Future of the National Health Service

Chris Bryant Excerpts

Wednesday 22nd September 2021 Westminster Hall

[Chris Bryant (Rhondda) (Lab)]

I congratulate my hon. Friend the Member for Leeds East (Richard Burgon) on securing this important debate, especially at the moment.

In essence, the NHS is about people. It is about its workforce. There can be as many hospitals and clinics as we want, but without any staff in them, they will not make anyone’s health any better. I am painfully aware that after covid, so many of the people who work in the NHS are—I think the medical term is—knackered. They are completely and utterly exhausted. I know of dermatologists and pathologists who ended up helping out in intensive care units in addition to doing their ordinary day job. They were doing hours and hours every week and have got to the end of the year and are completely and utterly exhausted.

There is a phenomenal backlog; we all know about the numbers of people on waiting lists. That is partly because lots of people did not to present to their doctors because they did not want to bother them or were frightened of getting covid. There are lots of terrible stories of people who are presenting very late, particularly with cancers. I had a stage 3B melanoma, and I am painfully aware that if I had left it a few more months, I might not be here today. At the time, I was given a 40% chance of living a year. I know what it is like for all those families who feel desperate that someone has been delaying, and then get terrible news. It is also a phenomenal additional cost to the NHS if somebody presents later, because the surgery and the treatment will be far more complicated.

There are all the cancelled operations for elective surgeries that are not necessarily life threatening but life enhancing, such as knees and hips. When I was first elected in 2001, we still had the waiting list hangover from the previous Government, with people waiting five years for a new hip or knee. That is where we are now. That leads me to a real concern that the Government, with their new healthcare levy, are frankly putting the cart before the horse. If we do not have the people to deliver, throwing money at the NHS will not make the blindest bit of difference to health outcomes.

In the UK, we have roughly three doctors per thousand head of population. The rest of the EU, including countries that have many, many fewer than us, have 4.2. We are 1,939 consultant radiologists short. That is one of the things that will make a difference to whether people with late-stage cancer live or die. In oncology, 189 more clinical oncologists are needed in the UK now, and that is without considering the increase required to deal with the backlog, as well as the new presentations. We have roughly 650 consultant dermatologists in the country; we need roughly another 200. Skin cancer is one of the fastest-growing areas of cancer death in the UK. Only 3% of diagnostic laboratories in the UK are fully staffed at the moment. That means delays in getting results, in particular from histopathology, to doctors to be able to start the necessary treatment.

I have some quick-fix answers, and I hope the Minister will implement all 11 of them. First, reward staying on in the profession, because lots of people are retiring early. Secondly, reward coming back into the profession, because getting more retirees back in would really help with the workforce problem.

Thirdly, sort the gender pay gap. That is one of the problems that is making it much more difficult for lots of women to stay in the profession.

Think about providing sabbaticals to people. Sometimes burnout can be prevented just by allowing somebody to have a three-month or six-month sabbatical, knowing they will come back in.

Sort out the pension problem. I know the Government think they have done that, but it is still an issue and is why lots of people are not carrying on.

We have to deal with the fact that overtime is now paid less than it was five years ago. Lots of people are saying, “I don’t really want to do an extra clinic on a Saturday morning or a Sunday afternoon.”

We have to deal with pay erosion—a point that was made earlier. If we keep on not paying doctors enough in the NHS, in the end they will choose to go to Australia, Canada or New Zealand.

We have to sort out the issue of private sector capacity sucking far too many consultants out of their NHS work, day in, day out. That simply means that people, including in very poor constituencies such as mine, will say, “You know what? I’m going to find the £5,000, £6,000 or £7,000 to have that hip or knee operation for my Auntie Val, because it is about the quality of her life.”

We have to train more people. I do not know why we are still lagging behind what we know we need. We should have more places for training, and we should be encouraging other disciplines, such as pathology, dermatology, emergency care and so on.

We have to sort out the immigration factors, which play into all this and mean that so many doctors who have worked here for some time are going back to the countries they were born in because they do not feel that they have a place here in the UK. Finally, please stop putting the workforce last in deciding what we do about the NHS. We cannot run an NHS permanently at 95% or 98% capacity, because then when there is a crisis, such as the one we have had over the past two years, the whole thing is—and this is a technical term—buggered.

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[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak and listen in this debate. I thank the hon. Member for Leeds East (Richard Burgon) for setting the scene and all those who have made contributions. Every one of us is definitely agreed on one thing: the importance of the NHS, what it does and what it has done over time. If we needed further reinforcement of that, what we have seen in the past year has told us. In my family, I lost my mother-in-law to covid, so I do understand. During those difficult times for families, health service workers are there, masked up and doing their best to try to preserve life.

As my party’s health spokesperson, I must emphasise the importance of the NHS and highlight the issues of concern for my constituents, to ensure that the future of the NHS is maintained and provides hope to those who currently feel that it is not being maintained in the way that it should. It is a devolved matter, as the Minister knows. During the 18 months of the pandemic, we might have taken our NHS for granted in a way. We did not take the staff for granted; that is not the point I am making. The point is, the NHS was there, we depended on it and it was important to have it in place to help out. I put my thanks on record to all those healthcare workers across the United Kingdom of Great Britain and Northern Ireland.

