Health and Care Bill

Geraint Davies Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Wes Streeting]

It was a great pleasure to see the Minister at the Dispatch Box, but I must warn him and the Minister for Care and Mental Health, the hon. Member for Chichester (Gillian Keegan), that the Government will not convince us that their position on workforce is right even by sending out the most charming members of their Health team. I will go into the reasons for that. I start with enormous thanks to Members of the House of Lords for the enormous amount of work that they put into making the Bill much better than it was when it left the House of Commons. In particular, I thank my noble Friends Baroness Thornton, Baroness Merron and Baroness Wheeler who showed great wisdom and stamina in forging huge alliances in the other place to get the consensus needed to make the improvements that we are discussing. I also thank Liz Cronin and Richard Bourne for supporting the shadow Lords team.

The NHS is facing the greatest crisis in its history. Covid has not gone away, and the covid pressures on the NHS certainly have not gone away. Instead, it is in the unenviable position of having to deal with those ongoing challenges at the same time as trying to address the significant backlog that existed before we went into the pandemic, when a record 4.5 million people were already on NHS waiting lists.

Today, we see that there is a staff shortage of 110,000 across the NHS as well as 105,000 vacancies in social care. Six million people are now waiting for NHS treatment—the longest waiting lists on record—and they are waiting longer than ever before. Cancer patients are not being seen by specialists on time; they are waiting too long for diagnosis when every day matters. Stroke victims are being left to wait hours for an ambulance—except in the north-east, where over the winter heart attack patients were told to phone a friend or call a cab. It is therefore no surprise to learn today that public satisfaction with the NHS is at its lowest level in 25 years, since 1997. Of course, that was the year when Tony Blair led Labour to victory at the general election and delivered shorter waiting times and the highest patient satisfaction in the history of the NHS. The Government could do a great deal of good by learning from the example left by the last Labour Government and trying to rebuild the legacy that they have trashed over the last 12 years.

It is not just patients who are dissatisfied with the NHS. I know from speaking to frontline staff and NHS leaders across the country that they are exhausted after their heroic efforts of the past two years. They are burned out, they are overstretched, and there are simply not enough of them. They are proud of the NHS and proud to work for the NHS, but, in too many cases, people are going home at the end of a long shift and agonising about whether they did the right thing, agonising about whether they made the right decisions for their patients and agonising about whether they had forgotten a crucial detail. It is getting worse, not better. Some 27,000 NHS workers voluntarily left the health service in just three months last year, the highest on record. The Health Secretary has admitted that the Government will not meet their manifesto commitment to recruit the 6,000 GPs we need to get people seen on time and we know that many cases will simply present in overstretched accident and emergency departments. Today, we heard about the consequences of the failure to safely staff our health service.

On that note, I want to place on record my thanks to the Secretary of State for Health for his response to the Ockenden review—and to his predecessor, the Chairman of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt) for commissioning the review in the first place—and the commitment to implement in full not its recommendations, because Donna Ockenden has not made recommendations, but the must-dos she has set out. I cannot imagine the trauma of losing a child and we owe it to mothers who have been through that suffering to ensure that they are never let down again. This is not a party political point. The review spans two decades under Labour and Conservative Governments. I want to acknowledge that and be honest about that. The clear finding is that we must safely staff our maternity wards. Today, midwives are leaving the NHS in greater numbers than it is able to recruit them. That is just one of the reasons why we need a workforce plan for the NHS.

[Geraint Davies (Swansea West) (Lab/Co-op)]

I have just returned from Lithuania, where I was speaking to the head of migration in a refugee centre who said that they are welcoming their neighbours not just because they should but because they are providing a very valuable addition to their workforce. They are taking tens of thousands of people. Given that 1.4 million EU citizens who are registered to work in Britain have decided to stay in Europe, should we not be opening our hearts and homes and recognise the benefits some of them would bring by working in the NHS?

[Wes Streeting]

I thank my hon. Friend for his intervention. It is certainly the case that refugees fleeing Ukraine—indeed, other conflict zones around the world—bring enormous skills to our country. For as long as they are here and living with us, we should enable them to make whatever contribution they wish. If some of the people from Ukraine or elsewhere want to work in the NHS, we should absolutely welcome them with open arms.

--- Later in debate ---

[Geraint Davies]

It is, of course, 125 years since the birth of Aneurin Bevan, who famously said:

“Illness is…a misfortune the cost of which should be shared by the community”.

That cost, as the right hon. Member for Chingford and Woodford Green (Sir Iain Duncan Smith) said, should not be borne by the victims of genocide, abuse or slavery, so I support amendment 48 and, indeed, amendments (a) and (b).

I am the trade rapporteur of the Council of Europe in respect of safeguarding human rights, democracy and the rule of law. I very much hope that where there is abuse or slave labour, we pursue filtering out such imports from procurement in general. Curing illness should not be at the cost of creating illness and harm abroad.

Obviously we need security of supply. We have seen China use embargoes and trade sanctions against Australian wine and Lithuanian products, or whatever, so we need a safe supply, much of it home-grown, for when we face such a problem or a pandemic. I put it to the Minister that we need to look much more at generating production and procurement in the public sector. It is no good going to the pub landlord of the right hon. Member for West Suffolk (Matt Hancock) to get expensive PPE. We need both value for money and ethical sourcing.

Some of the proposals for integrated care boards involve corporations that have a vested interest. If we remove competitive tendering, waiting lists and costs would both go up. It is critical that we get value for money.

Looking at what happened in Wales during the pandemic, we find that the cost of PPE was, in fact, half the cost of PPE in England. The £1.1 billion given to Wales for test and trace was a Barnett consequential, but we spent only half of that, £533 million, because we used public sector procurement and production effectively.

Through a combination of ethical procurement and public sector provision, we can keep the light of the health service shining, we can keep the faith and we can build a stronger, more successful and cost-effective health service.

[Jeremy Hunt]

Like the shadow Health Secretary, I rise to speak in support of amendment 29, which the Government plan to vote down. This wholly innocuous amendment simply asks them to publish, every two years, independent projections of the number of doctors and nurses we should be training. The Government are rejecting the amendment because they think it would compel them to train more doctors, which is true, but it ignores the fact that this is the best way to reduce the £6.2 billion locum bill that is currently devastating the NHS budget.

The shadow Health Secretary was very generous to me, and I return the compliment by saying that I think he is doing an excellent job. I hope he remains shadow Health Secretary for many years.

I ask the House, in the nicest possible way, to reject the compromises proposed by the excellent Minister. The Government are publishing a 15-year framework, but he knows and we know that it will simply detail the number of doctors that the Government think they can afford, not the number of doctors we actually need. In the past—even last year—when the NHS has tried to publish the number of doctors it thinks it needs, it has been stopped by the Government. Why is there this reluctance to publish the number of doctors we are going to need in 15 years’ time, given that 97% of hospital bosses say that staff shortages are having an impact on the quality of care they are giving and there are 110,000 vacancies? The answer is simple: it is because the Government know we are not training enough right now. What message does it send to young doctors, newly qualified midwives and newly qualified nurses, who are incredibly stressed and pressured by the situation on the frontline, if we are saying to them, “Look, it is really tough now, but we are not even prepared to train enough doctors, nurses and midwives for the future to relieve that stress and pressure later on in your career”?