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The Minister for Secondary Care (Karin Smyth)
I will of course adhere to your instruction, Sir John.
I am grateful to my hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley) for bringing this important topic to the House. I know it is close to his heart, as a working doctor. I thank him for his continued dedication to the NHS, as a surgeon and an MP, and I thank his family, too, for their dedication to it. We welcome the knowledge and expertise that he has already brought us, and he has done so again powerfully today. What a lovely memento he has of his own father’s service.
I thank my hon. Friend for highlighting the incredible role that resident doctors play in our NHS. We absolutely recognise the challenges that they face as they progress through postgraduate training. We are committed to giving them the support that they need to develop and thrive in the NHS. My hon. Friend spoke passionately about the welfare of doctors. Let me acknowledge, as I know he would, the tireless professionalism and dedication that all health professionals show across the NHS daily.
The NHS is broken, but we have a plan to fix it. In his investigation into the state of the NHS last year, Lord Darzi identified that this Government have inherited an NHS that is in serious trouble, with record waiting lists, people struggling to see their GP, and quality of care often lagging behind other countries. He found that too many staff are disengaged, that levels of sickness absence are worryingly high, and that many people working in the system are still exhausted from the pandemic and its aftermath, which has resulted in
“a marked reduction in discretionary effort across all staff groups.”
The Government completely agree with that assessment. We are on a mission to fix our broken NHS by driving fundamental reform to bring our analogue health service to the digital age. Through our 10-year health plan, we will cut waiting lists, reduce waiting times and get the health service delivering for patients and staff once again. Those ambitions will be possible only thanks to the hard-working staff, so it is essential that doctors and others are properly valued, supported and looked after at work.
Employers across the NHS play a pivotal role in looking after doctors. Strong and effective leadership is fundamental to building a healthy organisational culture and too many NHS organisations are falling short in that regard. I have been shocked to hear stories, some of which we have heard again today, about the lack of support received by resident doctors, whether on shift patterns and rota changes, access to rest breaks while on duty, or really basic things that we should expect from any employer, such as hydration and the provision of decent food. We have heard about people sleeping in cars and not being able to go to a close relative’s wedding or to be the best person at their best friend’s wedding. It is unbelievable, really, and it cannot continue. It has to improve. We expect better from trusts and employers and we will make sure that that happens.
We brought an end to the industrial action by resident doctors that was impacting the NHS’s ability to deliver a good-quality service and having such a corrosive effect on the morale of the workforce. As part of that deal, resident doctors and dentists in training received an average uplift of just over 4% into the 2023-24 pay scales, on top of the average 8.8% uplift they received for 2023-24. The Government have committed to improve the current exception reporting process, and to work in partnership with the BMA and other health organisations to review the current system of training, as my hon. Friend the Member for Bury St Edmunds and Stowmarket highlighted, and rotational placements. That is in addition to the work being undertaken by NHS England to improve working lives.
We want to work with the unions on the key issues that doctors face on the frontline, and improve their working lives. That applies to all NHS staff. For example, we are working at the moment with the BMA resident doctors committee to improve the exception reporting process. We know that is important to residents, and we agreed to address it as part of their pay deal.
It is vital that we look after the health and wellbeing of the whole NHS workforce. High-quality care and support for patients cannot be effectively provided without a compassionate and inclusive working environment. My hon. Friend listed a number of actions, some of which are more easily addressed than others. We would expect many of them to be included as part of a supportive culture in trusts. I accept that some are more challenging and involve discussions with NHS England, the Government and trusts, but I do not think that many are beyond local trusts and systems, working with the profession, to resolve.
The mental health of doctors and all NHS staff is incredibly important. We saw the strain and trauma placed on staff during the pandemic. They do so much for patients, and we owe it to them to ensure that they are properly supported in return. The NHS offers occupational health and wellbeing services for staff when they need them, but provision can be patchy. There is a drive to improve the quality of those services across the NHS. Not only can that reduce sickness absence and improve retention, but proactive and preventive occupational health can lead to improvements in productivity and, in the long run, save taxpayers money.
Access to specialist mental health support is important. I know that services such as the practitioner health programme, which we have heard about this afternoon, are highly valued by many doctors. NHS England is currently reviewing the mental health and wellbeing support available across the NHS, and looking at how it can be made more equitable and sustainable. There is no doubt that we need to continue to improve the mental health support available to NHS staff, and I look forward to seeing the outcome of that review. NHS England is also moving forward with a joint initiative with NHS charities to invest £10 million in health and wellbeing initiatives for staff. That will provide grants for better facilities and invest in improved wellbeing support.
I want to make a point about violence, which I do not think my hon. Friend particularly highlighted in his speech. Sadly, the threat of violence in the workplace is another thing that NHS staff are dealing with, as we saw in last week’s horrific assault in Oldham—I extend my wishes to the nurse and her family for a speedy recovery, as I know we all do. I reiterate that the Government take a zero-tolerance approach to that type of behaviour. Doctors, nurses and all healthcare workers are the backbone of our NHS and should be able to care for patients without any fear of violence or abuse.
At a national level, NHS England is focused on improving workplace experience, with the NHS people promise and the NHS retention programme addressing the issues that matter to staff, whether that be improving opportunities for flexible working, tackling racism and discrimination, preventing and reducing violence in the workplace, or improving facilities so that staff have the basic opportunity to rest and recover. Resident doctors face many challenges as they progress through postgraduate medical training, as my hon. Friend outlined. Expanding access to less than full-time training, rationalising and reforming statutory and mandatory training, and increasing choice and flexibility in rota management are just some of the things we are looking to do to improve their working lives.
We are also working with NHS England to support the GP workforce, including with measures to boost recruitment, to address the reasons why doctors are leaving the profession and to encourage them to return to practise. The NHS is working to address training bottlenecks, so that there are enough GPs for the future and patients can get the care they need. We have provided £82 million of additional funding for 2024-25 to address GP unemployment and support the recruitment of more than 1,000 new GPs.
In conclusion, through the 10-year plan, we are engaging widely with staff, patients and the public and listening to their views on how we need to reform and modernise the NHS. That applies equally to the NHS as an employer. Our ambition is for the NHS to become a modern, innovative and supportive employer. That is a necessity if we are to continue to attract and retain skilled and experienced professionals, give them the support they deserve as they care for the nation, and build a robust and resilient NHS. I look forward to working with NHS England. My hon. Friend the Member for Bury St Edmunds and Stowmarket will bring great expertise to this work in the House, as will Members more broadly, to make it a reality.
Question put and agreed to.