Future of the NHS

Debate between Daniel Kawczynski and Preet Kaur Gill

Tuesday 24th October 2023 Westminster Hall

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Pritchard, and I add my thanks to my hon. Friend the Member for Wirral West (Margaret Greenwood) for securing the debate. She is a committed campaigner for our national health service, and she set out clearly how the NHS faces an unprecedented challenge. We have heard powerful cases put forward about the need for reform, including from the hon. Member for Southend West (Anna Firth). My hon. Friend the Member for St Helens South and Whiston (Ms Rimmer) focused on the workforce strategy for the NHS. I also thank my hon. Friends the Members for Liverpool, Riverside (Kim Johnson) and for Lewisham East (Janet Daby), who talked about sickle cell disease and equality in the NHS, and the hon. Member for Strangford (Jim Shannon).

This debate on the future of the NHS is timely as it is our first opportunity to put to the test the Government’s new slogan, which was unveiled at their conference:

“Long-term decisions for a brighter future”.

Personally, I would say that 13 years is long enough. What has been the result of that? Where we once spoke of winter crises, we now face crisis in the NHS all year round. Patient outcomes are declining, public satisfaction is at a 40-year low and improvements in healthy life expectancy have stalled.

One in seven of us are now stuck on waiting lists. Some 2.6 million people of working age are out of work and long-term sick—a record high. Across swathes of the country, dental deserts mean that patients are pulling their own teeth out because they cannot get the care they need. This Government was the future once, and their record is historically bad.

As the CQC warned last week in its “State of Care” report, the risk is that healthcare in this country becomes a two-tier system, where those who can pay get treated and those who cannot have to wait. My party will never accept that. We will always defend the principle of an NHS that is there for everybody when they need it, free at the point of use.

As we have heard, we need a serious plan for investment and reform if the NHS is to realise that promise. If the Government cannot deliver, we will. We will train thousands more doctors and nurses so that the NHS has the staff it needs, armed with cutting-edge technology to treat patients sooner and faster. We will get doctors and nurses to help to address the backlogs and pull the NHS out of permacrisis. We will reform the system to shift more care to the community, fix the front door to the NHS, and deliver a prevention-first revolution to shift focus from the NHS as a sickness service to it being a genuine, holistic health and care service.

One thing that will define the future of the NHS is the disease burden of the country. Children in school today will live into the next century. Our NHS has been there for us for 75 years and will need to be there for 75 more, but it will not be there if we carry on as we are. The change we need to make is the shift to prevention. Right now the situation is scandalous, given the clinical time and need that is taken up with treating illnesses that could have been avoided in the first place. Many of the biggest killers, from cancer to heart disease, could be drastically reduced through healthier lifestyles and environments, yet as we saw with the latest child measurement programme statistics released last week, primary schoolchildren are some of the least healthy there have ever been. Nearly one in four children are now obese by the time they leave primary school, which is absolutely shocking. Some prevalence studies show that four in 10 obese children have evidence of fatty liver disease.

Yet more shocking is the fact that, while these children are bombarded with adverts for junk food, such as KitKat cereal, or are begging their parents to fork out more than £10 for a bottle of Prime energy drink, the Government have seemingly abandoned their plan to tackle junk food promotions and adverts targeting children. I ask the Minister: when will the Government publish the consultation into the pre-watershed junk food ads ban? Where is the secondary legislation that they promised? They said that the delay was to allow time to consult, yet the consultation has been done and is probably sitting in a drawer in Whitehall somewhere. What is the hold-up? Will the Minister back Labour’s plan to ban junk food ads before the watershed and to introduce free breakfast clubs serving healthy food at school, so that every child gets the best start?

The future of NHS dentistry is also hanging by a thread. Dentists are leaving the NHS every year. Huge parts of the country are dental deserts, where practices are not even taking on NHS patients. The No. 1 reason that children end up in hospital is to remove rotting teeth. It has been six months since the Government announced their dental recovery plan, but where is it? Their response to the excellent Health and Social Care Committee report into NHS dentistry is also overdue; when can we expect that?

In the meantime, Labour has set out our rescue plan. We will have 700,000 more urgent appointments a year to bring down the backlogs. We will target funding to train up dentists in left-behind areas, and, of course, we will have a national supervised toothbrushing scheme for schoolchildren, because we know that the cheapest intervention means not needing to see a dentist at all.

