NHS Long-term Workforce Plan

Debate between Clive Efford and Steve Barclay

Monday 3rd July 2023 Commons Chamber

[Steve Barclay]

My hon. Friend is absolutely right. As we boost our domestic workforce training, there will be scope to reduce the number recruited internationally. From 1948 onwards, international recruitment has always played an important role in the NHS, and we are hugely grateful for the service offered by those recruited internationally, but we also recognise that as demography changes in other countries, there will be increasing competition for healthcare workers around the world, so it is right that we boost our domestic supply. That is what this plan does, and it is why this is a historic moment for the NHS in making that long-term commitment that will in turn reduce the demand on the international workforce.

[Clive Efford (Eltham) (Lab)]

I, too, add my condolences to the family of Bob Kerslake, who did excellent work in my borough tackling poverty. I would congratulate the Secretary of State on this announcement if it did not come 13 years into a Conservative Government. It is a bit like Bobby Ewing coming out of the shower, the way the Secretary of State is saying, “I’ve just realised there’s a crisis in the NHS.” We went into covid with 2.4 million people on waiting lists, which was a record. It is now up to 7.4 million. The report itself says that we have 154,000 fewer staff than we need today in the NHS. After 13 years in government, if the Tories really cared about the NHS, it would not be in the state it is in, would it?

[Steve Barclay]

The hon. Gentleman ignores the fact that since 2010, there has been a 25% increase in the NHS workforce. More than a quarter of a million more people now work in the NHS than was the case in 2010. There is a 50% increase in the number of consultants working in the NHS today compared with 2010, but the reality is that demand has increased as a result of an older population, advances in medicine and in particular the demands of the pandemic, and that is what we are responding to. We are also taking measures in parallel. We are on track to deliver our manifesto commitment for 50,000 more nurses, with 44,000 now in place. We also have beaten our manifesto target on primary care, with 29,000 additional roles in place. That means that people can get to the specialist they need, which in turn frees up GPs for those things that only GPs can do and ensures that patients can access care much more quickly.

Oral Answers

Debate between Clive Efford and Steve Barclay

Tuesday 25th April 2023 Commons Chamber

[Steve Barclay]

As the House knows, I am extremely committed to modern methods of construction and modular building capacity. We are using that as a central component of our new 40 hospitals programme. My hon. Friend will know that the RAAC—reinforced autoclaved aerated concrete—hospitals are very much part of that discussion, not just at Frimley but at King’s Lynn, at Hinchingbrooke and in a whole range of other settings. He will also know that we are in a purdah period, so we are constrained in what we can say, but we will have more to say on this very shortly.

[Clive Efford (Eltham) (Lab)]

We have had 13 years of Conservative government. There are record numbers of patients on waiting lists, record numbers of vacancies in the NHS, and a crisis of vacancies in social care. As for emergency care, the Government cannot meet their 18-minute target for category 2 ambulance responses. If the Conservatives were really concerned about the NHS, would we not be in a better position than this after 13 years?

[Steve Barclay]

The hon. Gentleman talks of 13 years. People are nearly twice as likely to be waiting for treatment in the Labour-run Welsh NHS as people seeking treatment in England, and, indeed, waits are longer in Wales: we have virtually eliminated two-year waits in England, whereas more than 41,000 people in Labour-run Wales are waiting more than two years.

NHS: Long-term Strategy

Debate between Clive Efford and Steve Barclay

Wednesday 11th January 2023 Commons Chamber

[Steve Barclay]

As so often, my right hon. Friend raises an extremely important point about how we best use the resources and significant investment being put into the NHS. He will recognise that a key part of delivering value for money is looking at the interfaces on the patient pathway through the healthcare system. Handover points are often when we have the most difficulty.

I am sure my right hon. Friend will welcome that I recently visited Maidstone to see how we track the patient journey through a hospital and into care—residential care or domiciliary care. We are putting control centres in place through the 42 ICBs, and our reforms are bringing health and social care closer together. An area of common ground across the House is on the need to bring social care and healthcare closer together, and the ICBs, which were operationalised from July 2022, are a key part of that.

