Heart and Circulatory Diseases (Covid-19)

Debate between Andrew Gwynne and Flick Drummond

Thursday 23rd June 2022 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

I thank the hon. Member for Strangford (Jim Shannon)—I call him my hon. Friend because he is my friend—not only for securing the debate but for his skilful, seamless segue from Westminster Hall to the main Chamber. I join him in paying tribute to all those who work in our health and care system—from doctors and nurses through to porters, cleaners and cooks. They all keep our health and care system going, and we thank each and every one of them for the work they do.

As we heard from the hon. Members for Strangford and for Motherwell and Wishaw (Marion Fellows), who leads for the SNP on these matters, the issue of health inequalities cannot be ignored. The hon. Gentleman talked about postcodes and the workforce not being spread equally, and those health inequalities are not spread evenly across the UK. The hon. Lady mentioned some endemic health inequalities in parts of Scotland, and the same is true of every part of the UK. The maps of deprivation, of certain black and minority ethnic communities, of income levels, of education levels, of obesity and of smoking prevalence can almost be overlaid, and directly correlate, with those for the conditions that we are talking about. Those health inequalities and how we tackle them must be at the heart of everything we do, whether we are talking about the UK Government and their health policy for England, or the devolved Governments across the nations of the UK and the work they do to tackle these same health inequalities in the communities we represent. Health prevention must be at the core of what we do, and I am grateful for the insight the hon. Lady gave on the work of the NHS in Scotland and the insight that the hon. Gentleman brings on the work of the NHS in Northern Ireland. I am a big fan of the Marmot way of looking at health inequalities and how we tackle the social determinants of health. If we get that prevention policy right, we tackle the very conditions that we are talking about.

The pandemic piled massive pressure on the NHS, and indeed the motion is on the impact of the covid-19 pandemic on people with heart and circulatory diseases. But these problems did not start with the covid pandemic. They have been exacerbated massively by it, but I am afraid that we are now seeing the consequences of 12 years of Conservative Government in England: soaring waiting times, an acute staffing crisis and the worst levels of patient satisfaction since the 1950s. We went into 2020 with the NHS in crisis, and the pandemic ruthlessly exploited and exacerbated the failures. As the Culture Secretary recently admitted, a decade of Conservative rule left our NHS “wanting and inadequate” before covid hit. That is nowhere more apparent than in cardiac care. At the start of 2020, 30,000 people were waiting more than 18 weeks for cardiac care. That was already an unacceptably high figure, but it has ballooned by an unbelievable amount in the last two years. Now, 319,000 people are on an NHS waiting list for cardiac care—that is 319,000 individuals anxiously awaiting essential care, worried for their future, worried about their health and worried about their lives.

Cardiac care is time-sensitive. For example, patients with severe aortic stenosis—I will put my teeth in to say that—who are treated within two years have a 50% chance of survival, but that falls to 20% after five years. Every day that the Government fail to act, more patients face worse outcomes. About 15 million adults in the UK have high blood pressure and about 270,000 people over 65 have undiagnosed atrial fibrillation. What does that mean? It means we are sitting on a ticking timebomb, and unless we pre-emptively support people to manage cardiovascular risk factors, the system will come under even more pressure. I urge Ministers to work relentlessly to get a grip on this crisis. They need to come to terms with the fact that, on their watch, cardiac care has been allowed to falter. It is maddening that in these circumstances the Government have not set out a robust strategy for cardiac care and how they plan to address these really important issues. When the Minister comes to the Dispatch Box, will she commit to a timeline for that strategy, or will we hear more warm words with precious little action?

I want to reiterate concerns raised about urgent and emergency care. We now know that the average response time for a category 2 emergency, such as a heart attack or stroke, is more than double the target of 18 minutes. In some parts of the country, it is far, far worse than that, as we heard from my hon. Friend the Member for Wirral West (Margaret Greenwood) . Does the Minister agree that no one suffering from a heart attack or a stroke should have to wait 40 minutes or more for an ambulance? If so—I am sure that she does, as we all do in the House; nobody wants to see those failings—what discussions have she and her colleagues had to sort it out? This is a crisis on multiple fronts, and I am afraid that we need action rather than words.

