NHS (Contracts and Conditions)

Debate between Rupa Huq and Helen Whately

Monday 14th September 2015 Westminster Hall

[Helen Whately]

I believe that the Secretary of State has done a good job of driving the NHS in the right direction, and I know that a large proportion of the workforce have been very supportive of him.

We are all in this room because we value the NHS, but we must not be complacent. We have to recognise when it lets people down. It is intolerable that if someone has the misfortune to get ill and be admitted to hospital at the weekend, they may be more likely to die. I am not going to repeat the statistics on that, because my hon. Friend the Member for Totnes (Dr Wollaston) helpfully updated us, and I suspect that my figures are not as recent as hers. She made a strong case, as have others, for why the NHS needs to have proper seven-day care, which must include the support services mentioned by the hon. Member for Warrington North.

The Royal College of Surgeons strongly supports seven-day care. It has said that one reason why outcomes are worse at weekends is that patients are less likely to be seen by the right mix of junior and senior staff; that such patients experience reduced access to diagnostics; and that earlier senior consultant involvement is crucial. Research from the NHS National Health Research Institute shows that 3.6 more specialists attend acutely ill patients on Wednesdays than on Sundays. More senior doctors need to be available at weekends—not just on call, as many consultants are at the moment, but present in hospitals.

The changes should not be about getting doctors to work intolerable hours, and that is not what is being proposed. As has been mentioned, only a small proportion of consultants exercise their opt-out. One could argue that the changes to the workforce, and to the consultant contract in particular, are about bringing the contract into line with what is actually happening. Looking at the terms of the workforce gives us an opportunity to ensure that there is an appropriate package for doctors in A&E, where there are large numbers of vacancies. That is the case in hospitals in and around my constituency in Kent, which is an area with a high proportion of out-of-hours work. It also gives us an opportunity to ensure that clinicians are recognised and rewarded for taking on management and leadership responsibilities. We really need clinicians to step up and take on those responsibilities. It gives us an opportunity to make sure that consultants are treated as professionals who take responsibility for their patients, their team and the whole service that they provide.

The NHS faces an incredibly tough time over the next five years. It faces rising demand for its services and rising expectations, and even with an extra £8 billion on its way, things will have to change. Senior doctors, along with senior nurses and other health professionals, will have to lead those changes. When I worked in hospitals grappling with the challenges of transformation, ideas came from everyone: junior doctors, senior doctors and patients. When it comes down to it, consultants, matrons and senior staff have to lead from the front and make things happen. They often face opposition from colleagues, so they need to be courageous and put in extra hours.

To ensure that that happens, and to get the NHS from where it is now to where we want it to be in five years’ time, there has to be a sense that we are all in it together. We cannot have a situation in which doctors blame managers and politicians, while politicians and managers point fingers at doctors. We absolutely have to move on and focus on doing what is best for patients, and what will achieve the best clinical outcomes. We have to build trust among all who are involved in healthcare and work out how we can have, and how we can afford, excellent care seven days a week, day and night. We have to support the healthcare professionals—consultants, nurses, managers and everyone else who is going to make that happen.

[Dr Huq]

Will the hon. Lady give way?

[Helen Whately]

I was just finishing.

[Dr Huq]

I just wanted to ask where the hon. Lady would place management consultants in that. The NHS in north-west London has spent, I think, £13 million this year alone on Saatchi and Saatchi, and various other groups. I just wondered where she would place that in that trajectory. Hopefully, it will be something we can all agree on.