NHS Update

Baroness Brinton Excerpts

Thursday 22nd July 2021 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I first record from these Benches our thanks for the hard work of the noble Baroness, Lady Penn, who has gone on maternity leave. We wish her and her baby all the very best for the future. Also, adding to the words of the Government Chief Whip, I thank the clerks, the virtual technicians, the managers and all our staff, for keeping the show on the road and for keeping us safe throughout this year. I particularly echo his words about their patience with us. We have continued to do our job and could only have done so with the support of these dedicated teams. I also thank the Lord Speaker, his predecessor, and Members of all those Committees that have been in almost permanent session this year, for guiding us through.

This is the last repeat Statement before the summer—I think this may be number 50; the Minister will know. We have three matters to deal with today: the somewhat puzzling Statement made in the Commons yesterday afternoon, the Written Statement from the Secretary of State which announced the results of the NHS pay review and—I have given the Minister notice—I will also address some of the issues raised in the Covid update given in the Commons this morning.

The Statement made by Helen Whately yesterday was an odd moment. We of course join her and the Minister in thanking Sir Simon Stevens for all his work in the NHS—he has also taken up his place in your Lordships’ House. We also join others in welcoming progress on the autism strategy, which the honourable lady talked about in her speech; although, in due course I will seek the views of the organisations who are experts in this area. However, the honourable lady gave what can only be described as a parliamentary doorstep clap for the NHS and its staff. Welcome though that might be, it does not pay the bills or provide the respect that this Government owe to our NHS staff.

The Statement was followed within hours by a Written Ministerial Statement outlining the NHS pay award. This is not a respectful way to treat Parliament or our NHS staff. As my honourable friend Dr Rosena Allin-Khan said yesterday, once again the Government have had to roll back on a shoddy, ill-thought-through position, with their 1% pay rise—a real-terms pay cut —rejected by the independent pay body. Less than an hour before, there were competing briefings on what the deal was to be and, at that moment, it turned out to be nothing. Our NHS staff deserve better than this. My honourable friend invited the Minister in the other place to shadow her in the A&E department where she has worked shifts throughout the pandemic. I suggest that she takes her up on that offer, and that the Minister here might do the same.

My right honourable friend John Ashworth has said:

“Ministers were dragged kicking & screaming to 3% for NHS staff. But after years of cuts & rising pressures, NHS staff will feel let down & disappointed especially after today’s chaos. And where is the pay rise for junior docs? Where is a fair pay rise for care workers?”


It really was not worthy of a Government. We had chaos and confusion, with the Government once again rowing back on their position. Does the Minister agree that the pay review body has done what Ministers could not and would not do in recognising that our NHS staff absolutely could not be given a pay cut? Does he accept that, after last year, this is not enough?

Does he accept that this is not an NHS-wide pay settlement? It does not cover all the health and care workforce, who do not fall under this pay review body, and it does not cover junior doctors—I declare an interest, as two are nephews of mine, both of whom were redeployed during the pandemic. We know that our junior doctors have been put on the front line, caring for sick patients, and redeployed across an understaffed, pressured NHS, and that their training has been disrupted. Will the junior doctors get a pay rise? Will all health staff employed in public health receive the settlement? Again, when we know absolutely the value of care workers, why do the Government not guarantee a real living wage for those working in social care?

How will this pay settlement be funded? NHS trusts do not even know what their budget is beyond September, and NHS employers pointed out that this settlement will cost the best part of £2 billion, so where is that coming from? Is the Minister expecting trusts to find it from their existing budgets? These Benches keep repeating this question: the Government seem not to appreciate how central this is to stopping the spread of the virus, so when will they address support for low-paid workers who have to self-isolate?

I posed many of the immediate questions yesterday to the Minister. Sometimes I felt enlightened by his answers and sometimes I did not, but the one I wish to go back to concerns the Government’s plans for September. Are they ready to reimpose safeguards? Will our schools get filtration units over the summer so that we can feel that our children will be safer? Will our teenagers be vaccinated so that, next year, this cohort can do a full year of learning without being sent home in their millions?