I suspect that one issue on which my right hon. Friend and I strongly agree is that it has to be underscored by data, so that we can see where the blockages are and prioritise the use of technology, such as machine learning, artificial intelligence, virtual wards and other innovations.

[Clive Efford (Eltham) (Lab)]

Will the Secretary of State give way?

[Steve Barclay]

I am being pretty reasonable on interventions, so if the hon. Gentleman will give me a moment.

[Clive Efford]

rose—

[Steve Barclay]

The Opposition want to hear what the Government are doing, and then they tell me that they do not want to hear.

[Clive Efford]

The Association of Directors of Adult Social Services surveyed English local authorities back in 2019, and it found that they had endured cuts of £6.3 billion in adult social care, resulting in a drop since 2014 of 425,000 beds. How much does the Secretary of State think that has contributed to today’s crisis?

[Steve Barclay]

I am delighted that the hon. Gentleman raises the additional funding that the Government are putting into social care. In his autumn statement, the Chancellor made the biggest social care spending increase of any Government in history: an extra £2.8 billion next year and £4.7 billion the year after. That is £7.5 billion over two years, on top of the £6.6 billion he put into the NHS over two years. At a time when, as a consequence of the pandemic and the war in Ukraine, inflation is extremely high and there are acute cost of living pressures for constituents across the country, the Chancellor prioritised spending not just on health but, as the hon. Member for Eltham (Clive Efford) helpfully highlighted, on social care. Bringing health and social care together is exactly what I set out in my statement to the House on Monday.

NHS Winter Pressures

Debate between Clive Efford and Steve Barclay

Monday 9th January 2023 Commons Chamber

[Clive Efford (Eltham) (Lab)]

Thank you, Mr Deputy Speaker; I was as enthusiastic to make a contribution as you were for me to make it. What contingency did the Secretary of State put in place for a spike in flu cases? He speaks as if it took the Department by surprise, but it was widely predicted that there would be a spike in flu cases following on from the lockdowns during covid. He has announced 4,500 places to ease pressure, but in his statement he said that in 2020 there were just 6,000 cases of delayed discharge per day—“just” 6,000, as if that is not significant—whereas last year it was between 12,000 and 13,000 cases per day. What he has announced is roughly one third of what he said was the average per day for the last year. Is this not just too little, too late?

[Steve Barclay]

First, the central announcement at the autumn statement was the additional capacity to deal with domiciliary care and further support for social care. That £500 million announcement was part of the £2.8 billion next year and the £4.7 billion the year after. The autumn statement recognised the fact—I would have to go back and check the transcript, but there were many comments around that period pointing to it—that this was likely to be the worst-ever winter because of the combination of pandemic pressure, covid admissions and the risk of flu, which has transpired to be the worst for 10 years. That is why, for example, we expanded the cohort eligible for the flu and covid vaccine to the over-50s and invested in the bivalent vaccine. It is why NHS England put in place an additional 7,000 beds. It is why we have been rolling out virtual wards of the sort used at Watford General Hospital, which is able to address the equivalent of an extra ward. Additional measures have been taken but, over the Christmas period, in line with what happened in Wales, in Scotland and internationally, we saw a rapid spike in flu, with a sevenfold increase in cases over a short period, on top of the pressures already in the system.

Oral Answers to Questions

Debate between Clive Efford and Steve Barclay

Tuesday 1st November 2022 Commons Chamber

[Clive Efford (Eltham) (Lab)]

11. What progress his Department has made on recruiting 6,000 more GPs by 2024.

[The Secretary of State for Health and Social Care (Steve Barclay)]

We are making progress on increasing numbers. The number of doctors in general practice has increased over the past three years, from 34,729 in September 2019 to more than 37,000 in September this year.

[Clive Efford]

I am grateful for that answer. I recently met representatives of the local GP network in my constituency who described to me their difficulties in employing GPs. What can the Secretary of State do to ensure that people choose to go into general practice and to make the job much more attractive, so that he hits his target of recruiting 6,000 more GPs, which he is woefully way off doing?

