NHS: Long-term Strategy

Alun Cairns Excerpts

Wednesday 11th January 2023 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I beg to move,

That this House condemns the Government for failing to recognise the current crisis in the National Health Service; regrets that, as a result of Government mismanagement, hundreds of lives may be being lost every week due to the collapse of emergency care while patients are finding it impossible to get a GP appointment, ambulance or operation when they need one; calls on the Prime Minister to acknowledge the crisis and act with the necessary urgency to mitigate the impact on patients; and further calls on the Secretary of State for Health and Social Care to ensure the NHS is never in this situation again by bringing forward a long-term strategy which will end delayed hospital discharges, provide the NHS with the necessary staff to treat every patient in good time, and reform primary and community care to reduce the number of people needing hospital treatment.

I rise to support the national health service, which is going through the biggest crisis in its history, and most importantly, to defend the patients who are suffering as a direct result of 13 years of Conservative mismanagement of the NHS. This winter has shown just how high a price patients are paying: NHS staff are walking out on strike—in the case of nurses, for the first time in their history—patients are waiting entire days for an ambulance to arrive, and then days on end in A&E before they are admitted; there were 50,000 needless, preventable deaths last year, which experts have blamed on unacceptably long waiting times; and there have been hundreds of avoidable deaths every week this winter, because emergency care has collapsed.

The Secretary of State for Health and Social Care says that he disputes those figures from the Royal College of Emergency Medicine and the Office for National Statistics, but I invite him to listen to some of the stories behind the numbers. An 89-year-old fell in the bathroom and waited nine hours for an ambulance. The sepsis that caused him to fall killed him. His consultant said:

“Had I seen him within a couple of hours it could have been avoided. Maybe.”

Teresa Simpson, a 54-year-old woman from Hull, suffered a cardiac arrest and lost oxygen supply to the brain. She waited 16 hours for an ambulance, which arrived only when her husband phoned 999 a second time, after she had become lifeless. She passed away. A consultant in the north of England described a scene in a hospital waiting room this winter when a patient collapsed:

“They get CPR on the floor. I am forced to declare his time of death in front of frightened, horrified members of the public and his wife. On the floor of the waiting room. He was elderly and frail and hadn’t wanted to bother us. We had run out of trolleys and beds. In the whole hospital. This was by 10am.”

The Prime Minister refuses to describe this as a crisis.

Our motion before the House calls for a long-term plan to end delayed discharges, give the NHS the staff it needs to treat patients on time, and reform primary and community care, so that fewer people end up in hospital.

[Alun Cairns (Vale of Glamorgan) (Con)]

Will the hon. Member give way?

[Wes Streeting]

The Government do not have a plan, but perhaps the right hon. Gentleman will surprise me by telling me, against all hope and expectation, that they do.

[Alun Cairns]

Clearly, some of the statistics and cases that the hon. Member highlights are distressing and no doubt need to be investigated. The Prime Minister has rightly prioritised waiting times as one of his key commitments this year. How does the hon. Member account for the performance in Wales, which is worse than in England on all the statistics that we highlight, in spite of the Labour party having been in charge of the NHS there for more than 20 years?

[Wes Streeting]

I am grateful for the right hon. Gentleman’s intervention, because it brings me directly to the Government’s amendment to the motion, which is not a plan but a litany of excuses for the situation across the United Kingdom, including in Wales. I will run through them. By way of excuse, they say that the situation is challenging across the United Kingdom, and they are right: in Wales, the NHS is struggling; in Scotland, the NHS is struggling; and in Northern Ireland, the NHS is struggling. What do all parts of the United Kingdom have in common? Thirteen years of Conservative underfunding.

I will tell the right hon. Gentleman that, as he knows perfectly well as a Welsh Member, the reason why the Welsh NHS struggles more than England overall is the age profile of the population, the number of disabled people in Wales and the level of deprivation. The same disparities between Wales and England overall also explain the enormous health inequalities within England, which is why health outcomes in my city—in London—are so much better than in so many parts of the north or south-west of England. And you know the way to deal with that? It is genuine levelling up. But if people want a Government who tackle health inequalities so that every person in every part of the United Kingdom gets good-quality healthcare, they need to elect a Labour Government here in Westminster. That is the truth that the right hon. Gentleman does not want to admit.

I know that SNP Members will not be here today, because we are talking about England, but here is another truth that Nicola Sturgeon does not want to admit either: people in Scotland will be better off under a Labour Government too. She knows that just as well as anyone else.