[Baroness Brinton (LD) [V]]

My Lords, I echo the thanks to all the staff who have made a hybrid Parliament work over the last year especially, from these Benches, to the health team, because of the high workload of health and Covid business. I also repeat the good wishes to the noble Baroness, Lady Penn, as she starts her maternity leave.

Along with colleagues in the Commons, I am unconvinced that the first half of this Statement was planned to be delivered by the Minister yesterday. In the bizarre events of this week, of Covid restrictions being lifted, a rush of announcements—Monday’s, and today’s on vaccine passports—U-turns, and No. 10 contradicting Ministers, this Statement is definitely filed under “Y” for “You couldn’t make it up”.

Yesterday morning, the press were briefed and opposition politicians heard on the parliamentary grapevine that the NHS staff pay rise would be announced in the Statement. Even Sky News and the BBC news channel were saying that there would be an announcement on NHS pay in the Commons yesterday afternoon. Yet, when the Minister stood up, there was not one word about the pay award, just an end-of-term report and a much-deserved paeon of praise about how wonderful our NHS staff are—they are, and they deserve that praise. However, an extraordinary line in the Statement says:

“But I can assure those hardworking nurses: you should feel it soon”.


Well, they did. Four hours after that Statement, a Written Ministerial Statement and a press release were slipped out, bypassing parliamentary scrutiny, presumably in the hope that it would not be spotted. NHS staff, especially junior doctors and nurses, are appalled. I am not sure this is what the Minister meant by

“you should feel it soon”.

However, it gets worse. This morning’s Times says that the 3% NHS staff pay rise will be funded by robbing the expected increase in national insurance contributions reserved for the social care proposals leaked earlier this week by the Government. That is an absolute disgrace, especially given the appalling way that No. 10 has handled the social care reform proposals. After the Queen’s Speech, Ministers told us that it would be this autumn. Last week, they suddenly said that there would be an announcement this week but, this week, they have thrown the proposals back into the long grass, with a promise—again—of later this autumn, two years after the PM promised us, on the steps on No. 10, that this was his absolute priority. His actions are showing otherwise.

I know that the Minister understands that social care needs urgent reform and that it has borne the brunt of the first year of the pandemic. Can he confirm the Times story about the funding of the NHS pay rise and whether this decision was made by the Secretary of State for Health and Social Care or by the Chancellor of the Exchequer? Can he also say when the full proposals for social care will now be published, including the funding arrangements?

Moving to the only substance of this Statement, the autism strategy, we on these Benches also pay our respects to the late Dame Cheryl Gillan MP, who was such an advocate for those with autism. Peter Wharmby, the autistic writer, speaker and tutor, says that the autism strategy sets its targets very low in saying:

“Moreover, we have been able to transform society’s awareness of autism, as … 99.5% of the public have heard of autism … which is so important in autistic people being able to feel included as part of their community.”


Peter Wharmby is right. Much of the strategy talks about continuing as usual, but if you talk to autistic people or parents of autistic children, they all say that much needs to be done in supporting those with autism, especially in education and at work. Knowing that autism exists is not the same as providing the best environment for those with autism to overcome the barriers they face in society and giving them the support that they need to succeed. The Disabled Children’s Partnership points out that the pandemic has exacerbated existing problems around support for those with autism, creating further social isolation and poor health outcomes. It is depressing that the autism strategy is so unambitious.

One particular problem that parents face when trying to get support for their autistic children is an automatic assumption that parent carers are treated as a resource—worse, their parenting capacity is often questioned. There is no mention here of support for their needs. As John Bangs, a special needs expert, points out, this deliberately ignores carers’ legal rights. It is noticeable that this autism strategy makes no real reference to ensuring that parental and familial carers are supported. When will these wider issues relating to positive support for those with autism and their familial carers be addressed?

