Minister was Sudan, where we are the penholder and we face a situation where Russia has secured a Red sea base that it has long coveted. The situation reminds me of warnings given by Lord Dannatt, the former Chief of the General Staff, that every pound cut from spending on development today risks costing us more in future military operations.

Soft power is not just a nice-to-have; it is core to peace and security. I have looked into the numbers following the latest cuts, and after taking into account the ODA money spent on asylum costs as well as our commitments to the UN and the like, we have only about £1 billion left for the Foreign Office to spend on overseas aid. Is that really going to be enough, even just for those three priorities and the money that needs to be spent on that?

I am concerned that the ODA cuts will not be the last of the challenges. There are also rumours that the Foreign Office is expecting cuts, on top of those, of between 2% and 11%. In that scenario, it will sell its buildings. Will embassies shrink? I am concerned that we will lose the British Council, which only receives 20% of its funding from the FCDO and generates the rest of its income itself. I trust that an enormous amount of work is being done on the details of the cuts, but at the moment, we have heard nothing more than an aspiration about where the other funding will come from. I fear that we may look back at this time and say to ourselves, “This is when Britain left the world,” and yet, it really should be the time when we are able to say, “Britain is back, and we are back as a force for good.” \p Aphra Brandreth: Let me begin by saying that the decision by the Government to increase defence spending, funded in the short term by a cut in the ODA budget, is the right one given the current global context. It is an immediate solution that was necessary to bolster our defence budget to send a clear message to our allies and our adversaries alike.

Russia’s illegal invasion of Ukraine has brought a state of war back to Europe, but the security challenges we face as a country do not stop with Russia. Iran continues to be a destabilising influence in the middle east and globally. Meanwhile, China’s growing influence demands our attention. The rules-based international order, which the UK proudly defends, is under threat from many sides.

A strong foreign policy starts with hard power. That is why I support the Prime Minister’s decision to reallocate ODA to the defence budget, and I agreed with my hon. Friend the Leader of the Opposition when she called for that in advance of the announcement. It is important that we respond to the challenges of the day with a well-equipped, well trained and well supported armed forces. Our adversaries need to know that we have a credible deterrent, and our allies need to be able to look to us as a leader in Europe on defence.

It is clear that we are living in a time of mounting geopolitical tension and without a credible foreign policy strategy, those driving global instability will continue to gain ground. A successful long-term foreign policy strategy must recognise that hard and soft power are inseparable. As was referred to earlier, it was the retired US general and former Defence Secretary James Mattis, who said,

“if you don’t fund the State Department fully, then I need to buy more ammunition ultimately.”

These are exceptional times, but as stability returns to Europe, I urge the FCDO to prioritise restoring a strong ODA budget. It is critical that if the ODA budget is to be spent on defence in the immediate term, that money is spent directly on enhancing our national security and strengthening our armed forces, and not on the Government’s foolhardy decision to cede British sovereignty over the Chagos islands to Mauritius, in a deal that is likely to cost the British taxpayer billions of pounds, all at the expense of our security and strategic interests. With a substantially reduced ODA budget, it is critical that it is spent effectively. It cannot be right that a third of the overseas development assistance budget is spent here in the UK on supporting refugees and asylum seekers. It is clear that we need to rethink where our priorities for the remaining ODA lie.

One important area of ODA funding, which the Foreign Affairs Committee has been investigating as part of our inquiry into soft power, is the BBC World Service. With unreliable sources seeking to undermine our values, the World Service is on the frontline, so I encourage the FCDO to continue supporting it, especially as new challenges in information dissemination arise. The consequences of disinformation gaining traction are severe and we must safeguard that key asset in our soft power arsenal.

The lines between hard and soft power are increasingly blurred, yet they must complement each other to be effective. It was necessary to divert funding to meet security challenges. Now the FCDO must rethink how to preserve our soft power, tackle urgent issues such as disinformation and ensure British taxpayers’ money spent overseas serves our national interests. Above all, we must use those resources to expand our global influence and enhance our security in the face of evolving challenges. \p Uma Kumaran: I would like to thank the Clerks of the Foreign Affairs Committee, of which I am a member, and the International Development Committee for their support, and my hon. Friend the Member for Rotherham (Sarah Champion) for securing this supplementary estimates debate. Late  last year, the Foreign Affairs Committee heard evidence from the Foreign Secretary and the now former permanent under-secretary. It was a valuable opportunity for Committee members to hear, in the words of Sir Philip Barton, about the

“tough choices that have been made and will continue to have to be made”.

Those are the tough choices on our spending, on the aid budget, on investment spending and on our soft power resources. Those tough choices are not new, but in these volatile times when the power of diplomacy and our soft power matters more than ever, they can have seismic impacts.

In 2011, under the coalition Government, the BBC World Service had to eliminate five language services due to cuts of £46 million per year. This included the entire BBC News service in North Macedonia. Coalition cuts to grant funding from the Foreign Office meant that this trusted service with extensive reach—one in every eight Macedonians listened to the BBC—had to close. At the time, the country was attempting to join NATO and the EU. Russia was opposed. Since this cut, North Macedonia has been subject to a decade-long propaganda campaign from Russia—a campaign of misinformation that has spread fake news on covid, amplified regional tensions and demonised NATO and our European allies. In the past years, the UK has deployed military experts in disinformation to counter the malign influence of Russia on the western Balkans—an influence seeking to destabilise our entire continent.

The example of North Macedonia shows that we cannot risk a fractured approach. Cutting the BBC World Service, a globally trusted news source, and neglecting our soft power while our defence spending is countering misinformation does not seem the right thing to do. The absence of the BBC World Service allows our adversaries to step in and fill the vacuum left by the UK’s withdrawal, as was alluded to by the Chair of the Foreign Affairs Committee, my right hon. Friend the Member for Islington South and Finsbury (Emily Thornberry).

There are real dangers when we allow hostile propaganda to go unchallenged. It has been described as a tsunami of bad actors. When Conservative cuts forced the BBC World Service in the middle east, BBC Arabic, to cease broadcasting, the same frequency was taken over by Russia Today and Sputnik. The global director of BBC News told the Foreign Affairs Committee that, on the day of the walkie-talkie explosions in Lebanon, that frequency was “essentially Russian propaganda”. Russia is investing in disinformation to target Arabic-speaking audiences and to create false pretexts for its invasion of Ukraine.

Disinformation has real-world consequences, and where UK soft power retreats, hostile states step in. They are pumping in billions of pounds because they know what is at stake: the battle for the truth. Future assessments of funding for the World Service must consider the impact on international and national security of disinformation in our world. This is just one example that demonstrates that our national defence and our spending overseas are both vital for this nation’s long-term security.

I am pleased to see the Government’s commitment to BBC World Service grant funding reflected in the FCDO supplementary estimate. We know that there are tough choices to be made, we know that there are those who  wish to do harm to Britain and we know that the defence of our country in an ever more dangerous world is essential, so we must put Britain’s defences and Britain first. I am also pleased to see that, despite this, the Government have reiterated their firm commitment to prioritising programmes in Ukraine, Sudan and Gaza.

There are clearly many strategic calculations to be taken into account, but the impartial and trusted journalism of the BBC World Service is an antidote to disinformation. The risks from malign actors who want to undermine democracy will not go away any time soon. I strongly urge Ministers to ensure that assessments of funding for the World Service take into account the national security consequences of disinformation. \p Edward Morello: The Foreign, Commonwealth and Development Office plays a vital role in supporting and protecting people around the world, upholding Britain’s diplomatic presence and promoting our values and interests. In my short time on the Foreign Affairs Committee, I have been repeatedly struck by the impressive quality of the people we are fortunate enough to have working on our behalf  around the world. However, even as we face increasing geopolitical instability, transactional diplomacy and  wars in multiple regions, the financial pressure on the Department is testing our ability to play the role that Britain should be playing in the world. For over a decade, the maintenance of the FCDO overseas estate, which includes 6,000 properties across 180 countries, has been funded through the sale of assets. That is not a sustainable model, and the reality is that there is no more silverware left to sell.

Giving evidence to the Foreign Affairs Committee, Sir Philip Barton, the then outgoing permanent under-secretary, acknowledged that the current funding structure will not work for much longer. The cost of essential maintenance is estimated to be £250 million a year, and that figure is only rising. From next year, the ability to draw down from receipts of previous asset sales will disappear completely. Unless the Treasury allows for that additional cost in future budgets, the cost will have to be met by cuts elsewhere in an already overstretched Department.

This issue goes beyond bricks and mortar. The UK’s overseas presence is a direct reflection of our diplomatic standing and soft power. We cannot expect our embassies to champion British interests when they are in dire need of investment. The Foreign Secretary himself has recognised the need for a sustainable funding settlement and highlighted the condition of our estate in China as a particular concern. The Government must set out an alternative long-term funding model—one that does not rely on the fire sale of national assets.

At the same time, we must address the deeply concerning cuts to ODA. The UK has long been a world leader in international aid, and we are the fourth highest donor in absolute terms. The Government’s decision to reduce our aid budget risks undermining our ability to deliver on those commitments and the ones we have made to the world’s most vulnerable. The Prime Minister has rightly stated that the UK will prioritise Ukraine, Sudan, Gaza, climate finance and global health, but with a shrinking budget, delivering on those priorities will be close to impossible.

I recognise that difficult choices must be made to stand firmly with our allies in Ukraine during this critical time. Our support for the Ukrainian people must be strong and unwavering. It is a sad indictment of the current state of global affairs that in a war between the west and Russia, the first to withdraw from the fight was the United States. It is therefore even more vital that we increase defence spending to ensure that our allies around the world know that they can continue to rely on Britain in this increasingly unstable world.

The answer, however, is not to cut ODA. The Foreign Secretary himself warned of the risks of stepping back from development aid. The reality is that budget cuts will severely limit our ability to counter malign influence and to support fragile states. My party has warned that the UK’s decision to reduce its aid spending will

“leave a vacuum for Russia and China to fill”. \p James Naish: It is worth reflecting on the fact that UK service personnel are obviously key to the defence of our country, and those cuts started during the time when the Liberal Democrats were in government. The hon. Member talked about his party regretting the actions of this Government. Does he regret the decision to start cutting our service personnel from 2010 onwards? \p Edward Morello: I am not going to waste time re-arguing the coalition years—we have a global crisis happening. Either we all work together on this, or we keep nit-picking over the past. That is not the way to go forward.

I urge the Government to look at Liberal Democrat proposals to fund the much-needed uplift in defence spending not by cutting vital overseas development aid, but by reversing the tax cuts for banks introduced by the previous Government and by taxing the social media companies that, even now, are profiting from spreading disinformation on behalf of our enemies. We must work together to secure a sustainable funding model for the FCDO—one that protects our overseas estate and ensures that our diplomats have the resources they need to represent Britain effectively.

Finding a pathway to a just peace in Ukraine, a workable solution for the Palestinian and Israeli people, security for Europe and a united global approach to tackling the climate crisis, as well as the many other issues facing the world right now, in the face of a US Administration seemingly intent on joining malign states like Russia and Iran in rejecting international norms, requires the UK to be centre stage in international relations. Having a Foreign Office able to project British influence has never been more important. I urge the Government to set out a clear path on how we will maintain our diplomatic and development commitments in this increasingly uncertain world, and to ensure that Britain does not become just “some random country” but continues to play its historic role in global affairs. \p David Taylor: I will start, as many Members have, by recognising the urgent need to increase defence spending. Over recess, I went to Ukraine for a week—it is an existential crisis. If Ukraine falls, I am convinced that the Baltic states will be in Putin’s line of sight too. Like others in this House, I am obviously extremely pained by the decision to partly get there by cutting aid to 0.3%.

Members will know that I spent my career prior to coming to this House in international development. I set up the Labour Campaign for International Development and had the privilege of working for former Prime Minister Gordon Brown, who did such great things to lead on the world stage in this area when he was Prime Minister and Chancellor. I want to offer my expertise to the Government to find a way through this. I recognise that, across the House, and particularly on the Labour Benches, there are other Members who, like me, have expertise in development, and we offer ourselves to the Government to find ways to make the best of this bad situation.

The first point that I want to make is about front-loading multilateral commitments into 2026. We know that the ODA budget will go down to 0.3% of gross national income from 2027. We believe that by front-loading some of our multilateral commitments—to the Global Fund, for example—we can get round the cliff edge and help the largest number of people for the longest possible time. I know that there have already been discussions about the budget potentially going down in 2026. I urge the Government to look at other options so that we can keep aid spending at 0.5% for as long as possible.

My second point refers to the comments made by my hon. Friend the Member for Rotherham (Sarah Champion) about asylum costs. We strongly urge the Government to consider those costs and to reduce as quickly as possible the amount being spent in the UK. Every penny spent in the UK is not being spent helping the most vulnerable. To deliver that, the Government could formally budget for and commit to project reductions in in-donor refugee costs, with any overspends funded from outside the aid budget and any underspends provided to the FCDO as additional ODA resources.

My third point, which I will not talk about for long because I know that my hon. Friend the Member for Kensington and Bayswater (Joe Powell) has done a lot of advocacy on it, relates to the £2.5 billion of Chelsea FC money. The sooner we can get it into Ukraine and humanitarian aid the better, because it should, in theory, free up ODA money for other situations around the world.

My final point is that we now must focus time and effort on alternative forms of ODA spending. My right hon. Friend the Member for Birmingham Hodge Hill and Solihull North (Liam Byrne), particularly in his role as chair of the MP group on the World Bank, has some fantastic ideas about how we might be able to use things such as special drawing rights. I know that other colleagues are working on debt relief, which could offer alternative sorts of development financing. \p Alex Sobel: On alternatives, does my hon. Friend agree that it sometimes creates a false dichotomy to separate defence and ODA? In a human security approach, when there are crises such as conflict, famine or pandemics, we can utilise our forces to go in and deliver aid, as well as utilising traditional ODA. \p David Taylor: My hon. Friend makes an interesting point, which I hope he will get to make in more detail in due course. In the time available to me, I will carry on with a few other suggestions.

Another suggestion relates to British International Investment. I am not here to criticise the work that it is doing, but the point of ODA is first and foremost to help people in extreme poverty. Although admittedly it has improved, BII has a track record over the years of not necessarily focusing on the very poorest in society. For that reason, I think the Government should look at ways of making BII capitalisations additional to the 0.3%. \p Andrew Mitchell: Will the hon. Gentleman give way? \p David Taylor: I will not, if the right hon. Gentleman does not mind.

The justification for that could be that the BII makes capital investments, which are ultimately an asset on the Government’s balance sheet, and that finance does not count towards the Government’s budget deficit. That could be one way of justifying such a measure without going against the Government’s fiscal rules.

I have only 30 seconds left, so I will end where I started. Other Members have made points about how aid is in our national interest, and they are right to say so. For me, it has always been about how we can ultimately benefit other human beings. Where we are born is an accident; I am privileged to live in what I consider to be the best country in the world, but many are not. We must do everything we can to support the most vulnerable. \p Brendan O'Hara: That a Labour Government, after all they said during their years in opposition, have decided to take essential life-saving overseas aid away from the poorest people on the planet is truly astonishing and utterly shameful. They know that removing £67 billion of overseas aid will have devastating consequences. It will mean that the world’s poorest children will go unvaccinated, millions of girls will go uneducated, and projects set up to help communities recover and protect themselves from climate change will come to an end.

There is no running away from the fact that millions of people, mainly children, will die or have their lives permanently changed as a result of that decision. Nor can the Government escape from the fact that this was a premediated political decision taken by a Labour Prime Minister. That Prime Minister has tried shamefully to frame this debate as an either/or—we either spend the money on defence, or we spend it on overseas aid—but that is palpably not true. Indeed, it would be laughably disingenuous were it not so serious.

If we are—and I agree we are—heading into uncharted waters for European security and defence, the Government need to rip up their self-imposed fiscal rules and have an honest conversation with the public about what must be done. Explain to the public that with an emboldened Putin, and with America no longer a trustworthy or reliable ally, we in Europe have to look after and fend for ourselves, and that is going to mean tough choices.

This is morally reprehensible. The Government know that cutting overseas aid will make us less secure. As the hon. Member for Rotherham (Sarah Champion) said, if they need convincing, they should read the Prime Minister’s speech from 13 July 2021, when he laid it out line by line. It was an excellent speech—Labour  Members should read it—but I just wish he had meant it. Absolutely no one believes that we can make ourselves safer and more secure by making the world’s poorest even poorer.

When the Prime Minister announced the decision to increase defence spending by cutting overseas aid, he attempted to justify it, saying that it could only be funded “through hard choices” and that this was a “difficult and painful decision” for him. Well, it is not nearly as painful or as difficult as it will be for millions of impoverished children who do not know where their next meal is coming from, for girls who do not know when they will next be able to go to school, or for children who wonder why their siblings are dying of preventable diseases because they have not been vaccinated, or where their father has gone when he has gone to Europe to try to find work. Prime Minister, save me your crocodile tears about this being a “difficult decision”. This was not a difficult decision; this was an easy option. \p Yasmin Qureshi: Let me begin by declaring that I chair the Westminster Foundation for Democracy, an organisation that has done incredible work around the world and is partially funded by the FCDO.

The Foreign Secretary was right last week when he stated that realism includes being clear about what our values are. The reality is that alongside the military security gap left by the approach of the US Administration, we must also fill the gap in support for accountability, inclusion, and the rule of law. This is about UK security and prosperity. Our ODA budget supports stability and alliances that are critical to our national interest. We are losing the battle for hearts and minds in many parts of the world, while our rivals help friendly rulers, silence opposition, control the media and outlaw NGOs. If we do not step up, others will fill the vacuum.

