National Health Service

Baroness Brinton Excerpts

Thursday 14th January 2016 Lords Chamber

[Baroness Brinton (LD)]

My Lords, I, too, thank the noble Lord, Lord Turnberg, for securing this important debate. I also want to thank all the people who work in the NHS at the moment. We need to recognise that much of it works very well, despite the pressures which I am sure we will focus on during this debate.

My starting point is that the world is changing. With the demographic time bomb, a large increase in the older population and the conditions associated with that, comorbidities and the changes in the technology delivering medical services, our NHS is facing perhaps the biggest challenge of its time. That is before we even start to look at the financial allocation.

I, too, want to focus on public health. There are concerns about the £200 million in-year cuts which are impacting on the ability to help the public prevent their own need to call on the health service.

I congratulate the noble Lord, Lord Fowler, on the fantastic AIDS campaign. We need a public campaign on how to use the health service now. The number of people who bypass the GP and go straight to A&E, despite what has been done on this subject, is still appalling. Talk to any emergency doctors and they will tell you that there are plenty of people who they should not be seeing there.

The noble Lord is not the only person asking for a commission; my colleague Norman Lamb in another place has also said that we should have one on the entirety of health and social care, for all the reasons that noble Lords have mentioned. We have been talking for years about full integration, and I shall come on in a moment to an example of where I see one particular small project working very well.

Our NHS faces a much bigger crisis, and that is staffing—both nurses and doctors. Not only are we exporting a large number of them—over 5,000 doctors applied for certificates to work abroad, and many of them have gone—but I am not sure whether noble Lords are aware that UK doctors make up only 63.5% of doctors currently registered in the UK. That means that over one-third of our doctors have been foreign-trained. Some 91,000 of our nurses at the moment have trained abroad—that is, one in seven. It is an enormous number. We may have separate debates on how we do not train enough and how 10,000 nursing places have been lost. We have been thinking on a very short-term basis about medical education over the past five years, specifically since the removal of the SHAs. It is vital that we start to plan longer-term. Hiring doctors from abroad may work in the short term but often causes problems in their own areas and countries. While some trusts work closely with other countries—such as the West Hertforshire trust, which works with nursing schools in the Philippines—that is not universal.

My final point is about good integration. Hertfordshire is launching the Sloppy Slipper Swap this month, funded by the county council and the CCG. Some 4,000 people in Hertfordshire have trips and end up in hospital. Most of those are at home and are caused by poor footwear, so it is great to see a fully integrated campaign run by the libraries to ensure that people have access to education and a free pair of slippers, as well as advice about winter warmth. That is the sort of project that we need to see replicated throughout the country.