Resident Doctors: Industrial Action

Debate between Edward Leigh and Wes Streeting

Thursday 10th July 2025 Commons Chamber

[Wes Streeting]

I strongly agree with my hon. Friend—he is absolutely right. I am happy to stand corrected, but there is genuinely no historical precedent in the history of British trade unionism for a trade union to have successfully negotiated with the Government of the day a 28.9% increase for its members and then go out on strike. I think that undermines the BMA, and the more reasonable voices in the BMA with whom we continue to work constructively. It certainly undermines our NHS.

It also reinforces the grossly unfair caricature, which is often thrown at trade unions by the Conservatives, that they are all unreasonable, do not want to work with the Government of the day and are only interested in combat and agitation. In my experience, the vast majority of trade unions and trade unionists are interested in constructive engagement, striking good deals and moving forward the interests not just of their members, but of our whole country. I urge the BMA resident doctors committee to stand in that proud tradition of British trade unionism and in the proud traditions of the wider Labour movement, but I am afraid I do not see those traditions or behaviours reflected in the current approach of the BMA RDC.

[Sir Edward Leigh (Gainsborough) (Con)]

We can all argue about the past, but if it helps the Secretary of State, I think we should just say today that the whole House absolutely 100% supports him in his robust attitude. [Hon. Members: “Hear, hear.”] Of course we all love doctors, but the starting salary is not so very bad. They have a job—a very good job—for life, which most people do not have, and he could also mention that they have a much better career structure than most people. A far higher proportion of them get the top job—namely, as a consultant—and the consultant’s starting salary of £110,000 a year is not a bad whack.

[Wes Streeting]

First, I think that the right hon. Member’s opening statement and the response across the House underline to the BMA and the resident doctors committee that they do not have support across this House—from the left across to the right, with maybe one or two noises off—and that is not typical in my experience of being in this House for the last decade.

I think the career of resident doctors and the prospects they can look forward to, which the right hon. Member described, have worsened. That is one of the things that is at the heart of the dispute they have taken up with the previous Government and now with this one. Many of the things doctors used to be able to look forward to—guaranteed jobs and progression into consultant roles or general practice—have steadily eroded. We have far too much doctor unemployment and far too many specialty bottlenecks. We have what I think is a really unreasonable set of behaviours towards resident doctors in terms of placements, rotations and the ability to take time off work to attend weddings and other important life moments. The tragedy of the position we find ourselves in is that I recognise that and I want to address it. We can do that together without the need for strike action, and those are not reasons for strikes. Worse still, especially at a time when I am prioritising dealing with doctor unemployment, they are inflicting further costs on the NHS, patients and the taxpayer. That makes my freedom and flexibility and my resources to deal with those issues more limited—that is the tragedy of their tactics.

NHS 10-Year Plan

Debate between Edward Leigh and Wes Streeting

Thursday 3rd July 2025 Commons Chamber

[Wes Streeting]

I thank my hon. Friend for that question. On whether people feel cautious optimism or quiet scepticism based on the experience that he describes, I have heard the same thing so many times. “I love AI, genomics and machine learning—yep, great. But can you just give me the basic technology that works?” Well, I can confirm that in 2026-27 we will make sure that we create a single log-on for staff. I am not holding my breath for that to be the front-page splash tomorrow, but that one thing, as well as saving loads of staff time, will give them confidence that genuine change is coming.

[Sir Edward Leigh (Gainsborough) (Con)]

As always, the Secretary of State makes a good fist of an impossible job, but I think we all know in our heart of hearts that this model, which takes 38% of public funding, is unsustainable in the long term. He mentions the Australian outback; I have been a voice in the wilderness, urging him to replicate the excellent Australian system, which is a mix of public and private. I will not do that again now, but may I ask him to at least look at Australia’s pharmaceutical benefits scheme, which ensures national procurement of medicines, so that people who have a medical card there get their medicines cheaper than people here?

[Wes Streeting]

I am always willing to search the world for ways to spend taxpayers’ money more effectively, and the right hon. Gentleman makes some good arguments on making sure that we get a good deal on medicines pricing, and on using the real procurement power of the single payer model—but therein lies the answer to the other part of his challenge. It is the single payer model, created in 1948, that makes the NHS ideally placed to get much better value in procurement, and to harness and lead the revolution in AI, machine learning, genomics and big data, in a way that many insurance-based systems struggle with. I assure him that if there were a better way of funding the NHS, I would have the political courage to make the argument, but we looked at other systems of funding and concluded that that is really not the problem. It is not the model of funding; it is the model of care, and that is what we are going to sort out.

New Hospital Programme Review

Debate between Edward Leigh and Wes Streeting

Monday 20th January 2025 Commons Chamber

[Sir Edward Leigh (Gainsborough) (Con)]

Will the Secretary of State forgive me if I give the House a few seconds’ respite from the blame game by trying to make a positive suggestion? Everyone accepts that the real problem facing our hospitals is the number of frail and elderly people who do not need to be in hospital and should be in some sort of care facility. Does the Secretary of State agree that while building brand-new, all-singing, all-dancing hospitals is very expensive, there is a future for smaller cottage hospitals such as the one in Gainsborough and a case for opening other facilities so we can move elderly, frail people out of those big hospitals into a caring environment and free up space?