The WFD is part of the answer. It operates in 50 countries, strengthening democracy and the rule of law. Its FCDO grant this year was about £8.5 million, with additional country-specific grants to maximise the impact globally. However, funding cuts are already hitting us. The WFD’s spending review bid for flat cash of £8.5 million in 2026-27 would fund programming in 20 countries and 14 global initiatives on artificial intelligence in Parliaments, public debt, climate, electoral integrity and women’s political leadership. Its reach would be significant: 5,000-plus participants, half of them women, would engage with over 1,600 parliamentarians, 2,400 parliamentary staff and 1,700 political party officials. This work delivers results, including anti-corruption reforms, improved rule of law, climate legislation security and a stronger UK relationship with democratic leaders.

However, inflation could leave a funding gap of over £500,000, equivalent to 70% of the WFD’s work in the Indo-Pacific. We cannot afford to let that happen. Investing in democracy is investing in the UK’s security, prosperity and global influence. With so many bad-faith actors now in the world, and with a constant assault on democracies across the world, the important work of the Westminster Foundation for Democracy is vital and should be protected. \p Ellie Chowns: I share the horror, outrage and deep disappointment and disillusion- ment of many hon. Members in the House, across many parties, and of people across the country at the Government’s terribly short-sighted and counterproductive decision to fund greater investment in defence through slashing the development budget.

Like many hon. Members, I know how important the development budget is because I spent practically my entire career before I came to this place working in that field. I have seen it face to face and on the ground. I know that investing in health, education and nutrition helps increase human security for the long term, and that investing in conflict resolution, peace building, democracy support, and women’s and girls’ rights builds human security globally and makes the world, and us, more secure in the long term, as well as in the short and medium terms. So it is impossible to understand why the Government have taken this incredibly counterproductive decision. The three D’s of defence, diplomacy and development are united: they work together. We cannot possibly increase one by slashing another.

It is unbelievable that this decision has been made, because it is so unnecessary. A Member on the Government Benches talked earlier about needing to “send a clear message”, but what is the message that has been sent by this decision, which follows in the slipstream of President Trump’s blocking and dismantling of the United States Agency for International Development? It is the wrong message. Members on the Government Benches—indeed, the Prime Minister himself—have talked about “tough choices”, but it is a wrong choice, because there is an alternative. We did not have to fund this investment on the backs of the poorest and most marginalised.

There are other choices available to us. We should ask those with the broadest shoulders to bear the burden of increased investment in defence and security. Our neighbours in France are doing exactly that by looking at wealth taxes. In his summing up, will the Minister explain why the Government have decided to fund investment in defence by undermining diplomacy and development in slashing the aid budget, leaving us all more insecure in the long run? \p Abtisam Mohamed: I am a member of the Foreign Affairs Committee, and we have heard from FCDO representatives about the important work the Department does and how essential it is for the Department to have the resources to execute its work effectively. The world is witnessing a watershed moment unfolding before our very eyes. The world order is visibly in the process of being challenged, and it is transforming all aspects of organised human life. That provides an immensely challenging environment for foreign policy, from wars in Sudan, Gaza and Ukraine to concerns about climate change.

Last week, the Prime Minister demonstrated strong leadership and reinforced that we have a strong presence in the global arena, which highlighted that we must continue to remain actively engaged and agile in our foreign policy. The Prime Minister’s commitment to increase defence spending in light of the volatility is the right one, but while I recognise that defence spending is  important, so too is international development, particularly given the diplomatic soft power that it lends the UK. As we navigate these changing and unpredictable global power dynamics, international development is an area of historical strength for us. UK aid makes the world safer and saves lives, and cutting support for countries that need it the most will only add to insecurity worldwide.

We have heard from voices outside the aid sector, as colleagues referred to earlier. Lord Richard Dannatt, a former head of the British Army, said that

“cutting aid risks making us weaker, not stronger…well-targeted aid prevents conflict and reduces the burden on our armed forces in the long run.”

Analysis from the ONE Campaign supports that; its evidence demonstrates that every 80p spent on activities that spur economic growth and political stability can avert spending of up to £80 on future conflicts. Cutting the aid budget will undercut our ability to build global partnerships and alliances. When the UK helps countries to adjust to climate change and to grow and prosper, we build our relationships and our influence. When countries such as ours withdraw, China and Russia stand ready to step in.

I turn to the impacts that the cuts will have on a specific group: women and girls across the world. As we celebrate International Women’s Day later this week, it is critical that we stand up for protecting gender equality with the UK’s ODA budget. That includes improving access to education and maternal healthcare, preventing and responding to malnutrition and gender-based violence and combating early marriage and female genital mutilation. When ODA is reduced, we know that women’s equality programmes are the first to be cut. When a cut was implemented in 2021, 41% of initiatives for women and girls were the first to be lost. When Governments take action to close gaps and eliminate barriers for women and girls, to realise their rights to live safely and to learn and earn equally, we create safer, healthier and wealthier societies.

The UK’s leadership in international development has long been a source of national pride and global respect, and we should not now head in the opposite direction. If we are to see a decline in aid to support the world’s most vulnerable communities, the Government could show serious ambition to reform the global economy, which could include tackling the broken global debt system to enable the countries most in need to emerge from poverty. Fixing global debt for developing countries could be achieved by compelling private lenders operating in the City of London to co-operate in debt relief negotiations. \p John Whittingdale: It is a particular pleasure to follow the Chair of the Foreign Affairs Committee, the right hon. Member for Islington South and Finsbury (Emily Thornberry), and four fellow members of the Committee.

I make it clear that I strongly support the increase in defence spending to 2.5% of GDP. I fear that that may not be enough and that we will have to spend more if we are to maintain our security against the threat that is now clear. I therefore accept that part of the funding of  that needs to come from ODA, although I feel the pain of both the Chair of the International Development Committee, the hon. Member for Rotherham (Sarah Champion), and my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell). That makes it even harder to swallow the £9 billion bill we face paying to maintain a base on the Chagos Islands.

I will focus specifically on soft power. I welcome the establishment within the FCDO of the Soft Power Council; it is very important that strengthening hard power should not be at the expense of Britain’s soft power. A number of Members have already talked about the BBC World Service, which is one of our great assets. It was very welcome that in the Budget, the Government increased their contribution by £32 million, but it was concerning that the BBC recently announced a reduction in its contribution of £6 million, with the loss of 130 jobs. While all 42 language services are being maintained, the World Service defence committee has already pointed out some of the damage that those reductions will do, with the loss of regional editors, science coverage and business programmes. I am particularly concerned about the letter that the Chair of our Committee received a few days ago from the director general, in which he said:

“In the last few days we have been asked to prepare for further engagement with the FCDO on the impact of the reduction in Overseas Development Spending.”

I would like the Minister to assure us that there will be no reduction in the Foreign Office’s funding of the BBC World Service. Indeed, I hope he will give serious consideration to the BBC’s request that in the longer term, the Government consider taking on the full funding of the World Service.

We on the Committee have also heard from the British Council, another aspect of soft power. It is absurd that the loan of £250 million given to the British Council has to be renewed each year, creating huge uncertainty. I hope that a solution can be found to put that funding on a long-term basis.

I finish by referring to an issue of huge concern to me and many others: media freedom. Both this Government and the previous Government have very good records on supporting media freedom around the world; we set up the global Media Freedom Coalition. However, as the Minister knows, media freedom is under huge threat. I urge the Government to continue to press the cases of Jimmy Lai, a British citizen imprisoned in Hong Kong, and of Alaa Abd el-Fattah, a British citizen imprisoned in Egypt. The Minister also knows that in Ukraine, 97 journalists have been killed since 24 February 2022, 12 while on duty, and the most recent withdrawal of funding—that of USAID—will put at risk over half the media outlets that are bravely reporting what is happening in Ukraine. I hope that the Minister can provide support to them, too. \p Nusrat Ghani: I call Blair McDougall. \p Blair McDougall: Thank you, Madam Deputy Speaker. It is appropriate that we have such a distinguished internationalist in the Chair for this debate. [Interruption.] That did not get me any extra time for my speech.

I recognise the impossible decisions that the Government have to take, but I hope that we do not set up a false dichotomy in which we believe that our moral preferences have to be at odds with our strategic interests. I recognise, though, that the Government are making budgetary decisions in response to very painful real-world events that are taking place every day. I represent many of the FCDO workers from East Kilbride, and I myself worked for 10 years delivering aid. I do not want to repeat what others said in pleading for the international development budget, but I want to ask the Government about one thing, and perhaps challenge them on it.

If, as the right hon. Member for Sutton Coldfield (Mr Mitchell) said, we are not still the development superpower, what is our offer to the global south? We know what Russia’s offer is: blood for gold. It will kill your enemies for you, through mercenaries, and take precious minerals out of your country. We know what China’s offer is: infrastructure in return for debt that keeps you in its power. We cannot offer violence, and we cannot demand subservience. It seems to me that our offer is values, but values need to be projected through vehicles. In the time I have, I want to mention two of those vehicles.

I add my voice to those of right hon. and hon. Members who have spoken in defence of the BBC. Others have spoken about how development helps to save money on defence. That also works the other way around: when defence fails, development picks up the pieces. If we need one example of that, we can look to Afghanistan. When we left Afghanistan, we left behind the BBC World Service. It is now the only broadcast journalism in the country—the only thing that is still there, saying to those people, “We have not abandoned you.” The cuts that we are discussing imply very deep cuts to the World Service, which I hope we will not see.

The second thing I wanted to plead for is the democratic infrastructure that supports dissidents and democrats around the world—the people I worked with. As we stand here, that infrastructure is being dismantled because of Elon Musk’s vandalism. The most extraordinarily brave people I have ever met are being utterly abandoned. \p Stephen Gethins: I congratulate the hon. Member on his contribution. He and I disagree on a lot, but not on this. Will he pay tribute to those who work with the conflict, stability and security fund, which is particularly important in all the areas that he rightly touched on? \p Blair McDougall: I am very happy to do so. The hon. Gentleman and I have worked closely together on Georgia—a country in the backyard of Vladimir Putin that is on day 96, I think, of huge street protests, all for lack of the cost of a single storm shadow missile in recent years. We cannot fill all the gaps, but I hope that we can triage, and can look at places such as Ukraine, Georgia, Moldova and Belarus, where a small amount of money makes an enormous amount of strategic difference.

If investing in arms allows us to fight, we must remember to invest in the reasons why we want to fight in the first place. The fundamental weakness of the authoritarians with whom we are in this unspoken war is the same. Every act of brutality is a confession of their weakness. They know that if their people were free  to choose, they would not choose the form of Government that is there. All that those authoritarians offer is corruption, violence and brutality against their own people, who will choose to be on our side in the global fight, but we need to put in the resources to make that case every single day around the world with confidence. \p Chris Law: Like everyone in this House, I stand in full solidarity with Ukraine and recognise the threat posed by hostile actors such as Putin. I agree that UK defence spending must increase to enhance our national security. However, the decision to raid the development budget does not increase security. It does the very opposite.

Decreasing overseas development assistance is utter folly, and it fundamentally undermines efforts to bring about justice, peace and security in the world. The Prime Minister knows that. He stood in this Chamber and criticised Boris Johnson and the previous Conservative Government when they made their first cuts. He made these very points. He was elected on a manifesto that pledged to rebuild Britain’s reputation for international development, with a new approach based on genuine respect and partnership. We all agree with the need for that. Instead, in a fashion that has become typical of his leadership, he has U-turned on his promise, and went even further in making cuts than the Conservatives were willing to go.

Put simply, this decision by the Prime Minister is a death sentence for hundreds of thousands of people. It will have a devastating impact on millions of the world’s most vulnerable and marginalised. Children will go hungry and will miss out on lifesaving vaccinations. They will die as a result. Girls will lose access to education, family planning and reproductive health clinics. As a consequence, they will be forced into early marriage and will have an increased risk of being victims of gender-based violence. Refugees will lose access to accommodation and vital support services, and will be displaced once again. The Prime Minister has reneged on his promises, and the UK Government have abandoned their moral duty, all without any impact assessment whatsoever. They have done this with a callous disregard for the lives of others throughout the world.

It does not have to be like this. In 2023, Germany, our G7 European ally, spent 0.82% of GNI on ODA, while others such as the Netherlands, Ireland, Denmark, Sweden and Norway spent greater percentages than the UK. We are all facing the same threats, so why is the UK the only one cutting back? I look forward to hearing the Minister’s response to that.

The Prime Minister has once again sought to appease President Trump, and to follow the leader of Reform and short-sighted right-wingers who believe that those in the rest of the world simply do not matter, and that our actions abroad have no impact at home. It is wrong. The UK’s role in the world is built on hard power, soft power and diplomacy. As a former member of the International Development Committee, I travelled around the world, and heard of the devastating impact of the UK’s first cut to ODA in 2020. I heard how trust in the UK has been eroded, and I heard directly from leaders of countries who are increasingly turning to others, such as China and Russia, to fill the void left by the UK’s absence.

The threats that we face are interconnected and disregard international borders. We have faced a global pandemic and we will encounter more. We are in the midst of a climate emergency, which is not going away. We are experiencing war in Europe and a challenge to the rules-based system. These issues should be a catalyst for increasing development aid and for solving these problems collectively, but tragically, this Labour Government are following in the footsteps of the Conservative Government, who used covid as an excuse to make cuts. Labour is using defence spending as its excuse to step away when it should be stepping up. This madness must stop. All of us in this House must come together and find another route for financing defence spending—a route that is in our national interest. This simply cannot come to pass without a fight. \p Alice Macdonald: I thank the Chair of my Select Committee for securing the debate. Twenty years ago, the words of Nelson Mandela rang out just down the road in Trafalgar Square. He called on the world to “make poverty history”, stating that

“as long as poverty, injustice and gross inequality persist…none of us can truly rest.”

I hope we remember those words as we continue this conversation.

I do of course welcome the uplift in defence spending, but to someone like me who has campaigned and worked in international development for years, the decision to cut aid is, as the Prime Minister himself acknowledged, very painful. When I think of why our aid matters, I think of the women I met in Dadaab refugee camp, who had finally secured some safety after years of uncertainty. I think of the children being vaccinated against life-threatening diseases. I think of the response to the Ebola crisis, which not only saved lives in the countries affected but protected us all. I think of our development work as not only lifesaving, but a form of international insurance for us all.

UK aid constitutes about 1p in every pound of public spending, and, as we have heard before, it brings a huge return on investment. It is a down payment to prevent the spread of disease and conflict, to tackle the upstream drivers of migration, and to increase prosperity. I say that because many of my constituents wrote to me urging me to speak today, but I think we receive far fewer emails about aid than about other matters. As we continue this conversation about the very difficult choices that have to be made and other forms of financing, we must continue to make the case for aid, both in its own right and in our own interests.

I do not want to repeat all the points that have been made, but I think we need to focus on a few key issues. As the Chair of the Select Committee emphasised, the timeline is key, and I hope that the Minister will respond on that. Can we expect aid expenditure to remain at 0.5% next year and the year after, before we get to 0.7%? That could save billions of pounds and millions of lives. I would not like to be in the Minister’s shoes, because these are difficult if not impossible decisions, but will the House be updated on the spending criteria that will be used? Will it be a decision between bilateral and multilateral,  between one country and another, and between this or that programme? As my hon. Friend the Member for Hemel Hempstead (David Taylor) pointed out, there is expertise, and we hope to work with the Government constructively on this.

UK legislation already sets out what we need to consider. Ministers must be satisfied that our aid

“is likely to contribute to a reduction in poverty”,

and is provided in a way that contributes to reducing gender inequality, as was mentioned by my hon. Friend the Member for Sheffield Central (Abtisam Mohamed). That focus on women and girls is vital. I back the call from many non-governmental organisations, including CARE and UNICEF, for a new commitment to target at least 20% of bilateral official development assistance on gender equality, and I hope that the Minister will respond directly to that call.

I echo what has been said about the need to reduce the amount of money spent in this country on refugee costs. According to the most recent figures, it was 28% of the aid budget. I know that our Government are committed to bringing down that spending and tackling the backlog, but the sooner we can do that, with a clear commitment that the money will go back to the aid budget, the better. I hope that the Minister can update us on the conversations with the Home Office about that. There should be a whole-Government approach taken, involving the Treasury, the Home Office and development.

We must leverage other forms of financing. I am short of time, so I will just mention debt. We have done a great deal on that before as a Labour Government, and I hope we will do so again, because 32 African countries are spending more on their external debts than they can spend on healthcare and education, which is a scandal. I hope we can also do more on remittances. We know how much is sent overseas from diaspora communities here; the cost of doing so is still far too high, and reducing it would not be a cost for this Government.

These are indeed challenging times, and I appreciate that these are tough choices, but we must retain a clear commitment to returning to 0.7% as soon as circumstances allow. We are an internationalist party that believes in the power of aid, and we will fight to ensure that remains the case. \p Joani Reid: East Kilbride in my constituency has a long and proud history as a key part of the UK’s international development efforts. Generations of dedicated civil servants have worked there to tackle global poverty, strengthen partnerships, and uphold Britain’s reputation as a force for good in the world. However, I must express my deep concern about the fact that the Government are on the verge of severing that proud connection. The proposed closure of the overseas development office in East Kilbride is a mistake, not just for my constituents but for the integrity of Britain’s global development work. Let me be clear: East Kilbride is not a suburb of Glasgow. It is a town in its own right, designated as part of the new town movement by the post-war Labour Government. \p Andrew Mitchell: Will the hon. Lady give way? \p Joani Reid: I am sorry, but I will not, for reasons of time.

East Kilbride is Scotland’s second largest town, with its own economy, its own economy, its own identity— \p Andrew Mitchell: On a point of order, Madam Deputy Speaker. \p Nusrat Ghani: Is it really a point of order? \p Andrew Mitchell: Yes, it is. As far as I am aware, it is not true that the office in East Kilbride is being closed. It is being moved to Glasgow, and I am advised that the Government have no plans to change that arrangement. \p Nusrat Ghani: The point of order is noted, but that is not a matter for the Chair. Time is limited, so we will go back to Joani Reid. \p Joani Reid: Thank you, Madam Deputy Speaker.

