I associate myself with the Prime Minister's remarks about the importance of carers in our country. This week's events have demonstrated just how loathed this Prime Minister is—and that is only in his own party. As his Administration is too distracted by their internal divisions to deal with the challenges we face, can he explain why on earth the country should support him if 148 of his Back Benchers do not trust him?

The whole House will unite behind the Prime Minister on his determination to hold Ukrainian war criminals to account, but is he aware that there are five alleged Rwandan war crimes perpetrators living freely in the UK, who have been doing so now for 16 years and have neither been extradited nor put before the British courts under our existing laws? As he prepares to go to the Commonwealth Heads of Government meeting in Rwanda, will he look carefully at this issue, because it is bound to be raised with him? Will he reassure the House and the Rwandan Government that he takes these matters extremely seriously, and that what has so far been justice massively delayed for 16 years will not be grotesquely denied?

I could not make out whether that introductory noise was cheers or boos. I join the Prime Minister in his comments about carers. Why did his Culture Secretary, who I think is hiding along the Front Bench, say that successive Conservative Governments left our health service wanting and inadequate when the pandemic hit?

I think the Prime Minister just agreed with the Culture Secretary. He did not deny it. Perhaps she said it because it is true. It starts with GPs. People were unhappy with the service they were getting before the pandemic—there were not enough GPs and it was too hard to get an appointment—and that is why he promised 6,000 new GPs, but his Health Secretary admits that he will not keep that promise. Despite the hard work of doctors, people cannot see a GP in person, and they are unhappier than ever with GP services. If GP provision was wanting and inadequate before the pandemic, what is it now?

The Prime Minister talks big but I have a letter here to the Prime Minister from the right hon. Member for Hereford and South Herefordshire (Jesse Norman) in which he said, “under you”—that is you, Prime Minister—“the Government seems to lack a sense of mission. It has a large majority, but no long-term plan.” The Prime Minister's “big plan” act is so tired that even once-loyal MPs do not believe him. It is not just about waiting for a GP appointment but waiting for all NHS treatment. Take cancer: for over a decade, waiting times for cancer care have been going up. The Prime Minister's solution was supposed to be diagnostic hubs. The Health Secretary has been on a victory lap this week, but here is the rub: since those hubs were opened last year, 135,000 extra people are now waiting for scans and tests. Can the Prime Minister think of a better way to describe soaring cancer waiting lists than “wanting and inadequate”?

The problem is that the cancer waits have been going up for 10 years and they are even higher now, so blaming the pandemic just will not wash. Perhaps the Culture Secretary was talking about the state of NHS buildings. Before the pandemic, the National Audit Office said that they were a risk to patients. The Government's response: paint jobs and fix-ups, pretending that is the same as building new hospitals. The Treasury and the Cabinet Office apparently do not think the refurbs will even be delivered. Take University Hospital of North Tees: the ceiling is falling in, the roof leaks and staff have to hose down the pipes to stop them freezing over. Failure to fix “wanting and inadequate” NHS buildings is putting patients at risk, isn't it?

Pretending no rules were broken did not work, pretending the economy is booming did not work and pretending to build 40 new hospitals will not work either. Conservative Members want him to change, but he cannot. As always with this Prime Minister, when he is falling short he just changes the rules and lowers the bar. In March, he proposed changing the NHS contract. He wants to double the length of time patients can be made to wait for surgery from one year to two years. On top of that, he scrapped zero tolerance of 12-hour waits at A&E.

Raising taxes because you have failed to grow the economy is not a plan for the NHS. Members of his Cabinet admit that the Conservatives left our health system wanting and inadequate when the pandemic hit. There are fewer GPs, more waits for cancer tests, buildings are crumbling, and he is changing rules to cover up failure. Constituents like Hamza Semakula and Akshay Patel highlight real human pain due to NHS inadequacies.

Concerned about sewage overflows into precious chalk streams. The Environment Act 2021 includes important measures; when can we expect meaningful improvements and reductions in storm overflow sewage?

I am concerned about the Prime Minister's continued leadership given that at least 41% of his own MPs do not support him, and even Unionist leaders in Scotland will not back him. How does he expect to continue?

Scotland has the option of independence as it is undemocratic to be stuck with a Prime Minister and party we do not trust or support. Can you explain how this situation is democratic?

Given that we agree on cutting unnecessary spending, could you consider scrapping HS2 to save billions of pounds?

Given his history of lawbreaking, can you commit not to break international law in relation to Northern Ireland?

Given the poor accessibility of Manchester airport due to lengthy commutes from North Wales, will you ensure that the north Wales line features in the updated rail network enhancements pipeline?

Despite promises of new hospitals and more staff, the Brontë birth centre is at risk of closure. Can you explain why expectant parents are forced to travel far for childbirth despite your commitments?

Will my right hon. Friend join me in complimenting Bradford on becoming the city of culture? Will he praise the team from Durham? In 2025, Durham will celebrate the bicentenary of the Stockton and Darlington passenger railway. Will he encourage progress on Ferryhill station development, reinvigorate the Leamside line, and deliver a great county deal for County Durham?

In Monday's confidence vote, the Prime Minister secured the support of just two Scottish MPs. Given this lack of support, should he resign as Prime Minister or write a letter of resignation to himself?

Last week, the Princes Centre in Princes Risborough celebrated its 10th year as an independent daycare provider. Will my right hon. Friend join me in thanking Kim Challoner and her team for their first-class service? As Chequers is near Princes Risborough, will he visit to deliver these congratulations personally?

Two weeks ago, the Prime Minister told the House: 'To the best of my knowledge, everybody is getting their passport within four to six weeks'. However, the Passport Office quotes a 10-week service time and many constituents wait much longer. Cancelled summer trips could cost families more than £1 billion due to this backlog. Given the cost of living crisis, does the Prime Minister accept that the Passport Office's backlog is placing additional pressure on these families?

My constituency faces unrealistic housing targets, putting pressure on the council to develop plans closing successful working docks and losing beloved sites like Deangate Ridge. Can my right hon. Friend reassure constituents that there will be flexibility in meeting numbers so the council can produce a plan delivering appropriate housing while protecting important local sites?

My constituent Mark is sponsoring two Ukrainian sisters. While the older one has been allowed into London, the younger one (a minor) was sent back to a war zone. Is sending vulnerable children back to a war zone the right policy?

I asked my right hon Friend about increased research funding for aortic dissection as called for by the Aortic Dissection Charitable Trust. Will he update me on progress? Also recognise the value of patient awareness videos featuring Bob Harris, survivors and relatives?

The Ukrainian Freedom Orchestra and the Kyiv Symphony Orchestra should be supported in their tour of the UK by expediting visa applications and waiving fees, as done by European neighbours. Will the Prime Minister do so?

The Department for Environment, Food and Rural Affairs investigated the cause being algal bloom. Will the Prime Minister look at how to support this vital industry affected by this freak event?

Belgium provides a social tariff for the poorest. Is it time to provide a similar social tariff and end injustice of prepayment meters?