Health and Social Care: Winter Update

Edward Argar Excerpts

Wednesday 15th January 2025 Commons Chamber

[Edward Argar (Melton and Syston) (Con)]

As ever, I am grateful to the Secretary of State for his typical courtesy in giving me advance sight of his statement. May I join him in saying that our thoughts are with the nurse in Oldham who was so viciously attacked? Like him, we wish her a full and speedy recovery. May I also echo his words of gratitude to NHS and social care staff for all they do to help and support patients and our constituents?

We last heard from Ministers on winter pressures just before Christmas. Yet, as the Secretary of State has set out, the situation has continued to grow more severe. We have all heard about those pressures in the media and from patients, constituents and staff. Indeed, I will take this opportunity to acknowledge the work of the hon. Member for Tooting (Dr Allin-Khan), who I know has been on the frontline and has, I suspect, seen those pressures—the unacceptably long waits in A&Es for ambulances, and corridor care and its impact on patients—at first hand. When someone calls an ambulance, they need to know that it will come, but it cannot if it is sitting in a hospital car park. At my local hospital in Leicester, for example, over 36% of ambulances handing over had a one hour-plus wait, and I am sure that that is replicated around the country.

The Secretary of State highlights that the number of patients in hospital with flu is triple what it was a year ago, yet it appears that the rate of flu vaccine uptake for over-65s, at-risk groups and healthcare workers is lower than last year. He wants more people to be vaccinated, and I share that view, but will he set out in more detail what he is doing to further drive vaccine rates and ensure that vaccines are available for all those who need and want them?

As the Secretary of State said, more than two dozen hospitals declared critical incidents last week. Although I welcome the fact that the vast bulk of those incidents have been stood down, will he set out what support and additional resource is being offered not only to hospitals that have reached the point of declaring critical incidents, but to others that continue to face pressures?

Last year, the Government provided additional funding for hospitals and social care to boost capacity and, vitally, the number of beds in hospitals, as well as to tackle delayed discharges. Will the Secretary of State set out in more detail what he is doing in a similar vein? Will he update the House on how many people currently in acute settings are fit for discharge but have not been discharged for a variety of reasons?

The Secretary of State mentioned pay, and said that he had negotiated a deal. I say gently to him that what he did was not negotiation but capitulation to an inflation-busting pay rise.

None of these pressures comes as a surprise to me or to the Secretary of State. He was open and candid, as he often is, in acknowledging that there would be a winter crisis this year. NHS England directors were warning that they did not have the resources needed to surge capacity or increase social care packages now, which the Conservative Government provided in previous years. The royal colleges said that nothing had been done to mitigate a winter crisis, and NHS organisations said that they needed more support to prevent ambulance delays, overcrowded A&Es and people being stuck in hospital beds because of a lack of community and social care. He knows—we have spoken about it before—the importance of flow from ambulance to A&E, and from A&E to a bed or to discharge. What extra steps is he taking to increase the number of care packages now rather than in the future, and will he consider allowing community hospitals, such as mine in Melton Mowbray, to play a greater role in providing care to local communities in order to ease pressure on acute settings?

Those concerns were all raised in September and October. My predecessor as shadow Secretary of State, my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins), asked about them, yet the Secretary of State failed to provide an update to the House until Ministers came to the House just before Christmas. Indeed, I recently asked a named day question about when the Secretary of State started chairing his weekly winter preparedness meetings. Despite, one hopes, a quick look at his diary giving the answer, I received a holding answer. I only got the correct answer after that holding answer had been sent to me, stating that it was in December. Can he say on which date in December the first of those meetings was held?

Before Christmas, I and the Conservatives called for a winter-specific bed increase plan. We still have not had one. Will the Secretary of State set out what he is doing to increase the number of beds and the amount of capacity now?

While the Secretary of State talks the talk, he has not done the work ahead of this winter. Will he now reassure patients and staff that he will urgently boost capacity, resources and support to ensure our constituents get the care they need when they need it?