[Steve Barclay]

I touched on that exact point in an earlier answer. There are parts of the country where it is more difficult to recruit GPs; that is why we have a targeted fund to attract people into those areas, with grants of up to £20,000. Alongside the appointment of GPs, we are also looking at using the wider primary care skills workforce, so that people can get to the appointment that they need.

Ambulance Pressures

Debate between Clive Efford and Steve Barclay

Monday 18th July 2022 Commons Chamber

[Steve Barclay]

I do not know the specific circumstances of the case my hon. Friend highlights, but in general good consultation and engagement with stakeholders will of course lead to better and more informed decision making. Where decisions have been taken and the outcomes proceed in a sub-optimal way, I know from my knowledge of my hon. Friend that he will make such a case in the strongest terms.

[Clive Efford (Eltham) (Lab)]

It is worth remembering that the 2010 to 2015 Conservative Government took £6 billion out of social care, so it is no wonder that we are facing a logjam. Since 2015, not once have the Government hit their four-hour target at A&E, and it is down to less than 72% on average right now. This logjam is created by the Conservative Government’s mismanagement of our national health service, so what is the Secretary of State going to do to get back to the four-hour target for A&E?

[Steve Barclay]

This Government are investing in our NHS. That is why the resource departmental expenditure limit, which in 2010 was £99 billion, went up last year to £150 billion. It is why we are investing more than £10 billion in capital this year alone. It is why the NHS will get an uplift of about £38 billion over the five years from 2019-20 to 2024-25, and it is why this Government have invested in our 40 hospitals programme as part of a £22 billion commitment.

Committee on Standards: Decision of the House

Debate between Clive Efford and Steve Barclay

Monday 8th November 2021 Commons Chamber

[Steve Barclay]

I am not sure whether all Members on the Opposition Benches would support that proposal, because there is value in MPs having a continued connection with the world outside of politics. Banning all second jobs would have captured some in this House who work, for example, as doctors or nurses, and have supported the NHS through the pandemic. It makes sense to build on the work of my right hon. Friend the Member for South Northamptonshire and the procedure that she developed when she was Leader of the House.

We share a commitment to a system that encourages and communicates the right values, attitudes and behaviour, and that makes it clear to Members that in performing their parliamentary duties, they are expected always to act in the public interest, with courtesy, professionalism and respect.

[Clive Efford (Eltham) (Lab)]

I am grateful to the Minister for his apology, as far as it went. Last week, it was quite clear that the Government did not agree with the recommendations in the Standards Committee’s report, so I am not clear today: are the Government saying that they now agree that Owen Paterson behaved badly and incorrectly, or are they just apologising for the process that they imposed on us last week?

[Steve Barclay]

What I am saying is that Mr Paterson has left Parliament; he has resigned, and therefore suspending him from the House would no longer be applicable.

It is the work of every Member to safeguard Parliament’s reputation by upholding its principles and abiding by its rules. Moving ahead, our shared responsibility is to identify and seize opportunities to improve the system—to ensure that it is robust and fair, that is commands the confidence of Members and our constituents, and that it is aligned with the fundamental principles of natural justice. To that end, I welcome forthcoming contributions from colleagues. I can assure you, Mr Speaker, that the Government will be listening carefully to the insights and views of Members from across the House.

Health and Social Care Levy Bill

Debate between Clive Efford and Steve Barclay

2nd reading
Tuesday 14th September 2021 Commons Chamber

[Steve Barclay]

I think one needs to see whether these are roles that are driving efficiency and creating savings elsewhere, or whether they are viewed in isolation. That is why one needs to understand the workforce as a whole, where there are overlaps within the NHS but, above all, how we deliver reform, which is something I know that the Secretary of State for Health and Social Care is passionately committed to doing. That relates to the point that was rightly raised by my hon. Friend the Member for Winchester (Steve Brine) on the delivery of reform in order to maximise the value for money of the spend that the levy will unlock.

Finally, we need to fund our vision for the future of health and social care in this country over the longer term. As the Prime Minister said, with proper funding, we can not only tackle the NHS backlog and expand the social care safety net but afford the nurses’ pay rise, invest in the best equipment and prepare for the next pandemic. We can provide the largest investment ever to upskill social care workers and build the modern, more efficient health service the British public deserve.

