The Gulf

Debate between Charlotte Leslie and David Nuttall

Wednesday 4th May 2016 Westminster Hall

[Charlotte Leslie]

I absolutely would ask the Minister that. I was going to say that—rather unusually—I have talked about what Britain can learn from the Gulf, because I know that Members such as the hon. Gentleman will be able to speak powerfully on other areas that we must look at.

It is easy to carp morally from the sidelines on issues such as human rights, which are a huge concern to us all, but that is not always the best way—it is seldom good at all—to achieve the practical change we want. I argue strongly that, if we want Gulf nations to improve their human rights and their freedom of speech, which essentially will improve their security far more effectively, the way to do that is to engage.

His Excellency Sheikh Nahyan bin Mubarak al-Nahyan commented on how the UAE has achieved such pluralism while maintaining the Emiratis’ confident identity as rather conservative Muslims. This applies well to international relations and to the hon. Gentleman’s comments:

“Pluralism is not diversity alone, but the energetic engagement with diversity…Pluralism is not simply tolerance, but the active quest for understanding along lines of difference...Pluralism demands dialogue...Dialogue does not mean everyone at the table will agree with one another”.

There is much on which we can engage with the UAE—I take the hon. Gentleman’s point on human rights—and much to work with from our history with Bahrain. I know that we will hear some fascinating first-hand observations from colleagues who have visited Saudi and other Gulf states.

I will finish by repeating a point that was made to me by the exceptional Minister of State for International Co-operation, her excellency Reem al-Hashimy, one of the incredibly impressive women Ministers in the highly conservative Muslim society of the UAE. She emphasised that the UAE could not “export” its pluralism to neighbours simply by preaching. It could demonstrate the possibility of such a pluralism within a conservative Muslim state only by doing. I hope the debate will be in some way instrumental in Britain’s continuing to meet the challenge that it shares with the Gulf states across our differences, by listening, talking, understanding and doing.

[Mr David Nuttall (in the Chair)]

It is my intention that we will start the winding-up speeches at half-past 10. Nine Members have indicated that they want to contribute. I do not intend to implement a formal time limit at this stage, but I ask everyone to restrict their remarks to four minutes. Otherwise we will have to impose a formal limit.

EU Working Time Directive (NHS)

Debate between Charlotte Leslie and David Nuttall

Thursday 26th April 2012 Westminster Hall

[Charlotte Leslie]

My hon. Friend makes an extremely good point. That issue was contested to some extent when the directive was first introduced, but the previous Government saw it as a health and safety issue, and therefore the NHS was included in it. There are many reasons why we need not be in this position. There are many aspects of the negotiation that are deeply regrettable, and I agree with my hon. Friend. Although this is going over old ground, it is vital to look at that to find out how to get out of our current situation and secure patient care.

[Mr David Nuttall (Bury North) (Con)]

My hon. Friend will be aware that maternity units have closed in many constituencies, including mine. I was told that one reason why the health authority wanted to reconfigure the unit, as it put it, was the impact of the working time directive. Does she find that impact of a European regulation on my constituents in Bury North as shocking as I do?

[Charlotte Leslie]

I find it shocking and outrageous that that is allowed to happen. Its importance cannot be overestimated. Lives are being put at risk because of Brussels bureaucracy that does not even begin to protect the workers whom it says that it is designed to protect. This is one of the most important issues in the NHS, and I urge the Minister to do everything possible to work with colleagues in the Department for Business, Innovation and Skills to sort it out.

To return to the point about the flu pandemic, many people say that things will be okay because the 48-hour week is an average that can be measured over six months; so if there is a pandemic everything will be fine, because the doctors can sort it out and go back to normal afterwards. Well, if the pandemic were to last more than six months, I do not know where that would leave us. If it were to last less than six months, we would not have any doctors able legally to perform routine functions. That demonstrates how rigid, bureaucratic, badly thought-through and frankly dangerous the directive is.

The cost, however, is not only human: it is financial, and it is massive. Colleagues are concerned about the closure of their constituency hospitals and the ability of those hospitals to find coverage. Hospitals are floundering and struggling to find staff for an ever-increasing demand on the NHS. Let us not forget that the restriction on staff is happening at a time of unprecedented demand on our health system. Stafford hospital closed its accident and emergency department in the evening because it could not find cover. Other hospitals are taking other measures and spending exorbitant amounts of money on temporary staff to fill the gaps. Many colleagues will have read about the £20,000-a-week temporary doctor who was brought in to fill the gaps. Hon. Members will be shocked to learn that a staggering £2 billion has been spent in the past two years on temporary staff in the NHS. If we think about the financial challenges that the country faces and where else that £2 billion could have been better spent, that figure demonstrates how crucial the issue is. One hospital trust spent £24 million on temporary staff because of the staffing problems caused by the directive.

As I have hinted, the grim irony is that, for all the contortions and scheduling arrangements that hospitals, doctors and trusts go through to accommodate the directive, it is not even doing what it was supposed to do and make the work-life balance for doctors better. I received an e-mail from a junior doctor who is soon to get married and wants to spend time with his fiancée and plan his wedding, and who is frantic, not only about the erosion of his training and his future professionalism, but also about the destructive influence of the directive on his home life and his work-life balance. He writes:

“The directive certainly hasn’t made any impact on quality of life. Having worked 60-70 hours a week, now doing 48 hours, I am no less tired...the stated aims of improving work life balance and improving training are farcical.”

Then he goes on to talk about the realities that junior doctors face. He says:

“There is simply not enough time in the 48 hour week to get trained, particularly in the craft specialities, so we all go in on our days off. If we don’t, we don’t get trained and it is us, our careers, and ultimately the patients who suffer. Training used to happen in our official working hours, now we work just as hard, but get trained in our time off, and don’t get paid.”

And he is not alone. The Association of Surgeons in Training reported similar exhaustion because of the directive, and the Royal College of Physicians, as I have already mentioned, reported soaring sick leave since it was introduced.

I have spoken to junior doctors who report worrying signs of things to come. Given the contortions of shift working under the directive and the changes to on-call working time, junior doctors increasingly report that they are reluctant to specialise in disciplines that have more arduous on-call demands and require presence at the hospital, such as acute medicine, general surgery, obstetrics, gynaecology and anaesthesia. An unofficial straw poll of senior house officers in one city showed that they nearly all did everything they could to avoid being on the acute register because that was such a nightmare. They just thought, “Why would we?”

Statistics showing the number of applications and the number of positions available in those disciplines suggest that junior doctors who report such trends are not wrong. We are beginning to see our most talented doctors moving away from the disciplines that put the most stress on their work-life balance because—let me stress this—of the directive. When making lifestyle choices, doctors are looking at those specialist disciplines and thinking, “Why would I go into that?” which is extremely worrying for the future of our NHS provision. We have to stop that trend before it becomes more cemented.