NHS Staff Pay

Eleanor Smith Excerpts

Wednesday 21st March 2018 Commons Chamber

[Mr Hunt]

The most important thing about the deal is that it will discourage people who might be reaching breaking point, because of personal circumstances, from packing it all in and leaving the NHS family. There is a particular proposal to allow much greater flexibility in the buying and selling of annual leave, so that people who need to work less because of things that happen at home, and perhaps people who want to work more, find it much easier to do so. This is therefore part of a much bigger shift towards the flexible working that we know everyone wants these days.

[Eleanor Smith (Wolverhampton South West) (Lab)]

I absolutely appreciate the Secretary of State’s announcement on pay. As a nurse who has worked for more than 40 years, I know that it is greatly welcomed by everybody across the patch, including porters. I want to ask, however, about wholly owned subsidiary staff. I believe that some of them are not under “Agenda for Change” terms. Will they get the pay rise as well?

[Mr Hunt]

First, I thank the hon. Lady for welcoming the deal. I think she is the first Labour Member who has done so, and it is not insignificant that she is a nurse. A wholly owned subsidiary is a legal structure that was made possible by a change in the law introduced in 2006, under her party’s Government, and is actually an alternative to outsourcing. Employees would be far more likely to benefit from “Agenda for Change” pay rates within such a structure than if they were outsourced, which the last Labour Government tried so hard to encourage.

Oral Answers to Questions

Eleanor Smith Excerpts

Tuesday 20th March 2018 Commons Chamber

[Mr Hunt]

In my first few years as Health Secretary, the message I heard loud and clear from the NHS was that it did not want a huge structural reorganisation, so we are very cautious about changing statutory structures. We want to encourage integration, but in time, if the NHS says it would like the statutory structure changed, we will of course listen.

[Eleanor Smith (Wolverhampton South West) (Lab)]

4. What estimate he has made of the number of NHS trusts that have established wholly owned subsidiary companies.

[The Minister for Health (Stephen Barclay)]

NHS Improvement has informed the Department that 42 foundation trusts have reported consolidated subsidiaries, but there might be a few instances of subsidiaries being too small to be consolidated.

[Eleanor Smith]

What assessment has the Minister made of the impact on staff morale, retention and recruitment where trusts have set up wholly subsidiary companies and introduced a two-tier system whereby new staff terms and conditions are not part of the NHS “Agenda for Change” or the NHS pension scheme? Is this the back door to privatisation?

[Stephen Barclay]

Had the hon. Lady been able to attend the recent Westminster Hall debate on this issue, she would have heard that in the trust under discussion the staff survey showed an improvement in responses as a result of the subsidiary because many staff valued the flexibilities in the new contracts that the subsidiary could offer.

Organ Donation (Deemed Consent) Bill

Eleanor Smith Excerpts

2nd reading: House of Commons
Friday 23rd February 2018 Commons Chamber

[Michelle Donelan]

I agree. Choice is the key to making the Bill as successful as possible, as is education. Some people might donate those organs if they knew how the process would work, but there needs to be an element of personal choice. It is our body, at the end of the day, and we should be encouraging people to help others rather than forcing them, which will not be successful.

Members have made the point—I do not want to labour it, but it is important—about reaching out to all communities, including those from ethnic minorities, among whom the number of donors is particularly low at the moment. In fact, shockingly, in March 2017 there were 634 people from the black community in need of organs, and only 72 people on the donor list died and were suitable organ donors. That is a really small proportion.

[Eleanor Smith (Wolverhampton South West) (Lab)]

I thank the hon. Lady for raising that issue. Our community is experiencing what is called a silent crisis, because of the lack of knowledge and willingness to discuss organ donation with family members and concerns about the integration of the body after death. I take on board what she says—we must be mindful that there is a lack of knowledge among our community, and the Bill would improve that.

[Michelle Donelan]

I thank the hon. Lady for her intervention.

Only 1% of people a year die in circumstances suitable to allow their organs to be donated. It is important that we have an honest conversation today and do not say that the Bill is the panacea that will solve the problem, and that if someone is on the organ register, they will automatically get a donation. That would give people false hope. That statistic also means that we should potentially review the current regulations on age restrictions for the donation of certain organs. For example, heart valve donations have an age restriction of 60, whereas countries such as Spain just look at the quality of the organ.

The most important mechanism for ensuring that the Bill is as effective as possible is transport infrastructure and investment in staffing. It is no good unless we have enough helicopters, bikes, trained staff and support workers to facilitate the Bill. We must ensure that it does not just help people who live in urban areas. My constituency is very rural in parts, and some areas are harder to get to, but that does not mean that people there should be any less likely to benefit from donations. Other countries that have introduced Bills such as this, including France, Sweden and Bulgaria, have seen a reduction in their organ donation rates partly because of a lack of investment in infrastructure, so that is crucial.