Finally, briefly on the Covid Statement in the Commons today, page 4 says that

“two doses of a covid vaccine offers protection of around 96% against hospitalisation.”

But the key bit of information we need in the “pingdemic” at the moment is the rate of double-jabbers getting Covid. I understand that it is part of the same study that is quoted, but what is the answer and where can we find it? If the pingdemic is due to the virus spreading —we hear of police and control rooms unable to operate and empty shelves at supermarkets—perhaps it is time we actually understood how many double-jabbers are getting Covid and having to go into self-isolation, and thereby creating a problem. The Minister needs to consider whether lifting all restrictions on Monday was the right thing to do.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) [V]]

My Lords, I join the noble Baronesses, Lady Thornton and Lady Brinton, in thanking my noble friend Lady Penn for her hard work over the last 18 months and wishing her well in her pregnancy. She looked absolutely fantastic as she left, and our hopes and good wishes are with her.

I also thank the usual channels, the House of Lords staff and the Speaker’s office for all their contributions to the virtual House and for keeping the business of the House going during this awful pandemic. There has been an enormous amount of traffic from the Department of Health—more than 50 Statements, 2 Acts and hundreds of regulations. I thank all noble Lords for their challenge, their scrutiny and their patience during this difficult time.

The pay review body has given us its recommendations, and we have accepted them. I thank it for its work and insight. I reassure the noble Baroness, Lady Thornton, that the Office of Manpower Economics will publish its analysis online shortly. We are extremely pleased that we can follow the guidance of the pay review body. Junior doctors have their own separate framework, worth 8.2% over four years. They are working from that framework today.

On the funding of the pay review, as noble Lords know, we gave the NHS a historic £33.9 billion settlement in 2018 and have provided £92 billion to support front-line health services throughout the pandemic. The pay uplift will be funded from within that budget, but we are very clear that this will not impact funding already earmarked for the NHS front line. We will continue to make sure that the NHS has everything it needs to continue to support its staff and provide excellent care, throughout the pandemic and beyond. That is why we accepted the PRB’s recommendations in full and provided NHS workers in scope with the pay rise.

On the question from the noble Baroness, Lady Brinton, on safeguards in September, I cannot make any guarantees but I definitely hope not. We very much hope that we are in the final stages of this pandemic, as the impact of the vaccine is being felt, bringing down the R number and saving those who are infected from hospitalisation, severe disease and worse.

The noble Baroness, Lady Thornton, talked about filtration for schools, and I noted her question on this yesterday. I said that we had been looking at it. I am not aware that the results of that analysis have come through yet. To be honest, I am wary of investing too much in unproven technologies. The two things that have been proven to work are isolation and vaccination; we are backing those two measures most of all. However, I accept her point about the importance of ventilation and will continue to look at it.

Likewise, the JCVI is looking very carefully at vaccination for children. We are working with international partners to get to the bottom of it. At the moment, we have a clear read-out—we will move—but our priority is providing either third shots or variant booster shots in the autumn to the most vulnerable. That is where our priorities are at the moment.

The noble Baroness, Lady Brinton, asked about social care. I note the Government’s statement on that; we will bring reform recommendations in the autumn. On her point about the autism strategy, I also pay tribute to the contribution of Cheryl Gillan, who worked so hard in this area and whose impact is still being felt.

I think the noble Baroness, Lady Brinton, overlooks some of the really good work in this strategy. There is £74 million of funding for a number of high-priority projects, which have been designed in collaboration with stakeholders from the community. I guide her to the implementation plan that accompanies the strategy, which has detailed recommendations on a six-point implementation matrix that has grit and traction. I would be very grateful for her feedback on that.

I pay tribute to parent supporters; the noble Baroness, Lady Brinton, is entirely right that they often bear the brunt of care and are often best placed to care for and support those with autism. I remind her that we have provided £31 million through the mental health and well-being recovery action plan specifically for the parents of those with autism, recognising how the pandemic was hitting that group in particular.