NHS: Doctors’ Strikes

Lord Stirrup Excerpts

Wednesday 5th July 2023 Lords Chamber

[Lord Markham (Con)]

Yes, of course, the noble Lord is absolutely correct; retention is key in all this. That is looking at all aspects of the package and work conditions and everything around those. That is what the workforce plan addresses, I hope, because recruitment and retention are key.

[Lord Stirrup (CB)]

My Lords, pay is the headline issue in this dispute, but behind it lies a wholesale collapse of morale within the NHS workforce, and that is about much more than just remuneration. The NHS Long Term Workforce Plan addresses some important issues but by no means all of them. Does the Minister not think that the morale issue, which is so crucial to the future of the NHS, will be better attacked through the kind of radical approach suggested by Sajid Javid than the “evolution” proposed by the Health Secretary?

[Lord Markham (Con)]

I think the morale of doctors is best approached by a number of measures. As I said yesterday, there is not one silver bullet. There are a number of things: clearly, pay is important; pensions are very important, and we have addressed those, and so are working conditions. I was at Whipps Cross Hospital, one of the new hospitals, last week. The morale boost to staff there, knowing they are getting a new hospital, is massive. All those features are vital to improving morale.

General Practitioners: Recruitment and Retention

Lord Stirrup Excerpts

Monday 12th June 2023 Lords Chamber

[Lord Markham (Con)]

I completely agree that we need to look creatively and flexibly. We are on target to deliver 50 million more appointments, which is 10% more each day. That is through recruiting more staff. We have about 29,000 more staff in the GP work space, and that is using them flexibly and creatively.

[Lord Stirrup (CB)]

My Lords, part of the pressure being experienced by secondary care specialists is as a consequence of inadequate time for appropriate diagnosis by primary care specialists—the GPs. Numbers are, of course, a part of this, but what are the Government going to do about setting targets for consultations with GPs that reduce the pressure on hospitals and see more patients dealt with in primary care?

[Lord Markham (Con)]

I totally agree; it is all about getting upstream of the problem. I visited an excellent surgery—Greystone House in Redhill—where they are doing exactly that. They are taking their most critical 1% of patients in respect of need and trying to get appointments in ahead of time so that they can move into preventive measures; I absolutely agree.

NHS: Allocation of Financial Resources

Lord Stirrup Excerpts

Thursday 11th May 2023 Lords Chamber

[Baroness Manzoor (Con)]

My Lords—

[Lord Stirrup (CB)]

My Lords—

--- Later in debate ---

[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.

Excess Deaths in Private Homes

Lord Stirrup Excerpts

Tuesday 10th January 2023 Lords Chamber

[Lord Markham (Con)]

Again, I spoke further to Sir Chris Whitty exactly on this. He writes an annual report on this. We will be doing so in the same way and looking at all the factors.

[Lord Stirrup (CB)]

Can the Minister tell the House what happened to cancer diagnosis and referral times during the course of 2022, and what the prognosis is for these crucial measures over the coming year? If he does not have the statistics to hand, can he write to me and place a record in the Library?

[Lord Markham (Con)]

I will happily provide the detail on that. We all know about the 62-day challenge. That has been the focus of Ministers ensuring that we are bearing down on that number, so that an increasing proportion are treated within that period.

Children in Care: CAMHS Waiting Times

Lord Stirrup Excerpts

Monday 5th December 2022 Lords Chamber

[Lord Stirrup (CB)]

My Lords, clinical staff are at crisis point throughout the NHS. What contribution are staffing levels in this area making to current waiting lists, and what is being done to address it?

[Lord Markham (Con)]

I do not know what contribution it is making to waiting lists. However, I do know that the long-awaited workforce plan—which noble Lords opposite have quite rightly asked me about many times, and I am very glad to say we are now producing it—will include these types of people as well, because they are clearly a very important component of the workforce that we need.

NHS: Waiting Lists and Increased Spending

Lord Stirrup Excerpts

Tuesday 22nd November 2022 Lords Chamber

[Lord Markham (Con)]

My noble friend is correct. Efficiency is very important, as pointed out in a previous Question. I have done some work in this space, and there are some trusts that are absolutely on the path to the 130% increase in elective treatments compared with 2019, for which the funding is in place. There are other trusts that are not. Clearly, my job and the job of all the department’s civil servants is to understand why that is and to challenge those trusts that are not; to support them where they need that support; and to ensure they are introducing best practice and innovation in order to make sure they all get back towards that level. There are some very good performers and others that are not so good.

[Lord Stirrup (CB)]

My Lords, we hear a lot in this House about the recruitment of doctors and nurses. However, any organisation facing the kind of challenges confronting the NHS would ordinarily be doing its utmost to retain its talent. The NHS, in many ways, seems to be doing the opposite. When will it develop a comprehensive strategy for the retention of its experienced clinical personnel, without whom it would simply be unable to function?