We should be quite bold in reviewing this issue. Some countries have adopted a policy that I admit I was originally very uneasy about, whereby someone who is an organ donor and has not opted out of the system is higher on the priority list to receive a donation. I now think that that is quite fair, because if someone is prepared to give a donation, they should be more likely to receive one.

The UK has one of the lowest donation consent rates in the world, and that is really not good enough. I am hugely supportive of the Bill, but I echo the caution that it depends on the infrastructure, education and support that we give people, so that we can ensure that the Bill is as successful as possible.

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[Mrs Hodgson]

My hon. Friend has made exactly the right point. This does not apply only to, for instance, kidney and heart transplants; it applies to the whole donor register. The Government must listen to the concerns of black and Asian communities, not just during the consultation but beyond, so that we can develop a solution to this problem.

[Eleanor Smith]

I hope that the Bill succeeds and that there will be consultation with members of the BME community to ensure the successful delivery of a public education programme to increase awareness.

[Mrs Hodgson]

That is precisely the point. It is a question of education and public awareness as well as the acceptance of the sensitivities that exist among all people, not just members of particular religious or ethnic-minority communities.

NHS Winter Crisis

Eleanor Smith Excerpts

Wednesday 10th January 2018 Commons Chamber

[Eleanor Smith (Wolverhampton South West) (Lab)]

It is a pleasure to follow the hon. Member for South West Wiltshire (Dr Murrison).

As a nurse who has worked in the NHS for more than 40 years, I know too well the effects of the winter crisis. Yes, winter is the time when the NHS faces pressures, but the Government have claimed that they were better prepared for this winter crisis, with their national medical director explaining that they had been preparing since last winter. How can that be true when the Government announced that they would postpone non-urgent operations? Not only does that put patients’ physical and mental health at risk, but it creates a backlog of operations, which NHS staff will still have to catch up on.

Unison spoke out about the handling of the NHS only in February last year. It also highlighted the Government’s promise in their manifesto to properly fund the NHS. In their 2017 manifesto, the Government pledged to give the NHS the resources it needs. In the autumn, they also pledged that the NHS would receive an additional £377 million to ease winter pressures, but they failed to disclose the fact that although they are providing funding, they are undercutting that by asking the NHS to make savings in some areas.

Where has the funding the Government provided to ease winter pressures gone? The Royal Wolverhampton NHS Trust provides services to the hospitals in Wolverhampton that care for patients in my constituency. Hospital staff have been working under increasing pressure, because for more than half the days between 20 November and 31 December last year, bed occupancy in the Wolverhampton trust was above 90%. Over the same period, one in six ambulance handovers were delayed for more than 30 minutes. This would not be happening if, as the Government claim, the NHS was well prepared.

There has been widespread outrage over this winter crisis, but NHS staff have been highlighting the pressures on the NHS throughout the year, and for many years. We have campaigned, met the Minister, written articles and held protests about the Government’s treatment of the NHS and the underfunding over the past seven years. When will the Government face the fact that the funding they have provided is simply not enough?

NHS Pay

Eleanor Smith Excerpts

Wednesday 13th September 2017 Commons Chamber

[Dr Wollaston]

That is an important point. I very much hope that my hon. Friend will contribute to the Committee’s inquiry. As well as looking at the new routes into nursing, we will look at the skills mix, roles within health and social care more widely, the impact of Brexit and language testing, workload and morale. We will be seeking contributions from hon. Members across the House and from people outside.

As I said, we will miss something if we just look at the issue as one of pay. Pay restraint is estimated to contribute between £3.3 billion and £3.5 billion of the five year forward view efficiency savings up to 2019-20. If that goes, what will fill the gap? We have to be careful that there is no loss of services or losses in the workforce, because workforce pressures—probably more than any other issue—contribute to nursing staff leaving the profession. We have to look at the bigger picture.

[Eleanor Smith (Wolverhampton South West) (Lab)]

I have been a nurse for 40 years, but this is not just about nursing. There are other groups as well, including occupational therapists and physiotherapists, who are also registered professionals. Along with everybody else, they are just as important as nurses.

[Dr Wollaston]

The hon. Lady is absolutely right. Look, for example, at the applications for nursing courses. Even though the number of applicants has gone down, it may not ultimately result in a loss of numbers entering nursing. Some of the applicants from that overall drop in numbers might have gone on to other courses, so we need to look at the bigger picture. In opting to look at the nursing workforce, the Health Committee is not saying in any way that other parts of the workforce are not important. The NHS is a team, but it would be difficult for us to report within a certain timeframe if we looked at the entire workforce. I have no doubt that we will look at other aspects of the workforce over the course of this Parliament. I assure the hon. Lady that we will not lose sight of the bigger picture and I hope that she will contribute to the inquiry.

