Defending Public Services

Debate between Lord Clarke of Nottingham and Heidi Alexander

Monday 23rd May 2016 Commons Chamber

[Heidi Alexander]

From memory, I seem to think the budget going to the NHS in Wales has been cut in Westminster.

Let us have a look at the figures. In March 2011—[Interruption.] The Health Secretary would do well to listen to these figures, because I am about to tell him the record of his term in office. In March 2011, 8,602 patients waited more than four hours on trolleys because no beds were available. Four years later, the figure was up sixfold, to 53,641. In March 2011, just one patient had to wait longer than 12 hours on a trolley. Four years later, 350 patients suffered that experience. The NHS waiting list now stands at almost 3.7 million people—the equivalent of one in every 15 people in England. Only 67% of ambulance call-outs to the most serious life-threatening cases are being responded to within eight minutes.

I could reel off more statistics, but I will instead read a letter that I received the other week:

“Dear Ms Alexander,

I recently had the misfortune of using the A&E at my local hospital in Margate. My wife feels that I was lucky to escape with my life.

My experience has convinced me that our health service has never been more under threat than since Mrs Thatcher.

The fact that I was sent home after 4 hours without seeing a doctor and returned by emergency ambulance with a now perforated appendix I blame mostly on the conflict between the Health Secretary and the Junior Doctors. Had this been resolved he would have been able to concentrate on the woeful lack of resources our NHS faces.”

Take the experience—[Interruption.] The Parliamentary Private Secretary to the Health Secretary says, “Show us the letter”. I have it here, and I got the permission of the individual who wrote to me before referring to it.

Let me refer to another example—the experience of Mr Steven Blanchard at the Swindon Great Western hospital last November. He said in an open letter to the Swindon Advertiser:

“We arrived at 6.40pm and were asked to sit with about 15 others in the unit. It became apparent this was a place of great suffering and misery…Firstly, there was a lady who was doubled up in pain who had been promised painkillers three hours before and I witnessed her mother go again and again to reception until she was begging for pain relief for her near hysterical daughter.”

Another old lady

“who had been left on her own by her son…was sat picking at a cannula in her arm trying to pull it out…A very frail and sick old man was sat in a wheelchair and he had been in the unit since 8am. He kept saying over and over ‘a cup of tea would be nice’…then I watched as urine trailed from him and fell on to the floor beneath the chair…At 10.30pm he was taken to a ward after 14 hours.”

Mr Blanchard said that he and his partner were finally seen at 1.20 am, and stated:

“Never before have I seen people crying out of desperation…I don’t know what is to blame or whether it’s lack of money or lack of staff but this place was what I can only describe as ‘hell on earth’.”

That is what is happening in our NHS in 2016, and such stories are becoming more common. Ministers may not like to hear it, but they need to start taking responsibility.

[Mr Kenneth Clarke]

There are always pressures in the giant national health service as demand grows and expectations rise, and there always will be. The hon. Lady could have made this speech as an Opposition spokesman 10, 20, 30 or 40 years ago. After 20 minutes, she has not yet suggested a solitary policy proposal as an alternative to the Secretary of State’s, and she has not said whether she agrees with him about seven-day working and all the rest of it. She is describing sad incidents in which things have obviously not been ideal or as they should be, but does she have anything to suggest by way of policy that may contribute to helping the NHS in future?

[Heidi Alexander]

Having had these exchanges over the Dispatch Box for the past nine months, it strikes me that the reality of what people are experiencing in hospitals is sometimes missing from these debates, and that is why I thought it important to quote from those letters.

On workforce challenges, nothing sums up this Government’s failure on the NHS more than the way that they have treated NHS staff. We have had pay freezes, cuts to training places, and the first all-out doctors strike in 40 years—a strike that the Health Secretary did not even try to prevent; in fact he provoked it. He has spoken about seven-day services, but he said little about how he proposes to improve weekend care without the extra resources and staff that the NHS will need. We can only assume that his plan is to spread existing resources more thinly, asking staff to do even more and putting patients at risk during the week.