From the moment a patient dials 999, they are being systematically failed. As we know, our NHS staff are heroes. Without them, the system would have buckled under the weight of incompetence and indecision during the pandemic, but they are fighting an uphill battle and the Government are letting them do it alone. That needs to change.

There is also a failure to acknowledge the role that prevention plays with health and social care. The Government have cut public health budgets here in England—that happened before the pandemic, and it is just not acceptable—and it means that only half of adults over 40 are attending regular health checks, which were introduced by the Labour Government in 2009. Those health checks have provided crucial evidence for spotting diseases early on, not least cardiovascular disease. With the fall in health checks, many opportunities to spot avoidable problems are being missed, especially among people from disadvantaged communities as I and the hon. Member for Motherwell and Wishaw outlined earlier. Indeed, the disproportionate impact of covid-19 showed starkly just how unequal a country we have become in health terms.

We also have huge numbers of people reporting difficulty in accessing primary care, as the hon. Member for Strangford referred to in his contribution. Some 40% of surveyed heart patients or those at risk of cardio- vascular disease had their appointments cancelled or rescheduled more than once. In 2019, the Prime Minister promised the British public that he would deliver 6,000 extra NHS GPs. Instead, numbers have gone down—another broken promise to add to the never-ending list of broken promises that define this Tory Government. Will the Minister explain to the House why the target is not being met and explain to patients why they are waiting longer than ever before?

We know from the Getting It Right First Time national cardiology report that the NHS needs 760 new cardiac physiologists and almost 100 consultant cardiologists to meet anticipated demand. Again, I reiterate the concerns raised about urgent and emergency care, because we need those staff in place. We need that workforce.

[Mrs Drummond]

The hon. Gentleman makes an interesting point, but how does he then account for the fact that in Labour-run Wales the waiting lists are even longer? I think 21% of the population are now on the waiting list, and that has extended dramatically, far more than in the NHS in England.

[Andrew Gwynne]

As we discussed at the start of the debate, the NHS is four systems that work together. We are here in the UK Parliament to hold the UK Government to account for the NHS in England. In terms of the NHS in Wales, the Welsh Government receive a block grant, as indeed do the Scottish Government, and they decide how to spend that money themselves.

There are some great things about the Welsh NHS, not least its leading the way on public health issues across Wales, and we can learn things from there, but I want to ensure that the promise about GP access that the hon. Lady’s Government made to the people in my constituency in England is kept. That is why I posed that point to the Minister. Again, we need the Government to outline how they plan to fill those vacancies and whether the workforce plan, when it finally materialises, will include speciality-level data and strategy to fill those gaps.

We in the Opposition have been clear. Labour would put patients first and sort out the mess that the current Government have left our NHS in. The last Labour Government brought waiting lists down from 18 months to 18 weeks, and we would do that again—[Interruption.] The Comptroller of Her Majesty’s Household, the hon. Member for Nuneaton (Mr Jones), chunters from the Front Bench, but I remind him that, while patient satisfaction is worse today than it has ever been and our waiting lists are some of the highest in NHS history, when we left office, patient satisfaction was the best it had ever been and waiting lists were among the lowest in NHS history. That is our record and I am proud of it.

That progress has been undone by this Conservative Government. Again, we are on standby to step in and protect our NHS. But we would focus on prevention. That prevention would improve outcomes and guarantee access to GP services for those who need them. We would publish a robust and comprehensive workforce strategy, and transform pay and conditions in the process. As part of that, we would support the hundreds of thousands of cardiovascular patients who are anxiously awaiting treatment. We would support health and social care staff who are shattered and demoralised after carrying us through the pandemic, and we would build an NHS that was resilient, accessible and fit for the future.

At the heart of that is a public health agenda that will seek to resolve the health inequalities that are endemic in too many parts of the country, where those health conditions are holding back the life chances of the constituents we represent and causing misery, poverty and pain. That is why a holistic approach to public health, and within that a strategy to deal with heart and circulatory diseases, is crucial. I hope the Minister understands the real importance of that. We stand ready to support her while she is in Government to get the strategy right, but getting that strategy right is crucial.