As I said, East Kilbride is not Glasgow. Closing the development office and shifting the jobs to Glasgow is not just tinkering with the administration of the FCDO; it is a blow to our community, which has built itself around the development opportunities that the office provides. It is taking well-paid, skilled jobs from a town and centralising them in a city—the kind of decision that too often leaves towns behind. I know that many of my hon. Friends share my concerns about the hollowing out of towns such as East Kilbride, and I urge the Government to think again.

The decision to close the development office has been made at a moment of deep uncertainty for the civil servants working in international development. The Government have already made this very difficult and painful decision. It is not a decision that I celebrate, but I support it, because governing means taking tough choices, not easy ones. However, closing the office and moving it to Glasgow, at a time when there is such deep uncertainty about the international development budget and no clear evidence that it will do anything other than cost money in the immediate term, is ill advised.

Labour has a proud legacy, built by pioneers such as Judith Hart, and we must not allow it to be weakened by short-term thinking. We are now in an era where words are not enough and an era of show, not tell. If we really believe in the role that East Kilbride can continue to play in shaping Britain’s international engagement, the answer is clear: take the closure off the table, and use the money to focus on the announced priorities in international development. \p Richard Foord: I support the Government’s increase in defence spending from 2.3% to 2.5% of GDP. I would like to see them go further, and for it to rise to 3% as soon as possible. There is an urgency to increase defence spending, and it would have been wrong to wait until the spending review later this year, yet the reduction in development assistance is the wrong place to look for the money. It is not only devastating for humanitarian projects and development assistance; it has significant geopolitical consequences.

For years Britain has led the way in providing development assistance to countries in desperate need, helping them to develop while also strengthening our global influence. However, with both the US and the UK now cutting back on aid, we risk creating a vacuum that will be filled by authoritarian actors. Countries that were previously aligned with the west will have little choice but to shift fully towards countries that are hostile to the UK. This is not speculation, because I make my observation based on historical precedents.

In 2021, France suspended €10 million in aid and halted military co-operation with the Government of the Central African Republic. The Central African Republic sought alternative partners, including for security, and went to Russia’s Wagner Group. Wagner deployed mercenaries to support Government forces in their fight against rebels, solidifying Russia’s role in the Central African Republic. Russia then secured economic resources and mineral resources, such as gold and diamonds, from the Central African Republic.

When Russia expanded its foothold in Africa, it gained both economic leverage and political influence, and the political shift is apparent in the Central African Republic’s voting record at the United Nations. Historically, the Central African Republic aligned with the west in supporting key resolutions, such as on the continuation of the UN Observer Mission in Georgia. More recently, on critical UN votes—for example, the votes on Ukraine at the General Assembly—the Central African Republic has either abstained or voted against resolutions condemning Russia.

We are also seeing that elsewhere—for example, with China’s belt and road initiative. It is well known that China has deepened its ties with both Tanzania and Zambia by investing in roads, ports and energy projects. Meanwhile, western influence in those countries has waned, with China emerging as their primary partner. We have seen senior Zambian Government officials, including Ministers and permanent secretaries, participating in training programmes focusing on governance in Beijing every year, thus pushing China’s authoritarian ideology and influence across Zambia. Historically, when the west withdraws, China and Russia step in, and that is exactly what will happen with the cuts to the FCDO budget, particularly the cut in development aid to 0.3% of GDP.

To conclude, let us not erode democratic values across the globe or weaken our ability to advocate for a fairer and more democratic world, because that is also in British interests. \p Several hon. Members: rose— \p Nusrat Ghani: Order. We are dropping the time limit down to three minutes. \p Cat Eccles: In the uncertain global situation we currently live in, I welcome the announcement of increased defence spending. I am sure it will also be welcomed by 63 Military Intelligence Company in my constituency of Stourbridge. It is based at the Army reserve centre, with minimal permanent staff and more than 90 reservists from across the Black Country and beyond. It was great to see a female officer leading the Remembrance Day parade this year—a celebration of its diversity and strength.

As part of the increased defence spend, we must harness the power and skill of British business. Last week, I visited Welin Lambie, the UK’s leading designer, manufacturer and service provider of davits, winches and lifting appliances for the global marine and offshore industry. Founded in 1901, the business found a home in Brierley Hill in 1989. It proudly employs over 40 local people and trains multiple apprentices each year. I was impressed to hear that it sources nearly all its materials from within a five-mile radius, and it is the leading supplier to the US navy and the US coastguard. Welin Lambie is keen to break into the UK defence market, but when under the previous Government it bid for Ministry of Defence contracts, it narrowly lost out to a Spanish firm.

I also welcome the Government’s continued support for Ukraine. Last year, I had the opportunity to visit, and some of the things I saw and heard will never leave me. We visited a children’s hospital in Kyiv that had been bombed by Russia just a few weeks before, showing that, by targeting civic infrastructure, Russia is not even following the rules of war. I met the strongest and most resilient people who were steadfast in their continued fight against Russian aggression, and Ukrainian MPs who are battling against Russian propaganda and misinformation on a new frontier of digital combat. I also met ordinary people helping one another rebuild their homes and villages, and doctors and nurses treating and rehabilitating the ever-growing number of casualties. On a visit with the mayor in Chernihiv, it was clear that funding to Ukraine is not always reaching the people who need it most—ordinary hard-working Ukrainians—and I urge FCDO Ministers to ensure that funds sent to Ukraine are fairly distributed across the country to the communities that need them most.

It was disappointing to hear that the increased funding will come at the expense of ODA, and I am still not convinced it is the right thing to do. I understand that security at home is of vital importance, but should we as the Labour party really be cutting support to some of the world’s most vulnerable people? There is crucial work happening in developing countries in health, education and climate change, and abandoning that work leaves a void for Russia and China to fill. What does it leave for our support for Gaza, Sudan and beyond at a time when the US is pulling its aid? Investing in international development is an important contribution to security both at home and abroad. \p Brian Mathew: I believe the UK’s international development spending must be used effectively, with a primary focus on poverty reduction, and we must reverse the ODA cut and get back to 0.7% of GNI, which was probably our proudest achievement as Liberal Democrats in the coalition Government. We must put the United Nations sustainable development goals at the heart of our international development policy, including access to clean water, sanitation, health, education and achieving food security.

However, for now we are where we are, and with our total aid budget likely to be cut to around £9 billion a year, we must strive to get the very best value for our money—not just for the sake of the Exchequer, but for  the massive good that British aid can still do in the world if it is not squandered. For example, approximately £4.3 billion is spent on asylum seekers arriving in the UK each year, a large proportion of the overall aid budget, leaving only £4.9 billion for actual aid work overseas. Now that budget has been further depleted to increase defence expenditure, it is vital that we bring down the costs associated with asylum seekers urgently. That could be done in the following way.

Asylum seekers arriving in the UK illegally, in small boats or by other highly dangerous means, need protection. They need support, they need compassion—they are people—but what they do not need is to be put in hotels with no plans for their future. As anyone who has been cooped up in a hotel for more than a few weeks will know, that will cause their mental health to suffer, and their drive and determination to wane. Asylum seekers come here full of hope for a better future for themselves and their families. They want to work. We should give them the chance and the support to do so, instead of leaving them in administrative limbo in hotels around the country, costing the taxpayer billions. If they have the chance to work their way into our society, instead of remaining a burden on the Exchequer and a burden to themselves, it would free up a large part of the remaining aid budget that could be spent on improving lives in the developing world, so that people do not need to risk their lives to come here in the first place.

People come here risking their all and that does not cease once they enter our borders. To protect them from the clutches of human trafficking—[Interruption.] I had better sit down. \p Brian Leishman: I thank my hon. Friend the Member for Rotherham (Sarah Champion) for securing the debate.

The enormity of the challenges facing the world right now can seem somewhat overwhelming. We are all, at varying speeds, suffering from the existential threat of climate change. We live in a global economy that is stacked in favour of the few, to the detriment of the many. These issues are driving forces for the volatile, unstable world we live in today. Our Government’s attitude to the international community and how we tackle our own domestic issue of increasing inequality should, therefore, be shaped by the principles of human rights, compassion and social justice—the very principles our party and our wider movement were founded on.

To cut overseas aid is a moral failing. Foreign aid should not be considered as an expense to be cut. It is an investment in global stability, security and a commitment to making the world a better place. As with all cuts, whether domestic or foreign, it will be the poorest, the most disadvantaged and the most vulnerable people who will be hardest hit.

Tomorrow, we have the International Women’s Day debate. Women and girls in conflict-ridden areas such as Sudan, Yemen, the Democratic Republic of the Congo, Syria and Gaza absolutely need our help. Cutting aid in those regions is not just short-sighted. It will abandon and consign millions to persecution, famine, illness and death.

The Government claim the cut is necessary to fund an increase in defence spending, but framing things in that way is, frankly, wrong. Cutting international development,  as many hon. Members have mentioned today, does not strengthen our security—actually, it weakens it. Aid is a strategic investment in our long-term national interest. We have seen the United States slash its foreign aid budget. AIDS and HIV clinics in Ukraine, Uganda, Liberia and South Africa are running out of medicine. In Sudan, 80% of emergency food kitchens have been shut down. People will starve because of the American decision. Let us not make that same mistake.

International leadership is desperately needed, arguably now more than ever. The UK cutting overseas aid damages our credibility and diminishes our role on the world stage. Let us lead by example, not retreat into isolation. Let us reaffirm our commitment to being a force for good: a nation that stands up for its values, its security and, frankly, our global responsibilities. I implore the Minister and the wider leadership to restore the UK’s overseas development aid budget. \p Alex Ballinger: Twenty years ago, I joined the Royal Marines. Roughly a year later, I was deployed to Afghanistan. I remember the challenges we faced: daily attacks from rockets and mortars and daily threats of improvised explosive devices, and the massive underfunding and disappointments with the Ministry of Defence’s procurement system. Many of us had to buy our own body armour. We ran out of desert boots had to walk around in 40° heat in black boots. We were driving weapons-mounted installation kit Land Rovers, which provided no protection against the landmines in the area.

I understand that defence underfunding is not new. However, since 2010, when the UK last spent 2.5% of GDP on defence, a decade of austerity under the Conservative Government has completely hollowed out the capability of our armed forces. With Russia’s full-scale invasion of Ukraine now in its third year, it has never been more important for our military to rebuild its capability to show strength and support for our allies in Europe. I completely back our Prime Minister and his decision to increase defence spending back to 2.5% of GDP, and his ambition to go further in the next Parliament.

This is the right course of action. The most effective way to ensure peace in Europe is through strength. However, state-on-state conflict is not the only conflict that threatens us in the UK. There are more active conflicts across the globe than at any time since the end of the second world war—in Gaza, Sudan, Yemen, Myanmar and the Sahel—and we need a strong military to protect our citizens and deter our enemies.

However, hand in hand with defence is our vital spending on international development. When I was in Afghanistan, serving alongside British soldiers and marines were humanitarian workers, doctors and engineers. Our armed forces were working side by side with aid workers, just as British-backed aid workers are now doing in Ukraine alongside the brave Ukrainian armed forces. There are so many stories of the bravery of aid workers across the world’s conflict zones, where fighting is causing destruction, starvation and violence against women. \p Laura Kyrke-Smith: I thank my hon. Friend for bringing deeply fragile and unstable conflicts such as Afghanistan into this discussion. Does he agree that aid plays a deeply stabilising role in such  conflicts and, as such, contributes to global stability and security and to our own national security? Does he agree that that should be recognised in the tough choices we have to make on development spending? \p Alex Ballinger: Absolutely. I think that those of us who have served would recognise that development and defence are completely complementary. When we reduce our development spending, our defence spending needs to go up.

After leaving the Royal Marines, colleagues and I worked with civil society in Syria, helping to keep hopes of a different, more tolerant country alive during that civil war. Those groups are probably now the best hope for Syria’s civil society and for a more tolerant and stable country.

Aid helps to mitigate the worst impacts of conflict and to prevent further conflict. I am concerned that cutting our development budget so deeply will undermine our ability to stabilise fragile states, reduce the drivers of extremism and stop further conflicts emerging. The implications of that will be felt here in the UK, with a greater chance of spikes in food and energy prices, increased migration and threats from extremist groups. Our military and security services will face those challenges at a time when their attention should be on Ukraine. While I wholly support raising our defence spending, I encourage the Government to look over the next two years at opportunities to avoid such drastic cuts to our aid budget, in particular our investments in conflict zones and on conflict prevention. Each pound we spend on conflict prevention can save £16 in aid to mitigate the destruction caused by conflict.

I welcome the pledge the Prime Minister made for an international fund for Israeli-Palestinian peace last December, and I hope that that remains a priority for the FCDO after the latest announcements. I strongly support the increase in defence spending announced last week, but, as a former marine, I also urge the Government to value the critical role our aid budget plays in delivering vital aid in conflict zones and preventing conflicts altogether. \p Nusrat Ghani: Due to time constraints, we now come to the Front Benchers. I call the Liberal Democrat spokesperson. \p Monica Harding: This month marks 10 years since the passing of the International Development (Official Development Assistance Target) Act 2015, which committed this country to spending 0.7% of our national income on international development. It was a proud moment that represented the culmination of almost half a century of effort and advocacy by my party, the Liberal Democrats. However, that legislation was created through a political consensus across the House, which built on the work of the reforming Labour Government of 1997, who committed to make poverty history, and was continued by a coalition of Conservatives and Liberal Democrats.

Britain is a leader in international development due to both our expertise and our generosity, and our influence on the world stage has grown as a consequence. Development opened opportunities for trade and growth, and worked alongside defence and diplomacy as a third element of our foreign policy to keep us secure at home.  The Prime Minister’s cut to the international development budget last week to 0.3% of GNI puts an end to that shared consensus. Let me be clear: Liberal Democrats support the increase in defence spending. We called for the uplift to 2.5% of GDP even before the Prime Minister committed to it, but we have laid out alternative funding plans.

The world is changing fast, not least in the past six weeks, so we must adapt. But this diminishing of our development spend will make us less, not more, secure. International development serves our national and border security interests. It is our investment in a more stable world and it pays dividends. By contrast, when we retreat, actors whose values and interests are not ours seize the opportunity. Even as we watch, President Trump and Elon Musk gut USAID, which was responsible for a fifth of global development spending. China is moving to fill the gap, deepening its partnerships in the Indo-Pacific and Africa, where, in 2024 alone, Beijing agreed more than $50 billion in loans and aid. As we have heard, when budget cuts forced the closure of the BBC World Service’s Arabic radio in Lebanon, Radio Sputnik—the Russian-backed radio service—moved in.

Development spending serves our health here in the UK, and that is put at risk by the Prime Minister’s cut. Through our support for multilateral organisations, such as Gavi and the Global Fund, we have not only saved millions of lives, but prevented diseases such as Ebola from reaching pandemic proportions and causing devastation on British shores.

As Anneliese Dodds’ resignation letter makes clear, last week’s decision will make it impossible to maintain all of the UK’s development commitments. It may mean cutting strategic programmes that make vital contributions to UK security, including peacebuilding and deconfliction work in fragile states. This will only produce more violence, more failed nations and more refugees and, in the breeding grounds of instability and extremism, risks the emergence of new terrorist groups that could threaten us here at home.

The development cut will mean scaling back the climate finance that develops resilience and mitigation measures for countries on the frontline of climate change and reducing anti-poverty programmes for those very same nations. We know that for every 1% increase in food insecurity, there is a 2% increase in migration. The interaction of climate change and poverty with the high birth rates and extremely young populations in much of the global south is a recipe for the vast displacement of people. We know that in the next 10 years, 1.1 billion young people across the global south will become working-age adults, yet in those same countries we expect only 325 million jobs to be created, so supporting these economies is in our interests. More conflict will only exacerbate the situation. Last year, even as the world’s largest humanitarian catastrophe unfolded, more than 2,000 people from Sudan crossed the channel on small boats.

We already have the highest levels of refugees and migration since the end of the second world war, and the Prime Minister’s decision risks further displacement. Will the Minister clarify why no impact assessment was done in advance of these cuts? When will it be done, and when will this House see it?

In 2023, the UK spent 0.2% of GNI on official development assistance within the UK, more than £4 billion of which was used to host in-country refugees. If anything like that continues, we will be left with just 0.1% of GNI to finance our overseas aid objectives. That would make our aid spend the smallest of any of the 32 countries that comprise OECD’s Development Assistance Committee, save for Viktor Orbán’s Hungary, and lower than the rest of the G7. That is a long way to fall from being a global leader in development spending and the second biggest donor of the G7.

Will the Government reconsider their decision to count in-country refugee costs as ODA, so that what little remains after this cut can be used to advance UK interests abroad? Will the Minister confirm that, in view of the Government’s statements in the other place yesterday, the money for the Integrated Security Fund will be ringfenced? Can he also confirm that, to safeguard British soft power, the current level of ODA allocated to both the BBC World Service and the British Council will be protected?

Will the Minister clarify how much of the total 0.3% has already been assigned to multilateral commitments? Is the money still ringfenced? If it is, how much will be left available for bilateral assistance? How will this cut affect UK-run programmes in Sudan; in Gaza and the west bank; in Jordan, where UK ODA is used to support displaced people and prevent future waves of refugees; in the DRC; and in Myanmar? Most importantly, is 0.3% the floor or the ceiling?

In the past, Britain’s overseas aid spending, which has reached 13.8 million people with food aid, helped 95 million people to cope with the effects of climate change and inoculated 15 million children with lifesaving vaccines, has reflected the deep generosity of the British people—we see that again and again in just how much is donated to appeals in response to natural disasters across the world—but we should never mistake development for charity. We reap the benefits of a safer, richer world through increased trade and growth and—critically—through our security, national health and border security.

I had hoped that the Government would reset the UK’s place on the world stage, as they promised. I had hoped that they would return us to the 0.7% target, as promised in their manifesto. In the past, Labour Front Benchers, including the Prime Minister, spoke with vigour about the importance of development for security and the short-sightedness of previous Conservative cuts. Now, in dereliction of its values, Labour has gone further than the Conservatives ever did.

