NHS at ‘unprecedented’ breaking point as dossiers reveal state of nation – live

Downing Street said the state of the public finances did not mean action could not be taken to tackle child poverty.

Sir Keir Starmer is under pressure, including from some of his own MPs, to scrap the two-child benefit cap.

The Prime Minister’s official spokesman said: “When it comes to that policy, there’s a simple reason that the Government didn’t include in the manifesto, and that is the Government isn’t prepared to make unfunded promises that can’t be kept.”

He added: “The Chancellor has actually set out that the situation facing the public finances is worse than previously thought and that’s why she’ll be providing an update on that in due course.

“But that doesn’t mean we can’t take action to tackle child poverty. And we are developing an ambitious strategy to reduce child poverty and give children the best start in life.”

Health Secretary Wes Streeting said the Government hopes to agree a pay deal with junior doctors that “we can deliver and the country can afford”.

Shadow health secretary Victoria Atkins told the Commons: “In opposition, (Mr Streeting) described the 35% pay rise demand by the junior doctors committee as reasonable. What he didn’t tell the public was that this single trade union demand would cost an additional £3 billion, let alone the impact on other public-sector workers.

“So, will he ask the Chancellor to raise taxes or will she ask him to cut patient services to pay for it?”

Mr Streeting, in his reply, said: “What I said was that the doctors were making a reasonable case that their pay hadn’t kept up in line with inflation, but we were clear before the election that 35% was not a figure we could afford.

“We are negotiating with the junior doctors in good faith to agree on a settlement that we can deliver and the country can afford.”

Rishi Sunak’s decision to scrap the second phase of HS2 will cost up to £100m and it could take three years to shut down sites where work has begun, an official report has revealed.

The former prime minister’s plans also mean the government has £592m worth of land and property on the route from Birmingham to Manchester It needs to flog, which the government spending watchdog has warned could take years and distort local housing markets.

The former PM used his conference speech that October to confirm plans to scrap HS2’s northern leg, sparking fury among local leaders, business chiefs and senior Tories including David Cameron.

Our political correspondent Archie Mitchell has the full story:

Local authorities spent £2.7billion last year on road maintenance, according to a National Audit Office report, Jabed Ahmed writes.

A survey of local authorities by the Asphalt Industry Alliance shows only half of roads (48% in 2023-24) across the country are in good structural condition, with the state of roads further deteriorating year on year.

Some 1.9 million potholes were filled in England during 2023-24, the highest number since 2015‑16.

The report further found there are currently significant gaps in the Department for Transport’s information on the condition of local roads, limiting its understanding of the condition of the network.

The department for transport has announced an additional £8.3bn in long-term funding for local roads maintenance, but it is not yet clear how this will be allocated.

A Conservative MP has insisted the NHS was not broken by Tory cuts as they called on the Government to build a “cross-party coalition” of support for reforming the health service.

Conservative MP George Freeman (Mid Norfolk) told the Commons: “All of us are serious about the health service and about the need for reform about which the Secretary State has spoken.

“I have your back in pushing for reform and could I gently, he has his moment of triumph, but gently encourage him to reach out and build a cross-party coalition of support for serious reform.

“The NHS is broken, not by Tory cuts, but by years, years – we’ve been pouring money in, it needs to modernise for the 21st century.”

Health minister Stephen Kinnock replied: “(Mr Freeman) was doing so well at the start and then he kind of blew it there a bit towards the end. But, look, it’s absolutely right that we put country before party and we will work with whoever has the best interests of rebuilding our public services at heart.”

Earlier, Dame Priti Patel also defended the Conservatives’ record on the NHS, saying: “Over the last 14 years in Essex we’ve actually seen some improvements in our emergency care services, particularly with our ambulance trust, and that is something that should be commended.”

Health Secretary Wes Streeting has confirmed the Government will continue with some aspects of the Tories’ dentistry recovery plans, but said he would be dropping the “gimmicks”.

Speaking during health questions, he told the Commons: “NHS dentistry is non-existent in huge parts of the country, there were aspects of the previous government’s dental recovery plan which we will stick with because they’re the right solutions.

“There are other gimmicks which we will not proceed with and we will come forward, as I’ve stated, with a serious plan to reform the dental contract.”

Asked when the public will see change, Mr Streeting said 700,000 dental appointments would be delivered “as a matter of urgency” to address “dental deserts”.

Following a question from Labour MP Alice Macdonald, Mr Streeting described her constituency of Norwich North as the “Sahara of dental deserts” because there are only 36 dentists per 100,000 residents.

Later in the session, shadow health minister Saqib Bhatti said: “We had agreed with NHS England that the first (dental) vans would be on the road by this autumn, and I know that this timescale was welcomed by colleagues across the House, will (Mr Streeting) confirm that dental vans will be on the road by this autumn?”

Mr Streeting replied: “I couldn’t have picked a better example of the desperately low ceiling of ambition the previous government had than the fact that they laud after 14 years their triumph of dental vans roaming the country in the absence of actual dentists and dental surgeries. What an absolute disgrace.”

National Audit Office report has found as of March 2024, Transport for London and HS2 limited spent £30.1 billion in total on the programme, with most of the spend on Phase 1 (£27.8 billion), Jabed Ahmed writes.

HS2 Ltd estimates that closing down Phase 2 will take three years to complete at a cost of up to £100 million. It will take until summer 2027 for all remediation works to be completed.

Disposing of the land, which the HS2 programme had spent £592 million on buying, will take several years to complete and distort local housing markets, according to the report.

Completing phase one could cost up to £57bn, significantly above the current £44.6bn funding package, HS2 forecasts.

The state of the NHS is at an “unprecedented” point with health workers working at the “limits” of a breaking system, the National Audit Office report has found.

The document read: “The scale of challenge facing the NHS today and foreseeable in the years ahead is unprecedented.  

“When we consider how the health needs of the population look set to increase, we are concerned that the NHS may be working at the limits of a system which might break before it is again able to provide patients with care that meets standards for timeliness and accessibility.”

The NAO has raised urgent questions about the mismatch between demand for NHS services and the funding the health service will receive.

The report warned: “Either much future demand for healthcare must be avoided, or the NHS will need a great deal more funding, or service levels will continue to be unacceptable and may even deteriorate further.”

The £369 million renovations of Buckingham Palace have been “well managed” but challenges which led to cost increases, such as structural damage and asbestos discovery, “could have been foreseen”, the National Audit Office (NAO) has said.

The NAO said the East Wing of the palace was 78 per cent over its estimated cost, but other projects such as the picture gallery and the roof came in 25 per cent under the forecasted costs.

NAO head Gareth Davies said: “Updating decades-old plumbing, heating and electrics, as well as adding new lifts and lavatories in one of the UK’s most famous buildings, is a significant undertaking which has been well-handled to date.

“Sound planning and project management has enabled the programme to remain within budget to date and respond well to challenges such as the pandemic.

“While risks remain as the programme draws to a close, if these continue to be managed effectively, the result should represent good value for money.”