NHS Long-term Workforce Plan

Debate between Debbie Abrahams and Steve Barclay

Monday 3rd July 2023 Commons Chamber

[Steve Barclay]

The hon. Lady raises a fair point. It also applies to the issue of stroke. The elderly population has increased in many coastal and rural communities. That has created significant pressure: for legacy reasons, services are often in other parts of the country. We have five new medical schools in place, and we have looked at those parts of the country where it is often hard to recruit. Part of the expansion will be to look further at what services are needed in different areas. The hon. Lady’s point also speaks to that raised by the Chair of the Health and Social Care Committee. By giving greater autonomy to place-based commissioning through the integrated care systems, we will enable people at a more local level to design the services and the workforce that they need, and that includes the flexibilities required to retain local staff.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I welcome the workforce plan. Given that it has taken 13 years, one tends to wonder why it has taken so long, but then of course we remember that there is a general election on the horizon.

Page 121 sets out a labour productivity rate of 1.5% to 2% per year. That has never been achieved by the NHS or any other comparable health system, so what assumptions is the Health and Social Care Secretary making in relation to achieving that?

[Steve Barclay]

First, this is a plan developed by colleagues in NHS England, so these are assumptions that have been agreed by those who lead within the NHS. It is about ensuring that people operate at the top of their licence. It is about having new and expanded roles, such as advanced practitioners and associate roles, that allow people to progress in their careers and, in doing so, freeing up capacity for senior clinicians, who often spend time doing things that do not need to be done by people in those roles.

Of course, there are also rapid changes in technology. We often talk about the developments in artificial intelligence, and I have touched on developments in the life sciences industry. I have also mentioned advances in screening and genomics. All those developments will in turn help us to prevent health conditions, and treating those conditions early will be not only better for the patient, but better value for money for the taxpayer.

Recovering Access to Primary Care

Debate between Debbie Abrahams and Steve Barclay

Tuesday 9th May 2023 Commons Chamber

[Steve Barclay]

My hon. Friend has a great deal of experience, and he is right to focus on the amount of clinical time often spent on non-clinical issues. Sending reminders through the NHS app will reduce non-attendance. We are also looking at the key interface between secondary care and primary care, as well as considering which appointments can be done elsewhere, such as through pharmacies and the additional roles. The online booking system can better triage people to the right place, and there will be some self-referral in order to take pressure off GPs—not for things that carry a clinical risk, such as internal bleeding, as the Opposition suggest; but for things like hearing aids. If a person has taken a hearing test, they will not need to clear an appointment for a hearing aid through their GP.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I reinforce what colleagues have said. This is a step in the right direction, but it fails to grapple with the grave situation in which there has been a threefold increase in waiting lists since 2010, including a twofold increase since 2019, before the pandemic. In Oldham we have fewer GPs and more patients with increased acuity, so when will we get our fair share of the promised 6,000 GPs?

[Steve Barclay]

I have recognised throughout that demand has increased. Primary care is treating 10% more patients than before the pandemic, with around 1 million appointments a day. There is more demand, not just because of the pandemic but, as I said in my opening remarks, because we have a third more people over the age of 70, and they are five times more likely than younger people to go to their GP. That demographic change, the impact of the pandemic and a change in public expectations of advances in medicine are all creating additional pressure, which is why it is right that we use the full range of additional roles and that we invest in technology, in addition to the 2,000 more doctors in general practice.

NHS: Long-term Strategy

Debate between Debbie Abrahams and Steve Barclay

Wednesday 11th January 2023 Commons Chamber

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

The Health Secretary will be aware that our hospital bed numbers are approximately half the OECD average, at fewer than 2.5 per 1,000 compared with 5 per 1,000 in the OECD. He will also have read reports in The Observer about the facility that was made available in the Health and Social Care Act 2012 that allows hospitals to allocate up to 49% of their hospital beds to private patients. Does he regret that?

[Steve Barclay]

The issue of bed capacity does indeed matter. I made the point a few moments ago that flow in hospitals is obviously constrained when bed numbers are high. That is exactly why, in the statement on Monday, I highlighted the importance of discharge, and of things like discharge lounges so that we can better facilitate those patients that are free to leave. But this is not simply about hospital bed capacity; it is about step-down intermediate care capacity and also, as we heard a moment ago, about the innovation that means we are better able to facilitate those patients who want to recover at home but want the safety net of some clinical support when they are doing so. It is about looking at the capacity in the whole of the system, not simply in the hospital; otherwise, the hospital itself becomes a magnet.

NHS Workforce

Debate between Debbie Abrahams and Steve Barclay

Tuesday 6th December 2022 Commons Chamber

[Steve Barclay]

He does not want to intervene, so let me deal first with what he left out. His speech, like his motion, ignored a number of salient points. He did not mention, for example, the autumn statement, which one would have thought was fairly significant, providing an extra £6.6 billion for the NHS over the next two years. The NHS Confederation, no less, has described the day of that settlement as a “positive day for the NHS”, and the chief executive of NHS England has said that it should provide “sufficient” funding to fulfil the NHS’s key priorities.

