Health and Care Bill

Debate between Baroness Tyler of Enfield and Baroness Harding of Winscombe

Lords Hansard - Part 1 & Report stage
Thursday 3rd March 2022 Lords Chamber

[Baroness Tyler of Enfield (LD)]

My Lords, I will be exceptionally brief and make two very quick points, but first I need to apologise for, when I spoke earlier, omitting to mention my registered interest as a non-executive director of the Royal Free London NHS Foundation Trust.

I very strongly support Amendment 80, moved so ably by the noble Baroness, Lady Cumberlege, and pressed so very cogently by the noble Lord, Lord Stevens, and others. It is absolutely fundamental to everything that the Bill is designed to achieve, and we will not achieve those things unless the workforce is addressed.

In relation to Amendment 111 in the name of the noble Lord, Lord Hunt, I say that it is so important that we have a review into the distribution of GPs in England. I was very concerned when we debated in Committee the huge variation in list numbers in different parts of the country. The biggest lists were in the most deprived areas. If you track that back to the debate we were having on health inequalities, where there was a huge consensus across the House, it is clear that we are never going to fundamentally tackle health inequalities unless we have far greater equality in things like the size of GPs’ lists.

[Baroness Harding of Winscombe (Con)]

My Lords, I also support my noble friend Lady Cumberlege and Amendment 80. The noble Lord, Lord Stevens, made two points: I would just like to add a third to his argument. He argued that workforce planning needs to happen. There is no large employer of people that does not plan its workforce other than the NHS. We need to do it, and I do not think anyone in this Chamber is going to disagree. He also said that this would not happen without legislation. I will not repeat the points I made at Second Reading or in Committee, or those that he just made so eloquently.

My third point, which I would like to add, is very much addressed to my noble friend the Minister. It is that this amendment will not bring the downsize that the Treasury truly fears. This is actually an amendment of sound management that enables the NHS to manage finances and people better. While there will be more money spent on training, this is actually the way to control the costs of the ever-growing demand for health and social care. If you do not plan, you cannot control the costs. This is actually the way to do the very thing that the Treasury is most concerned about.

Far from locking in old, established ways of working, this is also the way to drive transformation because, unless we are honest about the ever-growing demand for clinicians of every profession, we will not face the fact that we will need to change the way those clinicians work together as medicine and science evolve and all of us age. This is a way to deliver the very thing that the Treasury most wants: control of the finances and transformation of our healthcare services.

With that, I add one final point, and I hope noble Lords will forgive me for repeating what I said in Committee. There is another reason why we need to do this now. Our NHS people are exhausted, and they have lost hope that we understand what it is really like on the ground for them. By passing this amendment, we will give them hope; we will show them that, collectively and cross-party, we really understand that it is they who make our wonderful, precious health and care system work, and we are committed to helping them going forward.