The world is becoming ever more dangerous. The norms of the international order have been turned on their head. Only yesterday in the UN, the United States denounced the sustainable development goals developed collaboratively in pursuit of a better world. The Liberal Democrats had hoped that the UK would step up and lead on development, recognising its vital importance to our future security. Instead, the Government have cut development to its lowest level this century. That is a short-sighted, strategically unwise decision that will leave us less safe. It is not only the millions of the world’s poorest who will feel that, but our constituents, too. \p Nusrat Ghani: Before I call the shadow Foreign Secretary, I remind Members that they should refer to other Members by their constituency or by their title if they are a Minister, not by their first name. \p Priti Patel: I begin my remarks by paying tribute to the many speakers in the debate, and in particular the Chair of the International Development Committee, the hon. Member for Rotherham (Sarah Champion), who has been a long-standing advocate for development aid. I have had the great privilege of working with her, and I thoroughly understand her commitment.

I will pay tribute to a few other colleagues. My right hon. Friend the Member for Sutton Coldfield (Mr Mitchell) has been a long-standing, dedicated and passionate advocate not just for 0.7%, but for the effective use of that funding, and for working with the private sector, which he and I have both had the enormous privilege of doing. I also pay tribute to the right hon. Member for Oxford East (Anneliese Dodds) for her commitment. I have had the privilege of working with her as well, and during her time in government she was professional and committed to her brief. Of course, last week the Government sent her here to defend Labour’s indefensible Chagos surrender deal, which uses money transferred from the aid budget to defence to pay for the lease of a site that we have sovereignty over. \p Josh Fenton-Glynn: rose— \p Priti Patel: I will not give way because I do not have time.

To spare the blushes of the Minister, I will not relitigate the debate. I am glad that he is in his place because there is a lot to cover. He will speak passionately about development aid and assistance because of his background and experience. I would like to ask him a question about the British Indian Ocean Territory and which budgets the lease costs will come from. Will it be from the FCO, defence or ODA budgets? We still need an explanation of that. I thank the Minister, because before the debate started I received a flurry of answers to some of the questions I have been posing on this issue. However, just for the record, I still do not have clarification, so there will be more.

I want to speak about defence spending and ODA. The Government were right to follow our calls to redirect some ODA funds to support the defence budget at this critical time. \p Emily Darlington: rose— \p Priti Patel: I will not give way as we are very short on time. I hope that the hon. Member will respect that.

The threats that we and our allies face necessitated that decision, and there is consensus across our respective Front Benches on that. Importantly, it shows our enemies and adversaries that we as a country are serious about dealing with the malign influences and challenges we face. The Minister knows the implications, but we must always look to increase our defence spending and resources. We will work collectively on that.

We all recognise, as I think the debate has shown, that many of the decisions on ODA are difficult. There are strong views in this House on the choices that have been made, including among those on the Opposition Benches. My hon. Friend the Member for Chester South and Eddisbury (Aphra Brandreth) pointed out some of the choices. My right hon. Friend the Member for Maldon (Sir John Whittingdale) spoke about how we must still champion media freedoms, about some of the real pressures that exist and about the key values that we will stand up for.

As a former Secretary of State for International Development—I have been there and I understand— I know the benefits and the impact of UK aid: how we stand strong in the world, the use of soft power and the way in which we save lives. Whether that is through the Global Fund or Gavi, we know those funds very well. We have been a huge supporter of them, and Britain has saved and changed lives around the world. We are all proud of that; there is no question.

These points have been made already, but I ask the Minister: where will the Government take the lead—on which development programmes in particular? We know about Sudan—the Prime Minister has referred to that—but there are so many other areas of conflict in the world. They include Yemen, and I am afraid to say that I have not heard Yemen mentioned in this House for too long. Where will we be on the replenishment of Gavi and the Global Fund? I know Ministers will say that they will wait until the spending review, but given that ODA spending will still be pegged to a proportion of GNI, will the Minister give a commitment on the potential for published plans?

We want to know more about the split of ODA between Government Departments. Home Office spending of ODA on asylum has already been raised several times, and I know that the Minister will want to speak about that. We also want to know more about the integrated security fund and the decisions and choices that will be made on that. What clarity can be given? Similarly, CDC was mentioned. Can there also be clarity on its role and that of British International Investment, and some of the opportunities that exist there?

I want to briefly touch on Ukraine, and some other areas too. It is quite clear that we stand shoulder to shoulder with Ukraine. The Ukrainians’ fight is our fight. They are on the frontline protecting the very principles that underpin our way of life: sovereignty, democracy and the rule of law. Can the Minister say, particularly with the forthcoming changes in defence spending, whether the Government will turbocharge the work following the summit the Prime Minister led at the weekend? Importantly, the Americans have already spoken about pausing military aid and intelligence sharing. What work will we do now to make sure that that does not happen in the headline ways that we have heard? How will we respond to that? Are we having constructive dialogue with our friends in the US Administration to safeguard key intelligence and security assets? This is a defining moment.

I want to touch on the middle east as well, and particularly on some of the discussions we had in the urgent question yesterday on Gaza and the ceasefire. We must ensure that we always stand strong when it comes to standing up for the hostages. New discussions  have taken place in Cairo. When plans are forthcoming, what role will we play as a country in some of those areas?

I must raise the issue of Iran. Our diplomatic and security efforts obviously have to ensure that we address that malign influence. I welcome the Government’s actions, which were undertaken yesterday, on the enhanced tier of the foreign influence registration scheme. However, I want to press Ministers to go further and have a consistent and serious approach to security and defence across Government, because this is a whole of Government effort now.

We have heard day after day in this House about the threats posed by Russia, Iran and China, which continue to cast a dark shadow over freedom, democracy and our national interests. We have to stop going cap in hand to China. We have to do much more, and I hope the Minister will reflect upon what I consider to be the Government’s reckless approach in kowtowing to China. What will we do to ensure that the vacuum that will now be created in some parts of the world will not be filled by China? How will we stand up to it?

Finally, it is pretty clear that we live in an increasingly dangerous and uncertain world. The threats are increasing and growing. The Foreign, Commonwealth and Development Office has one of the world’s greatest privileges, which is to stand up and look after our security, defence and freedom using soft power and all its levers. We urge Ministers, within the scope that they have now, to tackle the real threats and challenges that we all face globally, while also giving voice and representation to many of the issues that colleagues have spoken about today in the House. \p Stephen Doughty: I start by thanking all hon. and right hon. Members for their passionate and sincere contributions to today’s debate. We have an incredible wealth of experience here, not least among the former Ministers and former and current Committee members. I am a former member of the International Development Committee. I also want to thank the many people who work in the international development sector and on wider foreign affairs and security issues, notably those who have served in our armed forces. We thank them, and all those who have served our country in humanitarian, security and defence roles, for their service.

I particularly want to thank the Chair of the International Development Committee, my hon. Friend the Member for Rotherham (Sarah Champion), for opening the debate. She made her points strongly and forcefully. She has played an important role as Chair of that Committee, and we take very sincerely the points that she made and hear them all. I will make sure that they are communicated to the new Minister of State in the other place. These are challenging times, and they demand tough choices and clear leadership. I would also like to pay my own tribute to the work of my former ministerial colleague, my right hon. Friend the Member for Oxford East (Anneliese Dodds). I have known her for nearly 30 years, and she is a person of absolute integrity and sincerity. I am sure she will continue to contribute in the House on many matters of importance. I thank her for her work.

I also want to thank all the staff in the Foreign, Commonwealth and Development Office, in our arm’s length bodies and in other organisations including the BBC World Service and the British Council for the incredible work they do. Ministers and Conservative former Ministers will know the incredible work that our teams of staff have done on these matters, both for the previous Government and for this Government, and it is absolutely right at times of uncertainty such as these that we recognise their contribution and their work. I thank all the hon. Members who made that point in the debate.

I want to be as transparent and as open as I can. I have noted all the many different points made today, including those about specific geographic locations and programmes. I am going to be completely honest: I am not in a position today to answer some of the questions about specific funding for specific programmes, but I will ensure that those points are heard loud and clear by the new Minister of State. I take those points with sincerity, and this debate has been helpful in allowing me to understand the priorities of the House. \p Emily Darlington: I know my hon. Friend’s absolute passion and the experience in this area, particularly on international development, that he gained under the last Labour Government. As chair of the all-party parliamentary group on aid match, can I ask whether he sees a role for the generosity of the UK public in ensuring that they can match and supplement our efforts in rebuilding countries, but also in furthering our aims right across the world? \p Stephen Doughty: Absolutely, and I pay tribute to my hon. Friend for her experience and work on these issues over many years. She is right to say that aid match is crucially important, and we very much hope to continue that work. The generosity of the British public is remarkable, whether in relation to Gaza, to Ukraine or to the many other crises around the world. I pay tribute to all the communities and individuals up and down this country for their brilliant generosity and fundraising. \p Julian Lewis: Would it be fair to say that the step that has been taken to use development money for the immediate or relatively prompt increase in defence spending is essentially a short-term measure that will have to be substituted with long-term measures, given that the increase in defence spending, if it is to fund a security contribution to a divided Ukraine, will be an indefinite commitment? \p Stephen Doughty: I obviously cannot speak for what will happen many years into the future, but the right hon. Gentleman is absolutely right: our intent is to get back to 0.7% of GNI as soon as the fiscal circumstances allow. The Prime Minister has been very clear about that. \p Anna Dixon: Will my hon. Friend give way? \p Stephen Doughty: I will not take any more interventions, because of the time; I need to respond to the points that have been made.

It was clear that all of us across the House agree—with a couple of exceptions—that our defence spending needs to go up. There is absolutely clear unity on Ukraine. We will obviously be setting out the further work following the summit at the weekend and how we will go forward. There have been important conversations on that over recent days involving myself, the Foreign Secretary, the Prime Minister and others.

At this time of profound change, with conflicts overseas undermining security and prosperity at home, the Prime Minister rightly took the decision to increase spending on defence to 2.5% of GDP from 2027. That will be funded by cutting our spending on overseas development from 0.5% to 0.3% of GNI. The Prime Minister was absolutely clear that this was not an announcement that he was happy to make—I know that a couple of Members suggested the opposite. The Prime Minister is a man of integrity and sincerity on this issue, and I urge colleagues to look carefully at what he said about it.

For me, this was a sincere but difficult decision, not least given my experience working for humanitarian and international development NGOs and, indeed, at the former Department for International Development. I too have seen the positive impacts of Britain’s proud record on overseas development on lives around the world, as hon. Members reflected on. As the Prime Minister said, we will continue to play a key role in doing everything we can to move towards rebuilding our capacity, and we remain committed to working in Sudan, Ukraine and Gaza and on tackling climate change, on supporting multinational efforts on global health and challenges such as vaccination, and on our commitments to the overseas territories.

I have to level with the House, and I hope that people can see and feel this: in this dangerous new era, the defence and national security of this country must come first. This is not the 1990s. This is not even 2005, and I cannot look at what I, or indeed other Ministers, do every day and not recognise that we have to respond differently to the very serious threats facing this country, our continent and the world. I say that in deep candour.

This difficult choice reflects the evolving nature of the threats we face and the strategic shifts required to meet them, while maintaining economic stability—the foundation of this Government’s plan for change. We will ensure that every pound of development assistance is spent in the most impactful way, equipping the FCDO to deliver the plan for change internationally. The changes in this estimate reflect that approach, and the FCDO will continue overall, not just through ODA, to focus on growth, security, Europe, migration, climate and nature, and development.

Reducing the overall size of our ODA budget will necessarily have an impact on the scale and shape of the work we do. We will consider how to maximise the value of our budget throughout the ongoing spending review, but ODA alone is not, and has never been, the single answer to the many challenges of international development. We have to use all the levers at our disposal to support our development aims and make use of all forms of development finance to maximise the impact of our ODA. We have set out the detail of the changes being made.

Many Members have raised concerns about asylum spending. The Home Office introduced policy and operational changes within the asylum system to reduce   the impact on UK ODA spend. The Home Secretary is committed to ensuring that asylum costs fall, and indeed there has already been an impact. The Government have taken measures to reduce the asylum backlog and the use of expensive asylum accommodation in the next spending review period, and to increase detention capacity to facilitate more removals.

The Chief Secretary to the Treasury considered the impact of the rise in GNI and the reduction in asylum costs, among other changes to ODA forecasts, in the round and agreed that the FCDO would receive an uplift to its 2024-25 ODA settlement in the region of £540 million. Many colleagues have raised questions about 2025-26. We will be setting initial budgets for 2025-26 to minimise disruption to key programmes as we transition financial years. The details of that will be set out in due course. The ODA budgets for future years are under review by the Government, and we will confirm details to the House in due course. I want to be honest that we cannot provide categorical assurances at this stage, but I assure Members that their points have been heard clearly.

Many Members raised debt relief. Supporting developing countries to tackle unsustainable debt is a key development priority of this Government. We need to take the twin-track approach of tackling the immediate challenges and the underlying drivers of unsustainable debt.

BII was mentioned, and it is a crucial part of our development architecture. We have provided additional support to BII, and we will work closely with it on its role. Indeed, in 2023, BII-backed businesses provided more than 1 million jobs, paid $2.5 billion in taxes and generated huge amounts of electricity, and we need a clearer role for it. I have taken on board the important points about the British Council and the funding that we give it, and about the BBC World Service, which we hugely support—our part of the funding for it has gone up by £32.6 million in the 2025-26 fiscal year. The role of SDRs has been pointed to.

I want to highlight that we will continue to centre absolutely everything that we do internationally on women and girls. Impact assessments have been mentioned many times. Of course, impact assessments, including of impacts on women and girls, will play a crucial role. I have mentioned UK Aid Match and many other things.

These are incredibly difficult choices, but they are the right choices for the circumstances in which we find ourselves. They are not choices that we make lightly. I say sincerely that I have heard all the contributions that Members have made. We will come back to the House in due course with further information. I commend the estimates to the House. \p Sarah Champion: I thank everybody who has spoken in the debate, and express my deep regret that some were unable to do so, but there are many avenues in this House for Members to make their voices heard. I end by saying that I am very concerned about those who might step in, with less generous intent, if we leave the international stage.

Question deferred (Standing Order No. 54). \p Emily Thornberry: On a point of order, Madam Deputy Speaker. For clarification, when I made my contribution, I referred to Jordan. I should have referred the House to my entry in the Register of Members’ Financial Interests, as I recently went to Jordan at the invitation of the King, and I should have said so. \p Caroline Nokes: I thank the right hon. Member for putting that point of clarification on the record. \p UNKNOWN: [Relevant documents: First Report of the Business and Trade Committee, Post Office and Horizon scandal redress: Unfinished business, HC 341; Second Report of the Business and Trade Committee, Priorities of the Business and Trade Committee, HC 42.]

Motion made, and Question proposed,

That, for the year ending with 31 March 2025, for expenditure by the Department for Business and Trade:

(1) further resources, not exceeding £952,875,000, be authorised for use for current purposes as set out in HC 655,

(2) further resources, not exceeding £1,035,833,000, be authorised for capital purposes as so set out, and

(3) the sum authorised for issue out of the Consolidated Fund be reduced by £2,037,739,000.—(Justin Madders.) \p Liam Byrne: I put on the record my profound thanks to the Backbench Business Committee for making time for this debate, and to the Liaison Committee for some of the arrangements that have made today possible.

The Prime Minister has underlined time and again that growth is the No. 1 priority, so I am grateful that the House has agreed to put the Department for growth, together with its accounts, under the microscope today. In readiness for today’s debate, my Business and Trade Committee has taken the precaution of talking to hundreds and hundreds of businesses up and down the country, to trade unionists and to consumer groups, and has laid in the House a report on what we heard from literally thousands of voices. In a way, that is what these accounts and estimates, and the Minister, should be judged against when we consider this matter today.

Let me make three points quickly to get the debate started. I start with the point that struck me hardest when we were listening to business voices up and down the country: for all that divides us in this House, there is a terrific unity of purpose in the business community in this country—unity not only about the possibility of becoming the fastest-growing economy in the G7, but on what we need to do to hit that target. The overwhelming majority of businesses want Ministers do more to grow the markets into which they sell. They want to see an ambitious reset with the European Union, fast-tracking of the free trade deals with Switzerland, the Gulf Co-operation Council and India, and for us to do absolutely everything possible to avoid the peril of tariffs from the United States. However, they also want to see a complete transformation in the way in which we use public procurement to support businesses in this country. Minister after Minister has said from the Dispatch Box, “We will do more to buy British.” Well, it is time to actually deliver on that promise.

Secondly, businesses want the right workers for the roles that are available. Pretty much everywhere we went, the challenges of getting the right workforce were the No. 1 priority of the people we heard from. It is true that we heard a lot of concern about the rising costs of business. People are worried about the impact of the Employment Rights Bill, the national minimum wage changes and the national insurance increases all coming at the same time. However, I heard businesses say that they could live with that if they saw the rapid development and publication of a growth plan, along with the comprehensive spending review. I regret the fact that  that has kind of moved sideways, because given what this extremely hard-working Minister is doing with the Employment Rights Bill, it would have been in his political interests for his colleagues to table that industrial strategy and growth plan sooner rather than later. \p Christopher Vince: I appreciate a fellow Harlowian giving way to me. Does my right hon. Friend agree that part of employment is about skills, and one way the Government can support businesses is by ensuring that young people have the skills to succeed in business and in all workplaces? \p Liam Byrne: My hon. Friend is 100% right. We heard businesses say to us loud and clear that they wanted radical and bold changes in the way that the skills levy was organised. The Government have moved to introduce flexibilities, and business want them to go further, faster.

