NHS Workforce

Debate between Emma Hardy and Holly Lynch

Tuesday 6th December 2022 Commons Chamber

[Emma Hardy]

As I pointed out in my speech when I was talking about radiotherapy, the reason people are leaving the profession is to do with the work-life balance. It is not just a question of the number of people who are leaving midwifery, but a question of the number of people in midwifery who are reducing their hours to try to achieve that balance. Does my hon. Friend agree that something is seriously amiss when people have not fallen out of love with the job, but are simply finding that they cannot do the job while also maintaining the home life that they need?

[Holly Lynch]

Once again, my hon. Friend is absolutely right, as I know when I meet those children of NHS staff who hold up signs saying, “When my mummy is late home it means that I am a lonely kid”. As other Members have pointed out, when NHS workers are exhausted at the end of a shift but find that the cavalry is not arriving and there is no one to take over, they cannot walk out of their jobs as other people might be able to. They have to stay and deliver patient safety, rather than leaving those patients at risk. Questions about the life-work balance and childcare—who will feed the kids when they get home?—are not easy questions for workers in that position to answer.

We have to transform the experiences of mothers and families using maternity services. Like almost every other parent who has had to use those services in recent years, I can say that it is a massive worry. You are told, “Once your waters have broken and your contractions are this regular, come to the hospital”, but even after that point I kept being asked not to come to the hospital, because there was only one bed left and it might be needed for someone else. That is the last thing you want to hear when you are in labour. Worrying about staffing and bed shortages compounds what is already one of the most stressful experiences that women—indeed, parents—can go through.

Let me now say something about paramedics, and all those working on the frontline of our ambulance services. I have worked closely with paramedics, in particular with the GMB’s union representative, Sarah Kelly, on the Protect the Protectors campaign, and I have spent a day out with paramedics, seeing just how relentless their days are. Analysis carried out by the GMB found that there were 7.9 million calls for an ambulance in 2010-11, but by 2021-22 that had risen to 14 million, a pretty staggering increase of 77%. The monthly handover delays report from the Association of Ambulance Chief Executives reveals that the performance of ambulance services fell to its lowest ever level in October. The report shows that, across the month, 169,000 hours of ambulance crew time were lost due to delays. That meant that paramedics could not answer over 135,000 calls for help. That number represented 23% of ambulance services’ total potential capacity to respond to 999 calls. All three of these metrics are the worst in the NHS’s history.

Staff have balloted for industrial action, and we can see how they do not feel listened to and that they are carrying so much responsibility. My hon. Friend the Member for Ilford North (Wes Streeting) has already made this point powerfully from the Dispatch Box. None of us here in the Chamber today has to face the reality multiple times a day of knowing that, no matter how hard we work, there could be fatal consequences for the vulnerable people we are looking after because the system in which we work is fundamentally failing. We do not carry that burden; we ask the paramedics, and all NHS staff, to carry it.

We know that, in addition to this, too many workers—after making such an exhausting contribution to the NHS—are facing financial hardship for their efforts. Like in midwifery and other areas of the NHS, research indicates that one in 1,000 ambulance workers have left since 2018 to seek a better work-life balance or better pay, or to take early retirement. It is not that workers are asking for more pay for the sake of it; it is because inflation is at 11%, energy bills have gone through the roof and the cost of fuel to enable them to get to work has shot up. The National Institute of Economic and Social Research has predicted that around 30,000 households could see their monthly mortgage repayments become greater than their monthly income in the months ahead. If the Government got a grip of these factors, they would not have so many workers being forced to ask for more pay just to make ends meet. I ask the Government to please speak to workers, to work with their trade unions and to work through their concerns, which are very real.

Turning to NHS dentistry, I presented a petition to the Government on 1 November on access to NHS dental care, signed by 549 people online as well as a number of signatures in hard copy—some are still coming into my office. Like all MPs, I have had so much casework in recent months where local people simply cannot see an NHS dentist. The British Dental Association says that more than 43 million dental appointments were lost between April 2020 and April 2022, including more than 13 million appointments for children.

Dentistry is now the No. 1 issue raised with HealthWatch, with almost 80% of the people who contact the organisation saying that they find it difficult to access dental care. The General Dental Council says that almost a quarter of the population—24%—report having experienced dental pain in the last 12 months. More locally, HealthWatch in Calderdale contacted every dental practice across Calderdale last year to establish whether they were willing to accept new NHS patients, whether they would register a child and whether they were offering routine appointments. Every dental practice told HealthWatch that it could not currently register a new NHS patient of any age. It is the same story.

Data from the British Dental Association reveals that 3,000 dentists in England have stopped providing NHS services since the start of the pandemic. For every dentist leaving the NHS entirely, 10 are reducing their NHS commitment by 25% on average. A BDA survey from May 2022 shows that 75% of dentists plan to reduce the amount of NHS work they do next year, with almost half planning to change career, seek early retirement or enter fully private practice. As in other areas of the NHS, the combination of pressures and remuneration is driving what remains of a depleted workforce away. It is a self-defeating cycle that the Government have to step in to break.