[Wes Streeting]

I thank the right hon. Gentleman for a rare constructive contribution from the Conservative Benches—not rare from him, for he is regularly constructive; it is the rest of the Conservative party that we have a problem with. Let me reassure him that one thing we are determined to do is deliver a shift in the centre of gravity, out of hospitals and into communities, with care closer to home and indeed in people’s homes. As I saw on a visit to Carlisle over the new year, good intermediate step-down accommodation sometimes provides better-quality and more appropriate care and better value for the taxpayer. That intermediate care facility in Carlisle, funded through the NHS by a social care setting, was providing great-quality rehabilitation in a nicer environment at half the cost of the NHS beds up the road. This Government will deliver both better care and better value for taxpayers.

Health and Adult Social Care Reform

Debate between Edward Leigh and Wes Streeting

Monday 6th January 2025 Commons Chamber

[Sir Edward Leigh (Gainsborough) (Con)]

I welcome the consensual parts of the Secretary of State’s statement, but I wonder whether we have been entirely honest with the public about the sheer unaffordability of the cap proposed by Dilnot. I do not absolve my own Government from this: maybe we should start telling the truth to the public. Does the Secretary of State think we need a new social compact on bringing in social insurance so that people can plan for their entire life? They would know that they will have to pay more in taxes during their life for their old age, but at least they would have certain rights.

[Wes Streeting]

The right hon. Gentleman is right to say that we need a debate as a country about the balance of financial contribution between the individual, the family and the state. I well understand why David Cameron was so concerned about catastrophic care costs and people having to sell their homes to pay for their care and the problem he was trying to solve. With every Government since, the issue has been seen as less urgent than others, but that does not mean it does not matter or that we should not consider it as part of the Casey commission. We need to consider all these issues in the round and, as much as we can, build a consensus not just in this House, but throughout the country about the balance of financial contribution and what is fair, equitable and sustainable.

NHS: Independent Investigation

Debate between Edward Leigh and Wes Streeting

Thursday 12th September 2024 Commons Chamber

[Sir Edward Leigh (Gainsborough) (Con)]

I greatly respect the Secretary of State, and, as an older person who relies on the NHS, I support his radical zeal. I repeat what he said in his statement: cancer is more likely to be a death sentence for NHS patients than for patients in other countries. We have had this conversation previously, but can he at least look at the health systems in other countries, particularly those in the Netherlands, Australia, France and Germany? Those countries, which have wonderful health systems protecting the vulnerable, use a mixture of social insurance and public and private funds to maximise inputs into their health services.

[Wes Streeting]

Every time the right hon. Gentleman praises my zeal for NHS reform, Labour Members get very nervous. Let me reassure him that I have looked at other countries, and I will definitely continue to do that. I genuinely do not think that it is the model of funding that is the issue—the publicly funded, public service element. I hope that he knows me well enough to understand that if I did think so, I would be more than happy making, and would quite enjoy taking on, the argument, but I think that the equitable principle that underpins our NHS is one that we should cherish and protect. The single-payer model has enormous potential for the century of big data, AI, and machine learning. There is huge potential there that we must unlock, but that does not mean that we cannot learn from the way that other countries organise care, particularly in the community and particularly social care. This week, I met virtually with my friend the Health Minister in Singapore. I will continue to work with my international counterparts to learn from other countries whose health outcomes are far better than ours.

Budget Resolutions

Debate between Edward Leigh and Wes Streeting

Monday 11th March 2024 Commons Chamber

[Wes Streeting]

I agree with the hon. Member. Politics is about choices, which is why we choose to end the tax breaks enjoyed by private schools, which are attended by the 7%, in order to fund more teachers and education for the 93%. The Conservatives have not nicked that policy yet—it could be any day now—but it does say something about choices.

There is something else that I found really galling. When the Government appointed Sir Kevan Collins as their catch-up commissioner, they could not have found someone better to advise on education, life chances and how to correct the obvious damage that had been done to children’s education as a result of successive lockdowns. Most of us in this House—on both sides—felt that the lockdowns were necessary, given the scale of the virus, but we ought collectively to acknowledge that there was a consequence and a debt to be repaid to that generation. When Sir Kevan Collins published his report, which was commissioned by the Government, the Prime Minister decided that he could not do any more. If the Prime Minister’s children attended state schools and he understood the challenges that such schools were facing with recruiting teachers and providing the wide range of extra-curricular opportunities that so many independent schools offer, I wonder whether the Prime Minister would have made the same political choices—or is it just for other people’s children that this Prime Minister and his Government have low aspirations?