[Clive Efford (Eltham) (Lab)]

It seems to me that we are spending this money twice, so can the Minister tell the House specifically how much will go into the NHS from this increase and how much will go into social care? What I am hearing from him is that we are going to deal with the backlog, which will take us back to pre-pandemic levels. That will leave us with a 2 million waiting list, so can he tell us specifically how much is going into the NHS and how much is going into social care?

[Steve Barclay]

Of the £36 billion, £5.4 billion is going to adult social care, with the rest going into the NHS or through Barnett. That is over three years.

Oral Answers to Questions

Debate between Clive Efford and Steve Barclay

Thursday 24th January 2019 Commons Chamber

[Clive Efford (Eltham) (Lab)]

In every answer that the Secretary of State and his Ministers have given this morning, they have declined to recognise that they lost the vote on the deal by 230 votes—by more than two to one. Exactly how are the Government going to listen to Members of this House so that we can agree a deal and move forward?

[Stephen Barclay]

I do not know whether the hon. Gentleman came in partway through topical questions, but I opened my response to the first question with a recognition of the result. I have referred in a number of answers to the engagement that the Prime Minister and ministerial colleagues are having. Indeed, in my exchange with the right hon. and learned Member for Holborn and St Pancras (Keir Starmer), I mentioned meetings with trade union leaders today, and I spoke about meeting the SNP First Minister. Listening to the hon. Gentleman’s question, it is almost as though the last hour has not happened. We accept that the result of that vote was significant, and we are listening to the result. We have taken a number of measures as a consequence.

European Union (Withdrawal) Act

Debate between Clive Efford and Steve Barclay

Wednesday 9th January 2019 Commons Chamber

[Stephen Barclay]

There is a legitimate point as to how we engage with the House as a whole—with Members on both sides—as we move into the next phase. I have already touched on my desire, and the Prime Minister’s commitment, to look at how we do that with the devolved Administrations in a more targeted way. If we look at the first phase, we will see that a huge amount of hours have been spent on engagement. The Prime Minister has spent a huge number of hours at this Dispatch Box. There are opportunities for us to work in a much more targeted way, to listen to Members’ concerns about issues such as citizens’ rights and employment, and to look at how, through the Select Committees in particular, we can work in a much more targeted way. I think that the next phase lends itself to that approach. I gently say to the hon. Gentleman, however, that that also requires a dialogue both ways. If Members are going to jump in, before we have even responded, with a judgment on the withdrawal agreement or on measures that have been taken, that suggests a lack of engagement on their part to work in a collaborative way.

[Clive Efford (Eltham) (Lab)]

I had my first consultation with the Prime Minister last night—two years into the process. The Secretary of State is talking about the backstop, but the DUP, which has a confidence and supply agreement with the Government, is vehemently opposed to what he is laying out. How did the Government get themselves into this position? The answer is that they did not consult. If they had taken on the view of this House earlier in the process, they could have negotiated with Europe something that could have been acceptable to this House. The Government have put themselves in this position.

[Stephen Barclay]

First, as we move into the next phase, there is an opportunity to operate in a much more targeted way with the House. Secondly, on the pause—[Interruption.] I am trying genuinely to answer the hon. Gentleman’s question. The pause was about listening to the House’s concerns about the backstop. Look at the comments yesterday by the Taoiseach, who said:

“We don’t want to trap the UK into anything—we want to get on to the talks about the future relationship right away.”

That is because the Prime Minister has been listening to the House and relaying that. As we move from a phase that was about implementing the result into a phase that is about trade negotiations and how they align with the sectoral interests of both the different nation state economies and the Select Committees, there is scope for a different dialogue, and I am very keen to signal that.

EU Exit: Article 50

Debate between Clive Efford and Steve Barclay

Monday 10th December 2018 Commons Chamber

[Stephen Barclay]

Again, we risk straying beyond the scope of the statement, but the point is that the Prime Minister made it clear that we will have a vote, so it is delayed; it is not withdrawn.

[Clive Efford (Eltham) (Lab)]

In the event that the House votes down the deal in the meaningful vote and that there is no majority in the House for no deal, in order to deliver on the will of the House, will the Government consider suspending article 50?