We also heard business say that there is a good environment when it comes to start-up finance, but a terrible environment in this country for scale-up finance—I will return to that in a moment. People want much stronger relationships between universities and businesses, and we in this country still do not have something like the Fraunhofer institutes in Germany, which have as their slogan that they are the research and development departments for the Mittelstand. Where those knowledge transfer partnerships work, they are good, but they need to be far more prevalent. Finally, we heard businesses say loud and clear that the planning system needs a complete overhaul. The infrastructure in this country is terrible, and we must drive down energy prices; right now, many businesses are being priced out of doing business because our energy prices are sky high.

For all our differences, there are important points on which we can agree. We on the Business and Trade Committee will continue to judge Ministers against many of the things that we heard from the business community as we travelled up and down the country, and I will flag up two or three points that we want to zero in on. \p Gareth Snell: My right hon. Friend’s point about energy costs and opening markets chimes with everything that the ceramics industry is telling me about what it is facing. He is right about the need for growth, and as well as being a wonderful Chair of the Committee, he is a doughty campaigner against inequality and inequity. I am sure that he will agree that we need to ensure that the benefits of growth are felt in every community, be it in Birmingham or Stoke-on-Trent, and particularly in those communities that sadly, under the last Government, did not get the benefits they deserved. \p Liam Byrne: My hon. Friend is an extraordinary champion for the city he represents, and for the industry that has made that city great over the centuries. He is absolutely right: when the industrial strategy is published, we must understand whether it is driving growth and better wages, and whether it is transforming people’s ability to earn a good life in every corner of the country. We cannot again have the situation that we had over the past 10 to 15 years, where 70% of the growth and wealth in our country has been concentrated in London and the south-east. We must genuinely level-up this country and pull together a cross-party consensus, to the extent that we can, on the changes that are needed. Why? Because  if we can get that cross-party consensus, we can redesign the economic institutions in our country in a way that is sustainable for the long term.

I wish to flag three issues that pose questions to the Minister who is asking us to agree the estimates today. First, there is a real worry in the small business community about whether it will be adequately supported by some of the changes that the Minister is helping to drive through. We all know that what has bedevilled our economy for a long time is a long tail of underproductive, often smaller, firms. If we are to raise wages, raise the rate of economic growth, and become the fastest growing economy in the G7, we must transform the productivity rate of a lot of our small firms. How will new technology be diffused through supply chains? How can we ensure that small and medium-sized businesses have support in deploying new technology that could change their business? \p Rosie Wrighting: I thank my right hon. Friend for his chairmanship of the Committee. Given the Prime Minister’s recent announcements, and our increased defence spending, does my right hon. Friend agree that it is important to support small and medium-sized defence enterprises? \p Liam Byrne: My hon. Friend is a brilliant member of the Committee, and she makes a brilliant point. We know that we must come to a strategic culture and defence mindset in this country, so that our industry can innovate as fast as the battlefield changes. We all know that there are defence manufacturers—drone manufacturers in particular—that struggle to get the working capital that they need to fund and grow their businesses, month by month. We will have to change the way that we support smaller businesses, and that means transforming access to finance.

Time and again, the Committee has heard about business leaders being brought in once a firm gets to a particular size, and it being snapped up and shipped out, in particular to the United States, because we do not seem able to supply equity finance or debt finance of between £50 million and £500 million. We have to think anew about how we ensure that the British Business Bank, the National Wealth Fund, the private sector and the proposed changes to pension funds work together to completely revolutionise access to finance for businesses in this market. In the estimates, there looks to be a welcome £414 million increase in funding for the British Business Bank. Although it is hard to decode the accounts, it looks like about £127 million of that is provision for bad debt. Will the Minister clarify that? The Committee will continue to press for us to completely transform access to finance, including through an inquiry that we will launch later in the year.

The final fear that I wanted to flag, which is coming through loud and clear to Committee members, is that the Government just do not work for business in the way that they need to. We have heard over and over again about one Department doing something that completely undermines the work of another, or one regulator doing something that completely undermines what a different Department or regulator is trying to do. We do not yet see anything about how we can knit Government together in a wholly new way in either the Green Paper on industrial strategy, or any of the commentary about the estimates. In the good old days, when I was Chief Secretary to the Treasury, what we were beginning to test— \p Andrew Griffith: There was no money left. \p Liam Byrne: Well, there was an awful lot more money than there is now. We certainly did not have a debt interest bill of £100 billion a year, which is what the bill has risen to, and why so many difficult choices are having to be taken. At that time, we were beginning genuinely to consider how to create single, pooled funds that came together from different Government Departments. A challenge for us in the House is that we have to reflect on the fact that we reinforce silos in Government, and do not reinforce joined-up Government. This estimates debate is a good example: we are considering the accounts of the Department for Business and Trade, but in an ideal world we would also have here Ministers from the Department for Science, Innovation and Technology, the Treasury, the Department for Environment, Food and Rural Affairs and a couple of other Departments, and we would ask those Ministers how they were working together to deliver a joined-up offer to our business community, because businesses have not got time to muck around and deal with all the red tape; they are trying to build a business. \p Joe Morris: I thank my right hon. Friend for giving way—he has given way a few times already. When I speak to businesses in my constituency, I pick up that young people who want to remain in the most rural communities simply cannot get to the jobs that they want to get to, and that businesses in rural settings have real trouble accessing a lot of the help that he refers to. Does he believe that one of the particular sins of the past 14 years is that the business climate has been unfriendly to business, and particularly unfriendly to small rural businesses? \p Liam Byrne: My hon. Friend is right, but we have to look to the future. We have to understand how Government will connect together and ensure a transformation in regional transport and connectivity. So many parts of our country are bedevilled by a lack of internet connectivity, so they cannot access the kind of applications that might give them access to artificial intelligence, for example, or to international markets. They cannot get access to the internet full stop. We have to think boldly about how we join Government together in a revolutionary way.

Finally, I wanted to mention the Post Office. When we look at these accounts in the round, we see a 44.8% increase in the amount allocated, taking the figure up to nearly £6 billion a year. That is partly driven by £444 million for the British Business Bank, but it is overwhelmingly driven by about £1.3 billion extra for the Post Office. The good step has been taken of increasing funding for the Post Office compensation scheme, but that money is still not going out the door fast enough. I accept that that has improved, but the Committee will return with some tougher questions for Ministers in the light of their response to our recent report.

My final point, which I urge on both the Minister and his colleagues in the Treasury, is that we cannot transform the Post Office into the organisation it could be by drip-drip-dripping the funding for modernisation through to it. The Post Office needs a proper five-year to 10-year funding plan so that it can genuinely become the organisation that it could be. When these accounts  were published by the Department, they were qualified and late. I know that civil servants have to work hard to iron out a number of problems, and we have asked the permanent secretary for monthly updates on how he is doing in bringing the kind of clarity that this House should expect. I thank the civil servants and the Department for the extraordinary work that they do; they are absolutely mission-critical to the hopes of so many of us in this country and to our becoming the fastest-growing economy in the G7. \p Caroline Nokes: I will have to put Back-Bench Members on an immediate five-minute time limit, which may well go down in due course. \p Alison Griffiths: I will do my very best to reduce the comments I was going to make, Madam Deputy Speaker. I pay tribute to the Chair of the Business and Trade Committee, the right hon. Member for Birmingham Hodge Hill and Solihull North (Liam Byrne), for his very thoughtful comments, which reflect the considerations of our Committee.

Business is the lifeblood of our economy. It creates jobs, funds our public services and drives the success of our country, yet under this Government, businesses face an onslaught of damaging policies that threaten growth, confidence and livelihoods. The Government’s £25 billion national insurance jobs tax is making it more expensive to hire workers, their family business tax punishes those who drive local economies and their 1970s-style employment laws are stifling business growth. The result? The fastest rate of job losses since 2008.

Instead of supporting enterprise, this Government are actively making it harder for businesses to thrive. The budget of the Department for Business and Trade is being slashed by 6%, which means less support at a time when firms need it most. The so-called Employment Rights Bill—or, perhaps, the unemployment rights Bill—will cost the Government £1 billion, while its fair work agency could add an astonishing £6.3 billion burden. Those costs will inevitably be passed on to businesses and workers alike.

This is not just about numbers on a spreadsheet: these policies have real consequences—workers losing their jobs, families struggling with rising costs and businesses already being forced to shut their doors. The Government claim to support growth, yet their policies are driving firms into significant financial distress, with more than 632,000 businesses now at risk. That is a 32% increase in just one year.

The irony is that Britain remains an attractive place to invest. The PwC chief executive officer survey ranked us second only to the United States, but, alas, that survey took place before the Budget. A strong economy depends on strong business confidence, yet confidence in this Government’s economic management has been shattered. Businesses no longer trust that the Government have a clear strategy for growth, which the right hon. Member for Birmingham Hodge Hill and Solihull North has already mentioned.

The numbers speak for themselves. More than 200 leading hospitality and retail firms have warned that Government policies will force them to cut jobs and scale back investment. Businesses face ever-changing regulations, increasing tax burdens and a Government who appear out of touch with their needs. \p Ashley Fox: My hon. Friend refers to the increase in regulation. The Government’s Employment Rights Bill, which I have in my hand, is 192 pages long. Only this week, Government amendments totalling 216 pages have been tabled for this House to consider in two days next week. Does that not present any business with a vast quantity of new regulation to consider? \p Alison Griffiths: My hon. Friend is absolutely right. The time that we have next week to consider this number of amendments seems wholly inadequate.

Businesses are facing ever-changing regulations and increasing tax burdens. Many have said that they were misled—duped—into believing that this Government were pro-business when their actions tell a very different story. Analysis by the Nuffield Trust has found that if the fair work agency were to increase social care workers’ wages to match the NHS Agenda for Change band 3, the cost could be as high as £6.3 billion, including an increase to the real living wage costing £2.2 billion. That is another measure in the out-of-touch Employment Rights Bill. It is as if the 32 members of the Cabinet have a very limited understanding of the private sector and of business as a whole.

Business owners, entrepreneurs and workers do not need more red tape and tax hikes. They need a Government who understand that growth does not come from the state dictating terms, but from unleashing the potential of enterprise, and they need policies that encourage investment, not deter it. Businesses in my constituency of Bognor Regis and Littlehampton are already struggling with the global impacts on their business environment, let alone the challenges at home. The day one rights given by the Employment Rights Bill give the presumption of innocence to workers and the presumption of malevolent intent to employers. The reality is that neither is correct.

The Government need to understand that when business thrives, Britain thrives. That is the only way in which we will restore confidence, protect jobs, and secure a growing economy. \p Gregor Poynton: I speak today as a member of the Business and Trade Committee and as the MP for Livingston constituency, determined to see this Department play its vital part in delivering the Government’s No. 1 mission of economic growth and economic renewal, all underpinned by a pro-worker, pro-business approach. One of the crucial elements in delivering that mission is the delivery of a modern and ambitious industrial strategy. It is towards that industrial strategy that I will primarily address my remarks.

It is my belief that the UK economy is in a moment of peril. Fourteen Tory years of underfunding, instability, and a lack of investment in our people and infrastructure have left us with anaemic growth. If we do not get the next few years right, that trend will continue, despite the best efforts of our business leaders and our workers. However, I also see opportunity. The Business and Trade Committee went around the country gathering evidence for our report and speaking to those with a stake in our economy—from sole traders to global corporates, from trade unions to academics. Time after time, we heard and saw the same thing: the huge optimism and potential for our country and the businesses that  power it. What those people wanted from Government was stability, predictability and coherence. If we as a Government can provide that, they believe that they can unleash our country’s potential.

There was universal positivity about the Government’s focus on an industrial strategy—a belief that it will drive investment, create high-quality jobs and ensure that businesses, including those in my constituency of Livingston, thrive in the economy of the future. Economic prosperity does not happen by accident; it takes businesses, business leaders and workers. It requires vision, leadership, and a Government willing to invest in the industries that will power our future. The Green Paper sets out how the strategy will support growth sectors, drive productivity, and ensure that Britain remains a world leader in financial services, fintech, manufacturing, green technology, life sciences and more. These are not just abstract commitments; they have tangible benefits for people and businesses in my constituency of Livingston, and across Scotland and the wider UK.

Take, for example, the significant opportunities in Scotland’s renewable sector. With the right industrial strategy, we can fully harness the nation’s potential in onshore and offshore wind, hydrogen production, sustainable aviation fuel and battery technology, creating well-paid, secure, future-facing employment across Livingston constituency and elsewhere that benefits workers, families and communities alike. Contrast this approach by DBT and the wider Labour Government, rooted in a long-term strategy and tangible investment, with the record of the SNP Scottish Government over the past 18 years. It is frankly staggering that Scotland— a country with truly extraordinary economic potential, not least in the area of renewable energy—still lacks a dedicated industrial strategy. Not only that: under successive First Ministers, businesses of all sizes were shunned, and their growing concerns about Scottish Government economic policy were ignored. \p Chris Law: Will the hon. Member give way? \p Gregor Poynton: Go ahead—I would like to hear the hon. Member’s intervention. \p Chris Law: I am glad that the hon. Gentleman would like to hear it. What I just heard was breathtaking. I remind him that Scotland’s economy is one of the best performing in the UK. Since 2007, Scotland’s GDP per person has grown by 10.5%, outperforming the UK’s 6.5%, while productivity has risen at an annual rate of 1%. I would be curious to know what figures he is working from, because it is a topsy-turvy world, since Scotland has had the highest rate of foreign direct investment in the UK for the past nine years in a row outside of London. \p Gregor Poynton: I am afraid the hon. Member often falls into the trap of thinking that being just a little bit better than the Tories is good enough for Scotland. I see Scotland as much more than that.

While this Government are providing businesses with the certainty that they need to plan for the future, the SNP has been content to manage decline without a plan to stimulate growth or attract investment. It failed on delivering green jobs, despite grand promises on renewable  energy that never materialised, and failed to support manufacturing, leaving companies without backing. Contrast that with the UK Labour Government’s crucial action to protect jobs and investment at Grangemouth, a site of huge economic importance to Scotland. The Prime Minister’s announcement of £200 million from the national wealth fund represents a clear and unequivocal commitment to ensuring that Grangemouth remains a hub of economic and industrial activity. This investment will not only safeguard existing jobs but unlock new opportunities in green energy and advanced manufacturing.

That is Government working in the interests of business, workers and our long-term prosperity. It is in that spirit that I hope and believe that Grangemouth will become a central part in DBT’s industrial strategy and its thinking and work for years to come. The SNP Scottish Government and previous Tory Governments had years to act but failed to do so. They have squandered opportunities and failed to plan for Grangemouth or for Scotland’s economic future. This Labour Government have stepped up and secured a future for Grangemouth workers, providing them with a training guarantee and working with industry partners to build long-term resilience for the site. The contrast could not be sharper.

I look forward to working with my dedicated and talented collegiate Committee colleagues from all parties as we continue to scrutinise the work of the Department. This Government are committed to driving growth and building an economy that works for everyone. The opportunity to get ahead is what everyone wants for their family. That is why I am in politics, driven to ensure that no one in this country is held back by their circumstances. A modern industrial strategy is key to making that happen. \p Caroline Nokes: I will now reduce the time limit to four minutes. \p Peter Fortune: I regularly meet business owners big and small across Bromley and Biggin Hill. The story is the same no matter who I talk to, be it big franchisees, independent care providers or small family-owned start-ups: British businesses do not feel supported by this Labour Government. Instead, they feel hamstrung by Labour’s tax rises and red tape. The Department for Business and Trade’s budget may be over £3.3 billion, but any business will say that things are getting worse, not better, under Labour.

I have lost count of the number of local enterprises who have told me that they have stopped recruiting, and are making redundancies, delaying investment and increasing prices, all after Labour’s tax-raising budget. That should not come as a surprise to the Government. Hiking employers’ national insurance contributions by £25 billion will cost jobs. Imposing reams of new employment red tape will deter businesses from hiring. There may only be one Cabinet member who has started their own business, but this is simple stuff. If they make it more expensive and difficult to hire and grow, businesses will not hire or grow. That is what anti-business, anti-growth Government look like. Labour’s policies are causing economic growth to slow down, unemployment to rise fast and inflation to increase again.

Bromley and Biggin Hill has nearly 4,800 small businesses. They are the lifeblood of the local economy. If they thrive, our community succeeds. If they fail, our community suffers. But Labour is making their jobs harder, as it is for small businesses across the country. A new survey by the Federation of Small Businesses shows that a third of small employers plan to cut jobs, with nine in 10 worried about Labour’s Employment Rights Bill. Small business confidence has also fallen to a record low because of the pandemic, with confidence among small firms plummeting more in London than in any other English region. This Labour Government are not helping businesses to deliver economic growth; instead, they are taxing them to the very brink. \p Sarah Edwards: As a member of the Business and Trade Committee, I am pleased to share the Committee’s priorities for this Parliament, and the way in which the evidence that we have gathered has shaped our work plan. I recently hosted a roundtable in Tamworth with local businesses and, given our close relationship with West Midlands combined authority, I also invited our mayor, Richard Parker, to discuss his plans for skills development across the region. One of the main themes that emerged from our discussion was the difficulty that businesses experienced in finding the right workers.

With the transition to a greener, more digital economy, businesses need a skilled workforce. The Minister’s recent announcement about making apprenticeships shorter, more agile and tailored to business needs responded directly to what we have heard across the country. In Tamworth, I spoke to representatives of Kier Group and Simpson Strong-Tie to explore how we could encourage young people, especially women, to consider the construction sector. With clearer pathways, we can ensure that the skills needed to support economic growth and deliver the housing and infrastructure that our country needs are in place.

A great example of regional success is Cornerstone Partnership, a social housing developer in Tamworth. With support from the combined authority, it has been able to access finance through loans, demonstrating how devolved powers can direct resources effectively. However, challenges remain for smaller businesses that struggle to access finance from institutions such as the British Business Bank or face barriers when exporting. I should like to hear a little more from the Minister about how businesses will be enabled to access the additional £415 million for the bank.

