NHS Winter Pressures

Baroness Merron Excerpts

Tuesday 10th January 2023 Lords Chamber

[Baroness Merron (Lab)]

My Lords, from this Statement one might conclude that the NHS is facing challenges but that, overall, things are moving in the right direction. This could not be further from the truth and does not reflect how dire the situation has become. It is clear that the Government have failed to grasp what everyone else has managed to: that there is a deeply urgent crisis in health and social care, where irrevocable damage is being done to people’s lives.

While on the one hand the Government are bringing in legislation that will mean that NHS staff can be sacked for exercising their right to strike, on the other they are refusing to conduct meaningful pay negotiations that could end the strikes in the health service. Indeed, they only thought to convene an NHS recovery forum this week, when we are already half way through the winter.

It is increasingly becoming clear that the sporadic pots of money proposed as sticking plasters for various pinch points are not being deployed quickly enough. For instance, the £500 million emergency adult social care discharge fund was announced in September, but some half of it still has not yet reached the front line. The NHS has now said that it is too late to make a difference to the winter crisis. Has the Minister identified what is stopping the funding coming through? What plans are in place to deal with this so that funding can promptly get to where it is needed? It is no good making announcements and then not following through.

Nor is it easy enough to work out whether funding is new or recycled money. I hope the Minister will be able to clarify this now and in the future. The nature of this Government’s approach to funding health and care—half a billion pounds here one week, another few million there—gives the impression of knee-jerk reactions rather than strategic policy-making. In fact, the approach is so last minute that, after making the announcements in yesterday’s Statement, an extra £50 million was suddenly found and a further press release was issued.

Yet we know that prevention is better than cure in every sense. A GP appointment costs the taxpayer much less than a desperate patient turning up at A&E. Is the Minister content with this eternal hole plugging? What plans are there to move towards a more holistic and sensible long-term approach, including plans to fix primary care so that patients can see the GP they want in the manner they choose? What plans are there to recruit the care workers needed to care for patients once they have been discharged from hospitals, and to pay them fairly so that we do not lose them to other employers? As ever, where is the comprehensive and detailed workforce plan to train the doctors, nurses and health professionals that the NHS so desperately needs?

Underlying this has been an abject failure to make the social care system sustainable. Half a million people are waiting for social care assessments. They clearly are at major risk of having to be admitted to hospital as a result. How will the Minister work to prevent this, especially when care workers are leaving in droves to work in retail and other sectors? Is there a government target for when the number of people waiting for assessments, often in pain and discomfort, might finally start to come down?

The Statement cites Covid, flu, strep A, scarlet fever, and even CQC inspections as reasons why the NHS is under such strain. Is this not surely passing the buck, when other countries face similar challenges and yet are not gripped by such chronic crises every single winter?

In the context of an ageing population where demand on the system will only increase, is the Minister willing to assure your Lordships’ House that a sustainable social care solution will finally be produced before the next winter hits? The NHS Confederation has responded to yesterday’s Statement by referencing the obvious contained in the Government’s words on the need for

“the right wraparound care for those being discharged from hospital”.

The NHS Confederation also says that

“after a decade of austerity neither the social care sector nor the government are in any position to ensure it.”

Does the Minister agree with that analysis: that it is the choices of this Government over the past 12 years that have had a direct and devastating impact on the current delays? It is this fundamental that the Statement has failed to address.