We need to look at the big picture regarding the total budget for health and social care. The right hon. Member for North Norfolk (Norman Lamb) has long made this point, and we have both made it clear that it is time for us to take a cross-party approach to sustainable funding for health and social care in the long term. I look forward to working with him on that over the course of this Parliament.

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[Kwasi Kwarteng (Spelthorne) (Con)]

It is a great honour to have been called in this serious debate. I am pleased by the way in which it has been conducted, as we have heard some very good speeches, in particular the maiden speech by the hon. Member for Portsmouth South (Stephen Morgan). It was an amusing, entertaining, heartfelt and serious speech, and I have no doubt that the hon. Gentleman will make valuable contributions in this Parliament and in years to come. It was a salutary speech because it gave one faith in the House of Commons.

Having been a Member for seven years, I have seen many debates—and some yah-boo politics—in which people apportioned blame for the crisis. Labour says that the Tories cut too much and that it was all the bankers’ fault that we had a deficit of £160 billion—the largest peace-time deficit in our history. The right hon. Member for North Norfolk (Norman Lamb), who was a Front-Bench member of the coalition Government for their full five years, will remember clearly the context in which we came up with the difficult policy of the pay cap. It was not a whimsy, and we did not do it for the hell of it to put people under pressure. The pay cap was a serious response to a difficult and chronic problem—the deficit.

I do not want to apportion blame, and I echo my right hon. Friend the Secretary of State in recognising that the global crash was not entirely Labour’s fault—I am willing to give it that—but the history of the public finances from 2001, eight years before the financial crisis happened, shows that we ran a deficit in every single one of those years. To borrow a phrase—a mantra—from a departed colleague, Labour did not fix the roof while the sun was shining. The Labour party had a record of fiscal incompetence, and it was against that backdrop that public sector pay restraint became an issue. It is important to look at the history to explain why the pay cap was instituted in 2011.

[Eleanor Smith]

The hon. Gentleman talks about eight years, but Andrew Lansley’s Bill basically destroyed the NHS. That is why we are in this state with the pay cap. I think the hon. Gentleman has forgotten about that.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

I would like to allow the hon. Lady to speak early on, and there is nothing wrong with intervening, but we do need short interventions. That would be great. I need to know if Members will be giving way, too. I would like to get all speakers in, but the more interventions we have the less chance there is that I will be able to do that.

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[Eleanor Smith (Wolverhampton South West) (Lab)]

It is a pleasure to follow the right hon. Member for Broxtowe (Anna Soubry).

As a nurse of 40 years, I can say that the issue we are debating today is close to my heart. I, like many other NHS staff, struggled to make ends meet with the 1% pay cap, which acted as a pay cut. Since 2010, NHS staff who have decided to stay in the profession have experienced a real-terms pay cut of 14%. They are overstretched and undervalued, which is making patient care in the NHS a real concern. The 1% cap is forcing many experienced staff out of the profession, putting strain on those left. Others are pushed into the arms of agencies where they could earn many times their normal hourly rate, and others pursue a second job to make ends meet, working extra hours to increase their earnings. This puts a strain not only on their financial life, but on their family too.

In my constituency of Wolverhampton South West, I have constituents who work as nurses telling me they are leaving the NHS because of increasing workloads, which has caused them great stress, and years of pay restraint that has left them feeling undervalued and demoralised. Many hard-working nurses are turning to food banks, facing missing meals and struggling to pay their bills. Pay has not increased, but utility and grocery bills have. The Royal Wolverhampton NHS Trust employs over 8,000, and 7,297 are non-medical staff. Another constituent who is a ward manager at a local rehabilitation hospital in Wolverhampton contacted me explaining how she had been fortunate to train with an NHS bursary and to then be employed there as a staff nurse since 2001.

In response to a recent question by my hon. Friend the Member for Easington (Grahame Morris), the relevant Health Minister said that the Government changed the funding system for pre-registration tuition and bursaries to the standard student support system. This change means we have moved away from centrally imposed number controls and financial limitations, and therefore the artificial cap has been removed. That is not the case, as the latest UCAS figures show that applications for midwifery and nursing have fallen by 23% this year as health students are put off under this Government. Under this Government, it is difficult to train and to make a living as a nurse. That is why I am proud to have stood and been elected in the 2017 general election on Labour’s pledge, in a fully costed manifesto, to scrap the NHS pay cap and reinstate bursaries—unlike the Tories, who have given out massive tax giveaways worth £70 billion over five years.