I also spoke to PI-KEM, a small company in my constituency that started with five employees and now exports globally from its base in Tamworth. In just over a decade, it has increased its workforce to more than 30 employees. Despite that success, it faces long waits for suitable industrial units. Many businesses whose representatives I have spoken to are in a similar situation, unable to find mid-range industrial space to grow into. Small and medium-sized enterprises are the backbone of our economy, constituting 99.8% of all private sector businesses, but they are under immense pressure, especially with rising costs and energy challenges.

The energy crisis has hit businesses hard, especially in sectors such as hospitality. I hear time and again that energy bills are forcing businesses to close. The good  news is that, as of December 2024, the Energy Ombudsman can represent businesses with up to 50 employees, expanding its reach beyond just microbusinesses. I am currently working with the ombudsman on behalf of one of the microbusinesses in my constituency, which has faced unfair back-billing practices by its energy supplier.

Our high streets have been affected by business closures, but in Tamworth we have embraced our heritage as a driver of regeneration. Our unique selling point is our history and heritage, and we are using it to bring businesses back to the town. For instance, our grade I listed St. Editha’s church and Tamworth castle can be key drivers of growth. Local businesses have collaborated on events such as the Athelstan 1100 festival, which brought the community together and attracted visitors. With the Government’s £270 million funding for the Arts Everywhere programme, towns such as Tamworth can continue to showcase their heritage, support local businesses and regenerate town centres.

There is much more to discuss, but let me end by saying that whether it is a question of improving access to finance, supporting digital transformation or helping businesses to export, with the right support we can achieve sustained growth, but we must remain agile in the face of an unpredictable global context. \p John Cooper: I, too, am a member of the Select Committee.

Perhaps no other Department has an impact on the lives of so many Britons. The economy affects each and every one of us, and when the Government’s No. 1 priority is the fastest sustained economic growth in the G7, then—to use football parlance—the Chancellor is the midfield general and the Department for Business and Trade is the big striker in the opposition box. The rest of us—all of us—have a spot on the terraces, but oh dear! We have barely kicked off, and we are pinned in our own half.

Where is business confidence, given that less than a quarter of the businesses that cheered Labour on, signing a letter ahead of the election, are still waving their red scarves? One said that it now feels “duped”. What of the financial back-up? The eye-catching headline figure in the supplementary estimates is that the Department has been allocated a total funding increase of £1.8 billion, yet that money is largely earmarked for Post Office compensation. It is absolutely right and proper that the victims be compensated quickly, but there should be no pretence that the money is a shot in the arm for DBT.

Although the extra £440 million for the British Business Bank is good news, is it enough? This country lacks not for start-ups but for scale-ups, and we hear time and again that a lack of finance from risk-averse banks is the block. Scale matters. The Business and Trade Committee heard only yesterday that although work by the previous Government had created an ideal environment for the emerging technology of quantum computing, Britain has earmarked a few billion pounds for the sector—impressive, until one hears that the United States is injecting over $50 billion. The US’s R&D spend alone is perhaps seven times our total budget in this field.

No Government are ever in full control of events, and the storms of war are howling. Even as this Government’s industrial strategy is being shaped, defence is now the utmost priority. If we as a nation are not secure, we are  not a nation. Wars are fought in trenches and on myriad battlefields, but they are won in boardrooms and on the shop floors and shipyards of industry. Economic growth, then, is a key arrow in the British quiver. But do these estimates give us hope for growth? Rather than confidently striking out for new global deals, Britain today looks like a cork in a storm-tossed sea—at the mercy of events, and not their master.

On a Business and Trade Committee visit to Brussels, we explored what the Government might expect of their much-vaunted reset of relations. Troublingly, Britain lacks for any clear definition of its ask beyond warm words about defence and security, yet the EU, being made up of good protectionists, already has an invoice drawn up.

We have acceded to the comprehensive and progressive agreement for trans-Pacific partnership—that is not easy to say, especially with these teeth. It covers a bloc of over 500 million people and includes countries such as Australia, Canada, Japan and Singapore, and economies that are ripe to bloom, such as Vietnam and Malaysia, in contrast to the sunset economies of Europe, which have sclerotic growth. Yet we are told that trade deals take up British GDP only marginally. We lack ambition. \p Alison Griffiths: I want to follow up on my hon. Friend’s comment on international trade. Does he agree that the Government currently lack the capability to support businesses appropriately in international trade? \p John Cooper: I completely agree that much more needs to be done on international trade. As I said, we lack ambition in this field, because we base so much of what we expect on previous deals. Frankly, there has never been a deal like CPTPP, the putative deal with India and the dripping roast that is a free trade deal with the US.

The Department for Business and Trade needs to step up, not be beaten before we even start. Growth is the destination that we in this House should all agree on; the path there is where the disputes lie. We are in an economic relegation zone after a dud Budget. Can the Department for Business and Trade help pull off the shock result that we all need? Britain’s got talent, and the Department for Business and Trade can boost it. \p Sonia Kumar: As a member of the Business and Trade Committee, I welcome this debate and the opportunity to look at our priorities for the future. Small and medium-sized businesses make up 99.9% of British businesses, employing over 16 million people. As the daughter of a greengrocer, my speech will focus on supporting SMEs to grow our economy.

It is crucial that the Government’s plan to deliver long-term growth includes digital inclusion, improving financial literacy, improving access to finance, workforce reskilling, and expanding the export-led growth capabilities of SMEs. Digital exclusion is not just a social problem, but an economic one. The Government’s digital skills plan recognises that businesses and workers must be equipped with digital capabilities to drive growth, yet millions of adults and thousands of businesses lack the digital skills and financial literacy needed to compete in both today’s and tomorrow’s economy. They face barriers to digital adoption, including cost, lack of awareness and difficulty accessing Government support.

I have spoken to several businesses in Dudley and I recently held a networking event, and those from small businesses repeatedly said that they do not have the time to learn digital skills, and using social media as part of their marketing strategy was walking into the dark. SMEs also face barriers in accessing finance to scale up and enter new markets abroad.

I support the Business and Trade Committee’s priorities, so will the Department agree to spend on expanding financial incentives, as Governments must make grants, R&D tax reliefs and digital adoption funding easier to access, especially for SMEs outside London and the big cities; to focus on financial literacy so businesses can thrive; to streamline public procurement as too many tech SMEs struggle to win public sector contracts due to the overly complex processes; and to have initiatives for businesses to access finance, whether that is seed money or scaling up to export? Lastly, will the Government commit to maximising opportunity in the industrial strategy for all towns like Dudley to ensure that no town is left behind on this journey to economic prosperity? \p Several hon. Members: rose— \p Caroline Nokes: Order. There is now a three-minute time limit. \p Chris Law: Obviously, increasing investment in Scotland’s economy is crucial to delivering the SNP Government’s priorities, which are improving public services, supporting a thriving economy, tackling the climate emergency and eradicating child poverty. I want to put this on the record again, just to be very clear in this House about the facts: Scotland’s economy makes it one of the best-performing parts of the UK. Its GDP has outgrown the rest of the UK by 50% since 2007, and productivity is at an average rate of 1.1%. It is vital that the spending of the Department for Business and Trade complements the Scottish Government’s efforts to increase investment and ensure economic prosperity.

Increasing trade and attracting inward investment are critical for Scotland. In 2023, Scotland secured a record number of foreign direct investment projects, maintaining its position as the top performing UK area outside London for the ninth year running. According to Ernst and Young’s annual analysis, 142 FDI projects were secured in Scotland, which is double the UK’s growth rate. Scotland is clearly the best place to invest in these islands. However, this success must not be jeopardised by decisions by the UK Government. Obviously, the pressure employers are feeling on national insurance is negatively impacting on Scottish businesses, limiting their capacity to contribute to the economy. This tax on jobs undermines efforts to support businesses, entrepreneurs and investment.

Labour’s political choice to remain outside the EU single market and customs union is costing the UK billions every year. Brexit—a decision Scotland never voted for— continues to hurt Scottish businesses, trade opportunities and economic prospects. A January 2025 analysis by the office of the chief economic adviser estimates that Brexit trade barriers could cost Scotland £4 billion, with exports potentially down 7.2% or £3 billion compared  with EU membership. Scotland’s future therefore lies in the EU and the European single market. The Labour Government must acknowledge that standing outside the EU is driving down investment and growth.

This will be crystalised by the potential trade war being initiated by President Trump as part of the “America first” trade policy. Free trade, a long-established principle, is under significant strain, bringing uncertainty for trade, with the USA and other nations imposing tariffs. I would speak about the vulnerable whisky industry, which needs to be revisited. I heard only today that the Government are withdrawing the idea of making English whisky a single malt, and I am pleased to hear that.

I will finish by saying that the UK must recognise the value of Scotland’s industries and potential emerging sectors. Scotland is at the forefront of the energy transition and cutting-age technologies, presenting substantial opportunities for future growth. I look forward to hearing more about investments in Scotland, particularly in those sectors. \p Amanda Martin: It was interesting to hear from the hon. Member for Dumfries and Galloway (John Cooper) about the importance of shipyards. Portsmouth was once—from 1511 to 2014— a fantastic shipbuilding city, with a strong tradition of building some of the greatest ships. It played its part by repairing and refitting over 1,600 ships during the first world war. After Labour’s commitment in 1998 to build the Invincible class aircraft carriers, in 2011 Pompey shipbuilders played a crucial role in the construction of the two new aircraft carriers by helping to build 6,000-tonne sections of the midship of HMS Queen Elizabeth. I am proud to say that my son is currently serving on that ship.

But like so many other parts of this country, Portsmouth has been let down. Under the previous Government, despite Portsmouth being the home of the Royal Navy, the heart and industry of my city of shipbuilding was cut away. In 2014, shipbuilding was taken from Portsmouth, and it has left a deep scar. The answer to the industry being removed was to have a Minister for Portsmouth. Despite having three token Ministers for Portsmouth given to us under the previous Government, charged with bringing economic growth to the city, Portsmouth under the Tories was failed again and again and again. Ten thousand adults in Portsmouth North are living on the minimum wage, a stark reality showing a lack of economic growth and strategy in my city to ensure jobs for local people.

Nelson once said, “England expects”. Madam Deputy Speaker, Portsmouth expects. It is refreshing to see a Government—a Labour Government—identifying the need for an industrial strategy across the country. While we may not return to shipbuilding in its same volume and while we may be in the south-east, we are unique and we need a strategy and action. Will the Minister outline what difference he sees in this Government’s modern industrial strategy from those that have been tried —or should I say in the case of my city, not tried— so that my city and the people in it can see a future  of growth, investment, security and well-paid jobs for themselves, their families and future generations? \p Ashley Fox: The Government were elected eight months ago with a promise to go for growth, but so far most of their policies seem designed to make life more difficult for business. Their £25 billion national insurance jobs tax is a direct assault on the businesses that create jobs. The increase in capital gains tax, the introduction of the family business tax and the family farm tax all discourage entrepreneurship.

The 1970s-style employment laws are slowing  business growth and discouraging job creation. Labour’s Employment Rights Bill will increase costs to businesses by £5 billion, borne mostly by small businesses. Take day one rights. If, after less than one week, it becomes apparent that a new employee is the wrong fit for a business, a complicated process must be followed to dismiss them. Speaking as a former—though fully qualified —solicitor, I know the businesses that will be hit hardest are the ones with no human resources department. Get the process wrong, and they could be taken to court for unfair dismissal. Another example is the obligation for the employer to notify an employee in writing that they have the right to join a trade union. Is that something we would reasonably expect from the local publican, or the proprietor of a family newsagent? In what world is that really going to occur? Yet if it does not occur, those small businesses will on the hook for an additional four weeks’ salary in damages. That will have brutal consequences for very many microbusinesses and will deter them from employing people.

The Bill also establishes an advisory board for the enforcement of labour market rules. That body will advise the Secretary of State on matters relating to the labour market. It is an expensive and pointless exercise. The Secretary of State has plenty of avenues to collect advice already. There will be a complicated process for selecting members of the panel, which will consume considerable amounts of civil service time and money. The members of the board will be paid hundreds of pounds a day. This is a sham process designed to allow the Secretary of State to hand out sinecures to receive advice on strategy from his union friends that he could have got for free.

The first instinct of this 1970s-style old Labour Government is to regulate, to stifle innovation and to back the unions over business every time. We Conservatives will stand up for business and the people who make the economy work, and will continue to champion its success. \p Cameron Thomas: I hope the hon. Member for Portsmouth North (Amanda Martin) will pass on my thanks to her son for his service. I do wonder how Lord Nelson would feel about the increasing necessity for us to align with our English channel neighbours.

Labour’s national insurance hike will hit small businesses, social care providers and local GP services across the country. This rise will have dire consequences for the many historic villages and towns of my rural constituency. In recent years, small businesses have increasingly been forced out of our historic high streets and replaced by soulless international chain stores and restaurants with the resources to cope with inflation. Over time, our high streets are losing their unique character.

Among the small businesses that will suffer are pubs and breweries, which generate approximately £15 billion of tax revenues each year. According to UKHospitality, the economic value of the hospitality industry in Tewkesbury is £67 million a year. Last month, I visited the Plough in Prestbury, where I spoke with the landlord, Emma, who told me that this one establishment is worth £100,000 a year to HMRC. Having diversified and restructured to the nth degree, she is now accumulating debt to stay solvent. The pub is also her home. How do the Government expect to accrue revenue if they tax such businesses into oblivion?

Small local businesses are vital to the unique identities of rural high streets across the country. They are often the backbone of local economies, and it is important that we do not inadvertently force them to the wall. This single policy will have such an outsized impact—I hope the Government will review this decision with economic growth in mind. \p Caroline Nokes: To wind up for the Liberal Democrats, I call Clive Jones. \p Clive Jones: I offer my thanks to the Chair of the Business and Trade Committee, the right hon. Member for Birmingham Hodge Hill and Solihull North (Liam Byrne), for delivering a powerful opening speech and for securing this important debate. I absolutely agree that public procurement should be more focused on buying British, and that access to finance needs to be improved sooner rather than later, so that our defence industries can upskill and respond to what is going to be a growing need. The Department for Business and Trade is synonymous with what Britain truly needs. Britain needs growth—most of us in this Chamber will agree with that. Businesses need confidence in the UK as a place to invest.

We have a Government who are staring stagnation in the face and failing to learn the lessons from the Conservative party’s economic vandalism, which stretched household finances to the brink. Businesses are now left bracing for further pain once the Chancellor’s job tax comes into force. Like many others, I am particularly concerned about the impact it will have on the hospitality sector and the great British pub. Last Saturday, I visited the Station Tap in my constituency, which has been a pub for 150 years. While I pulled one of the worst pints of my life, the owners shared their concerns about the Budget. The rise in national insurance contributions for just this one pub will add £12,000 to its business costs every year. It is no wonder that in a survey by the British Chambers of Commerce, 82% of firms said that the rise in national insurance contributions will impact their business, forcing them to change their plans, make redundancies and stop investing in people and in growth.

Changes to NICs were not the only issue with the Budget that the Station Tap’s owners raised with me. It is overwhelmingly obvious that business rates are broken. They asked me to give a clear message to the Minister that business rates are outdated and need meaningful reform—most importantly, sooner rather than later. We would not be in a position where I seemingly have a new business raising this matter with me every week if the Government were getting on with the work quickly.  The owners are especially concerned about the planned reduction in relief for hospitality, which could cost independent publicans £3,000 to £5,000 a year.

Other businesses in Wokingham warned that the loss of the relief could see their businesses pushed to the brink. Wokingham has some of the best pubs in the country—The Queen’s Head, the Queen’s Oak, the Duke’s Head and the Walter Arms, to name just a few. The Government should be championing those pubs. What steps are they taking to monitor the impact of the reduction in business rates relief, and the rise in national insurance contributions on pubs? If the Minister’s monitoring reveals that this Government’s policies are leading to a higher rate of business closures or are deterring investment, will he implore the Treasury to reverse the taxes and, instead, tax the big banks, implement a proper tax on the super-profits of oil and gas companies and tackle tax avoidance by properly investing in His Majesty’s Revenue and Customs?

People across the UK are watching with concern as the United States engages in economic sabotage of the global economy. In the UK, Britain’s steel sector is bracing itself for the pain of Trump’s tariffs, which are set to be applied next week. This will negatively impact our manufacturers, forcing price rises or reduced sales to the United States. Will the Minister urgently update the House on his Department’s efforts to ensure that the UK is excluded from the steel and aluminium tariffs?

It would also be helpful to understand what retaliatory action the Government would take if these tariffs were applied and whether it would include some action against Elon Musk’s Tesla. Nobody wants a trade war. It is bad for business, bad for consumers and bad for diplomatic relations. However, if we are to be attacked, we must ensure that we simply do not take it on the chin. That is why I admire the confidence of our great Commonwealth and NATO ally, Canada.

Donald Trump is trying to undo our western alliance, threatening to annex a nation that shares our King, and seeking to weaken its economy as a staging ground for that proposed takeover. The Canadian Prime Minister and the Leader of His Majesty’s Opposition in Canada are united in wanting to be at the negotiating table to get the deal done with the UK as soon as possible. As for Canada becoming the 51st state of the USA, I do not know any Canadians who are interested in that. \p Caroline Nokes: Order. I remind the Liberal Democrat spokesman to bring his remarks to a close so that we have time to hear from the Minister and the shadow Minister. \p Clive Jones: Thank you, Madam Deputy Speaker.

We need to take action to deepen bilateral trade with Canada. Does the Minister share Canada’s sentiment about strengthening our economies? Does he agree that we need to take tougher action to stand up for our Canadian friends? Will the UK return to the negotiating table and start working on a trade deal with Canada as soon as possible? \p Caroline Nokes: I call the shadow Minister. \p Harriett Baldwin: I shall try to make my speech short and snappy, Madam Deputy Speaker. I congratulate the right hon. Member for Birmingham Hodge Hill and Solihull North (Liam Byrne) on securing this afternoon’s debate, which has allowed many Members to articulate the concerns that they are hearing from businesses in their constituencies and enabled them to talk about the great importance of growth.