[Lord Markham (Con)]

I thank the noble and gallant Lord for his question. I was delighted to see in the Chancellor’s Statement a commitment to a workforce strategy for five, 10 and 15 years, something that all of us in this House have been asking for. It will look at all the needs in respect of recruitment and, crucially, retention. That is very much part of the agenda.

Coronavirus: New Cases

Lord Stirrup Excerpts

Monday 11th July 2022 Lords Chamber

[Lord Kamall (Con)]

My noble friend makes a very important point. You always have to look at these things in the round and you have to look at the trade-offs. Many noble Lords will recognise that, when we went into lockdown, there were build-ups in many parts of the NHS backlog and an increase in people suffering from mental health issues—the numbers were even larger than they were before—so clearly, we have to look at this as a trade-off. We have a living with Covid strategy. We constantly get updated by the UKHSA, which is looking at all this data. We are ready to stand up should we need to.

[Lord Stirrup (CB)]

My Lords, the recent welcome inroads into NHS waiting lists are now being reversed. What plans do the Government have to ensure that, as Covid pressures mount, over the winter in particular, crucial NHS services and diagnoses are sustained—particularly, for example, early diagnoses of cancers?

[Lord Kamall (Con)]

The noble and gallant Lord makes a very important point: we have to continue with the living with Covid strategy, and keep an eye on the Covid cases, but also be aware that we need to clear the backlog, and that people have missed appointments. One of the things we are doing is looking more at diagnostics. Many noble Lords will be aware that about 80% of the waiting list is people waiting for diagnosis. Of those waiting for surgery, about 80% of them do not need to stay overnight in hospital. We want to make sure that we get the right balance between monitoring what is going on with Covid and at the same time clearing the backlog.

GP Access

Lord Stirrup Excerpts

Tuesday 7th June 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Baroness makes an important point. Because of the focus on Covid and making sure we were keeping everyone safe, especially before we had a vaccine, precautions clearly had to be put in place. Of course, at the time it seemed eminently sensible to make sure that doctors and patients were protected. As the noble Baroness rightly highlights, the unintended consequence of this has been a backlog in seeing other patients. One of the things we are doing is making sure that, as we roll out these community diagnostic centres and modernise primary care, we can see patients in a more timely way. The GP does not necessarily have to be the first point of contact.

[Lord Stirrup (CB)]

My Lords, how are the Government measuring and reporting retention levels of clinical staff in the NHS? This is one of the ways that will enable us to assess the effectiveness of the measures the Minister has said the Government are putting in place.

[Lord Kamall (Con)]

I thank the noble and gallant Lord for the question. The important point is that sometimes the assessment is done at a local level, sometimes it is done at an overall level and sometimes the department gathers the statistics. As we modernise and digitise the system, a lot more of that information will be able to be processed centrally, so that we can understand where we need to have better planning and to redeploy resources to meet the needs in certain areas.

Children: Cancer

Lord Stirrup Excerpts

Thursday 26th May 2022 Lords Chamber

[Lord Kamall (Con)]

All these issues are being looked at as we understand more about childhood cancer and also in the context of wider support. That is important not only during the time they are receiving treatment; as the noble Baroness rightly says, it is not just about the cancer itself but about some of the poor patients and their families, because when they get the bad news it affects their mental health. We have to look at this in a holistic way and there are a number of initiatives. I will write to the noble Baroness with some more detail.

[Lord Stirrup (CB)]

My Lords, early diagnosis is key to successful outcomes in all kinds of cancer. In the long-term plan the Government set out an ambitious target for increasing the early diagnosis of most cancers. Can the Minister tell the House what impact Covid, the subsequent backlog and the shortage of clinicians in the NHS is having on the achievement of this target, how progress towards it is being measured and how it is being reported?

[Lord Kamall (Con)]

I thank the noble and gallant Lord for that question. I am really sorry—I have completely forgotten what it was. Can he remind me?

[Lord Stirrup (CB)]

Could the Minister tell us what impact Covid, with its backlog and the shortage of NHS clinicians, is having on how the target is being measured and reported?

[Lord Kamall (Con)]

I completely apologise to all noble Lords. It is important that we look at this issue; I am afraid I will have to write to the noble and gallant Lord with more detail.

Breast Screening

Lord Stirrup Excerpts

Tuesday 14th December 2021 Lords Chamber

[Lord Stirrup (CB)]

My Lords, this issue, like many across the NHS, is exacerbated by what the Financial Times today referred to as a workforce crisis. When will the Government take urgent action to stem the large and increasing outflow of trained medical personnel that is proving so debilitating to the provision of health services across the board?

[Lord Kamall (Con)]

In previous debates this week I have outlined what we are doing to increase recruitment. On the specific issue in the mammography workforce, Health Education England is providing £5 million to support a new training and development programme through the National Breast Imaging Academy. That itself will increase recruitment, improve screening targets and increase early diagnosis of cancer.