I think it is fair to say that we know why the Prime Minister was so wedded to the non-dom tax status. In fact, the only way the Chancellor could have upset his neighbours more was if he had raised taxes on helicopter rides and heated swimming pools too. But at least the Prime Minister can now look the British people in the eye and honestly tell them that we are all in this together. In fact, we have to pity poor non-doms—they cannot even look to their friends, or indeed their husbands, in the Conservative party to defend them any longer. Nor can pensioners, incidentally, because 8 million pensioners will see their taxes increase as a result of this Chancellor’s decisions. I do not think that is right or just, and I do not think people will forget it come the general election.

I turn to the Prime Minister and how he evaluates his own performance. At a Wetherspoons in Maltby last week, he told the public that at the start of this year we “turned a corner.” He is right: at the start of this year the economy turned the corner from flatlining and entered recession. Rishi’s recession is taking a heavy toll on working people. Labour’s candidate for Rother Valley, Jake Richards, told me about John from Maltby, who lives just down the road from what was probably the first ’Spoons the Prime Minister has ever been in. John is a veteran of our armed forces. He served his country and now, thanks to the recklessness and incompetence of this Government, he cannot make ends meet. That is the price that people are paying, and it is why this country is crying out for change.

Having crashed the economy just two years ago, the Conservative party is at it again with a £46 billion unfunded tax plan. Can any Conservative Member explain how on earth they are going to pay for the abolition of national insurance? This is a bigger unfunded commitment than the “kamikwasi” Budget of the right hon. Member for South West Norfolk (Elizabeth Truss). Mortgage payers are still paying the price for that grotesque act of economic self-harm, and the Conservatives are at it again—

[Sir Edward Leigh]

rose—

[Wes Streeting]

I hope that the right hon. Member for Gainsborough (Sir Edward Leigh) can tell us why.

[Sir Edward Leigh]

This is great knockabout stuff, but I would like to make a serious comment on the whole national insurance thing. With the retention of the triple lock and with fiscal drag, more and more pensioners are being dragged into paying tax. I understand that the Labour party will support the cut in national insurance rather than in income tax, so what is its long-term plan?

[Wes Streeting]

The right hon. Member made a right and fair point earlier about the cuts to national insurance and what is happening to pensioners’ incomes at the moment, but the Government’s long-term plan is totally unfunded. They cannot tell us how they will fund it or when it will be delivered by. I am happy to give way if anyone wants to correct me on that, as I am sure the whole country would like an explanation on this £46 billion unfunded tax plan. We cannot have a situation where once again the Conservative party gets away with an entirely unfunded gimmick. We saw where that led our country before, and Labour will not play fast and loose with the public finances in the way that the Conservatives have—[Laughter.] It is no use laughing. I am amazed that Conservative Members still laugh when people’s mortgages are going up month after month. They still have the audacity to laugh at their recklessness and not take responsibility for their mistakes.

NHS Workforce Expansion

Debate between Edward Leigh and Wes Streeting

Tuesday 28th February 2023 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I beg to move,

That this House condemns the Government’s failure to train enough staff to tackle the worst workforce crisis in the history of the National Health Service with a current shortage of 9,000 hospital doctors and 47,000 nurses; notes reports that the draft NHS England workforce plan calls for a doubling of medical school places to address this crisis; calls on the Chancellor of the Exchequer to use the upcoming Spring Budget to end the 200-year-old non-domiciled tax status regime; and further calls on the Government to use revenue generated by ending that regime to adopt Labour’s plan to expand the NHS workforce by doubling the number of medical training places, delivering 10,000 more nursing and midwifery clinical placements, training twice the number of district nurses each year and delivering 5,000 more health visitors.

To anyone who has needed medical care in recent months, it is blindingly obvious that the NHS is desperately in need of more staff. Doctors and nurses are overworked, hospitals are understaffed and the staff are burnt out. Patients are waiting longer than ever before, and 13 years of the Conservatives’ failure to train enough staff has broken the NHS, leaving patients to pay the price. In the words of the right hon. Member for Gainsborough (Sir Edward Leigh), Labour has a plan; where is the Government’s?

[Sir Edward Leigh (Gainsborough) (Con)]

The point I have been trying to make in recent months is that we should try to learn from the experience of Europe, where they have very effective social insurance systems and much more effective outcomes, so when the hon. Gentleman says he has a plan, I think we would all like to know what the plan is. Is it radical reform, or is it just more and more taxpayers’ money thrown into the NHS?

[Wes Streeting]

I am grateful beyond words for that intervention. I will outline Labour’s plans immediately and return to the right hon. Gentleman’s challenge—proposing a social insurance system—a little later in my remarks.

The point of this debate is that there is a serious shortage of staff. Labour has a plan to address that shortage, whether that is measures for retention of the staff we have or our plan for the biggest expansion of the NHS’s staff in history. The Conservatives have no plan, so let me outline what Labour’s plan is. We will double the number of medical school places so that we train 15,000 doctors a year. We will train 10,000 new nurses and midwives every year. We will double the number of district nurses qualifying each year and train 5,000 more health visitors. In a formula that will become familiar in the run-up to the next general election, we are clear about how we would pay for it, too. We will pay for it by abolishing the non-dom tax status, because patients need doctors and nurses more than a wealthy few need a tax loophole.