The hon. Gentleman chose not to mention that significant funding. He also—much to the surprise of the House, perhaps—chose not to mention the uplift for social care that was announced in the autumn statement. Opposition Members often call for more funding, so I would have thought that they would be keen to hear about the extra £6.6 billion of additional funding for the NHS, about the biggest funding increase for social care provided by any Government in history, and about the £8 billion that we have committed to elective care. That, bizarrely, was also missing from his speech. He talked about the backlogs—those in England, that is; the backlogs in Wales are much greater—but he did not talk about that £8 billion for elective care, which will fund the building of diagnostic centres and surgical hubs in the constituencies of many Opposition Members.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

rose—

[Steve Barclay]

I do not know whether there is a community diagnostic centre for a surgical hub in the hon. Lady’s constituency, but perhaps she will share with the House what extra investment is being made there.

--- Later in debate ---

[Debbie Abrahams]

As someone who worked in the NHS during the last period of Labour government, I was proud of being able to ensure that my constituents would have an appointment with a GP within 24 hours. I was proud of the fact that someone who needed elective care would receive it within 18 weeks. I was proud of the fact that the treatment of someone diagnosed with cancer would start within 60 days. That is not what is happening on the Secretary of State’s watch. Can he tell me why my constituency has fewer GPs than it had in 2015, along with an increase in demand? How is this delivering the quality care that I know we had on my watch and that of the last Labour Government?

[Steve Barclay]

We are investing in more doctors. We have 2,300 more doctors—a 3% increase. We also have 3% more nurses than we had last year. In fact, under the former Prime Minister, my right hon. Friend the Member for Maidenhead (Mrs May), there was the biggest ever increase in medical undergraduate places—a 25% increase—along with the opening of five new medical schools. Of course, the training takes about seven years, so that is still in progress. As was pointed out during Health questions this morning, we are dealing with the consequences of the pandemic, which is why we are investing in more checks, scans and other procedures, and there will be an extra 9 million of those by March 2025.

Urgent and Emergency Care

Debate between Debbie Abrahams and Steve Barclay

Monday 5th September 2022 Commons Chamber

[Steve Barclay]

I fear that the question was written before the statement. In the course of the statement, we have covered the significant additional funding that is going in, whether that is in primary care with the £1.5 billion on GP capacity, the £450 million on A&E capacity, the £150 million on ambulances, the £50 million on 111 call-handling or the £30 million on St John auxiliary ambulance capacity—to name just a few areas.

As to the hon. Gentleman’s wider charge on Government funding for the NHS, I remind him that health funding is on track to be £4 in every £10 of day-to-day Government expenditure, which is a significant increase on 2010. We have also just been through a pandemic in which the fiscal response, as the former Chief Secretary to the Treasury, my right hon. Friend the Member for Chelsea and Fulham (Greg Hands) will know, was about £400 billion. Significant funding has gone in, and the statement today has shown that a number of factors, in particular the integration between social care and the NHS, are at the heart of solving the issue of delays on ambulance handovers.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

For the week ending 12 August, there were nearly 1,000 excess deaths. We know that that is just the tip of the iceberg and it is likely to get worse; that is about 10% more than the five-year rolling average. What are the Secretary of State’s estimates of how much worse it is going to get over the winter months, and what is he going to do about it?

[Steve Barclay]

I have set out a range of things that we are doing to tackle what we recognise are significant pressures facing the NHS, whether that is through the taskforce that we have set up, which is targeted on delayed discharge; the intensive work that has been undertaken with, in particular, the 10 trusts that account for 45% of ambulance delays; the improved capacity within our call handling; or looking at our data, as was raised earlier, on the variation in performance between ambulance trusts on areas such as conveyancing or within the integration between the NHS and social care. I pay tribute to the huge amount of work that is being done within the NHS and social care in recognising that there are significant challenges within the system, which is why so much work has gone into addressing that over the summer.

Public Health Restrictions: Government Economic Support

Debate between Debbie Abrahams and Steve Barclay

Tuesday 13th October 2020 Commons Chamber

[Steve Barclay]

Among the range of measures that we have put in place as support, one speaks directly to my right hon. Friend’s issue, which is the rent support of up to £3,000 for businesses that are forced to close. The Welsh Government can then use Barnett consequential funding to support businesses and to design a scheme as they see fit, but it is for the Welsh Government to design those schemes, not the UK Government. That is what devolution entails. What we have done through the comprehensive package of measures that we have put in place is ensure that there is Barnett consequential funding to allow the Welsh Government to put that support in place.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

Like infectious diseases of the past, covid is a disease of poverty. Various indicators, including cuts to local authority funding, show that regional inequalities have been exacerbated over the past decade. Contrary to the Minister’s earlier remarks about the generosity of the packages to local authorities, only 10% of costs associated with the pandemic have been reimbursed by the Government. What is the Minister’s assessment of the actual impact that the recent announcement of measures have had on the Government’s ambition to level up?