Brexit: Risks to NHS Sustainability

Debate between Lord Clark of Windermere and Lord Winston

Wednesday 12th July 2017 Lords Chamber

[Lord Clark of Windermere (Lab)]

My Lords, I am delighted to participate in this debate and to follow the noble Lord, Lord Cormack, and his clear, erudite and free-thinking contribution to the debate. I especially congratulate the noble Lord, Lord Warner, on allowing us an opportunity to debate this issue. When he approaches anything, he approaches it in a meticulous manner. Securing this debate today and concentrating our minds on sustainability and the risks involved with Brexit is a useful exercise for us to undertake, so I thank him for that.

I approach the debate with some hesitation, and I am sure that other noble Lords will feel likewise. At one level, none of us wants to say or do anything that will shake people’s confidence in the National Health Service. It is indeed the most efficient health service in the world, and it still delivers a wonderful service to the general population of the United Kingdom. I would hate to think that anything that I might say might cause distress to patients. However, as the noble Lord, Lord Cormack, hinted, as parliamentarians we are privy to information that is not available to other people. I suspect that I know quite a lot more about what goes on in hospital than even the Minister, whom I hold in the highest regard. I understand his sincerity and his commitment to the NHS, but so much of his information is, naturally, fed to him by his civil servants—I understand that, and I am not attacking civil servants. I looked after the Civil Service in my previous existence.

As the Minister may have noticed, I have tried to take a different approach to collecting information. Of course I accept the facts and look at the statistics but over the years, through my friends and associates, I have tried to build up contacts in the health service. People who work in the health service and in hospitals give me the picture as they see it—how it actually is—and it is up to me whether I believe it or not. I have to say that the picture is far worse than I had imagined, and I will try to develop some of those points today.

However, I start with a point raised by the noble Lord, Lord Warner—Euratom. I spent seven years as a director at Sellafield and I suspect that I know a little more about nuclear reprocessing than perhaps most of the general public do. I simply do not understand the Prime Minister’s obsession with leaving Euratom. Perhaps she does not understand what it is—Euratom is a legal entity separate from the European Union—yet she took a decision on it, apparently against the advice of other Cabinet Ministers. I hope that after this debate the Minister will feel empowered to feed the information up to the Secretary of State.

The issues surrounding Euratom are very serious, and I want to spell them out in words of one syllable because that is the only way that I can understand them. Quite simply, leaving Euratom could—I emphasise “could”—restrict the UK’s access to radioisotopes, which are critical to scans and treatment for cancer. It is as serious as that. We do not have reactors in this country capable of producing radioactive isotopes. We import them largely from France, Germany and Holland, and the control and safety monitoring of those isotopes is carried out by Euratom. By cutting our links with Euratom, we expose ourselves.

To put this issue in context, half a million scans are performed every year in Britain using imported isotopes and, on top of that, over 10,000 cancer patients have treatment involving their use. I just think that it is too big a gamble to take a decision on what I can only think are ideological grounds. That is a big, big error and I hope that the Government will rethink their position.

Going back to the basic issue, I suppose there are two basic problems. One is clearly finance. We spend less on healthcare than any of the other G7 nations, with one exception. I believe that the Government should make a commitment to go for at least the average spend on health among the G7. That would give us an opportunity in the years ahead to start an expansion.

A second problem is staffing—at every level. Throughout the National Health Service there is a panoply of overwork, low morale and staff working in what I can only describe as desperate conditions. Nurses finish their shifts in tears time after time. They are frustrated because they simply do not have the time to perform their job—their vocation of care—and they feel that they let the patients down, simply because they are understaffed. I have heard reports of nurses working a 12-hour night shift—that is the average length of a night shift—without being able to stop to have something to eat. That is happening regularly. The Minister might say, “Ah, but the numbers are made up with agency nurses”—and they are. But one only has to think about it to realise that, as the reports I get confirm, agency nurses can do the mundane things but most of them are not familiar with the work of the hospital or ward in which they are working. So even with the numbers increased by agency nurses, the onus on the regular staff of the hospital is increased.

It is not only about nurses, where we are 40,000 short of what we need, let us consider doctors. Where I live, the north Cumbria trust has 48 vacancies for consultants—we cannot get any consultants or nurses to work on the west coast of Cumbria. Right next to Sellafield, the largest industrial site in Europe, there is no hospital of any quality within an hour-and-a-half’s drive. That is the seriousness of the problem.

For the first time ever, more nurses are leaving the profession than joining. The worry is that the greatest drop was among the English or British-trained nurses, which was far higher than among the European-trained nurses.

I hope the Minister will consider looking again at the abolition of the bursary scheme if the indications at the beginning of September show that there is going to be a fall in the numbers. We cannot stand another decrease in the number of nurses. I say this to the Government because they need reminding: their track record is not good. They were the Government who cut nurses’ training by 10% in the years following 2010, and it has taken us a long time to recover.

I end with a thought on the residency of European Union-educated nurses. From exchanges with the noble Baroness, Lady Williams, I understand that after five years of working in the health service, or any permanent employment, European Union citizens can get the right to residency. Then, after a further year—six years in total—they are entitled to UK citizenship. That seems straightforward, but what concerns the nurses and the European Union is this: can those rights be withdrawn willy-nilly by any British Government in the future? That is a serious problem that the Government have to address in order to reassure people working in the health service.

[Lord Winston (Lab)]

Before my noble friend sits down—