Growth is essential. We talk about the importance of defence and of increasing spending on it from 2.5% to 2.7% and then up to 3%, but of course we want the economy to grow at the same time. In the estimates before us today, the Secretary of State has laid out his ambitious goals for his Department. First, on the aim of delivering a comprehensive industrial strategy, I simply ask, eight months in, when will businesses see that. Secondly, on a plan to provide small businesses with tools and support, I simply ask, eight months in, when will small businesses see that. Thirdly, on a trade strategy that recognises that high-quality trade deals are necessary to give businesses access to international markets to boost jobs and deliver economic growth here, I simply ask when businesses will see a change on that front. Fourthly, on delivering sweeping changes to employment law, I have to say that, sadly, businesses have seen that. They have seen that the sweeping changes outlined in the Employment Rights Bill, which we will be scrutinising next week, will take us back to 1970s-style employment laws, adding £1 billion in costs just to the Government’s cost base alone. I wonder, Madam Deputy Speaker, whether at the end of the debate you might share a few words on whether it would have been appropriate for those hon. Members who receive contributions from unions to have declared them in the debate. We have had an excellent debate, but I did not hear any declarations of interest.

I heard excellent contributions from those on the Conservative Benches—from my hon. Friends the Members for Bognor Regis and Littlehampton (Alison Griffiths), for Bromley and Biggin Hill (Peter Fortune), for Dumfries and Galloway (John Cooper) and for Bridgwater (Sir Ashley Fox). They outlined and summarised the challenges that businesses face up and down the country. In contributions from the hon. Members for Tamworth (Sarah Edwards), for Dudley (Sonia Kumar), for Livingston (Gregor Poynton), for Portsmouth North (Amanda Marton), for Dundee Central (Chris Law), for Tewkesbury (Cameron Thomas) and for Wokingham (Clive Jones), we heard a range of concerns felt by real businesses that create the wealth of this country.

I turn to trade. I note that, in the supplementary estimates, the Department marks an increase under sub-head A4, the account that includes first and foremost the trade policy implementation and negotiations group. The note explains that the increase is owing to

“An international reorganisation within DBT which has brought our International Strategy and Development teams into this group from Strategy and Investment.”

Strategy and investment, meanwhile, have been cut by almost the same amount that this account has been increased by. I wonder whether there is a little bit of smoke and mirrors going on when it comes to the amount dedicated to increasing trade.

Increasing trade is one of the key routes to economic growth. Businesses in our constituencies would really benefit from further opening up of free trade. I note the welcome news that the Prime Minister talked to the President of America about a free trade agreement last week, but as of the end of January, no official or Minister from the Department had made any attempt to engage with the US Administration on trade. The Department has chosen to abandon the position of chief trade negotiator, which is either deliberate self-harm or wilful incompetence.

There was almost no public recognition by the Department or its Ministers of the UK’s accession to the comprehensive and progressive agreement for trans-Pacific partnership, which does indeed trip off the tongue. There is growing evidence that instead of investing in opportunities for trade with the US, Canada and the fast-growing markets of Asia, the Government are reverting to their ideological safeguard, relying on Brussels, and developing a Trojan horse strategy to realign the UK with the European Union.

Is the Department actually being given the tools that it needs to deliver on trade deals? If the Government claim to have set their sights higher, should not the resources reflect that? I worry that we are seeing a classic example of big words, big ambitions and Ministers just saying the word “growth”, but nothing taking place that actually delivers growth. It is eight months to the day since those on the Labour Benches entered Government. How many businesses in this country can say that things have got better for them in the last eight months? How many are more confident? How many can say that they expect the trade situation facing the United Kingdom to improve? \p Justin Madders: First, I thank my right hon. Friend the Member for Birmingham Hodge Hill and Solihull North (Liam Byrne), and indeed the hon. Member for Dumfries and Galloway (John Cooper), for securing the debate, and for the work that they do on the Business and Trade Committee. The hon. Member for Dumfries and Galloway littered his speech with football analogies, to the extent that I wondered whether you were going to show him a red card, Madam Deputy Speaker, but you did not. He made many criticisms of the Government, but all I would say is that we are not even at half-time yet. Let us wait until we get to the end of the match. There were a number of important and interesting contributions to the debate. I will try to address as many of them as I can in the time that I have.

It is clear that the Department is central to driving economic growth, ensuring that we remain competitive on the global stage, and making work pay for everyone. The Government’s growth mission has been our top priority since day one of taking office, because we understand that without economic growth we cannot invest in public services, nor can we raise living standards for hard-working families. To secure the growth that we need, we are guided by four key principles: building long-term stability; renewing our commitment to free and fair trade; easing the investor journey; and being a strategic, growth-focused state. We have wasted no time in getting to work on that, and in fixing the foundations of the economy. My Department has been at the forefront  of those efforts, and I will try to explain the things that we have done as I answer the points raised during the debate.

I start with the comments of the Select Committee Chair, my right hon. Friend the Member for Birmingham Hodge Hill and Solihull North. I was pleased to hear that he found terrific unity of purpose on the Government’s ambitions for growth. I join him in paying tribute to the civil servants who are helping us to deliver on those ambitions. He raised a number of important points. He talked about getting the right workforce, as did my hon. Friend the Member for Tamworth (Sarah Edwards). We will have a levy-funded growth and skills offer that will deliver greater flexibility for learners and employers. That will be aligned with our industrial strategy, creating routes into good, skilled jobs in growing industries.

As a first step, we will ensure shorter duration and foundation apprenticeships in targeted sectors. That will help more people to learn high-quality skills at work, fuelling innovation in businesses across the country and providing high-quality entry pathways for young people. We will, through legislation, reduce the minimum duration of apprenticeships to eight months, so that shorter apprenticeships are possible from August 2025. Trailblazer apprenticeships in green energy, healthcare and film and TV production will be among the first to take advantage of that new offer. Also, in response to calls from employers, assessment plans will be less burdensome, focusing on the must-haves for occupational competency, rather than testing every knowledge, skill or behaviour.

The Select Committee Chairman made an important point on an issue that I have been looking at carefully: how we harmonise regulation, make sure that we do not have different Departments talking to different people and saying different things, streamline, and ensure a cohesive environment in which businesses can invest and grow. He will be pleased to know that I have been meeting colleagues from other Departments, and particularly Lord Vallance, the Minister of State for science, research and innovation, who is looking at innovation in this area. We also now have Government growth boards, which are looking at this Government’s missions to ensure that that cross-departmental grip on matters.

The Select Committee Chair, along with my hon. Friends the Members for Dudley (Sonia Kumar) and for Tamworth, asked how we can use the British Business Bank to help businesses access finance. We are looking very closely at that. The bank is operationally independent, but we are working with it to ensure that businesses can navigate the market better and have clearer information and options available to them. There is also a package for encouraging tech adoption among SMEs, and we hope that the British Growth Partnership will get that pension fund investment into some of the UK’s fastest growing companies.

The Select Committee Chair asked about the figure of £126.7 million. My understanding is that it is the result of a revaluation of the Department’s investment portfolio. That is a standard process, and I am happy to put him in touch with officials for a more detailed explanation of that, if he requires it.

My hon. Friend the Member for Livingston (Gregor Poynton) asked about the Grangemouth refinery. It is deeply regrettable that we have had to step in and put  plans in place there. There is £100 million for the Falkirk and Grangemouth growth deal, which will help boost the local economy. There is a £1.5 million project to look at credible, long-term industrial options for the site, which we expect to report in the spring. The National Wealth Fund will also provide nearly £200 million of growth opportunities for the area.

My hon. Friend the Member for Portsmouth North (Amanda Martin) highlighted the devastating impact that a lack of a strategy can have on a community in her constituency. I join Opposition Members in thanking her son for his service in the defence of our nation. She will be pleased to know that our industrial strategy Green Paper, “Invest 2035: the UK’s modern industrial strategy”, sets out the eight key growth-driving sectors into which we want to channel investment and support in the long term. We want to unleash the full potential of those priority sectors to spur growth, spread wealth and drive up employment across all four nations of the UK. Each of the industries will have its own sector plan, setting out how we intend to support businesses, build on existing successes and unlock new opportunities. Those sector plans are being designed in partnership with business, devolved Governments, regions and other key parties. The industrial strategy, alongside sector plans for the growth-driving sectors, will be published later this year, and will be aligned with the multi-year spending review. \p Gareth Snell: The Minister is making an excellent speech setting out this Government’s ambitious plans. While he is looking at the industrial strategy and those eight high-growth areas, can I make a pitch for him to remember those foundational industries that sit below them, including ceramics? Without ceramics, refractories and those foundational industries, delivering the growth that the Department wants in those eight high-growth areas will simply be impossible. \p Justin Madders: I thank my hon. Friend for that intervention. I knew as soon as he rose that he would raise the subject of the ceramics industry, such is his record of championing it. I will certainly pass his comments back to the relevant Minister. \p Tom Collins: Working in industry, I have personally experienced the power of partnership between Government and industry when the Government set clear, powerful goals, and then collaborate with industry on delivering them. That has, in my experience, really fuelled innovation and is key to delivering the growth that we desire. Does the Minister agree that a partnership with industry, in which the Government set goals and we work together to deliver them, is key to delivering a successful industrial strategy? \p Justin Madders: I absolutely agree with my hon. Friend, and that is what we are attempting to deliver with our industrial strategy. Engagement with businesses is continuing on that. Publication will, I believe, be in the late spring, and we will ensure that it is a very successful launch.

I will draw my comments to a conclusion, but I want to acknowledge Conservative Members’ barrage of criticism for the Employment Rights Bill. I refer the House to my entry in the Register of Members’ Financial Interests,   just to make sure that the shadow Minister is not disappointed. No doubt we will debate the Bill in more detail next week, but I do hope that Conservative Members will have actually read it by then. They kept talking about going back to the 1970s, but the legislation that the Bill repeals is from 2023 and 2016, so we are going back to 2015 at best. I hope that they get some better lines before Report.

In conclusion, we are making the UK a more attractive and easier place in which to invest and do business through our expanded Office for Investment. Our sectors of the future are being emboldened through our modern industrial strategy, which will ensure that we have the right environment and skills for them to innovate, invest and create clean growth. Small and medium-sized businesses are being supported with the capital and conditions that they need to thrive, and millions of employees are being afforded greater protections at work, so that they can support their family and enjoy a higher standard of living, because we are determined to end the race to the bottom. I thank all Members for contributing to the debate, and I am grateful for the important work of the Business and Trade Committee. I look forward to continuing to work with it. I commend these estimates to the House. \p Liam Byrne: This has been an excellent debate. Let me once again say that I am incredibly grateful to the Backbench Business Committee for ensuring that we could spend time together debating the issues at stake. We heard some brilliant speeches from across the House. In a way, my ambitions for the debate were satisfied, because I wanted to ensure, after our report on the priorities of the business community, and having secured this debate, that we actually heard business voices in this Chamber, and in the corridors of power. We do not give enough time, space or attention to business voices, and to hearing about the challenges in boardrooms and on shop floors. If we did that a little bit more, it would surprise us how much consensus there is in this country about the big moves forward.

This is for the economic historians among us. We have to recognise that we are at one of those moments in history that occur every 30 to 40 years. We have a series of geopolitical shocks, and then we have a big, agonising debate about whether the country is in decline, whether it is all going to hell, or whether there is a different way forward, in which the country rallies together and chooses to build a different kind of sovereign capability. Inevitably, that has consequences for the kind of state that emerges. We went through this in the 1980s, the 1940s and after world war one. We have to conduct that argument now at a moment when it is clear that the United States—that great power, that great ally of ours, that built the multilateral system beginning in 1944 in San Francisco and then through to the end of world war two—in the words of Joseph Chamberlain, is a weary titan no longer able to grasp the orb of its fate. We have to recognise that for those of us who support that multilateral rules-based order, we will have to step up. That will be difficult and expensive, but it will bring new opportunities for business growth and, crucially, for our constituents to earn a good living.

The Deputy Speaker put the deferred Questions (Standing Order No. 54). \p UNKNOWN: Resolved,

That, for the year ending with 31 March 2025, for expenditure by the Department of Health and Social Care:

(1) further resources, not exceeding £7,956,143,000, be authorised for use for current purposes as set out in HC 655,

(2) the resources authorised for capital purposes be reduced by £1,140,958,000 as so set out, and

(3) a further sum, not exceeding £6,827,154,000, be granted to His Majesty to be issued by the Treasury out of the Consolidated Fund and applied for expenditure on the use of resources authorised by Parliament. \p UNKNOWN: Resolved,

That, for the year ending with 31 March 2025, for expenditure by the Foreign, Commonwealth and Development Office:

(1) further resources, not exceeding £592,196,000 be authorised for use for current purposes as set out in HC 655,

(2) further resources, not exceeding £439,129,000, be authorised for capital purposes as so set out, and

(3) a further sum, not exceeding £862,823,000, be granted to His Majesty to be issued by the Treasury out of the Consolidated Fund and applied for expenditure on the use of resources authorised by Parliament. \p UNKNOWN: Resolved,

That, for the year ending with 31 March 2025, for expenditure by the Department for Business and Trade:

(1) further resources, not exceeding £952,875,000, be authorised for use for current purposes as set out in HC 655,

(2) further resources, not exceeding £1,035,833,000, be authorised for capital purposes as so set out, and

(3) the sum authorised for issue out of the Consolidated Fund be reduced by £2,037,739,000.

The Deputy Speaker then put the Questions on the outstanding estimates (Standing Order No. 55). \p Caroline Nokes: With the leave of the House, I will put the Questions on motions 3 to 8 together. \p UNKNOWN: Resolved,

That, during the year ending with 31 March 2026, a number not exceeding 39,850 all ranks be maintained for Naval and Marine Service and that numbers in the Reserve Naval and Marines Forces be authorised for the purposes of Parts 1, 3, 4 and 5 of the Reserve Forces Act 1996 up to the maximum numbers set out in Votes A 2025–26, HC 638. \p UNKNOWN: Resolved,

That, during the year ending with 31 March 2026, a number not exceeding 97,940 all ranks be maintained for Army Service and that numbers in the Reserve Land Forces be authorised for the purposes of Parts 1, 3, 4 and 5 of the Reserve Forces Act 1996 up to the maximum numbers set out in Votes A 2025–26, HC 638. \p UNKNOWN: Resolved,

That, during the year ending with 31 March 2026, a number not exceeding 35,800 all ranks be maintained for Air Force Service and that numbers in the Reserve Air Forces be authorised for the purposes of Parts 1, 3, 4 and 5 of the Reserve Forces Act 1996 up to the maximum numbers set out in Votes A 2025–26, HC 638. \p UNKNOWN: [Relevant document: Eleventh Report of the Committee of Public Accounts, Excess Votes 2023–24, HC 719.]

Resolved,

That, for the year ending with 31 March 2024:

(1) resources, not exceeding £219,401,000, be authorised to make good excesses for use for current purposes as set out in the Statements of Excesses 2023–24, HC 657 and HC 725, and

(2) resources, not exceeding £2,417,000, be authorised to make good excesses for use for capital purposes as so set out. \p UNKNOWN: Resolved,

That, for the year ending with 31 March 2025:

(1) further resources, not exceeding £99,602,165,000, be authorised for use for current purposes as set out in HC 613, HC 655 and HC 661,

(2) the resources authorised for capital purposes be reduced by £25,436,251,000 as so set out, and

(3) the sum authorised for issue out of the Consolidated Fund be reduced by £1,683,639,000. \p UNKNOWN: Resolved,

That, for the year ending with 31 March 2026:

(1) resources, not exceeding £402,046,708,000 be authorised, on account, for use for current purposes as set out in HC 446, HC 605, HC 614, HC 656, HC 660, HC 662 and HC 706,

(2) resources, not exceeding £92,524,444,000, be authorised, on account, for use for capital purposes as so set out, and

(3) a sum, not exceeding £409,837,337,000, be granted to His Majesty to be issued by the Treasury out of the Consolidated Fund, on account, and applied for expenditure on the use of resources authorised by Parliament.—(Justin Madders.)

Ordered, That a Bill be brought in upon the foregoing Resolutions;

That the Chairman of Ways and Means, the Chancellor of the Exchequer, Darren Jones, Emma Reynolds and James Murray bring in the Bill. \p UNKNOWN: Presentation and First Reading

James Murray accordingly presented a Bill to authorise the use of resources for the year ending with 31 March 2024, 31 March 2025 and 31 March 2026; to authorise the issue of sums out of the Consolidated Fund for those years; and to appropriate the supply authorised by this Act for the years ending with 31 March 2024 and 31 March 2025.

Bill read the First time; to be read a Second time tomorrow, and to be printed (Bill 193). \p UNKNOWN: Motion made, and Question put forthwith (Standing Order No. 118(6)), \p UNKNOWN: That the draft Food and Feed (Regulated Products) (Amendment, Revocation, Consequential and Transitional Provision) Regulations 2025, which were laid before this House on 29 January, be approved.—(Vicky Foxcroft.)

Question agreed to.

Motion made, and Question put forthwith (Standing Order No. 118(6)), \p Caroline Nokes: I can inform the House that the Joint Committee on Statutory Instruments has considered the orders on motions 10 and 11 on capital gains tax and determined that they raise no issues that need to be reported to the House. \p UNKNOWN: That the draft Double Taxation Relief and International Tax Enforcement (Belarus) (Revocation) Order 2025, which was laid before this House on 3 February, be approved. —( Vicky Foxcroft.)

Question agreed to.

Motion made, and Question put forthwith (Standing Order No. 118(6)), \p UNKNOWN: That the draft Double Taxation Relief (Russian Federation) (Revocation) Order 2025, which was laid before this House on 3 February, be approved.—( Vicky Foxcroft.)

Question agreed to. \p Imran Hussain: I rise to present a petition on the minimum income threshold for partner and family visas, alongside a corresponding online petition,   signed by more than 420 residents in Bradford, declaring that everyone deserves the right to family life under article 8 of the European convention on human rights, and that it is fundamentally wrong that people are denied the ability to sponsor a spouse or family member to live with them because of an arbitrary income threshold that is now being reviewed by the Migration Advisory Committee.