Other Members have made points today about the potential of community pharmacies. Having worked in a pharmacy when I was in the sixth form doing my A-levels, it became clear to me that this was often the longest standing and most trusted relationship that members of the community had with a healthcare professional. The pharmacy was the shopfront that was always open during the pandemic, where people could go and meet somebody who knew them and knew their circumstances. That really is the value of community pharmacies. We know they have the capacity to do so much more, and hon. Members on both sides of the House have spoken about unlocking that potential and relieving some of the pressure on A&E departments and GP surgeries by empowering community pharmacies to deliver the work they are best placed to deliver because of their deep roots in our communities.

Labour has a plan for the NHS. It is costed, comprehensive and will save the NHS. In today’s debate, the Government have not had the humility even to acknowledge that there is a problem in the NHS, never mind having a plan of action. That is why a Labour Government cannot come soon enough.

School Uniform Costs

Debate between Emma Hardy and Holly Lynch

Tuesday 5th November 2019 Westminster Hall

[Emma Hardy]

I agree in part, but I want to put a bit of pressure on the Minister to try to force schools to ensure that uniforms are as cheap as possible, because there are alternatives out there.

This is not just about the increasing cost of uniforms; the fashionable zero-tolerance approach to behaviour is also having an impact on the education of children from hard-up families. More than one in 20 parents reported that their child had been sent home for wearing non-approved clothes or shoes, or even the wrong socks, as a result of struggling to afford the costs. That is something that came up in the evidence. Children are being sent home or are being put into isolation for the day because their uniform is not absolutely accurate. Based on Department for Education statistics on the number of children in primary and secondary schools across England, that translates to about half a million children having suffered the indignity and humiliation of being sent home from school or put in isolation—punished for no reason other than the misfortune of having been born part of a family that is living in poverty.

The pernicious nature of poverty sours even what we might remember as the fun parts of school. It is known that children from disadvantaged backgrounds are likely to miss out on school extras, such as trips or music lessons, but evidence has emerged recently showing that the growing trend of schools increasing the number of dress-up days, often as a means of shoring up their depleted funds, is resulting in an increase in the number of unauthorised absences among those pupils.

An analysis of attendance data by the Association of School and College Leaders shows a significant increase in the number of unauthorised absences among pupils on 14 December. The date puzzled the researchers until they realised that the date was traditionally Christmas jumper day. Unauthorised absences among pupils regarded as disadvantaged in the schools studied were nearly three times higher than on a typical day. For those regarded as without disadvantage, it was still nearly twice as high. At the risk of sounding like the Grinch before Christmas, I encourage schools to change Christmas jumper day to something more straightforward, such as Christmas hat day. The school could provide all the materials for the children, who could still dress up and enjoy Christmas, but it would not put off children from poorer backgrounds from attending school that day and learning, just because they cannot afford the cost of a Christmas jumper.

The fact that the embarrassment of standing out drives pupils to skip school casts a different light on the Children’s Society’s findings: about one in 10 said that the unaffordability of uniforms had led to the child wearing unclean or ill-fitting uniforms to school. I received feedback from some teenage girls about that, and they talked about the humiliation they felt at having to go to school in ill-fitting uniforms. One parent told me that her daughter was sent home because her skirt was too tight and was seen as not correctly following the school uniform code. However, the girl had grown considerably after a sudden growth spurt, and the parent was unable to afford a new uniform, especially as the need for logos makes it more expensive.

Our children are growing up in an increasingly image-conscious world where bullying has become easier through social media. As I have said, children in poverty are four times more likely to have a mental health problem by the age of 11. It seems unlikely that there is no connection between children being forced to go to school in ill-fitting or unclean uniform and their feeling an impact on their mental health.

My response to hearing the harrowing testimony from mothers at the Education Committee hearing was to organise a uniform exchange in my constituency, called RE:Uniform, which began at the beginning of summer term and ran through the summer holidays. Thanks to a network of volunteers—in particular, I thank Reverend David Speirs and Susie Steel from the Methodist Church, the Hessle Road Network and many others—items of school uniform that were no longer needed but still perfectly wearable were collected at pick-up-and drop-off points. They were washed, ironed, sorted and made available, for free, to anyone who needed them. It was a huge success—we helped more than 500 families and we intend to repeat it. That kind of scheme should be part of everyday life. Although some schools do similar schemes, one of the great things about the RE:Uniform project was that it mixed up uniform from across the city. Some areas may have a more expensive generic uniforms, and it might end up being distributed to another area of the city. That was its strength and the reason it worked so well.