The Health Secretary also failed to say what experts think about his approach. For example, Professor Sir Bruce Keogh said that the NHS was making good progress towards improving weekend care, but that that became “derailed” when the Health Secretary started linking seven-day services to junior doctors. Fiona Godlee, editor of The British Medical Journal, said that, by picking a fight with doctors, the Health Secretary has set back NHS England’s established programme of work on improving services at weekends. Not only does he have no plan to deliver a seven-day NHS, but he has ripped up the plan that was already in place to improve weekend care. You couldn’t make it up, Mr Speaker.

The Health Secretary often reads out his usual list of stats on staff numbers, but to know what is really happening we must look beyond the spin. A recent survey of nurses by Unison found that almost two-thirds believe that staffing levels have got worse in the past year, and 63% said that they felt there were inadequate numbers of staff on the wards to ensure safe and dignified care—that figure was up from 45% the year before. Whether GPs, nurses or midwives, numbers of staff have not kept pace with demand.

Analysis by the House of Commons Library shows that, in the Labour Government’s last year in office, there were 70 GPs per 100,000 of the population, but that figure has now fallen to just 66. In Labour’s last year, there were 679 nurses per 100,000 of the population, but there are now just 665. No wonder that doctors and nurses feel pushed to breaking point. If we do not look after the workforce, patients will suffer. There was nothing in the Queen’s Speech to help the workforce—no U-turn on scrapping NHS bursaries, no plan to train the staff the NHS so desperately needs, and no plan to improve working conditions.

Oral Answers to Questions

Debate between Lord Clarke of Nottingham and Heidi Alexander

Tuesday 13th March 2012 Commons Chamber

[Heidi Alexander (Lewisham East) (Lab)]

10. What discussions he has had with the Lord Chief Justice on the potential effect of his planned changes to legal aid on the number of litigants in person.

[The Lord Chancellor and Secretary of State for Justice (Mr Kenneth Clarke)]

Substantial numbers of cases already involve litigants in person, so the courts already deal with this situation. The Government recognise that the changes to legal aid are likely to increase the number of litigants in person. The evidence appears to show that some cases featuring litigants in person are resolved more quickly, whereas some cases take longer.

--- Later in debate ---

[Mr Clarke]

Well, we have just discovered that the Labour party’s policy is to make substantial cuts in criminal legal aid. If the Government had made that proposal, that would no doubt have led to amazing attacks on our disregard for the principle that a person is innocent until proven guilty and to comments about the high risk of injustice in criminal trials. On the savings we are making in the cases to which the hon. Gentleman refers, the fact is that courts already deal with litigants in person. Any judge or tribunal knows that they have to pay particular attention to make sure that people are not disadvantaged by not having legal representation, but as the Under-Secretary of State for Justice, my hon. Friend the Member for Huntingdon (Mr Djanogly), has just explained, we have tried to identify cases in which the informality of the tribunals means that applicants should not be at any particular disadvantage if they do not have a lawyer there in any event.

[Heidi Alexander]

What assessment has the Secretary of State made of the additional cost that will be incurred by the legal system overall as a result of the increased numbers of litigants in person?

[Mr Clarke]

We are not persuaded that that will give rise to any increase in costs. Everybody accepts that cuts need to be made to legal aid. It is just that the Labour party is against every single cut that we suggest in particular. This cut is perfectly straightforward and will not give rise to the difficulties that the hon. Lady points out—[Interruption.] I can only say to the Opposition spokesman that he is obviously so discommoded by realising that he nearly gave out a policy on the subject a moment ago that he is getting rather carried away. We have carefully selected cuts in legal aid concerning less serious cases where cuts can be made without any risk to justice whatever.

Oral Answers to Questions

Debate between Lord Clarke of Nottingham and Heidi Alexander

Tuesday 11th January 2011 Commons Chamber

[Mr Clarke]

I was obviously involved in the collective discussions, as were colleagues, and we took the best legal advice. I remind the right hon. Gentleman that the previous Government accepted the legal obligation. The Government in which he recently served undertook two consultations, and they canvassed four years as a possibility. [Interruption.] With great respect, they did canvass four years, and they also accepted that prisoners should vote in all elections, including local government elections and referendums. We have drawn back from that. We are proposing that they should vote only in parliamentary and European elections.

[Heidi Alexander (Lewisham East) (Lab)]

4. What recent discussions he has had with ministerial colleagues on the likely effect on the expenditure of other Departments of his proposed changes to expenditure on legal aid.