Around half of all employees in the UK earn under the current frozen threshold of £29,000, including nurses, police community support officers and nursery teachers at the start of their careers, disproportionately impacting women and young people, who are unable to exercise their right to family life.

The petition states:

“The petitioners therefore request that the House of Commons urges the Government to take a compassionate approach to partner/family visas, withdraw the previous Government’s changes to the minimum income threshold, and ensure that any future threshold be accessible and no higher than the National Living Wage.

And the petitioners remain, etc.”

Following is the full text of the petition:

[The petition of residents of the constituency of Bradford East,

Declares that everyone deserves the right to family life under Article 8 of the European Convention of Human Rights and therefore the minimum income threshold for partner/family visas should be withdrawn.

The petitioners therefore request that the House of Commons urges the Government to take a compassionate approach to partner/family visas, withdraw the previous Government’s changes to the minimum income threshold, and ensure that any future threshold be accessible and no higher than the National Living Wage.

And the petitioners remain, etc.]

[P003049] \p UNKNOWN: Motion made, and Question proposed, That this House do now adjourn.—(Vicky Foxcroft.) \p Josh Newbury: It is a privilege to have secured a debate on a chronic but often misunderstood condition that affects many people across our country: the correlation between type 1 diabetes and disordered eating, known as “T1DE” for short. Separately, those two conditions are well-known and well documented, but together they exacerbate one another and can, in extreme cases, become a life sentence.

On an individual level, type 1 diabetes is a chronic autoimmune condition characterised by the pancreas being unable to produce insulin, meaning that those with the condition are required to carefully monitor their blood glucose levels and administer insulin. As we know, that delicate balance demands constant attention. Many of us have the luxury of going out for dinner and choosing a meal based on what we like the sound of—shamefully, in my case, often with too little thought to the sugar content, calories or how the body will digest it. For those with type 1 diabetes, however, that blissful ignorance simply is not an option. For them, life revolves around counting carbohydrates, monitoring blood sugar levels and injecting insulin. It is relentless. To put that into numbers, a child diagnosed with type 1 diabetes at the age of five faces up to 19,000 injections and 50,000 finger-prick blood tests by the time they are 18. Every moment of every day is a balancing act between food, activity and insulin. \p Jim Shannon: I commend the hon. Gentleman for securing the debate. I spoke to him outside the Chamber and he knows exactly what I am going to say. I have been a type 2 diabetic for almost 20 years, and I understand very well the fact that monitoring food intake is part and parcel of daily life. For those who suffer from an eating disorder, the constant food noise needs to be addressed by a professional, but diabetic clinics do not have the resources to deal with that. Does he agree that we need mental health support links for diabetics throughout the United Kingdom? \p Josh Newbury: It is a pleasure to take my first intervention from the hon. Gentleman. I pay tribute to him for his campaigning on this issue and the personal experience that he brings to the House. I will come later in my speech to my experience of mental health services. I absolutely agree that we need to ensure that people with type 1 and type 2 diabetes have all the support they need for their mental health and managing their condition.

For some, type 1 diabetes morphs into a the deeper challenge of disordered eating—it is not difficult to see how that can happen. Given the strict attention to diet and nutritional information that type 1 diabetes necessitates, unhealthily restrictive and avoidant approaches to food can sometimes, at least to begin with, be indistinguishable from healthy diabetes management. As we know, in some cases, one side effect of insulin-based treatment can be weight gain. That leads some people with type 1 diabetes to realise that by restricting their insulin intake, or even stopping it altogether, they can essentially eat  what they like and lose weight. However, the medical consequences of that are stark, including kidney problems, bone wastage, amputations, blindness and even death.

One of the most insidious aspects of T1DE is how difficult it can be to identify until its devastating consequences for both physical and mental health begin to manifest themselves. People suffering with T1DE often say that the isolation that comes with trying to navigate both a chronic illness and disordered eating is unimaginable for anyone who has not experienced it. \p Sarah Bool: I thank the hon. Gentleman for securing this debate. As someone with type 1 diabetes, having been diagnosed only four years ago I completely understand the feeling of isolation just from having diabetes, let alone having to deal with disordered eating as well. Does he agree that we need to destigmatise both conditions, so that we can ensure the right support for patients? \p Josh Newbury: I completely agree with the hon. Lady, and I thank her for the lived experience that she brings to this House, and for how candid she has been in sharing her experiences. I could not agree with her more.

Many people are falling through the cracks of a system that often fails to recognise the unique needs of people who live with both type 1 diabetes and disordered eating. While disordered eating in those with type 1 diabetes is sometimes referred to as “niche” or “rare”, it is becoming increasingly clear that it is simply under-recognised, and it is often missed. Evidence suggests that up to 40% of women and girls, and up to 15% of men and boys with type 1 diabetes experience some form of disordered eating. That is a quarter of the 400,000 people in the UK with type 1 diabetes. \p Alex McIntyre: My hon. Friend makes the important point that this issue affects so many people. I have direct experience with a family member who had type 1 diabetes and what, back then, was referred to as diabulimia. They could not get support because the medical profession did not accept that it was a condition. Does my hon. Friend agree that part of tackling this issue is recognising its impact on families across the country, as that is the first step to ensuring that people get the support they need? \p Josh Newbury: I agree with my hon. Friend. We need far better awareness of this condition, and better support for people affected and their families—I will come on to that a little later in my remarks.

As my hon. Friend said, a key issue we still face is the absence of internationally recognised criteria for T1DE, which hampers accurate diagnosis and classification, as well as collaboration and research. Within our NHS, pockets of fantastic practice have existed for a long time, but overall the current system often does not take account of the unique challenges faced by people with T1DE. Eating disorder specialists might lack the necessary understanding of diabetes management, while diabetes care teams may not be fully equipped to deal with the psychological aspects of eating disorders. The gap in knowledge and siloing of services means that people with T1DE sometimes come up against exclusion criteria and will end up disengaging from services at a critical point in their condition.

The need for joined-up, bespoke services is where the five NHS England T1DE pilot sites come in. Those trailblazing projects are combining diabetes and eating disorder support into one service, helping people to recover faster from T1DE and reducing repeated hospital admissions. That is where my interest in T1DE comes in, because in a past life I worked in the communications team at the Coventry and Warwickshire partnership NHS trust. When it was selected as one of the second wave of pilot sites, I had the privilege of working on preparations for the launch of the new service. Although I sadly moved on before the service was launched, that was a highlight of my years working for our NHS. What I learned about T1DE in those few months has stayed with me, as has the expertise and dedication of Dr Tony Winston and his team at the Aspen centre in Warwick, which is to be commended.

I pay tribute to CWPT and all the pilot sites for the pioneering work they have done to develop these services from the ground up, co-designing them with patients who at last are being heard and treated. Diabetes UK told me that it supported NHS England in the development of those pilots, and it is calling for long-term funding to ensure that best practice is shared and, most importantly, that support is offered by those services on a sustainable footing. \p Tom Collins: I congratulate my hon. Friend on securing this important debate. Type 1 diabetes is incredibly demanding to live with. It is a game of numbers, and as such it can be greatly helped by technology, which is developing rapidly. I wish to put on the record how important it is that the Government ensure universal access to such transformative technology for all who are insulin dependent with diabetes. Even if someone’s iPhone can be their pancreas, type 1 diabetes is unique in its constant psychological demands. It invades people’s lives socially as well as practically, with the result that type 1 diabetes combined with disordered eating is a perfect storm. Does my hon. Friend agree that it is important that we provide not just practical but emotional support that is integrated not just around an individual but also the family, to provide for the severe depths of need for this complex condition? \p Josh Newbury: I completely agree with my hon. Friend’s comments on the need for technological advancement. I will come on to support for the family a little later in my comments, but it is critical to have a support network around people with T1DE.

To the credit of the last Government, they recognised the need for T1DE-specific services, but they allowed the initial two pilots, in Bournemouth and London, to close in April last year. Those of us who are members of the all-party parliamentary group on diabetes have heard stories about patients who have suffered as a result of that cliff edge.

Having inherited a highly uncertain and unfunded position, I very much welcome the Government’s recent announcement of a 12-month extension to the ongoing pilots. That will ensure sufficient patient numbers and, more importantly, safeguard vital services where they already exist. I encourage the Department of Health and Social Care to seek additional investment through the spending review. Now that services have been up and running for over two years, our focus should turn  to building up to a national offer, so that people with T1DE in parts of the country like Staffordshire can benefit for the first time.

Another vital effort will be raising awareness of T1DE, particularly within general practice and eating disorder services, to ensure that people with both conditions receive tailored care. This is a call not solely for increased training for healthcare professionals, but for greater recognition of the issue within the system as a whole. The King’s Fund and Centre for Mental Health report, “Long-term conditions and mental health: the cost of co-morbidities”, shows that complications stemming from mental health illnesses in people with long-term physical illnesses increases the cost of care by an average of 45%.

In June 2022, a parliamentary inquiry into T1DE was launched. It was very ably co-chaired by Theresa May and Sir George Howarth, both then Members of this House. I acknowledge the work of the hon. Member for Harrogate and Knaresborough (Tom Gordon), who I have known for many years, who co-wrote the inquiry’s report during his time working for the Juvenile Diabetes Research Foundation, now Breakthrough T1D. The inquiry gathered evidence from experts, those with lived experience, researchers and voluntary sector leaders.

The report was launched in January last year and the key findings included the need for international diagnosis criteria, updated National Institute for Health and Care Excellence guidelines, the continuation of funding so that pilot sites can become centres of excellence, better data sharing, and a T1DE peer support offer to reach every corner of the country. I urge the Government to look at increasing awareness and training, particularly to give families and carers the tools and support they need to be able to play their part in early intervention and treatment pathways, as hon. Friends have mentioned.

Diabetes UK is currently funding a research project into the prevention of T1DE in children. It will test out an intervention designed to help parents and carers recognise signs of unhealthy eating behaviours. There is a lot of great work going on for us to build on.

To conclude, I thank those running the NHS pilot projects for all their work, Breakthrough T1D and Diabetes UK for the briefings they have given me, and all the Members who have contributed to the debate. We must do everything we can to support people with type 1 diabetes and disordered eating. The issue is not small or rare, and it deserves our attention in this place. By raising awareness, integrating services and providing support for families, we can help people overcome T1DE and lead healthier, happier lives. \p Ashley Dalton: I thank my hon. Friend the Member for Cannock Chase (Josh Newbury) for securing the debate and all hon. Members who have contributed. The hon. Member for Strangford (Jim Shannon), who appears to be quickly making an exit but remains in his place, spoke about mental health. The hon. Member for South Northamptonshire (Sarah Bool) spoke about destigmatisation for disordered eating and for type 1 diabetes. By sharing her diagnosis in this place, she is making a huge contribution towards destigmatisation, and I thank her for that. My hon.  Friend the Member for Gloucester (Alex McIntyre) shared his family’s story, which is heartbreaking and shows the impact that these issues have on people. My hon. Friend the Member for Worcester (Tom Collins) talked about technological advancement and support.

As my hon. Friend the Member for Cannock Chase outlined in his remarks, type 1 diabetes and disordered eating—T1DE—is not a widely known condition, yet it potentially affects up to a third of people with type 1 diabetes. People with T1DE find themselves trapped in a battle between needing to control their diabetes with insulin and trying to control their weight in an unhealthy way. It is a vicious cycle. People with T1DE experience increased ill health and, sadly, an increased chance of early death. Studies have shown that people with T1DE who restrict insulin have a mortality rate more than three times higher than those who do not.

We should pay tribute to the diabetes charities that are doing so much for people living with diabetes across the UK and tackling this problem head on, such as Beat, which has dedicated helplines for people struggling with this condition; Breakthrough T1D, which funds international research to cure, treat and prevent type 1 diabetes and its complications; and Diabetes UK, which does a fantastic job of articulating the community’s needs to Government. \p Tom Gordon: I congratulate my friend, the hon. Member for Cannock Chase (Josh Newbury), on securing this debate. As was mentioned, I used to work for the type 1 diabetes charity JDRF, as it was then—it is now Breakthrough T1D. We used to regularly have meetings with Ministers in the Department of Health and Social Care. One of the key things that I and, I am sure, Members across the House would like to see is the new Government taking up the recommendations of the report by Theresa May and Sir George Howarth. Will the Minister agree to meet the APPG for diabetes to talk about how those recommendations can be implemented? \p Ashley Dalton: I am more than happy to meet the APPG to discuss those matters.

I was really moved to read Lynsey’s story on the Diabetes UK website. One thing that really stood out to me was her experience of turning 18 and moving to an adult clinic. She said:

“I became a number in a system, rather than a patient. Every time I went, I saw a different team, and would have to explain my entire medical history. It felt like it wasn’t worth my time, and I certainly wasn’t going to have a conversation about what was going on with people I didn’t know.”

After just a few appointments, Lynsey stopped going. T1DE cuts across diabetes and mental healthcare, and Lynsey’s interactions with the NHS show that we must never treat patients like interchangeable statistics, bouncing around a cold system that does not seem to care for them. Instead, each patient should benefit from a unique, joined-up approach.

To its credit, NHS England has recognised that there is an unmet need for better treatment of T1DE. As my hon. Friend the Member for Cannock Chase has recognised, it has begun piloting type 1 diabetes and disordered eating services, two of which came online in 2019. The aim of those pilots was to develop the evidence base around how best to manage T1DE by testing an integrated  pathway, which means that patients such as Lynsey would not be obliged to recount their medical history on every visit. In the past five years, NHS England has expanded on the original pilots, with funding extended for five T1DE pilot sites until March 2026 to ensure that there are sufficient patient numbers for us to get a full picture of what is happening on the ground. I thank my hon. Friend for his contribution to those pilots.

While those pilots are gathering evidence, NHS England is looking carefully at the findings, with a view to developing a future national strategy. Each of the five new pilot areas is submitting quarterly data to the evaluation, and it intends to publish its analysis of the data by September. \p Jim Shannon: I thank the Minister for her comprehensive and helpful response. I first came to this House in 2010, and in 2015 a diabetes plan for the whole of the United Kingdom came out of Westminster for all the regions together, but that came to an end. I had always asked and hoped for that plan to come together again. Will she consider having a diabetes plan for all of the United Kingdom of Great Britain and Northern Ireland working together, because I understand that in Northern Ireland we have the highest number of type 1 diabetics anywhere in the United Kingdom? \p Ashley Dalton: As I am sure the hon. Member knows, health is obviously a devolved matter. However, I am more than happy to look at the issues he has raised and come back to him.

The data from the pilot areas will also be shared with all the integrated care boards, so that we can build up the case for more investment in T1DE from ICB budgets while looking at ways in which NHS England can support ICBs in commissioning their services.

While those pilot sites are doing critical work, the NHS is supporting people with diabetes to live well. Central to that is making sure that patients have access to annual reviews that cover eight processes recommended by the National Institute for Health and Care Excellence. We know that people who attend annual diabetes reviews have much better outcomes for emergency hospital admissions, amputations, retinopathy and mortality. That is why it is right that the NHS is investing £14.5 million over the next two years, supporting up to 140,000 people between the ages of 18 and 39 to receive additional tailored health checks by healthcare staff. That support will include vital support to break down any stigma associated with diabetes while helping those people to manage their condition, from blood sugar level control and weight management to minimising the risk of heart disease.

As has been touched on, technology plays a critical role in helping people with diabetes to live healthier lives, and there is great potential to do the same for people with T1DE. NICE has made positive recommendations on offering real-time continuous glucose monitoring and hybrid closed loop technology to adults and children with type 1 and type 2 diabetes, meaning that those treatments are now offered on the NHS. Over two thirds of people with type 1 diabetes currently use glucose monitoring to help manage their condition, and following NICE’s recommendations on hybrid closed loop systems, NHS England has developed a five-year national strategy that began in April last year. I know that five years will  seem like a long time to many of those young people struggling with this condition here and now, but the NHS does need an implementation period to ensure we have all the right people with the right skills within specialist adult services. We cannot compromise an inch on safety, and NHS trusts should only ever provide hybrid closed loop if specialist trained clinical staff, experienced in using insulin pumps and continuous glucose monitors, are in place. \p Tom Collins: I can speak from personal experience about the power of hybrid closed loop systems and the safety they present from day one, compared with the conventional treatment using injections. I encourage the Minister to explore every way possible—using collective peer forums or any other vehicles that can be imagined—to accelerate the deployment of hybrid closed loop technology as fast as we possibly can. \p Ashley Dalton: I thank my hon. Friend for that intervention, and for sharing his lived experience. I am more than happy to consider his suggestions and discuss them further.

Finally, I will touch on the encouraging work of the early surveillance for autoimmune diabetes—ELSA—programme. Type 1 diabetes is not preventable, but the sooner we reach people, the sooner we can care for them. ELSA is a children’s screening programme that  can detect type 1 diabetes through a simple fingerstick blood test by looking for four antibodies associated with a higher risk of developing diabetes. ELSA launched in November 2022, and over 20,000 children have already taken part. The study has made a huge effort to screen all of those children by February, and we are still waiting to hear whether that ambitious target has been reached. I would be pleased to keep my hon. Friend the Member for Cannock Chase and the House updated on that programme.

It is clear that T1DE is a serious and often overlooked condition that requires a more integrated and compassionate approach to care. The work being done through NHS pilot programmes, investment in diabetes management, and advances in technology all represent meaningful progress, but there is still much more to do. It is vital that we continue to build on the evidence gathered through these initiatives to ensure that people with T1DE receive the tailored, consistent and supportive care they deserve. No patient should feel like a number in the system, or be forced to navigate a fragmented approach to their health. By working together through Government, the NHS and charities, we can ensure that people with T1DE receive the right support at the right time. I look forward to working with my hon. Friend to get this done.

Question put and agreed to.

House adjourned.