Securing the future of general practice is also integral to the future of the NHS as a whole. People trust their GPs, and the relationships that they build with their patients are irreplaceable, but despite the Government’s much-vaunted primary care recovery plan, record numbers of GPs are still leaving the profession. In 2019, the Government promised to deliver 6,000 extra NHS GPs. Will the Minister explain why that promise has been broken? How does he expect to move more care from acute settings to the community if general practice continues to decline at this rate? Where is his equivalent to Labour’s fully costed plan to recruit 8,500 mental health professionals, with support in every community and every school, to relieve the pressure on frontline GPs? And will the Minister say what proportion of the community diagnostic centres that have been set up in recent years are actually in the community, rather than in an existing healthcare site?

The Minister will surely acknowledge the point that there will be no sustainable future for the NHS without tackling the crisis in social care. Thousands of people are stuck in hospital beds who are medically fit to leave but are unable to do so, because the care that they need in the community is not there to support them. Can he explain how he expects to find a sustainable solution to that persistent problem without getting serious about pay and standards and addressing the chronic workforce shortage in the sector?

It is also a poor reflection of this Government’s long-term planning that the NHS is still stuck using creaking, outdated equipment, and has fewer scanners per person than Greece. Freedom of information responses from NHS trusts have revealed that half—48%—still have an MRI or CT scanner in operation past the recommended lifespan of 10 years. One in five trusts are using the same scanners that they had when the last Labour Government left office in 2010.

Does the Minister not agree that it is time for an upgrade? There are currently 1.6 million people waiting for diagnostic scans and tests in England—three times as many as when the last Labour Government left office in 2010. Slow, outdated equipment is part of the problem, so will the Minister follow Labour’s lead, with our “Fit for the Future” fund to double the number of CT and MRI scanners?

To really make the NHS fighting fit for the future, we should grasp the opportunities in the explosion of innovation in health technologies, too. Right now, a revolution is taking place in medical science, technology and data that has the potential to transform our healthcare. By using Britain’s strengths in life sciences and NHS data, we could transform the model of healthcare in this country using prediction, prevention and highly targeted precision medicine.

Today, genomic screening can spot predisposition to big killers such as cancer or heart disease. Let us imagine: if every family could choose to screen their baby’s genetic information, they would be empowered to give their child the healthiest start in life. Last month, I visited the Precision Health Technologies Accelerator at the University of Birmingham, part of the life sciences park that it is building there. Over time, it hopes that the campus will grow into a leading life sciences hub, bringing together the best of our university, business and the NHS, and creating more than 10,000 jobs in the process. That is really exciting.

The next Labour Government will build on the strength of our life sciences sector. The development of coronavirus vaccines shows us how industrial policy can work, with the state playing a crucial role in partnership with the private sector. Yet the Government scrapped the Industrial Strategy Council and, since 2019, the UK has dropped from second to ninth in global life sciences league tables for inward foreign direct investment. Where is the Government’s strategy to put the NHS at the front of the queue for cutting-edge innovations in the health sector and end the postcode lottery in the adoption of new treatments and diagnostics?

[Daniel Kawczynski]

Bearing in mind that the Shrewsbury and Telford Hospital NHS Trust is the worst-performing for A&E in the United Kingdom, will the hon. Lady commit, if there is a Labour Government, to backing the £312 million investment in our local trust—yes or no?

[Preet Kaur Gill]

I thank the hon. Gentleman for his question, but I do not have the level of detail to be able to make any such commitment. He needs to speak to the Minister to ensure that the valuable investment they have been able to obtain for people in Shrewsbury is actually realised. That is really a conversation for him to have with the Minister.

There is no doubt that the NHS needs serious reform if it is to serve for the next 75 years. Since the Prime Minister and Health Secretary made a pledge in January for 5,000 more beds in time for winter, the number of hospital beds in England has fallen by almost 3,000. After a promise to clear all patients waiting 78 weeks or more for treatment by April this year, which was a shockingly low bar, the number rose last month from 7,300 to 9,000 patients. Despite making it one of their flagship five pledges to cut waiting lists, the Government have again broken their own record this month, with the number of patients waiting now at 7.8 million.

This Government cannot be trusted with the future of the NHS. Whether it is the social care crisis or the RAAC—reinforced autoclaved aerated concrete—scandal, the Government have literally failed to fix the roof while the sun was shining. The NHS will not survive another five years of this. Labour’s 10-year plan of change and modernisation will build an NHS fit for the future, shifting the focus of healthcare from the acute sector into the community to boost prevention, diagnose conditions earlier and provide treatment closer to people’s homes.

In closing, I want to put on the record my deep thanks to all our NHS staff for going above and beyond for patients, and especially everyone at the University Hospitals Birmingham trust in my constituency, which is the largest trust in the country.