NHS: Allocation of Financial Resources

Lord Markham Excerpts

Thursday 11th May 2023 Lords Chamber

[Lord Roberts of Llandudno]

To ask His Majesty’s Government what financial resources are being allocated for (1) additional beds, (2) extra ambulances, and (3) the recruitment and training of extra NHS staff.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

The delivery plan for recovering urgent and emergency care services sets out how we will provide 5,000 additional permanent beds, backed by £1 billion of dedicated funding to support capacity. We are also providing ambulance services with £200 million of additional funding in 2023-24 to grow capacity and improve response times, alongside delivering 800 new ambulances. We are committed to publishing a long-term workforce plan for the NHS, which will be published shortly.

[Lord Roberts of Llandudno (LD)]

My Lords, over the years, we have had many promises for the NHS. I wonder how the 40 new hospitals are getting on. We were also promised £350 million a week if we came out of Europe. The present Prime Minister made promises earlier this year; are they any more sound? Are there 5,000 more hospital beds, 800 extra ambulances and thousands of staff? Given the conflict over nurses’ pay and other NHS pay and conditions, we are suspicious. I ask the Minister for a full, detailed Statement on the funding and progress of all these pledges.

[Lord Markham (Con)]

We have been giving a lot of Statements. Just this week, I was telling the House about the primary care plan; we announced the social care plan earlier in April; and we had the emergency recovery plan and the elective recovery plan. The plans are in place, and they are starting to show improvements, which will continue.

[The Lord Speaker (Lord McFall of Alcluith)]

The noble Lord, Lord Campbell-Savours, is taking part remotely.

[Lord Campbell-Savours (Lab) [V]]

My Lords, is it not possible that the great British public just might be prepared to see a far greater proportion of their taxes diverted from ill-thought-out and often totally unnecessary tax concessions to the better off, which invariably fail any incentive testing anyhow, in favour of a properly funded National Health Service that slashes waiting times, properly funds health professionals and meets the health requirements of the British people? That is what the public want. Just ask them and look at the polling data.

[Lord Markham (Con)]

We are putting in record investment. Right now, we are spending about 12% of our GDP on health services; a few years ago, the figure was more like 7% or 8%, so there is record investment. I think the whole House would agree that how we use that investment is the most important thing. We have seen that certain hospitals have a 13% lower cost per patient treatment than others because of effective use of technology. That is where I want to see investment take place.

[The Lord Bishop of St Albans]

My Lords, I welcome what His Majesty’s Government are doing to try to get on top of this very difficult problem. Will the Minister give us a little more information, particularly about ambulance services? In Hertfordshire, which is in my diocese, category 2 call-outs, for strokes and hearts attacks, should have an 18-minute response but the response is averaging two hours and six minutes at the moment. There is a great deal of anxiety among ordinary people when these things happen. When do we think that the money going to the ambulance service is going to bring response times down?

[Lord Markham (Con)]

I am pleased to say that the figures announced today show that response times are coming down. For category 1, the most serious, we achieved the 15-minute target for 90% of calls. We are moving in the right direction, albeit there is a lot more that needs to happen in this space. That is what the investment in 800 new ambulances is about, as well as the £200 million of funding. Most importantly, it is about making sure we have the right services in place. Some 50% of ambulance calls do not result in a trip to the hospital. There are fall services, which are often best placed to help, which will pick people up in their home.

[Baroness Blackwood of North Oxford (Con)]

My Lords, I declare my interest as chair of Genomics England. Some 3.5 million people live with rare diseases but only 5% of those conditions have a specific therapeutic. Condition management is essential, but patients struggle to find it because of poor awareness and a shortage of specialist clinicians and nurses. The England Rare Disease Action Plan 2023 commits to a workforce strategy but it does not commit to anything on capacity. What are the Minister’s plans to resource the rare disease workforce?

[Lord Markham (Con)]

This will be another element covered in the long-term workforce plan, making sure that we have got every route covered. My noble friend mentioned signposting people to those services. We are shortly launching a new app service—some 30 million people already have it—to make sure we are signposting to the place where people can get the right treatment for everything, including rare diseases.

[Lord Laming (CB)]

My Lords, does the Minister agree that one of the best ways to help the health service would be if the Government would allocate money dedicated to social care services? This would relieve the pressure on beds. Many beds would be relieved—thousands of beds—and it would prevent people having to go into hospital. Is that possible?

[Lord Markham (Con)]

Yes, and we are doing it. We have committed to an up to £7.5 billion increase in funding over the next two years. We announced last month a social care plan which is addressing this and reforming the sector, and we are starting to see the changes.

[Baroness Merron (Lab)]

My Lords, the Royal College of Emergency Medicine described as unambitious the Government’s plan to see 76% of A&E waits meeting the four-hour standard by 2024. As this target has not been achieved in the past two years, how does the Minister see it working to drive down waiting times? How will the Minister ensure that hospitals are not prioritising patients with minor conditions at the expense of those in greater need of admission simply to allow them to meet the target?

[Lord Markham (Con)]

Numbers out just this morning show that we are now at 75% of people being seen within four hours, so we are close to the 76% target. That is the best since September 2021. I am the first to admit that we want to go further, as the noble Baroness states. It is about making sure we have got the care in the right places. We are triaging to make sure that the most important cases are seen first and, as I mentioned in a previous answer, we have things such as fall services, which can avoid trips to A&E in the first place, and more primary care in place to avoid visits in the first place. That is what the primary care recovery plan is all about.

[Baroness Jolly (LD)]

My Lords, sometimes the NHS is a bit like a greedy child, always needing more. In his Question, my noble friend mentioned additional beds, extra ambulances, and recruitment and training. Will the Minister tell us what budget each of these items comes from? Will the Minister enlighten the House about this issue?

[Lord Markham (Con)]

The budgets are in the allocations for each ICB and each hospital, and within them there are specific allocations to make sure that these fundings are rooted in the place where they have the most effect. As for making sure that really does happen, it is the responsibility of each ICB to make sure it is doing that. Ministers hold them to account by each having seven ICBs to take care of and make sure that they are hitting those targets.

[Baroness Manzoor (Con)]

My Lords—

--- Later in debate ---

[Baroness Manzoor (Con)]

My Lords, I very much welcome the significant sums of money that have been put into the NHS to date by the Government. It is not just increases in beds that we need in hospitals. We live in an age where we have made significant inroads and innovation in technology, diagnostics and so forth, including artificial intelligence. Will my noble friend the Minister say how new technologies are being used to ensure that patients are not needing the extra beds in hospitals and creating the old mistakes we know of?

[Lord Markham (Con)]

I shall answer quickly. As I said, there is already a 13% lower cost in a hospital which is digitally mature. We have virtual wards going in to make sure that we can treat as many as 50,000 patients every month to improve the flow and improve services.

[Lord Stirrup (CB)]

The Minister has mentioned the long-awaited workforce plan. While we have been waiting we have seen a number of interesting initiatives, such as the greater use of pharmacies and the proposal to put SAS doctors into GP surgeries. Will the workforce plan look holistically at the totality of healthcare professions and qualifications, so that in future the workforce can be used in the most efficient way possible?

[Lord Markham (Con)]

Absolutely. The plan is looking at the use of Pharmacy First, as the noble and gallant Lord mentioned, and at the use of technology and the productivity improvements that will make. It is looking at the use of apprenticeships and at how we can bring people back into the nurse and doctor workforce. It is obviously looking at things such as pensions, which we are improving so we can retain more of our doctors. It is a holistic and very detailed study. I know it is taking a while to come out, but it will be worth the wait.