When Conservative Members are not talking about other parts of the United Kingdom, they say that health pressures exist right across the world, but international pressures do not explain why the average wait for an ambulance is 14 minutes in France, while heart attack victims and stroke victims routinely wait an hour for an ambulance here in England. International pressures do not explain why it is that, over the past year, one in six UK adults had a pressing need for medical examination or treatment but could not get access. They do not explain why this is the highest figure out of 36 European countries and almost triple the EU average. Their excuses about international pressures do not explain why cancer outcomes in England are behind other comparable countries. None of that explains why the state of the NHS is as bad as it is today, but perhaps the hon. Member for Bosworth (Dr Evans), who was trying to intervene, wants to stand up and justify why it is that, after 13 years of Conservative Government, his constituents are waiting an average of an hour for a heart attack or stroke case.

--- Later in debate ---

[Alun Cairns (Vale of Glamorgan) (Con)]

I must admit that I was surprised by the audacity and tone that the hon. Member for Ilford North (Wes Streeting) took when introducing such an important debate. Not one Welsh Member of Parliament from the Labour party is present. I think they may share my disappointment in the tone the Labour party is taking over this serious issue, bearing in mind the performance of the Labour party and Government in Wales in failing to deliver on the NHS. Who knows, those Members might be embarrassed or angry; maybe they are angry and embarrassed at the hon. Member for Ilford North. I hope they are certainly disappointed by the performance, waiting times and outcomes for our constituents in Wales.

Tone really does matter. This is a really important debate, and we need to consider it in the way the Secretary of State recognised the issues facing every part of the United Kingdom. The Chairman of the Health and Social Care Committee, my hon. Friend the Member for Winchester (Steve Brine), also recognised that and urged the use of responsible language. This needs to be followed through. When I have highlighted deficiencies in the NHS in Wales in the past, I have been accused of undermining the NHS or attacking NHS staff. I hope I will not be accused of that now, as that is not my objective. I am instead frustrated with the Labour Government in Wales and the outcomes my constituents are experiencing. I make this contribution in support of the NHS staff, clinicians and all the apparatus that delivers an effective and efficient health service.

Much has been said about data and waiting times, and I could go on and on about that. No matter what statistic the hon. Member for Ilford North highlights, I could trump him every time with worse performance in Wales. I am not celebrating that, because my constituents and my family experience that performance. I am disappointed by the political tone the hon. Gentleman is taking in seeking to exploit the challenges facing the NHS and its staff having come out of a global pandemic. That is something we absolutely need to recognise.

I will highlight some statistics to encapsulate the experiences of my constituents and others in Wales. After 25 years of a Labour Administration in Wales, accident and emergency times, primary care delays, cancer treatment times and waiting lists are much longer than they are in England, or than they were previously. In England, 5% of patients are waiting longer than 12 months; in Wales, 23% of patients are waiting longer than 12 months. I will not bore everyone with lots of numbers, but I will take that to the next level of statistics: 7.9% of patients in Wales are waiting longer than two years for treatment. That is why Opposition Members have to accept and recognise that this a serious debate that affects every part of the United Kingdom, Europe and beyond.

[Simon Baynes (Clwyd South) (Con)]

Does my right hon. Friend agree not only that the statistics for Wales are markedly worse than for England, but that in Wales the expenditure per head on health is 15% higher than in England?

[Alun Cairns]

My hon. Friend makes an important point. The hon. Member for Ilford North pointed to the lack of funding for the NHS in Wales, but since 2010, only the Labour Government in Wales have ever cut NHS funding—no other Government in the UK have done that. When I was the Secretary of State for Wales, we renegotiated a funding formula that the First Minister, who was the Finance Minister at the time, said was a very fair deal. That formula means that Wales receives £120 for every £100 that is spent in England, and there is a funding floor attached to it. That highlights the generosity and fairness of the settlement, bearing in mind the inequality that the hon. Member for Ilford North highlighted earlier.

In my final minute, I will comment on the strike action. Every point that the Leader of the Opposition has made about the challenges of strikes, and every criticism that has been made of the Prime Minister and Secretary of State for Health and Social Care, could equally apply to the First Minister and Health Minister in the Welsh Government. That demonstrates the complexity of the situation. The Welsh Government say that they cannot act until they have more money, but they need to remember that they are getting £120 for every £100 that is made available in England, and they have tax-varying powers. Are they saying that they want to tax the English more in order to spend more in Wales? They can vary taxes however they want—[Interruption.] They can vary taxes and that is the choice that they have to make. They decide where they spend their money. In closing—

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. Sorry, time is up. We have to be fair to everybody.