NHS: Long-term Strategy

Caroline Johnson Excerpts

Wednesday 11th January 2023 Commons Chamber

[Dame Angela Eagle (Wallasey) (Lab)]

Through neglect, ideological hostility and incompetence, the Tory Government are presiding over the worst crisis the NHS has ever seen. Some 7.3 million people are on the waiting list; there has been a virtual collapse of emergency response; and people cannot see a GP or get follow-up treatment without unacceptably long waits. Today, there have been reports of more than 1,000 excess deaths a week—the highest total, excluding the pandemic, since 1951. There have been many, many preventable deaths on the Government’s watch, and each and every one is a tragedy.

Our NHS is in crisis from top to bottom. There are patients in hospital beds who cannot be discharged because there is no domiciliary care and nowhere for them to safely go. Ambulances are queuing for hours, unable to admit critically ill patients. There are inhumane waits in A&E before anyone can be admitted to beds they desperately need. Staff, who are already burnt out from the stresses of the pandemic, are unable to care properly for patients and are barely able to get through a shift because of the emotional exhaustion of having to deal with those failures.

A nurse at Arrowe Park in the Wirral, which serves my constituency, wrote to me recently. After 21 years of service to our NHS, she says she has

“never worked in such an unsafe environment”.

She says:

“Staff are literally on their knees, leaving shifts late in tears, and leaving in their droves”.

My constituent went on to detail a case in another local hospital in which a patient had a cardiac arrest in a hospital corridor. Frankly, a hospital should be the best place to have a cardiac arrest if somebody is going to have one, but it is now not so in Tory Britain. The individual collapsed and died.

With 132,000 NHS vacancies in England—over 17,800 in the north-west alone—our NHS is dangerously understaffed, under-resourced and under-respected. That is why NHS staff at the end of their tether have taken the desperate decision to go on strike. That is why any Government worth their salt would have decided to negotiate properly with them, to listen to them and to try to deal with and recognise that, in the last 13 years, a real-terms cut of 20% in nurses’ remuneration is simply not acceptable, but what did they do? They chose to have a divide-and-rule strategy, and they chose to try to scapegoat and blame NHS staff for the terrible conditions I have been talking about.

Perhaps the Government should consider legislating for a minimum service outside of strike days, because we are going to be in the absurd position of having, by law, guarantees on strike days—they could be negotiated anyway and always have been—that do not apply on non-strike days. It is an insult when the Secretary of State meets the health unions and says they have to increase their productivity. They are working beyond any amount of time that any human being should be asked to work.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I confess to being a bit confused by the Labour party’s position on minimum service levels. We all want to ensure that our constituents are as safe as possible. The ambulance workers want to ensure that people are as safe as possible. The hon. Lady has said herself that these things would be negotiated anyway. But the challenge people face on the ground is not knowing who is going to come in, the fact that people do not have a say on whether they are going to come in and the fact that a negotiated settlement might be different in different areas of the country, which makes messaging and public health messaging very difficult and puts people at risk. So why is Labour so against minimum service guarantees?

[Dame Angela Eagle]

I think the hon. Lady, and I know that she is a doctor, needs to recognise that these agreements have always been made when there have been strike days in the NHS—always. I think she also needs to recognise that any Government who were being responsible would have negotiated to put an end to these strikes, recognised the fantastic service that nurses have given and dealt with the issue, instead of going for confrontation.

[Dr Johnson]

Will the hon. Lady give way?

[Dame Angela Eagle]

I am not giving way again.

I am going to leave the last parts of my speech to another constituent of mine, an 83-year-old who fell alone in his home and was left. The ambulance was called at 4.15 in the afternoon—it was thought he had a fractured hip—and he was warned of a potential 14-hour wait. My constituent said he

“naively thought this must be the worst case scenario and thought it was very unlikely to be that long”.

He could not move, he could not sleep and he could not go to the toilet. Eighteen hours later, the ambulance arrived—18 hours later—at 10.15 the following morning. At the hospital, things got no better. There were patients on trolleys lining the corridors. For nearly another 24 hours, this 83-year-old man immobilised with pain was to lie on a trolley in a hospital corridor after 18 hours of waiting for an ambulance.

This is in no way acceptable. This should not be accepted by any Government worth their salt. They should hang their head in shame at what they have done to our NHS. We need to have a Government finally, which we will after the next election, who will solve these problems, instead of seeking to blame everybody else—the weather, the pandemic, the staff and any number of other things. It is about time we had a Government who have the guts to take responsibility for the decisions they have made and put it right. We are going to have such a Government soon. Shamefully, we have not now.

--- Later in debate ---

[John Redwood (Wokingham) (Con)]

No one can deny that the health service is under extreme pressure. No one can look at it and not realise that there has been a big surge in extra demand, that there are problems from the hangover of covid when a large waiting list for less urgent treatments built up, and that we are short of doctors and nurses, not because Ministers will not authorise their appointment but because there are vacancies to be filled. As one of those who has been urging for some time to see a published workforce plan, I welcome the decision of Ministers to insist on that, and the sooner we get it the better. However, I am quite sure that there are a whole series of workforce plans already in the many dozens and hundreds of working trusts and quangos that constitute the NHS. It is about aggregating and making sense of those plans.

[Dr Caroline Johnson]

We often talk about the shortage of doctors. We know we cannot create a doctor overnight. It takes a substantial amount of time to train them. The Chancellor, a former Health Secretary, invested in five new medical schools to increase the number of doctors in training. Does my right hon. Friend agree that the Chancellor, with the Health Secretary, needs to invest more money in more medical schools and medical school places, but also look at how we increase the number of doctors by reducing the amount of bureaucracy and paperwork they have to fill in, so that they can spend more time doctoring and less time filling in forms?

[John Redwood]

Yes, indeed. From my hon. Friend’s own expertise, I am sure she is right. When people talk about productivity, they do not believe that hard-pressed staff have to work harder; they are saying there must be smarter working, making jobs more manageable or enabling them to concentrate on the things they are most skilled at, with more relief for the other necessary record keeping, which may indeed need slimming.

My hon. Friend is right that we could expand our training places further, but as we have heard there has been a big increase in educational provision and it takes seven years for it to flow through. I am glad we are getting to the point where we will see some benefits from that. We need more homegrown talent. Many people are attracted to the privileged career of being a doctor and the more we can allow to do that, the better. However, given the immediate urgency of needing more capacity, and therefore more doctors and nurses, the most obvious place is to look at all those who have already had the training and have left the profession or the NHS for one reason or another. Some may be in early retirement. That is probably not something my hon. Friend wants to change because she enjoys her new job, but there are many others who are not in a very important job like her who might be attracted back. I hope the Treasury will be engaged in the review, because I hear from doctors, as many do, that the quirk in the tax system at just over £100,000 where some of the better paid doctors are resting, producing a more penal 60% rate, is an impediment to extra working. I also hear about the pension problems that have been cited on both sides of the House. The Government need to take those issues more seriously if they wish to accelerate returns.

Ministers have very clearly set out that they want more NHS staff and have obtained much larger budgets in the last three years to help bring that about. They have also said very clearly that the public’s priority—and indeed the Opposition’s priority—is to get more treatments and get those waiting lists and waiting times down for those needing more urgent or emergency care. Those Ministers must translate that through the senior health service managers into ways of spending that extra money. If it needs a bit more extra money, there is always some extra available—every time we meet another additional sum is announced—but it has to be well spent. It has to be spent on motivating and recruiting the medical workforce.