NHS Workforce

Holly Lynch Excerpts

Tuesday 6th December 2022 Commons Chamber

[Holly Lynch (Halifax) (Lab)]

It is a pleasure to follow my hon. Friend the Member for Salford and Eccles (Rebecca Long Bailey), who made an incredibly powerful speech.

I do not think I am being dramatic when I say that a genuine sense of fear has set in across the country about being in a position of needing to use the NHS. Almost every family now have a story about how they or, even worse, a loved one have needed to access care and have had a very difficult experience. People’s experiences range from waiting at A&E to waiting for an ambulance, from being unable to get a dentist appointment when they were in pain and urgently needed one to facing a wait years long to see a specialist. One member of my team called up on 25 November and was told, “You’re in luck: there’s been a cancellation at the GP’s, so they’ll book you an appointment—but it’s for a telephone consultation on 20 December.” The chronic pressures in staffing across the board are affecting healthcare in every part of the country.

[Margaret Greenwood]

This afternoon we have heard some horrendous stories about people waiting for ambulances: hideous delays of 16 hours or more for people in pain and sometimes truly tragic circumstances. Does my hon. Friend agree that that shows the abject failure of this Government to provide a health service that we can all be proud of?

[Holly Lynch]

My hon. Friend is absolutely right. Not only is there a massive impact on patient safety and care, with detrimental outcomes for patients, but there is a loss of service to others: while paramedics and ambulances wait outside A&E, there is an impact on care for all the other people who need that provision. My hon. Friend makes a really powerful point.

I want to focus on some key areas of the NHS workforce, starting with midwifery. The chief executive of the Royal College of Midwives, Gill Walton, has told the Health and Social Care Committee that England is more than 2,000 midwives short of the numbers it needs, and the situation is getting worse. The RCM’s analysis shows that midwife numbers fell by a further 331 in the year to November 2022. We need a plan because, as other hon. Members have said, the staffing shortages are driving further staffing shortages. More than half of all midwives surveyed by the RCM said that they were considering leaving their job, with 57% saying that they would leave the NHS in the next year.

In November last year, I joined a March with Midwives rally in Halifax, where midwives held up signs that they had made themselves and that said things like, “I’m a physically and mentally exhausted midwife”, and, “I can’t keep saying sorry for no beds, no midwives, no support and no time”. What really brought home how it is not just about the impact of short staffing on patients and patient safety was the signs that midwives’ children had made themselves. One sign said, “My Mum falls asleep on the driveway after work”. It was made by a girl who told me that she had come out of the house one morning ready for school, only to find that her mum had driven home after a nightshift, pulled on to the driveway and fallen asleep in the car because she was so exhausted. A younger child had made a sign that simply said, “Mummy being late from work equals me being a lonely kid”.

Case studies conducted by the Royal College of Midwives highlighted not just the strain on the service, but the strain in the workforce and their families. A midwife called Julia said:

“We’re reducing the time we give to women, having to close facilities, reduce antenatal education, postnatal visits cut to a minimum. Stretched physically is one thing, you can rest your body eventually when home, but the mind, the mind does not have an easy off switch. The constant unrealistic expectations on maternity staff is damaging their mental health, it’s impacting on the wider service and it’s putting women, babies and families hopes and dreams in danger.”

This is why a Labour Government with a commitment to train 10,000 additional nurses and midwives every year cannot come fast enough.

[Karin Smyth]

My hon. Friend is making some excellent points, particularly about the impact of those exhaustion levels on families. In my speech I spoke about the recruitment of families who looked forward to their jobs and were proud of working in the NHS. That is important to bringing future generations into the health service, and giving encouragement to young people in schools. It is still a fantastic career, but does my hon. Friend agree that helping young people not to be deterred by that negative publicity and helping them through training routes is a crucial way of solving the current workforce problems?

[Holly Lynch]

We have all told stories about the NHS heroes in our constituencies today, but my hon. Friend is right about the need to transform that into an attractive skills plan. Some of the midwives and their children whom I met were extremely proud to be in NHS families. Every member of those families is affected by that shared sense of pride, but also by that shared sense of exhaustion, and there are problems for the whole family when there are problems for the NHS worker. My hon. Friend has made a powerful point.

[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.