Future of the NHS

Christian Matheson Excerpts

Monday 31st January 2022 Westminster Hall

[Christian Matheson (City of Chester) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gray.

There are actually a couple of aspects of the speech of the hon. Member for Stockton South (Matt Vickers) that I agree with and congratulate him on. First, I do not support PFI either. History suggests that although that hospital was completed and perhaps started under a Labour Government, PFI was originally a Conservative initiative under the Major Government, so I would not be too confident about attacking it but I am pleased that it is gone.

I also profoundly agree with the hon. Member’s support for NHS staff; I think we will be hearing a lot of that this evening. The NHS is recognised and envied around the world. It is something that we should celebrate and admire, not chop up, neglect and sell off piecemeal at every opportunity. It is the NHS and its staff that are getting us through this pandemic. I would like to take this opportunity, as I am sure all hon. Members would, to once again thank the NHS and care staff who have worked so hard and sacrificed so much over the last two years.

The NHS cannot continue to look after us if we do not look after it. Tory mismanagement over the last decade and the pressures of the pandemic mean that the NHS is running on empty and surviving solely on the good will of its employees. Even before the pandemic, we were seeing record waiting lists and staffing shortages. Now the numbers are through the roof.

[Ian Lavery (Wansbeck) (Lab)]

On that point, my hon. Friend mentions that the NHS is running on empty—of course it is. A Unite survey published in January 2022 showed that 77% of the NHS workforce believe that they are worse off than they were a year before, 55% are working during their lunch breaks, and more than 50% are working in excess of their contracted hours. Is it any wonder that the NHS is running on empty?

[Christian Matheson]

I could not have put it better myself. The NHS is running on empty, but also on the good will of the staff because they believe in the NHS and in what they are doing. There were 6 million people on the waiting list in England in November—the highest number ever recorded. In my constituency of City of Chester, the latest figures show that 36,000 people are waiting for care at the Countess of Chester Hospital.

Those record waiting lists are also true for NHS dentistry, as my constituency neighbour, my hon. Friend the Member for Weaver Vale (Mike Amesbury), has pointed out. Some people are being told that they may have to wait up to two years for a NHS dental appointment. Over the past few months, many of my constituents have told me the difficulties that they have had in finding and accessing an NHS dentist in my constituency and the surrounding areas. On average, there are only 4.4 dentists per 10,000 people in England, and the number is shrinking. With shortages of staff, a lack of funding, the pressures of the pandemic and dissatisfaction with NHS dentists’ contracts, the waiting lists are growing. Many dental practices are feeling pressure to turn private just to be able to cover wages and equipment costs, and to survive as a business.

Dr Simon Gallier, who owns a dental practice in my constituency, wrote to me with a heavy heart to say that earlier this month, he had to make the difficult decision to make his dental practice private; he had to inform over 7,500 patients that they will no longer be receiving NHS treatment. Practices around the country are doing this not through choice, but out of necessity and lack of funding. Dr Gallier just cannot make ends meet. Indeed, in the last year for which figures were available, 2018-19, the amount spent on dentistry fell in real terms, compared with the six years previously. While the £50 million announced recently by the Minster is welcome, only £7 million of that will go to dentistry in the north-west, which is clearly insufficient when the national budget for England was over £2 billion in 2019. With fewer NHS dental practices, many constituents have no choice but to go private—an option many will not be able to afford, especially given the cost-of-living crisis we face. I worry that the Tory masterplan all along has been to starve the NHS of funding, resulting in inevitable back-door privatisation—or perhaps there has been a more sinister scheme to monetise dentistry, as there has been in similar services, including some GP practices and many vets practices.

Dentists cannot afford to operate under the NHS, so they sell the practice to an umbrella company, which is the front for a finance company. That company then offers quasi-insurance or membership programmes, in which the patients pay an amount every month that entitles them to an annual check. That stream of money from numerous practices becomes a valuable commodity in the City of London, which the Conservative party exists to serve, along with Putin-linked Russian oligarchs, but we will not mention that now.

Talking of privatisation, what I fear is not the sale, lock, stock and barrel, in a public floatation, as happened in the 1980s, but sale bit by bit, behind the scenes, to private companies that extract money for their profit—money that should surely instead be spent on patient care. NHS dentistry is in crisis. I will not look that £50 million gift horse in the mouth, but let us be clear: much more is needed.

--- Later in debate ---

[Edward Argar]

I will just finish this point and then give way to the hon. Lady. The hon. Member for Liverpool, West Derby (Ian Byrne) made the point, which the hon. Member for Middlesbrough touched on as well, that it is important to look at the extent of the involvement of private sector providers, which accelerated when the Labour party was in power. The hon. Member for Liverpool, West Derby talked about the 2012 legislation and “any qualified provider”, but that was not brought in by the 2012 legislation; it was brought in by the Gordon Brown Government in 2009-10, under the term “any willing provider.” The name was changed, but nothing substantive changed from what the Labour Government had introduced in terms of the ability to compete for contracts.

[Christian Matheson]

Will the Minister give way?

[Edward Argar]

One more sentence and I will give way to the hon. Member for Hornsey and Wood Green (Catherine West); then I will try to bring in the hon. Gentleman.

One of the key changes allowing private sector organisations to compete for and run frontline health services came in 2004, again under a Labour Government, when the tendering for provision of out-of-hours services by private companies was allowed.

--- Later in debate ---

[Edward Argar]

The hon. Lady will know that when it comes to integrated care boards we, as a Government, introduced an amendment building on the already clear provisions in the Bill to prohibit conflicts of interest. I do not know whether she voted for the Government amendment, but it did exactly that, making it clear when the Bill was on Report that private providers and those with significant private interests could not sit on NHS integrated care boards.

[Christian Matheson]

The Minister is being generous with his time. Let us get the history right. The reason why the Labour Government increased the involvement of private sector bidders was simply to be able to increase capacity quickly—to get the waiting list and waiting time backlogs down, which they had inherited from the previous Conservative Government and that were massive. In terms of the 2009 Bill, I seem to remember that there was a provision in there that gave preference to NHS bidders.

[Edward Argar]

I am grateful to the hon. Gentleman. Although we occasionally cross swords in the main Chamber or here, he knows I have a great deal of respect for him. All I would say gently on the point about the 2004 changes is that they came seven years into a Labour Government, so I do not know the reason why they had not been able to make progress before then.

We continue to work closely with the NHS to implement the changes that it has asked for, so that we can build back better and secure our NHS for future generations. As the shadow Minister, the hon. Member for Denton and Reddish, rightly said, the covid-19 pandemic has tested our NHS like never before, and all our NHS staff have risen to meet these tests in extraordinary new ways.

Hon. Members on both sides have rightly raised the point about the pressure that NHS staff have been under. Those who have been under pressure dealing with this pandemic are the people who will also be working flat out to deal with waiting lists and backlogs. We need to ensure that we are honest with the British people and that those staff have the time and space to recover, emotionally and physically, from the pressures they have been under. That is hugely important and we acknowledge the workforce.