I know we clapped the NHS staff. I live out in the countryside but, believe it or not, I could hear the clapping starting three miles up the road. I could hear the clapping in the midnight air from people in the village of Greyabbey down the road. People were out in numbers creating that crescendo of noise. We need to galvanise public compassion and our sense of community and wartime spirit to restore to the NHS the pride we have. I look to the Minister to do that.

This is a debate about the NHS, but the Northern Ireland protocol is preventing 910 medicines from getting into Northern Ireland. That will have an impact on the NHS. It is not the Minister’s responsibility, but would he convey to the relevant Minister the importance of our having medications that are available in the rest of the United Kingdom? They are available on the mainland, but we cannot get them in Northern Ireland. It is terribly frustrating, and a further 2,400 medicines may be at risk. It is an important issue, and it is an NHS issue. It needs to be on record.

I feel that the prioritisation of treatments and services are at the forefront of the future of the NHS. Too many people are awaiting cancer treatment. I am pleased that the hon. Member for Rhondda (Chris Bryant) is here. His story is a personal one. I remember speaking to him in the Chamber. I did not quite know what was happening, but I had not seen him for a while, and I did notice that there was a scar on the back of his head.

[Chris Bryant]

A scar?

[Jim Shannon]

Well, I noticed it after the surgery. Our NHS saved our honourable Friend’s life. It is good to hear his personal story as well.

Health reconfiguration is crucial to ensure that our NHS is held to its highest standard. By the same token, these changes must be assessed to ensure that they benefit the future of the NHS. We want the correct funding. I hope that the Minister will reaffirm that he will encourage the Secretary of State to undertake discussions with his counterparts in the devolved institutions to weigh up how this will impact on other parts of the United Kingdom. People are waiting for life-saving cancer treatment, and people are waiting years for a consultation. Unfortunately, some of my constituents waited and did not get the surgery. They did not get their diagnosis early on and some of them are not here today. That is the reality of the waiting times that we all worry about.

The King’s Fund states that

“even under the most optimistic circumstances outlined in the NHS Five Year Forward View, an additional eight billion a year in funding was to be needed by 2020.”

We are already a year behind. If we want to protect and maintain our NHS, we must ensure that the correct funds are in place to secure its future in the United Kingdom. I urge the Minister to listen to NHS workers and focus on what they are telling us. The Minister needs to protect their jobs and livelihoods and the NHS.

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[Edward Argar]

I appreciate why Opposition Members might not want to hear what Labour Governments did in the past, given the extent to which they massively accelerated the privatisation of our NHS. To address the hon. Lady’s point directly, we do believe that there is a role for private providers, the independent sector, voluntary organisations and others in providing healthcare services in this country.

Workforce is an issue that a number of colleagues have rightly raised. I am afraid I cannot say to the hon. Member for Tooting and others that, among other things, I am taking on responsibility for mental health in my new portfolio. However, following the departure of my hon. Friend the Member for Faversham and Mid Kent (Helen Whately) to the Treasury, as of about three days ago, I will be assuming responsibility for workforce alongside the other responsibilities in my portfolio. I look forward to working with her and the hon. Member for Ellesmere Port and Neston (Justin Madders), who I believe is the shadow Minister, as well as meeting with Opposition Members who take a close interest.

The hon. Member for Rhondda (Chris Bryant) spoke with typical wisdom on that matter and made a number of very powerful points. At the risk of a negative impact on my career prospects—although the reshuffle has just happened, so hopefully I can get away with it now—I agree with a lot of what he said. He highlighted that, were it not for a prompt diagnosis, he would not be here. For what it is worth, I think I speak for everyone in the Chamber—if not on all points, then certainly on this one—when I say we are all extremely pleased that he is still with us. He is a man of great integrity and strong beliefs, and I look forward to working with him. We meet on a number of things. I am happy to meet with him to talk about his suggestions and how they might factor in to how we move forward, in the spirit of bipartisan and constructive discussion.

[Chris Bryant]

Get on with it.

[Edward Argar]

With the meeting or the job, or both? A number of hon. Members have raised “Agenda for Change” and pay and conditions. I hope I can reassure them, as I sought to do with the hon. Member for York Central (Rachael Maskell). It is not our intention that integrated care boards depart from “Agenda for Change”. The Bill is drafted in such a way as to seek to replicate what is currently there. On Second Reading, I offered to have a meeting with her. I would be very happy to have that meeting, if she gets in touch.

On funding, this Government have passed legislation increasing NHS funding by £33.9 billion by 2023-24 and put £2 billion into elective recovery. In addition, the Prime Minister announced a massive cash injection into our NHS a couple of weeks ago.

I want to give the hon. Member for Leeds East a little time at the end, so I will just make a couple of quick points. The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) is right: we are always happy to learn from our Scottish friends. In response to the hon. Member for Strangford (Jim Shannon), that is a matter of medicine supply which I discuss regularly with the Northern Ireland Health Minister, and it is absolutely vital that we seek a resolution. I believe that the previous approach by Lord Frost is the right one to find a sustainable way forward.