[Wes Streeting]

Where to begin, Madam Deputy Speaker? The shadow Health Secretary does a really good line in diagnosing the problem as if these are somehow new facts to him, or to the country. In fact, one does not have to be a Minister of long service in this House, or indeed a Member of long service, to remember that only a short matter of months ago, the shadow Secretary of State was a Minister in the Department. Time and again, he asks questions about the state of the crisis and the challenge in the NHS without showing a shred of responsibility for that crisis, which he played a part in creating.

It is not just the shadow Secretary of State but every one of his predecessors who had a hand in creating the situation that Lord Darzi spelled out: underinvestment and botched reform. It is the situation we see today, with pretty much every part of our health and care services—be it primary care, community care, mental health services, secondary care or social care—under extraordinary and historic pressures. It is all very well criticising from the Opposition Benches, but the shadow Secretary of State demonstrates the same pattern of behaviour as his predecessor: acting like the arsonist criticising the fire brigade for not doing enough, quickly enough, to put out the fire they started. It is truly shameful.

I turn to the questions raised by the shadow Secretary of State. On delayed discharges, in December—the latest data we have—12,000 on average per day were medically fit for discharge but unable to be discharged. Bed numbers are broadly the same as they were this time last year: 102,546, versus 102,226 under the previous Government. That actually says something about what we have experienced in our weekly updates: the work that is taking place between health and social care services to improve the flow of patients is having some effect when we take into account our ability to flex bed numbers up and down against the backdrop of higher occupancy from flu, the added challenge of norovirus, and the other seasonal conditions that we see at this time of year.

The shadow Secretary of State asked about vaccination uptake. As I said in my statement, there have been more flu vaccinations this year than there were last year, but he raised the important issue of vaccination rates among NHS staff. Those rates are lower than we would like or expect, and we have to do some work with staff to understand why that is the case and how we can encourage further uptake. As I said, if staff are suffering with flu having not been vaccinated, not only is that a really unpleasant experience for them, it is an unpleasant experience for their colleagues if staff are off sick, and indeed for patients who are waiting longer.

On critical incidents, the shadow Secretary of State asked about the support that is being provided to NHS organisations. NHS England regional teams are working closely with integrated care boards to ensure appropriate responses are in place to address and mitigate the issues identified within each declared critical incident, all of which will have variations. We have also seen NHS England—rightly, in my view—using the critical incident tool proactively to ensure we can provide wider system support to emergency departments that are under particular pressure.

The shadow Secretary of State asked about additional funding for winter. When I was shadow Health and Social Care Secretary, I was very clear about my cynicism regarding the pattern of behaviour we saw from our predecessors. Year after year, they would arrive in the middle of winter—often after the winter peak—with a gimmicky package of last-minute funding that delivered too little, too late without making any real difference on the frontline, all to give the impression that they were doing something to mitigate the crisis in the NHS, in which they played a serious part. I said that we would not do that, and we are not doing it. As soon as we came into office, looked at the books and saw the black hole, the Chancellor released additional funding for the NHS in-year to ensure that it had the resources it needed not to cut back. Thanks to the decisions taken by the Chancellor, the NHS has received more than £2 billion more in-year than it would have received if the Conservatives had remained in power, so we do not need any lectures on funding. Indeed, they continue to oppose the £26 billion we provided for the NHS.

Finally, the shadow Secretary of State accuses us of capitulation to frontline doctors who were out on strike because of the way they were treated by our Conservative predecessors. I just say to resident doctors who are following these proceedings, and to patients who can see the state of the NHS today and wish it were better, that we are now left in no doubt. Had the country kept the Conservatives in power, doctors would have been on the picket lines instead of the frontlines this winter; taxpayers would have continued to pay a heavy price for failure; and patients would continue to pay the price through delayed, rearranged or cancelled operations, appointments and procedures. It is proof positive that even after it was booted out of office, the Conservative party has not listened, has not learned, and is not fit to govern.