My Lords, I endorse the comments of my noble friend Lord Kamall about recognition of those doctors who have decided not to take action. There can be no way that doctors abandoning patients is compatible with the Hippocratic oath they have taken. For 17 years as chancellor of a university, I have listened to doctors on qualification saying that they are taking their Hippocratic oath and that they will give priority to patients and do no harm. Taking five days of industrial action does a great deal of harm to the patients and, of course, to others in the profession who have to pick up the load—the nurses, the consultants and others.
I endorse the great disappointment expressed by the noble Lord, Lord Stoneham, that the report by the noble Baroness, Lady Casey, is going to be so slow in arriving, given that it is so essential to the next steps in the health service.
I wonder whether the Minister could come back on the point I made to her last week about resident doctors taking industrial action and then signing on as locums at a premium rate in another health authority or hospital, whether in the NHS or otherwise. Resident doctors are doing the profession enormous harm. Extraordinarily, we still have incredibly high entry standards for doctors. It remains one of the most popular and sought-after professions for school leavers. I take with a pinch of salt this idea that they are all leaving. Lots of doctors go on rotation to America or Australia and to get experience around the world, but I still think that, thank goodness, they regard working in Britain as a worthwhile activity and profession. But the damage these resident doctors are going to do to that trust and respect is enormous.
I thank the noble Baroness for her comments and the background. I shall particularly pick up on the issue of moonlighting, which she has raised before. As a point of reference, during the industrial action in 2022-24, it was picked up. There were isolated and anecdotal incidents of this behaviour. It is difficult to get accurate information, and with the current systems in place there is no clear or easy way to monitor the practice. However, resident doctors moonlighting while on strike is clearly unacceptable and in clear breach of the GMC code of practice. As I have said before, it is up to the employers to take any reports of this very seriously, and I am sure they will.
I echo the noble Baroness’s comments about the medical profession in this country. We have some extraordinary people working in the whole of the NHS, not just the doctors. It is a phenomenal organisation, and we believe it is our absolute duty to do everything we can to protect it and preserve it for the future, and to keep it true to its principles of delivering care free at the point of delivery and reaching everyone that needs it.
(2 weeks, 4 days ago)
Lords ChamberI thank the right reverend Prelate for his very thoughtful contribution. It is particularly of the moment, and I completely recognise everything he said about this needing to focus on people.
We have to look at this technology as enabling better care and freeing up time. How many of us go to the GP and experience frustration at the restriction on the time that we are allowed to spend with the GP, because so much of their time is taken up with admin? Of course, data protection is central. The health service is not the only area where we are looking at systems of data protection, and the normal protection methodology will be brought to bear. We have to make sure that, in governance, there is a much more transparent and open style, which, frankly, we all have to admit has been missing in some cases. This is an opportunity to look at that.
I must admit that I will have to have a conversation about where the ethical discussions will actually take place, but I know that, throughout the professional bodies, these considerations are taken into account all the time. It is fundamental. The direction of travel is to have people at the centre, building the workforce, so that they have the opportunities to thrive and do their jobs to the best of their abilities for their patients.
My Lord, this is a pot-pourri of worthy aspirations, with the most extraordinary sense of déjà vu: hospital to community; sickness to prevention; a patient-driven NHS; league tables; foundation trusts; funding following the patients and outcomes. I was a contemporary of Alan Milburn, and he is behind this; these were all measures that we were discussing long ago. Maybe they have not been sufficiently implemented—and I so welcome the noble Lord, Lord Scriven, asking where the timetable and implementation plan are, and how this is going to happen.
But I must leap forward to the most serious issue of the day. We are all united on the importance of the NHS. It is incredibly difficult to change it, manage it and lead it. How can it be right for resident doctors to be taking industrial action for five days later in July? They have had an incredible increase compared with other members of the public sector, and the Government have said that they will help them on their work conditions. For those who say that their greatest pride is in helping patients, this is a shocking state of events—in a career that people want to join and that has long-term respect. Will the Minister ensure, very specifically, that the department checks up on whether any junior doctor taking industrial action then moonlights in another health authority, or in a private health provision, so that while they are taking industrial action they are also earning, at a premium rate, making up the gap left by the other doctors on industrial action?
As someone who has been involved in the plan, I start by saying to the noble Baroness that although it might echo things that have happened in the past, there is an enormous difference now. There is a depth of collaboration, bringing people together and recognising the different cultures in organisations. Of the 200 bodies that are going to be dismantled, Healthwatch is one; it has been very positive and has contributed to the future plan for how this is all going to look. There has been a step change in how we get out and work with people. It is a very ambitious plan, which I am pleased about. I am also very optimistic, because, quite frankly, too many professionals have gone too close to the edge and they realise what is on the other side if we do not all pull together and do something about this.
We are disappointed about the BMA decision to strike. The majority of resident doctors did not vote to strike, and threatening strike action that could harm patients will set back progress. I assure the noble Baroness that no one on these Benches is welcoming the strike. The basic truth is that, thanks to this Government, resident doctors have received a 28.9% pay rise compared to three years ago, and the highest pay award in the entire public sector this year. The Secretary of State met the BMA yesterday. Although he has made it very clear that the Government cannot go further on pay than we already have this year, he has offered to work with resident doctors to resolve issues they might face around working conditions. It will, of course, be down to their managers to work with staff to come up with a plan to deal with the action that is being proposed.
Does my noble friend agree that, in these difficult times, waste is to be avoided at all costs? We have the wonderful Imperial War Museum with the Holocaust galleries. The last thing that anybody wants is to waste over £30 million on a memorial museum in the beautiful Victoria Tower Gardens when that money could be spent—
With respect, the noble Baroness was not here at the beginning of this debate.
I tried very hard, but the traffic was very bad.