[Stephen Barclay]

Part of the difficulty for the House of working out the will of the House is that Opposition Members keep changing their minds. [Interruption.] I am sure—[Interruption.]

Oral Answers to Questions

Debate between Clive Efford and Steve Barclay

Thursday 6th December 2018 Commons Chamber

[Stephen Barclay]

I know that my hon. Friend has considerable experience, particularly on issues such as China, in which I know he takes a deep interest. The key point is that it will be a sovereign choice for the UK whether it extends the implementation period. He alludes to the fact that significant work is already going on. For example, the economic and financial dialogues the Treasury has with countries such as China, India and Brazil lay the groundwork for much of the trade discussions that colleagues in the Department for International Trade are concluding.

[Clive Efford (Eltham) (Lab)]

The Secretary of State for International Trade promised that he would have 40 trade deals ready to sign the day after we leave the European Union. What assessment has the Secretary of State for Exiting the European Union made of his right hon. Friend’s progress on that?

[Stephen Barclay]

I am both pleased and encouraged by the progress that my right hon. Friend the Secretary of State for International Trade is making. The point is that, through the deal that the Prime Minister has negotiated, we now are in a position where we can pursue an independent trade policy. That is clear on page 1 of the political declaration. Part 5 of the political declaration sets out a clear timetable to put momentum into the discussions in order that we can not only negotiate and sign during the interim period but get to that future trade agreement with the European Union, which will allow us to start those trade agreements with the rest of the world.

NHS Winter Crisis

Debate between Clive Efford and Steve Barclay

Monday 5th February 2018 Commons Chamber

[Stephen Barclay]

A party preparing for a run on the pound will be in no place to give funding to the NHS. It is the agreed convention of the House that responses to Opposition day debates are provided by the Department within 12 weeks. The Secretary of State will of course do that within that period, and there is a good reason for that. As I set out in my opening remarks, the data will not be available until mid-March, so the hon. Member for Leicester South (Jonathan Ashworth) is premature in asking this urgent question.

The facts are that the NHS was better prepared for winter this year. The number of 111 calls dealt with by a clinician has doubled compared with last year. Over 1 million more people have been vaccinated for the flu virus, 99% of A&Es have GP streaming and over 3,000 more beds have been made available since November, reflecting the extent of the plan.

[Clive Efford (Eltham) (Lab)]

So everything in our NHS is fine, is it?

[Stephen Barclay]

If the hon. Gentleman would like to compare with the performance of the NHS in Wales, we will undertake a comparison. The reality is that this year, we have had pressure on the NHS as a result of flu. The difference is that in 2009, the Conservative party did not play politics with the flu pressures. This year, the hon. Member for Leicester South has done so. He should compare it with the pressure in Wales and see the excellent performance we have had in comparison.

--- Later in debate ---

[Stephen Barclay]

The hon. Lady raises a very valid point. It is exactly why we will have a Green Paper this summer looking at what steps need to be taken to address this issue. On both sides of the House, we recognise that more needs to be done on how we address these concerns, and that is what the Green Paper will tackle.

[Clive Efford (Eltham) (Lab)]

I am sure that the Minister did not mean to mislead the House regarding the impact of the flu epidemic on our A&Es, so will he confirm that the delays to people being treated in A&E, and the fact that people have been waiting on trollies in corridors and that ambulances have been queueing at the doors of A&E, predated the flu epidemic?

[Stephen Barclay]

The hon. Gentleman makes quite a serious allegation of my misleading the House. What I was very clear about is that there has been a 35% increase in attendances at A&E as a result of flu this year compared with last year, and that around 3,000 beds are currently occupied by patients with flu and around 700 beds are occupied by those with norovirus. Clearly, that has resulted in significant seasonal pressures this year, which have placed strain on the system. That was recognised by the Government in the additional funding that was put in place. It was recognised by the NHS, as Sir Bruce Keogh set out in the early planning that was undertaken, and it is simply wrong for the hon. Gentleman to ignore the impact of flu this year, given the way that in 2009 the then Opposition were very responsible in recognising its impact.