Health and Social Care Workforce

Debate between Daisy Cooper and John Redwood

Thursday 13th July 2023 Commons Chamber

[John Redwood]

That is right. I hasten to add that there are many examples of good practice in the NHS. In the hundreds of trusts, units and management commands in the NHS, there are some very fine examples. In a large organisation such as this, part of the skill lies in spreading the best practice from the places that know how to do things and are doing them well to those that need help or support. They may not be aware of what is feasible, given the resource to which they are committed. I have found whenever I have been involved with something that was not working well that bad management have often made a mistake and appointed some good people but not in the positions of influence and power where they can really make things happen. Where someone is trying to recover something that is not running well, it is often about identifying the people who are good but who may be sidelined, frustrated or not being used properly, and then transferring them into different roles, to give the idea to the others that the organisation can be a good one.

My hon. Friend was hinting at where someone wants to get to if they are leading any organisation. They want success, because success breeds success; people want to work for a successful and happy organisation. If morale is allowed to sink, performance starts to get poorer. If performance sinks, really good people perhaps do not want to be associated with it or they are frustrated that they are not given the power to sort it out. The organisation could then get into a downward spiral, which it needs to avoid.

Let me move on to a slightly tougher message and spoil the party. I take as my text the work that the Chancellor of the Exchequer and his team have been doing and his recent big speech at the Guildhall on productivity. His research revealed that productivity in crucial public services, particularly the NHS, is considerably below its 2019 levels. We are all sympathetic to the fact that there was a major disruption of the NHS’s work for the period 2020-21, and probably we would also expect there to have been difficulties in in 2022 after the impact of a major diversion of effort and activity into tackling the pandemic. We are all very grateful to those brave and talented staff who did what they needed to do to see people through. However, over that period a large additional amount of money was provided, not just for the pandemic, but now on a continuing basis, along with some additional staff, as we have been commenting on, yet we are still not back to the productivity levels we were at in 2019.

As the managers of the NHS go about creating a more contented and happier workforce, in the way I have been describing, they need to say to people, “You are going to be better paid, but we can also look at your promotion, grading and job specifications,” because the good ones should be able to get additional pay and go up the scale into more important jobs. There has to be something for something. The managers have to help the staff to deliver more treatments, consultations and diagnoses, which must be possible because we are not even at the levels we were at in 2019.

[Daisy Cooper]

I have met scores of people working in the NHS at different levels; I am sure the right hon. Gentleman has too. When I talk to them about the productivity gap, they give me two or three clear examples of why there is a productivity problem. One is that there are more sick days because of burnout and exhaustion. It is unfortunate that the Government are cutting funding for mental health hubs, which have been a huge source of help for staff, particularly in hospital settings.

The NHS workers I have spoken to also talk about scanners that are way past their use-by dates and take far too long to get going, and about IT systems that do not speak to each other. They have to use eight or nine different IT systems between wards, or even on one ward, and old computers take too long to set up in the morning. It is that kind of tiresome daily grind. We sometimes know about that here in Parliament, when computers do not start in the morning and things do not work, and people end up getting frustrated.

Does the right hon. Member recognise that the productivity problem is not just about rotas, but about investing in technology, IT and scanners that work, making sure that water is not coming through the ceilings and giving mental health support?

[John Redwood]

I agree with all that. I have been very careful not to criticise the staff; I am talking about a management problem. If there are too many agency staff, then time has to be spent explaining to them how that particular hospital or department works, which would not be necessary if the regular staff had turned up. If there are gaps because of staff absences or people having resigned, that puts more strain on people and the system does not work efficiently.

All my remarks are made in the context of what I said at the beginning about trying to make these jobs more worthwhile and feasible. We need to look at how that can be done, and managers have to answer questions about whether some of them are imposing too many requirements on people that are not directly related to them performing their tasks better. There have to be limits on how much other general management information or other management themes they want to pursue, when the main task is to clear the backlogs and to treat the patients. The patients should come first, second and third, and that is not always possible if managers are making many other demands. So that is where the management teams need to take the organisations.

I was coming to the other good point that the hon. Member for St Albans (Daisy Cooper) makes, which is also well made the workforce plan. We are living through an extremely exciting digital revolution. It may even be speeding up with the developments in artificial intelligence, which could be dramatically helpful. There is a continuing task in the NHS, which sometimes thwarts those attempting it, to make sure technology is applied in the right way and is understood and friendly to use, so that hard-pressed and busy medics can find it a support, rather than a tribulation or a barrier.

Given the NHS’s huge range of data and experience, artificial intelligence should be an extremely valuable support, aiding diagnosis and decisions on treatment. I am not one of those who think that computers can do these things on their own or are about to take over the world. In the model we are talking about, the computer is an extremely important assistant that can do research and produce first drafts—that kind of thing—in a way that speeds up the work and effectiveness of the professional. However, it has to be controlled and guided by the medical professionals, who have the judgment, wider experience and expertise. The quality and speed of what they do could be greatly enhanced with the right kind of AI backup. For example, if they are facing a condition they do not know much about because it is rare, the computer would be able to give them immediate access, one assumes, to the details of what has happened in similar cases, what it looks like and how it might be treated.