[Holly Lynch (Halifax) (Lab)]

I am grateful to my hon. Friend for securing this debate and for sharing that example with us. She is making a powerful speech. A Huffington Post journalist recently visited Moorside primary school in Halifax and published an article that reflected not only on cuts in schools but on how poverty at home had an impact on a child’s learning, through hunger in the classroom and school uniforms. The article included some incredibly powerful images of tiny children’s feet in pumps with holes in them and of holes in school uniform sleeves. Does my hon. Friend agree that while the Government do support a number of schemes to make sure that children are fed and can learn in the classroom, there is not a great deal of support for families to pay uniform costs?

[Emma Hardy]

I agree with my hon. Friend that the Government can do more. In fact, the Welsh Government are insisting on a limit on school uniform costs and on gender-neutral uniform. They are giving parents the power to hold schools to account if they are not acting in the parents’ interest, but unfortunately we do not have that option for schools in England. The scheme that we ran was very successful, but it could have been even more so had all schools been encouraged to take off the badges and have generic uniform, because if uniforms did not have badges, they could be shared more easily across the city.

Putting costs and poverty aside for a moment, we need to think about a sustainable future and consider the pressures on the environment and the challenges of climate change. Last Saturday I attended a fantastic event in Hull: an eco and affordable fashion show, where people had made incredibly inventive clothes out of discarded materials. I sat next to an amazing woman who called herself “the mean queen” and said she could live on hardly anything. She had knitted a bag out of the tape from a video cassette—it was absolutely amazing. I am not saying we all need to that, but perhaps we need to think about sustainable fashion and reusing things.

There is no evidence that a school uniform, let alone a highly prescriptive and zealously enforced school uniform, improves educational outcomes for any children, disadvantaged or otherwise. A perception seems to have grown over time that, somehow, the stricter the uniform, the better behaved the child, but I have seen no evidence of any correlation. Having a uniform that all parents and children can access is more likely to build positive relationships with parents and the community, and, therefore, instil a better attitude to learning at school.

The Department for Education states that it

“strongly encourages schools to have a uniform”,

and believes that

“uniform can play a valuable role in contributing to the ethos of a school and setting an appropriate tone”.

The Department insists that schools should have a uniform, but I put it to the Minister that perhaps it needs to do more to ensure that it is affordable for everyone. Currently, the Department expects schools only to “take account” of its published guidance on school uniforms. The guidance states that a school’s uniform policy should be clearly set out and subject to reasonable requests for variation, and that any changes should take into account the views of parents and pupils, but there is no mention of affordability. Specifically, it says:

“No school uniform should be so expensive as to leave pupils or their families feeling unable to apply to, or attend, a school of their choice, due to the cost of the uniform. School governing bodies should therefore give high priority to cost considerations. The governing body should be able to demonstrate how best value has been achieved and keep the cost of supplying the uniform under review.”

The evidence I have presented shows that the guidance is routinely ignored. Parents up and down the country are starving themselves to pay for school uniform. In September, Lord Agnew agreed with me that the approach of some schools to uniform was “ridiculous” and “mindless bureaucracy” on their part. He said,

“They don’t realise that actually this is an additional burden for a family that’s not well off”,

and that he was

“happy to amend the guidance.”

That was very welcome, but in the light of the fact that schools clearly disregard the guidance, the Minister should make it statutory. In response to a written question in July, the Minister said that the Department intended to put the school uniform guidance on a statutory footing,

“when a suitable legislative opportunity arose.”

I would like to think that neither my nor any other party would oppose that proposal, and that we can all unite in agreement. It could, therefore, be progressed extremely quickly, although I realise that time is getting a little tight. Instead, however, it has been put on the back shelf.

We need to poverty-proof the school day, beginning with a school uniform price cap. The Children’s Society proposes taking a similar approach to that of the Financial Conduct Authority in its capping of rent-to-own products. It proposes the benchmarking of prices and an average as the cap. That would involve a school’s regulatory body surveying the market to ascertain the cost of school uniform items and setting the cap based on that. Then, under statutory guidance, schools would be responsible not only for ensuring that they are making affordability a primary concern, but for demonstrating that their uniform policy is in keeping with the cap. In short, under the cap, would a family be able to afford the items of uniform set out in the school’s policy?

Introducing such a measure would not be without challenge. It would require some extra administrative work for schools, to ensure that their uniform cost is within the cap. Crucially, it would require an honest and accurate assessment of the incomes of poor families and the other claims on their spending, to decide what is realistically affordable for them. Recently, many decision makers have struggled to accept the true scale and nature of poverty in this country.

The measure should alleviate the unnecessary costs facing all parents. However, for millions the root cause of the problem will remain—ever-increasing poverty in our country. In response, the Labour party is prepared to reinvest in this country, to make work pay and to properly support those who are out of work or disabled. It will create a unified national education service for England, to provide cradle-to-grave learning that is free at the point of use. Fully funded, it will begin the huge task of turning around the effects of years of cuts and neglect, and will incorporate all forms of education, from early years through to adult education. That will be built on the principles that underpin the Labour movement: a society should be judged on how it treats the weakest and most vulnerable, and should believe that every child—and adult—matters.